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Sunday, February 16, 2014

So, where does the money go: Childhood Cancer Research Funding (2010)

Prior to Fathers Day 2007, I had not given much thought to how funding for cancer research worked. That all changed. We thought we would share some thoughts and observations based on my own experiences and our research. This only seeks to inform, raise questions and to provide a platform for discussion. Nowhere in here will we suggest what charity you should support. But, without the right amount of funds directed towards the right research, PAC2 will only continue to grow, and we really want to shut it down. Let's just look at a few of the groups competing for your money.
Summary

  • HOSPITALS: it may be difficult to determine what percentage of a donation to a hospital would be directed towards research into childhood cancer. Donations may cover operating costs, research into other diseases, and/or childhood cancer research.

  • AMERICAN CANCER SOCIETY: In 2010 directed $0.01 (a penny) to childhood cancer research for every dollar of public support. (Total expenses: $951,123,000 and total directed at childhood cancer research: $11,900,000. Source:ACS)

  • LEUKEMIA & LYMPHOMA SOCIETY: directed $0.02 to childhood cancer research for every dollar of public support. (Total public support: $287,625,000 and total directed at childhood cancer research: almost $6,000,000. Source LLS)


Hospitals
When a child is treated at a hospital, the hospital incurs costs and produces a bill for the treatment. The bill covers labor, drugs, supplies, new equipment, other operating costs and, if it has a facility, some may be directed to research. Obviously not all hospitals have research labs, and the size and funding varies.

Many if not all hospitals have a fundraising arm. If you are at a facility that treats both adults and children, generally the funds it collects support operating costs, additions the hospital may desire, and some may go towards research. Research may be into treatment of any disease you can imagine. Some may go towards cancer research, both adult and childhood cancers. So, if you give to XXX Hospital, your money is directed towards many various causes, with an unknown portion related to childhood cancer research.
With hospitals, it would seem you need to ask if you can direct your donation to the cause you want to support.
Obviously, St. Jude is likely the hospital the majority of the public thinks of if and when they think of childhood cancer. Their marketing campaign is hugely successful. The post "What if...." has the actual data on St. Jude. In summary:
  • St. Jude treats about 350 - 425 kids per year (about 3% of the 15,000 diagnosed per year)
  • St. Jude received $682 million in support (donations and bequest) and $82 million in grants from NCI, NIH, and, historically, organizations like CureSearch for Childhood Cancer, St. Baldrick’s Foundation, Alex’s Lemonade Stand Foundation and Rally Foundation for Childhood Cancer Research.
  • St. Jude spent $282 million on research on all diseases, 36% of support.
  • St. Jude fundraising expenses were $135 million. ALSAC admin and general costs were $51 million.

The American Cancer Society

The mission statement of the American Cancer Society (ACS) reads: "Founded in 1913, the American Cancer Society (ACS) is the nationwide community-based voluntary health organization dedicated to eliminating cancer as a major health problem by preventing cancer, saving lives, and diminishing suffering from cancer, through research, education, advocacy, and service. With more than two million volunteers nationwide, the American Cancer Society is one of the oldest and largest voluntary health agencies in the United States. Headquartered in Atlanta, Georgia, the ACS has state divisions and more than 3,400 local offices."

Many chose to become involved with the ACS fundraising events, including the "Relay for Life". The funds collected by the ACS are used for many causes. The numbers, in millions:

Childhood Cancer Research - $12
Other Research - $136
Prevention - $149
Detection/Treatment - $112
Patient Support - $271
Management - $68
Fundraising - $202
Looks black and white to us. The numbers speak for themselves with regard to the funding for childhood cancer, but just to be clear, 1% of funds are directed towards research to cure the entire suite of childhood cancers. That's actually up from about half-a-penny last year.

Imagine you participate in a Relay-For-Life. You raise $1,000. $280 (28%) goes to admin and fundraising costs. Only $10 of that $1000 you raised is targeted towards childhood cancer.

