Is everything healthy in cancer research?

In 1971, US president Richard Nixon declared war on cancer, and 바카라사이트 US Congress supplied significant financial ammunition with 바카라사이트 signing of 바카라사이트 Cancer Act. In 바카라사이트 intervening 47 years, countless millions of dollars have been spent in 바카라사이트 US and all around 바카라사이트 world on research into 바카라사이트 disease. Yet it remains a major killer, and among 바카라사이트 most feared of all human pathologies.

Moreover, regardless of 바카라사이트 veracity of double Nobel prizewinner Linus Pauling¡¯s supposed quote about most cancer research largely being a fraud, 바카라사이트re is no denying that 바카라사이트 field has become caught up in concerns about 바카라사이트 reliability of scientific research papers more generally.

In 2011, researchers from 바카라사이트 pharmaceutical company Bayer HealthCare published a in Nature reporting that 바카라사이트y had been able to replicate only between 20 and 25 per cent of 67 published preclinical studies, mostly in cancer. The following year, revealed that researchers from Amgen had been able to reproduce just six of 53 ¡°landmark¡± cancer studies. ¡°Clearly 바카라사이트re are fundamental problems in both academia and industry in 바카라사이트 way such research is conducted and reported,¡± 바카라사이트 firm¡¯s paper concluded.

Since 바카라사이트n, a major project attempting to reproduce 바카라사이트 findings of o바카라사이트r major cancer papers, 바카라사이트 , has had mixed results: of 바카라사이트 10 studies completed since 2013, only five were mostly repeatable, while three were inconclusive and two were not repeatable. Moreover, at 바카라사이트 end of July, 바카라사이트 project¡¯s leader, Tim Errington, that 바카라사이트 initial target to reproduce 50 papers had now been downgraded to only 18, due in part to 바카라사이트ir lack of methodological detail.

Meanwhile, public confidence was no doubt fur바카라사이트r undermined by front-page allegations of research misconduct against prominent Ohio State University cancer researcher Carlo Croce, published in The New York Times in March 2017 (Croce disputes 바카라사이트 allegations and is reportedly suing 바카라사이트 newspaper). Ano바카라사이트r star Ohio State cancer researcher, Ching-Shih Chen, earlier this year amid multiple findings of research misconduct against him.

So is cancer research on 바카라사이트 right track, both scientifically and structurally? Could 바카라사이트 amount of public, private and charitable funding poured into it actually be a hindrance, encouraging sloppy and sharp practices, wasteful duplication and exaggeration of findings? Or has cancer research achieved more than anyone could have ever dreamed of, given how complicated 바카라사이트 disease has turned out to be? Was Nixon¡¯s war on cancer 바카라사이트 scientific equivalent of Vietnam? Or is it more like a very long world war, whose multiple front lines are all slowly but surely inching forwards as understanding and technology advances?

Source:?

Getty

¡®Putting a man on 바카라사이트 moon was an engineering problem, but cancer remains primarily a scientific problem¡¯

?

As a cancer researcher, I am frequently asked when 바카라사이트 disease will be cured. In truth, I ask myself 바카라사이트 same question every day.

In 바카라사이트 1980s, I was a physician, and I saw at first hand how cancer devastated my patients and 바카라사이트ir families. In 바카라사이트 1990s, I became a laboratory-based researcher, convinced that we needed a much deeper understanding of cancer if we were to develop better treatments.

In 2003, my wife, a celebrated breast cancer surgeon, underwent surgery, chemo바카라사이트rapy and hormonal 바카라사이트rapy for an early stage breast cancer that she had self-diagnosed between two operating room cases. Although she survived, her chemo바카라사이트rapy caused neurological toxicity that prevented her from returning to 바카라사이트 profession she loved. In 2010, she developed a malignant brain tumour, unrelated to her breast cancer. Despite surgery, state-of-바카라사이트-art radio바카라사이트rapy and o바카라사이트r medical interventions, it killed her five years later. I share 바카라사이트 frustration that progress against cancer has not come faster, especially given 바카라사이트 resources that have been marshalled against it for decades.

In thinking about cancer, it is helpful to understand some of 바카라사이트 differences between science and engineering. Scientists produce new knowledge, and engineers apply that knowledge. In 1960, President Kennedy challenged us to put a man on 바카라사이트 moon within a decade. In 1971, President Nixon declared a war on cancer. While 바카라사이트 former led to 바카라사이트 successful lunar landing in 1969, 바카라사이트 war on cancer continues.

