40 Years Later: Progress in the War on Cancer?

Sept. 21, 2011 -- A new report shows we've come a long way in cancer care and research in the last 40 years -- but we still have a ways to go, and a re-commitment from government may help lead the way.

Advances in cancer research will face threats if Congress goes ahead with budget cuts to federally funded research, a report from the nation's leading cancer research organization warns.

The report from the American Association for Cancer Research (AACR) details decades in progress against cancer since the National Cancer Act became law in 1971.

The law created the National Cancer Institute and also launched what politicians, beginning with President Nixon, termed the "War on Cancer."

Advances in Cancer Treatment

The group's report laid out some of the progress researchers have achieved against cancer over the last 40 years. Key areas include:

• The discovery of more than 290 genes related to cancer, its growth, and what happens when the body's ability to repair damaged cells goes off course, possibly leading to tumor growth. Tumors can also have a wide range of genetic profiles, often making effective cancer treatment a frustrating moving target.
• Early detection through routine screening has helped increase the survival rate for many cancers. Screening recommendations have helped push the five-year survival rate to above 90% for cervical, breast, and prostate cancers, when they're detected early.
• Improvements and advances in chemotherapy have driven up survival rates of other cancers, including lymphoma, Hodgkin's disease, and testicular cancers.
• Advances in genetics have given rise to entirely new classes of cancer drugs. Some of the drugs target tumor receptors. Others go after tumor genes to disrupt growth. That's allowed the development of more than 30 targeted cancer drugs that can go after tumors while sparing surrounding healthy cells.
• Genetic testing has given doctors and patients more tools in understanding cancer risk. BRCA1 and BRCA2 are two genes that are now known to greatly increase a woman's risk of developing breast cancer and ovarian cancers. The genes are associated with the risk of breast cancer and aggressive prostate cancer in men.

Fight Over Funding

Cancer researchers warned on Tuesday that advancements in diagnosis and treatments, especially in the area of genetic tumor typing and personalized cancer therapy, will suffer if congressional budget cutting continues.

With some cancers, there is now the potential to "understand the nuance of every patient and tailor-make their treatment," said William Dalton, PhD, MD, director and CEO of the Moffitt Cancer Center in Tampa, Fla.

"Now is not the time to lose momentum," said Dalton, who also chairs the science policy and legislative committee at the American Association for Cancer Research.

Congress is currently in the throes of a months-long fight over federal budgets and deficits. The deficit reduction plan passed by lawmakers over the summer cut 1% from the budget at the National Institutes of Health. That translated to cuts of about $320 million across the agency.

It's all part of efforts to control the nation's $14.3 trillion debt.

In addition, millions in research funds funneled through the National Institutes of Health (NIH) and the National Cancer Institute (NCI) by the American Recovery and Reinvestment Act, also known as the stimulus bill, are beginning to wind down.

The Obama administration asked Congress to increase the NCI budget by 13% in 2012. The White House says increasing spending will have beneficial effects throughout the economy. And that's largely the message cancer researchers are pushing in their lobbying efforts.

New Challenges Ahead

About 570,000 Americans die from cancer each year, according to federal statistics. Many are preventable, particularly lung cancers, which are overwhelmingly caused by smoking. But the number of cancers is expected to increase drastically over the next three decades as the U.S. population ages.

"We can't afford to tolerate this level of human suffering," said Elizabeth Blackburn, PhD, who won the Nobel Prize in Physiology or Medicine in 2009 for research on the structure of chromosomes.

A committee of 12 lawmakers is trying to come up with $1.5 trillion in additional debt savings by Thanksgiving. Congress is supposed to vote on the savings by Dec. 23. Those efforts could include deeper cuts to discretionary programs, including those at the NIH and NCI.

Neither the House nor the Senate has yet approved funding levels for those agencies for the 2012 Fiscal Year.