It appears that no one is really looking for a cure, just a steady income or in some instances a windfall. Things look bleaker and bleaker for the U.S.
Scientists Play It Safe with Cancer Research
The Virginian-Pilot and The Ledger-Star, Norfolk, VA
06-29-09
By Gina Kolata
The New York Times
Among the recent research grants awarded by the National Cancer Institute is one for a study asking whether people who are especially responsive to good-tasting food have the most difficulty staying on a diet. Another study will assess a Web-based program that encourages families to choose more healthful foods.
Many other grants involve biological research unlikely to break new ground. One project asks whether a laboratory discovery involving colon cancer also applies to breast cancer. But even if it does apply, there is no treatment yet that exploits it.
The cancer institute has spent $105 billion since President Richard Nixon declared war on the disease in 1971. The American Cancer Society, the largest private financer of cancer research, has spent about $3.4 billion on research grants since 1946.
Yet the fight against cancer is going slower than most had hoped, with only small changes in the death rate in the almost 40 years since it began.
One major impediment, scientists say , is the grant system . It has become a sort of jobs program, a way to keep research laboratories going year after year with the understanding that the focus will be on small projects unlikely to take significant steps toward curing cancer.
"These grants are not silly, but they are only likely to produce incremental progress," said Dr. Robert Young, chancellor at the Fox Chase Cancer Center in Philadelphia and chairman of the Board of Scientific Advisors, an independent group that makes recommendations to the National Cancer Institute.
The reviewers choose such projects because, with too little money to finance most proposals, they are timid about taking chances on ones that might not succeed. The problem, Young and others say, is that projects that could make a major difference in cancer prevention and treatment are often crowded out because they are too uncertain. In fact, it has become lore among cancer researchers that some game-changing discoveries involved projects deemed too likely to fail and were therefore denied federal grants, forcing researchers to struggle mightily to continue.
Take one transformative drug, for breast cancer. It was based on a discovery by Dr. Dennis Slamon of the University of California at Los Angeles that very aggressive breast cancers often have multiple copies of a particular protein, HER-2. That led to the development of herceptin, which blocks HER-2.
Now women with excess HER-2 proteins, who once had the worst breast-cancer prognoses, have prognoses that are among the best. But when Slamon wanted to start that research, his grant was turned down. He succeeded only after the grateful wife of a patient helped him get money from Revlon, the cosmetics company.
Yet studies such as the one on tasty food are financed. That study, which received a grant of $200,000 over two years, is based on the idea that since obesity is associated with an increased risk of cancer, understanding why people have trouble losing weight could lead to better weight control methods, which could lead to less obesity, which could lead to less cancer.
"It was the first grant I ever submitted, and it was funded on the first try," said the principal investigator, Bradley Appelhans, an assistant professor of basic medical sciences and psychology at the University of Arizona. Appelhans said he realized it would hardly cure cancer but hoped that "it will provide knowledge that will incrementally contribute to more effective cancer prevention strategies."
Even top federal cancer officials say the system needs to be changed.
"We have a system that works overall pretty well and is very good at ruling out bad things - we don't fund bad research," said Dr. Raynard Kington, acting director of the National Institutes of Health, which includes the National Cancer Institute. "But given that, we also recognize that the system probably provides disincentives to funding really transformative research."
The private American Cancer Society follows a similarly cautious path. Last year, it awarded $124 million in new research grants, with some money coming from large donors but most from events such as walkathons and memorial donations.
Dr. Otis Brawley, chief medical officer at the American Cancer Society, said the whole cancer research effort remains too cautious.
"The problem in science is that the way you get ahead is by staying within narrow parameters and doing what other people are doing," Brawley said. "No one wants to fund wild new ideas."
He added that the problem of getting money for imaginative but chancy proposals had worsened in recent years. There are more scientists seeking grants - they surged into the field in the 1990s when the National Institutes of Health budget doubled before plunging again.
That makes many researchers, who need grants not just to run their laboratories but also sometimes to keep their faculty positions, even more cautious in the grant proposals they submit. And grant review committees become more wary about giving scarce money to speculative proposals.
Philanthropies, which helped some researchers try outside-the- box ideas, are now having financial problems. And advances in technology have made research more expensive.
"Scientists don't like talking about it publicly," because they worry their remarks will be viewed as lashing out at the National Institutes of Health, which supports them, said Dr. Richard Klausner, a former director of the National Cancer Institute.
Klausner added: "There is no conversation that I have ever had about the grant system that doesn't have an incredible sense of consensus that it is not working. That is a terrible wasted opportunity for the scientists, patients, the nation and the world."
The National Institutes of Health has started "pilot experiments" to see if there is a better way of getting financing for innovative projects, said its acting director, Kington, said.
There also is new money from the federal economic stimulus package passed by Congress, which gives the National Institutes of Health $200 million for "challenge grants" lasting two years or less.
But the agency has received about 21,000 applications for 200 challenge grants, and researchers who have applied concede there is not much hope.
"I did submit one of these challenge grants recently, like the rest of the lemmings," said Dr. Chi Dang, professor of medicine, cell biology, oncology and pathology at the Johns Hopkins University School of Medicine. But, he added, "there are many, many more applications than slots."
the problem
Some scientists say many researchers only go after sure-thing studies because they need to win grant money to earn a living.
