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Clinton News-Record, 1979-03-29, Page 23• • • Research is costly, but it works The investment made in research by the Canadian Cancer Society is administered through the National Cancer Institute of Canada, an organization which has been in existence since 1947 and which is recognized as one of the major Canadian agencies supporting biomedical research programs. The total research budget of the Institute U presently amounts to 'lc more than eleven million =• dollars a year and it' continues to increase in, step with the success of rd>y the campaigns of the— society. Although the cancer research community already provides an accounting for its ac- tivities in many ways, there is a continuing need to respond to pertinent questions and the following represents an attempt to answer some of the most frequently asked questions. 1. What has been achieved by past research? There are many facets of the cancer problem which require in- vestigation and these include prevention, diagnosis, detection, treatment and rehabilitation. Since approximately one out of every five deaths in North America is still due to cancer, it is obvious that progress in these areas of research has been far more limited than we would hope for. As progress in medical science continues, life expectancy increases and the total number of deaths from cancer will continue to increase because cancer risk increases markedly with age. But, if welook at the survival rate for in- dividual types of cancer --wd find that, for some sites, progress has been negligibly small while for others great strides forward have been made. For example, 25 years ago most children with acute lymphoblastic leukemia would not be expected to survive for as long as six months after the initial diagnosis was made but today many such children are long- term survivors and there are hopes for a normal life expectancy. Similarly, it is now possible to justify ex- pectations of long-term survival for many patients with Hodgkin's disease and two of the standard forms of treatment of this disease (radiation therapy with up-to-date and more sophisticated versions of the Cobalt bomb, and treatment by com- binatigns of drugs which inclue the vincad alkaloids) are based on discoveries and developments made in Canada. The diversity of forms that cancer may take makes it unreasonable to expect that progress will be made either on a broad 1 1, front or as an overnight development. Rather do we anticipate that in- dividual types of cancer will be seen to be more and more responsive as advances are made in their treatment. 2. Is cancer increasing? In 1932 the death rate among Canadian men for all forms of cancer was 174 per 100,000 of an age adjusted population." In 1975 the corresponding rate was 227.4. Yes, cancer is in- creasing in Canadian men.. In 1932 the death rate from cancer among Canadian women was 213.4 for an age adjusted population while the corresponding rate in 1975 was 165.3. No, cancer is not in- creasing among Canadian women, and, in fact, the death rate has decreased significantly. When we bear in mind that the death rate from lung cancer has in- creased in Canadian men from 4.6 per 100,000 to 76.4 per 100,000 in the same period and the death rate from lung cancer among Canadian women has increased from 2.5 to 16.6 per 100,000 it makes us wonder what the death rate from cancer would be like if we excluded lung cancer. If we adjust the rates referred to above, we find that the death rate for Canadian men for all forms of cancer except lung cancer has decreased from 169.4 per 100,000 in 1932 to 151.0 in 1975, and for Canadian women it has dropped from 210.9 to 148.7 per 100,000 in the same period. The message is simple. If it were not for lung cancer we would be winning the fight. Even this is not enough since a further break- down of these figures reveals that cancer of the pancreas in men con- tinues to increase at a steady rate whilst death from cancer of the stomach has decreased markedly. Similar trends are observed in the statistics for cancer of the same sites among women and to, these must be added a major decrease in t e death rate from car- cinoma of the cervix and uterus which was 33.4 per 100,000 in 1932 and was 8.9 per 100,000 in 1975. 3. What are the com- monest forms of cancer? The commonest form of cancer throughout the world is probably skin cancer but since so many forms can be treated by simple surgery and since they are often not a major threat to life, it is more common to ask what are the major causes of death from cancer. In North American men, cancer of the lung is responsible for more than three times as many deaths as cancer of any other site and this ratio continues to increase. In women, the most common cause of death from cancer is breast cancer and it is responsible for more than twice as many deaths as cancer of any other site. But this situation is changing and, if present trends continue, cancer of the lung will also be the major cause of death from cancer in women by the year 1984. * 4. Who is likely to get cancer? For most forms of cancer there is no simple genetic relationship nor can we easily identify factors which greatly modify our risk. Obvious exceptions to this general statement are cigarette smokers whose risk of developing lung cancer increases in direct proportion to the number of cigarettes smoked so that in- dividuals addicted to smoking two. packets of cigarettes per day have approximately 25 times the normal risk. Smaller but significant risk factors have been identified in the case of breast cancer - the woman who is