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href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/">Back to front page »</a></p> <div class="blog_post lead single cancer "> <div class="post-info"> <small class="post-date" id="day_6">March 6, 2008,  12:21 pm</small> <h2 class="post-title">Cancer Funding: Does It Add Up?</h2> </div> <div class="post-content"> <p>Should cancer spending be focused on the most common cancers? Or the most deadly cancers? </p> <p>That’s the dilemma for the cancer research community as it struggles to divvy up limited funds. After news yesterday that actor Patrick Swayze had been diagnosed with pancreatic cancer, several readers questioned the nation’s cancer funding priorities. I decided to look at the numbers.</p> <p>The National Cancer Institute has proposed a $6 billion budget in the war on cancer, allocating some funds for general cancer research and some for studies of specific cancers. But a review of the N.C.I.’s 2006 funding for five of the biggest cancers showed a wide disparity in the amounts of money spent relative to each cancer death and each new case of cancer. The data offer only a partial snapshot of public cancer spending in this country, as other government offices, such as the U.S. Department of Defense, also fund breast and prostate cancer research. </p> <p>The big loser in the cancer funding race is lung cancer. It is the biggest cancer killer in the country, yet on a per-death basis receives the least N.C.I. funding among major cancers. In 2006, the N.C.I. spent $1,518 for each new case of lung cancer and $1,630 for each lung cancer death, according to data from the institute and the American Cancer Society. <a id="more-282"></a></p> <p>Among the big cancers, breast cancer receives the most funding per new case, $2,596 — and by far the most money relative to each death, $13,452. Notably, prostate cancer, the most common cancer, receives the least funding per new case at just $1,318. But on a per-death basis it ranks second, with $11,298 in N.C.I. funds.</p> <p>Here’s a look at the N.C.I. cancer funding based on 2006 death rates and incidence rates for some of the most common and deadliest cancers.</p> <p><center></p> <table> <tr> <td><b>Cancer (Deaths)</b></td> <td><b>N.C.I. Funding per Death</b></td> </tr> <tr> <td>Lung (162,460)</td> <td>$1,630</td> </tr> <tr> <td>Colon (55,170)</td> <td>$4,566</td> </tr> <tr> <td>Breast (41,430)</td> <td>$13,452</td> </tr> <tr> <td>Pancreas (32,300 )</td> <td>$2,297</td> </tr> <tr> <td>Prostate (27,350)</td> <td>$11,298</td> </tr> <tr> <td></td> </tr> <tr> <td><b>Cancer (New cases)</b></td> <td><b>N.C.I. Funding per New Case</b></td> </tr> <tr> <td>Prostate (234,460)</td> <td>$1,318</td> </tr> <tr> <td>Breast (214,640)</td> <td>$2,596</td> </tr> <tr> <td>Lung (174,470)</td> <td>$1,518</td> </tr> <tr> <td>Colon (106,680)</td> <td>$2,361</td> </tr> <tr> <td>Pancreas (33,730)</td> <td>$2,200</td> </tr> </table> <p></center> </p> </div> <div class="post-tools"> <ul id="post-tools-282"> <li class="comments-tool"><a href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2008/03/06/cancer-funding-does-it-add-up/#comments" class="post-comment" title="Comment on Cancer Funding: Does It Add Up?">Comments (153)</a></li> <li class="email-tool"> <form method="post" name="emailThis_282" id="emailThis_282" style="display: inline;" enctype="application/x-www-form-urlencoded" action="https://web.archive.org/web/20080311022551/http://www.nytimes.com/mem/emailthis.html"> <input type="hidden" name="type" value="1"/> <input type="hidden" name="url" value="http%3A%2F%2Fwell.blogs.nytimes.com%2F2008%2F03%2F06%2Fcancer-funding-does-it-add-up%2F"/> <input type="hidden" name="title" value="Well%3A%20Cancer%20Funding%3A%20Does%20It%20Add%20Up%3F"/> <input type="hidden" name="full_text" value="%3Cp%3EShould%20cancer%20spending%20be%20focused%20on%20the%20most%20common%20cancers%3F%20Or%20the%20most%20deadly%20cancers%3F%20%3C%2Fp%3E%0A%3Cp%3EThat%26%238217%3Bs%20the%20dilemma%20for%20the%20cancer%20research%20community%20as%20it%20struggles%20to%20divvy%20up%20limited%20funds.%20After%20news%20yesterday%20that%20actor%20Patrick%20Swayze%20had%20been%20diagnosed%20with%20pancreatic%20cancer%2C%20several%20readers%20questioned%20the%20nation%26%238217%3Bs%20cancer%20funding%20priorities.%20I%20decided%20to%20look%20at%20the%20numbers.%3C%2Fp%3E%0A%3Cp%3EThe%20National%20Cancer%20Institute%20has%20proposed%20a%20%246%20billion%20budget%20in%20the%20war%20on%20cancer%2C%20allocating%20some%20funds%20for%20general%20cancer%20research%20and%20some%20for%20studies%20of%20specific%20cancers.%20But%20a%20review%20of%20the%20N.C.I.%26%238217%3Bs%202006%20funding%20for%20five%20of%20the%20biggest%20cancers%20showed%20a%20wide%20disparity%20in%20the%20amounts%20of%20money%20spent%20relative%20to%20each%20cancer%20death%20and%20each%20new%20case%20of%20cancer.%20The%20data%20offer%20only%20a%20partial%20snapshot%20of%20public%20cancer%20spending%20in%20this%20country%2C%20as%20other%20government%20offices%2C%20such%20as%20the%20U.S.%20Department%20of%20Defense%2C%20also%20fund%20breast%20and%20prostate%20cancer%20research.%20%3C%2Fp%3E%0A%3Cp%3EThe%20big%20loser%20in%20the%20cancer%20funding%20race%20is%20lung%20cancer.%20It%20is%20the%20biggest%20cancer%20killer%20in%20the%20country%2C%20yet%20on%20a%20per-death%20basis%20receives%20the%20least%20N.C.I.%20funding%20among%20major%20cancers.%20In%202006%2C%20the%20N.C.I.%20spent%20%241%2C518%20for%20each%20new%20case%20of%20lung%20cancer%20and%20%241%2C630%20for%20each%20lung%20cancer%20death%2C%20according%20to%20data%20from%20the%20institute%20and%20the%20American%20Cancer%20Society.%20%3Ca%20id%3D%22more-282%22%3E%3C%2Fa%3E%3C%2Fp%3E%0A%3Cp%3EAmong%20the%20big%20cancers%2C%20breast%20cancer%20receives%20the%20most%20funding%20per%20new%20case%2C%20%242%2C596%20%26%238212%3B%20and%20by%20far%20the%20most%20money%20relative%20to%20each%20death%2C%20%2413%2C452.%20Notably%2C%20prostate%20cancer%2C%20the%20most%20common%20cancer%2C%20receives%20the%20least%20funding%20per%20new%20case%20at%20just%20%241%2C318.%20But%20on%20a%20per-death%20basis%20it%20ranks%20second%2C%20with%20%2411%2C298%20in%20N.C.I.%20funds.%3C%2Fp%3E%0A%3Cp%3EHere%E2%80%99s%20a%20look%20at%20the%20N.C.I.%20cancer%20funding%20based%20on%202006%20death%20rates%20and%20incidence%20rates%20for%20some%20of%20the%20most%20common%20and%20deadliest%20cancers.%3C%2Fp%3E%0A%3Cp%3E%3Ccenter%3E%3C%2Fp%3E%0A%3Ctable%3E%0A%3Ctr%3E%0A%3Ctd%3E%3Cb%3ECancer%20%28Deaths%29%3C%2Fb%3E%3C%2Ftd%3E%0A%3Ctd%3E%3Cb%3EN.C.I.%20Funding%20per%20Death%3C%2Fb%3E%3C%2Ftd%3E%0A%3C%2Ftr%3E%0A%3Ctr%3E%0A%3Ctd%3ELung%20%28162%2C460%29%3C%2Ftd%3E%0A%3Ctd%3E%241%2C630%3C%2Ftd%3E%0A%3C%2Ftr%3E%0A%3Ctr%3E%0A%3Ctd%3EColon%20%2855%2C170%29%3C%2Ftd%3E%0A%3Ctd%3E%244%2C566%3C%2Ftd%3E%0A%3C%2Ftr%3E%0A%3Ctr%3E%0A%3Ctd%3EBreast%20%2841%2C430%29%3C%2Ftd%3E%0A%3Ctd%3E%2413%2C452%3C%2Ftd%3E%0A%3C%2Ftr%3E%0A%3Ctr%3E%0A%3Ctd%3EPancreas%20%2832%2C300%20%29%3C%2Ftd%3E%0A%3Ctd%3E%242%2C297%3C%2Ftd%3E%0A%3C%2Ftr%3E%0A%3Ctr%3E%0A%3Ctd%3EProstate%20%2827%2C350%29%3C%2Ftd%3E%0A%3Ctd%3E%2411%2C298%3C%2Ftd%3E%0A%3C%2Ftr%3E%0A%3Ctr%3E%0A%3Ctd%3E%3C%2Ftd%3E%0A%3C%2Ftr%3E%0A%3Ctr%3E%0A%3Ctd%3E%3Cb%3ECancer%20%28New%20cases%29%3C%2Fb%3E%3C%2Ftd%3E%0A%3Ctd%3E%3Cb%3EN.C.I.%20Funding%20per%20New%20Case%3C%2Fb%3E%3C%2Ftd%3E%0A%3C%2Ftr%3E%0A%3Ctr%3E%0A%3Ctd%3EProstate%20%28234%2C460%29%3C%2Ftd%3E%0A%3Ctd%3E%241%2C318%3C%2Ftd%3E%0A%3C%2Ftr%3E%0A%3Ctr%3E%0A%3Ctd%3EBreast%20%28214%2C640%29%3C%2Ftd%3E%0A%3Ctd%3E%242%2C596%3C%2Ftd%3E%0A%3C%2Ftr%3E%0A%3Ctr%3E%0A%3Ctd%3ELung%20%28174%2C470%29%3C%2Ftd%3E%0A%3Ctd%3E%241%2C518%3C%2Ftd%3E%0A%3C%2Ftr%3E%0A%3Ctr%3E%0A%3Ctd%3EColon%20%28106%2C680%29%3C%2Ftd%3E%0A%3Ctd%3E%242%2C361%3C%2Ftd%3E%0A%3C%2Ftr%3E%0A%3Ctr%3E%0A%3Ctd%3EPancreas%20%2833%2C730%29%3C%2Ftd%3E%0A%3Ctd%3E%242%2C200%3C%2Ftd%3E%0A%3C%2Ftr%3E%0A%3C%2Ftable%3E%0A%3Cp%3E%3C%2Fcenter%3E%0A%3C%2Fp%3E%0A"/> <input type="hidden" name="description" value="Should%20cancer%20spending%20be%20based%20on%20death%20rates%2C%20incidence%20rates%20or%20both%3F"/> <input type="hidden" name="pub_date" value="20080306"/> <input type="hidden" name="author" value="Tara%20Parker-Pope"/> <input type="hidden" name="section" value="Health"/> <input type="hidden" name="nytdsection" value="Health"/> <input type="hidden" name="nytdsubsection" value=""/> <input type="hidden" name="encrypted_key" value="HMD4eObZvlHOEC1LOJ9ZNg"/> <input type="hidden" name="encryption_partner" value="about"/> </form> <a class="post-email" href="https://web.archive.org/web/20080311022551/http://www.nytimes.com/auth/login?URI=http%3A%2F%2Fwell.blogs.nytimes.com%2F2008%2F03%2F06%2Fcancer-funding-does-it-add-up%2F"><strong>E-mail this</strong></a> </li> <li id="share282" class="share"> <a onclick="javascript:showHideShareTool('sharelist282', 'share282');" id="sharebox282"> Share</a> <ul class="hide" id="sharelist282"> <li class="delicious"><a href="javascript:blogPostShare('delicious', 'cancer,breast-cancer,prostate-cancer,pancreatic,lung-cancer,colon-cancer', 'March 6, 2008', '282');">Del.icio.us</a></li> <li class="digg"><a href="javascript:blogPostShare('digg', 'cancer,breast-cancer,prostate-cancer,pancreatic,lung-cancer,colon-cancer', 'March 6, 2008', '282');">Digg</a></li> <li class="facebook"><a href="javascript:blogPostShare('facebook', 'cancer,breast-cancer,prostate-cancer,pancreatic,lung-cancer,colon-cancer', 'March 6, 2008', '282');">Facebook</a></li> <li class="newsvine"><a href="javascript:blogPostShare('newsvine', 'cancer,breast-cancer,prostate-cancer,pancreatic,lung-cancer,colon-cancer', 'March 6, 2008', '282');">Newsvine</a></li> <li class="permalink"><a href="javascript:blogPostShare('permalink', 'cancer,breast-cancer,prostate-cancer,pancreatic,lung-cancer,colon-cancer', 'March 6, 2008', '282');">Permalink</a></li> </ul> </li> </ul> </div> <div id="related"> <h3>Related</h3> <ul> <li><a href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2008/02/06/despite-risks-vitamins-popular-with-cancer-patients/">Despite Risks, Vitamins Popular With Cancer Patients</a></li><li><a href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2008/03/05/an-actors-diagnosis-may-bring-attention-to-a-neglected-cancer/">An Actor's Diagnosis May Bring Attention to a Neglected Cancer</a></li><li><a href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2008/03/04/slight-cancer-risk-remains-after-hormone-therapy-stops/">Slight Cancer Risk Remains After Hormone Therapy Stops</a></li><li><a href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2008/02/11/most-breast-cancer-sites-get-it-right/">Most Breast Cancer Sites Get It Right</a></li> </ul> </div>   </div>  <div id="blog_comments"> <h3 id="comments">153 comments so far...</h3> <ul class="commentlist"> <li class="clearfix" id="comment-32098"> <div class="index">1.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32098" title="">12:58 pm</a> </div> <div class="comment"> <p>When you look at how many deaths versus new cases, the numbers are really staggering. 33,730 new cases of pancreatic cancer to 32,300 deaths? What a scary diagnosis.</p> <p><strong><br/> From TPP — Same with lung cancer. At least with the other types of cancer, it seems you have a fighting chance.</strong> </p> <p><cite>— Posted by Caroline </cite></p> </div> </li> <li class="clearfix" id="comment-32099"> <div class="index">2.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32099" title="">12:59 pm</a> </div> <div class="comment"> <p>My only observation on this is based on what I’ve seen in real life. When people lose their mothers or sisters or friends to breast cancer, they become– and remain– active in fund raising for breast cancer research to an extent I don’t see people get involved in fund raising for other cancers, even if they have lost family members to other cancers. I am going to guess we’re dealing with something primal on many levels, and therefore more saleable. It’s not just that breast cancer is more ’sexy’ the way some people have suggested, but that it is related to a fundamental way in which we identify women– in which women identify themselves, and in which men and children feel about them. Everyone has strong primal feelings about breasts. It’s just not the same with any other part of the human body. With that primal underpinning, breast cancer research becomes an unassailable brand with pins and coffee mugs and magnets and teddy bears (Barbara Ehrenreich wrote a great essay about breast cancer merchandising–would we give a man with prostate cancer a blue teddy bear?). To me it’s a lot like the fervor that went into polio research in the 40s and 50s–because it was robbing children of their lives, something else that strikes at a primal level– even as other diseases and cancers took lives. </p> <p>My biggest beef with all of this is that very little research funding –for any cancer– goes into studying the environmental causes of cancer. They are all geared toward genetic and behavioral causes. As a result, I believe many cancers will remain a mystery to us. </p> <p><cite>— Posted by francois </cite></p> </div> </li> <li class="clearfix" id="comment-32100"> <div class="index">3.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32100" title="">1:00 pm</a> </div> <div class="comment"> <p>What about ovarian cancer? This is surely one of the most deadly cancers, as well as one of the most difficult to detect.</p> <p><strong>From TPP — 2006 funding for ovarian cancer was $95.1 million. There were 20,180 new cases and 15,310 deaths. That translates to $6,212 per death and $4,713 per new case.</strong> </p> <p><cite>— Posted by Kim Schneiderman </cite></p> </div> </li> <li class="clearfix" id="comment-32103"> <div class="index">4.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32103" title="">1:08 pm</a> </div> <div class="comment"> <p>In the field of Economics there is something called the “equimarginal principle”. Briefly, it states that, when a fixed amount of money must be distributed among competing demands, the money should be allocated so that the last (marginal) dollar spent on each demand should purchase the same amount of utility as the last dollar spent on every other competing demand. Thus even though a particular type of cancer may be very common and/or deadly, there may not be additional promising avenues of research to pursue so that spending more money on it won’t buy very much. Conversely, spending additional money on promising research for a less common type of cancer may save more lives.</p> <p>I’m not saying that this principle will be easy to implement in the case of health care research in general, not just cancer. But it should be the guiding principle when it comes to allocating scarce research dollars. It makes a lot more sense than spending money based on the political power of particular interest groups. </p> <p><cite>— Posted by Keith </cite></p> </div> </li> <li class="clearfix" id="comment-32104"> <div class="index">5.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32104" title="">1:09 pm</a> </div> <div class="comment"> <p>This is interesting. I think it shows that women are better at organizing (for breast cancer research, etc.) and that “sexy” cancers get more (as someone mentioned yesterday). My father has advanced prostate cancer and is on the board of a national advocacy group. They have trouble getting prominent men with prostate cancer to help them, even in non-financial ways. On the other hand, ever famous woman who has been affected by breast cancer in any way seems to be doing something for the cause. You would think that with so many old men in congress, they would fight to get money for the disease they would be likely to get! </p> <p><cite>— Posted by Lisa </cite></p> </div> </li> <li class="clearfix" id="comment-32107"> <div class="index">6.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32107" title="">1:16 pm</a> </div> <div class="comment"> <p>To riff a little on comment #2, there is also a great deal of funding given to cancers that have survivors. A disease that leaves survivors, like breast cancer or leukemia is likely to have more advocates for fundraising than ones that kill quickly, like ovarian or pancreatic cancers. </p> <p><cite>— Posted by ekb </cite></p> </div> </li> <li class="clearfix" id="comment-32110"> <div class="index">7.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32110" title="">1:18 pm</a> </div> <div class="comment"> <p>Cancers may be distinct, but research findings for one kind of cancer are often helpful for research in a related kind. There are also probably diminishing returns to studying each particular type of cancer. </p> <p>Therefore, if you are looking to get the most “bang for the buck” out of cancer research, it makes sense to study obscure types of cancer more intensively than the per-person funding numbers would suggest.</p> <p>Research funding should be allocated based on how useful it is, not just on how many people are affected by that particular cancer. </p> <p><cite>— Posted by Jack </cite></p> </div> </li> <li class="clearfix" id="comment-32111"> <div class="index">8.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32111" title="">1:18 pm</a> </div> <div class="comment"> <p>To echo Francois, the real disparity in cancer research funding is exploring the environmental causes of cancer versus treatments. Why is there a disparity?<br/> Perhaps because finding what causes cancer could cost some large companies a lot of money while finding a treatment is a large revenue source. </p> <p><cite>— Posted by Hal Connolly </cite></p> </div> </li> <li class="clearfix" id="comment-32113"> <div class="index">9.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32113" title="">1:21 pm</a> </div> <div class="comment"> <p>Within the past decade, several innovative methods of treatment for various cancers have been introduced and made available to appropriate patients, but referrals by oncologists to these technologies are generally scarce. Today, there is sterotactic/conformal photon therapy, proton therapy, and - in Japan and Germany - the use of heavy ions in carbon therapy. These are all non-invasive treatments targeting tumors with a preciseness exceeding the skills of any leading neurosurgeon, as well as surgeons of other disciplines. There is not a single patient diagnosed with a brain tumor who benefits greater from a craniotomy for resection of a lesion than simply undergoing targeted radiotherapy. It is arguable, but in my opinion neurosurgery for a brain cancer is obsolete, but surgery, hospitalization, chemotherapy and all the adjunct services connected to some cancers are important sources of revenue. </p> <p><cite>— Posted by F.W. Fischer </cite></p> </div> </li> <li class="clearfix" id="comment-32117"> <div class="index">10.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32117" title="">1:26 pm</a> </div> <div class="comment"> <p>We are burning billions of dollars in Africa on AIDS (a preventable disease, just use a condom) when cancer is stalking our own people and striking them down in their prime. It’s time to put cancer research and America first and find a cure. </p> <p><cite>— Posted by Chris </cite></p> </div> </li> <li class="clearfix" id="comment-32120"> <div class="index">11.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32120" title="">1:27 pm</a> </div> <div class="comment"> <p>I think a substantial part of the funding equation is neither number of cases or number of deaths, but politics. People perceive lung cancer suffers as smokers - who have thus brought the disease on themselves. On the other hand, budgetmakers cannot resist the large and vocal advocacy groups for a cancer like breast cancer. </p> <p><cite>— Posted by Rose </cite></p> </div> </li> <li class="clearfix" id="comment-32123"> <div class="index">12.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32123" title="">1:31 pm</a> </div> <div class="comment"> <p>I wish there were no “most common cancers” or “most deadly cancers” for which to priortize funding. Unfortunately, cancer is very personal. I am thankful that so many more women are surviving breast cancer, and I have to attribute that to funding for research. I understand why survivors and their families fight hard for funding for “their” diseases, especially those with known familial risks. I am a 49 year old breast cancer survivor. I lost my mother to the side effects of breast cancer treatment while I was undergoing my own treatment. I have a nine year old daughter who already believes she will get breast cancer. I have nieces in their 30’s who are already having mammograms and biopsies. Before my mother’s and my diagnosis (less than four years apart), we had no family history for breast cancer. Now we do and we are scared for our daughters. </p> <p>And even though prostate cancer is very common and relatively rarely fatal, I lost my father to prostate cancer after a horrible nine year fight. Yes, my brothers are scared of prostate cancer, and we are scared for our sons. </p> <p>With breast cancer and prostate cancer (as with most cancers), it is hard to point to something the cancer patient did that caused it. </p> <p>When my grandfather developed cancer of the esophagus after many years of smoking cigarettes and a pipe, the “why” seemed a lot more clear. It doesn’t take a lot of research dollars to tell people to stop using tobacco. </p> <p><cite>— Posted by Penny </cite></p> </div> </li> <li class="clearfix" id="comment-32124"> <div class="index">13.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32124" title="">1:31 pm</a> </div> <div class="comment"> <p>Instead of looking at incidence of cancers and deaths, how about looking at quality of life years lost?<br/> Most fatal breast cancers occur in premenopausal women. These women may have careers, contribute to household income, have children that look up to them.<br/> Another peak in breast cancer occurs in elderly women who are more likely to have higher 5 year survival rates.<br/> Most lung cancers and prostate cancers occur in older individuals. </p> <p><cite>— Posted by Seth </cite></p> </div> </li> <li class="clearfix" id="comment-32125"> <div class="index">14.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32125" title="">1:32 pm</a> </div> <div class="comment"> <p>A few quick points</p> <p>1. You may wish to look at research spending per life year (or quality adjusted life year) lost, given the different prognoses for different types of cancer. </p> <p>2. Additional funding isn’t the only metric: With a condition like lung cancer that has a longer history research, there is a stock of research knowledge that additional dollars contribute less to than they do with conditions that have a shorter history of research.</p> <p>3. It’s also interesting to see where global research (Europe in particular) tallies up. Research efforts are complementary and spill over across borders. </p> <p><cite>— Posted by Rajeev C. </cite></p> </div> </li> <li class="clearfix" id="comment-32128"> <div class="index">15.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32128" title="">1:46 pm</a> </div> <div class="comment"> <p>When my father–a near-lifelong smoker–was diagnosed with lung cancer, he felt it was his “fault.” When I told others of his illness, they immediately asked “Did he smoke?” When I responded in the affirmative, they’d nod and say “Oh…well, what can you do?”