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The Other War

    Our presidential election captivated the world. But now there is no time to waste. Our dire financial picture, job losses, global warming, energy dependence, the war in Iraq and health insurance for all will be competing for time and treasure. But another pressing priority must also be addressed and reorganized from the ground up. That is the War on Cancer, launched by President Richard M. Nixon in 1971. We don’t have time to lose.        
    Considering the thousands of Americans who die every day from cancer, the impact of this disease on our country is every bit as critical as the War on Terror. If we can fund a $700 billion bailout for the banks or fund a $3 trillion war in Iraq, surely we can find the resources to reorganize and adequately fund research to cure cancer.          
    Cancer rates have hardly budged since Nixon’s time. Lung and colon cancer progress has been largely due to better screening and smoking cessation. Earlier and better diagnostic tools have improved breast cancer risk of recurrence in early stage breast cancers, and drugs like tamoxifen and Gleevec have had impact on some cancer patients. Compassionate groups have brought cancer patients information they can use and support they can count on. However, most cancer patients today find that the available treatments—chemotherapy, radiology and surgery—still do not produce cures.
     Despite $200 billion spent on research by taxpayers, donations and drug companies since 1971, we have archaic models in place that do not produce cures in human cancers; most cancer research is usually built on mice models, not human models. Mice have completely different molecular signaling, metabolic rates, physiology and immune systems. According to Clifton Leaf, former editor at Fortune and a cancer survivor, tumors in mice don’t have the quickly changing complexity of the most deadly human tumors. And research in the United States is usually aimed at shrinking tumors, not preventing metastasis, which usually kills 90 percent of cancer patients. There has been little progress in putting a dent in mortality rates. Unfortunately, tumor shrinkage on fatally ill cancer patients has little to do with survival or a cure. Leaf writes that 95 percent of the nearly 8,900 National Cancer Institute grant proposals awarded in 2003 never even mentioned metastasis. Most grant proposals are redundant.
     Leaf currently serves on many of the boards of cancer organizations, including the Susan G. Komen for the Cure, where he is a director. Yet he is outspoken on what is broken in our fight to find effective cures for the cancers that many of the “scientific echelons of cancer” hype as progress.
      As reported in the January/February issue of Cancer World, Leaf says we must change our whole dysfunctional, broken cancer research system. He says that vested interests in the way research grants are awarded, methodology, clinical trial regulations and the ownership of intellectual property (IP) have contributed to the poor results in tackling cancer. Leaf points to “freezers of millions of tumor specimens but no way of knowing what’s inside them.” He points to the National Cancer Institute as an example of the problem.
      According to Cancer World, “They are the plutocrats and are resistant to anything that will take away their power.” Despite the multitudes of people who run mile-after-mile and who generously donate to philanthropic groups to raise money for cancer, we have not turned that power into political will to change the system. Leaf cites the flaws in IP rules that permitted ownership of gene data. This taxpayer-funded original research gets turned into patents awarded to universities, who turn around and sell this data to developers, who have monopolies in the marketplace. This privatized knowledge has resulted in driving up drug costs to astronomical levels. Leaf, who is writing a soon-to-be-published book on cancer research, points to the poor leadership in the cancer community, fragmentization of information and a risk-adverse attitude to potentially life-saving drugs as standing in the way of reforming our broken cancer establishment.
    One of the big problems is a reluctance by drug companies to mix and match potentially life-saving drugs made by different companies that are created by this IP protectionism. Few cancer drugs affect the multi-faceted genetic mutations and proteins that complicate cures for such a complex disease. Yet, a combination of several different drugs made by different companies working in concert could produce “chemotherapeutic cocktails” that may prove successful.
      Another roadblock to success in this fight against cancer is the cumbersome way research is shared, both internationally and nationally. Licensing contracts and FDA trials that are too cautious in testing drugs for very sick patients can hamper getting new drugs to market. Knowledge-sharing and creating universal academic exchanges could break down the “elitism” Leaf points to in the cancer community.
      Despite Leaf’s criticism of the progress in the cancer community, very worthwhile not-for-profits like the Multiple Myeloma Research Foundation have welcomed his ideas. Leaf favors universal health care and streamlining the sharing of biomedical research findings in a Google-like databank. Though he doesn’t see miracles on the horizon in the near future, he is optimistic that the Obama administration may prove open to making the critical changes needed to reform a system that is broken. Reforming derivative drug development, funding basic research, fostering “provocative” thinking and sharing information are just the beginning. Chicago philanthropist Lou Weisbach and Dr. Rick Boxer have created the American Center for Cures (ACC); they advocate creating a cabinet position devoted to finding cures (see page 23).
    We need advocates like Weisbach, Boxer and Leaf to lead this reform. It would be a relief for the millions of cancer patients and their families if they no longer feared for their futures. With a new administration sensitive to their needs, lives can be saved, treatment costs can be eliminated, and health care can be offered to all Americans. Maybe if our funding priorities are centered on the needs of the common man and not solely by profit-driven special interests, changes to benefit Americans and those suffering all over the world will be the centerpiece of our humanitarian quest to conquer cancer in our lifetime.

Published: December 06, 2008
Issue: Winter 2008 - Annual Philanthropy Guide