3. The need for a change
Since the rate of deaths from cancer has seen little improvement (5% reduction) over the past 50 years and because the annual "WORLD CANCER REPORT" by the World Health Organization (WHO) continues to report rising figures in the number of cancer deaths and new cases each year is proof enough that a paradigm change in cancer research is needed.
The key to this change can be extracted from item No. 2. "Meager results after 50 years" and can be summarized by two important points
1. The need to equate a reduction in cancer deaths as the principal measurement for assessing the progress in the fight against cancer because DEATH RATES are considered “THE PUREST MEASURE” (for example from researchers and groups like the American Cancer Society and the National Cancer Institute, etc. See The New York Times, April 24, 2009) compared to other parameters such as the number of people living with cancer. Therefore, it follows logically that the goal of researchers and their cancer research projects should be a reduction in cancer deaths. They should also provide a quantitative estimate of what their research will achieve supported by scientific arguments, and a plan describing the procedure to measure their results and finally provide the data of their experimental results .
2. The need to implement the DIALOGUE , about the needs, technology, physics, medicine, etc., was requested by CERN Director General, Rolf Heuer, during his opening speech at the first workshop of PHYSICS FOR HEALTH held at CERN, Geneva, from February 2 to 4, 2010, that should be carried on among scientists, health care service planners and providers, researchers, physicians, epidemiologists pharmacologists, biologists, and geneticists at drug companies and research centers; officials at the FDA, NCI, and NIH; fundraisers, activists, patients and anyone who claims to have a solution that will reduce premature cancer deaths and cost per each life saved.
The Table “ Cancer Research Projects Comparison ” at www.crosettofoundation.org/table.php?lang=en is responding to the above points 1. and 2 by rendering evident which are the best solutions with the highest potential to effectively reduce cancer deaths and if “implemented consistently” will lead to a substantial reduction in cancer deaths and cost reduction for each life saved.
By shifting the attention from shrinking tumors on humans or mice to reducing cancer deaths in humans, most likely there would be several projects, past or present, that would stand out from the table and could, if funded, achieve statistically acceptable and scientifically reliable, reproducible results in reducing cancer deaths. However they were probably never extended from a sample population to a larger population. By listing them now in the Table and by comparing their efficacy with other projects, these could be selected, and because the goal has now changed, they could have a chance to contribute more with respect to other cancer death reduction projects.
For these projects, “cost effectiveness” and “reproducibility of results” need to be tested first based on solid scientific grounds.
Using this Table as a tool, the “lousy model” mentioned by journalists in items 1 (Dimension of the Problem) and 2 (Meager results in 50 years) would be corrected because the award to a researcher of a grant or a publication (such as Science or Nature, or in other researcher’s best journals) would not be based on his ability to shrink a tumor in humans or mice, but would be given only to researcher who has good arguments to achieve the goal of reducing premature cancer deaths. First by being able to support his claims with scientific arguments, second by planning a measurement test on a sample population and third by showing that his solution did indeed reduced premature cancer death by conducting an experimental test on a sample population.
One of the big paradigm shifts is that instead of basing the review on the judgment of luminaries (who could be biased, or have an agenda different from cancer death reduction, or who might not always fully understand an innovation), one makes the research applicant the first reviewer of his own proposal in the sense that he must: a) estimate results provided by his proposal in reduction of cancer deaths, and b) provide a measurement plan and c) defend his claims from colleagues (peer review) that will be posted on the web in this “Comparison Table”. Ultimately he has to provide experimental results (the ones previously estimated) on a sample population.
Therefore, the researcher ultimately will be judged by the results from the experiment that he predicted. Right now, because estimated results and supporting arguments in reducing cancer deaths are not requested from the applicant, tax dollars are often wasted for “allure of illusions” in achieving something other than reduction in cancer deaths in humans.
(One should not interpret this as meaning that there is a preclusion to initiatives for basic research with mice, or the shrinking of a tumor. However, these should be considered intermediate objectives which can tell the researcher if he is on the right track in proving his theory. Further, these experiments should be able to demonstrate that they have achieved or have contributed to achieve a reduction in cancer deaths. Otherwise, if research is limited to experimenting with the reactions of mice, without results in cancer death reduction, this would show a purely theoretical illusion).
The Table is just a tool. In order for it to work and provide useful results, the collaboration of several parties is necessary - most importantly . A very important one is the journalists and media. Another is that of the Directors of research laboratories, the chairmen of international conferences in the field and the decision makers in the field of health care (who should guarantee the DIALOGUE).
1. The journalists should interview the researchers positioned at the top of the Table: “Cancer Research Project Comparison” when sorted by “Estimated percentage of lives saved”. For example, interview the one who claims 33% reduction in cancer deaths with a $15 million project in “Estimated Project Cost” and the one who receives funding from taxpayer dollars for $339 million in one year and who did not make an estimate of the percentage of lives saved. They should organize publicly broadcasted round tables inviting the researchers at the top of the list in “Estimated percent of lives saved” who are funded and those who are not funded. These researchers could then discuss publicly, asking each other questions, clarifying in this way why, after many years of public spending (about $300 billion), funds continue to be assigned to projects that are known in advance to be unable to provide cancer death reduction. (One should keep in mind that in science the JUDGE is THE EXPERIMENT and not the opinion of a luminary - different from what could be the practice in other fields-).
2. The Directors of research laboratories, chairmen of international conferences in the field and decision makers in the field of health care, should organize public meetings inviting researchers at the top of the list “Estimated percent of lives saved” funded and not funded, to discuss their claims with experts in the field appointed by them. They should give each researcher , or proposer of a solution, the possibility to ask questions of other researchers, to make sure that no question is ignored or answered evasively, and to evaluate whether the answers provided are based on solid scientific grounds or not. Ultimately they should guarantee that the DIALOGUE requested by CERN Director General is IMPLEMENTED CONSISTENTLY.
(Watch the video recording of CERN Director General opening speech at the workshop: “Physics for Health” where he request to implement THE DIALOGUE)