</p> <p>I think many see lung cancer as predictable retribution for a smoker’s habit, so it is much less likely to garner sympathy than cancers that seem to strike out of the blue–like breast cancer, or even those lung cancers that afflict non-smokers.</p> <p>Yes, lung cancer is almost entirely preventable. And I thank God that many people will be saved by our society’s shift away from smoking. But for many others, it’s already too late. </p> <p>And, if you’d been there to see my father’s last days, you’d know that no one–lifelong smoker or not–deserves to die like that.</p> <p><strong>From TPP — I agree and get so frustrated at this culture of blame. Smoking is addictive and there have been generations not aware of how deadly it is. One of the most powerful marketing/advertising machines in the history, the tobacco industry, continues to solicit new smokers from the ranks of children and teenagers and less educated people around the world. I think our tendency to blame smokers for their cancer has more to do with our own sense of relief when we can explain something. When we understand the reason someone is sick, that gives us a feeling of control. It’s meaningless random disease — like pancreatic cancer — that scares us so much. But smokers deserve compassion and empathy. Those of us who are not addicted to cigarettes are fortunate — it is a powerful force and my sympathy to those who are caught in its clutches.</strong> </p> <p><cite>— Posted by Carolyn </cite></p> </div> </li> <li class="clearfix" id="comment-32129"> <div class="index">16.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32129" title="">1:47 pm</a> </div> <div class="comment"> <p>The numbers are a bit misleading in the sense that, to some extent, cancer cells don’t know if they are arising in a prostate, a lung, or a breast. The mechanisms of growth, cell cycle control, and signaling overlap. </p> <p>It is a dance and researchers are forced to identify research projects as being related to anatomic regions, e.g., breast or prostate, when they are actually studying mechanisms that might be common to all cancer sites. </p> <p>Fortunately, breakthroughs can have wider use. For example, imatinib has had a real impact on the care both of certain leukemias as well as certain GI tumors.</p> <p><strong><br/> From TPP — Yes, one of the best articles written on the subject was by Jerome Groopman in the New Yorker. It makes the point that the way we study cancer may be misguided, losing the advantage of serendipity. The polio vaccine, antibioitics and even Viagra were all discovered by brilliant scientific accidents. Read his amazing article <a href="https://web.archive.org/web/20080311022551/http://www.jeromegroopman.com/articles/thirty-years-war.html" rel="nofollow">HERE.</a></strong> </p> <p><cite>— Posted by Bruce </cite></p> </div> </li> <li class="clearfix" id="comment-32130"> <div class="index">17.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32130" title="">1:49 pm</a> </div> <div class="comment"> <p>This is what drives me crazy. I know the NCI can’t be expected to fund diabetes research, but diabetes is now responsible for the deaths of over 225,000 Americans per year—and unlike every form of cancer, that number is *rising*. Unfortunately, it’s estimated that for every $100/patient our nation spends researching breast cancer—a disease that, admittedly, takes the lives of roughly 20% of its patients—we spend 1¢/patient researching diabetes—a disease that kills roughly 100%.</p> <p>And no, I’m not a diabetic; I just know and love several of them. </p> <p><cite>— Posted by Jeff </cite></p> </div> </li> <li class="clearfix" id="comment-32131"> <div class="index">18.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32131" title="">1:53 pm</a> </div> <div class="comment"> <p>Rajeev C (#14) is just right. We should spend money to reduce the number of people who get likely-fatal cancers when they’re relatively young. So, breast cancer is important to spend money on, as it often targets women when they’re relatively young. Prostate cancer is not that important to spend money on, since it’s often not malignant, and mostly affects men who will likely die of something else sooner anyway. </p> <p><cite>— Posted by Harlan </cite></p> </div> </li> <li class="clearfix" id="comment-32137"> <div class="index">19.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32137" title="">2:00 pm</a> </div> <div class="comment"> <p>I’m not sure what the supposed disparity is here. Prostate and breast cancer are the most common cancers found and diagnosed by gender. Shouldn’t it make the most sense that resources should be allocated to help the most people?</p> <p>The most common cancers overall are lung and colorectal cancer. 90%+ of the ~150,000 lung cancer is entirely preventable (don’t smoke, and make sure your family members don’t smoke), and colorectal cancer is a very slow-growing, 100% early curable cancer that can be diagnosed and treated by colonoscopy. Why do we need a big surge of funding in these relatively well-understood diseases? </p> <p>Poster #2 re: “My biggest beef with all of this is that very little research funding –for any cancer– goes into studying the environmental causes of cancer.” Like… Tobacco? Air pollution? Alcohol? Epstein-Barr virus? Hepatitis B/D virus? Human Papilloma virus? Frequent CT scans? I’m not sure what environmental factors you’re talking about needs a lot of funding, unless you’re venturing into the fringe category (deodorant, etc.).</p> <p>Poster #1, there is very little to be done about pancreatic cancer because the disease doesn’t become symptomatic until it has already reached a late stage (and usually metastasized). There’s some interesting basic research being done with adenoviruses and related viruses in regards to finding new treatments. Unfortunately there’s no good screening technique available to catch it early (where it could possible receive a surgical cure), and the same goes for lung cancer. There was a clinical trial conducted to use MRIs to screen for lung cancers in asymptomatic smokers, but found no significant benefit in doing so. </p> <p><cite>— Posted by Jason </cite></p> </div> </li> <li class="clearfix" id="comment-32140"> <div class="index">20.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32140" title="">2:08 pm</a> </div> <div class="comment"> <p>The real question is, when faced with the inequality in funding for different cancers, do we as a society simply re-allocate the existing funds (i.e. take away money from breast cancer research and give it to prostate cancer research), or do we advocate and vote for increases in the overall NIH/NCI budget to allow for more funding of cancers that have been traditionally underfunded without cutting back on funding of other cancers. Don’t forget that the reason that there are relatively fewer deaths from breast cancer compared to the number of new cases of breast cancer (compared to the statistics for lung or pancreatic cancer) is exactly because of advances in treatment that could not have occured without significant research funding and long-term commitment from doctors, patients, and advocates. </p> <p><cite>— Posted by Mary </cite></p> </div> </li> <li class="clearfix" id="comment-32141"> <div class="index">21.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32141" title="">2:09 pm</a> </div> <div class="comment"> <p>What about children’s cancers, which are a unique set that are different than adults’ diseases? Every time we cure a 2-year-old, we may have saved them for another 80 or 90 years. </p> <p>I would guess that the $ of research money invested in children’s cancers is much much less than that spent for research into adult tumors. How about prioritizing this vulnerable group, who cannot vote and advocate for themselves? </p> <p><cite>— Posted by J Kandel </cite></p> </div> </li> <li class="clearfix" id="comment-32142"> <div class="index">22.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32142" title="">2:10 pm</a> </div> <div class="comment"> <p>How many of those lung cancer cases are caused by smoking? I’d rather not have my money spent on researching a cure to a disease that people choose to get. </p> <p><cite>— Posted by Matt </cite></p> </div> </li> <li class="clearfix" id="comment-32143"> <div class="index">23.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32143" title="">2:15 pm</a> </div> <div class="comment"> <p>The comparative spending figures are doing just what they were designed to do. Keep us fighting and thinking about side issues and not about what is really wrong with the funding in the first place. In medical care we worry about price and little about results. Under the influence of today’s shamans, we are constantly offered the Promised land, if not today, maybe tommorow. </p> <p>The war on cancer goes back to Nixon’s era. It is and has been a bust. But in this case not even more warriors in the form of another $6 billion will make a valued, safe and sustainable solution, not now and maybe not for a long time.</p> <p>The reasons are not clear to many Americans and often denied. But the sad fact is that should a cure for cancer be found, the US economy would go bust. There would be real survivors and no need to treat them! It is not in the interests of researchers to find a cure. It is in their interest to find something promising, domething that has hope and may possibly be an new avenue to treat cancer. One that will require further research and more funding, but now from a drug company. What is crucial is that the disease, in this case, cancer, will linger on at least until the next big fund raiser.</p> <p>Now is for Americans to take the time to look back and say: “What have we been doing?” “What has what we have been doing done?” “Are we winning this war?” “And if we are why do we not see any tangible, meaningful results?”</p> <p>If the answers are not good, that we really have no gained little ground and have no solutions, we need to do something else. Even smart, healthy and flexible mice in the maze could figure out to look elsewhere when the cheese drop location had been changed. Only the foolish, unhealthy ’stay the course’ mice keep going back to the same spot after the cheese is moved. Sooner or later the ’stay the course’ mice die from starvation.</p> <p>We know that lung and some other cancers are not caused by but only associated with smoking. If this were not true, we should expect all smokers to get cancer and non-smokers to not get cancer. But the common factor is that smoking (and second hand smoke)have the ability to reduce oxygen and reduce the means to bring enough oxygen into the body. In other words, smoking and smoke clog the lungs and the body’s cells cannot get enough oxygen. A lack of oxygen could be a contributing factor in lung and other cancers. In fact, Otto Warburg, M.D. a two time Nobel Laureate came to the conclusion that a lack of oxygen in the human cell was a primary factor in cancer. He did so nearly 100 years ago.</p> <p>Many researchers have arrived at this and other possible causes of cancer but the medical system and economic need for drugs coupled and based on complicated and costly medical care are the predominant view and as the only way to cure cancer. Alternative views that are not part of this matrix are discarded, discounted and discouraged.</p> <p>Could there be natural, less costly and less toxic ways to prevent cancer. </p> <p>As Niels Bohr, another Nobel Laureate said, “No! No! You are just being logical. You are NOT thinking.”</p> <p>So Americans must start thinking about what $6 billion in independent non-medical research could discover? Would it be possibly yield any less than the current 100 year war? </p> <p><cite>— Posted by healthinfo </cite></p> </div> </li> <li class="clearfix" id="comment-32144"> <div class="index">24.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32144" title="">2:15 pm</a> </div> <div class="comment"> <p>Tara,</p> <p>While I see your point and agree we should be empathetic towards those who have lung cancer, most of the time smoking is the cause. In essence what you are asking the funding to go to is a type of cancer that is at a higher incidence because people make poor life choices. If you take away the number of cigarette associated cases of lung cancer then the number drops and you can see why that form would get less funding. I think our attention should be turned towards fighting tobacco industries that profit from the deaths of others. This being the case, the final decision does come down to the person, and choosing to smoke, even though addictive, is still a wildly poor decision even short term and they are simply choosing to continue that despite other avenues. As a scientist I agree with the way the money is being partitioned. And at the very base if fund lung cancer more, we are simply trying to play catch up with tobacco companies and trying to put a bandaid on an effect. I feel the most direct approach to limiting the devastation of lung cancer is to attack the source, which is of course tobacco and marketing.<br/> <strong><br/> From TPP — One important point is the fact that the entity that makes the most money off of cigarette smoking is not the tobacco company, the farmer, the retailer or the marketing or advertising industry. It is the federal government. There is a built in financial disincentive against getting serious about stop-smoking efforts. It only seems right that 100% of the money generated by smoking should go toward prevention and treatment of lung cancer, but it doesn’t. The reality is that many of us are sustained by the smoking economy, whether we smoke or not.</strong> </p> <p><cite>— Posted by Interesting </cite></p> </div> </li> <li class="clearfix" id="comment-32147"> <div class="index">25.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32147" title="">2:24 pm</a> </div> <div class="comment"> <p>As a doctor, I would just like to remind everyone that the #1 cure for lung cancer is simply not smoking. 90-95% of lung cancers are caused by smoking and all-cancer mortality would be reduced 50% by not smoking. Billions can be spent on lung cancer drug development and it will only lead to a 3-4 month added survival. I would like to see the non-smokers get back the health insurance dollars being used on smokers through a $4/pack health insurance tax. The extra cost would reduce smoking through economic reasons and the revenue would pay for care of currently uninsured without having to raise taxes elsewhere. I don’t see any politician spouting this simple advice. </p> <p><cite>— Posted by Dave </cite></p> </div> </li> <li class="clearfix" id="comment-32148"> <div class="index">26.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32148" title="">2:26 pm</a> </div> <div class="comment"> <p>I am a 47-year-old woman with advanced lung cancer. I have never smoked and I have never lived or worked around cigarette smoke. Therefore, it seems likely that something else–like radon, perhaps–caused my cancer. </p> <p>My heart goes out to anyone with this disease, regardless of their smoking history. I feel the stigma, too. People ALWAYS ask me about my smoking history when they learn of my diagnosis. </p> <p>New cancer stats may be going down, but the numbers of younger, never-smokers with lung cancer are going up.</p> <p>I’m sorry, but I just feel heartsick about how lopsided the attention to breast cancer is (and I do have good friends coping with breast cancer). My life should be a bit more than half over, but instead my chances of surviving 5 years are in the single digits. My children are still young and my life and career are still in their prime. What sense is there in this?! Many, many more women will die of lung cancer than breast cancer, but it’s treated like some kind of a dirty secret. </p> <p><cite>— Posted by Leslie </cite></p> </div> </li> <li class="clearfix" id="comment-32150"> <div class="index">27.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32150" title="">2:29 pm</a> </div> <div class="comment"> <p>Jason, I’ll quote my mother’s oncologist–when she asked him how on earth she had contraced a rare bone cancer, he told her, ‘by living in a chemical world.’ The only known cause of bone cancer is benzene, a chemical which since the 50s has become widely used in the production of thousands of everyday products. In the US alone, there are over 100,000 known and designated sites of benzene soil or groundwater contamination. If you’re lucky, they’re all in fringe areas that aren’t near you. In my case, my mother, my friend’s 37 year old spouse, and another friend’s 28 year old sister all died of this same rare bone cancer within an 18 month period. They all lived within a few miles of each other. </p> <p>A town near where I used to live– emphasis on the used to– had so many cases of breast cancer occuring in young women that two of the schools requested and received funding for special counselors for children whose mothers were ill or were dying. Oddly (not really, it was a prosperous town where a lot of wealth was linked to property value), there was nothing about it in the papers. I learned all this from a neighbor who was a doctor who was treating an unusually high number of cases.</p> <p>You might want to read Sandra Steingraber’s excellent “Living Downstream” to understand what I’m talking about. </p> <p><cite>— Posted by francois </cite></p> </div> </li> <li class="clearfix" id="comment-32152"> <div class="index">28.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32152" title="">2:34 pm</a> </div> <div class="comment"> <p>These figures don’t appear to be adjusted for the effects of health care distribution in this country. Among the uninsured, surely, cancer death rates must be higher, particularly from breast and colon cancers, for which insured people have regular access to preventive screening and early treatment. </p> <p>You have to assume that some patients had no access, let alone equal access, to the treatments that research developed, so the numbers are utterly meaningless. There’s nothing of substance here. If you break them out between patients who died because the treatments were ineffective and patients who died because they were treated too late in the disease — or not treated — then maybe you can draw some conclusions. </p> <p><cite>— Posted by Marce </cite></p> </div> </li> <li class="clearfix" id="comment-32156"> <div class="index">29.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32156" title="">2:43 pm</a> </div> <div class="comment"> <p>It looks to me like we spend WAY too much on cancer research. Look at a bigger killer — malaria. In 2004, malaria killed 1.2 million people; there were 300-500 million new cases. Total funding for malaria research was $323 million. Which works out to $269 per death, and about $0.81 per new case. </p> <p>(Stats from <a href="https://web.archive.org/web/20080311022551/http://www.malariaalliance.org/PDFs/RD_Report_complete.pdf" rel="nofollow">http://www.malariaalliance.org/PDFs/RD_Report_complete. pdf</a> ) </p> <p><cite>— Posted by Suzanne </cite></p> </div> </li> <li class="clearfix" id="comment-32157"> <div class="index">30.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32157" title="">2:46 pm</a> </div> <div class="comment"> <p>One could argue that the social and economic effects of breast cancer are greater than prostate cancer, despite the fact that more men get prostate than women breast cancer. Prostate cancer is uncommon in men less than 45, but becomes more common as men age. The average age at the time of diagnosis is 70. However, many men never know they have prostate cancer. Autopsy studies of men who died of other causes have found prostate cancer in thirty percent of men in their 50s, and in eighty percent of men in their 70s. There are about 30,000 deaths a year from prostate cancer, with the great majority of those being in the elderly.</p> <p>The biggest risk factor for prostate cancer is age. Which is to say that since we’re living longer we’re seeing a lot more of it. Many times prostate cancer is left untreated because the patient is so elderly and the cancer is growing so slowly that they are likely to die of something else first.</p> <p>Contrast that with breast cancer. Breast cancer is much more aggressive and it is likely to occur at a much younger age than prostate cancer. Breast cancer’s impact on women in the prime child rearing and wage earning years is much larger than prostate cancer is on men. The following statistics from the American Cancer Society illustrate this very well. </p> <p>Breast cancer incidence by age.</p> <p> * Birth to age 39: 1 in 228<br/> * Age 40 to 59: 1 in 24<br/> * Age 60 to 79: 1 in 14</p> <p>Prostate cancer incidence by age.</p> <p> * Birth to age 39: 1 in 19,299<br/> * Age 40 to 59: 1 in 45<br/> * Age 60 to 79: 1 in 7</p> <p>About 40,000 people (men and women) die from breast cancer a year in the US. About 30,000 men a year die from prostate cancer. Considering the greater social and economic impact of breast cancer, a 1.8 to 1 difference in federal research funding doesn’t seem entirely lopsided.</p> <p>Looking at the number of deaths, not just incidents of the diseases, if the purpose of medical research and care is to extend lives, it seems reasonable to spend significantly more on breast cancer than prostate cancer, which kills more people at younger ages.</p> <p>For most of the world’s population the impact of breast cancer is much greater than prostate cancer due to lower life expectancies. Men rarely live long to be affected by prostate cancer, but women are dying in their prime from breast cancer.</p> <p><strong>From TPP — I haven’t checked your stats but I’m assuming they are accurate. The problem is that prostate cancer has enormously high morbidity. How do you factor that in? Men are overdiagnosed and overtreated, leaving them impotent and incontinent as a result of treatment for a cancer that likely wouldn’t have killed most of them. The priority in prostate cancer needs to be finding a more reliable way to separate the risky cases from the slow cases and doing adequate research to determine which of the many treatment options are really the best. right now, it’s all being decided by surgeons and device companies who think their way is the best way, when there is no data to support that any one treatment is superior.</strong> </p> <p><cite>— Posted by John Knez </cite></p> </div> </li> <li class="clearfix" id="comment-32158"> <div class="index">31.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32158" title="">2:47 pm</a> </div> <div class="comment"> <p>My wife died of lung cancer two weeks ago. She was diagnosed in June 2007. Her treatment was pretty much useless. My uncle died of the same type of lung cancer in July 1969. His treatment and lifespan was pretty much the same as my wife’s.</p> <p>This is a disgrace. I just don’t believe that we could not find at least some regimen of drugs and other treatments that could stop the progression of cancer.</p> <p>All the money our government spends each year, all the money spent privately, spent by other governments and we can’t find a stop/cure for cancer??? Clearly, either the market system does not work or we just don’t value human life</p> <p><strong>from TPP — I’m so sorry for your loss. thanks for taking the time to comment and add to the discussion.</strong> </p> <p><cite>— Posted by rick g </cite></p> </div> </li> <li class="clearfix" id="comment-32159"> <div class="index">32.