Tobacco Stains Scientists’ Integrity
Integrity is the foundation of good science. It is needed to ensure the public’s trust and the lack of it becomes a danger to the public’s welfare. This is especially true in medical science, where a conflict of interest may lead to approval of a drug or technique that is potentially harmful to the patient. And whether a conflict of interest is real or perceived, it has serious repercussions to advancing medical science. This is why an article published yesterday in the NYT and elsewhere that showed that a group investigating lung cancer screening technologies was funded by a tobacco company was particularly troubling to read. While the researchers’ best intentions may have been to improve lung cancer survival, their actions in accepting the tobacco company’s money as the primary funding agent have caused their results to be scrutinized, their credibility to be questioned, more conflicts of interest to be exposed, and ultimately hindered an already daunting task of improving lung cancer screening.
Lung cancer is the leading cause of cancer-related deaths in the US, and like all cancers, has a much higher survival rate when caught early. A major challenge to improving survival has been that we do not yet have approved screening technologies to catch it at its earliest stages.
On the positive front an imaging technique called “spiral CT” has been able to identify early stage lung tumors. It is currently being examined by the NCI’s National Lung Screening Trial as a potential technology to catch lung cancer at its earliest stages, particularly in high risk individuals like smokers and former smokers. If proven to be successful in improving mortality, spiral CT could move into the arsenal of early detection techniques that include pap smears, mammographies, and colonoscopies.
Until recently, the major arguments regarding spiral CT have surrounded whether the technology actually saves lives and improves mortality from lung cancer. But, unfortunately, the answer is not as easy to determine as it seems. Both sides can make an argument that they are addressing the needs of the public health. Advocates for the trial have argued that the low-dose radiation and potential invasive techniques such as biopsies are risks that may ultimately cause more harm to patients. While proponents of spiral CT screening have argued that the imaging technique has identified early stage tumors and that the trial is not moving fast enough to get this screening approach approved.
Hence, why these researchers’ relationship with a tobacco company is so harmful; the investigators have argued for approval of this technique as a highly successful screening technology. But by accepting money from tobacco companies, their integrity has been tainted and their recommendations for approval of spiral CT have been questioned. So while they may have had good intentions and tried to be transparent, their actions have hindered progress.
As a cancer biologist with a background in early detection technologies, I have been a staunch proponent of imaging. It works in many types of cancers and it is only going to get better. We need more funding in this area and we need to find a better system to move these technologies through an approval process. But in this case, accepting the funding from tobacco was the wrong mechanism to support this research.
However, it is my hope that the research community can get over this set back and redouble their efforts on evaluating this technology. It is more important now to focus on improving funding for early detection technologies and finding better ways to evaluate, assess, and deploy these technologies to improve survival.
Posted in Staff
March 27th, 2008 at 2:40 pm
As a Lung Cancer survivor I am stunned and confused. There is no good answer to this issue. Lung Cancer is gravely underfunded and like most cancers early detection is the best way to fight back. It is obviously a huge conflict of interest to take any of big tobacco’s money . I think it speaks volumes about the current federal funding levels that the researchers for this study found the tobacco industry as the best route. 29% of all Cancer deaths are caused by lung cancer. We have to do something.
March 27th, 2008 at 4:15 pm
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March 28th, 2008 at 10:15 am
I agree with you Kathy. It is upsetting when this issue detracts from the focus of trying to get and effective early detection technique deployed into clinical care practice.
However, I am glad to hear that you are a lung cancer survivor and are staying vigilant. It is voices like yours that can remind the federal government and the medical community to not get distracted. Their efforts need to be devoted to finding the most safe, effective, and efficient way to get early detection technologies out to the community.
April 2nd, 2008 at 3:10 am
Medical research and its funding is a real minefield. Tobacco companines funding scientists to research into lung cancer - its uncomfortable. However is it not right that they should pay money to put right the wrongs they have done.
Another uncomfortable fact about medical research is that the results of the research usually are the property of the sponser(frequently a drug company) and not the research scientist. Which can lead to studies not being published if they do not give the results desired by the profit making organisation which paid for it.
I do not forsee a simple solution to medical research. This probably why the scientist chose to accept money from a dubious source rather than not do the research at all.
April 3rd, 2008 at 5:18 pm
what i don’t like is that people here are assuming that lung cancer is only caused by smoking, ITS NOT. more women are getting lung cancer a year every year that are not smokers. so please do not say lung cancer is always somehow related to smoking, that is just ignorant.
also i don’t see a problem with cigarette companies funding cancer research, why? because if you can help fix a problem why not. i would only have a problem if the cigarette companies were teh same ones that owned the spiral ct scanning machines, now there is a conflict of interest.
April 16th, 2008 at 6:29 pm
I am a nine year breast cancer survivor, but in the fall of 2006 I began feeling tired and just ‘not right’. My doctor ordered a CT scan that showed a 3mm pulmonary nodule. A follow up PET scan in January of 07 showed nothing but 3 gallstones. This past February I felt a group of hard little nodes above my collarbone that were biopsied and came back postive for primary lung cancer. An MRI showed at least 9 lesions on my brain. The PET scan found a small mass on one lung with activity in an adrenal gland and various nodes, putting me at stage 4.
Yes, I did smoke. I was also heavily exposed to asbestos as a child when my father istalled asbestos treated drop ceilings and he would come home every night covered in dust. He died of cancer at the age of 54. We also wore asbestos treated pajamas in the 60’s, and Monsanto was in my back yard here in MA.
A CT scan did absolutely nothing for me as far as early detection goes. I think it’s a crap shoot, and maybe if I had waited a few months before seeing my doctor it possibly could have been found before it went to my brain. But mine went from 0 to stage IV in a year with no symptoms. If the tobacco company wants to help, maybe they can come up with a product with no carcinogens or toxins. Cigarettes may or may not have been the sole cause of my cancer, but I’m sure they played a part. As far as I’m concerned, the CT scan is worthless in early detection.
April 17th, 2008 at 11:26 am
Michelle and Jay,
I think that one of the main issues that lung cancer survivors face is the feeling that they “deserve” their cancer if they smoked or the public’s perception that they deserve their diagnosis for participating in unhealthy behaviors. It is true that of those that smoke have a high risk of lung cancer, but it does not change how terrible the disease is and it should not change your access to support services or information. I just want to make sure everyone is aware that the LAF supports ALL people that have been affected by ALL cancers…no matter what the cause or the type.