July 30, 2008
Prologue for “Distant Casualties of War”
Cancer research is what I do and will accept no other occupation. Several years ago I was given the opportunity as a Senior NIH Postdoctoral Fellow to set-up a research project, publish my results, and eventually become a faculty member. This was at Thomas Jefferson University (TJU). I was given the NIH mandated salary and told that I had 2 years to develop a project, publish, and apply for grant funding. After 8 months my project had enough structure for me to start writing a manuscript, and supplemental grant application. Unbeknownst to me when I started my research the government invaded Iraq. I watched like every other American as the war started. I did not think it would affect me, but it did. To fund this effort the administration needed money. They took money out of the NIH budget. This caused the NIH to withdraw funding to labs that they deemed unproductive. One of those labs was the one I joined. The P.I. and junior P.I. got start-up positions, but the lab of 12 people had to go. I was put on administrative leave and still actually work there, but I’m not getting paid.
I had three alternatives. The first was to move to another state to seek the same opportunity. I cannot do that because my Mother who is now 77 lives in the Philadelphia area. The second was to work as a high-powered tech for another Ph.D. I can’t do this because of the fact that your supervisor will take credit for everything you do. The third and final option was to just wait. That was my option. I gave up everything and I mean everything to wait this thing out. I don’t even have a home at this time, but I still have my knowledge and experience. Since I had lots of time on my hands I decided to write. I write about cancer research and immunology. I try to explain the new therapies for cancer so that a layperson could understand it.
I wrote an opinion article about the effect the Iraq war had on cancer research and treatment. It was submitted and rejected. I made the mistake of sending it to a magazine based in Washington, DC. They said it was easy to attribute the lack of funding to government policy and abruptly denied the fact that the NIH had gotten short-changed. I admit the subject was controversial, but I felt censored. However, as you see in this article I am one of the casualties.
So I offer this to you and you can decide if our government caused the deaths of not only our servicemen, but also normal citizens.
Distant Casualties of War
Michael Alexander, Ph.D.
There are two words that need to be defined. The first word: Casualty (kaz’oo et ty), n., pl. –ties 1. Mil. a. a member of the armed services who is lost to his/her unit through death, wounds, sickness, capture, or because his/her where-abouts cannot be determined. The second word (words): Collateral damage (kel lat ‘erel dam’ ij), n. a. Unintentional harm to persons or property as a result of military action.
Aside from the brave men and women who are fighting for our country in Iraq and Afghanistan and their heroic casualties there are two other groups of individuals far from the battlefield that mirror the definitions offered above. The first group, that are probably worse off, are the millions of cancer patients who suffer pain and sometimes eventual death. These are the casualties. This from a disease, that up until now, had the potential of being a treatable non-life threatening disease of the future based on the rate of discovery cancer research. This future is now in doubt. The second group of casualties is an army of intelligent highly trained cancer research scientist. The second definition, collateral damage, refers to groups associated with the previous two. First the family and friends of cancer victims/survivors are unintentionally harmed emotionally. In addition the family and friends of cancer scientist who cannot work or have to leave the country also suffer from a similar fate. All of this and possibly more have to do with the government’s choice to divert funds from domestic spending to finance the Iraq war. The analogies attached to the above definitions may seem inaccurate. However war is war despite the battlefield. In this case just look at the people around you and think of which one of these people will get cancer and what will happen to them. Without proper allocation of cancer funding by the government our hope of a future where all cancers are treatable may not exist.
Cancer Funding
Where did the research money go? There’s more to it than the war expenditures. Of course the budget has shrank, but there is also this thing call inflation. The cost of cancer treatment has skyrocketed. The tax breaks and rebates have basically bankrupted the country. Because the job market is down the tax revenues are suffering. There is less money available to finance not only treatment, but also research, in the form of grants, that leads to its development. More importantly there is very little money to pay cancer research scientist through these grants. As evidence the governments 2007 budget for cancer research, through the National Cancer Institute (NCI), wanted to appropriate 4.75 billion. This was 40 million less than in 2006 and 71 million less than in 2005. Also in 2007 the NCI’s Clinical Trails Cooperative Group Program was ordered by the government to remove 60% of the proposed new clinical trials. This resulted in 2,000 to 3,000 patients being left out of participation in new trials. This is a money saving maneuver that is costing lives. Amazingly enough there is a financial incentive not to do this. It’s been estimated by economist that a 1% reduction in cancer mortality (deaths) results in the addition of more than 500 billion dollars to the national wealth. Despite this the cancer-funding crisis continues. So where does this leave us.