Caucasian, past the menopause, who had no children before the age of 35, who is overweight and comes from a family with a history of breast cancer is more likely to develop this disease than her sisters who meet none of these specifications. * 5. Is cancer caused by viruses? The answer to this general question is 'yes', but it is not easy to give such a simple answer to the specific question of whether cancer in man hag been shown to be caused by viruses. It is a fairly routine matter to induce leukemia in experimental animals by injection of viruses and it is also possible to induce several types of sarcoma and lymphoma in these animals. Similarly, human cells grown in tissue culture may also be infected with a virus and then the cells can be shown to be transformed to a type that pathologists have identified as being characteristic of human tumours. In addition, it is possible to isolate viruses from cultures of human tumour cells and show that such viruses can produce tumours when injected into ex- perimental animals. However, in most cases the final conclusive evidence that any virus can cause cancer in man is still missing. There is also a considerable body of evidence to suggest that all of us have the potential to produce tumour viruses by a system which lies dor- mant until activated by some as yet unknown outside mechanism. 6. Is cancer caused by the environment? Several outstanding scientists have examined statistics from all over the world and come to the conclusion that ap- proximately 80 per "cent of all cancer is preven- table. This has led other scientists to suggest that the 80 per cent of cancer that is preventable is due to factors contained in the environment. The search for such evidence is carried out by epidemiologists who use statistics to study the distribution of disease and the reasons for that distribution, and by experimentalists who study some of the many compounds we encounter in daily life and try to find out if any of them will give rise to cancer in laboratory animals. These tests take a long time and are so expensive to conduct . that every evaluation might cost a million dollars. Since there are millions of compounds, and mix- tures of compounds, in our environment it is not possible to study more than a few in detail. The Health Protection Branch of Health and Welfare (Canada) per- mits only a limited number of chemicals to be used in food be 'in cosmetics and each of these must be carefully screened to verify that" in standard laboratory tests they do not give rise to tumours in experimental animals. Although this provides reassurance as far as the quality of our food is concerned, a lot of research is being con- ducted to devise simpler and cheaper methods of determining whether contaminants of our environment represent a major carcinogenic hazard. 7. Are new methods of detection being developed? In a study carried out at the University of Alberta it was reported that 86 per cent of all cases of carcinoma of the pancreas had progressed to an advanced stage by the time they were detected. Since the efficacy of treatment is often correlated with the degree of advancement of the disease it becomes important to diagnose cancer at the earliest possible stage. Same years ago a blood test known as the CEA test was devised in Page 11 Montreal as a potential means of early detection of colo -rectal cancer. Although the final analysis of the results indicated that the test was not as specific as had originally been hoped for, the study markedly stimulated the search for methods of detecting early, cancer by im- munological reactions of the blood. Another example of this type of study is the work presently being conducted at McMaster University in which at- tempts are being madeto detect antibodies to a virus in women with carcinoma of the cervix, the underlying assum- ption being that this type of cancer may be caused by a Lvirus and that an- tibodies to this virus are . present in the blood of,. such patients. Send a mouse to college. Find out how today How funds were spent in 1978 (fiscal year ending September 30th, 197) Income from all sources totalled $25,519,970 in 1978. A detailed accounting will be found in the audited statement which is available upon request to any Unit of the Society. Expenditures totalled $22,795,396. These funds were used as follows : Research $12,928,936 Fellowships and professional education 278,645 Provincial cancer foundations and provincial programs 509,888 Education 3,774,121 Patient services 2,956,292 Cost of providing services 1,045,669 Cost of fund raising 1,301,845 $22,795,396 Resources at beginning of year 9,474,385 Net increase in resources for the year 2,724,574 Resources at end of year $12,198,959 Resources at end of year include $6,549,188 designated to meet specific commitments for research, hostel facilities, and other special projects and $34,235 for professional education. The remaining resources of $5,615,536 will be used to carry out the program of the Society in the six months prior to the next campaign in April. HOW CANCER DOLLARS WILL BE SPENT IN 1979 The Budget for 1979 .forecasts expenses of $22,207,875 for the following: Research $11,348,430 Research facilities and capital projects 51,500 Provincial cancer foundations 497,000 Fellowships and professional education 281,700 Education 4,202,006 Patient services 3,005,946 Cost of providing services 1,253,992 Cost of fund raising 1,567,301 Total budget $22,207,875 Less Forecast income from bequests and sundry 7,775,500 $14,432,375 Available for Expansion of Research Program 2,067,625 Balance required from campaign $16,500,000