------------------- CANCERFU.LET follows --------------------
Inadequate Funding of Cancer Research
This year alone, over 1.2 million Americans will be diagnosed
with cancer and over 600,000 will die of this dreadful disease.
Thus, every 30 seconds a person is stricken with cancer and
every minute another is dying. The number of Americans dying of
cancer every month is close to the number of Americans killed
during the entire Vietnam war. Statistically, at least one
person in family of four is expected to develop cancer in her
or his lifetime. The person dying of cancer is 14 years younger
than the one dying of cardiovascular causes. Many of the
victims are children. Behind these statistics are uncountable
personal tragedies. Not only the tragedies of those diagnosed
and dying, often in a prolonged and painful way, but also of
their families and friends.
The sum that the U.S. federal government spends on cancer
research (NIH, National Cancer Institute) this year is about two
billion dollars, less than $ 10 per person. This amount is
minuscule for a country with a 1.5 trillion dollars national
budget. This is especially striking when compared with wasteful
spending on other purposes. Despite the dissolution of the Soviet
Union, our main military adversary, we are still spending over
150 times more on defense and 15 times more on spying than on
cancer. Each B2 bomber costs the equivalent of the yearly cancer
research budget. The same is true for a single nuclear powered
submarine. Yet we still are building these dinosaures of the cold
war era, for which no military targets now exist. The total sum
which we are now paying for the fraud of bankrupt S&L
institutions would fund the National Cancer Institute, at the
current rate, for one hundred years. The list of items on which
our tax money is being spent at a rate of billions of dollars per
year, in a wasteful and sometimes ridiculous way, can go on and
on.
With new tools provided by molecular biology, significant strides
have been made during the past decade to understand the
mechanisms of cancer. The research of the past five years has
brought a revolution in understanding the mechanism of cell
proliferation ("cell cycle") and cell death ("apoptosis"). These
are the most most essential cellular events associated with
cancer. Numerous genes which are responsible for normal cells
turning cancerous have been identified, isolated and cloned. We
are thus provided, for the first time, with a rational basis for
entirely new strategies of cancer prevention and treatment. For
example, the gene-engineering approach offers the prospect of
either transforming a cancer cell into a normal one, or selective
killing of the former. It is now only a matter of time when more
effective treatments will be introduced into the clinic.
Unfortunately, time is running out for those stricken with cancer
and those who will be struck tomorrow. There is no doubt that
acceleration of cancer research will save many lives. If not our
lives, certainly the lives of our children and grandchildren. The
progress in cancer research also benefits areas such as AIDS,
genetic, immunological and aging associated diseases, as well as
many other biomedical fields.
No shortage of scientists that are able and willing to work in
the field of cancer exists. The funds, however, are inadequate to
support their positions and research. The latter is getting more
and more costly as the tools are progressively more
sophisticated. Less than 15% of the research proposals approved
for support are now being funded by the National Cancer
Institute. Many outstanding projects fall below the funding
level. The most innovative and most imaginative programs have
particularly bad prospects of funding. This is due to the fact
that there is an inherent element of uncertainty of the outcome
in such projects. With very limited funding usually only the
"safe" projects, with a very predictable outcomes, can
succesfully compete. Many talented researchers leave the field.
Fewer students are willing to take up careers in cancer research.
Since last year we have seen an alarming, nearly two-fold
decrease in the number of young scientists applying for NIH
grants. Private foundations provide some help, but can in no
way substitute for the lack of interest at the national level.
Repeated polls indicate that over 80 % of the respondents are
willing to pay additional tax if it is used to support biomedical
research.
It is important to point out the purely economic importance of
investment in health research. Biotechnology is the most rapidly
growing industry, worldwide. Government support for biotechnology
is proportionally greater in Japan, Germany and France than it is
in the United States. Consequently, we are losing the preeminence
we once had, and with it goes a multi-billion- dollar industry.
Needless to say, the investment we make now in basic biomedical
research will bring real savings in the cost of patient care for
years to come.
One may ask why the pharmaceutical industry does not rapidly
develop anticancer drugs and thus why public funds are needed for
this purpose. One reason is that the industry is not interested
in testing and promoting research in areas where the potential
drug cannot be patented. It now costs approximately a quarter of
billion of dollars to develop a single drug to the point of its
application in the clinic. One has to be naive to expect that any
company will invest such a sum if no profit is anticipated.
Perhaps thousands of promising new drugs collect dust on shelfs
of many laboratories, because for one reason or another they
cannot be patented. Another reason is that some cancer types are
rare. Development of a drug that would be active in only one
type of rare cancer and thus have a limited market, also is not
within the scope of the pharmaceutical industry. Likewise, the
research which carries significant risk or uncertainty in terms
of providing the immediate profit, is unlikely to be funded by
the industry.
Cancer collects its terrible toll every day. We need at least to
quadruple the public spending on cancer research to find the cure
for this terrible disease in our lifetime. Is it too much to ask
to spend the equivalent of three B2 bombers per year to achieve
this goal?
Zbigniew Darzynkiewicz, M.D., Ph.D.
Professor of Medicine
N.Y. Medical College in Valhalla, N.Y.