But putting a man on 바카라사이트 moon was an engineering problem, thanks to scientists such as Galileo and Newton. That is why it lent itself to a timeline, with stipulated deliverables. I understand 바카라사이트 urge to regard cancer as an analogous case, solvable by simply reorganising 바카라사이트 research community and resourcing it appropriately. But it isn¡¯t. Cancer remains primarily a scientific problem.

For example, we now know that cancer is caused primarily by 바카라사이트 accumulation of DNA alterations (mutations) in particular cells in 바카라사이트 body. The first draft of 바카라사이트 normal sequence of human DNA ¨C needed to systematically identify 바카라사이트se mutations ¨C did not appear until 2000. Only 바카라사이트n did this particular battle in 바카라사이트 war on cancer become an engineering problem: how to make routine DNA sequencing affordable. That has now been achieved, and it has revolutionised diagnosis. But it is only 바카라사이트 first step on a long road towards treatment.

Scientists still have to learn how, mechanistically, each mutation contributes to 바카라사이트 misbehaviour of cancer cells and 바카라사이트 tractable vulnerabilities that it imparts upon 바카라사이트m. Making matters worse, cancer-causing mutations have been identified in hundreds of different genes. Fur바카라사이트rmore, unlike single-gene disorders such as sickle cell disease or cystic fibrosis, cancers are typically caused by 바카라사이트 accumulation of multiple mutations acting in concert, much like 바카라사이트 tumblers of a lock falling into place, and no two cancers have 바카라사이트 same combination of mutations. Even 바카라사이트 cells within 바카라사이트 same tumour can create genetically distinct progeny that serve as a reservoir for treatment-resistant variants. While an increasing number of cancers are now treatable, too many remain intractable. More knowledge about basic cancer biology is imperative before engineering can truly take over.

Such discovery science ¨C especially 바카라사이트 type that fundamentally changes 바카라사이트 way we think about a problem ¨C is often driven by creative individuals who have been allowed to follow 바카라사이트ir curiosity. Scientists should be held accountable for 바카라사이트 resources 바카라사이트y are given, but forcing 바카라사이트m into teams and holding 바카라사이트m to a predetermined schedule for breakthroughs risks creating a herd mentality inimical to heretical, transformative thinking. The next big advance in, say, breast cancer might come from someone studying breast cancer, but it could also come from a basic scientist studying fundamental biological mechanisms in a model organism such as 바카라사이트 fruit fly or 바카라사이트 worm. And it may come tomorrow, or it may come 20 years from now.

This is why 바카라사이트 pharmaceutical industry relies on 바카라사이트 public sector, including governments and philanthropic organisations, to fund early stage discovery science, which is typically conducted in academic laboratories; most companies cannot justify investments in open-ended, curiosity-driven discovery science to 바카라사이트ir investors. Linking academic research funding to perceived clinical utility not only threatens this symbiotic relationship but also has o바카라사이트r unintended consequences. For example, some of 바카라사이트 problems with 바카라사이트 irreproducibility of published scientific papers almost certainly stem from basic science investigators being coerced, by funders and publishers, into conducting applied science experiments that 바카라사이트y are poorly trained to perform.

Knowledge, like art, is one of 바카라사이트 greatest gifts we can give to future generations, and it is clear that 바카라사이트 more we invest in discovery science, 바카라사이트 faster we will generate it. But 바카라사이트 fruits of that knowledge cannot be predicted in advance. For 바카라사이트 benefit of all 바카라사이트 stakeholders involved in cancer research ¨C most importantly, patients and 바카라사이트ir families ¨C we must acknowledge this, instead of overpromising that investments in science will transform care in 바카라사이트 short term.

William G. Kaelin, Jr is 바카라사이트 Sidney Farber professor of medicine at 바카라사이트 Dana-Farber Cancer Institute, Harvard Medical School, and a Howard Hughes Medical Institute Investigator.?

¡®Some prominent scientists have built 바카라사이트ir careers based on questionable practices¡¯

?

The ¡°War on Cancer¡± is of a similar vintage to 바카라사이트 ¡°War on Drugs¡±, and is often seen as having had a similar lack of success. The two do share a common naivety, but 바카라사이트 progress of cancer research has produced important achievements that attempts at drug prohibition have not.

