[Mb-civic] Cancer Research in Danger - Martin Abeloff and Edward Miller - Washington Post Op-Ed

[William Swiggard]

Cancer Research in Danger

By Martin D. Abeloff and Edward D. Miller
Monday, February 6, 2006; 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.

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