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32159" title="">2:47 pm</a> </div> <div class="comment"> <p>Breaking it down to cost per cancer, or even cost per death per cancer seems misleading. What research does is fill information gaps, so the real question should be this: </p> <p><i>What channel will provide us with more new and valuable information per dollar spent?</i></p> <p>It appears that we’ve researched lung cancer into the ground: we know how the vast majority of cases are caused (and therefore how to prevent or reduce that vast majority of cases); we know what it looks like from the very early stages to the very end stages; we know how it progresses; and we know the rates of success of several different treatment routes. </p> <p>Breast cancer, ovarian cancer, pancreatic cancer and other deadly cancers are sneakier. We have less data on the causes, progression and so forth. Additionally, cancers like breast and ovarian that occur in sexually charged areas of the body have the added variables of hormones- chemicals that seem to throw us off every time we think we know something. I would bet that we have substantially more to learn- about a specific cancer, cancer in general, and other information about our bodies- from studying what we know less about.</p> <p>Oh, and quit smoking, everyone- please. Those death numbers don’t have to be that high. </p> <p><cite>— Posted by Christina </cite></p> </div> </li> <li class="clearfix" id="comment-32160"> <div class="index">33.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32160" title="">2:49 pm</a> </div> <div class="comment"> <p>This seems like a bad way to evaluate research spending. What ought to matter most is cost vs. benefit. </p> <p>We need to ask the question, would increasing lung cancer research lead to fewer deaths (or better yet morbidity) as compared to other cancers?</p> <p>While the spending per death is high in the case of prostate cancer research, if there are many promising treatments that a appearing, then increasing spending would be appropriate. </p> <p> Lung cancer has a lower spending per death, but very high spending overall. If research for better lung cancer treatments isn’t producing results and there isn’t much hope on the horizon, then it would be completely appropriate to decrease spending.</p> <p>Just to be clear, I’m not advocating either of these positions, I’m just using them as examples. </p> <p><cite>— Posted by Brian Perkins </cite></p> </div> </li> <li class="clearfix" id="comment-32161"> <div class="index">34.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32161" title="">2:51 pm</a> </div> <div class="comment"> <p>Isn’t it time to re-open a world-wide debate on the fight against cancer? I recognise the advances that have taken place but there’s a question that people seem afraid to voice - haven’t the scientists let us down in view of the huge resources that have been devoted to the research? The basic cancer process - uncontrolled multiplication of cells - is the same for all cancers. We have had brilliant advances in biochemistry and understanding of DNA - so why have we not got further with cancer? And why is the scientific effort against cancer not a more prominent feature of government health programs? </p> <p><cite>— Posted by Jon </cite></p> </div> </li> <li class="clearfix" id="comment-32162"> <div class="index">35.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32162" title="">2:52 pm</a> </div> <div class="comment"> <p>I would like to add on to what Bruce said earlier about imatinib. My mother has suffered from a rare form of cancer called GIST that doctors wouldn’t even check for because there wasn’t a cure. Because of research on more common types of cancer there was the invention of Gleevec, which added 5 years to my Mom’s life. Most people will never hear of GIST or care about fundraising for it, but I’m ok with that because I know that one thing can help another and a cure for any type of cancer is a step in the right direction. </p> <p><cite>— Posted by Mia </cite></p> </div> </li> <li class="clearfix" id="comment-32164"> <div class="index">36.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32164" title="">2:57 pm</a> </div> <div class="comment"> <p>My mother passed away about 35 years ago from cancer of the pancrease at the age of 66. To my knowledge it is still incurable. However, my husband has just gone into remission from bone cancer which resulted from prostate cancer removed 12 years ago. </p> <p>A lot more is know on some cancers through many different research efforts; however, I agreed that you can not apportion the same amount of money for research for each type of cancer. It is much more complex and concers variables such as thge number of cases and probability of success of treatment.</p> <p>I feel that I must leave the budget an research decision to the helath experts, etc. I am a retired cost accountant and do not feel that I do not have significant knowledge on the subject of caner, even though it has touched various members of my family.</p> <p>Carol G </p> <p><cite>— Posted by Carol G </cite></p> </div> </li> <li class="clearfix" id="comment-32165"> <div class="index">37.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32165" title="">2:59 pm</a> </div> <div class="comment"> <p>$6 billion a year for cancer research? — just 2 weeks of an Iraq war that has gone on for years. How many Americans really have died because of this reckless adventure. </p> <p><cite>— Posted by C. N. </cite></p> </div> </li> <li class="clearfix" id="comment-32167"> <div class="index">38.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32167" title="">3:02 pm</a> </div> <div class="comment"> <p>I wanted to thank Tara for her very insightful comments, especially those regarding cigarette smoking in our society. I also wanted to address a couple of other comments. The person who said that a scientist wouldn’t want to find a cure but would rather find a potential cure is being illogical. Most scientists don’t make a lot of money and having a patent on a cure and potentially winning a Nobel prize represents a lot more security than having just another promising avenue of investigation. And the comment regarding pancreatic cancer typically being caught in later stages after having metastasized would seem to indicate that we should be working on metastatic cancers as opposed to throwing our hands in the air and saying this or that can’t be done (yes, dogma is a big enemy). Lastly, I’m not sure that all the money that has gone into breast cancer research is responsible for the decrease in breast cancer-related deaths as numerous people have suggested. From anecdotal evidence it appears that, along with some subsequent prophylactic therapy, lopping off the affected area or entire breast is still the primary treatment - a surgical procedure one can imagine “even a caveman” doing - and that increased awareness leading to increased self-examination and subsequent early evaluation and biopsy is possibly the predominant reason for the decrease in mortality, as opposed to the increased research dollars which have been spent. </p> <p><cite>— Posted by GaryB </cite></p> </div> </li> <li class="clearfix" id="comment-32169"> <div class="index">39.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32169" title="">3:12 pm</a> </div> <div class="comment"> <p>Smoking is not only linked to the vast majority of lung cancers, but it is also HIGHLY linked to increased risks of bladder, esophageal, stomach, mouth, and pancreatic cancer. TPP makes several good points about the addictive aspects of cigarettes and tobacco and what a large impact the tobacco industry as a whole plays in the American economy. However, I think it’s practically impossible to really resolve this issue right now. Not to mention that strange belligerence some doctors still encounter when they approach patients about smoking, who see it as a severe encroachment on their individual rights. These are sometimes the same patients who will continue to smoke through their chemotherapy for lung cancer with no desire to quit with all the best medical help they could have. Addressing this paradox, rather particular to America, is a real challenge in cancer prevention and treatment. </p> <p><cite>— Posted by Melinda </cite></p> </div> </li> <li class="clearfix" id="comment-32170"> <div class="index">40.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32170" title="">3:15 pm</a> </div> <div class="comment"> <p>The analysis has no meaning. Cost per death or per case do not determine the cost to find a drug which is depend on the genetic nature of disease and difficulty for the solution. The intention of this blog is to write something without knowing anything. </p> <p><cite>— Posted by KMN </cite></p> </div> </li> <li class="clearfix" id="comment-32172"> <div class="index">41.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32172" title="">3:23 pm</a> </div> <div class="comment"> <p>NCI’s budget was about $4.8 billion in 2006 - where is the $6 billion dollar figure from?</p> <p><strong><br/> From TPP : From the current budget plan. There is only about $5 billion in new money but there are some other funds that bring the total to $6 billion. Click <a href="https://web.archive.org/web/20080311022551/http://plan.cancer.gov/" rel="nofollow">HERE.</a></strong> </p> <p><cite>— Posted by Mary </cite></p> </div> </li> <li class="clearfix" id="comment-32175"> <div class="index">42.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32175" title="">3:28 pm</a> </div> <div class="comment"> <p>There is a stigma attached to all cancer and the worst one is lung cancer. You are blamed for causing it if you are diagnosed with cancer and especially lung cancer. So why should anyone try to help you? You caused it by smoking the demon cigarette. The same applies to COPD. You get no sympathy. It is a real shame sine all of the major illnesses are self induced, ie, heart disease. </p> <p><cite>— Posted by Edna Byars </cite></p> </div> </li> <li class="clearfix" id="comment-32178"> <div class="index">43.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32178" title="">3:42 pm</a> </div> <div class="comment"> <p>You have forgotten to list stomach cancer in these statistics. In North America, in contrast to Japan where they screen for it regularly, stomach cancer is caught at stage 3 or 4 at which point it is often too late to do anything about it. Stomach cancer ranks in the top 5 killers of cancer and yet most people will have never thought that they could have stomach cancer. Currently, the only drugs and drug cocktails that are in the pipeline for stomach cancer are practically afterthoughts. Whatever works with colon cancer is tried in stomach cancer. They need more money for clinical trials testing the efficacy of drugs in different cancers, instead of waiting 10 years once one drug has been found to be effective before trying it against another cancer. </p> <p><cite>— Posted by MM </cite></p> </div> </li> <li class="clearfix" id="comment-32180"> <div class="index">44.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32180" title="">3:50 pm</a> </div> <div class="comment"> <p>It is not necessarily true that targeted research is more likely to product results than is research intended to follow up leads without specifying the tumor location. What is dismaying is the news that only about 12% of research proposals are being awarded because of a shortage of funds. It is also not at all clear that the tendency of the NIH to support large and very expensive projects is going to have a greater impact than supporting more small investigator-initiated projects. Cancer research is still a field where one never knows which lines of investigation will turn out to be useful and which will not. </p> <p><cite>— Posted by David </cite></p> </div> </li> <li class="clearfix" id="comment-32181"> <div class="index">45.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32181" title="">3:50 pm</a> </div> <div class="comment"> <p>I am a Professor doing cancer research; specifically, breast cancer research. Because of the governments recent cuts, I have laid off both graduate students in mid-training and physician fellows who were doing research that (I think) was very important in finding treatments and cures. I am not whining. But it is very frustrating that in all of the discussion of this topic, and the discussions about government spending in the media generally, no one is mentioning that current congressional and administrative policies are choking american cancer research and slowly starving it to death. As post 37 notes above, we spend two weeks of Iraq war expenditures on cancer research, and that amount has been slowly shrinking for the last few years as inflation eats it up. The media evidently finds this a boring topic, and would rather focus on fights over who should get most, breast, lung, or prostate cancer researchers. As american cancer research is gradually dismantled by government neglect, the science media and science journalism will need to be held accountable; since I doubt any of the concerned lay people writing these posts know just how bad it is. </p> <p><cite>— Posted by RJ </cite></p> </div> </li> <li class="clearfix" id="comment-32182"> <div class="index">46.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32182" title="">3:51 pm</a> </div> <div class="comment"> <p>TPP: Your response to comment #15 describes pancreatic cancer as a “meaningless, random disease,” while in fact, more than 30% are ascribable to smoking and 15% are due to inherited genetic predisposition. People at high risk of pancreatic cancer by genetics or family history enhance their risk markedly by smoking.</p> <p><strong>From TPP — I hope it was clear that I wasn’t calling pancreatic cancer meaningless — my point was that it often strikes at random and we can’t make sense of it. but yes, i realize that there is an interaction with smoking.</strong> </p> <p><cite>— Posted by Jason K </cite></p> </div> </li> <li class="clearfix" id="comment-32185"> <div class="index">47.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32185" title="">4:03 pm</a> </div> <div class="comment"> <p>I am a 68 year old male who has recently been thru 2 occurances on lung cancer. Yes, I smoked for years.Isn’t it easy for others to point fingers and assing blame.I have had surgery, cyber knife radiation and chemo. I have come out of a 3 hour radiation session and seen women with breast cancer offered free massag, facial , make up redo.I was told it was for female breast cancer patients only.I also believe that there will never be a cure for cancer . There are way too many $$$$$ involved in treatment. </p> <p><cite>— Posted by Phil A </cite></p> </div> </li> <li class="clearfix" id="comment-32190"> <div class="index">48.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32190" title="">4:26 pm</a> </div> <div class="comment"> <p>My adult daughter has been battling malignant brain cancer for the past five years. She is alive today because of a chemo drug that was developed six years ago specifically for brain tumors and another that was developed four years ago for colon cancer. What are the funding statistics for brain cancer research? </p> <p><cite>— Posted by George Millington </cite></p> </div> </li> <li class="clearfix" id="comment-32191"> <div class="index">49.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32191" title="">4:27 pm</a> </div> <div class="comment"> <p>Don’t forget, Doctors used to prescribe smoking to their patients! So yeah, maybe MY generation should be blamed for their lung cancer, but certainly not my 74 year old grandfather. </p> <p><cite>— Posted by ADSS </cite></p> </div> </li> <li class="clearfix" id="comment-32192"> <div class="index">50.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32192" title="">4:27 pm</a> </div> <div class="comment"> <p>What about stomach cancer? Like pancreatic cancer, the symptoms don’t show until it is too late. Stomach is a world killer, but since it’s not high in the states, research is limited here. </p> <p><cite>— Posted by jl </cite></p> </div> </li> <li class="clearfix" id="comment-32193"> <div class="index">51.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32193" title="">4:27 pm</a> </div> <div class="comment"> <p>Scientific research isn’t just about priorities; it’s about possibilities. True isolated discoveries are both rare and unpredictable. Most discoveries result from research built on previous discoveries. We may all agree that cancer 1 has a “higher priority” than cancer 5. But we have the string for cancer 5 in hand; we haven’t found the string for #1, yet. So, some of the resources are spent in the search for the #1 string, but we pour the bulk of our resources into #5.</p> <p>Even priorities aren’t simple to determine. First, we’d have to all agree on a priority hierarchy. What does “higher priority” mean? It kills more people? It afflicts more? It’s unique among cancers? It is representative of a large number of cancers? It afflicts primarily children?</p> <p>Second, other factors play. Some of the reasons breast cancer is of more immediate research interest than prostate cancer are 1) prostate cancer can be diagnosed more reliably and caught sooner. When caught early, successful treatment is more likely with prostate than breast cancer.2) Post-treatment prognosis is, on average, 10 years(and improving) for prostate cancer, but only 5 for breast cancer. 3) Prostate cancer usually grows slowly, breast cancer is more aggressive. 4) Prostate cancer is less recurring than breast cancer.</p> <p>The reason lung cancer gets such a small proportion of research dollars is partly because the research has already been done. It was the first cancer we went after. The course and treatments for the disease are well known. The main cause — and the main prevention — is also known. The best way to proceed is to study a different cancer, and compare. Each datum adds to the knowledge base of all cancers, and leads to better answers for all. </p> <p>These are but some of the questions to juggle — and we haven’t yet added other diseases or other causes of death. (The single largest cause of death on earth is poverty.)</p> <p>I’m sure there are political and other factors that feed in as well, and it is easy and understandable to be cynical about them. But they are more easily identified and overcome. </p> <p>Of course, the “highest priority” is the cancer or disease that I or mine have. So we circle back tot he beginning.</p> <p>No cancer is good. No disease is good. And every death is tragic.</p> <p>My thoughts are with Mr. Swayze and all the others struggling with these issues. </p> <p><cite>— Posted by Carol </cite></p> </div> </li> <li class="clearfix" id="comment-32194"> <div class="index">52.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32194" title="">4:32 pm</a> </div> <div class="comment"> <p>The squeaky wheel gets the grease. While there may be some truth to the idea that the breast is intimately connected with how we identity femininity and caregiving, one could argue that these ideas are as connected with whole women as much as they are with a breast. The movement to encourage federal support for breast cancer research that began in the early 90s is one of the most often cited examples of grass roots advocacy.</p> <p>Given the way diseases that primarily affect women are treated within our society as a whole and the medical community specifically (a hundred years ago, Chronic pain or fatigue dis orders were nothing more than female hysteria… in the year 2008.. chronic pain or fatigue disorders [fibromyalgia and RSD].. are nothing more than female hysteria), I think the simplest answer.. that women are louder and better organized due to a common identity as an oppressed minorty.. is probably the most suited. </p> <p><cite>— Posted by jaye </cite></p> </div> </li> <li class="clearfix" id="comment-32196"> <div class="index">53.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32196" title="">4:34 pm</a> </div> <div class="comment"> <p>As someone who as actually done cancer research, I’d just like to say that cancer is an extremely complex disease. </p> <p>It’s not just about economics - I think the public is generally misinformed about just how long it takes to make glacial progress in basic science research. Once the mechanisms of the cancer are understood, you’re then faced with the complicated issue of how to treat something that the body does not recognize as “non-self,” which is why so many cancer therapies are so unpleasant.</p> <p>Believe me, plenty of scientists and clinicians want there to be a cure for cancer. But it is an extremely difficult problem, sometimes multigenic, and definitely influenced by environment and lifestyles. Also, we are living longer lives, which means that we are simply going to see more cancers because we accumulate that many more genetic insults with the extra years of life.</p> <p>I wish we would spend more time and effort on the environmental influences, that would surely help decrease the incidence and possibly the mortality rates with some of these cancers. But it’s easier to blame the researchers, clinicians and drug companies for not fixing all our problems… </p> <p><cite>— Posted by tt </cite></p> </div> </li> <li class="clearfix" id="comment-32199"> <div class="index">54.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32199" title="">4:35 pm</a> </div> <div class="comment"> <p>The National Cancer Institute is now able to fund less than 9% of all research applications it receives, whereas before the Iraq War and the Republican tax cut, it was able to fund about 30%. Some important proposals that have been denied money recently include studies of tamoxifen in women at risk for recurrent breast cancer, acute leukemia in children, links between obesity and lymphoma, prostate cancer incidence, genetic instability in cervical cancer, mechanisms of melanoma and genetic profiling studies of colon cancer.</p> <p>With the cost of the President’s ego project in Iraq now topping $2 trillion, to worry about differences in the tiny amounts of Federal funds allocated for breast vs. lung cancer is completely absurd. </p> <p>I doubt the President is bright enough to have included in his war calculations the hidden costs to the nation of completely undermining the cancer research effort. Or even worried about the costs to his own family were breast cancer to be diagnosed in his wife or mother, and his mangling of our ability to find new cures. </p> <p><cite>— Posted by Gerald V Denis PhD </cite></p> </div> </li> <li class="clearfix" id="comment-32201"> <div class="index">55.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32201" title="">4:39 pm</a> </div> <div class="comment"> <p>I am a 7 year survivor of peritoneal mesothelioma.The mean survival rate is 18 months. The only known cause of mesothelioma is asbestos exposure and as I write this congress is having yet another hearing defending why asbestos is still not banned in the US. The reason is obvious - there are powerful industrial lobbys working against a ban.<br/> I am a statistical anomaly with an orphan disease; fewer than 8,000 people in the US are diagnosed with mesothelioma annually. Federal research funds are, perhaps understandably, paltry. But there is one thing that can be done, Ban Asbestos Now. </p> <p><cite>— Posted by MBB </cite></p> </div> </li> <li class="clearfix" id="comment-32204"> <div class="index">56.