Forty-five years ago President Richard Nixon declared that “the time has come in America when the same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering cancer.”

Some four decades and more than $120 billion later Republicans have added more money to the National Cancer Institute budget than requested by President Obama to fund another Cancer Moonshot – bringing the total to more than $5 billion this year.

It might be a good idea to ask what have we won so far? We have made tremendous progress in treating relatively rare cancers of children. Breast and colon cancer are now often chronic diseases.

But rates of childhood cancer today are 50 percent higher than when the war began. Still taking into account the older age and larger size of our population, cancer deaths overall have fallen just five percent -most of this due to declines in smoking.

By now it is clear that curing cancer has nothing in common with what was involved in tapping existing technologies to place Neil Armstrong on the moon. In fact, for more than fifty years we have known a lot about how to prevent cancer from developing.

Much of the past effort against cancer has fixated on the wrong enemies, with the wrong weapons. While scientific research concentrates on the genome within, we are ignoring the exposome– all that we breathe, drink, eat and absorb through our skin. As President Bush’s Cancer Panel reminded us in 2010, the great majority cases of cancer occur in people born with healthy genes as a result of carcinogenic exposures at work, home, and school.