On Wednesday, the United States Senate Special Committee on Aging held a hearing to examine federal funding for cancer research and to explore treatment advances. In particular, the committee focused on “the impact of cancer on the body as it ages,” in the words of Sen. Bill Nelson of Florida, who chaired the session. Although the prepared speeches tugged at the heart, most of the questions that followed concerned dollars and sense, especially in light of necessary budget cuts over the past few years. “As a result of the sequestered cuts, [Francis Collins, director of the National Institutes of Health] had to stop 700 research grants from going out the door,” said Nelson in his opening comments.
Public health officials believe cancer will become the top killer of Americans by the year 2030, where a 67 percent increase in new cases is expected among individuals over age 65. This year, about 1.6 million Americans, most over 55, will receive a cancer diagnosis while more than 585,000 will die from the disease. Perhaps because of his unexpected youth, the most moving speaker of the day was Chip Kennett, 32, a cancer survivor, who simply stated, “There are no words to describe what it’s like to receive a cancer diagnosis.” He had been diagnosed with stage 4 lung cancer and told of his demoralizingly slim chances of surviving it. “I was by all accounts healthy, except for a blurry spot that showed up in my right eye.” He advocated in part for more lung cancer spending, which is relatively underfunded due to the stigma that lung cancer is caused by smoking. (He and lung cancer survivor Valerie Harper, who also testified, have never smoked.) His young family, including a new baby, support him in his continued fight and advocacy for increased cancer research investments.
Following Kennett's testimony, Sen. Susan Collins (R-Maine) struck at the heart of the matter when she asked, with refreshing bluntness, a single question of Dr. Harold E. Varmus, director of the National Cancer Institute: “What should we be spending?”
Varmus’ answer was far less succinct. He noted how technological innovation means costs for research do not increase at simple rates and research does not transpire over a single year but often takes several years to complete. He said that a “consistent increase of six to seven percent each year” would cover the bottom line. Currently, NCI funds about 13 percent of the applications it receives for research grants, though Varmus suggested that figure may be somewhat deceptive, as new proposals generally do not do as well as existing projects. “We know we’re missing important opportunities,” Varmus noted, adding that the NCI does well when it is able to fund about a third of its applications. He further explained that weeding out the top third is relatively easy and that percentage of funding can effectively cover all promising avenues of research. When researchers don’t get funding, “careers terminate inappropriately” he stated somewhat ominously.
His thoughts were echoed in part by Dr. Thomas Sellers, director of the H. Lee Moffitt Cancer Center and Research Institute, who called for "bold thinking, innovation." Sellers described currrent cancer research funding as "stifling" in that institutes like his own had only enough money to invest in the "obvious next steps." He said, “We’re funding incremental science instead of swinging for the fences.”
Meanwhile, Sen. Kelly Ayotte, (R-N.H.) wanted to know about the coordination among different agencies: How is it factored into the overall equation of our national cancer budget when the Department of Defense (DOD) receives research money for a cancer project? Does it coordinate with the NCI in such cases?
“If you look at the entire national cancer program there are many other private and public sources of money,” Varmos said, noting that some of the scientists who receive support from NCI are also backed by the DOD. In her concluding remarks, Collins worried there are “too many silos of research” without enough sharing of the fruits of publicly funded projects. In cash-strapped America, where many people still have not recovered from the devastating recession of 2008, funding additional cancer research to save the lives of mainly older citizens may not be a priority agreed upon by all, especially when the current funds are not well-managed.