When we hear the words "cancer diagnosis", the first things we want to know are the chances.
The chances of survival, or the chances that a certain treatment will or won't work.
We know about these chances today because of cancer researchers and the work they have done over the years to understand cancer as a disease.
Last month I went to Washington D.C. with almost 600 inspiring cancer survivors and volunteers to lobby Congress for increased investment in cancer research with the American Cancer Society Cancer Action Network.
Here's why that was so important.
Who are cancer researchers and what do they do?
At the front of the fight against cancer are cancer researchers. These are not the doctors you see in the clinic, but the doctors behind the scenes who work in laboratories. They study how cancer works so they can figure out how to save lives by finding better ways to treat and screen for cancer.
Cancer research happens all across the country, in labs at universities, pharmaceutical companies, small biotechnology companies, and at the National Institutes of Health (NIH) itself. Most researchers have PhDs or MDs, or are working toward either degree as graduate or medical students.
Researchers study cancer using different approaches. One of the most common ways is to study the behavior of cancer cells growing in petri dishes. Cancer cells can be directly isolated from patient tumors, which essentially allows scientists to study a tumor in a dish.
Scientists have been studying cancer cells in the laboratory since the first cells to be grown in a dish were isolated in the 1950s. These cells, cervical cancer cells called HeLa cells, were taken from Henrietta Lacks without her consent, and about whom the book, The Immortal Life of Henrietta Lacks, was written.
Incredibly, HeLa cells have contributed to multiple scientific and medical innovations, including development of the HPV and polio vaccines, establishment of the fields of virology and aging, and the mapping of the entire human DNA sequence (the human genome).
The impact that HeLa cells alone have had on scientific discovery is just one illustration about the importance of cancer research.
Cancer research is also important for the development and improvement of cancer screening methods, like the colonoscopy or pap smear, which screen for colorectal and cervical cancer, respectively.
Cancer causes death most often occur at later stages of disease. This is why catching a tumor early is so important. In fact, the prognosis for early stage cancers, like colorectal cancer, is quite good because it has not yet spread to other parts of the body.
In particular, the colonoscopy and pap smear are relatively simple screening methods that we know work to reduce cancer deaths. As screening improves and more people get screened, tumors are found early and removed, drastically decreasing the chances that patients will die.
Why do we need more money from Congress for cancer research?
Research is expensive.
In order to do their jobs, cancer researchers who do not receive private funds need public funding, which comes from government grants. The major government grant funding institutions in the US are the NIH and the National Cancer Institution (NCI). The NIH funds biomedical research of all types, while the NCI is focused on cancer research.
Did you know the NIH is the largest public funder of scientific research in the world? To support this much research, the NIH budget is huge, over $30 billion every year.
If you pay taxes in the US, you are a direct contributor to this funding. When we think of taxes, we think a lot about how big our refund will be this year. Or why the roads in Boston are still so terrible.
But our taxes also work to fight cancer. These dollars have contributed to some amazing discoveries, like the discoveries made using HeLa cells.
Although funding for the NIH and NCI has increased in recent years, when it is adjusted for inflation, it is still lower than in was in 2003.
From the American Cancer Society Cancer Action Network.
What does this mean for cancer researchers?
Each year the pool of money for cancer research is limited, which makes it harder for scientists to obtain funding. The graph below illustrates that this trend is true for both new and established scientists: the success rate for an independent grant (called an R01) has decreased over the past 20 years, from 23-28% in 1998 to around 18% 2016.
This means that in 2016, only about 18% of scientists across the country who applied to the NIH or NCI for an R01 were actually awarded the funding.
It is lot to ask. These billions of dollars can certainly be allocated to many other important things.
But the investment in cancer research is critical. Although we have made a lot of advances in understanding cancer and improving treatment options, we still have a lot of work to do.
For example, pancreatic cancer, which is difficult to detect and screen for, still has a bleak outlook. In 2018, it is estimated that 55,440 people will be diagnosed with pancreatic cancer, and 44,330 will die because of this disease.
There are also a number of rare cancers that are not as heavily researched as others (like breast or lung cancer) and as such, treatment options can be very limited. However, for those who have lost family members to these rare cancers, continued investment in cancer research is an important rallying call, as it may mean development of a life-saving treatment for others in the future.
Where are we now?
A few days after I left D.C., Congress approved a $2 billion increase for the NIH for next year, bringing the total investment to $39.1 billion for 2019.
This was a great step forward. Cancer is nonpartisan and increased funding for cancer research is something that is widely supported. Every year we have to fight for the research funding that will ensure scientists can continue to find new, creative, and innovative ways to fight cancer and save lives.
Have more questions about research and how government funding works? Email me at outoftheivorytowerscience@gmail.com!
Until next time..
