September 14, 2006

Op-ed: We’re beating cancer, so why stall funding for research?

Earlier this year, with surprisingly little media attention, we celebrated a major milestone in the fight against cancer — for the first time in record-keeping history, the number of American lives lost to cancer declined.

by Dr. Raymond DuBois

Earlier this year, with surprisingly little media attention, we celebrated a major milestone in the fight against cancer – for the first time in record-keeping history, the number of American lives lost to cancer declined.

This is a remarkable accomplishment, particularly in light of our aging and growing population. And it was just the latest in many signs of progress in our efforts to end the suffering that this disease causes millions of Americans each year. Consider that:

• Cancer survival has doubled in the past 20 years – today, more than 10 million Americans are alive after facing a cancer diagnosis.
• Death rates from the four most common cancers (lung, breast, prostate and colon) have been declining since 1990.
• Today, more than 75 percent of children with cancer are alive at least five years after their diagnosis.

However, at what should be a time of great hope and optimism, there instead is growing a sense of dread among those of us who have dedicated our lives to the fight against cancer.

After years of strong national commitment to biomedical research, and a doubling of the National Institutes of Health budget between 1998 and 2003, national research funding has taken a sudden dismal turn. On the surface, under the budget being proposed by President Bush, NIH funding will remain roughly flat at $28.6 billion for fiscal year 2007. In reality, the NIH budget will drop nearly 4% when adjusted for inflation. The proposed budget of the National Cancer Institute alone will suffer at least $40 million in cuts.

Just this week, the newly appointed director of the National Cancer Institute, Dr. John Niederhuber, told the New York Times that in light of dire fiscal times for federal research funding, NCI programs would need to be phased out. While Niederhuber indicated that the NCI cancer centers – of which Vanderbilt-Ingram Cancer Center is one – will be preserved as the “crown jewels” of the national cancer program, the idea that other promising research programs may be eliminated is more than worrisome.

Currently, cancer is a disease that will directly impact 1 in 3 of us and indirectly affect each and every one of us. Scientific research sponsored by the NIH has proven to be a tremendous bargain for the American people, largely fueling the gains we’ve made against cancer and other diseases. Estimates are that the War on Cancer has cost each American less than $300 apiece since it was declared by President Nixon in 1971. Not only has this federal investment led to better treatment and cures, it has also made the United States the world leader in biomedical innovation, technology and discoveries.

Unfortunately, discoveries in these areas require expensive advanced technology. All of which makes the drop in NIH funding that much more disconcerting to American scientists. Fewer of the most promising grant proposals are being funded, and grants that are being awarded are much smaller. Two years ago, about 20% of grants that had been deemed worthy of funding after rigorous review by scientific peers received support. Today, the research is more exciting and potentially more valuable, but the proportion of funded grants has fallen to 10%. If the current budget proposal becomes reality, the proportion of successful grant applications will dip into the single digits. Certainly, no one could legitimately argue that more than 90% of American medical research is unworthy of support. If that were the case, then more people would be dying of disease, not fewer.

Meanwhile, other countries are nipping at our heels. China has unveiled a plan to become a world leader in biomedical research and has increased its 2004 national funding to roughly the equivalent of the NIH budget, at $26 billion. China plans to pump $110 billion into its research enterprise by 2020, which will far surpass what the United States has slated. The potential for a reverse brain drain and loss of our status as the world leader in innovation and technology is a very real threat.

I fear most that we will lose a generation of young, talented investigators, who possess the potential and ingenuity to make breakthrough discoveries in the future. Without grant support, many bright young scientists will simply leave the field. Still others who might have dedicated their lives to biomedical research will choose other careers that appear more stable. Medical science is built on continuity. If we lose only one generation of scientists, we will spend several more generations hustling to make up lost ground. In the meantime, opportunities for treating, preventing and eliminating cancer will, at best, hold stagnant. At worst, cancer deaths will begin to rise again. We can’t let that happen. Yet, it will happen unless we, as a nation, reaffirm our commitment to support biomedical research.

DuBois is director of the Vanderbilt-Ingram Cancer Center, Benjamin F. Byrd Professor of Molecular Oncology, and internationally acclaimed scientist in the field of colon cancer research.