Money Matters Episode 349: The Battle for Cancer Research Funding w/ Dr. Fumiko Chino

EP349 -

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Welcome to Money Matters with Chris Hensley, where we spotlight financial literacy issues in the Houston community and beyond. And now your host, Chris Hensley.

Unfortunately, he did die from cancer, and that's what set me on the path to actually become a researcher, to become an active, um, physician, um, to try to really think about how are we actually improving access? How are we improving cure rates? How are we, um, you know, improving the quality of life or the lived experience of a cancer diagnosis so [00:01:00] that more people can make it to walk their daughter down the aisle or attend their grandchild's, you know, Little League game?

You know, like that next part of just, you know, putting cancer in their rear view mirror.

Christopher Hensley RICP, CES: Welcome to Money Matters. I'm your host, Christopher Hensley. Federal cancer research funding can sound like an abstract line in a government budget, but behind those numbers are the discoveries, clinical trials, screening technologies, and treatments that eventually reach patients. More than 18 million Americans are living after a cancer diagnosis, and the country has made significant progress in cancer detection and treatment. The Association for Clinical Oncology is now raising concerns about a proposed reduction in overall National Institutes of Health funding and what that could mean for future progress. Joining me today is Dr. Fumiko Chino, an oncologist and associate professor in oncology. Chino [00:02:00] conducts research on healthcare access, quality affordability, financial toxicity, and disparities.

Christopher Hensley RICP, CES: She also has testified before Congress about the harms of medical debt. Dr. Chino, welcome to Money Matters.

Dr. Fumiko Chino: Thank you so much. I really appreciate the invitation to speak today about the importance of cancer research funding and all of the innovations that federal investments have, have really produced for, uh, our patients living in the United States today

Christopher Hensley RICP, CES: Well, I love it. Now, this is a, the show is national and even international, but you're here in Houston, so there's an affinity. So, I, I just dropped my son off at school. I went through the Med Center on the way home. So, so listeners who are local, they know that this is, uh, this, we, you know, right here in the heart of the Med Center in Houston, so it is a, uh, a, a big topic for everybody, but specifically something really close to us. When people hear federal cancer research funding, it can sound removed from their everyday lives. How does [00:03:00] that funding eventually translate into better care for someone sitting in an oncologist office?

Dr. Fumiko Chino: Oh, absolutely. We're talking about, um, higher survivals. We're talking about better quality of life. We're talking about actually often less toxic treatments than what, you know, what your mom or your grandmother might have received, you know, twenty or fifty years ago. Um, for a person sitting in my office, you know, again, I'm a treating oncologist, so I absolutely see active, uh, you know, cancer patients, um, on a daily basis.

Dr. Fumiko Chino: This federal research funding is not really abstract. It's the backbone of their care. It's what really, um, lays the, for developments and innovation in cancer care. It's really been the groundwork for life-saving treatments, and we know that these, um, clinical trials in terms of, like, the funding from, uh, cancer research, um, the clinical trials that they fund are actually also active, uh, cancer treatments, um, for people who may not [00:04:00] actually have other options.

Dr. Fumiko Chino: So there's more than fifty thousand people in the United States, you know, right now every year, um, on these clinical trials that are directly or funded or supported by the National Cancer Institute. So the type of, um, funding cuts that have been proposed could be just devastating. It's something that where it would not just affect the future for some of our patients, it would actually affect their present.

Christopher Hensley RICP, CES: Wow. So, I mean, we hear, I get tied into the numbers and the and the research aspect, but the research isn't just research. This is stuff that's actively being used in people's lives on a day-to-day basis and helping. Uh, so, so we're seeing that, the possibility of that rolling out. More than 18 million Americans are living after a cancer diagnosis.

Christopher Hensley RICP, CES: What are some of the screening tools, treatments, or clinical advances patients benefit from today that begin with federally supported research?

Dr. Fumiko Chino: When we [00:05:00] think about, uh, federal investments in research, we're really talking about something that it can impact the full cascade of care from diagnosis to survivorship. So you highlighted the fact that there are so many survivals, and that is a direct result of robust cancer research funding, um, from years ago, even sometimes decades ago.

Dr. Fumiko Chino: Um, when we think about how this actually translates to, um, our patients, um, an analysis actually looking at new cancer drugs that were approved by the FDA over the last two decades found that ninety-nine percent of new drug approvals had at some point, um, National Institutes of Health funding. So we're talking about, uh, the...

