“For the last 50 years every major medical breakthrough can be traced back to investments in the NIH, which houses the National Cancer Institute (NCI),” said Wayne A. I. Frederick, interim chief executive officer of American Cancer Society and the American Cancer Society Cancer Action Network.
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In this episode of In the Headlines, Jacquelyn Cobb, associate editor of The Cancer Letter, and Claire Marie Porter, reporter, talk about the sweeping changes at HHS they reported on for last week’s story: Kennedy announces massive cuts, centralization at HHS—NCI and FDA hit.
These changes, which include centralization, consolidation of departments, and another 10,000 firings of employees from across agencies, come at a time when new leadership is stepping into their roles as directors of NIH, CDC, FDA, and CMS.
This story really serves as a “documentation,” said Claire. The Cancer Letter included full transcripts of primary documents from HHS on their massive cuts, Robert F. Kennedy Jr.’s instagram video justifying the upheaval at HHS, as well as a statement by ACS CAN critiquing Kennedy’s changes.
Also in this episode, Jacquelyn gives an overview of what has happened to the Department of Defense Congressionally Directed Medical Research Program grants, and what is unique about the DOD cancer research programs. In recent days, CDMRP funding has been cut by 57%, eliminating the pancreatic, lung, and kidney cancer programs.
“They’re just gone,” said Jacquelyn. “And that was really shocking because these were some of the newer programs.”
Other stories mentioned in this podcast include:
- Q&A with Wilmot Cancer Institute’s Jonathan Friedburg: Jonathan Friedberg tells us how he built a cancer center in an underserved area of New York State
- DOD cancer research programs face 57% funding cut in year-long continuing resolution
- Breast cancer activists in the 90s got DOD to fund cancer research—now that program has been gutted
- Guest editorial by former NCI director Kimryn Rathmell: We must support our junior colleagues
- Guest editorial by Jedd D. Wolchok, Joshua D. Rabinowitz, and Sohail Tavazoie: Weill Cancer Hub East to investigate connections between metabolism and anti-tumor immunity
This episode was transcribed using AI transcription services. It has been reviewed by our editorial staff, but the transcript may be imperfect.
The following is a transcript of this week’s In the Headlines, a weekly series on The Cancer Letter podcast:
Jacquelyn Cobb (00:00): This week on The Cancer Letter Podcast, Claire, what has the response been from RFK and just this stuff in general?
Claire Marie Porter (00:08): So, American Cancer Society’s Wayne Frederick, the interim Chief Executive officer of ACS CAN and a practicing cancer surgeon wrote up a statement and kind of a lengthy critique of, of these cuts and restructuring. There was one one quote in there that I thought was you know, really pertinent to us, and he said that for the last 50 years every major medical breakthrough can be traced back to investments in NH with houses and NCI. So, yeah.
Jacquelyn Cobb (00:35): Yeah, absolutely.
Paul Goldberg (00:44): You are listening to the Cancer Letter Podcast. The Cancer Letter is a weekly independent magazine covering oncology since 1973. I’m your host, Paul Goldberg, editor and publisher of The Cancer Letter,
Jacquelyn Cobb (00:58): And I’m your host, Jacqueline Cobb, associate editor of the Cancer Letter. We’ll be bringing you the latest stories, groundbreaking research and critical conversations shaping oncology.
Paul Goldberg (01:08): So, let’s get going.
Jacquelyn Cobb (01:18): Just a heads up at the time we’ve recorded this episode, the firings hadn’t officially begun, but as of Tuesday evening, there have been reports of firings happening throughout HHS. We’ll continue to cover this story in future episodes and issues as we find out more. Okay. Hello, Claire. Thank you for being with us today. Paul can’t make it, so it will just be the girls. how was your weekend?
Claire Marie Porter (01:41): My weekend was good. It was beautiful. all the flowers are coming up here. It was like an 80 degree day on Saturday, and then yesterday I went down to the Delaware with my friend and sat by the water. yeah, it feels like change has come in, so I’m happy. Yeah, there’s like bees and bugs out here, which is my second love. Second to journalism Yeah. Is bugs and critters, so I’m really happy. <laugh>.