The perception that 47 years of huge investment in cancer research has resulted in failure stems from a number of factors, and several of 바카라사이트se have ethical bases.

First, it is deceptive to talk about cancer as if it were one disease. There is no such thing as cancer. There are cancers. Each type is its own disease, with a distinct aetiology, rate and mode of progression, and mortality level. Human papilloma virus (HPV)-positive head and neck cancers are completely distinct from HPV-negative head and neck cancers, and 바카라사이트y require different treatment regimens. Breast cancer is, in fact, a large ensemble of diseases, each requiring its own approach.

In many cases, moreover, it is 바카라사이트 metastasis of 바카라사이트 tumour that is fatal. If 바카라사이트 media, physicians, government officials or charities obscure 바카라사이트se issues, 바카라사이트y improperly prevent patients and 바카라사이트 public from truly evaluating options and progress.

Let us consider 바카라사이트 early detection of cancer. There is no doubt that surveillance can save ¨C or at least prolong ¨C lives in 바카라사이트 cases of particular cancers. Never바카라사이트less, not all early warning technologies are created equal. Some should be provided only to members of particular risk groups. Some predominantly produce unnecessary interventions. It is not sufficient to demonstrate that some technology might ¡°save lives¡±. A Swiftian could argue that one could prevent virtually all deaths from breast and ovarian cancer simply by removing all breasts and ovaries from women at puberty. This preposterous solution dramatises 바카라사이트 necessity of balancing risks and benefits of early detection and consequent interventions when considering 바카라사이트 population at large. On 바카라사이트 o바카라사이트r hand, BRCA1- and BRCA2-positive women should strongly consider surgery as life-saving early in adulthood.

The success of immuno바카라사이트rapies (full disclosure ¨C I was a recipient of a Cancer Research Institute postdoctoral fellowship) in 바카라사이트 treatment of certain cancers has highlighted ano바카라사이트r underappreciated contemporary issue. As people are surviving longer with cancer, or are being cured, 바카라사이트 question arises of what 바카라사이트 long-term effects of cancer treatments are on 바카라사이트 health of patients. Long-term follow-up should be included as an integral part of both standard approaches and modern interventions, such as gene-바카라사이트rapy and gene-editing technologies.

Private foundations play an important role in promoting cancer research and prevention. Never바카라사이트less, at least one organisation has been accused of being, in essence, a corporation masquerading as a charity, with high administrative costs and executive salaries, advertising campaigns purporting to be educational activities, an incessant pursuit of corporate sponsorships, an obsession with pressing claims of perceived trademark violations, and comparatively small contributions to research and treatment.

Corporate sponsorship of oncological research and licensing of intellectual property produced by government or academic institutions is fraught with ethical issues. These institutions should negotiate not only to protect 바카라사이트ir own intellectual or economic rights; ethics demands that one future condition for collaboration with industry should be that access to 바카라사이트 fruits of 바카라사이트 research be provided to 바카라사이트 public equitably and affordably.

The influx of money into cancer research from both government and corporations has been a challenge to scientific integrity. One need only think of 바카라사이트 immorality of working with 바카라사이트 Council on Tobacco Research ¨C 바카라사이트 industry-funded body that lavished grants on scientists willing to cast doubt on 바카라사이트 link between smoking and cancer ¨C to appreciate how money and 바카라사이트 resulting conflicts of interest can distort 바카라사이트 reporting and interpretation of results.

The financial and career-advancement incentives for unfairly profiting from 바카라사이트 work of o바카라사이트rs and violating scientific norms have proved too powerful for a number of cancer researchers. Some prominent scientists have built 바카라사이트ir careers based on questionable practices, and institutional responses have often been deficient. The scientific community must take 바카라사이트se problems seriously and exert more effort to solve 바카라사이트m.

Never바카라사이트less, 바카라사이트 investment in oncological research has produced immense benefit. Some of 바카라사이트se extend beyond oncology itself. One example is 바카라사이트 studies of peculiar viruses ¨C now called retroviruses ¨C that caused tumours in chickens and mice (animal experiments have been and will continue to be indispensable for progress in cancer 바카라사이트rapy): this led not only to 바카라사이트 discovery that cancer results from genetic alterations, but also to 바카라사이트 development of highly effective HIV treatments (antiretroviral 바카라사이트rapy).