Dr. Fumiko Chino: our federal infrastructure is really supporting the next new cancer cure. And that comes along from, again, when we think about these research dollars, um, supporting, um, you know, new ways of actually, uh, detecting cancer, new and effective cancer treatments, and then [00:06:00] again, how to optimize survivorship so that people, um, who are living past cancer are able to thrive in survivorship, not just live.

Christopher Hensley RICP, CES: Wow. So, you know, one of the things you shared with us, it's not just from the diagnosis. It's all the way from diagnosis to survivorship, all of the different phases there. This is important to people who are experiencing this. The Association of Clinical Oncology describes the FY 2027, or 2027 proposal as an approximately 12% reduction in overall NIH funding.

Christopher Hensley RICP, CES: What could that mean in practical terms for patients and researchers?

Dr. Fumiko Chino: Well, we're talking about a potential five billion dollar cut in NIH funding, so again, National Institutes funding, which includes the National Cancer Institute. Um, we're talking about stymying the advances that have led to higher cure rates. When we think about the advances that have happened, we're talking about a survival rate that has increased from [00:07:00] seventy-five percent to over ninety-one percent for breast cancer.

Dr. Fumiko Chino: We're talking about more people living with metastatic melanoma, an aggressive skin cancer, um, from-- you know, that raised from ten percent to over fifty percent. So, you know, we're stymieing those next advances that can cure cancer. Um, but we're also talking about, again, people who are on treatment who have less-- would have less options from clinical trials.

Dr. Fumiko Chino: We're talking about even, like, the idea of a brain drain. So I work a lot with our most promising new minds in, uh, medicine and in cancer, and I'll work from an undergraduate to, you know, a medical student or even, you know, someone more advanced in their training. And we're seeing people actually exiting the research pathway because it's just not sustainable for their careers.

Dr. Fumiko Chino: And we're losing those bright minds that someone that might discover the next cancer cure, and they're going into tech or, you know, some other, um, aspect of care. You know, they're focusing on, you know, AI or something like that. Um, [00:08:00] and we're potentially finding that, you know, we're gonna be in a bad place, um, tomorrow, but also in a year, in ten years.

Dr. Fumiko Chino: Um, we're stretched pretty thin in terms of thinking about, um, you know, the, the minds, the best minds with their, with their research proposals. It's, it's already underfunded, um, and we're talking about additional cuts. Um, we've had the benefit in the United States of really, um, you know, decades-long investment in innovation, and unfortunately, we're gonna find that stymied.

Christopher Hensley RICP, CES: Wow. I, just to piggyback on what you're sharing with listeners, I've worked with nonprofit groups where when the economy has dipped and funding has gone down, when people don't have pockets open for, for charitable organizations, where it's literally gutted them. But when we look at it from a medical perspective and this brain drain, the the future person who could have the cure for cancer, there's less of a talent pool because [00:09:00] we just don't have the resources to keep up with it to be competitive.

Christopher Hensley RICP, CES: That person might go into tech or they might go into a different field. So a very, very important thing for, for listeners to, to note and, and pay attention to. Now, the proposal treats overall NIH funding and National Cancer Institute funding differently. Why should people concerned about cancer pay attention to the entire NIH budget, not only the NCI number?

Dr. Fumiko Chino: I think that there is a, like there's an overall picture in terms of fostering innovation in the United States. So that includes cancer treatment, but of course, all, uh, all health conditions. Um, we really have benefited, again, like I said, um, from sustained investment, um, within our our health, and it's, it, it's all engines firing that we need.

Dr. Fumiko Chino: Um, we need investments in the NIH, and then specifically earmarked for cancer treatment development and support. Uh, so it's, it's the full [00:10:00] picture

Christopher Hensley RICP, CES: I love it. I love it. If federal funding is reduced or remains uncertain, which areas are likely to fill it first? New research grants, early career scientists, laboratory work, community research sites, or existing studies?

Dr. Fumiko Chino: We're gonna feel it across the board, unfortunately. But I wanna actually highlight in terms of the patient populations that will be directly impacted, we're talking about those hard to treat cancers, aggressive cancers that grow quickly, where we need to really find a, a good targeted treatment. Um, we're talking about pediatric cancers, you know, cancers in kids where, you know, again, the huge success rate, um, has-- you know, we have transformed childhood leukemia, where the survival rate used to be ten percent and now survival rate is ninety percent.

