Where's the Bailout for My Cancer Patients?

Senator Ted Kennedy's death from brain cancer underscores the urgent need for more funding of basic cancer research. Despite the best efforts of a team of top doctors, Kennedy died 15 months after the diagnosis of a malignant brain tumor called glioblastoma. Over the past ten years, some progress has been made against this deadly illness and the silhouettes of some promising new approaches are becoming visible. But our treatment options remain woefully inadequate.

The annual budget of the National Cancer Institute (NCI) is just under $5 billion. With over 560,000 cancer deaths each year, that comes to less than $10,000 in research spent for every cancer death. That simply is not enough money spent on a problem that strikes almost 1.5 million Americans each year and causes nearly one of four deaths.

Research for certain cancers is especially under funded. Earlier this year, I helplessly watched a dear friend and patient die from esophageal cancer, both of us knowing that only 22 million dollars each year -- about $1,500 per death -- was being spent by the NCI on the disease annually. One reason is that patients with esophageal cancer don't have a strong advocacy group to push for their fair share of the funding pie. Lung cancer, which tops the list of cancer killers in America, only gets about $1,500 per death. At the top of the list based on research spending per death are cervical cancer (about $19,000), breast cancer (about $14,000) and brain cancer (about $12,000). Click here for a chart that I compiled with the help of statisticians at the NCI that breaks down government spending on the top cancers.

Of course, there shouldn't have to be a competition among cancer advocacy groups. There should be adequate funding of basic medical research to help discover the underlying cellular mechanisms that many cancers share and that hold the key to prevention, early diagnosis and effective treatment. But there's not enough money for our young researchers. In 1980, almost 25 percent of first independent government grants went to scientists under age 35; that figure has plummeted to only 4 percent as the first-grant age rose from 34 to 42. Faced with increasing competition for shrinking dollars, many of our best and brightest are considering other careers.

My cancer patients desperately need a bailout. The best way to increase our spending on cancer research responsibly is through health care reform. The Institute of Medicine has estimated that about 20 percent of the annual $2.5 trillion in health care costs is unnecessary. That's $500 billion annually or 100 times the current budget of the National Cancer Institute. There could be no better tribute to Senator Kennedy or wiser investment in our own futures than to fix a broken system that threatens to bankrupt us while inadequately addressing one of our most devastating health problems.

For this week's CBS Doc Dot Com, I take you behind the scenes to an edit bay at the CBS Broadcast Center in New York. I talk to Dr. Henry Friedman, an expert on brain cancer. He is co-deputy director of the Preston Robert Tisch Brain Tumor Center at Duke University Medical Center. In addition to hearing about the latest treatments for the disease, you'll see the secret behind how we do long-distance interviews for the CBS Evening News with Katie Couric.

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Comments

[Dale Larson]

It's time to end our "risky experiment" of "For-profit health insurance". It's a proven failure.

HR676 (http://hr676.org) Single Payer system that is proven, pro-business and pro-people:

* Slashes at least 30% of costs off the top by removing private insurance overhead.
* Companies take health care expenses off their books. Stock value increases. Better able to compete internationally.
* Small companies could have access to higher skilled workers because previously they couldn't compete in the labor market by offering similar benefits.
* More entrepreneurial ventures will launch since they have more money and less unrelated risk.
* Dramatic drop in bankruptcies.
* Dramatic drop in lawsuits. Most of these lawsuits are simply to obtain money to cover health care if something interrupts their coverage.
* Reduced system complexity. Greater efficiency due to fewer regulations.
* Savings from employees not having to fight with their insurers during work hours.
* HSA and MSA dollars redirected back into the economy for goods and services.
* Additional money to spend from not having to carry "uninsured motorist coverage" on your auto policy.
* Contract employment is more viable for workers since they are guaranteed access to health care.
* People are covered when unemployed. No chance of being wiped out financially if you lose your job.
* Health care providers (doctors, hospitals, therapists...) see increase in business with much less administrative expense.

[KrugnacTheMagnificent]

Part of the funding problem has to do with the concentration of resources. When the NIH doubled their budget last decade, the percentage of money going to new scientists didn't go up one iota.

As the big labs soak up the money, there are fewer and fewer crumbs left over for the budding scientists at the bottom of the food chain.

