Lobby led to billions in cancer research

Survivor persuaded Congress to set up Defense program

June 28, 2008|By Euna Lhee | Euna Lhee,Sun Reporter

When Fran Visco welcomed 1,600 breast cancer researchers and their advocates to Baltimore this week, she was doing more than opening a symposium for scientists. She was celebrating one of the most successful medical lobbying efforts in the nation's history.

The researchers and physicians are funded by the Department of Defense - an unlikely source for cutting-edge programs in breast cancer.

It was 17 years ago that Visco, a Philadelphia lawyer and breast cancer survivor, began lobbying for increased spending to fight breast cancer.

Her efforts paid off two years later, when Sen. Tom Harkin, an Iowa Democrat, expanded a tiny Defense Department mammography project to $210 million.

Now known as the Congressionally Directed Medical Research Programs, its grants have provided a total of $4.7 billion to scientists who study not only breast cancer but also autism, ovarian cancer, prostate cancer, neurofibromatosis and other diseases far removed from the battlefield.

Officials acknowledge that the beneficiaries of the research extend beyond the military to the general public. And they said no one suffers as a result.

"The money is added to the president's budget after all the soldiers' needs are met.

"It's not the same dollar amount year after year," said Dr. Melissa Kaime, deputy director of the Congressionally Directed Medical Research Programs. "This program does not take away from the defense budget."

Promoters of breast cancer research also seem happy with Defense management, which has supported the involvement of patient advocates in the selection of research projects from the outset.

About $2 billion in Defense funds has gone into breast cancer research since 1993, including $138 million this year. But Visco, 60, said it's not about the size of the budget.

"We don't want to throw money at the scientists," she said. "We need money that will be spent well."

The funds pay for large gatherings of researchers like this one every few years.

The fifth "Era of Hope" conference has brought together scientists, physicians, breast cancer survivors and policymakers. The events conclude this afternoon with a session on: "How will we eradicate breast cancer?"

During the opening ceremony Wednesday, Visco challenged the researchers by asking, "What have you been doing for the past 10 years?"

According to Dr. Sara Sukumar, an oncologist at the Johns Hopkins Kimmel Cancer Center, the answer is "a hell of a lot."

"It's difficult to come up with one solution to treat the multiple subtypes of breast cancer," she said. "But we've showed that breast cancer is a very treatable disease."

Better than MRI

One of this year's hot topics is the development of a cheaper but effective alternative to breast magnetic resonance imaging. A $500,000 Defense grant helped finance the Mayo Clinic's development of molecular breast imaging (MBI), a new technique that allows detection of small tumors in dense breast tissue.

"I truly believe that we have a technology that will change breast cancer imaging in the future," said Dr. Carrie Hruska, a post-doctoral research fellow at Mayo. "But there's still work to be done."

One of the problems with traditional mammography is that a tumor may be obscured if the woman has dense breast tissue. If a suspicious area does show up in a mammogram, one of the next steps may be MRI, which costs up to $5,000.

But by using two specialized gamma cameras positioned around the breasts, MBI is less affected by dense tissue and provides results just as accurate - for only $500. That's because the equipment is less expensive and the results are easier to interpret, Hruska said.

Another technique

"We're filling a void and finding an easy-to-implement technique as an adjunct to mammography," she said, emphasizing that MBI would not replace the mammogram for women over 40, but rather supplement the screening technique. She said she hopes to see the cameras in clinics next year.

Hopkins' Sukumar received a $10 million grant from Defense in 2004 to find new ways to halt breast cancer metastasis, an elusive process that causes cancer cells to spread throughout the body. It's the cause of death in most cancer patients.

The funding allowed Sukumar to collaborate with other investigators from the University of Maryland and the University of Texas. She also works with Johns Hopkins pathologists through the Rapid Autopsy Tissue Donation Program, in which patients donate their bodies to science.

"The DoD's approach is attack one question, and if everyone focuses on it, an answer will be found," Sukumar said.

To win grants, researchers, including scientists from the National Institutes of Health, submit proposals in a competitive process every year. Specialists and consumers from nonprofits, such as the National Breast Cancer Coalition, sit on panels to help select the winners and set program goals.

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