Dr. Fumiko Chino: So we have more kids living to be adults. I, I know I actually have colleagues that were treated as children, um, for childhood cancers, and they have now [00:11:00] dedicated their life to reinvest in cancer treatment because they have in their own lives realized how much that's benefited them. And so it's across the board gonna hurt everyone.

Dr. Fumiko Chino: But again, just being very patient-patient facing, we're talking about the people who are most vulnerable, you know, the young patients, the people with rare cancers

Christopher Hensley RICP, CES: A discovery can take years or decades to become an improved treatment. Could a funding decision made today affect the treatments available to patients five, 10, or 20 years from now?

Dr. Fumiko Chino: Absolutely. Unfortunately, I think, you know, with decreased funding, we will see, quote-unquote, a payback, right? Uh, and not a good one, unfortunately. Um, we know that, for example, uh, you know, over fifteen years ago, the National Cancer Institute, um, started something called the RAS Initiative, which is to actually try to focus innovation around, uh, a target which was considered undruggable.[00:12:00]

Dr. Fumiko Chino: The RAS Initiative over time has developed, and we were actually proud to show within our ASCO annual meeting, so that's a, a large meeting of oncologists, um, a drug that actually doubled survival for people with, with pancreatic cancer. So, you know, these innovations take time. It is a process. We need to have rigorous science, and it can save lives.

Dr. Fumiko Chino: Um, it can save lives today, but it will also make a huge difference for our kids, you know, ourselves even. Um, When we think about some of these cuts, they're just, unfortunately, a little shortsighted when we think about the benefits over the long run.

Christopher Hensley RICP, CES: And you know, a lot of, with everything that's going on today, there's numbers and data that's pulling at us from different sides, and so it's very hard to bubble this up to the top of people to, to care about it, to know how big a impact this has on our lives. Was there a particular experience or turning point that [00:13:00] changed the way you think about this issue?

Dr. Fumiko Chino: Well, for me, myself, um, you know, the reason why I went into oncology or cancer care was because of my own, um, you know, my own story. I'm actually a cancer widow. And so when my husband was diagnosed with an aggressive cancer when he was, you know, in his twenties, it became the lived reality of our marriage that, uh, cancer treatment and innovations were the things that, you know, potentially would offer him a new treatment when things were unfortunately getting pretty dire.

Dr. Fumiko Chino: Um, unfortunately, he did die from cancer, and that's what set me on the path to actually become a researcher, to become an active, um, physician, um, to try to really think about how are we actually improving access? How are we improving cure rates? How are we, um, you know, improving the quality of life or the lived experience of a cancer diagnosis so that more people can make it [00:14:00] to walk their daughter down the aisle or attend their grandchild's, you know, Little League game?

Dr. Fumiko Chino: You know, like that next part of just, you know, putting cancer in their rearview mirror.

Christopher Hensley RICP, CES: Thank you for sharing that with us. I think all of us, if we hear this, everybody knows somebody who's been touched by cancer. It's, it does not discriminate. It touches everybody's lives, so super-duper important for this topic for us to, to, to know more, to learn more about it. What happens to a promising clinical trial when funding becomes uncertain? Could patients lose access because a study's delayed, reduced, or never opened?

Dr. Fumiko Chino: Absolutely. Uncertain funding really can delay all clinical trial innovation. Um, you know, it means that fewer promising treatments move forward, and unfortunately, it means more lives lost to cancer. And for many patients, again, the clinical trials could be, like, that next option for them when [00:15:00] they don't have, um, other, uh, alternatives.

Dr. Fumiko Chino: It really can make a difference again today, but also tomorrow. Um, I think that when we-- we can underplay these things as an abstract concept, it's just a number on a page, but for people with cancer, this is their life

Christopher Hensley RICP, CES: And you have been so passionate about this topic, you actually, uh, testified, uh, about it. Uh, can you tell us a little bit about that experience?

Dr. Fumiko Chino: Absolutely. I was to talk, um, before the HELP committee, which is the Health, Education, Labor, and Pensions, um, specifically actually about the harms of medical debt. Um, we know that our cancer treatments, um, are quite good, quite innovative, um, but they also come at a cost and, um, that cost, uh, measure, um, in terms of how it's affecting patients, um, can be excruciating.

Dr. Fumiko Chino: Um, I have focused on innovation in cancer, but also affordability in cancer. Um, one of the amazing thing about cancer research [00:16:00] funding is actually how it it is sometimes funding de-escalation trials. So again, the idea of a higher value treatment. Um, I'm a radiation doctor. My treatment is an everyday, Monday through Friday treatment.