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32204" title="">4:40 pm</a> </div> <div class="comment"> <p>50 years ago, doctors prescribed cigarettes for pregnant women to “calm them down”. Advertising used to highlight the “health benefits” of tobacco. The U.S. Government used to put cigarettes in solider’s rations. (I remember people smoking on airplanes in the 1980’s - not too smart to allow something on fire in close proximity to hundreds of gallons of gasoline…)</p> <p>A lot has changed since then, because of money allocated to tobacco research. Maybe not intense, scientific lab research trying to find a cure, but long-term epidemiological population studies determining the definitive link between cigarettes and lung cancer. Even after we knew of that link, more research was needed to show the cancer risk of second-hand smoke. </p> <p>20 years ago, it seemed insane that a virus could cause cancer (HPV & Cervical cancer), or that a bacteria could cause ulcers (H. Pylori and stomach ulcers). Medicine and science continually change, and that is why we still need funding of “well-understood” diseases, especially if they are still deadly. </p> <p><cite>— Posted by DVN </cite></p> </div> </li> <li class="clearfix" id="comment-32208"> <div class="index">57.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32208" title="">4:47 pm</a> </div> <div class="comment"> <p>Other factors you must realize in looking at Research (both basic and clinical) spending are:</p> <p> (1) a snapshot in time can be misleading: in the case of breast cancer for example, we are at the point where finally great success in treatment has been attained (not good enough I know, but compared to when I started in the seventies, remarkable), At such a point the numbers of deaths (hopefully) drops significantly, so the ratio of research dollars to deaths suddenly increases.</p> <p> (2) With lung cancer of course, the majority (but not exclusivity) of disease is preventable by known means. Perhaps a better measure in such a case is the ratio of $ per non-preventable deaths (meaning no history of smoking), which in this case would increase spending per death by a factor of greater than 4.</p> <p> Other have submitted equally useful warnings on the limitations of the measure you write about. </p> <p><cite>— Posted by Ken </cite></p> </div> </li> <li class="clearfix" id="comment-32210"> <div class="index">58.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32210" title="">4:52 pm</a> </div> <div class="comment"> <p>I used to work in the technology policy field–the common wisdom then was that many types of cancer were too hard for lawmakers to understand. (Don’t smirk–ask five random people where their pancreas is, then ask them where their colon is–I bet you’d be surprised how few know).</p> <p>Prostate cancer, however, is something that our (almost entirely male) lawmakers know very well. </p> <p>So if you wanted to “sell” an idea for new funding which cancer would you use?</p> <p>Staying on the cynical (realistic?) level we need to look again at the numbers–is it really so easy to separate out research for one kind of cancer vs. another? I’m no researcher but I suspect that those numbers will get muddier the more you zoom in.</p> <p>Perhaps some of the difference in funding numbers represents a legalistic distinction rather than a research distinction. </p> <p><cite>— Posted by Darin </cite></p> </div> </li> <li class="clearfix" id="comment-32211"> <div class="index">59.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32211" title="">4:52 pm</a> </div> <div class="comment"> <p>Admittedly cost vs. benefit is one way of allocating funding, but it completely misses the simple fact that an advance in the understanding/treatment in one form of cancer may have applicablity to many other forms of cancer. Chemotherapy research initially focused on lymphoma/leukemia. Now, it is a widely used treatment for cancer.</p> <p>Yesterday, I was diagnosed with a form of leukemia that strikes ~7000 people every year. How much money should be spent on research for my cancer? </p> <p><cite>— Posted by David </cite></p> </div> </li> <li class="clearfix" id="comment-32212"> <div class="index">60.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32212" title="">4:53 pm</a> </div> <div class="comment"> <p>Speaking as a cancer researcer,</p> <p> The reason it may seem that it billions are being spent, and no real progress has been made is because cancer is a very deep seated problem. Cancer is a proliferation of your “own” cells that has gone awry, and it is very difficult for your body or doctors who would like to design drug therapies to detect the difference between your cells and the cancer cells. Great inroads have been made in understanding how cancer works, and those billions were very well spent here and were absolutely necessary to get the the point we are now in our understanding. But therapies using current techniques are a way off.<br/> I want to also make an point here. It is also very possible that using the current techniques, cancer drug therapy for MOST cancers will NEVER be accomplished effectively, although we know for some types of cancer there are effective therapies. This is because increasing our knowledge about how cancer works may not improve our ability to fight (all) cancers. This is partly because cancers cells and normal cells may be impossible to separate biochemically in a way that allows us to completely kill one without the other. If we compare for example the rust in your car. We can spend billions to understand better the chemical process of how rust occurs. This information may be very useful to prevent rust, or perhaps there is a simple kind of light rusting we can treat with a chemical and get rid of. But no matter how much knowledge we gain, at the end of the day, if a part in our car breaks, it just needs to be taken out and replaced, and no “chemical”/drug treatement we apply will, or is ever, going to have any appreciable affect at fixing the broken car.<br/> There is a light at the end of the tunnel, I believe. Nearly ALL cancer cells, even benign tumors, are quite easily able to be distinguished by their size and shape from normal ones under a light microscope. It is very feasible that if small enough robotic devices could be built that roam the body safely, then it would actually be fairly simply to program them to distinguish between cancer cells and normal cells, and then kill off the cancer cells. There is another possibility also and that is if imaging technologies (which we should be spending some of these billions and getting the best mathematicians and physicist to be working on this) could achieve imaging resolution where single cancer cells can be distinguished from normal cells deep within the body, then highly focused (diffraction limited) radiation could pick off single cancer cells one at a time. It would take killing about 5,000,000 cells/second to cure a kilogram sized tumor is a few days. Currently the resolution for our best deep imaging technologies is too low (100-1000 micrometers), and we would need 0.1-1 micrometer resolution for this to be effective.<br/> I think one of these last two methods are the only real hope to cure ALL cancers. Their development will also be essential if stem cells are to ever get off the ground, because it is likely that successful stem cell therapies will also have the unfortunate side effect of producing or promoting the possibility for new cancers to develop. </p> <p><cite>— Posted by Tim </cite></p> </div> </li> <li class="clearfix" id="comment-32213"> <div class="index">61.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32213" title="">4:55 pm</a> </div> <div class="comment"> <p>I recently lost my 36 year old son to bone marrow cancer. It was extremey painful 6 month journey and his chemo meds cost $6,758.91 for a 21 day cycle. How can anyone afford to survive if they don’t have insurance? And even if they do, the co-payment is $2,000! This country needs to get their priorities straight and reallocate money in the budget of the “wealthiest country in the world” to concentrate on finding cures for cancer and assuring health insurance for everyone. </p> <p><cite>— Posted by KE </cite></p> </div> </li> <li class="clearfix" id="comment-32214"> <div class="index">62.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32214" title="">4:59 pm</a> </div> <div class="comment"> <p>(re #35) I am also a GIST patient who has benefited greatly from imatinib therapy. I was 37 with 3 children under 10 when the words “advanced metastatic cancer” changed my world. I am soon to be 40 with no evidence of disease on my last ct. That said, the odds of developing resistance soon are quite high. I, and others like me, depend on continued research and clinical trials as we face the threat of progression with each ct scan. Unfortunately, when cancer funding is cut, it is most often the research that focuses on obscure cancers. GIST patients benefited from CML research and now renal cell carcinoma patients are taking the second line GIST drug. That alone should tell us that progress can be made with continued funding for even the rarest of cancers. </p> <p><cite>— Posted by Angie </cite></p> </div> </li> <li class="clearfix" id="comment-32215"> <div class="index">63.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32215" title="">4:59 pm</a> </div> <div class="comment"> <p>While I was hospitalized for my prostate cancer surgery, my roommate was a young man, just 20 years old, with advanced testicular cancer. That’s where I’d spend the money. </p> <p>Help the children, help the young people. </p> <p><cite>— Posted by Vincente </cite></p> </div> </li> <li class="clearfix" id="comment-32216"> <div class="index">64.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32216" title="">4:59 pm</a> </div> <div class="comment"> <p>Can I bring up another scary point that not many people know about? Do you realize that Oncologists are slowly being squeezed dry in terms of the compensation from Medicare they get from giving chemotherapy to cancer patients? Very soon, oncologists will be so poorly reimbursed for the chemo they give in their officies that they will no longer be able to do it. They will be forced to send EVERYONE to be admitted to the hospital just to receive chemo. Worse, they may stop accepting Medicare altogether.</p> <p>We can debate about funding for research for each of the different types of cancer all we want, but at the end of the day, if there aren’t oncologists around to treat your cancer with drugs that come from research dollars, we will all suffer. BTW the american society of clinical oncology predicts a deficit of 4,000 oncologists in this country by 2020. Poor reimbursement will be largely to blame for this. </p> <p><cite>— Posted by Oncologist </cite></p> </div> </li> <li class="clearfix" id="comment-32217"> <div class="index">65.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32217" title="">5:00 pm</a> </div> <div class="comment"> <p>Lung Cancer is an ugly disease. My mother who is 55 was diagnosed with it in November of 2006 with Stage IV Non-Small Cell Cancer. Since that time she has undergone 4 lines of various treatments and has just entered hospice as there is nothing else the doctors can do for her. Yes, she was a smoker at one point in her life, but has been a non-smoker for nearly 20 years. I think the real question is, isn’t there a way to develop a screening test? I know that researchers are very close to this, but the fact is that with Lung Cancer by the time it is discovered, it is typically in the late stages of the disease and not much can be done. </p> <p>I agree with Carolyn, no one smoker or not deserves to go through the stages of Lung Cancer. </p> <p><cite>— Posted by Tracy </cite></p> </div> </li> <li class="clearfix" id="comment-32218"> <div class="index">66.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32218" title="">5:01 pm</a> </div> <div class="comment"> <p>The National Cancer Institute spends only $6 billion a year in the war on cancer.<br/> Per ACS 559,650 are expected to die of cancer in 2007, 1,500 per day.<br/> Pancreatic cancer will kill 33,370, nearly all of 37,170 newly diagnosed.<br/> In contrast Taxpayers in the United States will pay $137.6 billion for the cost of the Iraq War in FY 2007, or $500 billion to date. We clearly need to redirect our efforts and funding to save many more American lives, as well as others.<br/> Cancer is a disease that can be beat with enough funding and research. But, first we will need to defeat the disease that has affected our judgement.<br/> <a href="https://web.archive.org/web/20080311022551/http://www.nationalpriorities.org/costofwar_home" rel="nofollow">http://www.nationalpriorities.org/costofwar_home</a> </p> <p><cite>— Posted by Dale </cite></p> </div> </li> <li class="clearfix" id="comment-32219"> <div class="index">67.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32219" title="">5:02 pm</a> </div> <div class="comment"> <p>The real problem with cancer funding is that too little of it is focused on preventing environmental causes of cancer. In the long term, it’s much cheaper to prevent cancer than to focus all our energy on curing people after they get sick. Not to mention the human cost of all that preventable illness. </p> <p><cite>— Posted by Gwen </cite></p> </div> </li> <li class="clearfix" id="comment-32220"> <div class="index">68.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32220" title="">5:05 pm</a> </div> <div class="comment"> <p>I still stay, take a percentage of any money donated for cancer and give it to literacy and job training for potential dropouts, and getting people off drugs so they can get a job, fund their own insurance (if even partly), so we don’t have to pay the full freight for their treatment, that was caused by cigarettes and toxic living, paid for with their welfare money. </p> <p><cite>— Posted by Lisa S. </cite></p> </div> </li> <li class="clearfix" id="comment-32222"> <div class="index">69.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32222" title="">5:09 pm</a> </div> <div class="comment"> <p>Tara, the problem of funding disparities doesn’t just exist in cancer research, it’s a problem that plagues all of biomedical research. Consider autoimmune diseases. For FY 2007 NIH supported $433 million in research into Type I diabetes, $94 milion for research into Multiple Sclerosis and $84 million for research into Lupus. All of these diseases are autoimmune in nature, they all have about the same number of living patients and the morbidity and mortality of the disorders is roughly similar. As in cancer, the major difference in funding results from the relative effectiveness of voluntary health agencies that lobby for funding for each disease.</p> <p>Outside of the pharmaceutical industry, the largest funder of biomedical research is by far the United States government through the National Institutes of Health. Each year, the NIH publishes a list of the amount of money it spends on research into every disease in its portfolio. If people are curious, they can look at the list by following this link: <a href="https://web.archive.org/web/20080311022551/http://www.nih.gov/news/fundingresearchareas.htm" rel="nofollow">http://www.nih.gov/news/fundingresearchareas.htm</a> </p> <p><cite>— Posted by Kay </cite></p> </div> </li> <li class="clearfix" id="comment-32223"> <div class="index">70.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32223" title="">5:11 pm</a> </div> <div class="comment"> <p>To #38, Posted by GaryB</p> <p>1. to remove the mass of the tumor, any tumor, easy or not, is still the most effective treatment, not only reduce death but also other discomfort tumor may cause ;<br/> 2. you have a good point assuming something other than research $ may’ve reduced breast cancer fatality. However, there have been controversial opinions among breast cancer experts on effectiveness of prevention procedures, such as self-examination or even mammography. Education definitely increases people’s awareness so they would take early/better action to seek diagnosis and treatment. </p> <p><cite>— Posted by Peter in OH </cite></p> </div> </li> <li class="clearfix" id="comment-32227"> <div class="index">71.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32227" title="">5:32 pm</a> </div> <div class="comment"> <p>Some knowledgeable researchers have noted that cancer also comes from the oxidative stress of respirating oxygen over time, which is just a component of the atmosphere we breathe. There is an engaging an accessible science book on touching on this topic by the writer Nick Lane, entitled, “Oxygen.” While the human cost is unfathomably tragic, at some level might consider coming a recognition that there is only so much that can be done to treat and prevent. That we should identify and pursue intelligently. </p> <p><cite>— Posted by Alan </cite></p> </div> </li> <li class="clearfix" id="comment-32230"> <div class="index">72.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32230" title="">5:33 pm</a> </div> <div class="comment"> <p>To answer some questions - about 85% of lung cancers are caused by smoking. But to say people “choose” to get the disease is ludicrous. Choosing to smoke does NOT equal choosing to get lung cancer, just like choosing to drives does not equal choosing to die in a car accident. </p> <p>Also, as a former NCI employee, I can say with certainty that the main reason lung cancer research is so underfunded is because there is no survivor consitutency. The mortality rate is so high there’s no one left to advocate. </p> <p>In contrast, breast cancer survivors are the most vocal and most organized - and yes, they have successfully pushed federal and private funding toward that disease. </p> <p><cite>— Posted by Brian </cite></p> </div> </li> <li class="clearfix" id="comment-32231"> <div class="index">73.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32231" title="">5:38 pm</a> </div> <div class="comment"> <p>You all showing how ignorant and stupid you all are.</p> <p>you are all offensive in thinking every case of LUNG CANCER IS CAUSED BY SMOKING, its not you MORONS. Lung cancer in women is increaseing every year and its not due to increased women taking up smoking, THEY DON’T KNOW WHY people get it, and die from it even though they have never smoked nor lived iwth smokers.</p> <p>FOR YOU TO SAY THAT THEY SOMEHOW DESERVED OR BROGUHT THIS ON THEMSELVES IS SICKENING.</p> <p>You all discust me to no end. </p> <p>I HAVE HAD A FRIEND DIE FROM LUNG CANCER THAT DIDN’T SMOKE A DAY IN HER LIFE AT 30.</p> <p>FOR YOU TO SAY THAT IT WAS PREVENTABLE AND THAT FUNDING IS NOT “DESERVED” THERE, IS SICKENING. </p> <p>I SINCERLY HOPE THAT YOU OR A LOVED ONE NEVER HAS TO GO THROUGH LUNG CANCER TREATMENT, BUT IF THEY DO MAYBE THEN YOU WILL SEE THE STUPIDITY OF YOUR STATEMENTS.</p> <p>I feel sick to my stomach hearing such stupid statements from people. </p> <p><cite>— Posted by JHO </cite></p> </div> </li> <li class="clearfix" id="comment-32234"> <div class="index">74.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32234" title="">5:54 pm</a> </div> <div class="comment"> <p>Here are some interesting stats I got from Table 1 of an address by the outgoing president of the American Association for the Advancement of Science and published in SCIENCE, VOL 319, pp 424-434, 25 JANUARY 2008. What follows is excerpted from the article.</p> <p>CONTRIBUTORS TO GLOBAL MORTALITY IN 2000</p> <p>Fundamental cause, Millions of years of life lost<br/> Childhood and maternal malnutrition, 200<br/> High blood pressure, cholesterol, overweight, low physical activity, 150<br/> Unsafe sex, 80<br/> Tobacco, 50<br/> Unsafe water, 50<br/> War and revolution (20th-century average), 40<br/> Indoor smoke from solid fuels, 35<br/> Alcohol, 30<br/> Urban air pollution, 6<br/> Global climate change, 5</p> <p>Table 1. Contributors to global mortality in 2000, categorized by fundamental causes. Units…are millions of years of life lost to premature deaths in the year 2000 (= numbers of premature deaths in 2000 from the indicated cause × average loss of life expectancy per death from that cause). The categorization of fundamental causes and associated lost-life estimates are from WHO (5), except for “war and revolution”; that figure is the author’s estimate for the 20th-century annual average, based on a UN figure of about 100 million conflict-related deaths in the 20th century (6) and the author’s guess of 40 years of lost life expectancy per conflict-related death. Attributions of relevant “shortfalls and drivers” are the author’s (7).</p> <p>John P. Holdren is Teresa and John Heinz Professor of Environmental Policy at the Kennedy School of Government as well as professor in the Department of Earth and Planetary Sciences, Harvard University, and director of the Woods Hole Research Center. He served as president of the American Association for the Advancement of Science (AAAS) from February 2006 to February 2007. This article is adapted from the Presidential Address he delivered at the AAAS Annual Meeting in San Francisco on 15 February 2007. </p> <p><cite>— Posted by Kevin </cite></p> </div> </li> <li class="clearfix" id="comment-32238"> <div class="index">75.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32238" title="">6:28 pm</a> </div> <div class="comment"> <p>I work at a convenience store. Every pack of cigarettes we sell has a health warning (”SMOKING IS A LEADING CAUSE OF LUNG DISEASE,” etc), plus a graphic picture, such as of diseased lungs, incase people didn’t already get the message. </p> <p>But they don’t. You wouldn’t believe how many packs of smokes I sell to young people, and to people who look overweight. Absolutely sickening. What part of “Smoking is a proven killer!” don’t they understand? But it’s their choice, and their money. Ironically, when people quit now, it’s usually because it’s too expensive, not because they care about their health. </p> <p><cite>— Posted by Keith </cite></p> </div> </li> <li class="clearfix" id="comment-32239"> <div class="index">76.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32239" title="">6:29 pm</a> </div> <div class="comment"> <p>I’ve spent some time in a lab at the NCI; it makes me nervous when laypeople discuss funding of this type of research. Scientists understand that the particular topic being studied can sometimes be of little consequence; oftentimes, an obscure cancer can serve as an excellent model for some other cancer (this is, incidentally, why mice are frequently used, even if their cancers are not exactly like our own). </p> <p><cite>— Posted by anon1980 </cite></p> </div> </li> <li class="clearfix" id="comment-32241"> <div class="index">77.