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Living in Interesting Times
A Grateful Goodbye to 2008 and a Committed Hello to 2009
 In trying to find a quotation to launch this letter, I searched Wikipedia for the origins of the phrase “may you live in interesting times.” The experience was just like many aspects of 2008 economic discussions—there exist many “expert” opinions but no certainty. The innocent Wikipedia reader is left unconvinced that anyone in China (or elsewhere) knows the exact origin of the “Chinese” curse, “may you live in interesting times.” The Yale Book of Quotations also states that “no authentic Chinese saying to this effect has ever been found.”
Regardless of the origin of the phrase, another, more colloquial saying—“be careful what you wish for”—comes to mind. For our global society, 2008 was a year of economic loss, panic and confusion. Fortunately for the Prostate Cancer Foundation (PCF), and medical researchers in prostate cancer, the same 12 months were a tremendous year of clarity and gain. Discovery continued at a a brisk pace and tangible progress was achieved. To summarize why we, as a biomedical research funding foundation, had a wonderful year and why 2009 promises so much based upon 2008, I have divided this letter into several parts including Organizational Highlights and a Research Recap. This is not a “Pollyanna” letter. I close with a final section, Keeping Us Up at Night: the Unemployed (Research Ideas) List.
Organizational Highlights
Despite watching the Dow nosedive, PCF achieved 103% of our pre-global-recession budget of $37 million. Both in total research funding awarded and total funds raised, 2008 was the greatest year in the history of PCF. This striking feat was achieved through a mix of compelling research programs, many new relationships, and the generous support of our friends.
During the year we received:
- $11.7 million from Safeway shoppers in the face of the June stock market decline and peaking gasoline prices. (The success of this program is due to the leadership of Steve Burd, Chairman of Safeway and PCF Board Member);
- 67,000 individual checks averaging $31 each from direct mail;
- 340 applications that we are currently reviewing for ten $100,000 PCF Creativity Awards.
- $1 million given in December from an anonymous donor to support the PCF Creativity Awards program;
- nearly $150,000 from the online giving of fans of Dan Fogelberg whom the world lost to prostate cancer and whose widow Jean asked them to channel their grief into action for research;
- $2.5 million from our Home Run Challenge with Major League Baseball; Major League Baseball
- nearly $600,000 raised by more than 10,000 golfers on 200 golf courses as part of PCF’s Arnie’s Army;
- more than $125,000 through the efforts of Winter Vinecki, a 9-year-old girl whose father is fighting aggressive prostate cancer.
While these are just a few examples, we achieved our revenue goal in the context of running a national search for a new Executive Vice President of Development with the enormous commitment of our Interim Director of Development, Jan Wolterstorff and our Vice President of Events, Jan Haber. Our success was also supported by the evolution of our website (still in process) and the expansion of our PCF Online Store.
At PCF and our research institutions, we maintain that “the world doesn’t owe us a living.” This Jeffersonian notion governs the work-ethic in university laboratories, where investigators do not hesitate to write competitive grants, which will further fund their research. Similarly, PCF staffers wrote grants, ranging from $25,000 for a Journal Club to $1 million to partly fund a $3 million Challenge Award in Intracrine Androgens. The latter grant was funded through the New York State Tax Check Off Program for Prostate Cancer Research. This tax check-off program was inspired by several New York-based PCF Board Members including The Honorable Earle Mack.
Looking back on Q4 2008, and the more than 260 individual year-end donor calls I made from Thanksgiving through New Years Eve, I have four impressions. First, I was surprised that many chose to continue giving despite major reduction in their personal wealth. Second, many said if it was a choice between saving lives and giving to other worthy charities (including collegiate alma maters), saving lives with effectively-stewarded cancer research would remain “above the line” for making charitable gifts. Third, there was virtual unanimity that 2009 would be terribly challenging for those giving to PCF. Finally, the improvement in PCF communications in the past 24 months and my personal calls made a difference. What I heard was that PCF cannot communicate enough as long as it’s responsible, factual, realistic in expectation, and reflects caring for what patients and families experience.