Jacquelyn Cobb (02:06): I wanna talk to you more about that because I’m very scared of bugs, so I think I need some of your, like, influenced to help me with that.
Claire Marie Porter (02:12): Yeah. I can influence you.
Jacquelyn Cobb (02:13): Awesome. <laugh>
Claire Marie Porter (02:14): What about you? What’d you do?
Jacquelyn Cobb (02:16): Well, yeah, I was telling you about this in our morning meeting. I was in Portland, Maine, and we literally had snow. So very different experience, but…
Claire Marie Porter (02:23): Sorry about that.
Jacquelyn Cobb (02:24):
Yeah, we just hung out. But it was a nice, it was a nice fun weekend just hanging out with friends and family, so it was good. But yeah, I will take us through this week’s headlines. I’ll jump right in.
(02:35):
Our cover story this week was a Q&A with Jonathan W. Friedberg, director of the University of Rochester Wilmont Cancer Institute. and him and Paul talked about how Wilmont became the 73rd NCI-designated cancer center. So that’s definitely a big exciting story. they had a really interesting conversation, so definitely check that out.
(02:54):
We had a column by former NCI Director Kimryn Rathmell, one of her weekly columns about supporting young people in oncology right now, amidst all this uncertainty.Specifically their, not our, your—listeners—junior colleagues.
(03:10):
And we also had a guest tutorial about the new Weill Cancer Hub East by the scientific leads of the hubwhich will focus on the connection between metabolism and, and anti-cancer immunity. the hub will. The guest editorial also spoke about that, butthe hub—that will be the hub’s focus.
(03:28):
Today, we’re gonna dive deeper into two of our stories: our sort of weekly roundup, which is like eight stories in one, and then later we’re gonna talk a little bit about my story about the DOD grants being—facing severe funding cuts.
(03:44):
Okay. So yeah, Claire, if you wanna take the lead on the roundup. I know I had a couple sections in there, but it was mostly your labor, I guess I’ve said that before, but you really took control of that one, thankfully.
Claire Marie Porter (03:56): Yeah, yeah. It was, it felt kind of like I know Paul’s referred, it, referred to it as kind of like a documentation, but this week really felt like a documentation because we hadlike RFKs kind of verbal attack on NIHthat he put on social media. We put the whole transcript in there.
(04:13):
We had American Cancer Society’s response to the sweeping cuts at HHS. We had a fact sheet that was distributed to HHS employees listing all the consolidations and cuts, which is kind of the lead of the roundup, I would say this week. And so they’re all, they’re all in there. Those transcripts are in the gray boxes. And yeah, we just think—decided to include all the text, kind of, you know, document it as, as Paul says.
(04:36):
The big thing from this week was, you know, the sweeping NIH or the sweeping HHSwhich includes NIH, consolidations and cuts. ACS and American Cancer Society Cancer Action Network released this statement that was kind of outlining the consequences these changes could have on cancer programs.
(04:53):
We had an update in there on Columbia’s CCSG, and then we had mentioned the new appointments. So Bhattacharya is now, you know, officially the director of NIH, Marty Makary is leading FDA, and then Trump’s picks for Medicare and Medicaid, Mehmet Oz, the administrator the administrator position—I guess he, he had his first went through the first step of the hearings, and then Susan Monarez was tapped for CDC to lead the agency.
(05:20):
And then you covered the NIH Senate forum and potential forthcoming tariffs on pharmaceuticals.
(05:25):
So a lot of things going on. But yeah, the big story, the biggest takeaway is, is HHS. So combined with previous staff cuts and resignations and retirements that have been happening, about a quarter of the department’s entire workforce has been cut. There’s been a complete reorganization of HHS centralization of functions, consolidations of different HHS divisions, and the restructuring of, of HHS is kind of it’s more of the same, you know, in accordance with President Trump’s executive order, the DOGE, or the implementing the President’s Department of Government Efficiency Workforce Optimization Initiative, which I always have to read because it is such a mouthful <laugh>.
