Viewpoints: NIH cutbacks bite into research for cancer cures and treatment

In a basement laboratory on the UC Davis campus, a team of young researchers, from graduate students to newly minted Ph.D.s, are helping create better radioisotopes to seek out human tumors – and deliver treatments. On the Sacramento campus, scientists are developing new molecules that home in on leukemia stem cells but spare normal cells. And in neighborhoods throughout Sacramento, lay health workers are surveying Hmong residents about their knowledge of hepatitis B and risk of liver cancer, and collecting blood samples to look for disease biomarkers.

These are samples of the burgeoning research enterprise at UC Davis. Thousands of people at the university – including 750 students and post-docs – are working in one way or another to reduce the cancer burden – not just for our region, but globally. In the past decade, our expanding understanding of the human genome and the decreasing cost to use it for research has dramatically accelerated progress against the disease. And nearly all of the work under way comes thanks to federal investment in biomedical research. Without it, we will lose important ground in our work to prevent, control and, hopefully, someday eradicate cancer.

That investment is especially critical now with the aging of the baby boomers. Consider the numbers. In 2009 there were 39.6 million Americans over 65. That same year, 391,000 Americans over 65 died from cancer. Seventeen years from now, 74 million Americans will be over 65. If we do not improve cancer treatments by then, the number of cancer deaths among older Americans will nearly double to 731,000. That figure is higher than the total number of reported cancer deaths in 2012 for all age groups – 600,000. This is why continued funding to fuel bold advances in cancer treatment is urgent.

Tragically, public investment in cancer research has taken a beating over the past decade. Most cancer research funding comes from the National Cancer Institute, part of the National Institutes of Health. Since 2003, appropriations for the NIH have remained essentially flat. Taking into account the rate of biomedical inflation, the agency has effectively lost about $6 billion in purchasing power to fund research.

With automatic, across-the-board spending cuts, the NIH will lose another $1.5 billion, hundreds of new scientific grant proposals that would have been funded will be turned down, and research training grants will be eliminated, according to NIH director Francis Collins. The cuts will translate to a loss of $6 million in grant funding to UC Davis.

As Collins has said, research funding is not a spigot you can easily turn off and back on. That's because the scientific pipeline has been built with generations of scientific talent, each one building on the knowledge and gains of those preceding them through mentorship and training. This work to unlock the mysteries of diseases like cancer lowers death rates and health care costs, and eases the financial and emotional tolls they take on families.

The deterioration of the pipeline comes at a critical time. Although death rates from most types of cancer have fallen because we are finding and treating tumors earlier, advanced cancers have proved much more challenging. This nation's investment in cancer research has allowed us to develop the tools to drastically cut that death rate. These tools are not simply costly new drugs. They are methods to interrogate tumors at the molecular level. They are tests to identify a tumor's genetic characteristics so we can choose appropriate treatments on a patient-by-patient basis so we can spare patients therapies that cause side effects but offer no benefit.

Our ability to define genetic changes that cause cancer also allows us to personalize treatment by harnessing the patient's own immune system to stop tumor growth. The recently reported therapy that genetically alters a patient's immune cells to reverse a usually lethal adult leukemia is a good example.

There is no question that when Congress cuts a trillion dollars from the federal budget hard choices have to be made. But further reductions in lifesaving medical research and in the education and training of the next generation of scientists are foolish. Even in terms of the nation's financial health, these cuts make no sense because they crush the entrepreneurial spirit that drives the nation's economic engine.

It would be a tragedy if today's bright and ambitious science students viewed the erosion of the biomedical research pipeline as reason to take their talents to private industry or elsewhere. It would be even more tragic to lose ground on our substantial progress toward finding better ways to prevent, diagnose and treat cancer at a time the U.S. population most needs hope for cures.

Ralph de Vere White is director of the UC Davis Comprehensive Cancer Center and associate dean for cancer programs at the UC Davis School of Medicine.

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