Cancer Research Cutbacks

<http://www.washingtonpost.com/wp-dyn/content/article/2006/02/05/AR2006020501058.html>

Cancer Research in Danger

By Martin D. Abeloff and Edward D. Miller

Monday, February 6, 2006; Page A15

For medical researchers, the National Institutes of Health is a formidable
economic engine that powers this country's scientific advances. It hands
out grants to more than 212,000 investigators at more than 2,800
universities, medical schools and other research institutions. It is the
lifeblood for studies leading to vaccines, antibiotics and new treatments
for some of humankind's most devastating illnesses.

In the late 1990s and beginning of this decade, Congress and the president
rallied around a plan to double the nation's research commitment in just
five years. It's no accident that this surge of research dollars led to
remarkably rapid progress. The five-year survival rates for many cancers
are improving, and the advances in laboratory, clinical and population
research will clearly accelerate this progress.

Unfortunately, however, the focus in Washington seems to be shifting to
other fiscal priorities. In the past three budgets, research
appropriations slowed dramatically -- and recently they have diminished.

The NIH budget in the current fiscal year rose by less than inflation for
the second year in a row. This meant a net loss of buying power, fewer
research grants and fiercer competition for the remaining dollars. Even
worse, decisions made over the past few months will result in a net budget
decrease for NIH -- the first cut in its budget in 36 years and only the
third in its history.

When combined with an expected 3.5 percent rise in biomedical costs this
year, Washington's decision to cut research funding hits laboratory,
clinical and translational investigations (which seek to link medical
research to its practical applications). On an inflation-adjusted basis,
the current NIH appropriation is smaller than it was four years ago. In
constant dollars, NIH funding has declined by more than $1 billion since
2003.

What a dramatic, and disturbing, turnaround. Shrinking research support
could have ramifications even for the nation's best medical investigators.

For instance, five faculty members at Johns Hopkins's Kimmel Cancer Center
-- Bert Vogelstein, Kenneth Kinzler, James Herman, Stephen Baylin and
David Sidransky -- recently were recognized by Science Watch newsletter as
the most influential researchers in oncology, based on the number of times
their work was cited in scientific studies in the past decade. (An earlier
report named Vogelstein the world's most-cited researcher over a 20-year
span, with a remarkable 106,401 references to his work in other studies.)
All of these cancer investigators have depended heavily on NIH grants
throughout their careers. All are working on highly promising projects.

Vogelstein and Kinzler are widely regarded as the leading experts in
molecular genetics and were largely responsible for defining cancer as a
disease of genetic mistakes. They've invented genetic screening tests that
identify people at high risk of colorectal cancer.

Herman and Baylin are pioneers in a new field known as epigenetics, the
study of gene alterations that occur without DNA mutations. They are
credited with pioneering research into molecular changes that can stop the
formation of tumors.

Sidransky is a leader in the study of cancer biomarkers, which are the
earliest molecular changes in the cancer process. His work led to the
development of screening tests for cancer.

Though these five investigators are the best in their field, their work
could be slowed or greatly diminished by the squeeze in NIH funding.

Scientists across the country have seen delays in processing grant
applications, elimination of cost-of-living allowances for multiyear
grants and cuts in continuing grants previously awarded. For young
researchers, there is the real danger that they may not receive any NIH
funding. Some of our best and brightest young investigators -- the next
generation of Vogelsteins -- may leave the profession. What a loss that
would be for American biomedical research.

Given recent discoveries that have dramatically increased our
understanding of complex aspects of cancer, we are positioned to make
significant breakthroughs in the next decade -- but only if federal
support is strengthened.

We have reached a pivotal moment in medical history. None of us wants to
cut back on the exciting studies at the Kimmel Cancer Center and other
research programs. Reducing and eventually eliminating the death and
suffering from cancer in all its forms would be a stunning achievement. It
is a goal our leaders should embrace with enthusiasm rather than slowing
financial backing for this nation's medical research.

Martin D. Abeloff is director of the Kimmel Cancer Center at Johns
Hopkins. Edward D. Miller is dean and chief executive of Johns Hopkins
Medicine.

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