Retail executive and breast cancer survivor Farla Efros approached cancer the same way she rescued struggling companies: with strategy, discipline, and relentless preparation. She explains why patients are forced to become CEOs of their own care and why the system rewards those who can.

Every year I leave ASCO with hundreds of selfies that become one giant mosaic. This year’s image tells a bigger story than the science alone. It captures the people, conversations, and growing realization that the next challenge in cancer care isn’t discovery. It’s making sure patients can reach it.

Patients now need executive level skills to survive diagnosis, treatment, and access. This essay featuring Kathy Giusti breaks down how healthcare incentives create that reality, who benefits, who pays, and what must change to reduce risk and restore accountability.

Women were excluded from U.S. clinical trials until 1993. That decision shaped drug safety, outcomes, and cost for decades. This essay breaks down the incentives, capital flows, and regulatory gaps that sustained it and what must change next.