The Condition Cancer Research Is In

Sabrina Tavernise in The New York Times:

In a letter to colleagues announcing his departure as the director of the National Cancer Institute, Dr. Harold Varmus, 75, quoted Mae West. “I’ve been rich and I’ve been poor,” he wrote, “and rich is better.” The line was characteristic of Dr. Varmus: playful and frank, not what one might expect from a Nobel laureate. But it also distilled a central question facing biomedical research today. Is the decline in funding that has shaken universities and research labs here to stay? If so, what does that mean for scientific research? Dr. Varmus, whose last day at the cancer institute is Tuesday, recently reflected on financial constraints in science, the fight against cancer and his own efforts to remain healthy. Our interview has been condensed and edited for space.

Where are we in the fight against cancer?

One of the major advances we’ve had as a result of cancer research is deep recognition of the complexity of cancer. It’s not one disease, it’s lots of different diseases. Every single cancer is different when you look at it on a genetic level. When the president recently announced his precision medicine initiative, a lot of it was based on the information we are getting from genetic and molecular analysis of cancer. Precision medicine depends on being much more precise about diagnosis. That allows you to target therapies more correctly and make better inferences about likely outcomes. This is the most transforming thing that’s happened. We are beginning to understand now how different sets of mutations increase or decrease the likelihood that somebody’s going to respond to a therapy. There have been some sensational successes in immunotherapies. Some use antibodies that block the immune system’s self-regulation. I think there’s tremendous promise here. Cancer goes through an evolutionary process that is complex and not fully understood. There’s a tremendous amount of basic disease research to be done.

Is that basic research getting done?

People feel their likelihood of getting funded is greater if they work on things that may have a clinical application. I’m worried about that, because I look at the big things that have changed the face of health care, and it’s usually the result of some pioneering discovery not made in conjunction with the notion of how to treat somebody. You’ve got to do clinical testing, but if we become slackers on funding the absolutely most fundamental things, we will not hit upon the real answers. To understand how a normal cell becomes a cancer cell — we can’t lose sight of that.

What’s your advice on staying healthy?

I don’t want to go to my doctor, ever. I know flesh is heir to disease. I’ve been taking aspirin every day. It can be protective against cancers, heart disease and some strokes. I believe in keeping cholesterol levels down and keeping a healthy lifestyle. I try to be on my bike or doing something every day. Not just for health — I choose the sports I like. It’s a social event as well.

More here.