One piece can change a picture

A picture can be made of many different pieces. Sometimes, a change in a single piece has the potential to change the whole picture. For me, such a picture came together in late December when…

  • I spent the second half of the month in University of Iowa Hospitals and Clinics taking care of patients with leukemia.
  • Congress passed a budget that will prevent another partial government shut down. While everyone involved agrees the deal that was reached leaves much to be desired, it will replace the arbitrary funding cuts in government programs known as the “sequester.”
  • I traveled to Washington, DC for an important meeting as a member of the National Cancer Institute “National Clinical Trials Network Working Group.”

How do these pieces fit together, and what does the resulting picture show?

  • Taking care of patients with acute leukemia reminds me of how far we have come over the past few years in our understanding of the biology of leukemia. However, it also reminds me of how far we have to go with respect to treating many leukemia patients. Additional advances for these patients are within our grasp but will only come through investment in research. For me, this piece of the picture highlights the importance of research if we are to improve care for our patients.
  • With the current dysfunction in Washington, funding for biomedical research in general, and cancer research in particular, has been shrinking steadily for the past few years. The sequester took another big cut out of the cancer research budget. Politicians across the political spectrum say they are supportive of cancer research, but have not been able to get past their differences to actually support it. For me, this piece of the puzzle highlights how important it is to get priorities straight.
  • A major focus of the Working Group meeting I attended in Washington was to advise the National Cancer Institute on which types of clinical cancer research studies to support. Implicit in this recommendation is a discussion of which types of studies should not be supported. This is particularly important but also painful because of the shrinking pool of funding for cancer research. This piece of the puzzle highlights how not getting priorities straight can have real-life consequences.

These pieces come together to tell a pretty bleak picture: We are losing an opportunity to speed progress in cancer research and help more of our patients because of a lack of research funding.

However, another picture is possible. It is possible the latest budget agreement will lead to appropriation of funds that result in a leveling out, or perhaps even an increase, of support for cancer research. If the decision to pass a federal budget is followed by a decision to appropriate more funds for cancer research, then the overall picture is brighter indeed.