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Abstract:

Wafik S. El-Deiry, Editor-in-Chief, Cancer Biology and Therapy

I left the lab, clinic, and new administrative responsibilities at the Penn State Hershey Medical Center and Penn State Hershey Cancer Institute to visit Washington, DC on May 5, 2010 as a part of a united coalition of cancer societies and advocates including the Association of American Cancer Institutes (AACI), the American Society of Clinical Oncology (ASCO), the American Association for Cancer Research (AACR), and Friends of Cancer Research (FOCR). The American Cancer Society (ACS) was also represented through two of its ACS Professors (myself and Ethan Dmitrovsky). Over 100 prominent physicians, scientists, advocates, and cancer survivors descended on Capitol Hill to deliver a simple tripartite message: NIH funding saves lives, creates jobs, and ensures that the U.S. continues to lead in the life sciences. The target NIH budget we discussed was 35.2 billion dollars for FY 2011, and part of our message was to also encourage support for an FDA budget of 2.857 billion dollars in FY 2011. We heard that FASEB had an effort on the same day with a similar target NIH budget of 37 billion dollars. For reference, President Obama's FY 2011 budget increases the NIH's funding to 32.1 billion dollars and increases NCI's funding by $163 million to 5.264 billion dollars.

Our schedule was typical of other events scheduled by the Science Policy and Legislative Affairs Committee (SPLAC) of the AACR and counterparts in the respective societies.1 Participants in the events cooperated and spoke with one voice to congressmen, senators, staffers, and their assistants. Some congressional leaders were invited to speak to the whole group including Senator Lautenberg who spoke on the evening of May 4 and shared his own father's battle with colon cancer at a relatively young age and his own ongoing battle as he is receiving chemotherapy. Lautenberg mentioned working on a bill to make sure hundreds of chemicals added to food are tested for their long-term effects on cancer or autism prior to FDA approval. Representative Louise Capps was recognized for her national commitment to the fight against cancer. Dr. Bill Dalton, Chair of the AACR's SPLAC welcomed participants on May 5 and then we heard from Jon Retzlaff about NIH/NCI appropriations and from Dr. Jeff Allen about FDA appropriations. Barbara Duffy Stewart, the Executive Director of the AACI welcomed Daniel Smith, the Staff Director for the Senate Health, Education, Labor and Pensions (HELP) Committee spoke and gave participants advice on approaching law-makers to get the message across. Being brief and to the point and being specific about what was being asked for were important pointers. At lunch time after several visits on Capitol Hill, Dr. Douglas Blayney, President of ASCO spoke and welcomed Jeremy Sharp from the Senate HELP Committee. Sherrod Brown (D-OH) was recognized with an award presented by Dr. Michael Caliguiri and during his talk, Mr. Brown shared his mother's battle with leukemia.

While on legislative visits during the day it was surprising to hear that despite ongoing efforts to raise awareness of the funding crisis situation that has gone on for most of the last decade, the feeling on the Hill was that scientists are not engaged enough or effective in bringing their concerns. In a world with much going on with terrorism or natural disasters these days and upcoming elections and other distractions, it is perhaps not so surprising. A message is getting through though because on March 17, 2010, 99 Representatives joined Rep. Markey (D-MA) in signing a "Dear Colleague" letter sent to House Appropriations Committee Chairman (and Chairman of the Appropriations Subcommittee on Labor, Health and Human Services, Education, and Related Agencies) David Obey (D-WI), and to Representative Todd Tiahrt (R-KS, the Ranking Member of the Subcommittee, supporting at least a 7% increase for NIH.

The meetings on Capitol Hill varied in their intensity and in their perceived effectiveness. The question was even asked as to how effective can we be when we speak in a hallway with a staffer or a staffer's assistant for a very brief time. Everyone is supportive of cancer research but yet we continue to fight for funding that barely keeps up with inflation when the American Recovery and Reinvestment Act (ARRA) funding runs out.

Of course to be effective in delivering our message we had to assume our different roles and share our own experiences as well as fill in our part of the story. This meant reminding the legislators of the successes of basic science for example with gleevec, tarceva, or avastin. It meant for a cancer survivor who was with our group to share her own personal experience with lymphoma and her current participation in a clinical trial. This was particularly effective in our meeting with Arlen Specter who is a lymphoma survivor and who has been a champion for biomedical research funding. A group of us from Pennsylvania plus some guests met with Senator Specter (Figure 1). An important part of our message was that moving basic ideas and new treatments for cancer from the laboratory to the clinic takes years, multidisciplinary cooperation, dedication, and sustained funding. We did this while sharing the excitement of genomics and genetics, and the quest for personalized cancer therapy using the latest technologies for gene sequencing of tumors, susceptibility loci and circulating tumor cells. Specter urged aggressive advocacy for cancer funding and suggested that eliminating lesser priorities could be a very effective way to increase resources for cancer research that can benefit patients.

Figure 1 Pennsylvania delegatoin and guests meet with Senator Arlen Specter at his office in the Hart Senate Building, Washington, D.C., Left to Right: Joan Pitcher (Penn State Hershey Cancer Institute), Elizabeth O'Brien (Wistar Institute), Ellen V. Sigal (FOCR), Barbara Duffy Stewart (AACI). Back Row: Arthur P. Staddon (Karnell Cancer Center), Michele Fetting (Leukemia and Lymphoma Society), Senator Arlen Specter (D-PA), Wafik El-Deiry (Penn State Hershey Cancer Institute), Ronald B. Herberman (Intrexon Corporation), Bill Nelson (Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins, Baltimore, MD).

Everyone wants translation of basic science to benefit patients and society at large. Translational research is challenging in the best of circumstances and is largely limited these days by sufficient funding especially during critical early phases. With tough economic times philanthropy is also not keeping up with the needs to advance science and translate knowledge for patient benefit. There is risk with great ideas but if we don't test our ideas we won't uncover the breakthroughs. Importantly, to quote Francis Collins in his address on April 28, 2010 to the House appropriations subcommittee: "Science is not a 100-yard dash. It is a marathon-a marathon run by a relay team that includes researchers, patients, industry experts, lawmakers, and the public." At risk is not just the slow progress and loss of leadership in biomedical science, but also the next generation of scientists who will continue the war on cancer.

So what can we do now as scientists to get the message out about cancer funding and the tangible benefits of cancer research? It is important to get the facts about reductions in mortality over the last decade, and to understand well the return on investment for the little money spent since the war on cancer was started by President Nixon in 1971. The return on investment involves new jobs created for every dollar spent and more importantly a huge benefit in terms of lives saved. Cancer survivors are an important part of the economy and with 11 million survivors, an important voting constituency. It is critically important to share the excitement of what is possible as well as to take every opportunity to be pro-active in communicating with the legislators as well as the public about the important scientific advances taking place at cancer centers across the country. In this age, not only are the professional societies great facilitators, but our voice can also be heard through the news media and electronic media such as Facebook and Twitter. I have used Twitter to advocate for cancer research funding on various occasions in the past couple of years (http://twitter.com/weldeiry) and the use of this media is becoming more popular (http://journals.lww.com/oncology-times/Fulltext/2010/01100/Oncologists_Using_Twitter_to_Advance_Cancer.3.aspx). We need to communicate much more in order that we may get to a point where society can allow us scientists to actually fight the war on cancer rather than spend most of our time fighting to fund the war on cancer.

References:

El-Deiry, W.S. Lobbying congress to make cancer funding a priority. Cancer Biol. Ther. 5:467-469, 2006.