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| In Brief 2001 Budget Request Scientific Priorities for Cancer Research Infrastructure Needed for Cancer Research How We Work
Cancer Information for Patients and Health Professionals  |
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How We WorkNCI's Role in Cancer ResearchThe National Cancer Institute (NCI) is charged to lead our Nation's research effort to conquer this disease in all its forms. As the Federal focal point for cancer research in this country, NCI conducts, coordinates, and funds cancer research, and provides vision and leadership for the cancer research community. Each day, across the United States and around the world, thousands of NCI-funded researchers and clinicians are joined together by a common goal – they are working toward a day when cancers are an uncommon and easily treatable set of diseases.NCI supports this vital work through research programs that seek answers to the many remaining questions about how best to prevent and treat cancer. Pursuing these answers can take one of two interrelated and complementary paths – studying the cancer cell itself to uncover biological processes broadly applicable to all cancers, or studying one of the more than 100 specific types of cancer. Though these research approaches appear to be divergent, they are inextricably linked, and in fact, most fruitful when there is extensive interplay and cross-fertilization between them. As we develop an understanding of biological processes common to many tumor types, we gain new knowledge that can be applied to cancer-specific research, and as we make discoveries about a specific cancer, new questions about themes common to all cancers are prompted. Research on common biological processes, broadly applicable research, focuses on uncovering features that are common to all normal, precancerous, and cancerous cells. Basic research has taught us that one or more cellular mechanisms – cell growth, cell death, invasion, metastasis, avoidance of immune system attacks, and the accumulation of genetic changes that lead to cancer – are, in different combinations, responsible for most cancers. In addition to providing us with new insights into mechanisms common to cancer cells, basic research helps us to better distinguish one cancer from another based on molecular characteristics. Distinguishing cancers according to their molecular characteristics is becoming as important as the traditional way of defining a cancer by the site in which it arose. Basic research is not abstract; rather, it is the generation of essential knowledge that can be applied directly to each specific type of cancer that people experience. For example, scientists studying the process of angiogenesis, the formation of new blood vessels that tumor cells exploit to gain nutrients and growth factors, identified several potential anti-angiogenesis agents. The discovery of these agents, which may prove effective in combating a variety of human cancers, might not have occurred without broad research into the basic biological processes common to all cancers. Disease-specific research is aimed at uncovering the biological characteristics that are unique to each specific cancer, such as breast or prostate cancer. Here the goals are to design effective methods of preventing, detecting, diagnosing, and treating the cancer, and to address disease-specific survivorship issues. Disease-specific research also yields information that applies to many diverse cancers. For example, researchers studying the very rare childhood cancer of the eye called retinoblastoma discovered a gene, Rb, that when altered is the trigger that leads to retinoblastoma development. Scientists continued to study Rb and discovered the interconnected molecular machinery of a cellular circuit called the Rb pathway. This pathway is found in all cells, not just those that give rise to retinoblastoma, and at least one component of the Rb pathway is altered in every human cancer. Thus, a discovery unique to retinoblastoma eventually led to an understanding of a pathway that is found in all cells. Our efforts to answer the key questions of cancer research through either broadly applicable research or disease-specific research involves four classes of investigation – laboratory, clinical, population, and translational. Laboratory research focuses on the biology of cancer, the fundamental properties of cancer-causing agents and processes, and the body's defense against and response to cancer. In the clinic, research is carried out on cancer prevention, diagnosis, treatment, and rehabilitation. Population research focuses on the causes, risks, predisposition, incidence, and behavioral aspects of cancer. Finally, translational research builds bridges and intersections between and among the classes of research. It facilitates the movement of discoveries from laboratory and population research into the clinic and, conversely, provides a way for clinical insights to help direct laboratory and population-based research. This flow of information among the laboratory, the clinic, and the community helps to drive research in new directions. How do we know what questions to pursue in these four classes of research, be they broadly applicable or disease-specific? The keys to establishing this scientific direction are our planning and priority-setting processes; program review, progress review, and implementation efforts; and input we receive from our advisory groups and the community. |
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