No diagnosis strikes fear into people as thoroughly as cancer. It is the sum of all fears when it comes to health.
My mother died in 1961, when treatments were few, in great pain from cancer of the uterus. Four treasured friends died of cancer more recently, but in equally awful ways; Barbara of bone cancer, Grant of colon cancer, Ian of brain cancer, and JoAnn of melanoma.
Cancer deserves its position as the most feared disease, even if it is not as lethal as it once was and many cancers can be treated. To know someone in the throes of cancer is to know something terrible. Heart disease kills more of us, but cancer is enthroned as the ultimate horror.
Yet we are, in some measure, winning the war on cancer; to medical science, it is less mysterious and more conquerable. But it has been a long battle against an implacable enemy.
The war on cancer is war with many theaters; cancer itself being a misnomer, as there are many cancers with very different profiles, rates of metastasis and treatments.
So it is both puzzling and appalling that Congress has allowed funding for government biomedical research to languish and has made it subject to the blunt tool of sequestration. Less money means everything slows down; research projects are drawn out or cancelled, and scientists are discouraged.
Nothing is as fatal for research as uncertain funding. You cannot shut down a line of research and start it up again as funds become available: It blunts the picks.
Scientists at the hard-rock face of research cannot be expected to sustain commitment when they do not know if their research grants will be renewed in the next budget cycle. Lawyers can anticipate steady work, why not cancer researchers? When we implore young people to study biomedicine, we are asking them to take up a career of uncertainty.
Enter the non-government funders, from giants like the American Cancer Society to small but determined outfits like the National Foundation for Cancer Research (NFCR).
This organization, according to its president, Franklin Salisbury Jr., believes in “adventure funding.” Although he eschews the description, Salisbury’s efforts might be called seed funding at the genomic and molecular level; understanding the role of genes in cancers and finding the mechanisms that control cells. He emphasizes the gap between science and medicine, and the need to provide funding to bridge that gap.
Salisbury also underscores the need for regular funding, rather than large periodic and unpredictable infusions. His organization, founded in 1973 by his father, Franklin Sr., a creative entrepreneur, and Albert Szent-Gyrgyi, a Hungarian-born physiologist and biochemist who won the Nobel Prize 1937, has been keeping research alive for some researchers like Dr. Curt Civin of the University of Maryland Medical Center and Dr. Harold Dvorak of Beth Israel Deaconess Medical Center in Boston.
NFCR is just one — and a small one, with a $15 million annual budget — of hundreds of cancer-related charities. Its uniqueness and what it portends for the whole future of research is its willing support, within the research community, of disruptive biomedical technologies as well as its appreciation for long-term support for particular scientists. These scientists are part of establishment teaching hospitals like Massachusetts General, as well as an honors list of top universities from Harvard to Oxford and across the Pacific to China.
Increasingly, China is becoming more important in biomedical research. American dollars are finding their way into Chinese research Institutions, as a new wave of collaboration outside of traditional channels is being established. These are sometimes housed in open medicine centers, six of which NFCR supports.
With the pressure here on government funding, researchers fear the government will fund only the safe and sure projects. This is being felt across the broad range of biomedical research in the, as scientists are turned away in larger and larger numbers from the National Institutes of Health empty handed. Respected researchers are turning to innovative funding sources, including crowdsourcing. A renowned virus researcher at Columbia, Dr. Ian Lipkin, is trying to raise $1.27 million, having been turned down by NIH, by crowdsourcing.
For better or worse, cancer research is going retail.