The Stats
Overall, Charity Navigator gives ACS 3 of 4 stars but only 1 of 4 stars for efficiency. John Seffrin, Chief Executive Officer earns $685,884 or 0.06% of expenses. Program expenses (what it spends on the programs and services it exists to deliver) are 72%, management 6% and fundraising expenses 22%. Total revenue in 2010 was $956,159. up about $60 million from 2009.

Questions
#1 - Are there ways to "direct" the money raised toward your cause? The ACS site provides the following options for "Donation Designation"; cancer research, breast cancer research, prostate cancer research, colorectal cancer research and lung cancer research. But is there a manner to direct your funds towards childhood cancer if your amount raised is significant?

#2 - Why, when 1% of the funds are directed at childhood cancer, do we see so many childhood cancer victims in the ACS literature?

(We know we'll hear the "well research into adult cancers can benefit children" argument. Well, most adult cancers do not occur in children. And simple downsizing of adult doses is where we are at now, and the long term consequences have been demonstrated time and again and again and again to be simply unacceptable. We need targeted childhood cancer research!)
The Leukemia and Lymphoma Society

From its website: "The Leukemia & Lymphoma Society (LLS) is the world's largest voluntary health organization dedicated to funding blood cancer research, education and patient services. The mission of LLS is to cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families. Since its founding in 1949, LLS has invested more than $600 million for research specifically targeting blood cancers."

We're sure many of you have had excellent experiences with the LLS. Many chose to become involved with the LLS fundraising events, including the "Light the Night" and "Team in Training". The funds collected by the LLS are used for many causes. The chart shows the various things supported (Year End 2009 data). The LLS has stated that almost $6 million of its $288 million in total public support is directed to childhood cancer. That equals $0.02 for every dollar of public support. The numbers, in millions:
Research - $69
Patient & Community Services - $92
Public Health Education - $43
Professional Education - $9
Management & General - $24
Fundraising - $45
Childhood Cancer - $6

So, you raise $1000 for LLS: $240 goes to LLS fundraising, general and management costs. $21 is directed to childhood cancer.

The Stats
Overall, Charity Navigator gives LLS 3 of 4 stars, and for fundraising efficiency, 2 of 4 stars. John Walter, the President, CEO earns $482,000 or 0.18% of expenses. Program expenses are 75%, admin 8% and fundraising expenses 18%. Total revenue 2009 was $277 million.

Questions
#1 - Are there ways to "direct" the money raised toward your cause? I believe that national Light the Night teams raising over $100k may direct the funding? Anyone with experience?
#2 - As it is not readily apparent, has anyone seen the percentage of funds directed towards pediatric blood cancer research?

UPDATE - JULY 2009 - Here is a link to some information directly from LLS. Judge for yourself.

UPDATE - APRIL 2010 - We're a little disturbed by LLS's latest idea for fundraiser events. They've embarked on a Totally Baldacious campaign, where participants shave their heads. I know I've heard that one before....oh that's right, St Baldricks has been doing that for many years solely in support of CHILDHOOD cancer research! Shame on you LLS...

UPDATE - AUGUST 2010 - from the LLS:
"LLS recently launched a research initiative focused on the long-term and late effects of today's curative therapies - many of these quality-of-life limiting consequences impact pediatric patients differentially as children can live for decades after they are cured. LLS just committed more than $2 million to new projects in this research area, thanks to generous donors, and anticipate investing more than $5 million over the next 3 years, in order to make today's cures safer.

We are also involved in the Alliance for Childhood Cancer - http://www.allianceforchildhoodcancer.org/acc/Main and the Pediatric Cancer Survivorship Legislation - http://www.capitolconnect.com/lls/contentpage.aspx?page=pediatricsurvivorship
"

We thank LLS for it's involvement!

National Cancer Institute
The National Cancer Institute (NCI) is part of the National Institutes of Health (NIH), which is one of 11 agencies that compose the Department of Health and Human Services (HHS). The NCI, established under the National Cancer Institute Act of 1937, is the Federal Government's principal agency for cancer research and training.

Here is the NCI total funding and the amount directed to childhood cancer over the past five years, it averages $176 million/year and ranges between 3.6 and 4% of NCI's budget. Over that same period, average NCI breast cancer funding was 24%, prostate 5% and lung 5%. During 2009 NCI did direct an additional $49 million in ARRA funds to support TARGET Research.

