Wednesday, September 24, 2008

Varmus on "The Cure" for Cancer

“These are incredibly complicated scenes that we're only beginning to understand thanks to the genome project and spinoffs from the genome project.

“And the hope that advocacy groups understandably have – that if we just do a little bit more research and apply it at the bedside, that we're going to cure cancer – is really terribly simplistic.

“And when scientists give support to that simplistic notion, which they are likely to do because it's the way of raising money, they create an expectation that's very hard to meet.”

...And he argued that the culture of unrealistic expectations is encouraged by the way science is taught in schools, with a focus on outcomes rather than process.

(More at the Globe and Mail)

My question: what proportion of research funding currently goes to BASIC cancer biology research with no obvious "therapeutic/therapeutic target" pay-off?


Anonymous said...

"Most of it".

Rob said...

Many of the comments on the Globe article suggest that cancer research is a waste of money. Perhaps funding agencies need to do a better job of emphasizing the progress made, as opposed to making unrealistic promises. Granted the 'progress made' is far less than was promised but if I had to have cancer I would much rather have it now than 30 years ago.

Anonymous Coward said...

Not surprisingly it's difficult to communicate the complexity of diseases like cancer. Our basic knowledge is growing exponentially and there is tremendous effort to translate it into concrete therapies. How many failed clinical trials do we have every year? Sometimes the benefit seem very incremental like IP chemotherapy vs IV in ovarian cancer. But the effort that went in to shave just a few percent in mortality and toxicity is almost heroic. Now compare that to say engineering a tumour-specific virus and getting that approved and you get a sense of the magnitude of the problem. I think the expectation comes from the fact that we've basically cured many diseases that were low-hanging fruits. It's not as easy as a vaccine or a recombinant protein. And it might or might not be worth the money; perhaps we could cure 100 smaller diseases for that price. That is a choice the public needs to make. Until then, everything we learn from cancer is basic human cell biology, and it has value well beyond cancer treatment. The money certainly isn't being wasted...

Kamel said...

"that if we just do a little bit more research and apply it at the bedside, that we're going to cure cancer – is really terribly simplistic."

It's true that this is terribly simplistic, and as the following quote says, scientists don't do much to dispel that simplistic notion.

I think one of the roots of the problem is the way we talk about it. It's always 'cure cancer' as though cancer was one homogenous disease. We never talk about curing viral infections, we talk about HIV or other viruses specifically. We don't talk about curing auto-immune diseases, we talk about curing diabetes. So right off the bat, cancer is fighting an uphill battle with this idea that it will all be cured at once. Some cancers basically *have* been cured (eg. prostate cancer has a 99% 5-year and 92% 10-year survival according to the ACS)

The other part of the problem, as AC points out, is the cure rates of 'low-hanging fruit'. Many cancers are diseases of aging. As people keep living longer, we're going to see more cases of various cancers which doesn't look good from the cancer cure perspective (as cancers become leading causes of death, because of progress in other areas)