With the passage of the National Health Service Act in 1944, the National Institutes of Health (NIH) was created and included the National Cancer Institute. With substantial public investment and participation of physicians and scientists throughout the country supported by NIH grants, the United States became the world leader in biomedical research.
Starting during the first term of President George W. Bush, I had the privilege of serving as Director of one of the 27 institutes and centers from 2003-2011. NIH is a great institution that has made immeasurable contributions to the health and economic vitality of our country. These contributions span heart disease, diabetes, asthma, eye disease, arthritis, and perhaps no set of diseases have been more influenced than cancer.
NIH tends to support basic discovery and early translational research rather than drug or other treatment development. But this basic knowledge is the foundation for all these other advances that more directly affect our health. Without the basic knowledge, other advances would be impossible. Let me highlight some of the NIH-supported researchers and their discoveries that have dramatically affected how breast cancers are characterized and treated.
- A biochemist named Elwood Jensen studied how cells respond to estrogen. He discovered, much to his and everyone else’s surprise, that estrogen did not bind to receptors on the surface of cells but rather went inside cells and bound to receptors that bind to DNA inside the cell nucleus and turn specific genes on or off. This explained how estrogen can control cell growth.
- A geneticist named Mary-Claire King was interested in why breast cancer occurred with high frequency in some families. She painstakingly identified some of these families collected DNA from these research volunteers to map the specific sites in their genomes that were responsible. This pioneering work led to the identification of the genes now known as BRCA1 and BRCA2. These discoveries have led to improved methods for assessing breast cancer risk in individuals and thereby guiding screening (including breast MRI starting at age 25) or risk-reducing surgeries.
- A physician and cell biologist (from New Castle, Pennsylvania and previous PBCC Potamkin Prize Winner) named “Denny” Slamon became interested in a cell-surface protein, called HER2, that appeared to play a role in stimulating cell growth. He thought this protein might be involved in cancer. Early on, he applied to NIH but failed because of the fierce competition for funds. Smaller organizations similar to the Pennsylvania Breast Cancer Coalition filled the gap and he pursued this idea. Once he had established the basic concepts, he obtained NIH funding and demonstrated that a particularly aggressive subtype of breast cancer has a lot of this protein on its cell surface. Importantly, he found that women with this subtype of cancer could often be successfully treated with a member of a new class of drugs called monoclonal antibodies, such as Herceptin®.
These are but three examples of NIH-supported research that has improved and extended the lives of those diagnosed with breast cancer.
Sadly, the current federal administration is no longer focused on attacking cancer, but rather on attacking the NIH and other federal institutions. Actions have been taken that undermine the ability of universities and academic medical centers to conduct research. Talented staff at NIH, both scientists and others associated with administering grants, have been summarily fired for no reason. The basic processes of grantmaking have been gummed up so that grant applications are not being peer reviewed, nor, even if highly meritorious, funded. Most recently, existing grants are being arbitrarily terminated.
Research on women’s health, in particular, is under extra layers of scrutiny. The administration is now screening NIH grant applications for approximately 200 key terms for additional review, possible revision or restriction, and even possible termination. Alarmingly, these terms include “women” and “female”. The webpage of the NIH Office of Research of Women’s Health has a document on “Sex as a Biological Variable” which describes the importance of the inclusion of women in clinical trials that was briefly labelled as a “historical document”.
In recent years, NIH has supported almost $800 million worth of research on breast cancer per year. Moreover, NIH funding contributed an estimated $5 billion to the Pennsylvania economy in 2024. It is vital that we all do everything we can to preserve and protect an institution that has contributed so much to our health and the health of our families as well as to the strength of our economy.
Please let your local, State, and Federal officials how you feel about the gutting of these research institutions and efforts. Together, we can make a difference. Consider donating to the Pennsylvania Breast Cancer Coalition or similar organizations. They can help provide bridge and supplementary funding that makes important research possible. But realize that the scale of the NIH investments in research is vastly greater than private organizations can provide.
If you have questions, please feel free to reach out to me at berg.grants.2029@gmail.comcreate new email.
Postscript: As one example of programs under attack, the Medical Scientist Training Program (MSTP) grant at one institution was apparently cancelled and more appear likely to meet a similar fate. The MSTP trains combined MD/PhD physician scientists who are crucial contributors to research. I know this from personal experience as my wife, Wendie Berg, MD, PhD, is a graduate of such a program. She has devoted her career to improving breast cancer screening and her research has benefitted tremendously from multiple grants from the Pennsylvania Breast Cancer Coalition. She is also a breast cancer survivor herself.