Of all things you don't want to turn into a popularity contest, cancer funding is one of them.
Rick Bangs, 51, likes to point out that the cancer he survived is the fifth most common cancer in the United States and the fourth most common cancer among men. But back in 2006 when he saw blood in his urine, neither he, nor his primary care doctor, considered bladder cancer for several months.
"I didn't push it," said Bangs. "At the time, I was back to what the general practitioner said and the urologist said, 'yeah, it could have been from your prostate.
"It never crossed my mind that it might be cancer. That's kind of naive, but that's the way it is," he said. Five weeks after his diagnosis, Bangs had his bladder removed and a neobladder made from intestinal tissue. He has to empty it every four hours -- day or night -- for the rest of his life.
But what irks Bangs isn't the hassle with a neobladder. After researching his cancer, Bangs discovered that bladder cancer fell into some of the silent cancers in America -- ones that are common and deadly, but don't receive the same amount of attention and money as some highly publicized cancers.
Take, for example, lung cancer. It is the most common cancer in the United States and a very deadly one, but it gets an average amount of funding -- $1,128 per new person diagnosed last year -- from the National Cancer Institute (NCI).
Breast cancer, on the other hand, is ranked No. 3 in new cases last year and received $2,976 per new case. Leukemia ranks ninth in new cases and got $4,831 per new case in 2008. However, bladder cancer, which ranks fifth, got around $340 per new case. That means the fifth most common cancer ranks 19th in funding.
Add in private money and special funding from the U.S. Department of Defense and the disparities between number of cancer victims and number of dollars grows.
"Bladder cancer doesn't have a strong patient advocacy group unlike the Komen foundation for breast cancer or Lance Armstrong's foundation for testicular cancer," said Dr. Edouard J. Trabulsi, associate professor of urology in the Kimmel Cancer Center at Thomas Jefferson University in Philadelphia.
"There's nothing all that new or exciting on the treatment front. Is that the chicken or the egg, where if there was more money there would be more research, I don't know," Trabulsi added. "But bladder cancer is sort of an orphan stepchild at least in urology-oncology."
Bangs, and other bladder cancer advocates say the difference is unfair. But those at cancer funding centers say doling out dollars cancer by cancer is not the best model. Rather, paying by scientific promising ideas saves the most lives in all cancers.
"Obviously, as a survivor, I think at least it should be equitable. There has been no forward progress in the treatment of bladder cancer in quite some time," said Bangs, who is a volunteer for the Bladder Cancer Advocacy Network.
But Dr. Otis Brawley, chief medical officer of the American Cancer Society, points out that when it comes to funding cancer, funding the most promising ideas can help any cancer.
"You actually pursue the easiest scientific opportunities because you don't want to be criticized of wasting the money," said Brawley. "You need to realize how you label something for one disease or another disease is not exactly not written in stone."