In health care there is a trend where hospitals are hiring more and more nurses to reduce the cost of hiring more doctors. The same dynamic applies in research. More and more "career post docs", many with limited English skills, are being recruited from abroad while new positions for independent scientists become fewer and fewer, and so hyper competitive that most do not have a reasonable opportunity to achieve it. And if a person tries and fails, the pay for "career post docs" is so pitiful in comparison to their training, education, and skill level that many would rather leave science altogether and be done with it.

Complaining about funding is easy. Taking an honest and critical view of the failures brought on by the scientific establishment itself is not.

[bccmeteorites]

Much of the time and energy spent on research is devoted to protecting the niche researchers have carved for themselves in a particular field. Protecting their research funding in lieu of and simultaneously making new discoveries, therapies or cures. Anything new is picked out with tweezers to keep sucking up more funding. It's a jobs program. No one has mentioned Sen. Grassley's investigative reports and subsequent condemnation on ghost writing and the smoke and mirrors being shoveled out by the pharmaceutical industry using university researchers as a proxy for legitimate clinical research trials, to help speed up the time table to marketing of fake inventions in the form of new and improved medical therapies highly touted in slick commercials. Scientific misconduct and fraud plagues even planetary science research. What is the answer? Prosecutions. The NIH equivalent prize goes to NASA as a funding source of fake research for the benefit of industry friendly entities. First find the solution then find the problem equivalent to its application to justify funding. Someone said, "cancer research is grossly underfunded" and encouraged bloggers to contact your representatives for more funding. That is the paradoxical answer to problem avoidance by breaking the link between common sense and the reality of the problem.

What happened with the banking industry? Rather than repairing the core issues that led to this catastrophe, throw more money at them and hope it serves as a buoyant enough apparatus to stop them from sinking.

http://www.bccmeteorites.com/misconduct-planetary.html

[lenjabiah]

All 100% true- you clearly know what you are talking about

[RMankovitz]

Regarding a bailout for cancer patients, here is my recommendation as a research scientist and author of several books on illness prevention.

I suggest that anyone with a diagnosis of cancer (particularly brain cancer) that is considering treatment by conventional oncology methods (chemo/radiation) immediately bailout, and instead contact the Burzynski Clinic in Texas. See:

http://www.burzynskiclinic.com/

Stanislaw Burzynski, MD, PhD, developed the antineoplaston treatment for cancer and, in my opinion, has cured more people of cancer than all of the oncologists in this country combined. Never heard of him? Both the FDA and the oncology industry tried to put him out of business, but those of us in the alternative health field came to his defense. Finally, even the FDA had to admit his procedure works, and they are presently running supervised clinical trials.

Unfortunately, you first have to qualify for these trials to get the antineoplaston treatments. In other words, the FDA is using the clinical trial approach to choke off widespread access to this amazing therapy, in some cases insisting that you first go through the horrors of chemo/radiation, which unfortunately lowers chances of success. The rest of the oncologists are ignoring him.

Very, very sad. We do not need more spending on cancer treatment - we need honesty in the medical industry.

For a list of Burzynski's more than 250 peer-reviewed research papers on cancer treatment:

http://www.burzynskiclinic.com/ph/media-corner-publications.html

Roy Mankovitz, Director
http://www.MontecitoWellness.com

[boomer131]

In the 1970's Richard Nixon declared war on cancer. Since then, some cancers, with large advocacy groups, have made significant progress in survival rates. Breast and prostate cancer are on the top of the list with 95% survival rates. Coincidently these cancers are easily detected at early stages. Cancer treatment, not cure, seems to be the focus. The new chemo and targeted therapy drugs have made cancer survivable to the extent that it's a chronic disease rather than an automatic death sentence. The cancer treatment business is huge. Huge profits for the healthcare industry and the pharmaceutical companies. There is just not enough emphasis on cure.

I have stage IV cancer and I'm on my fourth line of treatment so you could say that I have a dog in this fight. Fortunately, have good insurance. One of the chemo drugs I've taken is billed to my Insurance at $17,000 for 10 ml. The negotiated reimbursement (amount paid out by insurer) is $12,000. For that item alone, the insurer has paid out $204,000. There needs to be some way to get the focus on cancer research for the purpose of finding a cure. Until there's a financial incentive it's not going to happen.

[Dennis60]

Dr. Lapook, I am all to happy to answer your question. The bailout for Brain Cancer, (the beast that took my mom), went to satisfy the egos of politicians in the form of pork barrel spending. The state portions of the great Tobacco settlement was not spent on cancer research or even smoking sensation classes, but on the pet projects of lusty politicians. Much the same way stimulas money is now being spent. Instead of cancer prescreening or research in south florida, we got a womans health center in the extremely wealthy Weston. And our congressional Rep went on the news to brag about it.