Scientists Play It Safe with Cancer Research
The Virginian-Pilot and The Ledger-Star, Norfolk, VA
06-29-09
By Gina Kolata
The New York Times
Among the recent research grants awarded by the National Cancer Institute is one for a study asking whether people who are especially responsive to good-tasting food have the most difficulty staying on a diet. Another study will assess a Web-based program that encourages families to choose more healthful foods.
Many other grants involve biological research unlikely to break new ground. One project asks whether a laboratory discovery involving colon cancer also applies to breast cancer. But even if it does apply, there is no treatment yet that exploits it.
The cancer institute has spent $105 billion since President Richard Nixon declared war on the disease in 1971. The American Cancer Society, the largest private financer of cancer research, has spent about $3.4 billion on research grants since 1946.
Yet the fight against cancer is going slower than most had hoped, with only small changes in the death rate in the almost 40 years since it began.
One major impediment, scientists say , is the grant system . It has become a sort of jobs program, a way to keep research laboratories going year after year with the understanding that the focus will be on small projects unlikely to take significant steps toward curing cancer.
"These grants are not silly, but they are only likely to produce incremental progress," said Dr. Robert Young, chancellor at the Fox Chase Cancer Center in Philadelphia and chairman of the Board of Scientific Advisors, an independent group that makes recommendations to the National Cancer Institute.
The reviewers choose such projects because, with too little money to finance most proposals, they are timid about taking chances on ones that might not succeed. The problem, Young and others say, is that projects that could make a major difference in cancer prevention and treatment are often crowded out because they are too uncertain. In fact, it has become lore among cancer researchers that some game-changing discoveries involved projects deemed too likely to fail and were therefore denied federal grants, forcing researchers to struggle mightily to continue.
Take one transformative drug, for breast cancer. It was based on a discovery by Dr. Dennis Slamon of the University of California at Los Angeles that very aggressive breast cancers often have multiple copies of a particular protein, HER-2. That led to the development of herceptin, which blocks HER-2.
Now women with excess HER-2 proteins, who once had the worst breast-cancer prognoses, have prognoses that are among the best. But when Slamon wanted to start that research, his grant was turned down. He succeeded only after the grateful wife of a patient helped him get money from Revlon, the cosmetics company.
Yet studies such as the one on tasty food are financed. That study, which received a grant of $200,000 over two years, is based on the idea that since obesity is associated with an increased risk of cancer, understanding why people have trouble losing weight could lead to better weight control methods, which could lead to less obesity, which could lead to less cancer.
"It was the first grant I ever submitted, and it was funded on the first try," said the principal investigator, Bradley Appelhans, an assistant professor of basic medical sciences and psychology at the University of Arizona. Appelhans said he realized it would hardly cure cancer but hoped that "it will provide knowledge that will incrementally contribute to more effective cancer prevention strategies."
Even top federal cancer officials say the system needs to be changed.
"We have a system that works overall pretty well and is very good at ruling out bad things - we don't fund bad research," said Dr. Raynard Kington, acting director of the National Institutes of Health, which includes the National Cancer Institute. "But given that, we also recognize that the system probably provides disincentives to funding really transformative research."
The private American Cancer Society follows a similarly cautious path. Last year, it awarded $124 million in new research grants, with some money coming from large donors but most from events such as walkathons and memorial donations.
Dr. Otis Brawley, chief medical officer at the American Cancer Society, said the whole cancer research effort remains too cautious.
"The problem in science is that the way you get ahead is by staying within narrow parameters and doing what other people are doing," Brawley said. "No one wants to fund wild new ideas."
He added that the problem of getting money for imaginative but chancy proposals had worsened in recent years. There are more scientists seeking grants - they surged into the field in the 1990s when the National Institutes of Health budget doubled before plunging again.
That makes many researchers, who need grants not just to run their laboratories but also sometimes to keep their faculty positions, even more cautious in the grant proposals they submit. And grant review committees become more wary about giving scarce money to speculative proposals.
Philanthropies, which helped some researchers try outside-the- box ideas, are now having financial problems. And advances in technology have made research more expensive.
"Scientists don't like talking about it publicly," because they worry their remarks will be viewed as lashing out at the National Institutes of Health, which supports them, said Dr. Richard Klausner, a former director of the National Cancer Institute.
Klausner added: "There is no conversation that I have ever had about the grant system that doesn't have an incredible sense of consensus that it is not working. That is a terrible wasted opportunity for the scientists, patients, the nation and the world."
The National Institutes of Health has started "pilot experiments" to see if there is a better way of getting financing for innovative projects, said its acting director, Kington, said.
There also is new money from the federal economic stimulus package passed by Congress, which gives the National Institutes of Health $200 million for "challenge grants" lasting two years or less.
But the agency has received about 21,000 applications for 200 challenge grants, and researchers who have applied concede there is not much hope.
"I did submit one of these challenge grants recently, like the rest of the lemmings," said Dr. Chi Dang, professor of medicine, cell biology, oncology and pathology at the Johns Hopkins University School of Medicine. But, he added, "there are many, many more applications than slots."
the problem
Some scientists say many researchers only go after sure-thing studies because they need to win grant money to earn a living.
