Basic research in biology, primarily a function of the laboratory, seeks to understand how normal cells are regulated and how the regulation of cancer cells differ. A major task is to investigate the mechanisms that derange the normal control of cell growth and reproduction. This research is revealing much about the molecular level of cellular function and the communication between cells. Researchers believe that on the basis of such knowledge the way will be opened to cancer prevention or the achievement of substantially more effective therapies. Basic research is primarily conducted and supported by federal and university institutions.
Once potential therapies are identified, carefully devised and supervised clinical therapeutic trials have to be conducted to establish their validity. This necessitates a second level of research, clinical research, which requires knowledgeable, experienced physicians, support personnel and informed, cooperative patients. Clinical studies testing new treatments require just as much expertise as does the basic investigations, and they pose an additional problem --people cannot be standardized the way laboratory experiments can. It is the individual variations in patients that ultimately determine the effectiveness of new techniques. Thus, clinical trials using new drugs or other approaches require a combination of the skill or scientific inquiry and excellent medical practice. University clinics and private sector medicine cooperate in carrying out clinical trials. Support is less evident for these activities; especially those conducted in the private sector clinical care facilities.
The number of therapeutic questions that exist, and need to be answered to improve cancer therapy far exceeds the number of facilities that have declared themselves able to participate in such clinical research.
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