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                   Voice in the Debate
          
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The December 24 front-page story on Samuel Broder's resignation as
director of the National Cancer Institute suggested that the Clinton
administration may want to reduce the funding for governmental cancer
research in the belief that private universities can do a better or more
efficient job. An important voice often ignored in the high politics of
those debates is that of the patient--the group of sick patients who
join the doctors and nurses in testing important protocols in various
stages of experimentation.

I am a volunteer in Protocol NCI/NMOB 93-10, currently being tested as a
treatment for non-small cell (nonsmokers') lung cancer by NCI. This type
of cancer has notably resisted chemotherapy. NCI developed, and is now
testing, dosages of taxol and cisplatin in a Phase 1 trial in a way that
appears to show a significantly better response rate than so-called
standard treatment for the disease. While standard treatment shows about
a 20% response rate, my protocol is showing response rates in the
neighborhood of 60%.

The protocol resulted from NCI's own research, in cooperation with the
National Naval Medical Center, and from the talent of NCI and Navy
doctors.

There is obviously an important place for continuing research at large
universities; these centers will eventually participate in my protocol
in the Phase 3 stage of randomized clinical trials.

But cutting back NCI's basic research in earlier phases would be
unjustified. Many universities and drug companies cannot handle
extremely complex research studies. Governmental research also is not
subject to many of the conservative pressures involved in the grants
process, as the Post's December 26 front-page story on "America's
Science: Losing It's Cutting Edge?" makes clear. Insurance companies
also do not generally pay for experimental treatments; the government
pays patient costs for volunteers in protocols.

Maybe portraying government as the villain in medical research (and
elsewhere) suits politics more than medicine. If so, a special place in
hell should be reserved for those who play research politics with human
lives. Those who do this would change their views overnight if they, or
members of their family, were stricken with cancer. I hope the
administration, politicians in Congress, and private-sector lobbyists
keep in mind the interests of patients suffering a life-threatening
illness before they shift independent research away from NCI.

Richard L. Bacon
Potomac [MD]

[A Cancer Patient's Voice in the Debate, Bacon, letter-editor,
Washington Post, 1/19/95]

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