Importance of NCI-Funded Research Although based near Washington, D.C., the National Cancer Institute's (NCI) investment in cancer research enlists the skill and creativity of scientists from all over the world. In fact, most NCI-funded scientists are not located in Washington. They are found at universities, cancer centers, and hospitals throughout the nation and in other countries. In 1996, NCI spent more than $2.2 billion on cancer research and control. This large investment in cancer research is made in a number of ways. Three of the best known are:   Laboratory Research Much of the progress in fighting cancer hinges on the work of the nation's scientists who work in laboratories. The more we learn about cancer biology, the more we will understand about preventing, detecting, and treating cancer.   Advances in Laboratory Research NCI-supported researchers, working in laboratories throughout the nation, have made great strides in the fight against cancer and related diseases. For example: Oncogenes, which are involved in cancer, and their link to other human genes were discovered by NCI-supported scientists who later won a Nobel Prize for their groundbreaking work. The discovery that the development of the rare cancer, retinoblastoma, is due to alterations in both copies of the retinoblastoma gene led to the identification of a new class of cancer genes, called tumor suppressors. The inherited breast cancer genes, BRCA1 and BRCA2, were discovered recently by researchers with partial support from NCI. NCI researchers helped solve the puzzle of the three-dimensional shape of an enzyme key to human immunodeficiency virus (HIV). This information was placed in a public database by NCI, making it available to other researchers. Drug companies then used this information to create drugs that damage the enzyme, called HIV protease, and stop the virus from maturing.   Opportunities in Laboratory Research The key challenge is to continue to learn more about the nature of cancer. This involves strategies to look inside a cell and analyze its individual parts. By doing this, it will be possible to identify where changes occur that turn normal cells cancerous and to find ways to interrupt the disease process. For example: Researchers are working with oncolytic viruses that seek out and kill tumor cells, leaving healthy cells alone. Scientists are also learning to attach toxic substances to an antibody, an immune protein, that delivers the deadly toxin to tumor cells only, leaving healthy cells intact. Clinical Research Building on the research performed in our nation's laboratories, NCI supports clinical studies ­ research in which patients and healthy subjects take part ­ to test new treatments and ultimately compare them with standard therapies, to test new preventive agents, and to test new detection techniques. These comparisons make it possible to find out in an objective, unbiased way whether new treatments, detection techniques, diagnostic methods, or preventive agents are safe and more effective in people and under which conditions. NCI supports hundreds of clinical studies in cancer detection, treatment, and prevention studies. Clinical studies, involving about 30,000 patients, cover a broad range of scientific investigation and have yielded many new treatments. For example:   Advances in Clinical Research Paclitaxel (Taxol®) was identified by NCI's Natural Products Branch and evaluated in clinical studies in the mid-1980s. The Food and Drug Administration (FDA)-approved drug has proven effective in treating breast and ovarian cancers. Topotecan (Hycamtin®), a derivative of the compound camptothecin, went through NCI-sponsored clinical studies before being approved in 1996 for the treatment of ovarian cancer in patients who donot respond to standard treatment. Camptothecin was originally found by NCI's Natural Products Branch, and topotecan was discovered with partial NCI support. Irinotecan (Camptosar®), another drug derived from camptothecin, was developed by NCI-supported researchers and evaluated in clinical studies in the 1990s. The FDA-approved drug was shown to be effective in treating colorectal cancer that has recurred or progressed after standard treatment.   Opportunities in Clinical Research NCI is working to boost public awareness of clinical studies. With increased public awareness, more people will gain access to new and potentially helpful treatments. NCI-supported clinical studies now under way include: The Breast Cancer Prevention Trial, which will assess the safety and effectiveness of tamoxifen for preventing breast cancer. The nationwide study will recruit 13,000 women at increased risk for breast cancer. More than 12,000 women have already volunteered. he Prostate Cancer Prevention Trial, which is assessing the safety and effectiveness of finasteride for preventing prostate cancer in men aged 55 and older. The nationwide study has recruited 18,000 men without prostate cancer. They will be followed for seven years. The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial, which is a large study that will find out whether certain screening tests will reduce the number of deaths from these cancers. The NCI study will enroll 148,000 men and women aged 55 to 74. Trials of high-dose chemotherapy with stem cell transplants are comparing this therapy with other treatments for breast, ovarian, and other cancers. Community-Based Research Our personal habits and/or various things in the world around us can play a role in causing or preventing cancer. Some of these factors include diet, cigarette smoking, exposure to sunlight, and being around certain chemicals at home, at work, or in the environment. As part of a comprehensive approach to understanding cancer, scientists conduct research in communities throughout the country. They try to identify factors that influence cancer risk in individuals or certain populations. One approach is to focus on people who, in general, are more likely to develop cancer. This allows scientists to identify more easily specific factors that increase or decrease the risk of cancer. Studies in the community also allow scientists to understand how different people perceive their risk of cancer, laying the foundation for more effective education and prevention programs.   Advances in Community Research Although the landmark finding that linked cigarette smoking with lung cancer is the best known product of community research, there have been many others over the years. For example: Laboratory and community studies that have yielded strong evidence that women who have been exposed to certain types of human papillomavirus (HPV) are at increased risk of cervical cancer. This lead will have important implications for preventing and treating cervical cancer, the most common cancer in women worldwide. Laboratory and community studies that have shown an association between the bacteria Helicobacter pylori and an increased risk for stomach cancer. This work suggests new treatment and prevention strategies. Research in the community that linked an increased risk of liver cancer with the hepatitis B virus.   Opportunities in Community Research Racial Variations. Population studies are under way to look into why some races appear to be more or less likely to have certain cancers. These studies should reveal important new clues about the causes of cancer that apply to all races. Genetics. Scientists are studying groups of people to discover the frequency of genes that, when mutated, might predispose an individual to cancer. Identifying people with these gene mutations will make it possible to learn more about the interplay of genetics and environmental factors in the onset of cancer. Diet. Studies in communities over the past two decades indicate that diet can modify or enhance a person's risk of cancer. Studies now are exploring the possible role of specific dietary factors ­ fiber, fat, and antioxidants ­ in preventing or causing cancer. These studies could help people in adopting diets that reduce their risk of cancer. The Cancer Information Service provides a nationwide telephone service for cancer patients, and their families, the public, and health care professionals. The toll-free number is 1-800-4-CANCER (1-800-422-6237); services are provided in English and Spanish. People with TTY equipment may call 1-800-332-8615.   Back to How to Get It Return to Cancer Research Main Page