Which begs the question, do we really want politicians involved in medicine? Be very careful what you wish for.

[CaScientist]

While the tobacco settlement did indeed get hijacked away from research and smoking cessation, the stimulus money has definitely not been. The NIH has funded numerous funding requests for badly needed equipment for cancer research from those stimulus funds (my own lab was a beneficiary), so that "OOGA BOOGA big bad government is stealing your money" argument doesnt apply here.

[MrsPeel]

I wish, in your high-minded superior attitude, that you would spell correctly and use better grammar. I.e., it's "smoking cessation," not "smoking sensation." "Stimulus," not "stimulas." "Womens'," not "womans."

"The State portions of the great Tobacco settlement WERE not..." rather than "The state portions of the great Tobacco settlement WAS not..."

Please learn the correct meaning of "begs the question." It's not how you and others use it.

For example.

[kmswriter]

I oreface thus with I am not a doctor - just an observant consumer who can't stand waste - The govt, public and private funding have been filling the coffers of so called established research groups for years - much progress has been made in the discovery of and treatment of many cancers - however i am not convinced all the monies have been used appropriately.. much is spent on advertizement by PHARMA and healthcare cos as well as top heavy administrations of these groups that could be better used for research.

Why do I need to listen to PHARMA ads? why do i need to ask my doctor if the medicine would be good for my ailment? Seems to me the cure is worse than the problem....

Cut top heavy admin costs - stop PHARMA ads - and put these funds into research.. then i may be willing to listen to the need for additional funding. Doctors should do their job and provide the answers to health problems - not the other way around.

[CaScientist]

Excellent article Dr. LaPook, alway great to see something from a reasoned expert. One thing I would like to add before too many wingnuts chime in about "wasteful government spending". Those tax dollars that are put into cancer research directly benefit the pharmaceutical companies and the development of chemotherapy drugs. The companies that develop the drugs rely on publicly funded scientists for the basic cancer biology research that gives them a starting point and a target for their drug development, for clinical samples to test whether these drugs will work, and for the clinical trials that establish the safety and efficacy of those drugs. There is no better example of an effective public/private partnership than the one between NCI/NIH funded research and the pharmaceutical industry. I personally work in lung cancer, and the frustrating thing is that there is still no effective way to screen for it before the disease has reached an advanced and dangerous stage. The biology is there somewhere for a test as safe and effective as say, pap smears....but progress is excruciatingly slow because there isnt enough money left after all the other research priorities get funded.

[gino618]

The budget of the NCI is listed. What about all the other entities, state, local, private, etc., that also perform research?

The dollar amounts presented here are only part of the overall money used for research, and therefore are misleading.

[Rebecca Booth, MD - Huffpost Blogger]

Great job Dr. LaPook...such an inspiring segment! How exciting to engage the body's own immunity in this battle! I have a patient with colorectal cancer that has been removed from her colon and her liver. She is receiving immunotherapy at Duke and has NO side effects--she feels great, and currently no evidence of recurrence despite what would ordinarily be a very poor outlook. Thank you Dr.Friedman!

[DrLaPook]

Thanks Dr. Booth. Senator Kennedy wrote in his Newsweek article that he had the "best medical care that money can buy." And so he did. But he couldn't buy a cure that doesn't exist yet. The next step is to dramatically increase funding for medical research so that cures - not just improved survival for measured in months - can be found for such devastating diseases as brain cancer.

[overd0g1]

"The Institute of Medicine has estimated that about 20 percent of the annual $2.5 trillion in health care costs is unnecessary." So we've got a system that is 80% efficient, and we're looking at bringing the government in to make it more than 80% efficient!? The inmates are truly running the asylum.

[floridafun]

if every senate member who believes so strongly that public healthcare will destroy private insurance and would ration care and bankrupt america...would come together in the next couple weeks and drop the subsidized public option healthcare they now have as fed employees, i would say they really believe in their reasons for being against public option healthcare for all.

[apduncan1]

the same arguments were used against the emancipation of slaves: destroy private industry (cotton plantations), would ration labor and bankrupt america ... guess what? didn't happen

[CentristScientist]

Frankly, this is not a great example. Slavery did not really "end". Instead former slaves were made into de facto monetary slaves working as more or less indentured servants on farms and plantations. I don't think that there is a good analogy to the healthcare system.

