More on Quality and Safety

Sequester could doom funding for promising cancer research

An advanced stage cancer diagnosis used to be almost a death sentence, but that wouldn't have to be the case if we were wise in sustaining cancer research funding.

If we chose to fund more promising cancer research proposals, perhaps no child would have to die or grow up without a parent; no young couple would see their life dreams shattered by a life-threatening diagnosis, and no one would spend years wracked with uncontrollable cancer pain or nausea from chemotherapy.

Across-the-board budget cuts ― known as sequestration ― took effect on March 1, and their potential impacts are just starting to become clearer. For cancer patients and their families, these cuts spell despair:

  • One in two men and one in three women will be diagnosed with cancer in their lifetimes ― 1.6 million people will be diagnosed and around 580,000 will die this year alone. Three quarters of American households will find themselves caring for a cancer patient at some point in their lives. Every day you live, the odds get higher that you'll be affected by cancer in some way.
  • Many of these cancers are serious, so both patients and their caregivers depend on advanced research for hope of survival or to postpone death. The American Cancer Society estimates that one in every four deaths in the United States is caused by cancer. The National Institutes of Health (NIH) estimated in 2008 that the total cost of cancer was over $226 billion each year, including both direct medical costs and lost productivity from illness or premature death.
  • The Federal government is the largest funder of cancer research, and the sequester threatens to cut this funding by almost 23 percent in real purchasing power, to nearly 2001 levels.

Research funded by the National Institutes of Health (NIH) and the National Cancer Institute (NCI) has supported grants that have led to every major cancer prevention, detection, and treatment advance for decades. This kind of discovery work takes decades and costs so much time and money that few private enterprises can afford to conduct it. Many drugs that received FDA approval in the past 10 years were based on research initiated more than 30-35 years earlier.

Once stopped, promising research programs won't restart like flipping a light switch back on because unfunded scientists will leave the field to make a living elsewhere.

According to the American Cancer Society's "Catalyst for Cures" report, NIH funding represents less than 1 percent of the Federal budget, and only 17 percent of that amount goes to cancer research. Their analysis has shown that $23.6 billion in NIH-supported medical research in 2011 generated $69 billion in other economic activity, including 432,000 high-paying jobs in every state. Further, each dollar in Federal research investment is matched by around 32 cents in private sector research funding. In an environment where we are concerned to create jobs, cutting research funding is not just shortsighted ― it is economically and morally wrong.

Not only will sequester cuts lead to fewer prospective research projects being funded, fewer research jobs, and less economic activity, but they may cut short promising genetic research initiatives that are leading to drug development for brain tumors, ovarian cancer, metastatic melanoma, and cancers caused by genetic mutations.

The timing for funding cuts couldn't be worse. Today, collaboration and information sharing among researchers, hospitals, universities, medical schools, and both medical and corporate research centers is accelerating progress just at the time that funding is most threatened. Scientists are just beginning to understand the fundamental biological mechanisms that cause cancer and to translate that knowledge into new diagnostic techniques, medicine delivery systems, and improvements in pain control and quality of life for those suffering the most severe cancers.

Many grants today focus on basic cellular biology to understand what causes cancer, what allows cancer to spread from one body part to another, what components to target for treatment, genetic mutations that characterize certain cancers, new equipment and testing technologies to match new treatments to each individual patient, and so on. These are targeted toward finding more effective ways of killing the cancer without killing the patient.

It's time to decide what to do. Unless the large number of people who are affected by cancer ― as patients, family caregivers, healthcare providers, employers, and friends ― stand up and tell Congress to get serious about cancer research funding, affected families will be left with few options and little hope. If every one of us spoke up to our legislators, they might finally understand how many of us will hold them accountable to recognize that cancer research pays itself back many times over.

Cutting cancer research now hurts the nation both medically and economically. Restoring it won't take just political courage: it will take wisdom to acknowledge the facts of research funding and its payback in lives, jobs, and the health of the national economy. The problem is clear, and the time for each of us to act is now.

Deborah J. Cornwall is an experienced advocate on behalf of cancer patients and their families, and the author of Things I Wish I'd Known: Cancer Caregivers Speak Out.