As far as cancer research is concerned the pharmaceutical companies were supposed to take-up the slack by receiving special government consideration. This was a good idea, but very unrealistic. What these companies do is make a profit from the drugs used to treat cancer. They have developed some really effective drugs, but actually do very little basic research. University research is more theoretical in it's nature. University scientist want to find out how things work so that at some point newer treatments such as improved immune system manipulation (immunotherapy) can be developed and refined. Without this type of research new treatments cannot be designed. This actually was a serious miscalculation by the government. You can sit there and read this, but tomorrow or the next day you or someone you love may have a problem. The appearance of symptoms like a growth, bleeding, or fatigue maybe signs that a cancer is present. Then comes the diagnosis of a type of cancer that has no treatment. Now your saying to yourself: “Why didn’t anyone see this crisis coming? ” Most of us are uninformed about the cancer problem.
Cancer Problem
Most people in our population have no idea how many people die from cancer. You would be surprised to find out that there are about 2,500 deaths a day. The other thing is that these people are a cross section of our population. Not all are old, but some are very young. Even though the older you get the more susceptible you are to getting cancer because it generally takes time to develop. As a matter of fact, because of the baby boomers, 20% of the U.S. population will be over 65 in 2030. For this reason the deaths per day number will begin to increase almost exponentially (times ten) each day within the next 5-10 years if things remain the same. Racial inequities and poverty aggravate the situation because some of these people wait until it’s too late to see a doctor and die shortly after their diagnosis. This disease takes some of the most vibrant, productive, and important people we have.
Do you remember the “War on Cancer” (1970, Richard M. Nixon)? We are still fighting that war too. And here are the casualties. As mentioned above there are the active cancer patients dealing with the pain of treatment and the fear of death. Also there is this large (10 million) group of cancer survivors. Did you ever think of what they are going through? After getting a clean bill of health there are lingering concerns. Every pain, every headache, every swelling, or discomfort scares the hell out of them. It may mean the cancer has returned. The fear is real. To have to re-live the treatments or worse die are nightmares only someone who has lived through it could understand. Again the collateral damage here is in the form of the families and friends of the deceased. Both of these groups (survivors and families) suffer from a multitude of psychological disorders that are often temporary, but sometimes permanent. A psychologist is usually needed to help them cope with the psychological effects caused by this disease. One of the essential questions is: Why did they take money away from cancer research? Is the pursuit of oil and word domination worth it? Only time will tell. However, it is just a matter of time before there is the realization that a mistake was made. This whole situation has affected many people.
The Flight
Many of the people who can do something about curing cancer have left the country. It takes over 20 years of training to become a cancer researcher. Each type of cancer research is a mixture of many different scientific disciplines. If you are doing tumor immunology you must learn biochemistry, molecular biology, chemistry and cell biology. Each one of these is a separate scientific discipline that can be a scientific career by itself. It is not easy to walk away from this investment in time and effort either by changing careers or leaving the country. Can you blame them for this flight? These scientists have families to support and their livelihood in this country has been removed. Many scientists were educated here and want to remain, but find more attractive offers in other countries. For instance in England some American cancer research scientist get permanent core funding, a situation unheard of in this country. Remember these are some of the most highly educated and trained scientist in the world. There must be a way to turn this around. We owe it to them and the thousands of people in the future who will be diagnosed with cancer.
Possible Solutions
For a start the government needs to refocus it’s attention to domestic concerns. US citizens are prepared to make sacrifices if they feel that it would benefit people in this country. They should not be asked to suffer unemployment, low wages, inflation, and high prices just to make another country a democracy. Some of that money, which has been going to Iraq, needs to flow back into this country so that the population can have some hope things will get better. Too many people are still dying from cancer. This is something that can be improved dramatically if some policy changes are enacted. We have the technology and we have the people who can use that technology to reduce the death rate caused by this disease. Our health care system is the most advanced system on this planet. It just can’t be that hard to harness it in a way that will improve the care and treatment of cancer patients.
Some type of universal health care has to be a priority because the cost of cancer treatment and health care in general is increasing. This is mostly due to hospitals passing health care cost of uninsured individuals to insured individuals. If more people had access to health care many of the cancers would be treated earlier and possibly cured. The government could also set-up incentive funds for cancer research scientist to do specific types of cancer research. Another incentive for scientist would be the creation of an independent grant where the individual could decide which university to do the research at. This would allow more American scientist to stay in this country. Governmental funds could be allocated to offset the high cost of some cancer treatments making them available to more people. In addition to this the government could financially support efforts to address the mental health issues associated with this disease.
These are just a few of the many ways this country can not only reduce cancer deaths, but also deal with some of the issues associated with it. Each person in this country from Senator to trash man and Supreme Court justice to waitress can get cancer. So it would seem in the best interest of everyone if our government took a more active role in addressing the cancer problem. Without a concerted effort by our society we will continue to suffer from this disease called cancer. The definitions in the beginning have exactly the same meaning as before, but here they describe the results of a non-military conflict. This conflict is the long-lasting war between our population and cancer. Hopefully in the future there will be very few cancer casualties and the collateral damage kept to a minimum.
CANCER AND SOCIETY: Cancer has fundamentally changed our society in many ways. Some of these changes are obvious, but others are subtle and hard to recognize. This is an effort to document and observe those changes in the context of modern-day society.