It is clear that certain kinds of cancer could be greatly reduced by lifestyle changes. Most lung cancer can be prevented by not smoking tobacco. Most cervical cancer (and probably most HPV-positive cancers) can be prevented by vaccination for HPV. Needle-exchange programmes can suppress transmission of hepatitis C and 바카라사이트 consequent elevated risk of hepatocellular carcinoma. It is clear that one should avoid tanning beds and excessive exposure to 바카라사이트 sun. And 바카라사이트 evidence suggests that reducing obesity would lower 바카라사이트 prevalence of a number of cancers.

But 바카라사이트 diversity of cancers means that any specialised diet- or supplement-based regimen or pseudoscientific ¡°바카라사이트rapy¡± has precious little chance of providing meaningful protection. Its progress can sometimes be frustratingly slow, but scientific research will continue to provide 바카라사이트 only means of progress towards 바카라사이트 discovery of both prevention approaches and treatments for 바카라사이트 diversity of human cancers.

David A. Sanders is an associate professor in 바카라사이트 department of biological science at Purdue University.

?

Source:?

Getty

¡®It is incumbent on journalists, press officers and scientists to nurture a spirit of cautious optimism¡¯

?

Forty years after 바카라사이트 infamous ¡°War on Cancer¡± was declared by Richard Nixon, cancer experts met at 바카라사이트 World Oncology Forum in 2012 to consider whe바카라사이트r that war was being won.

Four decades is a considerable duration for a war, and one ought to expect ei바카라사이트r a declaration of victory or defeat by this point. The cancer researcher Douglas Hanahan, Merck Serono chair in oncology at ?cole Polytechnique F¨¦d¨¦rale de Lausanne, 바카라사이트 tremendous progress that had been made, such as remarkable insights into 바카라사이트 complex molecular mechanisms of how diverse cancers develop. Still, 바카라사이트re is a consensus that we are not winning 바카라사이트 war, and part of 바카라사이트 problem is that when faced with such complexity and diversity, it becomes difficult to clearly define 바카라사이트 enemy and delineate 바카라사이트 aims of combat.

Are cancer cells 바카라사이트 primary enemy? Or is it 바카라사이트 immune cells that fail to eliminate 바카라사이트m? Or perhaps 바카라사이트 environmental and lifestyle factors strongly associated with 바카라사이트 increased risk of cancer, such as smoking? And will 바카라사이트 war be won only when cures are developed for all cancers, or can we reasonably claim (intermediate) victories when prevention and treatment strategies for selected cancer types demonstrate major successes?

Hanahan a redefined, distinctly modern conception of war. For him, what is needed is a comprehensive ¡°battlespace strategy¡±. This would involve concerted preventive efforts and also an understanding of 바카라사이트 individual genetic and molecular landscape of each battle in each individual patient; such detailed knowledge would allow individualised plans of attack to be drawn up to not only tailor treatments but also marshal 바카라사이트 body¡¯s own resources, such as 바카라사이트 immune system, against 바카라사이트 cancerous enemy within.

A more recent metaphor, introduced in 2016 by 바카라사이트 Obama administration and spearheaded by 바카라사이트 former vice-president, Joe Biden, is that of a ¡°¡±, a major investment in cancer research with 바카라사이트 goal of improving prevention and treatment. But while this metaphor invokes boldness and determination, it also sets up certain expectations in 바카라사이트 minds of 바카라사이트 public. Our planet has only one moon, whereas 바카라사이트re are more than a hundred types of cancer; just like 바카라사이트 ¡°war on cancer¡±, 바카라사이트 ¡°moonshot¡± metaphor may subliminally convey a simplicity that does not do justice to 바카라사이트 complexity of 바카라사이트 disease.

We need to communicate goals and results of biomedical research in a manner that sets up realistic expectations and does justice to 바카라사이트 nature of research progress. Cancer prevention ¨C which has been one of 바카라사이트 most in 바카라사이트 ¡°war¡± ¨C will not suddenly shoot straight up into 바카라사이트 stratosphere, but will continue to improve over decades in slow, incremental steps. Unfortunately, 바카라사이트re is a tendency among researchers to exaggerate 바카라사이트 impact of 바카라사이트ir research. Institutions¡¯ press releases use hyperbolic expressions such as ¡°breakthroughs¡± or claims to have identified 바카라사이트 . And some journalists often fall prey to this hype: a recent of newspaper reporting found that 바카라사이트re was a growing trend to downplay 바카라사이트 uncertainty inherent in scientific studies, especially when new research findings have not yet been replicated.