Dr. Fumiko Chino: And when we think about, um, the difference between, for example, seven weeks of treatment every day versus one week of treatment every day, it's profound in terms of a patient's ability to actually receive that treatment, the amount of missed work that they might have, and again, the, the cost to them, um, physically, but also financially.

Dr. Fumiko Chino: So again, this idea that cancer research funding is only to discover a new drug, I think is false. We're talking about how do we use the treatments that we have even currently better, more efficiently, causing less problems for patients, um, and still maintaining those high cure rates

Christopher Hensley RICP, CES: So I, I wanna talk a little bit more about that, uh, that concept of, of [00:17:00] financial toxicity of cancer care, 'cause that's something that you study, um, that angle. I, I wanna dive a little bit more into that. You shared with us the, the idea of deescalation trials, affordability, people, even things like missing work.

Christopher Hensley RICP, CES: I think Houstonians, we take it for granted because we have, people coming from all over the world to get cancer treatment here in the medical center. But tell us a little bit more about that financial toxicity of cancer care. What are some things that we don't know or we haven't thought about?

Dr. Fumiko Chino: Yeah, absolutely. We know that cancer treatment unfortunately can be financially devastating for some people, even with health insurance, even when you've, you've kind of done everything right, right? You've lived a good life. You know, you didn't smoke, you exercise regularly, and then you still get hit with a cancer diagnosis, and then are kind of having to deal with the repercussions, including the financial repercussions.

Dr. Fumiko Chino: So this idea of financial toxicity was developed because we realized that for some people, the costs of the [00:18:00] treatment, um, was as toxic to them as some of the other side effects. Um, our research shows that, you know, up to a third of Americans with a cancer history, um, can have some problems, um, paying their bills.

Dr. Fumiko Chino: You know, they have to borrow money. Um, they might have to file bankruptcy at the worst case. Um, they may have to delay filling their prescriptions or even, like, split pills or skip doses. They may not be able to actually have the co-pay to get necessary scans or biopsies. Um, we know that unfortunately, um, medical care can be very expensive and that people have less potential buffer.

Dr. Fumiko Chino: Um, and you know, about one in three Americans, uh, actually can't cover a four hundred dollar emergency expense. Um, and so anything like a cancer diagnosis can unfortunately tip people over to financial ruin. Um, again, I think it-- not to keep harping about the cancer research funding, but it's, it's interesting to think about how, you know, we have more cures, right?

Dr. Fumiko Chino: And this idea [00:19:00] of right-sizing treatments, of, uh, personalizing care, it really does benefit patients. It is not one size fits all in cancer care today, and part of this tailoring is making sure that we are sort of seeing the person in front of us, not their cancer diagnosis. So that means making sure that we're accommodating their concerns, including, for example, people who need to prioritize continuing to work.

Dr. Fumiko Chino: And so with innovations like, for example, immunotherapy or again, again, as a radiation doctor, um, potential, uh, reduced number of treatments of radiation, we're really able to accommodate people, um, getting their cancer treatment and also still living their lives, going to work, paying the bills

Christopher Hensley RICP, CES: I mean, that, that's something to pause on and reflect on. I have a, a high school friend that just went through cancer, did chemo, but still worked. Uh, we're at a day and age where that's something... It's [00:20:00] different than our parents. I mean, the kinda treatments that we're seeing now are the- this is, it was kinda mind-blowing and, and, you know, she remained optimistic the whole time, but, but, um, th- that's a possibility.

Christopher Hensley RICP, CES: But for others, it's every- You mentioned the, the custom care and dialing it around the patient, and everybody's situation's different. Some people do not have the ability to do that, and so that's definitely something that should be thought about and taken into consideration. Um... I, I wanna ask you, could funding pressures widen the divide between patients who live near major cancer centers, uh, and patients in rural or unserved communities?

Dr. Fumiko Chino: Absolutely. I, I think we unfortunately know that cuts in things like federal research funding can make a huge difference in terms of someone being able to get that next new innovative treatment. So for example, the, uh, National Cancer Institute funds what's called the NCORP, which is the community cancer centers, um, that actually have [00:21:00] access, um, and are implementing, uh, large scale clinical trials for innovative treatments.

Dr. Fumiko Chino: And this can be an innovative treatment for a new drug, but it can also be things like how to control nausea best so that you can actually continue to work. So these, um, community cancer centers actually do provide care in the community closer to patients where they live so that people don't have to travel to Houston, um, to receive that next great treatment so that they can get it closer to home.