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32241" title="">6:36 pm</a> </div> <div class="comment"> <p>My wife died from esophageal cancer three years ago .She never smoked or drank.She was operated on and the Drs beleived they had removed all dceased tissue etc. For almost three years all the scans showed no indication of decease ,then two months later it showed up again in three limph nodes the Drs. indicated that there were no effective drugs for treating this type of cancer( my own research from every scource I could find, Books,internet, etc seemed to confirm that).The only Chemo drugs for the cancer seem to be two of the oldest chemo drugs,first used about 100 yrs ago The aparent reason for this being that there is little or no successful research on developing new chemos for the decease. I also found in my research that,generally by the time symtoms occur it cannot be successfully treated. I also learned that in Japan extensive work has been on screening programs for the decease.It is my understanding that at least all males of certain age are screened for the decease.Aparently this screening program has lowered the death rate for esophageal cancer tremendously in Japan. My opinion is that screening for certain types of cancer is not receiving the funding and attention needed in North America.the program used in Japan is simple(envolves scraping the lining of the esophagus)If this type program works in Asia,why do’nt we spend more on screening programs (and less if necessary on reseach for new drugs. </p> <p><cite>— Posted by Ken </cite></p> </div> </li> <li class="clearfix" id="comment-32242"> <div class="index">78.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32242" title="">6:41 pm</a> </div> <div class="comment"> <p>“How many of those lung cancer cases are caused by smoking? I’d rather not have my money spent on researching a cure to a disease that people choose to get. — Posted by Matt”</p> <p>My non-smoking mother has stage IV lung cancer and I am so sick of people assuming she brought this in herself or that her disease doesn’t deserve research money. People DO NOT choose to get lung cancer any more than they choose to get any other cancer. It is exactly this mindset that makes lung cancer, by far the deadliest of cancers because it is the one to receive the least amount of research money per death of any cancer. </p> <p><cite>— Posted by Susan </cite></p> </div> </li> <li class="clearfix" id="comment-32246"> <div class="index">79.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32246" title="">7:09 pm</a> </div> <div class="comment"> <p>There’s just so many factual inaccuracies about cancer posted here it’s impossible to refute them all. The nytimes website should join the 1990s and get rid of this ridiculously primitive discussion board format with no threads or moderation.</p> <p><strong>From TPP — I think the value of these boards is that people like yourself can contribute to clarify areas of inaccuracy. I do moderate this board and don’t see the many factual inaccuracies you cite. Perhaps you can enlighten us? I do moderate hundreds of comments a day so don’t claim to catch everything, but this thread in my view seems to be generating thoughtful and intelligent comments from readers.</strong> </p> <p><cite>— Posted by lls </cite></p> </div> </li> <li class="clearfix" id="comment-32249"> <div class="index">80.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32249" title="">7:19 pm</a> </div> <div class="comment"> <p>Wouldn’t it be just as meaningful to apply the same statistical methods to the research on all diseases e.g. heart disease, MS, diabetes, etc. I wonder what that would yield. </p> <p><cite>— Posted by TRS </cite></p> </div> </li> <li class="clearfix" id="comment-32254"> <div class="index">81.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32254" title="">7:38 pm</a> </div> <div class="comment"> <p>As a son who lost his mother a few years ago to Ovarian cancer, I am disappointed to not see this deadly and quite common cancer featured here. It seems that women’s health is once again, aside from in the politicized realm of breast cancer ignored. While Colon and Prostate cancers which mostly impact men are featured, equally prevalent killers of women are ignored.</p> <p><strong>FromTPP — Yes ovarian cancer is a terrible disease but thankfully it is not among the most common cancers. It was not included in my initial list simply because I had limited space and chose the cancers with the largest numbers. However, the reader in comment number three asked about it and I did provide the data there. In terms of funding, if measured based on new cases and deaths, ovarian cancer does get more funding than many other cancers. In 2006, funding for ovarian cancer was $95.1 million. There were 20,180 new cases and 15,310 deaths. That translates to $6,212 per death and $4,713 per new case. And one further point — the biggest cancer killer of women is lung cancer.</strong> </p> <p><cite>— Posted by symphonyofdissent </cite></p> </div> </li> <li class="clearfix" id="comment-32259"> <div class="index">82.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32259" title="">7:55 pm</a> </div> <div class="comment"> <p>Look at your numbers closely instead of just dropping a mediocre “investigative report” such as this.<br/> The data provided here is flawed and not properly explained. The National Cancer Institute does NOT spend $6 billion per year. We wish! it’s more like $4.8 that they actually had allocated in the last fiscal year. Moreover, of all that money, ONLY $2.4 billions were actually for research grants. How much do we spend in the wars per day? Wars are easier to fund than biomedical research. What a shame. Shame on us.</p> <p><strong>From TPP — The $6 billion is the total NCI budget for this year, but you are correct that money goes toward a variety of things. BUt my calculations are not based on the $6 billion number. They are based on the dollars allocated to specific cancers by the NCI in 2006 divided by the estimated new cases and cancer deaths for 2006, as estimated by the American Cancer Society. So whether the number is 4.8 billion or 6 billion doesn’t effect the math on the specific cancer spending.</strong> </p> <p><cite>— Posted by Data Not Correct </cite></p> </div> </li> <li class="clearfix" id="comment-32262"> <div class="index">83.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32262" title="">8:00 pm</a> </div> <div class="comment"> <p>Let me pose an ethical question. </p> <p>If saving lives (not curing cancers) is our goal, isn’t it better to invest public funds in the cancer research with the probability of saving the most lives per dollar? </p> <p>I realize that in looking at funding this way, the most pernicious and deadly cancers would not appear to be good investments in life-saving and would get only the lowest priority. Also, such an approach could ultimately become a self-fulfilling prophecy. The most difficult cancers might always find themselves at the bottom of the list.</p> <p>But funding is always going to be limited. Should we spend public funds to save the most lives or not?</p> <p><strong>From TPP — I think you pose an interesting question but consider this. Common cancers, like breast and prostate, likely are caused by a variety of different factors. Less common cancers are more likely to have a specific isolated cause. Sometimes we make more headway when trying to cure a rare disease than when trying to cure a common disease. </strong> </p> <p><cite>— Posted by rob </cite></p> </div> </li> <li class="clearfix" id="comment-32270"> <div class="index">84.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32270" title="">8:56 pm</a> </div> <div class="comment"> <p>I suppose another answer, is to put more money into the easiest to study cancers. With the idea that the other cancers would benefit from what is learned. </p> <p>For example as a microscopy person I would much rather work with mouse models on skin cancer, than other cancers because I can get to the tumor to see what it is doing fairly easily. </p> <p><cite>— Posted by Jesse R </cite></p> </div> </li> <li class="clearfix" id="comment-32272"> <div class="index">85.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32272" title="">9:12 pm</a> </div> <div class="comment"> <p>People with AIDS could be blamed for bringing their disease on themselves, but they are generally not. But over the last 25+ years, there has been a huge outpouring of media attention, fundraising, lobbying, etc. </p> <p>People with lung cancer could be blamed, too, and overwhelmingly are. It is a shame. </p> <p>I believe that the lack of research funds due to there being no evidence that the outcomes could be changed for lung cancer sufferers SCREAMS to the fact that we need to detect and diagnose lung cancer when it is in it’s early stages. Perhaps then the drugs and funding could have a REAL impact on outcomes. I have heard of several people whose lung cancer was detected accidentally in an early stage, they were operated on, and 8,9,10 years later, they are still alive to tell the tale.</p> <p>The Stigma needs to go away, and early detection methods need to be agreed upon and utilized. Insurance companies are in the way of this one. Women 40 and over can get a mammogram EVERY YEAR and it is paid for by insurance. It seems that people who smoke, smoked, grew up in a smoking household SHOULD be screened. Chest x-ray, low-dose CT scans, there is new research in a breath-test, blood-tests… lots of possibilities on the horizon, but people need to stop saying it is hopeless and a waste of money. I don’t believe that lung cancer will always be a hopeless case.<br/> I hope more people could believe this. </p> <p><cite>— Posted by Allison </cite></p> </div> </li> <li class="clearfix" id="comment-32273"> <div class="index">86.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32273" title="">9:12 pm</a> </div> <div class="comment"> <p>All this suffering makes me sad.</p> <p>Having lived my whole life with a “war” on cancer, it seems that only real progress has been made in treating childhood cancers, but I am often wrong. I’m guessing that many doctors and pharm companies have become very wealthy even when their cancer treatments are effective. How much does it cost to die of lung cancer in the US these days? How about France? Who has better recovery rates?</p> <p>It seems there is a cruel undercurrent here between folks who blame the sufferer (They smoked! Bad genes!) and those who blame a virus or environmental toxins (They didn’t eat right!). </p> <p>We all die one way or another. I think the largest cruelty is our lack of basic healthcare for all citizens, once you lose your job and healthcare coverage in US, your whole family gets to suffer. </p> <p><cite>— Posted by Tom </cite></p> </div> </li> <li class="clearfix" id="comment-32278"> <div class="index">87.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32278" title="">9:37 pm</a> </div> <div class="comment"> <p>What about lymphoma and leukemia? Why were they ommitted from your list and from your comments? What has the NIH accomplished in keeping these deadly illnesses at bay?</p> <p><strong>From TPP — They are only omitted because i didn’t have time to look them up. I was focusing on the big cancers. Lymphoma in 2006 had 66,670 new cases and 20,330 deaths. . NCI spending was $135 million. That’s $6,640 per death and $2,205 per new case. Leukemia in 2006 was 35,070 new cases and 22,280 deaths. NCI spending was $223.5 million. That’s $6,373 per new case and $10,031 per death.</strong> </p> <p><cite>— Posted by veronique </cite></p> </div> </li> <li class="clearfix" id="comment-32279"> <div class="index">88.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32279" title="">9:53 pm</a> </div> <div class="comment"> <p>I think it would also be interesting to look at the funding per case/death for pediatric cancers. </p> <p>Pediatric malignancies are very rare, yet great progress has been made over the past several decades. Part of this is due to funding but probably a more significant factor is the fact that most children with new cancer diagnoses get treated on clinical trials. Therefore, we learn what works (and what doesn’t) in kids far more quickly than we do in adult cancer patients.<br/> <strong><br/> From TPP — Isn’t there also an issue here that pediatric cancer is easier to treat because it tends to be genetic while adult cancer is some combination of genetic and a zillion different environmental interactions (smoking, pollution, hormones, pesticides, poor diet etc.) NCI spending on pediatric cancers was $179.6 million in 2006. About 10,500 kids are diagnosed each year according to NCI data. That translates to $17,105 per new case. In a quick search I couldn’t find annual mortality statistics for kids — although overall survival has jumped to about 80%. We are spending a lot on childhood cancer but it makes sense because 1) it’s working and 2) you get a lot more quality of life years when you save a kid than when you save an adult. But as has been reported, surviving childhood cancer doesn’t guarantee good health. These kids have lots of treatment-side effect issues to cope with as adults and there is still a long way to go in making treatments for kids less toxic and painful with fewer long-term effects.</strong> </p> <p><cite>— Posted by Ed </cite></p> </div> </li> <li class="clearfix" id="comment-32282"> <div class="index">89.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32282" title="">10:09 pm</a> </div> <div class="comment"> <p>This money is for biomedical research to cure cancers once they become deadly. What goes unmentioned here is money for prevention. Most cancers could be greatly reduced by environmental, nutrition, and health policies and programs to reduce the impact of well-known cancer causing agents. This would have the greatest impact on cancer rates and is less expensive in the long run. The focus on biomedical intervention is misplaced. </p> <p><cite>— Posted by Sarah </cite></p> </div> </li> <li class="clearfix" id="comment-32286"> <div class="index">90.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32286" title="">10:21 pm</a> </div> <div class="comment"> <p>Isn’t lung cancer the easiest and cheapest to prevent? Don’t smoke. Aren’t the majority of lung cancers caused by smokers? Why should more monies be allocated to a preventable cancer.</p> <p>I, too, would love to see more research on pollutants from big industry. Companies always seems to be able to dispute the results. </p> <p><cite>— Posted by Mark </cite></p> </div> </li> <li class="clearfix" id="comment-32287"> <div class="index">91.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32287" title="">10:28 pm</a> </div> <div class="comment"> <p>I am fairly certain that the majority of any reduction in the cancer death rate in the last decades can be attributed to education about prevention or early detection of the disease, rather than the development of effective treatments, drugs, or cures. </p> <p>Dont smoke,<br/> Use sunscreen,<br/> Screen often and early for common cancers<br/> Eat healthy foods and excercise… etc. etc. </p> <p>The main benefit of the funding of the ‘war on cancer’ has been a huge increase in our understanding of and ability to investigate molecular, cellular, and genetic biological processes; a huge increase in our general scientific knowledge, which spills over in terms of our understanding of countless other diseases. This is very important to our ability to make well informed lifestyle decisions, and amounts to money well spent. </p> <p>I agree that the rubric for the allocation of scarce medical research funding should not be how many people have a disease, but rather, how likely is that research to add to our understanding of biology and medicine in a valuable way. </p> <p>However, I am an advocate of fundamentally addressing the causes of that scarcity of funding such that more of the ‘fringe’ avenues can be well-funded. After all, if there were a clear-path to the solution of cancer, one that could be intuited based purely on the merits of a grant application, we would have a cure by now. </p> <p>I can also say that as a PhD student working in part at the NCI, I am perusing other career opportunities outside of scientific research; not because I don’t feel cancer research to be valuable or rewarding, but rather I would like some degree of job security. Current funding of research makes that security tenuous at best. The tragic result is a drain of bright young people from science and into industry or other fields… </p> <p><cite>— Posted by sam </cite></p> </div> </li> <li class="clearfix" id="comment-32288"> <div class="index">92.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32288" title="">10:28 pm</a> </div> <div class="comment"> <p>Re: #56<br/> H. pylori not only causes peptic ulcers but can also cause cancer:</p> <p>From the NCI: Research has indicated that infection with H. pylori increases the risk of gastric cancer, gastric mucosa-associated lymphoid tissue (MALT) lymphoma, and possibly pancreatic cancer. </p> <p><cite>— Posted by An Ounce of Prevention (the 2nd law of thermodynamics) </cite></p> </div> </li> <li class="clearfix" id="comment-32290"> <div class="index">93.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32290" title="">10:32 pm</a> </div> <div class="comment"> <p>PLEASE do a follow-up on childhood cancers. It is a very different scenario. Diagnosed early it can be “cured” but without research funding it cannot move forward. It is a clinical world that can be both fabulously optimistic and tragically sad. There is a Congressional bill - Conquering Childhood Cancer Act of 2007 - that addresses some of the funding disparities and is languishing. Why? I know a charming, loveable 3-year-old who is battling neuroblastoma and would love to know why she must endure “ouchies” when we live in a country that is so advanced in medicine? </p> <p>Thank you for using your reach to make change.</p> <p><strong><br/> From TPP — In my opinion, we can’t do enough or spend enough to combat childhood cancer. I can’t even imagine how it must feel to be a parent of a child in this situation. </strong> </p> <p><cite>— Posted by Eileen Sparling </cite></p> </div> </li> <li class="clearfix" id="comment-32295"> <div class="index">94.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32295" title="">10:36 pm</a> </div> <div class="comment"> <p>To those who believe lung cancer should be underfunded because 85% of the incidences occur in smokers, do you also believe funding for AIDS and HIV should be slashed because a high percentage of the cases can be prevented by practicing safe sex and not sharing needles? Do you believe that research for heart disease should be cut because so many people are overweight and eat bad diet? Same with Type II Diabetes? My mother died of lung cancer at the age of 58. Approximately $1 million was spent keeping her alive for 18 months. Money IS being spent on lung cancer - it is being spent on therapies that merely buy time rather than on real cures. </p> <p><cite>— Posted by Jane </cite></p> </div> </li> <li class="clearfix" id="comment-32297"> <div class="index">95.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32297" title="">10:39 pm</a> </div> <div class="comment"> <p>tt53 — thanks for your thoughtful comments, but didn’t you mean to say we accumulate more environmental insults, not genetic, as a result of more years of life? I’m not trying to push my point–just that to my understanding, the genetic factors don’t change whether you live to 50 or 70– or do they?</p> <p><strong>From TPP — Well said. The issue is whether these environmental insults flip a genetic switch. our genes stay the same, but how our genes interact with our environment is what changes.</strong> </p> <p><cite>— Posted by francois </cite></p> </div> </li> <li class="clearfix" id="comment-32298"> <div class="index">96.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32298" title="">10:39 pm</a> </div> <div class="comment"> <p>Re Post # 78. I agree. My mother has lung cancer as well. Its almost as though people are saying because others smoked and got lung cancer my mother deserves to be punished by not recieving proper funding and research on her cancer. Its a stigma that follows her everywhere and it isn’t fair. </p> <p><cite>— Posted by Kate </cite></p> </div> </li> <li class="clearfix" id="comment-32315"> <div class="index">97.</div> <div class="commentmetadata"> March 6th,<br> 2008<br> <a href="#comment-32315" title="">11:19 pm</a> </div> <div class="comment"> <p>Something that people don’t realize is that 1 in 4 women and 1 in 10 men with lung cancer never smoked a day in their life. But that number is greater than all the breast, ovarian and prostate cancer deaths combined. So those that think that smokers should be punished for smoking, what about them? </p> <p><cite>— Posted by Jack </cite></p> </div> </li> <li class="clearfix" id="comment-32322"> <div class="index">98.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32322" title="">12:20 am</a> </div> <div class="comment"> <p>TTP The $6 billion you are referring to represents not actual dollars but what NCI would like to get. They have only received $4.8 billion. This is the second year in a row that both NIH and NCI received cuts in actual funding. Three years ago they were flat funded which also reflects a cut because it doesn’t compensate for inflation. These cuts have slowed the research and caused researchers to leave the US and prevented talented young people from entering the research field.I find it unconscionable that we can fund the war in Iraq at $10 billion per month and we can’t find $6 billion a year to fight the war on cancer, declared by President Nixon, which will kill an estimated 565,650 people both male (294,120) and female (271,530). Shame on the President and the Congress for this disgraceful situation.</p> <p>Although nobody has mentioned it yet I am a Kidney Cancer survivor since 2001 and have gotten involved in advocacy because of the lack of research in my cancer and because I have seen what advocacy has done for other cancers to relieve some of the suffering and bring hope to those afflicted.</p> <p>We are all born to die but it should not bring pain and suffering. </p> <p><cite>— Posted by Fred </cite></p> </div> </li> <li class="clearfix" id="comment-32369"> <div class="index">99.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32369" title="">5:13 am</a> </div> <div class="comment"> <p>I feel the reason for the lack of funding in the field of lung cancer research is obvious. Most of those that have it know exactly where they got it from. Cigarettes! I am not saying that those people diagnosed are any less important, but if you took the statistic about how the money in distributed per diagnoses and changed it to per diagnosis of a non smoker, I am sure that the funding is well beyond adequate. </p> <p><cite>— Posted by Tyler </cite></p> </div> </li> <li class="clearfix" id="comment-32397"> <div class="index">100.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32397" title="">9:19 am</a> </div> <div class="comment"> <p>There is an important aspect of cancer research funding that is not mentioned yet. The funding largely goes to developing drugs that shrink tumors, in part because that is the easiest part to research (and maybe because pharmaseutical companies have an interest in them). But shrinking tumors is not the problem. From what I understand, the cancers that kill are the metastatic cancers (very invasive), and the research to reduce or eliminate metastasis is not well-funded at all. This type of research is much more difficult and much less interesting to drug companies. I agree that the research dollars are too small, but they also seem to be misspent. </p> <p><cite>— Posted by Bobby </cite></p> </div> </li> <li class="clearfix" id="comment-32404"> <div class="index">101.