Last week's announcement by the American Cancer Society that the number of cancer deaths fell in the United States for the second year in a row was celebrated by the media, medical professionals and politicians who proclaimed that the so-called "war on cancer" first declared by President Nixon in 1971 is finally being won.
But to hear cancer fighters tell it, unless there is a "surge" – a committed increase in funding for clinical trials and research--the country will sooon fall significantly behind in achieving victory.
Experts attributed the mortality decline to three factors: prevention, early detection and more effective treatments of tumors. While lifestyle changes and screenings can be effective by continuing education, human nature won’t ensure that people won’t smoke or be overweight. Bear in mind too that there are cancers which occur regardless of good behavior and other cancers which are generally diagnosed later.
Thus, the third leg in the cancer ending stool: proving the effectiveness of new drugs and/or the combination of different treatment modes through clinical trials. Researchers and oncologists believe that at this critical moment, when the tide is finally turning, this leg is wobbly at best.
Geoffrey Wahl, a scientist specializing in gene expression at The Salk Institute in La Jolla, California and president of the American Association of Cancer Research, likens the need for funding for cancer research to "fighting the terrorist within." He says that while Congress is debating fiscal 2007’s budget with increases for homeland security and continued spending on the war in Iraq, the National Cancer Institute may be subject to a $40 million budget cut this year.
The cancer death rate drop is more impressive if one considers that by Wahl’s estimate, Federal investment in cancer research during the past 35 years amounted to about $69.3 billion, roughly $8.50 per American each year.
NCI funding doubled from 1998 through to 2002, but starting in 2003 its budget has been flat, excluding even adjustment for inflation.
"For every 100 grant proposals that the NCI receives, only eight to ten get funded," says Wahl. He adds that of those grants actually approved, actual grant dollars are often cut. Wahl’s own grant on studying tumor suppression approved last June has been cut by 30 percent. This means he can’t hire the chemists, computer technicians trained in data collection, biophysicists and others experts necessary for sophisticated study.
"Cancer research used to attract the best and brightest, but there is increasing difficulty getting people to put their effort into something that has funding inconsistency," adds Wahl.
Lance Armstrong, the seven-time Tour de France winner who is himself a cancer survivor, recently expressed his concerns about NCI's proposed budget cuts, stating that the cuts are "not acceptable." According to a recent report in the USA Today, Armstrong plans to personally donate $5 million to the group over the next 10 years to help the cause.
Ironically, the same day that the American Cancer Society made its announcement, a clinical trial group at NCI which covers cancers such as lung, breast, leukemia and lymphoma announced that it was closing two trials to further patient enrollment, including one on non-small cell lung cancer, which is the type of cancer that felled Dana Reeve. In addition, the group withdrew or phased out of trials for treating melanoma.
These changes were a reaction to tightening federal purse strings, says Dr. Richard Schilsky, the chairman of the clinical trial group. "In December, the NCI sent us a notice that we had to plan for a worst case scenario meaning a budget cut of 10 percent. We had to produce a plan to reduce infrastructure and enrollment in clinical trials," says Schilsky.
But it’s hard to make the connection between hours spent by scientists and doctors in laboratories to your family member suffering from cancer.
Unless you’re an oncologist who sees the difference research can make every day.
"On a practical level, clinical trials answer the questions of why should I do treatment A or B," says Dr. Linda Vahdat, director of the Breast Cancer Research Program at Weill Cornell Medical Center in New York City.
Vahdat says that trials validate the effectiveness of drugs and treatments used alone or in combination. She cites the example of the results less than two years ago of a NCI-sponsored trial which showed that Herceptin, a drug used for meta-static breast cancer, can be used to reduce the risk of relapse in certain breast cancers by 50 percent.
"In one fell swoop, this study resulted in a change in the standard of care for breast cancer treatment," says Vahdat. "Without trials I have less guidance on how to treat my patients."
Wahl makes his case for getting Federal funding on track from several angles. He and other specialists believe that monies are needed just at the time when the greatest opportunity for gains is presenting itself. Wahl believes too that countries such as China and Singapore are putting dollars into hiring good cancer researchers and creating biotechnology companies.
Finally, Wahl says aging baby boomers create a demographic "perfect storm" that demands increased cancer research funding. "If we think of many cancers as a disease of aging, think about this group. It’s the largest single risk group we in the United States have ever had."
Foxnews.com Health contributor Angela Macropoulos contributed to this story.
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Dr. Manny Alvarez is the managing editor of health news at FOXNews.com, and is a regular medical contributor on the FOX News Channel. He is chairman of the Department of Obstetrics and Gynecology and Reproductive Science at Hackensack University Medical Center in New Jersey. Additionally, Alvarez is Adjunct Professor of Obstetrics and Gynecology at New York University School of Medicine in New York City.
Dr. Manny Alvarez serves as Fox News Channel's senior managing health editor. He also serves as chairman of the department of obstetrics/gynecology and reproductive science at Hackensack University Medical Center in New Jersey. For more information on Dr. Manny's work, visit AskDrManny.com.