[pcawareness]

Why is it that we have no problem in giving astronomical funds in tarp money to banks, yet can not afford to give the same amount of money to cancer victims?
Pediatric cancer funds are signifcantly lacking. Currenlty only THREE PERCENT of the NCI budget currently goes to fund pediatric cancer research. 12,000 children a year are given the horrible diagnosis of cancer each year in the US, and 75% will be dead with in five years. The adverse affects of harsh treatment last a life time. 2/3 of survivors can expect a chronic or serious illness by the time they arre 45. Acutelymphoblastic leukemia, the most common form of childhood cancer, requires a harsh 2-3 year treatment protocol. Because childhood cancers are rare, most drug companies will not invest in research/ medicines for them, since they yield little chance of gagnering a profit. . Because of this, federal funding for pediatric cancer research is very important. Plus, research into pediatric cancer often help adult cancers. The anti-folates were first used to treat children with ALL in the 1940's, and retinoblastoma has helped researchers understand other kinds of cancer including breast.
Why is that we can afford billions of dollars for banks, and yet nothing for our children???
IN 2008, the Carolyn Walker Pryce Childhood Canacer act was passed. It alloacted 150 million dollars over five years for pediatric cancer research? THis year, only 10 million will be spent of what was supposed to be thirty million!

[RealityThinks]

iff we just changed medicaid to be a nationa program to cover all indigent people ages 19 - 65 at 125% of poverty we could cove the uninsured.

Also - if we passed legislation to forbid denial of coveege for presisting conditions and allow for competition across states and also allow group purchasinf outside of business -

the problems with private care would be solved - it's pretty simple unless you goal is not to cover the uninsured and fix private healthcare

[gino618]

Wrong.

Medicare is subsidized by private insurers. Medicare patient services are discounted because the costs are absorbed elsewhere in the health care system - by privately covered patients - which raises the costs of THEIR services.

Putting everyone on medicare would NOT lower costs.... putting MORE people onto such a system would RAISE costs for those not in the system even more, creating an even larger problem.

[hershala]

Wrong. What would keep the insurers from increasing rates to be unaffordable by even the middle class? Nothing !!

The private insurance system is not private care or anything close to it. All it is is a way for private companies to make a lot of money. They routinely deny care to those who are ill, they impose huge out of network fees even when they do not have a doctor to treat the illness in network. We have had our insurance costs double in the last three years with no claims. What would there be to keep them from doubling again andf then doubling again? Nothing at all. All competition across state lines would do would be to allow insurers to have a bigger pool, there is no way it will reduce costs. Also group purchasing wouldn't lower costs. Never has in the past. My ex-employer paid exactly what we pay for the same coverage by the same company and my ex- employer has over 6,000 employees.

125% of poverty could be eligible for medicaid.? Our insurance premiums are more than 125% of poverty level for 2 people. We can affordit but people who make 125% of poverty couldn't afford to eat, live indoors, or any of the other extras we take for granted. They also could not afford prescription drugs because our policy does not cover them.

[WVGALE]

Amazing how we can find Trillions (yes thats with a "T") for wars in response to 3000 dead on 9/11 (and 8 years later we are told we are not winning in Afganistan) and a virtual pitance for something that kills tens of thousands annually.

But then Bush wouldn't be able to fly onto an aircraft carrier (as if he won the war singlehandedly) and proclaim victory if he spent the money on cancer research.

Where are our priorities?????

[WeMustSpeakOut]

Our country is morally bankrupt. The inhumanity doled out to us from our completely corrupt corporate government is appalling. I suspect they would pry our last pennies from our cold dead hands before they did something to actually promote the general welfare.

[apduncan1]

the war (invasion, occupation and genocide, really) in iraq is a war of plunder ... the stock value of halliburton goes up with every american gi killed

[chronic5]

Yes, trillions - 3 trillion by the time we're through with that war and we didn't even get lower oil prices...I guess we got George Bush's revenge and a sprawling new embassy and that's about it. Cancer seems to be epidemic among those born in the 50's and 60's and those are precisely the people with the most difficulty getting health coverage. I have two friends in that situation now.

[Dale Larson]

Moral of the story... People that are "C" students shouldn't run our country.

[anitaj]

Medical research is woefully underfunded. Please contact your representatives to urge them to make this long-term investment in ou future.

http://www.house.gov
http://www.senate.gov