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32404" title="">9:50 am</a> </div> <div class="comment"> <p>I think those who believe people with lung cancer “deserve it” are missing a major point - many people who are dying from lung cancer now are former smokers who quit long ago but are still paying for it. Tobacco prevention and education are relatively new, and many people who used to smoke and now have lung cancer truly didn’t know the damage they were causing. </p> <p>As for younger people who continue to smoke - knowledge alone is not enough to change/prevent behavior, there are greater social, political, and economic factors at play. As a health behavior researcher, I wish we could have more funds to research tobacco behavior change and implement new interventions to prevent tobacco use. As it stands now, a lot tobacco use prevention research and programming is funded with tobacco settlement dollars that come with restrictions on what can be said about tobacco and companies. </p> <p><cite>— Posted by MP </cite></p> </div> </li> <li class="clearfix" id="comment-32409"> <div class="index">102.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32409" title="">10:12 am</a> </div> <div class="comment"> <p>I realize the “correct” funding formula is difficult to agree on - how much should incidence and morbidity count? What about cancers with a high morbidity but great preventability (or very successful very early treatment)? How much should the prospects of success count in deciding who to fund? How much should the length of time or quality of life of the patient factor in? (eg is your $ buying a 70 year old man with prostate cancer another 5 years or a 20 year old man with testicular cancer another 40 years?). </p> <p>These are complex questions and not really answered by simply saying “the most common or most deadly” cancers should be funded more. </p> <p>TPP what I want to know is how does this disparity in your blog stats look if you divide cancers into the “marketable sympathy” cancers (breast cancer and childhood leukemia are prime examples) v “the perceived self inflicted punishment cancers” (most notably lung cancer). I stress I do NOT see lung cancer that way, but I recognize that this wrong perception affects its funding.</p> <p>Then once we’ve looked at the disparity in those terms - how much is that disparity reflected in public v private funding? Does the government funding seem “more blind” to the marketability or high-profile or self infliction perceptions? </p> <p>I would expect such a comparison to find that private charities who need to prove themselves by financial results would focus on the pink ribbons for breast cancer and cute children with leukemia projects, leaving lung cancer to rely on government funding.</p> <p>I hypothesise that this is a large part of the unequal treatment lung cancer gets.</p> <p>Anyone out there able to prove or disprove that? </p> <p><cite>— Posted by JillyFlower </cite></p> </div> </li> <li class="clearfix" id="comment-32411"> <div class="index">103.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32411" title="">10:18 am</a> </div> <div class="comment"> <p>MP I do think you’re kidding yourself if you think we haven’t known for a long long time now that smoking kills. It is still a live issue with minors who take up smoking because we don’t expect them to take the warnings with proper seriousness. But we have actually known about the connection for a long time now (recent movies recalling this revealation and the cover-up notwithstanding).</p> <p>Your post seems to accept the “self infliction” view but then seek to say they didn’t know what they were doing (implying if they had this would not be unfair). I would prefer to say that lung cancer is perceived (rightly or wrongly is not the point) as a disease you get after many years of smoking heavily, not a few years of smoking occasionally. And people tend to not be very good at 1) factoring in the addiction problem once they start which leads to unintended heavy long term use and 2) thinking 30 years ahead to when they might think problems would arise.</p> <p>Yes I know many people get lung cancer much more quickly on much less exposure, but the perception is one of old heavy smokers dying - and that doesn’t scare people enough to not start. And once they’ve started they find it much harder to quit than they expect.</p> <p>Humans are full of weaknesses. Before we say one group deserves to die of lung cancer for these weaknesses we should look at some of our own. </p> <p><cite>— Posted by JillyFlower </cite></p> </div> </li> <li class="clearfix" id="comment-32414"> <div class="index">104.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32414" title="">10:36 am</a> </div> <div class="comment"> <p>Let’s see, I didn’t smoke or drink. Never was really sick. Didn’t get colds of the flu yet I got kidney cancer. My odds of being alive at five years is less than any of the cancers you mention. Actually to be alive at two years is a major milestone. There is no cure and I don’t see on at the horizon. Yet the incidence of kidney cancer is on the rise. Where is our reasearch money? None existant really!! </p> <p><cite>— Posted by Elaine </cite></p> </div> </li> <li class="clearfix" id="comment-32421"> <div class="index">105.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32421" title="">11:38 am</a> </div> <div class="comment"> <p>JillyFlower, I guess I wasn’t as clear as I wanted to be. Specifically, I was thinking about baby-boomers and their slightly older peers who started smoking in the sixties and seventies - a time when smoking was seen as bad and generally unhealthy, but the severe health consequences were not yet widely known. The warnings that we are all so used to seeing on packages started in 1965, but for 20 years the labels simply stated that smoking was unhealthy, leaving a whole generation to smoke during through their teen and young adult years knowing that it was “bad” but not necessarily knowing that it was deadly. I do not believe that individuals who started smoking more recently or continue to smoke deserve to have lung cancer - no one should have to suffer in that way. I was just trying to add more to the context that TPP framed in #15. The funny thing is, I think we are very much in agreement - education and prevention of tobacco use are woefully underfunded and highly restricted, but we as a society seem very ready to blame people for the consequences of their behavior. </p> <p><cite>— Posted by MP </cite></p> </div> </li> <li class="clearfix" id="comment-32425"> <div class="index">106.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32425" title="">12:05 pm</a> </div> <div class="comment"> <p>Year over year, the American Cancer Society and the National Cancer Institute of funded breast cancer more than lung cancer. Yet, lung cancer surpassed breast cancer as the #1 cancer killer in America since 1987. Maybe if they focused their energy and funding on eradicating lung cancer for the next 20 years, they might make the same strides as they have with breast, prostate and colon.<br/> Lung cancer continues to get less funding because as people have said on this forum, most people think that they’ve brought it upon themselves. But the truth is, no one deserves to get lung cancer or any kind of cancer. That’s like saying that people who drink wine, deserve to get liver cancer, or people who are gay deserve to get AIDS. I’m not advocating smoking, it’s a dirty disgusting habit. And the big thing about smoking is that as a non-smoker, you get affected by being around a smoker because the chemicals coming off the tip of that cigarette are far worse than inhaling directly with a filter.<br/> The lung cancer advocacy groups need to join together in order to make progress on the lung cancer movement or they will continue to be in the same spot as they have been for the past 50 years. It starts with educating the general public, the pharmaceutical companies, the law makers, etc, that lung cancer is becoming an epidemic in this country. </p> <p><cite>— Posted by Tracy </cite></p> </div> </li> <li class="clearfix" id="comment-32429"> <div class="index">107.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32429" title="">12:25 pm</a> </div> <div class="comment"> <p>What about Kidney Cancer? It’s not even mentioned any where in this article. My husband is suffering from it. Doesn’t it get a mention at all? Dina Velkly<br/> <strong><br/> From TPP — I realize every cancer is important but from a practical standpoint, I can’t do the funding math for every type of cancer. There were 38,890 new cases of kidney cancer in 2006, and 12, 840 deaths from the disease. I wish your husband a strong recovery.</strong> </p> <p><cite>— Posted by Dina Velkly </cite></p> </div> </li> <li class="clearfix" id="comment-32437"> <div class="index">108.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32437" title="">1:43 pm</a> </div> <div class="comment"> <p>First, Lung cancer will take the lives of over 160,000 Americans this year–more than breast, prostate, and colon cancers, combined–making it the leading cancer killer. Lung cancer’s 15% five year survival rate has remained unchanged for decades. Conversely, significant funding for research and early detection has greatly increased five year survival rates for breast cancer (88%), prostate cancer (99%) and colon cancer (65%).</p> <p>Second, 30% of these people never smoked(and it’s growing), 30% stopped more than 10 yrs ago. The rest are a mixed bag. Would you ask an AidS patient…did you have lots of partners? Would you ask a heart patient if they ate lots of red meat? The stigma has got to stop…it’s really discrimination. And guess what, if you never smoked, and are given the diagnosis of Lung cancer, no one cares if you never smoked, tough luck. It happens every day.</p> <p>Maybe because Lung Cancer patients just don’t survive, they haven’t had a voice…Maybe those who are left behind should start screaming at the top of their lungs “NO MORE” </p> <p><cite>— Posted by Wendy </cite></p> </div> </li> <li class="clearfix" id="comment-32438"> <div class="index">109.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32438" title="">1:52 pm</a> </div> <div class="comment"> <p>You didn’t have “limited space,” because this is a blog, and you can post as many numbers as you want. Not that you have to, but limited space is not the reason, as evidenced by the lengthy list of comments posted here. Maybe more info up front and links to complete info could reduce the need for people to request more via the comments section.</p> <p><strong><br/> From TPP — Yes it’s a blog, but compiling the data is incredibly time consuming and I am only one person. Readers who want to do the math can Google “American Cancer Society Statistics 2006″ and then they can Google “Incidence and mortality rate trends in NCI funding for (fill in the blank for the type of cancer you are interested in.) Those two searches should turn up 2006 statistics on NCI spending, estimated new cases and estimated deaths. But as i’ve shown here, I’ve been happy to help readers who ask me specific questions</strong> </p> <p><cite>— Posted by Katie a </cite></p> </div> </li> <li class="clearfix" id="comment-32440"> <div class="index">110.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32440" title="">1:55 pm</a> </div> <div class="comment"> <p>I don’t think most people realize how difficult it is to cure disease. Just understanding a disease often requires the development of an entirely new field of science. And even after you understand how the disease works, figuring out how to cure it can require the development of yet another new field of science. But it is all worth it.</p> <p>For example, consider P53. P53 is a transcription factor involved in DNA repair and the control of the cell cycle (replication) and apoptosis (regulated cell death). When there is damage to DNA, P53 is involved in activating DNA repair proteins to fix it, halting the cell cycle until repairs are complete, and initiating apoptosis if the damage is so great that repair is a lost cause. When p53 is inactivated, rogue cells can proliferate uncontrollably forming cancerous tumors. Some people inherit a mutated copy of p53, but this is rare. Typically, p53 is mutated or deleted only within the tumor cells themselves, and this process contributes to more than half of tumors. The “War on Cancer” made it possible to learn all of this, and it largely funded the beginning of the molecular biology revolution, a new field of biology without which scientists would have been unable to discover, or even to understand, what p53 is doing. But now what? How do you compensate for lost p53 function? This is an extremely difficult problem. Compared to this, traveling to Mars is a cake walk. </p> <p>There are no magic powers involved in science. It’s a hard slog from beginning to end. Most ideas end up being wrong, so basic research is very expensive and unavoidably inefficient. You have thousands of people working on problems and you hope that someone gets lucky once in a while. The trenches of biomedical research are filled with people with PhDs and many years of post-graduate experience making less than 50K/year, and many of them have to drop out because labs can’t afford to pay even those meager salaries. More money helps, but it guarantees nothing. </p> <p>Drug companies don’t do much basic research because they can’t make money doing it. They apply the results of government-funded research to do more targeted drug-discovery, something that government-funded labs aren’t set up to do. As for drug discovery, most of the time, the process is so conceptually primitive that people are usually shocked to hear about it. Say you want to block an enzyme’s function. How do you find a drug to do that? Well, you take your gigantic library of millions of compounds and you just try them all. I know! It’s crazy! That’s why drug discovery is so expensive and most small pharmaceutical companies have disappeared. You need to be gigantic to absorb the cost of R&D and the risk of finding nothing new for years. Clinical testing is also expensive. These days, on average, it takes 12 years to take a new drug candidate through the clinical testing and FDA approval process at a cost of ~200 million dollars; ~400 million if you include the cost of drug candidates that fail to make it all the way through the approval process. That cost doubles if you include the cost of interest on the capital required to fund it. But if you find a winner, you can make a ton of money. Investors are rewarded for investing in a high risk industry by high rewards when they are successful. If the rewards were small, who would invest in such a risky industry?</p> <p>These days, there are other approaches, such as antibody-based drugs (i.e. Enbrel), but these are very, very expensive to manufacture, harder to administer to the patient, and only useful for certain applications. Still, they are doing a lot of good, making life bearable for thousands who had little hope a few years ago.</p> <p>But in spite of the difficulties, looking at the big picture, it is glorious. Scientific and medical advances are among the greatest achievements of our civilization. The Egyptians built great pyramids, and we ooh and ah at their magnificence, but they teach us little about the universe and do us little good. We have the opportunity to bequeath to future generations a much greater scientific understanding of our universe and also therapies to alleviate the pain and suffering of diseases that have gone untreated since the very beginning. These gifts will survive for as long as our civilization survives. Let these be our pyramids, built not for our glory, but for the benefit and enlightenment of all. </p> <p><cite>— Posted by Kanji Takahashi </cite></p> </div> </li> <li class="clearfix" id="comment-32441"> <div class="index">111.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32441" title="">1:55 pm</a> </div> <div class="comment"> <p>Point taken MP. Thanks for the clarification. </p> <p><cite>— Posted by JillyFlower </cite></p> </div> </li> <li class="clearfix" id="comment-32443"> <div class="index">112.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32443" title="">2:11 pm</a> </div> <div class="comment"> <p>I’d like to comment on the comments made by others summed up nicely in #86: “It seems there is a cruel undercurrent here between folks who blame the sufferer (They smoked! Bad genes!) and those who blame a virus or environmental toxins (They didn’t eat right!).” </p> <p>My father was diagnosed with a very rare cancer at 58, given a prognosis of “6 months to 5 years”, and died 5 months later, mercifully quickly and relatively painlessly. He did not have lung cancer, colon cancer, or any other cancer that your average person on the street has ever heard of. His oncologist at a major US cancer center had never seen a case like his before and told us she never expected to see it again. Science cannot tell us what causes this type of cancer; all medicine could do was try to forestall the inevitable. </p> <p>Yet it was astounding to me how many people, when they heard of his cancer, immediately said things (to my face!) like “Did he eat a lot of red meat?” </p> <p>I realized after a few months of this that what appears at first to be an urge to *blame* is an unfortunate human urge to whistle past the graveyard; identifying a cause for something is a way to tell ourselves “That won’t happen to me”. </p> <p>Certainly, to prevent what we can, we must identify causes whenever possible — so that other people do not suffer the same fate. Some patients — I’m thinking of Yul Brynner here, and his anti-smoking commercials–have used their own cases for public health purposes. But blaming the victim does nothing. </p> <p><cite>— Posted by Cat </cite></p> </div> </li> <li class="clearfix" id="comment-32450"> <div class="index">113.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32450" title="">2:41 pm</a> </div> <div class="comment"> <p>It turns out that this topic has been researched a fair amount. For people interested in what the peer-reviewed literature has to say, below are some places to look (and no claims that such papers will interest non-scientists). A last note is that we spend a lot on preventing and reducing smoking which is the leading cause of all cancers, especially lung cancer. We may not be underspending to the extent the blog’s analysis implied. </p> <p>One paper on the British system concluded that lung cancer spending was just fine, but that more funding was needed for CNS tumors, cervical and kidney cancers, and melanoma. (Burnet NG, Jefferies SJ, Benson RJ, Hunt DP, Treasure FP. Years of life lost (YLL) from cancer is an important measure of population burden–and should be considered when allocating research funds. Br J Cancer. 2005 Jan 31;92(2):241-5.)</p> <p>Another study found that we spend just about the right amount on cancer overall, but we don’t spend enough on chronic obstructive pulmonary disease, perinatal conditions, and peptic ulcer. (Gross CP, Anderson GF, Powe NR. The relation between funding by the National Institutes of Health and the burden of disease. N Engl J Med. 1999 Jun 17;340(24):1881-7.) </p> <p>These are also relevant:<br/> Curry CW, De AK, Ikeda RM, Thacker SB. Health burden and funding at the Centers for Disease Control and Prevention. Am J Prev Med. 2006 Mar;30(3):269-76.</p> <p>Lamarre-Cliche M, Castilloux AM, LeLorier J. Association between the burden of disease and research funding by the Medical Research Council of Canada and the National Institutes of Health. A cross-sectional study. Clin Invest Med. 2001 Apr;24(2):83-9.</p> <p>Aoun S, Pennebaker D, Pascal R. To what extent is health and medical research funding associated with the burden of disease in Australia? Aust N Z J Public Health. 2004 Feb;28(1):80-6. </p> <p><cite>— Posted by Noel Brewer </cite></p> </div> </li> <li class="clearfix" id="comment-32462"> <div class="index">114.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32462" title="">3:12 pm</a> </div> <div class="comment"> <p>The most interesting thing about this is that you have all really hit a nerve. As a member of the Board of Directors of a reasonably well known cancer advocacy organization, and one of the founders of another, my argument for years has been, “How do we ensure some form of real return on the investment for the billions of dollars that go into cancer research each year?” The cancer advocacy community assisted the NCI to double its annual budget in the period between the late 1990s and early 2000s, but we are still no further along in gaining real transparency about how that money is spent, what the real research successes are, and what is just money down the tubes. We absolutely need better ways to measure the value of every investment. </p> <p><cite>— Posted by Mike Scott </cite></p> </div> </li> <li class="clearfix" id="comment-32471"> <div class="index">115.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32471" title="">3:25 pm</a> </div> <div class="comment"> <p>Re: Comment #23, from healthinfo. You are stomach-turningly correct. Your assessment of the economic factor’s control over cancer is finally coming out of the closet. This blog brings it up from time to time, and more often than not in comments from health care professionals. Shouldn’t that tell us something? </p> <p><cite>— Posted by Karen </cite></p> </div> </li> <li class="clearfix" id="comment-32475"> <div class="index">116.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32475" title="">3:36 pm</a> </div> <div class="comment"> <p>I don’t mean to get entirely off the subject, but if we equate dollars spent for research with our ability to save lives, then we might want to take a closer look at the efficiency of some of the charitable organizations that have dedicated themselves to curing various ills. Just how good are they at pursuing their stated mission?</p> <p>Relevant case in point: The American Cancer Society, headquartered in Atlanta (with a New York City office on 56th Street—not exactly a low-rent neighborhood). </p> <p>According to Charity Navigator, (http://www.charitynavigator.org/)<br/> in 2005, the American Cancer Society devoted 31 cents of every revenue dollar to fundraising and administrative expenses. On total revenue of almost one billion dollars, that’s some slice of the pie spent NOT fighting cancer. </p> <p>Okay, maybe we can’t expect every modern charity to operate the way Mother Teresa cared for the poor and suffering, but paying their CEO over half-a-million dollars a year seems quite generous to me. </p> <p><cite>— Posted by rob </cite></p> </div> </li> <li class="clearfix" id="comment-32496"> <div class="index">117.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32496" title="">4:37 pm</a> </div> <div class="comment"> <p>I totally agree with and found out first hand where the focus and funding goes for types of cancers. When my husband died of lung cancer at age 54 (not considered an older) as previously stated, I called the American Cancer Society to find out if I could assist or volunteer in any way for the fight against lung cancer. I was told, “I’m sorry, but we really don’t have an initiative for lung cancer, our focus is mainly on breast cancer and some others.” This is when I researched the Lung Cancer Alliance helped raise thousands of dollars towards their only focus - lung cancer. Thank God they are stepping to the plate and making huge strides to awakening others of the need for early detection and funding for this #1 cancer killer. </p> <p><cite>— Posted by Sandi </cite></p> </div> </li> <li class="clearfix" id="comment-32506"> <div class="index">118.