Dr. John Mendelsohn, President of the University of Texas M.D. Anderson Cancer Center offered his ideas on how to advance the fight against cancer at the National Press Club on February 17th. He offered a ten point plan to shape congressional debate about the future of scientific research, cancer prevention, and healthcare reform.
Dr. Mendelsohn pointed out that new therapies and medical instruments are expensive to develop and are a major contributor to the rising cost of medical care. The current payment system rewards procedures, tests, and treatments rather than outcomes, so that today, cancer prevention measures and services are not widely covered.
His plan calls for a standardized electronic medical record accessible nationwide to ensure quality care for cancer patients with multiple providers at multiple sites. A national electronic medical record would provide opportunities to reduce costs, be able to identify factors that contribute to illnesses, determine optimal treatments, and detect uncommon side effects of treatment.
His plan seeks the formation of new partnerships to encourage drug and device development between research institutions, academia, and industry. According to the doctor, partnerships are needed to bring together sufficient expertise and resources to confront the complex challenges of treating cancer.
Traditionally, academic institutions have worked with biotech and pharmaceutical companies by conducting sponsored research and participating in clinical trials. By forming more collaborative alliances during the preclinical and translational phases prior to entering the clinic, industry and academia need to build on each other’s strengths to safely speed drug development to the bedside.
Today, therapeutic cancer research needs to focus on human genetics and the regulation of gene expression. More knowledge is needed on human genome and mechanisms, how to regulate gene expression, and how to advance technology in the field. Also, collecting data on experiences from clinical trials is needed to produce a greater understanding of the environmental factors that can lead to exciting research approaches.
Dr. Mandelsohn reports that currently the M.D Anderson Cancer Center is making advances in pursuing targeted therapies designed to counteract the growth and survival of cancer cells, identifying the presence of particular abnormal genes and proteins in patient cancer cells or in the blood, developing new diagnostic imaging technologies to detect genetic and molecular abnormalities in cancers in individual patients, researching anti-angiogenesis agents and inhibitors of other normal tissues that surround cancers, discovering ways to boost immune responses in cancer patients, and conducting research that hopefully will lead to the development of cancer vaccines.
The doctor pointed out that with the aging of baby boomers, it is very important to train future researchers and providers of cancer care. Shortages are predicted in the supply of physicians, nurses, and technically trained support staff that are greatly needed to provide expert care for cancer patients.
The pipeline for academic researchers in cancer is also threatened due to the increasing difficulty in obtaining peer-reviewed research funding. After growing by nearly 100% from 1998-2002, NCI’s budget has been in decline for the past four years and has lost 12% of its purchasing power. Lack of funding also discourages finding talented young scientists who can find promising careers elsewhere plus discourages seasoned scientists from undertaking innovative, but risky research projects.
In addition, Dr. Mandelsohn wants to see steps taken to ensure that efficient and cost effective clinical trials are designed to measure, in addition to outcomes, the effectiveness of new agents on the intended molecular targets. As he continued to say “Innovative therapies need to move forward more rapidly from the laboratory into clinical trials.”
Other steps that need to be taken include developing better tests to predict cancer risks, providing more education on preventing cancers, helping cancer patients move forward after surviving cancer, plus the healthcare system needs to make certain than everyone has access to cancer care if needed.
According to Dr. Mendelsohn, along with the improving five year survival rates, the cancer death rate has been falling by 1% to 2% annually since 1990 but we still have a long way to go. While survival rates improve and death rates fall, cancer still accounts for one in every five deaths in the U.S. According to NIH, it costs this nation $89 billion in direct medical costs and another $18.2 billion in lost productivity during the illness according to NIH.