We are at a point in the fight against cancer where decades of discoveries are translating into new diagnostic and treatment tools at an accelerated rate.
Unfortunately, this comes at a time when the agencies that fund cancer research face dire cutbacks.
Because Congress must make difficult decisions on what to cut, I went to Washington this week to speak to a committee of lawmakers about the relationship of the National Institutes of Health (NIH) to our nation’s cancer centers.
I felt it was important to offer tangible proof of the great strides that have been made in treating cancer because of NIH-funded research.
As the executive director of the Winship Cancer Institute of Emory University, and as a practicing radiation oncologist and cancer researcher, I see cancer patients every day. And I’ve seen how budget cuts are already slowing down the progress toward finding new cancer treatments that change a patient’s chances of beating the disease.
In Washington, I spoke on behalf of the Association of American Cancer Institutes, addressing members of the House Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies. The chairman of that subcommittee is Rep. Jack Kingston (R-Ga.), who’s from Savannah.
Rep. Kingston visited Winship in January 2012 and took away a new understanding of how research at a cancer institute translates directly into patient care. I urged other committee members to visit the cancer centers in their districts to see the outstanding work being done there.
The National Cancer Institute (NCI) is one of the NIH’s institutes. NCI awards its designation to cancer centers that demonstrate expertise in laboratory, clinical, and behavioral and population-based cancer research through successful competition for a Cancer Center Support Grant (CCSG). Winship first received NCI designation in 2009. It recently renewed its designation and CCSG through a competitive process, receiving a rating of “Outstanding” by a peer panel.
Winship is the first and only NCI-designated cancer center in Georgia.
While Congress continues to debate the remainder of the fiscal 2013 budget, NIH and NCI have prepared for cuts through fiscal 2021.
NIH will suffer a cut of $1.6 billion overall, with NCI losing approximately $250 million. These cuts will have a real impact on progress against cancer at Winship and other cancer centers. Continued progress in cancer research is dependent on the sustained efforts of highly skilled research teams at cancer centers across the country, supported by the NCI.
So much promise imperiled
A budget cut to NIH and ultimately NCI will decrease funding to cancer research in all parts of the country and affect many of the research teams working on new treatments and new cures. Rebuilding such teams, even after a short break in funding, could take years.
As an example, Winship has an outstanding research team making real progress understanding how to target newly discovered mutations causing lung cancer, the type of cancer causing the most deaths in our country.
We are seeing an increase in the number of lung cancer patients who have little or no history of tobacco use, and we are just beginning to understand the genetic risk factors of such individuals for developing lung cancer. A break in funding support of this and other projects could delay finding new and effective therapies for thousands of patients by years.
Our nation’s cancer patients deserve greater research attention to this deadly disease. More than 1.6 million Americans were diagnosed with cancer in 2012, with more than 570,000 people dying from the disease.
With 25 percent of all deaths in America caused by cancer — almost 1,600 per day — the disease is the nation’s second-leading cause of death. NCI estimates that 41 percent of individuals born today will receive a cancer diagnosis at some point in their lives.
But research has brought us to the point where we have better tools for treating cancer than ever before. At Emory’s Winship Cancer Institute, we are excited about the new proton beam therapy facility under construction in Atlanta, as well as the increasing number of our patients being enrolled in cancer clinical trials.
We also offer promising new therapies to patients in our specialized “Phase I” unit, which allows us to carefully study all the beneficial and any harmful effects of these therapies. We have offered such groundbreaking Phase I treatments to nearly 200 Winship patients per year.
We see that the impact of budget cuts through fiscal 2021 has already begun to affect our progress in research. Immediate effects will be felt in our research labs, with promising research slowed or even shut down; pending projects wiped off the boards; the next generation of bright young researchers unable to learn cancer research at the side of experts; and layoffs among trained cancer staffers, including those who coordinate clinical trials that test new cancer therapies.
At Winship, we enrolled more than 700 cancer patients, from all across the state of Georgia and beyond, in trials testing new treatments in 2012. We aspire to increase the number of cancer patients whom we can offer such hope, but we need sustained support to achieve this.
Cuts dangerous for economy
In addition to cancer centers, the NCI supports cancer research in communities all across America through the National Clinical Trials Network and its newly reorganized five cancer cooperative groups.
Twenty thousand to 25,000 patients participate in these network trials each year, and this research has defined many of the best treatments for today’s and tomorrow’s cancer victims. This research is well coordinated with our cancer centers and is necessary for outreach beyond our research universities into community medical practices, and for finding answers to some of the toughest cancer research questions as quickly as possible.
It is through this network that patients in such locations as southeastern Georgia are able to enroll in cancer clinical trials with their community oncologists.
Unfortunately, NCI support for these cancer cooperative groups has remained flat for more than a decade. Sustaining this support is critical to providing cancer patients the best access to the outstanding cancer care available through their participation in NCI-supported clinical trials.
NIH plays a vital role in our cancer centers’ research and also affects our nation’s overall economy. A United for Medical Research analysis released in January of 2013 projected the nation’s life sciences sector, which includes cancer research, would lose more than 20,500 jobs and $3 billion in economic output due to cuts to NIH.
These serious consequences for biomedical jobs and local economies mean that funding cuts will undermine U.S. competitiveness, at a time when other nations are aggressively boosting their investments in research and development.
We risk driving an entire generation of young cancer physicians and researchers out of the country — to practice their craft and advance their careers abroad — or out of the field altogether. At Winship, this threat is real, and we cannot afford to experience such loss. Such declines in funding will prevent Winship and other centers from quickly moving to a broader platform of personalized cancer care and research.
This personalized approach requires a time- and resource-intensive approach to every patients’ cancer to understand the very best plan for each patient’s care. This effort is well under way at Winship and other centers and will require a sustained and significant level of support to yield the positive results that we expect.
NIH’s full support of NCI-designated centers and their programs remains a top priority for our nation’s cancer centers. We are on a clear path to dramatic breakthroughs, both at Winship and at cancer centers throughout the country.
We have come too far in cancer research progress to lose Congress’ full support of NIH, and ultimately, NIH’s funding of NCI-designated cancer centers and the National Clinical Trials Network. Cancer patients and their families deserve the best that NIH, NCI and our cancer centers have to offer in order to provide lifesaving treatment.
Dr. Walter Curran is executive director of the Winship Cancer Institute of Emory University, the Lawrence Davis Professor and chairman of Emory’s Department of Radiation Oncology, and a practicing radiation oncologist.
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