Oh, This Will Be Fun: Kolata on the War on Cancer

I'll have more to say about this tomorrow, but I wanted to draw your attention to an article in today's NY Times that is critical of cancer research by Gina Kolata. Here's a snippet:

Many other grants involve biological research unlikely to break new ground. For example, one project asks whether a laboratory discovery involving colon cancer also applies to breast cancer. But even if it does apply, there is no treatment yet that exploits it.

The cancer institute has spent $105 billion since President Richard M. Nixon declared war on the disease in 1971. The American Cancer Society, the largest private financer of cancer research, has spent about $3.4 billion on research grants since 1946.

Yet the fight against cancer is going slower than most had hoped, with only small changes in the death rate in the almost 40 years since it began.

One major impediment, scientists agree, is the grant system itself. It has become a sort of jobs program, a way to keep research laboratories going year after year with the understanding that the focus will be on small projects unlikely to take significant steps toward curing cancer.

"These grants are not silly, but they are only likely to produce incremental progress," said Dr. Robert C. Young, chancellor at Fox Chase Cancer Center in Philadelphia and chairman of the Board of Scientific Advisors, an independent group that makes recommendations to the cancer institute.

The institute's reviewers choose such projects because, with too little money to finance most proposals, they are timid about taking chances on ones that might not succeed. The problem, Dr. Young and others say, is that projects that could make a major difference in cancer prevention and treatment are all too often crowded out because they are too uncertain. In fact, it has become lore among cancer researchers that some game-changing discoveries involved projects deemed too unlikely to succeed and were therefore denied federal grants, forcing researchers to struggle mightily to continue.

I actually think this is mistaking the symptom for the disease (I'm referring to funding, not cancer); the problem is systemic throughout NIH and much more deeper than funding levels. Like I said, more tomorrow (hopefully).

I will note, however, that last week, Sharon Begley made similar criticisms. This strikes me as some kind of organized campaign (not by Begley and Kolata, they're just the medium). Before you dismiss this as paranoia, if these articles were about healthcare or Social Security, no one would think twice about this. I've always argued that scientists need to organize politically over funding issues, even though many of my colleagues think this is beneath them.

Welcome to the real world.

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I will note, however, that last week, Sharon Begley made similar criticisms.

Similar in some ways, and opposite in others. Begley was effectively complaining that there is too much basic science going on, and not enough incremental development.

Of course, a huge part of the problem is that the general public (including most journalists) have a B-movie concept of how research works, with a lone genius going from bright idea to worldwide immortality during the prologue to a 90-minute movie before the real action starts.

By D. C. Sessions (not verified) on 28 Jun 2009 #permalink

Oh, yes, this will be fun. I'm writing about it too for tomorrow.

It's the same old complaints that we're too conservative without any ideas how we spend more money on risky ideas without that money being flushed down the toilet. After all, let's face it, the riskier the idea, the more likely it is to fail. Moreover, the given assumption, which is without a lot of science or evidence behind it, is that riskier ideas are somehow more likely to pay off big. That may be true, but the assertions to the effect are remarkably evidence-free.

If NCI were funding more speculative and exploratory studies, then the Times would be running an article headlined, "Grant System Funds Too Many Dead Ends."

I'm not saying the system couldn't be improved, just that it might not be so easy.