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32506" title="">5:04 pm</a> </div> <div class="comment"> <p>This all pales in comparison to what we are spending on defense. It’s ridiculous to talk about cost-effectiveness of health care research dollars spent/case OR death, when we are spending on the several orders more in the “war on terror”. </p> <p><cite>— Posted by Lauren </cite></p> </div> </li> <li class="clearfix" id="comment-32525"> <div class="index">119.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32525" title="">6:07 pm</a> </div> <div class="comment"> <p>Yes, the $6B figure is NCI’s wish list or “professional judgement” request. It has little or nothing to do with what actually gets funded.</p> <p>The NCI appropriation has historically been well below the proposed amount, but has now been basically flat since 2004, an unprecendented run of limited support. The numbers look about like this:</p> <p>2003: Requested $5.7B, Received $4.6B<br/> 2004: Requested $6.0B, Received $4.8B<br/> 2005: Requested $6.2B, Received $4.9B<br/> 2006: Requested $6.2B, Received $4.8B<br/> 2007: Requested $5.9B, Received $4.8B<br/> 2008: Requested $5.9B, Received $4.8B</p> <p>The “received” figures represent effective cuts every year, given the lack of inflation adjustment. So NCI is funding fewer research grants (which is what the vast majority of the NCI budget goes to) and is having to reduce funds to existing multiyear grants.</p> <p>If you don’t like it, vote accordingly. </p> <p><cite>— Posted by Budget Watcher </cite></p> </div> </li> <li class="clearfix" id="comment-32541"> <div class="index">120.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32541" title="">8:51 pm</a> </div> <div class="comment"> <p>To poster #4: If we only funded the research that had the most promise, we would never fund most diseases! How would the long underfunded diseases ever catch up in knowledge and progress to those diseases that are more highly funded? The gap would keep getting larger and larger as a greater portion of the funding went to the more promising (”short horizon to a cure” definition) research. We have to start somewhere if we are to make any gains in the underfunded diseases. </p> <p><cite>— Posted by Holly </cite></p> </div> </li> <li class="clearfix" id="comment-32545"> <div class="index">121.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32545" title="">9:08 pm</a> </div> <div class="comment"> <p>rob, 116, you nailed it. A man I worked with was engaged to a woman who raised funds for the American Cancer Society, and one comment I remember him making is how much fun he had at their consistently lavish events. It’s what one of my heroes, Dr. Samuel Epstein, calls “The Cancer Industry.” </p> <p><cite>— Posted by francois </cite></p> </div> </li> <li class="clearfix" id="comment-32549"> <div class="index">122.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32549" title="">9:46 pm</a> </div> <div class="comment"> <p>#23 and #125,<br/> There is no hidden agenda. Any scientist would gladly cure cancer if she could. Such an accomplishment would provide her with fame and glory beyond imagination. Individual scientists aren’t spending any time thinking about the health of the machine. They have no inclination to do so, and they don’t need to. You are assuming an inflexibility that doesn’t exist. If scientists were to succeed in curing one disease, they would just move on to the next. You can see this flexibility today. Researchers follow funding. For example, when AIDS funding mushroomed, many researchers switched from their old fields into AIDS-related research. This is the power of patient advocacy, as discussed earlier. Politicians set the agenda, and this being a democracy, constituents influence politicians. </p> <p><cite>— Posted by Kevin </cite></p> </div> </li> <li class="clearfix" id="comment-32550"> <div class="index">123.</div> <div class="commentmetadata"> March 7th,<br> 2008<br> <a href="#comment-32550" title="">10:02 pm</a> </div> <div class="comment"> <p>Some things could be done more efficiency. I’ve heard that in the NIH intramural program (the National Institutes of Health’s own research campuses), the administrator to scientist ratio keeps going up. The idea is that administrators make the decisions, and they rarely choose to inconvenience themselves. The same thing occurs in large public school systems. Now the NIH extramural program (giving research grants to scientists in outside universities and other research institutions) is much larger than the intramural program, but I don’t know if the number of administrators per grantee has changed over time. </p> <p>Still, it’s small change compared to the defense budget or to entitlement programs. According to #119, NCI is getting 4.8 billion this year. In February, a B-2 Stealth Bomber crashed unexpectedly in Guam. Each one costs ~1.2 billion. A billion here, a billion there…pretty soon you’re talking about real money. </p> <p><cite>— Posted by Kevin </cite></p> </div> </li> <li class="clearfix" id="comment-32601"> <div class="index">124.</div> <div class="commentmetadata"> March 8th,<br> 2008<br> <a href="#comment-32601" title="">7:58 am</a> </div> <div class="comment"> <p>Kevin and others:</p> <p>So you have a beef with defending the country, perhaps. Or with some other area the government spends taxpayer money. We all would probably dole out the money differently if we were deciding how to spend taxpayer money. But get over it already. You’re not going to redirect government spending by incessantly complaining about in some blog. Sorry, but you just sound so futile and tiresome to me.</p> <p><strong>From TPP — But isn’t that a large part of what blogs are for — to give people a forum in which to express their thoughts, frustrations and ideas? I don’t think there is anything futile about gathering the collective wisdom and insights of the public.</strong> </p> <p><cite>— Posted by rob earl </cite></p> </div> </li> <li class="clearfix" id="comment-32606"> <div class="index">125.</div> <div class="commentmetadata"> March 8th,<br> 2008<br> <a href="#comment-32606" title="">9:15 am</a> </div> <div class="comment"> <p>re:95</p> <p>No, I meant that we accumulate more genetic insults. We have structures at the end of our chromosomes, called telomeres, that shorten with every replication of the DNA contained w/in those chromosomes. So technically, longer life = more genetic insults.</p> <p>You are also right about environmental insults, too… </p> <p><cite>— Posted by tt </cite></p> </div> </li> <li class="clearfix" id="comment-32608"> <div class="index">126.</div> <div class="commentmetadata"> March 8th,<br> 2008<br> <a href="#comment-32608" title="">9:23 am</a> </div> <div class="comment"> <p>I think part of the issue here, too, is cultural. We have this idea that you can throw money at anything and solve it! </p> <p>Life is difficult, really difficult, sometimes. It is unfair. Biology is extremely complicated. Money is NOT the answer to curing cancer.</p> <p>And I agree, this blame the victim attitude is problematic, and one that seems to be directed at anyone who is having a tough time. Blame the mortgage crisis on the unfortunate people who were lured into thinking they could afford homes that they couldn’t! blame mental health issues on those who suffer from them! How about making more compassion part of our American culture? And maybe a little patience, too…I wonder how many people would be this upset about these different cancers had they not personally been affected by them? </p> <p><cite>— Posted by tt </cite></p> </div> </li> <li class="clearfix" id="comment-32620"> <div class="index">127.</div> <div class="commentmetadata"> March 8th,<br> 2008<br> <a href="#comment-32620" title="">10:42 am</a> </div> <div class="comment"> <p>Completely overlooked here are the orphan cancers. I understand that TPP didn’t look them up due to a lack of time, but these cancers such as multiple myeloma, CLL, Non-Hodgkin’s Lymphomas, Waldenstrom’s Macroglobulinemia and other hemotological cancers are relying on private donations rather than the government. Universities are doing what they can via small government funding and private non-profit organizations who help fund research. </p> <p>I am old enough to remember the phrase promoted by the American Cancer Society, “Cure Cancer with a check-up and a Check”. That clearly has not been the total answer if there is one. Cancers, as someone earlier pointed out present themselves in hundreds of ways. And government is not the only source of funding for research in the many diseases that affect humankind. So give generously to non-profits who are also focusing on specific types of cancer. Government funding is not a panacea! </p> <p><cite>— Posted by Arlene Carsten </cite></p> </div> </li> <li class="clearfix" id="comment-32636"> <div class="index">128.</div> <div class="commentmetadata"> March 8th,<br> 2008<br> <a href="#comment-32636" title="">12:32 pm</a> </div> <div class="comment"> <p>Be careful about judging charities based on their administrative costs. It’s a valid measure, and one I use myself. </p> <p>But a high admin cost doesn’t always come from waste or lined pockets. The Cancer Society, for example, does not only raise awareness and fund research. It also provides help to cancer patients and survivors, and their families.</p> <p>Here’s one example from the local branch level. My mother (smoker, alcoholic) came down with lung cancer. Yeah, I blamed her refusal to stop smoking, but that didn’t change the fact that she needed treatment. “Treatment” meant daily radiation for 3 months. She could not drive; I lived three states away. But, the local ACS office had a volunteer driver program. Most of the drivers were cancer survivors or family members of cancer patients. They not only drove my mother to and from her radiation treatments, but they offered her support, encouragement, and hope at the same time.</p> <p>Someone has to coordinate those volunteers. Someone has to insure them while they are volunteering. That means insurance costs and at least one staff member.</p> <p>That shows up in the “admin” costs.</p> <p>A “lavish” fund raiser might cost $10,000 to throw, but attract $500,000 in donations from the attendees. The $10K is admin cost. </p> <p>I’m not saying there isn’t waste. I’m not saying there aren’t opportunists everywhere and anywhere. I am suggesting that, like so many things in our grey-shaded universe, things are rarely as simple as a quick look would suggest. </p> <p><cite>— Posted by Carol </cite></p> </div> </li> <li class="clearfix" id="comment-32641"> <div class="index">129.</div> <div class="commentmetadata"> March 8th,<br> 2008<br> <a href="#comment-32641" title="">1:09 pm</a> </div> <div class="comment"> <p>I’m a pediatric oncologist and a cancer researcher. To follow up on several very insightful comments made here, funding of research into childhood cancer gives disproportionately high returns, for two reasons. One, as pointed out, is the impact of saving a young life: seventy years of life lost for each child, multiplied by the 2600 who die each year in the US, translates into 182,000 years of life lost every year.</p> <p>The second reason is that cancers in children tend to be “simpler” than cancer in adults, and contain fewer genetic changes. This is somewhat oversimplified, but it is true that research into the mechanisms of childhood cancer has given us profound insights into how cells become cancerous–information that could help people of ALL ages struggling with cancer.</p> <p>Sadly, childhood cancer is really off the radar in this country. The Children’s Oncology Group, which coordinates national clinical trials of new cancer treatments in kids, is currently funded at only 50% of the level that the National Cancer Institute has recommended. People should be outraged by this.</p> <p><strong>From TPP — all very interesting and helpful. thanks. </strong> </p> <p><cite>— Posted by J. Amatruda </cite></p> </div> </li> <li class="clearfix" id="comment-32658"> <div class="index">130.</div> <div class="commentmetadata"> March 8th,<br> 2008<br> <a href="#comment-32658" title="">4:35 pm</a> </div> <div class="comment"> <p>To #85 Allison<br/> Early screening methods for lung cancer have yet to prove useful actually. There have been several studies trying chest X-rays and CT scans, attempting to detect and cure the cancers at earlier stages, however no statistically significant reduction in mortality could be demonstrated. What could be shown was a big increase in the discovery of “incident-omas,” benign lesions that would cause the patient no problems or worries except that now for a brief period of time they are treated as potential cancer and worked up as such. This results in increased costs and worry to the patients, and busy over-load work for the doctors. </p> <p>To those who compare AIDS to smoking related lung cancer, I would caution you that one of the greatest population of victims of AIDS in Africa is monogamous, married females. These women are infected by their husbands who have had unprotected sex with prostitutes, however due to cultural barriers, the wives are unable to refuse sex to their husbands or insist they wear a condom. Also, there is no choice given to young children who contract AIDS from their mothers during childbirth or breast feeding due to inadequate supplies/provisions of AZT.<br/> Also, I don’t think anyone is saying that all lung cancer is smoking related, in fact, most non-smoking related lung cancers are of specific, relatively rarer types, that receive their own pathological designations and research money, which is no reflected in the general numbers. </p> <p><cite>— Posted by Melinda </cite></p> </div> </li> <li class="clearfix" id="comment-32689"> <div class="index">131.</div> <div class="commentmetadata"> March 8th,<br> 2008<br> <a href="#comment-32689" title="">9:37 pm</a> </div> <div class="comment"> <p>What cancer research to fund–these are very difficult questions to answer.</p> <p>However, criteria should not be determined politically, but scientifically or medically. </p> <p><cite>— Posted by jack </cite></p> </div> </li> <li class="clearfix" id="comment-32712"> <div class="index">132.</div> <div class="commentmetadata"> March 9th,<br> 2008<br> <a href="#comment-32712" title="">1:49 am</a> </div> <div class="comment"> <p>The mathematics of cancer screening are little understood by the public and are inherently daunting. The biggest factor is how likely the person screened is to actually get a lethal form of the cancer that can be cured if caught early. In the general population, with no unusual risk factors, only colon cancer screening has been conclusively shown to be worthwhile for saving lives. </p> <p>Paradoxically, subpopulations at higher risk can have a net benefit from screening more easily. I refuse screening for prostate cancer and wish my wife would stop having mammograms. However, I strongly support her having experimental screening for pancreatic cancer, which is actually quite promising, because her family history puts her at high risk. It would, however, make no sense for me.</p> <p>I have not read the studies on the economics of lung cancer, but there seems to be a consensus that: “Published studies suggest that the increased lifetime health care costs from smoking-related illnesses in smokers are partially or fully offset by the higher medical costs that result from increased longevity in nonsmokers.”</p> <p>I remember seeing a card table in the lobby of the Johns Hopkins cancer building asking for money for lung cancer research. It’s not my cancer, but I couldn’t help thinking that it was a national disgrace, in the greatest cancer hospital in the world had to raise money as from a church bake sale to cure the cancer that kills by far the most citizens. These are our fellow human beings who are suffering, and it is a rare human being who does not do something to kill himself each and every day. </p> <p>The Puritan spirit is still alive in liberal America, and it is still looking for witches to burn. </p> <p><cite>— Posted by Frank </cite></p> </div> </li> <li class="clearfix" id="comment-32723"> <div class="index">133.</div> <div class="commentmetadata"> March 9th,<br> 2008<br> <a href="#comment-32723" title="">3:45 am</a> </div> <div class="comment"> <p>Cancer is a very serious issue…. the point about malaria brings a very interesting twist to the debate… but what do we do when pediatric funding is about $180 million. However, pediatric cancer only makes up 10K of the 1.4 million cases of cancer every year. What do we do when the survival for anyone who is diagnosed with cancer as an adolescent of young adult has a lower survival and this population makes up 70K of the 1.4 million cases of cancer. No funding, no research, no public health understanding or epi… but this article brings up a discussion that is very important in todays society & medicine. </p> <p>for anyone interested in advocacy :<br/> <a href="https://web.archive.org/web/20080311022551/http://www.seventyk.org/" rel="nofollow">www.seventyk.org</a> </p> <p><cite>— Posted by Joe </cite></p> </div> </li> <li class="clearfix" id="comment-32738"> <div class="index">134.</div> <div class="commentmetadata"> March 9th,<br> 2008<br> <a href="#comment-32738" title="">5:02 am</a> </div> <div class="comment"> <p>Breast cancer not only kills women but it maims, cripples and disables them. Breast cancer is more recurrent than other cancers and is not considered cured after 5 years. It breaks bones and causes spines and legs to collapse. The man who saw the makeup classes should have looked further to see those confined to wheelchairs. The makeup classes offer a little respite to sick women in a society where women, much more than men, are judged by their appearance. Every class I ever heard of was donated & the gov’t didn’t pay for it. </p> <p>Because 1 in 8 women get breast cancer, the rich are not immune to it and some women, like Evelyn Lauder and Nancy Brinker, on behalf of her sister, Susan G. Komen, have conducted large fundraising efforts. Ralph Lauren funded a breast cancer hospital wing dedicated to a friend who died of breast cancer. It’s a rare person who has never known or cared about someone who has suffered from breast cancer. These are private fundraising efforts not paid for by the government.<br/> <strong><br/> From TPP — I’d like to clarify a statistic you used. It is commonly asserted that 1 in 8 women get breast cancer but that is not correct. This common breast cancer statistic i– “one in eight” — s often misapplied. The truth is that a woman’s lifetime risk for developing breast cancer is about one in eight, or 12 percent. About 178,000 women will be diagnosed this year, which amounts to 0.2 percent of adult women, based on United States census data. The odds that breast cancer will kill a particular woman is one in 35, according to the American Cancer Society. For more about breast cancer myths, click<a href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2007/10/01/despite-awareness-campaigns-breast-cancer-myths-linger/" rel="nofollow"> HERE</a>..</strong> </p> <p><cite>— Posted by Suzy Bee </cite></p> </div> </li> <li class="clearfix" id="comment-32755"> <div class="index">135.</div> <div class="commentmetadata"> March 9th,<br> 2008<br> <a href="#comment-32755" title="">10:18 am</a> </div> <div class="comment"> <p>Speaking of breast cancer, here’s an article about how <a href="https://web.archive.org/web/20080311022551/http://aromatherapy4u.wordpress.com/2008/03/04/preventing-breast-cancer-lack-of-night-darkness-connection/" rel="nofollow">not sleeping in a dark room</a> can significantly increase your chances of getting breast cancer.</p> <p>I would LOVE to see them put a chunk of that money into stopping companies from making poisonous personal care and household cleaning products that are also known to cause a variety of cancers, those <a href="https://web.archive.org/web/20080311022551/http://aromatherapy4u.wordpress.com/2008/03/05/trusted-brand-name-products-should-you-use-and-trust-them/" rel="nofollow">trusted name brand products are poisons and carcinogens</a></p> <p>Imagine, if we didn’t have such high rates of cancer in this country we wouldn’t need to put the money into this research, we could put it into other things that enhance the quality and safety of life. </p> <p><cite>— Posted by Evelyn Vincent </cite></p> </div> </li> <li class="clearfix" id="comment-32763"> <div class="index">136.</div> <div class="commentmetadata"> March 9th,<br> 2008<br> <a href="#comment-32763" title="">12:00 pm</a> </div> <div class="comment"> <p>Frank, (#132, 3/9 1:49am)</p> <p>Were you my husband, I would nag you (yes, nag) to get tested for prostate cancer. And I would be concerned that you want me to stop getting screened for breast cancer. </p> <p>Do you also shun annual exams? Unlike the mammogram, the initial test for prostate cancer is part of an annual exam, lasting for a few minutes. It’s more analogous to a pap smear in women. I assume your wife gets those, too?</p> <p>Do you not get insurance? How likely do you think it is that your house will suffer a fire? But you have the insurance, anyway, right? Because the cost of the risk is too high to chance, even for something as unlikely as that?</p> <p>Well, cancer screening is similar. You have a 1 in 6 chance of getting prostate cancer. You have a 1 in 220-230 chance of experiencing a house fire. But the cost of recouping from the fire makes the insurance worthwhile; the cost of advanced cancer makes the early screening worth while.</p> <p>This has nothing to do with witch hunts. </p> <p><cite>— Posted by Carol </cite></p> </div> </li> <li class="clearfix" id="comment-32795"> <div class="index">137.</div> <div class="commentmetadata"> March 9th,<br> 2008<br> <a href="#comment-32795" title="">1:01 pm</a> </div> <div class="comment"> <p>Cancer gets so much support from society at large, as well as from funders. And rightfully so, it’s a devastating illness. However, there are so many other illnesses that warrant increased support from funders and society. Unfortunately, less is known about these other ailments (e.g. aplastic anemia, endometriosis, lupus), making sufferers and there families feel invisible. I’m not advocating to take $ away from cancer. I’m only saying that attention should also be devoted to less-publicized conditions so sufferers can benefit from the outpour of existing support for cancer patients. </p> <p><cite>— Posted by ellsy </cite></p> </div> </li> <li class="clearfix" id="comment-32802"> <div class="index">138.</div> <div class="commentmetadata"> March 9th,<br> 2008<br> <a href="#comment-32802" title="">1:18 pm</a> </div> <div class="comment"> <p>i think that they need to focus on the most common cancers beacaus ehtey kill more people and we would have a lot more money for testing if we didnt have the stupid war going on.Thank goodness we have the new election for president because both democratics are going to end the war and thats just wat we need! </p> <p><cite>— Posted by stacy </cite></p> </div> </li> <li class="clearfix" id="comment-32820"> <div class="index">139.