Saturday, April 18, 2009



By Robert Weiner, Patricia Berg, and Paulette Garthoff


The stimulus legislation signed by President Obama has generated a sense of excitement and opportunity among the 17,000 scientists who will gather in Denver during April 18-22 for the 100th annual meeting of the American Association for Cancer Research (AACR).   Cancer still killed 565,000 Americans last year—18,358 developed cancer in Colorado, and 6395 died, according to CDC.  


Medical investigators have welcomed the increase in the NIH (National Institutes of Health) budget to $40 billion from $30 billion, including $8.2 billion for research. Advances against all diseases will benefit.


Cancer researchers have enthusiastically supported President Obama’s strong backing for science and cancer research --“seeking a cure for cancer in our time,” as he told Congress in February.  


A major portion of the new money -- $1.2 billion -- will go to NIH’s National Cancer Institute for its research as well as for outside grant distribution.   While most of the outreach funds will be directed to large, traditional grantees, a small portion ($100-200 million) will go to “challenge” grants for basic innovative research, often conducted at small laboratories. That is where the excitement begins to unravel a bit, because less than 10 percent of grant applications for small laboratories making novel discoveries are expected to be approved.


From discovering genes activated in breast and prostate cancer, to finding drugs to suppress cancers, to creating new diagnostic tools to locate and prevent the spread of the disease, the basic scientist’s mission is a major part of the progress that has reduced cancer mortality rates significantly since 1990, avoiding more than a half million deaths.  


The word “cancer,” in fact, is misunderstood--it encompasses more than 200 diseases, explains Dr. Margaret Foti, AACR’s CEO.   Although the death rate has declined two percent a year since 1999, 1,500 Americans a day still die from the disease –cancer is the nation’s number-two killer behind heart disease.


Dr. Foti says that “institutions all over the country are having emergency meetings” on how to apply for a share of the stimulus money and “maximize the opportunity” this moment creates.   Foti, who has spent 27 years running the country’s primary cancer research scientists’ organization, presses the point that cancer investigators are “right at the threshold of major discoveries” and “basic scientific knowledge is waiting” to be uncovered.   She notes the interlocking relationships among cancers—what she calls “a cascade of genes.”   Breakthroughs for one will pay off for others.   For example, she says that researchers are poised “to extrapolate breast and ovarian cancer findings to other cancers.”


The under 10% NCI funding of requested research projects is down from 25 percent a decade ago – and because of new applications the stimulus will not change that.   NIH has seen its budget go down in real terms every year for the past seven, a 14 percent decline. Stimulus money provides a useful two-year increase -- and NIH insiders are concerned about what happens after that.   Research must not end in two years.


Researchers must be as creative in their funding requests as in their quest for disease cures.   If the recent formula holds, grants will still be almost impossible to get.   It is necessary for large organizations to receive new funding.   The smaller players must also mobilize their work.   Dr. Foti asserts that funds are needed to “keep the lab research engine going, ensure new drugs to get into the clinical-trials pipeline, and support the development of molecular therapies.”


There is no substitute for the Federal research catalyst. Mark Hurlbert, the Avon Foundation's senior adviser for grants and partnerships, has noted that for breast cancer alone, $600 million annually has come from NCI before the Stimulus and the Department of Defense has provided $2.2 billion total since 1992, versus Komen $900 million since 1988, Avon $520 million since 1992, Revlon $110 million since 1992.


President Obama has declared April “Cancer Control Month.” With the proper mix of funding for institutions large and small and with a commitment to multi-year research, we will be closer to controlling cancer.  


Weiner is former White House National Drug Policy public affairs director, and former chief of staff of the U.S. House Aging Committee and Health Subcommittee. Berg is director of a breast cancer laboratory at George Washington University Medical Center’s Departme+nt of Biochemistry and Molecular Biology and Professor of Molecular Biology.   Garthoff is a former government analyst who has a family member who is a breast cancer survivor.