(06:02):
But yeah, so from that internal document that was circulating, we got a couple of numbers, which is, you know, open to the public now, but, so from 82,000 full-time employees it’s been reduced to 62,000 overall in HHS 28 divisions will be consolidated to 15 divisions and 10 regional offices will become five. The CDC will decrease its workforce by about 2,400 employees. And you know, this, it’s important to note that this restructuring is kind of coming at a time when the US is grappling with one of the, you know, worst measles outbreaks in more than two decades. Bird flu is running kind of rampant. Several recent human cases. So yeah, there’s a lot going on. And it’s all happening at once. But that’s, that was kind of like the lead of the roundup this week.
Jacquelyn Cobb (06:50): Yeah.
Claire Marie Porter (06:50): So,
Jacquelyn Cobb (06:51): Yeah. That’s crazy. Sorry for my ignorance here, but I, I obviously knew about all of the restructuring and the everything, but have, have people actually been fired yet?
Claire Marie Porter (07:02): I don’t believe so.
Jacquelyn Cobb (07:03): Okay. So it’s like they’re going to be, though.
Claire Marie Porter (07:06): I, yeah. I, I, I don’t hope I’m not giving you false facts, but I don’t believe so as of the publishing of this story, I haven’t, you know, looked into it much Monday morning, but <laugh> yeah, this was just the, an announcement. yeah. And then, you know, RFK, Robert F. Kennedy Jr., put out a response, like kinda six minute video on his Instagram and just kind of, I guess trying to provide further context for these sweeping massive cuts and the restructuring. So we can get into that if you want to. But—
Jacquelyn Cobb (07:40): Yeah, please tell me about the, the video. ‘Cause I, I didn’t watch the full thing <laugh>.
Claire Marie Porter (07:45): Sure. So, yeah, so he posted this video on March 27th, which was after these cuts were announced. and so he, he, you know, addressed everyone and said that he was pledging, you know, to eliminate, which is he was fulfilling the promise of eliminating this alphabet soup of departments, which he likes to say while still preserving core functions merging them into a new organization called Administration for Healthy America, or AHA.
(08:14):
So he talked about you know, how the rates of chronic disease have been growing. He said that cancer increased dramatically as our department has grown. We’ve the sickest nation in the world. So, he didn’t cite any cancer incidence numbers, and this claim is kind of echoing a story that we, that Paul wrote a couple of weeks ago about Trump’s executive order that drew on on on some kind of fringe data from researchers in Wuhan China.
(08:48):
This one study suggested that cancer incidence had in, had you know, increased and, but it was contradicted by data, a lot of data from US registries that was published by NCI and CDC and ACS.
(09:02):
We’re not sure exactly where this data is coming from. He didn’t, like I said, cite it or provide any reference for those numbers. But something that’s important to note is that he’s, he and Trump kind of when they, they mentioned this data, they don’t—kind of conveniently leave out the fact that mortality from cancer has decreased. And, you know, this is due to improvements in early detection treatment and overall healthcare, obviously.
(09:29):
So, yeah, the heart of the message was that, you know, this isn’t a problem that can be solved by, by money, that throwing RFKs message throwing money at the problem hasn’t fixed anything yet, so why would we expect it to in the future? so that was kind of his justification for these massive cuts. so
Jacquelyn Cobb (09:44): Yeah. Do you—no worries if not, but did just circling back to like the actual specific consolidation and you know, what actually is gonna happen, do we have any info about what’s happening at NCI specifically or what will happen?
Claire Marie Porter (09:57): Yes… Let’s see what I have here. Nothing official in the document that we put into the, into the story. So we have info for FDA and CDC, NIH, and CMS.
Jacquelyn Cobb (10:11): Yeah. Claire, what has the response been from RFK and just this stuff in general?
Claire Marie Porter (10:15): So, American Cancer Society’s Wayne Frederick, the interim chief executive officer of ACS CAN and a practicing cancer surgeon wrote up a statement and kind of a lengthy critique of, of these cuts and restructuring.
(10:28):
There was one one quote in there that I thought was you know, really pertinent to us. And he said that for the last 50 years every major medical breakthrough can be traced back to investments in NIH, which houses NCI. So, yeah.
Jacquelyn Cobb (10:42): Yeah, absolutely.
Claire Marie Porter (10:43): Yeah.
Jacquelyn Cobb (10:43): Yeah. And I mean, that’s basically exactly what you know, the small pieces of the roundup that I contributed was the, the NIH forum on basically just what’s happening at NIH and why it’s bad was basically the, the gist of the forum.
