What Happened to the War on Cancer?
By Dr. Rizwana Rahim
It has been four long decades since President Nixon declared a new and different kind of war, not on a country but on a disease: ‘War on Cancer’.
This war is still on, and the victory is not yet in sight despite billion of dollars poured into it. What happened? The enemy is more intractable than anything we encountered in any battlefield, real or metaphorical. On cancer, Scientific American, a popular science magazine, has a special edition, still on the newsstands, that reviews the scientific progress, and the recent issue of Time magazine has an article that summarizes what else is being done on para-scientific levels to spur progress. I recommend the Scientific American special edition for those interested in the latest research details.
To see that the death rate from cancer dropped just 5% from 1950 to 2005, according to the latest available data, when during the same timeframe, heart disease fatality dropped 64% is another cause of concern about why cancer-cure still remains so elusive.
The fact, however, is that the cancer incidence increases as we grow old, and if the current rates continue 1 in 2 men and 1 in 3 women may face a cancer diagnosis soon. This epidemiologically-educated guess gets worse as the baby-boomers get to be 60 or older.
Traditionally, most of the cancer-research funding comes from the National Cancer Institute (NCI) of National Institutes of Health (NIH), a government agency under the Department of Health Services (DHS). Those in the trenches, including some of my own family members who worked in NCI since when the war on cancer was declared and are still in the field (if no longer in the trenches), have long maintained that cancer, a multi-faceted complex disease, will not be conquered anytime soon. This is quite an unfortunate frustration, no matter how true, after a lifelong research and clinical effort.
NCI funds cancer research within traditional governmental constrains, and the competition is fierce among the best researchers in the field for the now not-so-benevolent government grants and other support. NIH's budget is subject now to much controversy and internal fights.
Just about 15% of the grant proposals submitted usually get NIH/NCI funds, and this shows not only the extent of competition but the frustration among some of the best researchers in the field. There would not be much disagreement with Harold Varmus, a Nobel Laureate and former director of NIH, and now of Memorial Sloan Kettering Hospital in New York City, that "the rate of discovery has been phenomenal….[and] we feel we understand some of the basic principles.’ The stubborn fact is that there has not been much progress on getting rid of the disease.
Apart from NCI there are other funding sources, including such non-profit organizations as American Cancer Society, Howard Hughes Foundation and others, along with a great effort from biotech firms. But there is a definite sense of urgency now when the situation has not much improved after such a sustained support for four decades, with the goals still so far away. To say that the war on cancer has been only scientific, free from politics, would be naïve.
New approaches are beginning to take shape, and one of them is Stand Up to Cancer (SU2C) which is promoting collaborative projects designed to make a quantum jump, just like the Multiple Myeloma Research Foundation (MMRF) is in a more focused direction. The SU2C advocacy managed to simulcast a 3-network collaboration (Katie Couric, CBS; Brian William, NBC; Charles Gibson, ABC) on 5 September 2008 to stress the problem. SU2C will finance collaborative projects, involving some of the most innovative cancer researchers.
SU2C has a superb scientific advisory committee that has Phillip Sharp, a Nobel Laureate cancer researcher now at MIT, as its chair. This committee will select projects, to be monitored by the American Association for Cancer Research. The idea is to "identify areas where we could accelerate progress, particularly in areas where there's need -- ovarian, pancreatic, glioblastoma," some of the worst cancer problems. Says Sharp, “One of MIT's strategies is to build nanomolecules that, when injected into the body, can hunt for cancer cells, bind to them and deliver therapies directly to the bad cells; -- or to build nanomolecules that could locate abnormal genes and silence them.” That means stay tuned.
SU2C is not the only group with this approach. The Multiple Myeloma Research Foundation is another that has made remarkable progress with new drugs like Thalomid, Velcade, Revlimid and Doxil.
Finally, to say that the war on cancer is still very much on and has made some progress is not comforting after four decades. New approaches are absolutely necessary, whether or not they promise anything.