Cancer Research: Going Private
The “privatization” of cancer research by a distinguished physician in Tennessee offers the promise of expanded and accelerated research, but it also raises questions about the potential for exploitation and abuse.
Dr. Robert K. Oldham, formerly with the government-sponsored National Cancer Institute, now is continuing experimental treatments in a Memphis hospital under auspices of a privately ownded research company. But unlike his work at the institute, where the treatment was provided without charge, he is asking payments of up to $35,000 from patients willing to subject themselves to the experimental treatments.
This has, quite understandably, stirred controversy, according to Times medical writer Harry Nelson. Because of the novelty of the concept, there is little agreement in the medical profession on the merits of the innovation and on whether additional controls and regulations are required to minimize the risk of abuse.
Some of the criticism has been blunted by Oldham’s reputation as an established, respected researcher who is continuing the work that he began so effectively while with the cancer institute. His credentials are not in doubt. And the establishment of his independent research could serve to help the government institute reexamine its own methodology, which Oldham has suggested is overly rigid, and broaden the base from which it selects those receiving experimental treatment.
Much of the controversy over going private focuses on the fact that it will serve as one more factor widening the gap between medicine available to those who can afford to pay high fees and those dependent on governments--federal, state and local--for care.
The institute is aware that most people with cancer are cared for by doctors who are not adequately informed about the newest therapy, including experimental treatments. To address that problem, it has expanded its Physician’s Data Query nationwide cancer-information service. Medical libraries and doctors with their own computers can have access to the data, among them current reports on the 1,000 ongoing experimental therapies.
Broader awareness of those experiments may help assure more equitable recruitment of persons most likely to respond to the experiments. Clearly, however, it would be intolerable if personal wealth determined the access. In that regard the Tennessee experiment with private treatment, while channeling new money and resources into research, is not a substitute for the programs of the national institute. On the contrary, the development of the private research facility is a further argument for more federal funds for the institute.
Beyond the need for additional funding, there are questions that both the medical profession and the Food and Drug Administration must address in assuring that for-profit operations do not exploit the desperation of cancer patients searching for an effective remedy after all conventional therapies have failed. Not everyone who might offer such services would have the credentials of Oldham or share his rigorous commitment to effective research.