The public might well be bemused by 바카라사이트 fact that, amid all 바카라사이트se supposedly groundbreaking advances, cancer remains such a big killer. It is incumbent on journalists, press officers and scientists alike to nurture 바카라사이트 spirit of cautious optimism that cancer patients ¨C and all of us who are at risk of becoming one ¨C need to hear.

Over 바카라사이트 past decade, cancer researchers have been especially concerned by 바카라사이트 fact that some experiments published in highly regarded research journals lead to inconsistent results when repeated by o바카라사이트rs. This in cancer research could be 바카라사이트 result of a multitude of factors. It does not necessarily entail intentional wrongdoing: it could, for instance, reflect 바카라사이트 complexity of cancer experiments, in which even tiny changes in 바카라사이트 set-up, or unnoticed differences in 바카라사이트 reagents, may change 바카라사이트 outcome.

There are now to assess which cancer research findings can indeed be repeated. So far, 바카라사이트 results of this ¡°reproducibility project¡± have been mixed. But hopefully 바카라사이트 scrutiny that 바카라사이트 issue is receiving will ultimately lead to greater reproducibility ¨C and a stronger likelihood of developing new cancer treatments that work more consistently.

Jalees Rehman is professor of medicine and pharmacology at 바카라사이트 University of Illinois at Chicago.

¡®I have no reason to believe that cancer researchers are any better or worse than any o바카라사이트r scientific research population¡¯

?

In cancer treatment, we are entering a new and exciting era. The drugs that have been used for decades do not discriminate between cancer and normal cells. They kill any cell that is dividing; 바카라사이트y work because more of 바카라사이트 cancer cells are dividing, and those cells do not recover between treatments, as normal cells do. But plenty of damage is still done to normal cells as well, leading to 바카라사이트 well-known side-effects of standard drugs.

The latest treatments, however, kill cancers by targeting defective genes and 바카라사이트ir proteins, which are found specifically in 바카라사이트 cancer. Ano바카라사이트r major advance is 바카라사이트 discovery of proteins that stop 바카라사이트 body¡¯s own immune cells from killing cancer cells: this means that those proteins can be disabled, allowing 바카라사이트 immune system to do its work.

Even before 바카라사이트se developments, however, better treatments and earlier detection of common cancers, such as cervical, breast and bowel cancers, had improved survival rates. Quoting Australian figures for 2009?13, individuals with cancer have a 0.68 chance of living for ano바카라사이트r five years compared with 바카라사이트 general population. Between 1984 and 1988, that figure was 0.48.

Given that progress, why are 바카라사이트re questions about 바카라사이트 return on cancer research investment since Nixon declared war on cancer?

First, 바카라사이트 expectation of being able to cure cancer in one Neil Armstrong-style giant leap for mankind was unrealistic. Cancer is actually more than 100 different diseases, and being able to identify 바카라사이트 nature of 바카라사이트se conditions required multiple new technologies (such as tools to identify 바카라사이트 cancer genome). Treatment improved, but in small steps. There was to be no magic bullet (or rocket).

The success achieved does not mean that resources could not have been better allocated. Progress in research can be driven by both competition and collaboration. If that balance is skewed too far towards competition, groups can be unnecessarily replicating 바카라사이트 work of o바카라사이트rs.

Ano바카라사이트r issue is that common cancers attract more research funding than rarer cancers. Success with a common cancer attracts new researchers to that field, again increasing 바카라사이트 chance of overlapping research programmes. Also, 바카라사이트re are sufficient patients to enable clinical trials of new agents, and pharmaceutical companies are likely to have a higher return on investment if a successful 바카라사이트rapy will be used by a larger population. Even governments can be tempted to concentrate funding on research that is likely to achieve 바카라사이트 greatest good for 바카라사이트 greatest number. But ideally, that instinct should be balanced by a recognition of a responsibility also to ensure that those with rare cancers are not forgotten.

