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Could We Have Cured Cancer by Now?

We need to re-imagine our national funding system for science, and instead demand and reward collaboration among scientists. That means doing away with our notions of the individual hero.

Earlier this month, scientific heavyweights came together for the first of a year-long series of talks designed to engage the general public in a conversation about cancer.

Commentary - in-story logoThese talks, organized by the San Diego Center for Ethics in Science and Technology, stem from issues raised in Siddhartha Mukherjee’s Pulitzer Prize-winning book, “The Emperor of All Maladies.”

More than a history, the book is a biography of cancer, asking us to consider the disease from medical, historical, cultural, sociological, personal and even linguistic perspectives.

This first event, on the cusp of National Cancer Awareness Day Oct. 8, featured controversial science journalist Clifton Leaf. His groundbreaking article from 10 years ago and newly published follow-up offer critiques of practices that promote independent science and disincentivize the sharing of data.

Leaf argued that this has slowed progress and shifted the focus of research away from patients and toward breakthroughs that will get the next grant and build a scientist’s career.

He didn’t point the finger at the scientists or indicate that their intentions are impure. Instead, he said the structure of how we fund research has subtly influenced the culture of science in ways that fall far short of maximizing the speed and efficiency of progress.

How do we begin to think about changing the entire system? It is a monumental task that will likely cost billions, inevitably have winners and losers, and may not actually work. And the stakes — with hundreds of thousands of people dying from cancer each year — couldn’t be higher.

If we agree with Leaf, and believe that what we need is greater sharing of data and ideas during research (not afterward in publication), then the task is to re-imagine a funding system that asks for and rewards collaboration. This sounds simple, but what would that really look like?

There are models of this we might consider.

Corporations do research and employ multidisciplinary teams of scientists and engineers who work together and share ideas in pursuit of breakthroughs. But the profit motive of these companies narrows the focus of research, and often promotes short-term gains over long-term risks with potentially big payoffs. Also, while there are often scientific collaborations within a company, they do not often extend to others.

The military is well known for its powerful and successful projects. The absence of the profit motive certainly makes them an important place for long-term, speculative research (much of which never “pays off”). These projects have led to world-changing innovations — modern computing, for example. But when we deal with “civilian” careers, including promotions based on individual achievement and salary incentives, it is hard to imagine translating the military model, restructuring the entire economic system.

California currently offers a small-scale alternative model that looks promising. In 2004, the California Institute for Regenerative Medicine was founded through Proposition 71 to institute a state agency that would fund stem-cell research. The institute offers many creative grants, such as “collaborative funding agreements” that are only funded when a California stem-cell lab demonstrates it will collaborate with another group outside of the state.

It has also funded research facilities including San Diego’s Sanford Consortium, which requires teams to move in and out of one another’s labs on a regular basis, facilitating more regular communication among them. But the institute is funded by general obligation funds totaling $3 billion, which will expire in 2017. For the institute to stay active, the state Legislature or the voters will have to find a way refund it.

Still, even this approach would require at least a majority of scientists — who thrive in a culture that worships individual accomplishment —to  rally around the idea of contributing to the cure(s) for cancer instead of potentially being the one to do it.

So we have to ask ourselves: Can we expect our scientists to be more selfless than the rest of us? Are we ready for such a profound change?

What if it might cure cancer?

This op-ed is part of a collaboration with the Emperor of All Maladies Project, exploring cancer as it exists both publicly and privately. This is the third Common Read project organized by a science and education alliance including Grossmont College, Point Loma Nazarene University, San Diego State University, University of California San Diego, the Reuben H. Fleet Science Center, Sharp Health Care and the Center for Ethics in Science and Technology. Learn more here.

Tate Hurvitz is associate professor of English at Grossmont College, and writes on behalf of the San Diego Center for Ethics in Science and Technology.  He lives in Chula Vista. Hurvitz’s commentary has been edited for clarity. See anything in there we should fact check? Tell us what to check out here. Want to respond? Submit a commentary.

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