Claire Marie Porter (10:58): Yeah.
Jacquelyn Cobb (10:58): But it was really powerful because the, you know, the people who were on the panel, it’s like witnesses are, you know, leaders in, it was oncology and Alzheimer’s research and ALS.
Claire Marie Porter (11:09): Okay.
Jacquelyn Cobb (11:09): But obviously we’re gonna focus on the oncology piece of it. And, you know, one of them was Monica Bertagnolli, former NIH and NCI director. but both of the oncology sort of, again, quote unquote witnesses—it feels weird to call them that, like it’s not a trial, but you know, the people that were there—they are cancer survivors themselves.
(11:26):
And you know, both of them said that they, you know, would not be there as they are if it wasn’t for the research that has been done at NIH and NCI specifically.
Claire Marie Porter (11:38): Yeah.
Jacquelyn Cobb (11:39): And I think I’m forgetting the numbers exactly, but both of them had participated in multiple clinical trials. So it’s not even like, you know, tried and true regimens. It’s, you know,
Claire Marie Porter (11:48): Straightforward treatment,
Jacquelyn Cobb (11:48): Innovative, yeah. Like the things that are happening now at NIH and NCI. So definitely an important <laugh> thing for, you know, real patients. And, you know, again, this is a tired trope probably, but you know, it, it really does affect everyone, even the, the leadership of oncology itself, so.
Claire Marie Porter (12:05): Right,
Jacquelyn Cobb (12:06): Right. Yeah. So maybe we can transition a little bit into my story. I know do we have anything else we wanted to cover from your story, Claire? I apologize.
Claire Marie Porter (12:18): No, no, it’s okay. I think those are the, those are the highlights. Yeah.
Jacquelyn Cobb (12:20): Yeah, yeah.
Claire Marie Porter (12:21): Yeah. If you wanna get into the documents, I mean, we have the whole transcript in the, in the piece.
Jacquelyn Cobb (12:26): Yeah. But I think it’s really cool that we’re doing full transcripts. I don’t know, like as I’ve been covering this stuff for The Cancer Letter, I’ve become a much more informed citizen in general.
Claire Marie Porter (12:35): Yeah.
Jacquelyn Cobb (12:36): And I’ve, I’ve been noticing how much more sort of informed and like up to date I feel when I’m reading like primary documents, you know, and like, really like actually watching the hearings and stuff like that. So I, I think I love that we, that we include that stuff in our stories, personally.
Claire Marie Porter (12:51): Yeah. It does feel unique to The Cancer Letter instead of, you know, this whole idea of, of “gray boxing” things and like putting in the whole thing and not interrupting a quote just because it’s what journalists typically do. Yeah. And it’s also just nice to have, you know, in a time when like, a lot of stuff is being wiped, you know?
Jacquelyn Cobb (13:08): Yeah.
Claire Marie Porter (13:09):
It’s, it’s good to have and it, it does feel like documentation. So I agree with you. Yeah. It’s cool.
Jacquelyn Cobb (13:14): Yeah, for sure. Yeah, so anyway, the DOD story was pretty crazy. I didn’t expect it to be as crazy as it was, honestly. We kind of assigned it on Monday, and I was like, oh, yeah, write about this. It’s, you know, yet another casualty in everything that’s happening right now. The CDMRP, the Congressionally Directed Medical Research Program, has basically saw a funding cut of 57%, and that’s sort of this like, wonky thing that happened because of the continuing resolution. I definitely dove deep into that in my reporting, but I ended up not including it too much in the story because it was complicated.
(13:47):
And, you know, ultimately what happened is that it was cut 57%, and that’s just, you know, this crazy gutting of, of the program. And what was interesting, and again, I didn’t include this in the story because it sort of evolved over the week, was that when I first started reporting on it, it was, we didn’t know. And I was working closely with patient advocates from a, a couple different organizations, and nobody really knew exactly how that leftover. It was 650 million. So, the before, in FY24, the funding for CDMRP the, the umbrella program was 1.5 billion, and then it was cut to 650 million, that’s the 57% cut.