</div> <div class="commentmetadata"> March 9th,<br> 2008<br> <a href="#comment-32820" title="">2:51 pm</a> </div> <div class="comment"> <p>Full disclosure, I’m an advocate for pancreatic cancer research and awareness and chair of the Pancreatic Cancer Alliance, an all volunteer group. <a href="https://web.archive.org/web/20080311022551/http://www.pancreaticalliance.org/" rel="nofollow">http://www.pancreaticalliance.org</a></p> <p>I’m posting links to a couple of spreadsheets I built as my mother was dying of pancreatic cancer in 2003. I wanted to understand how NCI spending was allocated and whether pan ca was in fact underfunded. Since then, NCI funding has more than tripled but spending on pan ca still ranks low, 11th overall, 14th in spending per death.<br/> <a href="https://web.archive.org/web/20080311022551/http://www.pancreaticalliance.org/docs/ncispending.htm" rel="nofollow">http://www.pancreaticalliance.org/docs/ncispending.htm</a></p> <p>The lack of pan ca research spending over time has also created a situation where improvement in five year survival has been impressive for many cancers over the past 30 years but negligible for pancreatic cancer.</p> <p>Five-year cancer survival rates<br/> Diagnosed Improvement<br/> in 1996-2003 since 1975<br/> Prostate 99% 32 points<br/> Melanoma 92% 9 points<br/> Breast (female) 89% 14 points<br/> Urinary bladder 81% 6 points<br/> All sites 66% 11 points<br/> Colon and rectum 65% 14 points<br/> Non-Hodgkin lymphoma 64% 15 points<br/> Leukemia 50% 14 points<br/> Ovary 45% 7 points<br/> Lung and bronchus 16% 4 points<br/> Liver 11% 7 points<br/> Pancreas 5% 3 points<br/> Source: Surveillance, Epidemiology, and End Results (SEER) Program (www.seer.cancer.gov) SEER*Stat Database, National Cancer Institute, report released April 2007.<br/> (more detail: <a href="https://web.archive.org/web/20080311022551/http://www.pancreaticalliance.org/docs/5yearsurvival.html" rel="nofollow">http://www.pancreaticalliance.org/docs/5yearsurvival.ht ml</a>)</p> <p>Short money for research lessens the attraction for people to specialize in pan ca. No early detection greatly reduces the opportunity for surgery, a patient’s best shot. And there are precious few places for a patient to go for excellent treatment given the complexity of the Whipple operation and the aggressive nature of the cancer itself — another product of the lack of attention the disease receives.</p> <p>Progress made in fighting so many cancers shows the difference that could be made for pancreatic cancer with what ultimately would be a small additional annual investment, less than the payroll of many baseball teams. </p> <p><cite>— Posted by tom cole </cite></p> </div> </li> <li class="clearfix" id="comment-32825"> <div class="index">140.</div> <div class="commentmetadata"> March 9th,<br> 2008<br> <a href="#comment-32825" title="">3:19 pm</a> </div> <div class="comment"> <p>Nobody deserves to get any kind of cancer.</p> <p>Lung cancer is the biggest killer and needs more funding.</p> <p>It is reprehensible and counterproductive to write off lung cancer victims because “they brought it upon themselves”.</p> <p>Not all smokers get lung cancer and some who never smoke get lung cancer…it deserves investigation. We must look to the environment.</p> <p>Exercising in polluted air for one hour is the equivalent of smoking a pack of cigarettes. Most major metroploitan areas suffer from some form of air pollution. People who exercise in those conditions may be putting themselves at risk for lung cancer. This is worthy of more funding. Lung cancer is the big killer that needs more funding. </p> <p><cite>— Posted by steve </cite></p> </div> </li> <li class="clearfix" id="comment-32833"> <div class="index">141.</div> <div class="commentmetadata"> March 9th,<br> 2008<br> <a href="#comment-32833" title="">4:12 pm</a> </div> <div class="comment"> <p>The anti-smoking campaigns have been wildly successful. There are more former smokers today than current smokers. Many of these former smokers are being diagnosed with lung cancer. I quit at the age of 25 and was diagnosed at the age of 52. It’s time to move beyond smoking cessation alone with regard to the number one cancer killer. The medical and insurance industries need to practice the same standard with lung cancer as they do with other big cancers (mammogram, colonoscopy, PSA), thousands of lives would be saved every year. It’s no mystery: Early detection saves lives. A CT scan helped detect my lung cancer early, which gave me a 60 percent chance of survival compared to a lousy 15 percent chance. Thanks in large part to their advocates, survival rates for breast and prostate cancers are 88 percent and 99 percent, respectively. With an 85 percent death rate for lung cancer, there are fewer survivors. And the guilt factor stymies many survivors and their loved ones. You may be surprised to see where the billions of dollars big tobacco forked over to big government has been spent. Check out <a href="https://web.archive.org/web/20080311022551/http://www.tobaccofreekids.org/reports/settlements/" rel="nofollow">http://www.tobaccofreekids.org/reports/settlements/</a> also for more information about the issue, see my blog at <a href="https://web.archive.org/web/20080311022551/http://www.dustydonaldson.blogspot.com./" rel="nofollow">www.dustydonaldson.blogspot.com.</a> </p> <p><cite>— Posted by Dusty Donaldson </cite></p> </div> </li> <li class="clearfix" id="comment-32834"> <div class="index">142.</div> <div class="commentmetadata"> March 9th,<br> 2008<br> <a href="#comment-32834" title="">4:20 pm</a> </div> <div class="comment"> <p>Almost impossible to find any mention of head and neck cancer. My young son, not a smoker or drinker, has been battling Ca of larynx for 10 yrs.[look up survival rate for head and neck ca.]. Early on, he was able to get mEDICAID COVERAGE. sINCE RETURN OF CA IN jUNE OF 07 HE HAS NO INSURANCE. hOWEVER, HIS dR. [jOHN dECKER] has kept him alive. Not to mention oncologist and radioogist. And with no insurance and contrary to many others, he has not been denied treatment. A visit to Dana Farber Ca Ctr recommended new chemo protocol and radiation. He received, bills are enormous. As a family, we are all paying on his many medical bills. His boss paid him, even though he was unable to work as a carpenter. So his treatment and the generosity of his employer are both unusual. He has total custody of a 13 yr old daughter and he is fighting to stay alive. I have submitted applications for financial assistance to NCI, ACA, and every other org that I thought would help. I received 1 phone call and followed up but no response after that. </p> <p><cite>— Posted by Dorothy Smith </cite></p> </div> </li> <li class="clearfix" id="comment-32861"> <div class="index">143.</div> <div class="commentmetadata"> March 9th,<br> 2008<br> <a href="#comment-32861" title="">9:54 pm</a> </div> <div class="comment"> <p>Cancer was unheard of 200 years ago and is now becoming more and more common. Why? The food we eat, the life styles we lead, the things we expose ourselves to. Microwave ovens, chemicals of all kinds, vaccines, drugs both prescription and over the counter. As long as there’s money to be had a cure will never be found. </p> <p><cite>— Posted by Leroy </cite></p> </div> </li> <li class="clearfix" id="comment-32920"> <div class="index">144.</div> <div class="commentmetadata"> March 10th,<br> 2008<br> <a href="#comment-32920" title="">8:15 am</a> </div> <div class="comment"> <p>It’s also because we live about 30 years longer than we did 200 years ago! </p> <p><cite>— Posted by tt </cite></p> </div> </li> <li class="clearfix" id="comment-32921"> <div class="index">145.</div> <div class="commentmetadata"> March 10th,<br> 2008<br> <a href="#comment-32921" title="">8:17 am</a> </div> <div class="comment"> <p>from JAMA<br/> Telomeres, cancer, and aging. Altering the human life span</p> <p>D. A. Banks and M. Fossel<br/> Richard & Rhoda Goldman School of Public Policy & Center for the Economics and Demography of Aging, University of California, Berkeley, USA.</p> <p>“Population projections of the aging global society and its fiscal and social impact have depended on assumptions regarding the human life span. Until now, the assumption that the maximum human life span is fixed has been justified. Recent advances in cell biology, genetics, and our understanding of the cellular processes that underlie aging, however, have shown that this assumption is invalid in a number of animal models and suggest that this assumption may become invalid for humans as well. In vitro alteration of telomeres affects cellular senescence, and in vivo manipulation of genes and diet can increase maximum life span in animal models if these discoveries are extended to humans. We may soon be able to extend the maximum human life span and postpone or prevent the onset of diseases associated with aging. Such a possibility requires that we recognize a growing uncertainty in any attempt to project international health care costs into the next few decades. The costs may be significantly lower than projections, if life span increases and age-related disabilities are postponed or less severe, or perhaps higher, if life span increases without altering the onset and severity of disability. An appropriate uncertainty regarding the human life span undermines any attempt to accurately predict health costs in the next century.” </p> <p><cite>— Posted by tt </cite></p> </div> </li> <li class="clearfix" id="comment-32923"> <div class="index">146.</div> <div class="commentmetadata"> March 10th,<br> 2008<br> <a href="#comment-32923" title="">8:29 am</a> </div> <div class="comment"> <p>Oh Leroy - they just weren’t as good at diagnosing/recognising diseases 200 years ago! People died of smaller things that were really symptoms of the end stages of cancer. </p> <p>BTW TPP it would be interesting to know the bowel cancer stats (not in your list) because the genetic factors that make you vulnerable to breast cancer also apply to bowel cancer - so if you’ve been diagnosed for breast cancer you ought to be tested for bowel cancer regularly. It is also the most common metastasis of breast cancer. So breast cancer research can also bring down deaths from bowel cancer. It isn’t a normal “random or personal factor metastisis” it is a known link in the genetic factors that cause both many cases of both cancers. I’m sure others are linked too.</p> <p>Makes it such a crime to waste breast cancer funding on fundraising activities. If people care about breast cancer research DON’T buy a damned ribbon - just donate. Or better still vote for a government that will fund it properly.</p> <p><strong>From TPP — Interesting point about bowel cancer as it shows there are synergies in research that can be exploited. i’m not finding bowel cancer stats on a quick search. will update if i find them.</strong> </p> <p><cite>— Posted by JillyFlower </cite></p> </div> </li> <li class="clearfix" id="comment-32925"> <div class="index">147.</div> <div class="commentmetadata"> March 10th,<br> 2008<br> <a href="#comment-32925" title="">8:49 am</a> </div> <div class="comment"> <p>I echo the comment that ‘no one deserves to die like that’. I lost my brother-in-law to lung cancer. He never smoked a cigarette in his life and, in every other way, lived a very healthy lifestyle. I hope that the assumption that ‘getting sick was his choice’ did not find its way into his care-givers let alone his treatment. I understand the frustration over paying for people’s risky behavior. If funding is based on these attitudes it would be unlucky to get a disease with such a stigma. </p> <p><cite>— Posted by Glenn </cite></p> </div> </li> <li class="clearfix" id="comment-32991"> <div class="index">148.</div> <div class="commentmetadata"> March 10th,<br> 2008<br> <a href="#comment-32991" title="">2:39 pm</a> </div> <div class="comment"> <p>Looks like the “war on cancer” is going about as well as the “war on drugs.” As soon as the government declares “war on something” I’m immediately skeptical about who’s purpose that “war” is going to serve. Start following the money, and it gets scary fast.</p> <p>It saddens me, because in today’s world very few people truly believe they have the power to heal themselves - and thus, they can’t. Cancer, from what I have read and what my heart tells me is completely misunderstood according to modern medicine.</p> <p>Cancer is trying to tell us something. Cancer itself isn’t deadly - unless the destructive conditions that led to cancer aren’t changed, or they’re caught too late. Cancer is ALWAYS in response to something - smoking, diet, chemicals, stress, chronic infection, lack of love, anger, etc. It’s as individual as the person who is afflicted.</p> <p>I’ll use a very obvious example here: say a person lives next to a toxic waste dump and they get cancer. They go and have cancer “treatments.” They have surgery and radiation (or whatever combo of the big 3), and try to remove the tumor. If they succeed, and the person moves back next to the toxic waste dump, do you think their “treatments” will be effective? Will their body be healthy again because that cancer tumor is not there? Of course not! They’ll be exposed again to the same chemicals that contributed to their cancer in the first place - the tumor will surely return. By creating a tumor, the body is saying, “hey, move away from that toxic waste dump!”</p> <p>CANCER IS ABOUT CHANGE. There’s no cancer, no matter how “terminal” that somebody somewhere hasn’t survived. That change can be environmental, physical, emotional or spiritual - or all of the above. People who are cancer survivors (from what I know which certainly isn’t everything) seem to have one thing in common and that is the willingness to accept and embrace change. Go survivors!</p> <p>Maybe for some people it’s moving away from that toxic waste dump. But maybe for other people it’s eliminating processed foods and changing their diet. Or, it may be changing that negative thought pattern and forgiving themselves for smoking after they’ve quit (why do some former smokers live a full cancer-free life, and others perish?). For some it might be forgiving and letting go of the guilt of a failed relationship. </p> <p>Cancer might solidify a person’s faith in God. For those lucky, wise people it might result in a complete realignment of their perceptions of reality - and thus their own innate divinity and ability to heal.</p> <p>Bottom line: if you’re trying to live the same way you were before cancer and expect “treatments” to keep you alive, you may as well put your hope in a pile of mud.</p> <p>Peace to everybody! Be healthy because you are! Love, love, love! </p> <p><cite>— Posted by Stine </cite></p> </div> </li> <li class="clearfix" id="comment-32996"> <div class="index">149.</div> <div class="commentmetadata"> March 10th,<br> 2008<br> <a href="#comment-32996" title="">3:07 pm</a> </div> <div class="comment"> <p>I’ve recently lost two close relatives to cancer (breast and colon). In each case, they didn’t go to their physician and get screened as per the ACS guidelines. Had they done so, both of them would still be amongst the living. </p> <p>I’m a big fan of the NIH and the work that it does. However, I think that there’s some room for improvement in delivering the message to the gneral public about what cancer diagnostic tests should be done when. If the drug companies feel that direct-to-consumer ads are profitable for them, why doesn’t the NIH spend some of our tax dollars to get the word out to folks as to when they should see their doc for certain diagnostic tests? We could have the best cures in the world (and spend a lot of money/patient), but if we can’t get people to get screened when they should, those cures won’t be effective. As an example, I’ve read that only 40% of the folks who should have a colonoscopy to screen for colon cancer have done so. That’s sad, given that early detection CAN save your life for colon cancer. Believe me, a colonoscopy is much less painful and embarassing than dying of colon cancer.</p> <p>I know that this is off-topic. It would be interesting to know what the NIH spends on patient education, and compare that to the dollars spent by the drug companies educating us about erectile dysfunction. </p> <p><cite>— Posted by Leslie in San Diego </cite></p> </div> </li> <li class="clearfix" id="comment-33011"> <div class="index">150.</div> <div class="commentmetadata"> March 10th,<br> 2008<br> <a href="#comment-33011" title="">5:07 pm</a> </div> <div class="comment"> <p>My bad TPP, I didn’t realize that the classification “colon” cancer in the US denotes what in Australia is called “bowel” cancer. So the stats are in your table. Interesting to know the overlap though.</p> <p>My grandmother had 2 sisters, 1 died of breast cancer in her 50s (typical risk profile, middle aged woman who never had a child or breastfed). The other sister died in her late 60s from bowel cancer with liver metastisis. We were told then (back in the 1990s) that there were suspected to be related genetic predispositions between the 2 cancers. As I understand it further evidence has emerged since then. Just anecdotally, a nephew of both these women who is an oncologist recommended that all the women in the family get checked for both breast and bowel cancer regularly after age 40. What genetic factors may show up as breast cancer in some related women may show up as bowel cancer in others. Obviously bowel cancer is much less likely to be detected early, and gets less funding. So perhaps a bright side - if such a thing can be found - for those battling early-detected breast cancer who suspect a genetic element (and not all breast cancer cases have that but many do) is that at least they got the cancer that was most easily detected and treated early. The prognosis for bowel/colon cancer is much much worse. </p> <p><cite>— Posted by JillyFlower </cite></p> </div> </li> <li class="clearfix" id="comment-33018"> <div class="index">151.</div> <div class="commentmetadata"> March 10th,<br> 2008<br> <a href="#comment-33018" title="">5:50 pm</a> </div> <div class="comment"> <p>1. Cancer was NOT unheard of 200 years ago. Read the historical descriptions.<br/> 2. Some commenters don’t want their tax dollars to pay for lung cancer treatments in smokers; others say that’s moralizing and ultimately self-defeating. It is. Some say that the health costs of a longer life balance out the costs of treatment for smoking-related illness. </p> <p><cite>— Posted by Anonymous MD </cite></p> </div> </li> <li class="clearfix" id="comment-33023"> <div class="index">152.</div> <div class="commentmetadata"> March 10th,<br> 2008<br> <a href="#comment-33023" title="">6:35 pm</a> </div> <div class="comment"> <p>As a 2+ year Stage IV lung cancer survivor, and a former smoker since 1970, I am so grateful to see articles like this one, finally addressing the shameful underfunding of lung cancer research by the N.C.I. When 50% of newly diagnosed lung cancer cases are in former smokers, the solution must include a strong emphasis on screening and earlier detection so that more of these lives can be saved. Just as the widespread use of the mammogram improved breast cancer survival, we must use the spiral CT scan to save the lives being lost to lung cancer - and fund much more research into new treatments that can cure all stages of lung cancer. Thank you, Tara, for speaking out. </p> <p><cite>— Posted by Susan Knerr </cite></p> </div> </li> <li class="clearfix" id="comment-33030"> <div class="index">153.</div> <div class="commentmetadata"> March 10th,<br> 2008<br> <a href="#comment-33030" title="">7:15 pm</a> </div> <div class="comment"> <p>Leroy,</p> <p>Hippocrates (he of the medical oath) coined the term “karkinos” for lumps (growths) that didn’t heal. He named diseases which created these lumps “karkinomas.” Asian medicine has recognized the concept of malignant growths for at least as long. 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Are there really people who do this?”</a></blockquote><div class="comment_author"><span class="com-author"><a href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2008/03/03/does-tv-belong-in-a-childs-bedroom/#comment-31108" title="Posted by Gayle">— Gayle</a></span><span class="com-post"><a href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2008/03/03/does-tv-belong-in-a-childs-bedroom/">Does TV Belong in a Child's Bedroom?</a></span></div></div><div class="pullquote"><blockquote><a href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2008/03/03/putting-your-kitchen-on-a-diet/#comment-31165">“I'll take the fondue pot.”</a></blockquote><div class="comment_author"><span class="com-author"><a href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2008/03/03/putting-your-kitchen-on-a-diet/#comment-31165" title="Posted by karen">— karen</a></span><span class="com-post"><a 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href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2008/02/29/the-cure-for-exhaustion-more-exercise/">The Cure for Exhaustion</a></h5> <a href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2008/02/29/the-cure-for-exhaustion-more-exercise/"><img class="callout wide" src="https://web.archive.org/web/20080311022551im_/http://graphics8.nytimes.com/images/blogs/well/posts/promos/fatigue165.jpg" alt="tired"/></a> <p class="summary">Patients with persistent fatigue got an energy boost from low-intensity exercise.</p> <p><ul class="refer"> <li class="free"><a href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2008/01/11/when-fitness-means-life-or-death/">Life or Death Fitness</a></li> <li class="free"><a href="https://web.archive.org/web/20080311022551/http://well.blogs.nytimes.com/2008/01/08/rating-home-exercise-equipment/">Rating Home Exercise Equipment</a></li> <li class="free"><a 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Muddle</a></li> <li class="free"><a href="https://web.archive.org/web/20080311022551/http://www.nytimes.com/2008/02/12/health/12well.html">Reinventing Date Night for Long-Married Couples</a></li> <li class="free"><a href="https://web.archive.org/web/20080311022551/http://www.nytimes.com/2008/02/05/health/05well.html">Coping With the Caveman in the Crib</a></li> <li class="free"><a href="https://web.archive.org/web/20080311022551/http://www.nytimes.com/2008/01/29/health/29well.html">Great Drug, but Does It Prolong Life?</a></li> <li class="free"><a href="https://web.archive.org/web/20080311022551/http://topics.nytimes.com/top/reference/timestopics/people/p/tara_parkerpope/index.html">All Past Columns</a></li> </ul></div></div> <div class="side_tool"><h4>About Well</h4><div class="story"> <p class="summary"><img class="callout" src="https://web.archive.org/web/20080311022551im_/http://graphics8.nytimes.com/images/blogs/well/tara75.100.jpg" alt="Tara Parker-Pope on Health"/>Healthy living 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The road to better health is paved with the small decisions we make every day. It's about the choices we make when we buy groceries, drive our cars and hang out with our kids. That's the focus of Well, The Times's new health blog. Join columnist Tara Parker-Pope as she sifts through medical research and expert opinions for practical advice to help readers take control of their health and live well every day. 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