APPENDIX 40
Letter to the Committee Specialist from
Professor W P Steward, Head of Department of Oncology, University
of Leicester
I refer to the letter of the 10 March 2000 inviting
comments on cancer research—A fresh look. I am Professor
of Oncology and Head of the University Department of Oncology
at the Leicester University.
The academic department of Oncology in Leicester
is one of the small groups of such departments which are not funded
by one of the national cancer charities. As such it receives no
core funding for research infrastructure and groups such as ours
have great difficulties in establishing clinical and laboratory
based research programmes. There is a "catch 22" situation
where the group cannot obtain project or programme grants because
it does not have a track record of research and yet it cannot
establish such a track record without some initial funding. In
order to address this, we are having to establish our own cancer
charity within the local counties. This is obviously a very unsatisfactory
situation as it diverts many of us away from spending as much
time as we should on our areas of expertise in research. This
will become an increasing problem as new academic departments
are formed in the United Kingdom in response to establishing high
quality Cancer Centres (a move which is being widely adopted in
response to the Calman-Hine initiative). The current policies
of the MRC and cancer charities is to focus funding on their core
groups making it extremely difficult for other new centres to
attract funding.
The coordination of cancer research in charity-funded
institutions appears to be reasonable but there is not effective
coordination of research in the other groups. It would seem to
me to be appropriate to form a network of all institutions who
would register their research and in this way some mechanism for
coordinating the different programmes could be established.
We are currently taking forward results of basic
research into our Clinic and have already instituted two trials
with agents which have been developed in the laboratories. I think
this is an unusual situation but is a good example of the close
cooperation between Scientists and Clinicians which exists in
Leicester. This makes it even more unfortunate that funding is
so difficult here when there is great potential to develop translational
research programmes.
I do not, personally, favour the establishment
of a UK national cancer institute—at least if it copies
the model in the United States. There could be an argument for
establishing a centre which coordinates cancer research in the
United Kingdom along the lines of the UKCCCR but, at a time when
funding is already very tight, I think this would be a great drain
on resources. Once funding had become less difficult, one might
consider the building of a physical institute.
We already have considerable industrial investment
in clinical trials of anticancer drugs but one can see this being
eroded in the future as our ability to prescribe new anticancer
drugs is reduced because of a lack of funds from the NHS. We have
already seen a downsizing of the Oncology branches of some of
the major pharmaceutical companies and I think this is a very
worrying development for the future.
I think that there has been a relatively high
standing of UK Oncologists in the international oncology community
in terms of the quality of research which has been undertaken
here. I believe, however, that this is being eroded now as funding
becomes ever more difficult to obtain and research groups contract.
There is enormous potential within the UK to undertake good quality
clinical and laboratory-based research and for these two groups
to interact to provide translational programmes. This is made
easier by the cross appointments between University and NHS Trusts
which occurs for the majority of clinicians. The regulatory regimens
are reasonable and ethics approval fairly straight forward to
anti-cancer trials.
In summary, I feel that there is a serious shortfall
of funding for cancer research within the United Kingdom and this
particularly relates to academic groups which are not core cancer
charity departments. There needs to be an alternative source of
funding for this increasing number of groups to ensure that high
quality research is undertaken. It is only with the presence of
research that Cancer Centres can flourish and offer the best quality
care possible.
31 March 2000
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