(14:26):
And at the beginning of the week, nobody knew how exactly that 650 million was going to be distributed to the 35 research programs that are under the CDMRP. And, you know, that’s 35 programs! A bunch of them are cancer, not all of them though. And that’s when I was, I was speaking with NBCC, and that was one of their main concerns was, you know, how are we gonna, there’s no, you know… The typical process involved in distributing these funds has been totally cut off, and it’s totally just up to DOD how they’re gonna distribute these funds.
(15:00):
In the, in the past, again, this is like pretty complicated, you know, policy level stuff, but there, there is like a very strict process including advocacy and letters and like letters of support, public letters of support by congress members and things like that. And all of that is cut out, and it’s, again, just based on what the DOD wants to do.
(15:20):
Then on, I think it was Thursday, maybe Wednesday, CDMRP came out with their funding you know, allocations, and we all had to sort of like scramble and figure out what that meant. And in that we found out that the lung, pancreatic and kidney cancer research programs were just cut. They’re just gone. And that was really shocking because you know, these programs, these were some of the newer programs.
(15:48):
But like the breast cancer research program has been around since 1991. They’ve gotten like pretty consistent funding over the course of the last 33 years. And this, this funding mechanism has helped a lot of people because it’s pretty unique in the terms of the type of projects it funds.
(16:06):
So, DOD is known for funding higher risk, higher reward research. So, where NIH is more known for funding, like in incremental research based on really rigorous research, rigorous science, excuse me, that is more of a sure thing. Obviously that’s not always the case with research, but more of a sure thing. Whereas DOD really is, is fueled by these more higher risk potentially breakthrough projects.
(16:36):
And the DOD is also unique in that they have patient advocates involved in the decision making of which of these grants gets funded. And like how, you know, all of, basically the advocates said that at every table where decisions are being made there is a patient advocate there.
Claire Marie Porter (16:54): Yeah.
Jacquelyn Cobb (16:54): And I think that’s really interesting because, you know, basically those two things taken together, the high risk and the patient advocates mean that the work done at the DOD is you know, really oriented toward making patients’ lives better.
(17:09):
It’s, you know, it’s the, the, whether or not the scientific question is like interesting or, you know, all of these other factors that go into you know, NIH grants are secondary to whether or not it helps patients quickly. so it’s definitely a unique funding mechanism. And that’s, I, I think it’s important to say that because the lung cancer, pancreatic cancer and kidney cancer programs they didn’t have like, the, the most funding in the world, like the Pancreatic cancer research program was given 15 million in FY24, and that’s what they lost.
Claire Marie Porter (17:41): Mm-hmm <affirmative>.
Jacquelyn Cobb (17:41): And, you know, compared that to breast, the breast cancer research program had a, saw a $20 million cut, so their cut was more than the entire pancreatic research cancer program.
(17:54):
But it’s, you know, these dollars, I think this is actually a great quote by Julie Fleshman, the president and CEO of the Pancreatic Cancer Action Network. She says, “these dollars were important to our community.”
(18:05):
You know, it’s, it’s very specifically these dollars because of the type of research that they fund the type of questions that they fund. So yeah, it was really intense.
Claire Marie Porter (18:17): Definitely.
Jacquelyn Cobb (18:17): I can talk more, I could talk more about it for hours probably, but it was a really intense week on my end, just sort of like working with the patient advocates to keep up to date on all of this and what does it mean, and yeah. Obviously it’s just really hard and sad.
(18:32):
You know, another, I think quote also by Fleshman, you know, like what does it say to patients and families and researchers when an entire program like this is just fully cut and destroyed? So, it was intense. And it’s, again, it’s like in the context of everything else that’s happening, it’s like, yet another cut.
Claire Marie Porter (18:47): Right.
Jacquelyn Cobb (18:47): But it’s, I think being so involved in, like, this story wasn’t part of a roundup. It was something I like reported on more deeply and really got into, and yeah, it hits different, it’s, it’s, it’s intense.
Claire Marie Porter (18:59): Yeah. Yeah. It’s, like humanized for you. Yeah.
Jacquelyn Cobb (19:01): Yeah!
Claire Marie Porter (19:02): Really personal level. Can you tell, tell me a little bit about the, kinda the backstory or the history of the DOD grant?
