High-profile cancers getting more research money
A NEW STUDY FINDS GAPS BETWEEN HOW MUCH RESEARCH IS DEVOTED TO INDIVIDUAL DISEASES AND THE ACTUAL TOLL THEY TAKE, WITH A CLEAR EDGE FOR THOSE WITH POWERFUL MARKETING
It was an ultrasound for another, minor problem that inadvertently delivered the grim news to Barb Routley: at 66 and with an almost total lack of symptoms, she was suffering from advanced cancer of the pancreas.
Five months later, her close-knit family in tatters, the Toronto woman was dead.
“My parents, they were together for 50 years. My dad lost his best friend. I lost my best friend,” says Meghan Case, Routley’s daughter. “It absolutely turned our world upside down.”
What particularly struck Case amid her grief was that the disease’s dismal survival rate had not changed in decades; science had achieved virtually nothing to help patients like her mother. A new Canadian study may explain why.
Researchers from Queen’s University uncovered jarring gaps between how much research is devoted to individual cancers and the actual toll each disease takes — suggesting a clear edge for those backstopped by powerful marketing, and a handicap for cancers with a stigma of personal blame.
Lung malignancies, for instance, account for four out of every 10 Canadians who die from cancer — yet just 15 per cent of North American clinical trials focus on the disease, they found. Pancreatic cancer is the source of 10 per cent of deaths, and only five per cent of trials.
Breast cancers, on the other hand, made up the same 10 per cent of mortality in 2013 — the year studied — but 30 per cent of clinical trials.
And the amount of research carried out in each area seems closely aligned to how much money is poured into that cancer, concluded the Queen’s study.
“It is a great concern to us,” said Michelle Capobianco, executive director of Pancreatic Cancer Canada. “The rate of death from pancreatic cancer has now surpassed that of breast cancer … By 2020, it will be the numbertwo cancer killer.”
Charities and government funders stress that the fundraising and scientific triumphs of cancers like breast and prostate are something to celebrate, but say they do want to address disparities.
Not everyone, though, accepts that resources are misaligned. The Canadian Breast Cancer Foundation suggests the Queen’s study is misleading, improperly mixing American and Canadian data and focusing too much on the number of deaths caused by different diseases.
Breast cancer may not claim the most lives, but affects more women than any other cancer, with 25,000 diagnosed last year alone, the organization said in an emailed response to questions. It cautioned against funding changes.
To determine how resources are distributed, the Queen’s team looked at the number of North American research papers and clinicaltrial results published in 2013 for the 10 most lethal cancers, and how much funding each cancer received.
The extent of the disparities “was quite striking,” says Dr. Chris Booth, a medical oncologist and Canada research chair in cancer population care, who led the study. “There were huge differences.”
Colorectal cancer, for instance, accounted for almost 14 per cent of cancer deaths in North America, and less than six per cent of the clinical trials published in 2013. Prostate cancer, on the plus side, was the subject of 17 per cent of the trials — and less than eight per cent of mortality.
A similar picture emerged for funding levels. Breast cancer received 28 times more money per patient who died — $14,000 versus $600 — than bladder cancer.
The high profile of breast cancer and the hugely successful pink-ribbon and other fundraising campaigns clearly help explain some of the gap. And that movement is fuelled by a motivated army: the large and growing pool of breast-cancer survivors, experts say.
Prostate cancer, centred on the popular Movember campaign and also aided by numerous long-surviving patients, has made similar strides in the last decade.
Meanwhile, some of the deadliest cancers have, by definition, few survivors to beat the drum, while lung cancer may suffer further from the stigma of its link to tobacco, despite the fact many patients are non-smokers.
“There is this overwhelming public perception: you must have brought it on yourself,” says the University of Toronto’s Margaret Fitch, who does psychosocial research around lung cancer.
But the relative success of single-disease charities is not the entire story.
The pattern identified by the study is similar to how the federal government’s Institute of Cancer Research and the Canadian Cancer Society have historically divvied up money, they say.
Surprisingly, some of the trend is explained by a U.S. military funding project, says Dr. Stephen Robbins, scientific director of the Canadian cancer institute. Since being set up in 1992, the Defence Department’s “congressionally directed medical-research programs” have directed by far the largest chunk of their funds — $3.1 billion — to breast cancer, followed by prostate cancer — and influenced the scientific community accordingly, he says.
Case and her family are doing their own part, holding fundraisers in her mother’s memory that have already collected almost $50,000. Given that the average pancreatic-cancer patient lasts no more than a year after diagnosis, loved ones are really the only hope, she says.
“If the family members don’t do it, it ends there with the person who died,” said Case. “We have to be loud.”