2009 will be the Year of Communication to keep the accomplishments of the PCF research family in the forefront of minds otherwise deluged with stories of loss, layoffs, uncertainty, and gloom. We were off to a good start before the global downturn. In 2008, we conducted a national search and hired Dan Zenka as our Vice President of Communications. Dan hit the ground running, and we now have a strategic plan for our website as well as a far expanded communications effort. We raised $215,000 in funding to upgrade our website further; we also secured our new web address, www.pcf.org , as a charitable gift—a great step forward for our brand and for making our website more accessible. (No need to type 32 characters to get there!)
The bottom line for 2008: thanks to you and the generosity of 64,659 individual donors, we navigated through one of the worst years in the modern American economy, funding research teams and the most promising ideas found on five continents—precisely as we set out to do in January 2008.
We know 2009 will not be 2008. Aided by the singleness of our mission, the flexibility of our size and the quality of our financial stewardship, the entire PCF team is focused on increased operational vigilance and the development of new programs and revenue streams to support our mission. We will report on our progress as well as our challenges throughout the year.
Research Recap
In contrast to financial markets, the foundation’s research efforts in 2008 were up. We launched 9 cross-disciplinary teams of scientists with $21 million in PCF Challenge Awards and provided crucial support to the careers of 19 of the world’s most gifted young investigators in prostate cancer though our Young Investigator Awards. Together, these programs will continue to move discovery forward and nurture needed human capital for the field. All 19 Young Investigator research projects are described on our website. In future Advances, I will highlight what they have discovered and how they are progressing toward the clinic.
Our 9 new Challenge Award teams join the Koch-PCF Nanotherapeutics Team at MIT and Harvard, and the Safeway-PCF S.T.A.R. (Special Team Amplifying Research) at Johns Hopkins, the University of British Columbia at Vancouver and the University of Michigan. The Challenge Award teams were selected out of 115 research team proposals from 105 cancer programs in 11 countries. In total, we have 11 teams working with multi-year grants on major solutions to ending death and suffering from prostate cancer.
During 2008, we continued to support the work of the PCF Therapy Consortium in partnership with the Department of Defense. In all, 21 new “first-in-man” clinical trials were initiated at 10 US centers with 551 new patients enrolled in 2008.
In 2008 scientific discovery represented the antithesis of what happened in the stock market. The list of progress made by our PCF-supported researchers is long. I can cite over 61 original research papers in prostate cancer that PCF Competitive Awards supported; all 61 substantially added to our molecular understanding of how to better diagnose and treat prostate cancer. Here is but a partial list of nearer-term developments that will help us fulfill our mission of ending suffering and death for prostate cancer patients:
Nearer-Term Developments in Diagnostics and Treatment
- In some patients with advanced prostate cancer it may be possible to induce another significant remission after the tumor has become resistant to Lupron and Casodex and Flutamide. This may be accomplished by better targeting and blocking the cancer cell’s signaling into the androgen receptor, a mechanism by which the cancer cell survives. Seminal work on this was done in Seattle and supported by PCF. Their findings were presented this past October at the 2008 Scientific Retreat. Abiraterone, one of the new agents identified by their research, moved quickly into phase 3 trials for ultimate FDA Review for treatment options with a low side-effect profile. MDV-3100 and BMS-564,929 are currently in clinical trials as well.
- IGF-1 (Insulin-like Growth Factor 1) was further implicated in driving the growth of tumors resistant to hormone therapy. New drugs are needed to block its action.
- Identifying four new candidate progression biomarkers: EPCA2, Chromosomal Fusions in urine, miR141 and other microRNAs, and CTCs (Circulating Tumor Cells). They are all in clinical trials and undergoing testing to evaluate their potential to improve upon the PSA test for detecting and monitoring a tumor to see if it is in remission or growing.
- Developing a genetics-based saliva test at any age for assessing heightened risks of sons, grandsons, and nephews of prostate cancer survivors. This “DNA test” is very near-term and what we will need in 2009 to intensify research in nutrition, prevention, intervention, and earlier detection in men far before they turn 40.
- Nutrition: as reviewed in our 2008 PCF Scientific Retreat, the molecular sciences of nutrition and metabolism for prostate cancer are getting firmly established. “Eat your broccoli,” “slow cook your meat” (thereby avoiding carcinogenetic PhiPs), and “drink your pomegranate juice” are maxims worth every patient and family’s attention. More on this and recipes can always be found in our Nutrition section at PCF.org.