Jacquelyn Cobb (19:09): Yeah, it’s so, it’s so interesting. It’s such a cool story.
(19:14):
Basically in 1991, I believe the National Breast Cancer Coalition, which is NBCC—I think I used that just as an acronym earlier, but it’s the National Breast Cancer Coalition, which is a group of activists. Basically, they noticed that there was a lot of funding and messaging about breast cancer awareness, and they were like, no, we need funding going toward breast cancer research, like treatment prevention screening, that type of thing. And they wanted more funding.
(19:44):
They, there was funding at NCI for breast cancer research, but there wasn’t a dedicated program. So Melanie Wyne, who’s the Chief Policy Officer of NBCC, I spoke with her this week and she basically gave me sort of the, the rundown. And The Cancer Letter has covered this, you know, firsthand. Paul you know, covered this as it was happening.
(20:05):
But yeah, it was basically that they wanted more funding for breast cancer research. And I think this is from actually our coverage of it, but the idea was that they learned from AIDS advocates about how to actually push for funding.
(20:19):
And the president of NBCC, the, the now president also of NBCC, was just this like fierce advocate and just absolutely demanded $300 million additional dollars for breast cancer research.
(20:38):
And yeah, it was, it was really interesting to read sort of the history at that point. And I don’t think that this was in my story, I think it was actually in our “In the Archives” story for last week. But how, at that time, NCI, NIH, professional societies, they all thought that was a crazy number to ask for. And Fran Visco, just, and NBCC, they just made it happen.
(20:58):
They worked with Tim—Tom Harkin, excuse me—at the time, who was the chair of the DOD appropriation subcommittee, and basically did this like clever maneuvering to get additional funding for breast cancer research. And it happened to be through the Department of Defense.
(21:13):
And yeah, it, there’s a really cool, I like this quote a lot from Melanie Wyne that the fact that it’s, you know, breast cancer research in the Department of Defense sounds very weird and incongruous, but the, it was a fluke of history because it was in peace time and there was sort of like this extra funding that they were willing to spend on breast cancer research.
(21:34):
So, yeah, so I mean, definitely I could, I could keep talking about this and maybe <laugh>, we might be going a little long. And that’s, you know, when you write a fun story like this, it’s, you know, it’s one of those things where you can just keep talking.
(21:47):
But you, listeners, you guys can read more about this on the Cancer History Project, it’s free. You don’t need a subscription.
(21:56):
So, and we have a lot of really cool coverage. We have a Q&A with Fran Visco, her telling the story from her first person perspective. We have coverage from Paul Goldberg as it was happening. It’s, it’s a really cool story. Definitely worth reading more.
(22:09):
It’s, there’s pretty funny quotes. I think I included some was the idea of like, you know, we don’t… NCI leader saying, you know, we want, we should be in control of the breast cancer research or cancer research in general saying, “we certainly don’t want our own B2 bomber program.”
(22:27):
So, it was really a, a saga in the nineties. So, really interesting and again, very jarring to see that, you know, something with such a long history is now just been—not gutted, because breast cancer research is okay-ish. So now that I’ve talked for hours about my little, like, hyper-fixation of the week…
Claire Marie Porter (22:46): No, it’s super interesting. And it was very, you know, probably one of our most linear episodes, I would say.
Jacquelyn Cobb (22:52): I know <laugh>, we, we followed the schedule, actually. Crazy <laugh>.
Claire Marie Porter (22:58): Yeah.
Jacquelyn Cobb (22:58): Oh my gosh. But we miss Paul. He’ll be back next week.
(23:01)
All right. Well, thank you so much, Claire. This has been a joy again, like we said, very linear. But we’ll miss Paul, we miss Paul, and we’ll be happy to have him back and be more crazy next week.
(23:11)
It’ll be fun, <laugh>.
Claire Marie Porter (23:13): Sounds good.
Jacquelyn Cobb (23:14): Thank you so much. And tune in next week for more.
(23:19)
Thank you for joining us on The Cancer Letter Podcast, where we explore the stories shaping the future of oncology. For more in-depth reporting and analysis, visit us at cancerletter.com.
(23:29)
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Paul Goldberg (23:40): Until next time, stay informed, stay engaged, and thank you for listening.