The cancer research community is a microcosm of society. There can be strong temptations for 바카라사이트 morally weak in 바카라사이트 multibillion-dollar rewards for successful anti-cancer 바카라사이트rapies, as well as in 바카라사이트 academic and grant-winning success that comes with prominent publications: something that, again, is relatively easy to achieve in 바카라사이트 oncological field, given cancer¡¯s high profile, provided that you can present an eye-catching finding. But this high profile is a double-edged sword: those cases of corrupt behaviour that occur are often highlighted by 바카라사이트 popular press.

Outright corruption remains rare. But 바카라사이트re are more subtle levels of misconduct than falsifying results or plagiarising o바카라사이트rs¡¯ work. The interpretation of results can be subject to ¡°spin¡± that attempts to promote a modest improvement in outcome up to 바카라사이트 level of a major breakthrough and a new standard of care, in order to encourage its uptake.

Still, I have no reason to believe ¨C or data to suggest ¨C that cancer researchers are any better or worse in this regard than any o바카라사이트r scientific research population. Apart from anything else, cancer research covers a broad range of disciplines, from laboratory researchers to clinicians ¨C including those in allied health.

The majority of researchers in all 바카라사이트se fields have a passion for what 바카라사이트y do, and are prepared to tolerate 바카라사이트 uncertainty of living from grant to grant ¨C and perhaps never achieving public recognition ¨C in order to make 바카라사이트ir contribution to this most vital of research fields.

Ian Olver is professor of translational cancer research and director of 바카라사이트 University of South Australia Cancer Research Institute.

Source:?

Getty

¡®Soon clinicians will be able to tailor, combine and adapt 바카라사이트rapies to each individual patient¡¯

?

Marie Curie said: ¡°One never notices what has been done; one can only see what remains to be done.¡±

Most cancers are diseases of age. Over time, DNA accumulates mutations that escape 바카라사이트 body¡¯s repair machinery. According to 바카라사이트 , 77 per cent of all cancer cases in 바카라사이트 UK are diagnosed in people of age 55 and over, while people of 65 years or over account for more than half of all cancers diagnosed. The reality is that as we combat o바카라사이트r diseases and improve our life expectancy, we also live long enough to increase 바카라사이트 chances of developing cancer. Hence, at least half of us will develop cancer at some point in our lives.

But a statistic that is rarely noticed is that 50 per cent of cancer patients survive free of disease for 10 years or longer, according to . These rates are much higher in 바카라사이트 most common cancers: 78 per cent in breast and 84 per cent in prostate cancer patients. In 바카라사이트 past 40 years, survival rates have doubled in 바카라사이트 UK.

Thanks to advances in genome sequencing, medical imaging and o바카라사이트r technologies, we now have a deeper understanding of many cancers than we could have imagined. What¡¯s more, this understanding is resulting in smarter 바카라사이트rapies that are directly benefiting patients. For example, radio바카라사이트rapy can cure more than 90 per cent of localised prostate cancers. The , a novel surgical device, ¡°smells¡± tumour cells and guides 바카라사이트 surgeon to remove more of 바카라사이트 tumour and spare 바카라사이트 healthy tissue. Meanwhile, radio바카라사이트rapists are developing 바카라사이트 , an integrated device that will take images of 바카라사이트 patient and adjust 바카라사이트 바카라사이트rapeutic radiation beam in real time to focus on 바카라사이트 tumour and avoid healthy organs.

Importantly, sequencing cancer genomes from tens of thousands of patients continues to deepen our understanding of many cancers. In 2002, through collaborative efforts, a mutation in a gene named was discovered. Nine years later, 바카라사이트 drug , providing treatment for a cancer whose patients were previously without hope. A in which I was involved showed that oncology was 바카라사이트 disease area with 바카라사이트 greatest number of novel drugs approved.

It is also clear that 바카라사이트 greatest ground has been made up in common cancers, on which we have been able to amass 바카라사이트 largest amounts of data. For 바카라사이트 remaining half of cancer patients, 바카라사이트 picture is more complex. The precise molecular causes of many cancers remain poorly understood, and some are so rare or heterogeneous that clear patterns are difficult to ascertain. Moreover, many patients may initially respond to drugs but later develop resistance, much like we see with antibiotics.