- Bone Targeted Therapy: RANK- Ligand Inhibitors are agents that block the growth and spread of bone metastatic prostate cancer. Testing on these agents is underway in clinical trials supported by the PCF Therapy Consortium.
- Different profiles of prostate cancer for personalized and predictive treatment are being defined on a gene-by-gene basis. Ultimately, treatment will not be an excellent approximation based on statistics, but on each patient’s “profiled” tumor, which is then deciphered for its genetic composition and sensitivity to existing and investigational treatment.
Fundamental Discoveries in 2008
- Prostate Stem Cells, from which prostate cancers arise, are now being dissected at a gene-by-gene level that will offer new and better understanding of how a prostate cancer cell arises in the first place. This data helps the scientific community understand what makes prostate cancer unique and what makes prostate cancer similar to other kinds of human cancers. Work by one of our Challenge Awards Teams at UCLA and by PCF Young Investigators is giving the entire research field—including the pharmaceutical and biotechnology sector—a real fundamental understanding of what “makes a cancer cell tick.”
- Epigenomics: we have learned from many, (and especially from PCF-funded groups in Baltimore and San Diego) that there is a vital biochemistry of controlling “the software” that permits the prostate cancer cell to spread, metastasize, resist hormonal therapy, and avoid the immune system. If prostate cancer is a form of potentially lethal cellular “terrorism,” the “mastermind” for the information needed to make a cancer cell lethal appears to lie in the epigenomic control of the DNA, not just in the DNA code. We need new drugs to block the “lethal software” programs. Epigenomics offers enormous insights in to how to look for the “Achilles Heels” of prostate cancer cells by helping define where all the “armor” is that makes these cells so difficult to control with exiting medicines.
Keeping Us Up at Night: The Unemployed (Research Idea) List
I try to remember to recite Reinhold Niebuhr’s version of the Serenity Prayer every night. It’s a good one for cancer researchers and oncologists to learn, regardless of one’s faith. The prayer asks for “acceptance,” for the things that cannot be changed, “courage,” for changing the things that can, and “wisdom” to know “the difference.” Our charge for 2009 is to energetically change the things we can.
For PCF that means focusing our efforts on bridging the gap between what we know at the molecular level about prostate cancer and what we have been doing with this knowledge. Federal investment in prostate cancer research has declined in the past nine years. Our knowledge about the disease, though, has expanded. Two patients under my care passed in part because we did not have new medicines for several recently identified targets that drive the growth of prostate cancer tumors. The HIF-1 gene, c-Myc gene, as well as BCL-xl genes are just a few of these targets, genes that, when over-expressed, drive some highly aggressive prostate cancers.
One of my 2009 resolutions is to create the “PCF Unemployed (Research Idea) List” (something I can control). Like an employment agency, we need to continue to connect viable research ideas to gainful employment through federal and philanthropic funding; whenever possible we will also enlist the support of leaders in the pharmaceutical and biotechnology industries. Finally, we will make the most of our expanded communications network by posting these ideas to our website to see if there are any potential employers (or benefactors). We will be acquainting the NIH Director and NCI Director with our research list in the Obama administration as soon as we know who they are!
I am closing with another Chinese phrase, this one with traceable roots: “The times produce their heroes.” I found it trying to verify the Chinese origins of the phrase, “may you live in interesting times.” As I look at the efforts of our world-class investigators, the perseverance of our supporters and donors, and above all, the courage of the cancer patients and their families that we serve, I realize that we at PCF are surrounded by heroes. From cancer, to economic duress, to numerous other challenges presented by our times, not a single individual would have asked for such a reality. Yet, they are all heroes united in the fight against prostate cancer.
The PCF team is honored to be in the service of heroes. We face 2009 with conviction, innovation and a healthy sense of realism. We remain committed to forwarding the mission of our foundation, despite the challenges that lie ahead.
Our Advances newsletter is an ongoing publication to keep friends of the PCF current on "the state of the science" and some of the most interesting developments in our fight against prostate cancer. To preserve critical resources and reduce our carbon footprint, Advances is published electronically and posted here. If you would like to have future issues of the newsletter sent to you directly via e-mail, please click here.
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