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Pancreatic cancer in the spotlight
Editorial
Pancreatic cancer in the spotlight
www.thelancet.com/oncology Vol 15 March 2014
which begs the question as to whether a collaborative or combined approach would be greater than the sum of all parts. Research for different cancer types also remains uneven. Funding for pancreatic cancer research is very low compared with other cancer types, and as a result, there are currently 81 clinical trials for breast cancer recruiting in the UK, but only eight for pancreatic cancer. Moreover, pancreatic cancer is a difficult disease to diagnose. Unlike breast cancer, which lends itself to self-diagnosis and for which there are well established screening programmes in place, pancreatic cancer presents with diffuse symptoms and often at a late stage. More research is therefore desperately needed to understand the basic biology of the disease and to develop appropriate screening programmes. More than 330 000 people are diagnosed with pancreatic cancer annually worldwide, and prognosis remains poor—just under 4% are expected to survive for 5 years after their diagnosis. This statistic has changed very little in the past 40 years. Pancreatic cancer is not an obscure cancer, but perceptions of it as a difficult challenge prevents progress. The recent successes in the treatment of another difficult cancer—melanoma—shows that it is possible to make great gains and challenge dogmas. However, it is not enough to wait for private sector investment. Government funding bodies should identify shortfalls in research funding in areas not covered by privatesector investment. Greater cooperation between funders could help lessen the disparities in research spending across cancer types and ensure spending is more closely aligned with clinical need and disease incidence. Charity and private-sector money often follows the path offering the greatest potential for success. Equally, large and vocal patient advocacy groups in a few cancers have exacerbated the funding discordance between cancer incidence and clinical need. Government funding can help to lessen these imbalances by supporting only the more difficult cancers. In doing so, patients with rarer or difficultto-treat cancers would no longer be forgotten and governments in turn might make more effective use of limited research budgets. ■ The Lancet Oncology
John Bavosi/Science Photo Library
In February, 2014, an advertising campaign launched in the UK by the charity Pancreatic Cancer Action generated a storm of criticism, depicting patients with pancreatic cancer stating that they wished they had other forms of the disease, specifically testicular and breast cancer. Although few would argue against raising awareness of an invariably fatal disease, the comparison with other cancers—and especially the idea that having one cancer is better than having another— prompted objections from several sources, including charities Breakthrough Breast Cancer and Breast Cancer Care. Specifically, the charities objected that the campaign was insensitive to individuals with breast cancer, and that the inference that breast cancer was curable was unhelpful. Ali Stunt—the founder of Pancreatic Cancer Action, who was herself diagnosed with pancreatic cancer in 2007—was quick to defend the adverts. She pointed out that the campaign was getting people talking about the disease, and had increased traffic to the charity website, particularly the page on symptoms. Furthermore, other charities (such as Macmillian Cancer Support) have backed the campaign, which now continues with a focus on the types of symptoms associated with the disease. While it is understandable why the campaign provoked a reaction, it must be acknowledged that, although charities are not-for-profit organisations, there is heavy competition for limited resources within the philanthropic sector. The economic downturn has not left charities unaffected. With less money to go around, individuals and corporations are more selective about where they give, and with so many causes seeking attention, donation fatigue is a serious concern. The Charity Commission reported in 2009 that roughly half of UK charities had been adversely affected by the recession. In a bid to capture hearts and open wallets, fundraising events are becoming increasingly high profile and shock tactics are now commonly used in advertising. Brand management has become crucial. There is substantial competition not only between different types of charitable causes, but also between those ostensibly working towards the same goal. In the UK, for example, there are at least three charities that focus on pancreatic cancer,
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Pancreatic cancer in the spotlight
www.thelancet.com/oncology Vol 15 March 2014
which begs the question as to whether a collaborative or combined approach would be greater than the sum of all parts. Research for different cancer types also remains uneven. Funding for pancreatic cancer research is very low compared with other cancer types, and as a result, there are currently 81 clinical trials for breast cancer recruiting in the UK, but only eight for pancreatic cancer. Moreover, pancreatic cancer is a difficult disease to diagnose. Unlike breast cancer, which lends itself to self-diagnosis and for which there are well established screening programmes in place, pancreatic cancer presents with diffuse symptoms and often at a late stage. More research is therefore desperately needed to understand the basic biology of the disease and to develop appropriate screening programmes. More than 330 000 people are diagnosed with pancreatic cancer annually worldwide, and prognosis remains poor—just under 4% are expected to survive for 5 years after their diagnosis. This statistic has changed very little in the past 40 years. Pancreatic cancer is not an obscure cancer, but perceptions of it as a difficult challenge prevents progress. The recent successes in the treatment of another difficult cancer—melanoma—shows that it is possible to make great gains and challenge dogmas. However, it is not enough to wait for private sector investment. Government funding bodies should identify shortfalls in research funding in areas not covered by privatesector investment. Greater cooperation between funders could help lessen the disparities in research spending across cancer types and ensure spending is more closely aligned with clinical need and disease incidence. Charity and private-sector money often follows the path offering the greatest potential for success. Equally, large and vocal patient advocacy groups in a few cancers have exacerbated the funding discordance between cancer incidence and clinical need. Government funding can help to lessen these imbalances by supporting only the more difficult cancers. In doing so, patients with rarer or difficultto-treat cancers would no longer be forgotten and governments in turn might make more effective use of limited research budgets. ■ The Lancet Oncology
John Bavosi/Science Photo Library
In February, 2014, an advertising campaign launched in the UK by the charity Pancreatic Cancer Action generated a storm of criticism, depicting patients with pancreatic cancer stating that they wished they had other forms of the disease, specifically testicular and breast cancer. Although few would argue against raising awareness of an invariably fatal disease, the comparison with other cancers—and especially the idea that having one cancer is better than having another— prompted objections from several sources, including charities Breakthrough Breast Cancer and Breast Cancer Care. Specifically, the charities objected that the campaign was insensitive to individuals with breast cancer, and that the inference that breast cancer was curable was unhelpful. Ali Stunt—the founder of Pancreatic Cancer Action, who was herself diagnosed with pancreatic cancer in 2007—was quick to defend the adverts. She pointed out that the campaign was getting people talking about the disease, and had increased traffic to the charity website, particularly the page on symptoms. Furthermore, other charities (such as Macmillian Cancer Support) have backed the campaign, which now continues with a focus on the types of symptoms associated with the disease. While it is understandable why the campaign provoked a reaction, it must be acknowledged that, although charities are not-for-profit organisations, there is heavy competition for limited resources within the philanthropic sector. The economic downturn has not left charities unaffected. With less money to go around, individuals and corporations are more selective about where they give, and with so many causes seeking attention, donation fatigue is a serious concern. The Charity Commission reported in 2009 that roughly half of UK charities had been adversely affected by the recession. In a bid to capture hearts and open wallets, fundraising events are becoming increasingly high profile and shock tactics are now commonly used in advertising. Brand management has become crucial. There is substantial competition not only between different types of charitable causes, but also between those ostensibly working towards the same goal. In the UK, for example, there are at least three charities that focus on pancreatic cancer,
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