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Cancer Needs A Bailout

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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Extraordinary Physicians Honored For Advances In Medicine

castleconnollybannerI attended the fourth annual Castle Connolly National Physician of the Year Awards last night in New York City. It was truly moving to hear the incredible stories of triumph of each honoree – from military surgery (Dr. Judd Moul), to curing head and neck cancer (Dr. Carol Bradford), to expanding palliative care services for people not expecting a cure (Dr. Diane Meier) – each awardee embodied the very best character and principles one can hope for in a physician.

But perhaps most moving of all was the story of lifetime achievement award-winner, Dr. Emil Freireich. Dr. Freireich was born to Hungarian immigrants, his father died when Emil was 2 years old, his mother worked in a sewing factory to provide for his needs growing up. Through sheer grit and determination, Emil managed to get himself to college and then medical school. He began his career in 1955 at the National Cancer Institute (and has been working at MD Anderson Cancer Center since 1965) where he was provided a challenge: to cure childhood leukemia. Here is what Dr. Freireich had to say about how things have advanced in the field of leukemia in his lifetime:

In 1955 when I began my career at the National Cancer Institute, children diagnosed with leukemia usually lived for about 8 weeks. They had about a 1% chance of surviving a year – and they had a median age of 5 years old at diagnosis.

The worst thing about leukemia was not the short life expectancy, but the way the children died. You see, leukemia destroys blood platelets (the part of the blood that allows it to clot), and produces its own anti-coagulant. So every child with leukemia died of massive hemorrhaging. As a doctor in 1955, when I entered the leukemia ward, all I saw was blood. The children were bleeding in their urine, stool, lungs, and even from their eyes. They would cough to breathe and spew blood as high as the ceilings. The wards were red with death.

But now, thanks to years of research and the development of combination chemotherapy, leukemia is not a death sentence. In most cases it can be cured, and in all cases we can stop the bleeding.

The most rewarding part of my career has been treating young children with leukemia, and watching these same children grow up to become physicians who treat other children with leukemia. I have passed the torch on to them, and I believe that they will one day find the cure for other cancers too. I believe we will get there soon.

I had the chance to interview Dr. Freireich for this blog last year. You may read more here. Congratulations to all the awardees of the event – carry the torch high for us docs, we need more stories of hope like yours… and thanks to Castle Connolly for such an inspirational evening.

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