Dr. Fumiko Chino: It, it allows people to really, you know, stay in their communities, and it also actually uh, supports infrastructure, um, uh, in places, you know, in rural areas, in, in non-major cities. That actually is, again, jobs, um, that are created. Um, and again, I always think we are investing in future cures, right? But we're also investing in the US economy, and we know that for every dollar, um, that the, the federal government invests in [00:22:00] research, that it pays back two and a half times.

Dr. Fumiko Chino: So we really are creating jobs and cures, um, and, uh, funding, uh, the American innovation machine.

Christopher Hensley RICP, CES: I mean, this is why I've always had health topics on this show, is because you have to convince the CFO, right? The money guy. But if you look at the numbers and when you do the preventative things, the things that you mentioned, like even providing some of the benefits of being at a major metropolitan city to people who are... Texas is huge. If you're in a, a, a rural city, but you're able to benefit through, through some of the stuff that, that has been discovered through this and, and, um, you're able to work more, right? Uh, less people calling in sick from work and, um, the healthcare, uh, right, the health plan, the insurance plan, there's less people making claims on the premiums for the group plan.

Christopher Hensley RICP, CES: All... So this is me trying to convince the CFO, so I'm gonna stop right... But, but this, this is literally who we, we, we need to, to, to hear this, that it's, it's, [00:23:00] um, it- it's a good thing on both sides there. So we, we are bumping towards the end of the show. I wanna ask you, how should Americans think about the return generated by cancer research funding, and where can listeners go to learn more or make their voices heard before Congress completes this FY 2027 funding process?

Dr. Fumiko Chino: Yes, I just wanna make a plug for the idea of sustained, robust federal investment, um, needs to keep pace with, um, our survivorship population. So again, 18 million people, as you've already, um, discussed, are cancer survivors in the United States today. And unfortunately, we know that there is an, um, increase in the number of Americans that are diagnosed with cancer every year.

Dr. Fumiko Chino: So we need to actually maintain robust funding so that we actually support those, uh, those new patients, um, through their cancer treatment into survivorship, and again, making sure that they're able to live with a high quality of life. [00:24:00] So an investment in cancer research funding is really in the, in a, an investment in America, in my mind.

Dr. Fumiko Chino: It's an investment in the futures of our own residents, our own citizens. Um, and it's an investment in actually keeping, um, you know, the US as number one. We, you know, we have had the benefit of, you know, having an incredible, um, uh, foundation of cancer research funding that has led to us being, uh, the world's innovator in terms of thinking about both cancer, uh, innovation, but also all of medical innovation.

Dr. Fumiko Chino: And so, you know, that sustained funding is really what what we need, um, to continue, you know, being at the top so that people come here, um, you know, to, to be part of our research, um, uh, engine as opposed to leaving the United States, um, to go to another country to contribute to their economy. Um, for anyone who's actually listen-- who's listening, who has been touched by cancer, they wanna make their voice heard, [00:25:00] um, I would really encourage them, uh, to go to asco.org/saveresearch.

Dr. Fumiko Chino: So that's asco.org/saveresearch with no space. That's actually, um, our landing page so that people can get a little bit more information about how they can, um, support, um, the vital investments, um, uh, in cancer research funding that is leading to the next cancer cure.

Christopher Hensley RICP, CES: If you're listening to the audio version on the podcast, don't worry, we're gonna have that on the podcast notes. We'll put the links there to that, so if you're driving, you don't have to pull over right now. Uh, we, will have that on the podcast links. Dr. Chino, as we close the show out, is there anything that I forgot to ask you that you'd like to leave with listeners today?

Dr. Fumiko Chino: I just wanted to highlight some of our incredible wins when we think about cancer research funding, the things that have really led to truly the next, um, the next phase of [00:26:00] cancer, um, treatment and tailored, um, uh, tailored and personalized medicine. So things like CAR T, where, you know, your own... Or, or immunotherapy.

Dr. Fumiko Chino: Again, this idea of something that's truly your body's defense system is actually being used supercharged to actually fight cancer. This is the next step in terms of cancer cure. This is the way to, you know, to, to guarantee better futures, um, for Americans, and cancer research funding is how we get there

Christopher Hensley RICP, CES: Only gonna do it if we get funding for it, so it's, we're, we've got good things going on, but yet you can't cut the money off on it. So Dr. Chino, thank you so much for being on the show today. Have a good rest of the morning there.

Dr. Fumiko Chino: I appreciate it very much