New Hope - Investing in Cancer Revolution

A profound revolution is under way in the diagnosis, prevention and treatment of cancer. Scientists and physicians are looking beyond our current treatments that have meant survival for millions of patients. We envision applying new knowledge and technologies to improve these therapies with a more personalized approach.

By understanding genetic and molecular mechanisms that drive the growth of a person's cancer, we now are formulating therapies that hit tumors selectively while sparing normal tissue and reducing debilitating side effects. Better yet, when we add more understanding of behavioral and environmental factors to our molecular knowledge, we'll be able to assess an individual's risk for cancer, intervene aggressively and prevent the disease altogether in many cases.

Gov. Rick Perry's timely and visionary proposal to create a $3 billion Cancer Research Fund that will provide $300 million annually for cancer research in Texas will give new hope to patients and families who face cancer.

This proposed investment will be put to excellent use by Texas research institutions. Federal research funding, mainly through the National Institutes of Health, is shrinking. Funds to advance research ideas from scientific discovery to the clinic — a process called translational research — are always hard to come by.

The need is certainly there — ask any of those 400,000 Texans who have survived cancer, or the families and friends of the 34,000 who will die of cancer this year.

Make no mistake; there already is plenty of good news. Within my own lifetime the combined effects of improved lifestyle, earlier diagnosis and better therapies have resulted in a near doubling of the five-year survival rate to 65% for cancer patients. There are more than 10 million cancer survivors in the United States. And the death rate from cancer (deaths per thousand population) has been declining for more than 10 years — a remarkable development because our population is aging and cancer risk increases dramatically above age 55.

Despite these favorable trends, projections show that our growing and aging population will result in a doubling of cancer cases in Texas over the next 25 years. For those future patients, and for the more than 35% who lose the fight now, we must do better.

A key to improvement lies in intervening earlier during the cancer care cycle, which begins with risk assessment, moves on to prevention, early detection, then treatment and survivor-ship. Earlier is better because most cancer deaths are caused by metastasis (the spreading of an original cancer to other organs), which generally occurs in late-stage cancer and is most difficult to treat.

Prevention and early detection measures have had some successes. Smoking causes 30% of all cancer, and with great effort tobacco use has been cut 50% over the past 30 years. And better screening helps us detect early breast, colon and prostate cancers, resulting in increased cure rates. But we have just begun to scratch the surface of prevention and early detection. We are developing new tools to predict cancer risk, by considering a person's genetics, family history, lifestyle factors and environmental exposure to cancer-causing agents.

From such a comprehensive risk assessment, individual prevention strategies will flow, with specific recommendations for behavior, environmental risk reduction and even pre-ventive medication. For example, molecular research is discovering genetic and protein markers similar to the prostate-specific antigen test, which will help us screen for risk or detect early cancer with fairly simple lab tests.

New targeted therapies — those aimed at a specific cancer gene or a protein that is the product of that gene — are giving us a glimpse of the power of individualized, focused treatment. A dramatic example of a successful targeted therapy is the drug Gleevec, which acts selectively on the single flawed protein that drives chronic myelogenous leukemia (CML), a cancer of the blood which once killed half of all patients within five years.

Today, 95% of all CML patients who take Gleevec live to that five-year mark. And they do so with far fewer side effects than those who received previous less effective, less targeted treatments. The registration clinical trials of Gleevec resulting in FDA approval were led by clinical researchers in Texas at M D. Anderson Cancer Center. We also have investigated new third-generation versions of Gleevec which further improve the targeting of CML.

Gleevec is a wonderful story, but CML is not quite your typical cancer. Most cancers have more than one culprit protein driving their growth. M D. Anderson researchers showed last year that CML's more lethal cousin, acute myelogenous leukemia (AML), can be driven by three or more separate molecular abnormalities. One drug is unlikely to knock down multiple targets. Progress against AML and most other cancers will require multiple targeted drugs.

Developing this tailored approach to cancer will not come cheaply. Research analyzing all of the many factors that go into risk assessment is expensive. Prevention trials are costly because they require a large patient population followed for a long time to yield results. Treatment regimens combining multiple drugs that hit separate targets will be even more expensive to investigate. But the outcomes will vastly reduce the pain, suffering and mortality of cancer patients. In time, effective early-stage interventions also will reduce the costs of treatment.

The Cancer Research Fund will improve the prospects of those threatened by cancer, which includes 41% of us. The fund will work by providing a boost for Texas research institutions, supporting innovation, stimulating collaboration, attracting brilliant scientists from around the world to Texas, and creating a great opportunity for our state to accelerate its goal of leadership in biomedical research and biotechnology.

The scope of cancer research is broad. It encompasses molecular biology, genetics, bioengineering, computer science, informatics, infectious diseases, structural biology, developmental biology, immunology — the list goes on. Many Texans and our great universities will have numerous opportunities to contribute. Lessons learned from cancer research will enable improvements in the treatment of many other diseases, as well.

The governor's $3 billion Cancer Research Fund will make Texas a world leader in cancer research, prevention and treatment, and that will benefit us all.