WASHINGTON, - Taxpayers with a stake in breast cancer research chose the Army to manage federal funds that are awarded to some of the best breast cancer researchers in the world.
Every year since 1992, Congress has added millions of dollars to the Defense Department's budget so the U.S. Army Medical Research and Materiel Command at Fort Detrick, Md., can help scientists fight breast cancer.
The Breast Cancer Research Program is just one of the congressionally directed medical research programs that have managed $6 billion in appropriations through fiscal 2010. Funding covers such afflictions as Gulf War illness, prostate cancer, spinal cord and traumatic brain injuries, autism and genetic studies of food allergies. But the largest share of money -– and the first research to be funded by the program -– goes to scientists whose work targets breast cancer prevention, detection, diagnosis and treatment.
"We don't invest any funds into raising breast cancer awareness or educational outreach," oncologist and Army Capt. (Dr.) E. Melissa Caime told American Forces Press Service. "That isn't the mission given to us by Congress. All of our funds go toward research and management of that research. And we really do try to complement other funding agencies and not compete, and so move the field forward in a unique way."
In 1992, breast cancer patients and survivors marched on Congress with a compelling request for more research, Caime said.
"They wanted research that was innovative, that was willing to take a risk and that was going to have an impact and leapfrog the field forward," she said. To manage the program, the advocates had a choice among the Army Medical Research and Materiel Command and other research institutions.
"When the advocates met with our commanding general at the time, they found a very welcoming organization," Caime said. "This command has done biomedical research for many decades specifically focused on the needs of warfighters, ... [including] military operational medicine, combat casualty care and military infectious disease focus areas."
AMRMC'S commanding general also was enthusiastic about the advocates' desire to have a larger voice in research, Caime said, "so we've had a very happy partnership since that time."
The Army brings to the program "a very organized and efficient way of managing the research," she added.
Any scientist around the world can submit a research proposal for funding, and scientists and consumers work together in a two-tier process to decide which projects receive funding, she said.
"We listen to consumers, who we call the survivor-advocates, because they are the ones living with the disease," Caime said. "They are the acid test for every research project. We ask: 'How is [the research] going to make a difference for them or future generations, and incorporate their viewpoints and passions in all of our programs?'"
The National Cancer Institute estimates that 207,090 women will be diagnosed with breast cancer this year, and nearly 40,000 will die. Also this year, an estimated 2,000 men will be diagnosed, and 390 will die.
The Breast Cancer Research Program tries to focus on leading-edge kinds of research, program manager Dr. Gayle Vaday told American Forces Press Service.
"The bulk of our awards are made in the early stages, where it's harder for researchers to get funding through other federal agencies," she said. "We try to give a new idea that opportunity. It's high-risk, but the potential for gain is there."
For example, Dr. Lance Liotta of George Mason University and Virginia surgeon Dr. Kirsten Edmiston received an early award for research that evolved into an ongoing clinical trial to test the ability of the antimalarial drug chloroquine to reduce the long-term survival and spread of a kind of breast cancer called ductal carcinoma in situ, Vaday said. A standard treatment is to remove a tumor surgically from the breast, but it can take several days after surgery to find out if all the tumor cells are gone, she added.
Dr. Sarah Blair and colleagues at the University of California-San Diego received an award to develop an automated system that examines thousands of cells while a woman is still under anesthesia during surgery and separates cancer from noncancer cells based on the proteins they produce.
In 1993, the program funded an application from Dr. Dennis Slamon, then chief of hematology and oncology division at the University of California-Los Angeles, to develop antibodies against breast cancer –- an idea that was unheard-of at the time, Caime said.
Slamon's genetic studies ultimately led to the development of a drug called Herceptin that helps some of the women who have a fast-growing and deadly form of the disease.
"We don't restrict proposals to specific topics," Caime said. "For this program we allow the good science to come forward. We don't try to tell the scientific field that we must have studies on [specific topics]. We let very excellent science with innovation come to the top."