“Why don’t you spend more on my cancer type?” and “why don’t you do more to highlight awareness?”
These are two questions we hear frequently, and topics that are close to many of our supporters’ hearts.
Understandably, everyone who has lost a loved one to cancer, or themselves struggled against the disease, wants to know that every effort is being made to tackle that particular cancer – whether it’s one of the more common forms such as bowel cancer or lung cancer, or a rarer cancer such as retinoblastoma.
Cancer is complex and it’s not just one disease. In fact, we’re the only cancer charity in the UK fighting over 200 cancer types. In an ideal world, we would make sure that research into all cancer types received the ‘perfect’ level of funding and equal prominence. But there are a number of reasons why this is a very difficult goal to achieve.
In this blog post we’ll look at why this is the case, and what we’re doing to try to address imbalances both in the research that gets funded, and in the coverage each cancer type receives.
All cancers are equal – but some are more equal than others
So let’s tackle the funding question first.
It’s important to understand that we don’t allocate pre-set amounts of money to particular types of cancer. We fund the best research proposals we receive from the scientific community, to maximise our chances of saving lives through the money we spend.
This means we depend on the presence of active research communities to draw up research proposals and send them to us. (We’ve blogged about how we choose which proposals to fund and the process involved before).
It’s also worth remembering that nearly half of our money – about 40 per cent – goes towards lab research on understanding the biology and causes of cancer – and this is relevant to all cancer types, affecting people of all ages.
This is fundamental stuff, leading to Nobel prizes and significant breakthroughs in understanding cancer’s true nature – such as discovering p53, the “guardian of the genome”, and lab work which underpinned the development of the breast cancer drug, Herceptin. You can read more about this work on our high-impact science pages.
We also recognise that people like to donate to the cancer that’s important to them – which is why in recent years we launched My Projects, a platform which allows you to support research into a cancer type of your choice.
And people who take part in Shine, our night-time walking event, can choose the cancer type to which they’d like their donations to be allocated. In both cases, this is supporting research that we’re already funding – it’s not to raise additional funds.
The way we fund research – called ‘response-mode’ funding – means that we inevitably end up spending more on some cancer types than on others. As an example, last year, we spent 4 per cent of our total research budget on lung cancer: the disease makes up 13 per cent of cancers diagnosed and causes 22 per cent of cancer deaths.
We wish it were more, but even if we said, “Right, we’ll spend £20m on lung cancer tomorrow”, we can only fund the research proposals put in front of us.
This is something we’re trying to change, and things have been getting better. For example, back in 2001, we helped produce a landmark report that looked at cancer research across the UK. It identified several gaps, and set out trying to get them filled.
Sticking with our example of lung cancer, the good news is that, since 2002, UK funding for this disease has nearly trebled. And since 2008/09, the number of lung cancer patients on clinical trials has increased threefold – in fact, three quarters of lung cancer patients in the UK who are currently on clinical trials are taking part in a trial supported by Cancer Research UK.
So we know there are gaps in funding that urgently need addressing, and cancers which are particularly hard to treat – like lung, pancreatic, oesophageal and brain cancers – that require more investment.
But it’s not always as simple as throwing money at a problem. We know from looking at other examples across the world that boosting research in an area is not always as simple as just investing more money. For example, in recent years the US government has invested heavily in early clinical trials for pancreatic cancer – but these haven’t translated into benefits for patients.
So clearly, money is necessary, but not sufficient. How can we make sure the research we fund will actually make a difference?
The right place, the right people, the right skills
We have a responsibility to cancer patients and our supporters to ask the right research questions that will ultimately improve survival. This could take many forms – for example, setting up infrastructure, bringing the right people together, and training up researchers in the field – not just spending money on research grants.
That’s why over the last few years, we have set up virtual Cancer Research Centres in 18 towns across the UK.
These bring people together from across the scientific and medical spectrum – from cancer doctors to researchers, statisticians to pathologists – so they can share their expertise and results, and carry out more life-saving research.
This means that local NHS hospitals are working with university scientists, cancer charities and others in the local area. The idea is that the result is more than the sum of its parts.
Scientists funded by Cancer Research UK collaborate freely with those funded by all sorts of organisations, exchanging information, coming up with new ideas, and ultimately, carrying out research that will save more lives. And it’s already starting to catalyse new initiatives.
It’s also why we’re actively looking beyond the UK to boost survival in lung cancer, and why we held a meeting last year with world-leading lung cancer experts to come up with a strategy that will help make this happen.
And it’s why we’re working closely with other charities to increase research into cancers of unmet need – for example, the Brain Tumour Charity, Pancreatic Cancer UK and the Pancreatic Cancer Research Fund.
And, importantly, it’s why we’ve invested in research on surgery. We know that nearly half of all cancer patients who are cured – of all ages, with all types of cancer – have surgery as part of their treatment.
Good surgery is vital. But in recent years there’s been a drop in the number and quality of research proposals to develop and refine current surgical techniques, as well as developing those of the future.
So, last year, we created eight positions at our Centres in Oxford, Cambridge, Southampton, University College London and Imperial College London to allow PhD surgeons to remain in research while completing their training. We hope this will lead to an increase in proposals in this area, so we can improve this mainstay cancer treatment, benefitting patients with many different types of cancer.
None of this research is particularly ‘cancer-site specific’ – but it’s vital, nonetheless.
Raising awareness as well as money
These are just a few examples of the many ways we’re trying to make a difference and make donations go further.
It’s not just as black and white as looking at the percentages and saying “breast cancer receives more money than prostate cancer.” There’s much more to it than that. And that’s why it makes it impossible to make these direct comparisons, and say one cancer’s ‘more important’ than another.
Which brings us to cancer awareness months. We often get asked why we don’t do more to highlight all the various cancer awareness months that have sprung up over the years.
October has become synonymous with breast cancer. November is ‘Movember’ for prostate cancer. December is well-known for being childhood cancer awareness month. And March is now a triple whammy – ovarian cancer, brain cancer and – again – prostate cancer.
And there are awareness days – World Cancer Day (this year it was on 4th Feb), men’s cancer day (29th Jan), children’s cancer awareness day later this week (9th Feb) to name but a few.
It’s a confusing and ever-changing picture, and there’s no global ‘central body’ that determines which awareness months and days belong to which cancer. Many awareness months grow organically from community groups, while others are led by charities. Some are set up firmly with fundraising in mind. Others try to make people aware of symptoms, or the need for screening. Some are a mixture of all of this.
There are several things to say about why we do and don’t mark particular awareness months.
Firstly, some of the big events – notably breast and children’s cancer awareness months – happen whether we do anything or not. We surf on these waves where possible, but can’t magic 30 days of media coverage from nowhere.
Secondly – hands up – sometimes we don’t know they’re happening – for reasons outlined above. It’s a confusing picture.
But the main reason is that scientific research doesn’t wait for awareness months. Our media team works 365 days a year to highlight research carried out in labs and hospitals around the UK, whenever results are found. We work on all cancers, all year round. We often simply don’t have time to find ways to promote specific awareness months on top of this – we wish we could.
Fortunately, the advent of online and social media is giving us opportunities to do more. We don’t have to rely on the media to pick up a story – nowadays we can tweet or post about things to highlight awareness more easily. So, over the course of 2013, you’ll probably notice that we are doing a lot more to highlight different types of cancer through things like Facebook, Google+ and Twitter. At least, we hope you will.
At the end of the day, we all share the same hope – from the most senior scientist, to the shop volunteer, the person who runs Race for Life, or the person who donates £2 a month – that one day, we will beat cancer – all types of cancer, in all ages.
Science Information Manager