Food for thought.

Cancer is a devastating disease at so many different levels. For some reason, there is a certain pride in heart disease: the executive has his heart attack, angioplasty and is back to work within a couple of weeks bragging, but the patient with cancer often tries to hide the diagnosis. Why?

When I was first drawn to oncology (as a geek high school student), I had read a Newsweek article about oncogenes. The discovery of these genes was going to lead to a cure for cancer in the next 10 years. Well, we are now 25 years down the road. We can treat more cancers than ever before, we have extended the survival and decreased recurrence in many, but .... for far too many, the outcome is the same. Death. I found an interesting quote yesterday.

Taken from Breast Cancer Update in an interview with Larry Norton (a breast cancer specialist at Sloan Kettering in New York):

"If you add together everything that Americans spend on cancer research in this country, and I’m talking about all segments of our society — government, industry and philanthropy — it’s between $11 or $12 billion, about two thirds of the $16 billion the tobacco industry spends on advertising and one sixth of the $68 billion Americans spend on soft drinks annually. The entire National Cancer Institute budget for cooperative group trials is under $158 million. If we really want to get rid of cancer, we know what to do. We just have to do it."

Pretty sobering statistics, eh? If dumped all the money that currently goes into tobacco advertising into cancer research will we have a cure? Maybe not -- but in many disease, we are moving closer to having a chronic disease. If that conversion to a chronic disease comes with quality of life....I think that is an adequate goal. And the amount we spend on sugared carbonated water? All of a sudden the Diet Coke sitting at my desk didn't taste right.

Right now, I am feeling like we live in a very toxic world. It seems to be moving faster and fast, in part because of the computer age that has made this blog possible. On many days, things feel off balance. Part of that is the innate stress of my work, but when I read things like the finances on cancer research, I know that we are off balance.

On February 4th, George Bush presented his proposed budge for FY2009. In that budget is a mere 29.3 billion for the NIH, increased from 28.9 in 2008 (NIH funds all sorts of basic science, not just cell biology and biochemical sciences). Between 1999 and 2003 there was a doubling of the NIH fiscal budget. Given inflation and the increased cost of doing research, the current rate of increase in the NIH budget has resulted in a 13% loss in the buying power of the NIH. (As we learn more, more sophisticated techniques are required.) This means the loss of research programs, the loss of morale in labs (which is hard to maintain at baseline), and the loss of young investigators. Without supporting our basic sciences, the foundation for novel therapies for cancer and other medical conditions will be lost.

I know that there is a limited pool. I see waste all the time. What are our priorities?

I have the utmost respect for our service men fighting the war, police officers, fire men (the path of my training has shown me that those people are exposed to horrors that most of us never consider or appreciate). I believe many people question the war in Iraq. The direct cost of that war is 845 BILLION dollars. The direct costs plus indirect costs (inflation, increased cost of oil, etc) may be as high as 3 trillion dollars (See link). Just think the industry that might have been generated had half of that money been diverted to research and education (without education, we will have no one to do research).

OK. I'm off my soap box. For now.