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The war on cancer: Enlist now

Monday, March 21, 2016

Cynthia Reinhart-King, Ph.D., associate professor in the Department of Biomedical Engineering at Cornell University, recently penned a guest piece in the Congress Blog of The Hill. Read the original here.

Photo of Cynthia Reinhart-KingCynthia Reinhart-King In President Obama’s State of the Union address earlier this year, he pledged a “new moonshot” to cure cancer, with new resources dedicated to the effort. Similarly, Richard Nixon declared a war on cancer in 1971. However, after 44 years of fighting the "war on cancer," we’re still losing and the lack of research funding is one of the key reasons.

The lifetime risk of developing cancer is approximately 40 percent and the lifetime risk of dying from cancer is about half that.  With these statistics, it’s almost impossible to not know someone personally affected by cancer. As a cancer researcher and associate professor at Cornell University’s Biomedical Engineering department, I receive almost daily emails from patients, families of patients, and friends of patients who are looking for help, advice, a cure. The emails are heartbreaking, and while there is little I can do to help these individuals in the short term, it is incredibly strong motivation for me to continue the fight from my lab.

While there have been advances in cures for some childhood cancers, the overall death rate for cancer has remained almost unchanged over the past several decades.  While there are some therapies that have helped prolong life, prevention strategies have improved, and there are new advances in early detection, our overall gains in being able to cure the disease are still minimal.

Notably, cancer is on track to overtake cardiovascular disease as the leading cause of death in the US. Why has cancer treatment research not made the same progress as work done in the cardiovascular field?  The short answer is that cancer is more complex.  Cancers have the ability to develop resistance to drugs, they can spread to other areas of the body, and they can remain dormant in the body for years only to recur even more aggressively.

The need for a cure is real and immediate, however most cancer investigators are only able to spend a small fraction of their time in lab. Many academic researchers spend most of their time instead writing grant proposals to fund their work-- each of these applications can take an investigator 100+ hours to create. Yet, grant money is essential. It pays for the research supplies, materials and salaries of staff and students who perform experiments. 

The current funding rate at the National Cancer Institute (NCI), the largest source of support for cancer research in the US, is approximately 9 percent for most grants submitted by researchers, meaning only 9 out of every 100 requests that are submitted receive money; the other 91 are rejected. Yet, without funding, research simply can't get done.

Innovation is being stifled. “High-risk, high-reward” proposals are less likely to be funded in a climate where there is simply not enough money to fund all of the good ideas that have the potential to lead to new treatments, therapeutic targets, and prevention strategies. Certainly, one can claim that billions of dollars have already been invested in cancer research since the inception of the NCI in 1937, and that it is not clear how increasing our investment in cancer research will result in better treatments. 

However, new technologies and research advances just coming on-line now have the ability to push cancer forward at the most rapid pace in history.  Novel drug delivery targeting strategies, new approaches to personalized medicine, and genetic manipulation schemes are being developed that have the potential to attack cancer in previously unattainable ways. New collaborations between biologists, engineers, and clinicians have the potential to attack cancer in new ways. And while the NCI just received the most significant increase in their budget in recent years ($4.95 to $5.21 billion), we have to ask whether this is enough to get the job done. Funding to the NCI has largely remained stagnant over the past decade, and this increase is long overdue.

Within this “moonshot,” the president asked for an additional one billion dollars to be devoted to cancer research. As a gauge, this is about 20-30 percent of the amount of money it takes to develop one new pharmaceutical drug, and it is a 20 percent increase over the current budget of the National Cancer Institute. The goal of this funding, as described by the vice-president, is to increase data sharing and collaboration between researchers.  Indeed, increased dialogue between scientists is needed in all of research, however, it alone will not cure cancer.  We need dollars that fund innovation.

Research is how the war on cancer will be won, and research can only be done with funding.  Doctors, researchers and patients are not the only ones who can fight the fight. You can enlist, too. Contact your senators and congressman and tell them what effect cancer has had on you, that you stand with the doctors, patients and researchers who are fighting for a cure, and urge them to increase funding to support life-saving cancer research. Make your voice heard, and tell your lawmakers to support innovation and give the cancer community the support they need to really win the "war" on cancer.