COVER

An investment in a cancer-free future

Brenda Rabkin April 8 1985
COVER

An investment in a cancer-free future

Brenda Rabkin April 8 1985

An investment in a cancer-free future

COVER

Brenda Rabkin

They deal in hope and daffodils, but the 300,000 volunteers of the Canadian Cancer Society (CCS) raised $47.6 million last year, $3.3 million more than in 1983. That is a sign of the public’s overwhelming fear of cancer: an estimated 255,000 Canadians will undergo medical care this year because of the disease, a further 86,500 will be diagnosed as having cancer, and 40,000 will die. But the country’s devotion to the society, a grassroots, charitable organization with more than 1,000 branches across Canada, is also a measure of the society’s credibility—and of the faith Canadians have in cancer research. Said the organization’s secretary-treasurer, Alan Martin: “We are held in very high esteem. But then again, there are very few people who are not affected by cancer in one way or another. It is a cause people can identify with easily. They view contributing to it as an investment in their future.”

Last year that investment amounted to $23.8 million—almost 50 per cent of the society’s annual 1983 revenues that it, through the affiliated but separately organized National Cancer Institute of Canada (NCIC), channelled into cancer research. In 1984 the CCS raised $26.2 million from its April door-to-door campaign; $3.4 million from the Terry Fox run in September; $8.3 million from be-

quests from wills; $6.8 million from inmemoriam donations from friends and families of cancer victims; $2.1 million from investments; and $700,000 from other sources. Of the total, the NCIC this year will spend $20.4 million, as well as $4.8 million from the continuing Terry Fox Fund, which it administers, in approving more than 400 applications for research grants and fellowships.

Expertise: Research applications go first to one of the institute’s eight granting panels, each one representing a different area of scientific expertise. The panel chairmen then present their recommendations to the advisory committee on research, made up of eight leading Canadian cancer researchers. The institute considers what the budget for each project should be, based on the granting panels’ suggestions. Final approval for applications comes from the NClC’s 14-member board of directors. Said executive director Dr.

Peter Scholefield: “In

general, the board accepts the recommendations of the advisory committee, but they are by no means a rubber stamp. Their concern is

to look at NCIC policy and decide in what new areas of research we should be developing programs.”

Competition: Other Canadian agencies support cancer research as well. For one, the Ontario Cancer Treatment and Research Foundation will distribute $4 million in grants this year, and in Alberta the Heritage Foundation for Medical Research has spent more than $4 million on cancer research projects over the past two years. But the NCIC is by far the largest single source of funds, and competition for them is severe. Since the 1970s, when the institute approved 40 per cent of the initial applications it received, requests have increased by 60 per cent. This year the NCIC plans to approve only 20 per cent of first grants. Said Dr. Nicholas Sinclair, NCIC member and chairman of the immunology department at the University of Western Ontario in London: “Money for cancer research is getting harder to come by because there are more good people vying for it.”

But the increased com§ petition has also brought ö a growing dissatisfaction I with the NCIC’S proce-

dures. Of the $11.5 million committed to grants of $160,000 or more in 1984-85, fully 90 per cent went to research groups or institutions including either NCIC members or granting-panel personnel. One critic is Dr. Rudy Falk, head of surgical oncology at the Toronto General Hospital, whose research has demonstrated that the benefits of cancer drugs are improved when a tumor’s temperature is raised. Said Falk: “I think that there is a bit of an incestuous situation in cancer funding right now.” But Scholefield said the NCIC increased the size of its board to 14 members from 11 in 1983 to allow for more representation from other disciplines. The board also reduced the maximum term for members to eight years from 12.

The NCIC’S defenders stress that because of the nature of cancer research it is difficult to make decisions that do not cause controversy, at least in hindsight, and they say that the money which the NCIC distributes, particularly from the Terry Fox Fund, has greatly benefited cancer research in Canada. Said Sinclair: “We still do not have all the building blocks in place, and that impacts upon our judgment of whether research money is being well spent. We need more hindsight, and Terry Fox money provides the opportunity to get it.”

Response: What is perhaps most significant about Fox fund grants is that decisions about selecting recipients are based on innovation and excellence on the part of the research team. Dr. Vern Paetkau of the University of Alberta’s biochemistry department was able to form a team of scientists with varied expertise in the areas of cell biology, immunology and molecular biology after receiving a $l-million grant over five years under the Terry Fox Special Initiatives Program in 1981. The team’s work with lymphocytes and lymphokines determined how the immune response is turned on and off at the molecular level, and contributed to the understanding of Interleukin 2, molecules from white blood cells which attack tumors. Said Paetkau: “At the time I applied for the money, the molecular approach to this type of biology simply didn’t exist. We have the liberty to take time to develop this approach.”

There were other advantages. The large sum of money enabled Paetkau to hire young scientists with not enough experience to get research funds of their own but who now have professional credibility because of their training on a reputable research project. And the money gave the scientists the chance to concentrate on the most valuable thing of all—their research. Declared Paetkau: “We have the luxury of being able to devote ourselves to work without having to worry about money. That’s an unusual opportunity in this country.”