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    New NCI director sets bold goals amid federal budget cuts

    Initiatives include more cancer centers, new research investments

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    Bob Gatty
    Washington—John E. Niederhuber, MD, named this summer by President Bush to become the 13th director of the National Cancer Institute, has a difficult task ahead.

    A physician who has dedicated his life to fighting cancer and who lost his wife to breast cancer 5 years ago, Dr. Niederhuber leads an institution that has asked Congress for an additional $800 million for fiscal year 2007, plus another $335 million annually for the next 4 years at a time when cuts are being demanded.

    "I've sat at a lot of bedsides and held a lot of hands," he told The New York Times in an interview, "including the hands of a beautiful woman who was very special to me. It gives me passion to get up in the morning and make a difference."

    Dr. Niederhuber has been a professor, cancer center director, National Cancer Advisory Board chair, external adviser to the NCI, grant reviewer, and laboratory investigator supported by NCI and the National Institutes of Health.

    "NCI has an important mission in protecting the health of the American people, and [has] many important initiatives under way," said Health and Human Services Secretary Mike Leavitt. "Dr. Niederhuber's commitment to service and experience as a surgeon, a laboratory scientist, and a leader in translating lab advances into treatments for patients will serve NCI and the nation well."

    Dr. Niederhuber has publicly acknowledged the budgetary challenges NCI faces and the fact that some cuts will have to be made and some programs phased out. However, he also has said that he hopes to invest more resources in high-tech drug discovery technology and that he plans to continue supporting cancer centers at universities across the nation, which he describes as "the crown jewels of the NCI's programs."

    In fact, NCI's budget request for 2007 included an annual increase of $164 million over 5 years to expand those centers from 60 to 75 and to achieve, in the language of the request, "a more extensive, robust, and active program through enhanced integration and outreach."

    Adding 15 new cancer centers would make it possible to establish centers in states and metropolitan areas where none currently exist, improving access by minority and underserved populations to state-of-the-art cancer care services and research, including community-based research, NCI said in its budget documentation.

    The agency said it would "broaden the geographic impact of the Centers, networks, and consortia and vertically integrate them with community and regional health care delivery systems." In addition, new outreach programs would result in stronger partnerships with government agencies and community organizations, NCI said.

    NCI also requested $171 million annually over the next 5 years to "re-engineer" cancer clinical trials. The money would be used to "build a highly interactive and optimally coordinated cancer clinical trials system that prioritizes and accelerates the development of new interventions and ensures that they are incorporated into medical practice," the Institute's budget request said.

    A budget increase for 2007 of $198.8 million was requested for new investments linking advanced imaging, nanotechnology, proteomics and biomarker discovery, and computational modeling into cancer applications. NCI said this increase would "dramatically accelerate our ability to reduce the adverse effects of cancer."

    An increase in 2007 of $190 million was requested to promote program integration and interdisciplinary team science.

    "Cancer research of the future will be energized as people from the various disciplines combine forces," according to the the text of the NCI budget request. "New paradigms of collaboration will mean new ways of thinking about how we do science. This new culture will require the creation of an environment conductive to change, the merging of old disciplines, and the development of new ones."

    NCI also asked for another $80 million in 2007 for medical informatics in support of President Bush's call for Americans to have electronic health records within the next 10 years. The request noted that several NCI-supported programs are already contributing to efforts to promote common standards and interoperability.

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    Bob Gatty
    Bob Gatty, a former congressional aide, covers news from Washington for Urology Times.

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