As someone who was funded as a Principal Investigator for National Cancer Institute research grants for 8 years, I would like to join the chorus and say the current approach does not work and needs a revolutionary overhaul.
Fortune magazine recently provided a nine part series on this problem and proposed solutions.
THE WAR ON CANCER: Why we are losing the war on cancer and how to win it
By Clifton Leaf
Fortune, 9 Apr 2004
Just count the bodies on the battlefield. In 2004, cancer will claim some 563,700 of your family, friends, co-workers, and countrymen. More Americans will die of cancer in the next 14 months than have perished in every war the nation has ever fought … combined. Even as research and treatment efforts have intensified over the past three decades and funding has soared dramatically, the annual death toll has risen 73%—over one and a half times as fast as the growth of the U.S. population.
Within the next decade, cancer is likely to replace heart disease as the leading cause of U.S. deaths, according to forecasts by the NCI and the Centers for Disease Control and Prevention. It is already the biggest killer of those under 75. Among those ages 45 to 64, cancer is responsible for more deaths than the next three causes (heart disease, accidents, and stroke) put together. It is also the leading disease killer of children, thirtysomethings—and everyone in between…
And the new cases keep coming. Even with a dip in the mid-1990s, the incidence rate has skyrocketed since the War on Cancer began. This year an additional 1.4 million Americans will have that most frightening of conversations with their doctor. One in two men and one in three women will get the disease during their lifetime. As a veteran Dana-Farber researcher sums up, “It is as if one World Trade Center tower were collapsing on our society every single day.”
So why aren’t we winning this decades-old war on terror—and what can we do now to turn it around?
That was the question I asked dozens of researchers, physicians, and epidemiologists at leading cancer hospitals around the country; pharmacologists, biologists, and geneticists at drug companies and research centers; officials at the FDA, NCI, and NIH; fundraisers, activists, and patients… Most felt, despite their often profound misgivings about the way research is done, that we’re on the right path.
Yet virtually all these experts offered testimony that, when taken together, describes a dysfunctional “cancer culture”—a groupthink that pushes tens of thousands of physicians and scientists toward the goal of finding the tiniest improvements in treatment rather than genuine breakthroughs; that fosters isolated (and redundant) problem solving instead of cooperation; and rewards academic achievement and publication over all else.
At each step along the way from basic science to patient bedside, investigators rely on models that are consistently lousy at predicting success—to the point where hundreds of cancer drugs are thrust into the pipeline, and many are approved by the FDA, even though their proven “activity” has little to do with curing cancer.
“It’s like a Greek tragedy,” observes Andy Grove, the chairman of Intel and a prostate-cancer survivor, who for years has tried to shake this cultural mindset as a member of several cancer advisory groups. “Everybody plays his individual part to perfection, everybody does what’s right by his own life, and the total just doesn’t work.”