Cancer researchers urge more funding

CHICAGO -- The nation's cancer specialists made an impassioned plea for greater federal investment in medical research yesterday, saying that a four-year budget freeze is slowing their work just as researchers close in on major breakthroughs in the treatment of the nation's number-two killer.

The National Institutes of Health budget doubled from 1998 to 2003, ushering in an unprecedented era of federal support for medical science. But NIH spending on research into cancer, or other diseases, has scarcely increased since that time, while inflation has raised the cost of doing research 13 percent. As a result, the branch of the NIH that funds cancer research has been forced to turn down research proposals while cutting the size of research grants.

"The pace of progress is at risk," said Dr. Allen Lichter, chief executive of the American Society of Clinical Oncology. Speaking at a press conference at the group's annual meeting, he noted that the four-year freeze is unprecedented since President Nixon declared "war" on cancer in 1971. "Will we make these discoveries a year later than we should have? Two years later? Five years later?" he said.

With only a small increase in the $28.4 billion NIH budget included in President Bush's 2008 budget proposal, Lichter said the 31,000 cancer specialists at the annual convention need to join other medical groups in pushing for a $1.9 billion boost in the federal research budget. Medical researchers have said that amount would be enough to regain some of the momentum lost since 2003.

Supporters of more research spending admit that they face an uphill climb winning a 6.7 percent NIH budget increase when the government is spending tens of billions on the Iraq war and running an enormous budget deficit. However, members of Congress on both sides have been circulating "dear colleague" letters this year urging support for an increase in medical research, Kevin Casey, director of government relations for Harvard University, said in a telephone interview.

"I think when all is said and done, there will be additional money for NIH. It's kind of premature to speculate on exact amounts," said Dan Gage, chief of staff to US Representative James Walsh of New York, the ranking Republican on a key appropriations subcommittee that is scheduled to take up the NIH budget next week.

Some members of Congress have questioned whether the NIH spends its money wisely, but yesterday, cancer specialists argued the $69 billion investment government has made in cancer research since 1971 has been an extraordinary success: the percentage of people who survive cancer for five years has risen from 51 percent to 66 percent. And the number of cancer deaths has begun to decline even though the population continues to grow and age.

Spurred partly by the doubling of the NIH budget a few years ago, the pace of cancer discoveries has reached a new high as researchers zero in on the specific genetic mutations that cause cancer and design treatments that attack the disease without harming healthy tissue. Just as important, researchers now understand that cancer is not one disease but hundreds, and each victim needs to be treated individually.

"We are moving rapidly in the direction [where] we match you as an individual with the appropriate therapy for you as an individual," said Dr. John Niederhuber, director of the National Cancer Institute, the branch of NIH that funds cancer. Niederhuber, who appeared at the press conference to push for more NIH funding, said he was not allowed to take a stand on the proposed increase, but "everyone in the audience knows how strongly I feel about this issue."

But the budgets since 2003 have steadily eroded the gains from the budget doubling, Niederhuber said. His office turned down 179 research proposals last year that would have been supported based on merit a few years ago and made budget cuts that resulted in cutbacks in tests of treatments for 4,500 patients.

Supporters of increased cancer research said the federal retrenchment comes at a time when the rate of cancer is about to skyrocket as the Baby Boom generation ages. People over 65 are 10 times as likely to develop cancer as younger people.

"The overall flattening of the NIH budget . . . has got everybody very, very worried," said Dr. Edward Benz, president of Dana-Farber Cancer Institute in Boston. He said a number of the institute's researchers have had their funding cut or seen promising new proposals rejected outright.

So far, he said, Dana-Farber has been able to make up for the declining federal funding by redirecting about $3 million a year from other sources. But, Benz warned, "Looking ahead, I don't know how much longer we can sustain this."

Scott Allen can be reached at allen@globe.com.