A portion of that NCI funding goes to the Children's Oncology Group. Dr. Peter Adamson discuss the new COG Foundation and funding arrangements here: An Important Message from Dr. Peter Adamson - Chair, Children's Onc...

Why is Federal funding for breast cancer five times the dollars per person life year lost when compared to childhood cancer funding? Why is Federal funding for prostate cancer, with a 99% five-year survival rate, nearly five times the total amount given to all types of childhood cancer? Why?

We challenge the entire paradigm of the NCI funding for cancer research. Have you ever known scientists who could manage? Think of cancer as a sinking ship, with all of us on-board. Who do we care for first? We get the women and children to safety. And we know many grieving Mom’s who would give up their seat to any child. But what we have is first class seating, funding, for adults.

Further discussion of NCI funding is provided in a review of the NCI's Pediatric Cancer Research and Pediatric Cancer-Related Activi... and the post NCI Funding: more lies, damn lies and statistics.

Susan G Komen
Just for comparison....Susan G. Komen for the Cure, formerly known as Susan G. Komen Breast Cancer Foundation, was established in 1982 by Nancy G. Brinker. Nancy promised her dying sister Susan that she would do everything in her power to end breast cancer forever. Today, Komen for the Cure is the world's largest grassroots network of breast cancer survivors and activists fighting to save lives, empower people, ensure quality care for all and energize science to find the cures. Thanks to events like the Komen Race for the Cure, they have invested nearly $1 billion to fulfill our promise, becoming the largest source of nonprofit funds dedicated to the fight against breast cancer in the world.

Overall, Charity Navigator gives SGK 4 of 4 stars, same as last year. For fundraising efficiency, SGK receives 4 of 4 stars, same as last year. Hala G. Moddelmog, COO, earns $532,000 or 0.18% of expenses. Program expenses are 83%, admin 11% and fundraising expenses 7%. Total revenue last year was $299 million. Course...that's before they started suing....

Childhood Cancer Research Focused Fundraising

So you see that not all cancer charities support childhood cancer research. You see that the NCI funding is lacking. We know that industry supported research into childhood cancers is relatively non-existent because they don't represent a market force. Who should you support if you want to focus on childhood cancers?

PAC2 has assembled a list of wonderful childhood cancer fundraising organizations here. Others can be found on the Coalition Against Childhood Cancer (CAC2) website (a collaborative project of many national and local childhood cancer groups). Please consider St. Baldrick's, Alex's Lemonade Stands, CureSearch, The Rally Foundation for Childhood Cancer Research, Cookies for Kids Cancer, Bear Necessities, B+ Foundation and others listed on CAC2. These guys direct money only to childhood cancer related causes, primarily research or patient/family support.

Awareness --> Funding --> Research --> CURE! Speaking from the heart, over the past 5 years, PAC2 has come to know, respect and believe in the great people in these organizations. We believe that they will find a cure. And we know they will work with you in virtually any capacity and are ALWAYS looking for leaders and volunteers. They will work with you directly to meet your needs. The best part is that the VAST majority (typically 80 - 90%) of any money you raise for them is directed towards cutting-edge research into childhood cancer or patient & family support. Period.

Other diseases, local police, the United Way, March of Dimes, Red Cross, Save the Whales, World Wildlife Foundation, the nature of charitable funding is that it is a business. There are over 900,000 registered with the IRS. It must be a pretty competitive business eh?

So we as consumers should know where our donations are going. And expect accountability. Transparency. Just like this note is attempting to be. If we're wrong somewhere....please let us know.

In the end, it's your call. Decide if you want $10 (ACS) or $21 (LLS) or, typically $800 (CC orgs on our list) of the $1000 you raise to go to childhood cancer research.

Research is the key to a cure.

Big Disclaimer – our thoughts, experiences and analysis of their financial data. We just wanted to inform and show the differences, raise a few questions for the community, and to say things that we think need to be said. We are NOT saying ACS or LLS is not right, they just aren’t focused on childhood cancer.

We are.

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