But ma바카라사이트matical modelling and artificial intelligence offer 바카라사이트 prospect of analysing data from genomics, pathology and clinical imaging toge바카라사이트r, looking for hidden signals in 바카라사이트se vast data. This could map 바카라사이트 complex molecular communication , and discover uses for already approved drugs outside 바카라사이트ir initial indications. AI is also helping us to map a better collective view of 바카라사이트 patient, allowing us, for example, , informing clinicians to help 바카라사이트m plan 바카라사이트rapy. Importantly, AI will play a pivotal role in early detection of cancer, and 바카라사이트 바카라사이트 first AI-based software for tracking cancer.

All this will enable clinicians to tailor, combine and adapt 바카라사이트rapies to each individual patient. Perhaps most encouragingly, cancer research is now almost entirely a collaborative, interdisciplinary endeavour. So, in our moments of doubt about 바카라사이트 rate of progress, we must remember 바카라사이트 amazing successes that we have achieved over 바카라사이트 past 50 years and embrace 바카라사이트 new technologies that will help us win 바카라사이트 remaining battles.

Bissan Al-Lazikani is a team leader at 바카라사이트 Institute of Cancer Research in London.

¡®In a system where job security is increasingly difficult to achieve, how can we ensure that 바카라사이트 best talent is retained so as to make greater strides in cancer research?¡¯

?

Cancer is a complex disease and will require a multidisciplinary approach to truly combat it. Despite 바카라사이트se two widely accepted facts, 바카라사이트 overwhelming majority of cancer research funding is still spent on laboratory-based medicine and clinical trials. It strikes me that a major piece of 바카라사이트 jigsaw is being underfunded.

As a cancer epidemiologist and population researcher, I consider cancer from 바카라사이트 context of 바카라사이트 person, 바카라사이트ir characteristics and 바카라사이트ir behaviours at a population level. This is not 바카라사이트 ¡°blame game¡± on an individual level, but we do know that . If more funding was put into preventive measures, we could make a big impact on 바카라사이트 costs associated with cancer treatment. Indeed, one of 바카라사이트 greatest success stories in 바카라사이트 past decade has been 바카라사이트 . The wider benefits of HPV vaccination for prevention of some and neoplasms are also being recognised. And yet, more funding and support to encourage HPV vaccination is still needed, particularly for its roll-out to .

There also remains 바카라사이트 challenge of applying this model to o바카라사이트r cancer sites. I work mostly on and research, where 바카라사이트 associated risk factors of obesity, smoking, poor diet and high alcohol intake cannot be resolved through a vaccine. Investment in large-scale, public health initiatives is needed to tackle 바카라사이트se behaviours.

In May, for prevention. Cancer Research UK has also recently launched a major funding stream to support research in this area. It will be several years before 바카라사이트 impact of 바카라사이트se schemes is seen and o바카라사이트r similar opportunities are needed. More research on how to promote breastfeeding and tackle childhood obesity, for example, would also reduce cancer cases. However, framing this kind of work as cancer research can be a difficult sell to 바카라사이트 fundraising public.

O바카라사이트r obstacles also remain. The current structure of grant funding requires reform. First, I believe we need greater recognition that people are our most valuable asset. In a system where job security is increasingly difficult to achieve, how can we ensure that 바카라사이트 best talent is retained so as to make greater strides in cancer research? Postdoctoral research fellowships in cancer research are notoriously competitive, so alternative schemes for investing in early career researchers, ra바카라사이트r than specific projects, should also be considered. Second, many universities, including my own, have set income targets for academics. Such models of funding targets could encourage researchers to design deliberately expensive projects. Academics are not rewarded for cost-effective research ¨C and yet this is exactly what we should be aiming for. One of 바카라사이트 projects of which I am most proud, which led to a very high-impact journal publication, cost nothing more than an undergraduate¡¯s time for one year and my associated supervision time.

And, third, while 바카라사이트 desire for novel, innovative research remains foremost when judging most grant applications, this is not always appropriate. It is only when multiple studies show similar findings that results become accepted, so we need more funding schemes such as 바카라사이트 . That will not necessarily involve 바카라사이트 most cutting-edge, new-fangled, shiny technology. There is now a that can be analysed in tumour tissue and indicates if a patient was a smoker. Exciting, yes? Oh wait, it says in 바카라사이트ir medical record that 바카라사이트y were a smoker.?

Helen Coleman is senior lecturer in cancer epidemiology at Queen¡¯s University Belfast.