Trump science funding cuts shake the foundation of U.S. research | STAT

Research Funding Disruptions: What They Mean for Prostate Cancer Treatment Development

BLUF (Bottom Line Up Front)

The 2025 federal research funding disruptions have significantly impacted biomedical research, including prostate cancer studies. NIH grant awards dropped 11.6% compared to 2024, affecting both established research programs and innovative high-risk studies that drive breakthrough treatments. The shift to upfront multi-year funding—while administratively simpler—has reduced the total number of projects funded and eliminated crucial annual review checkpoints that allowed the NIH to redirect funding from underperforming research to more promising work. This crisis particularly threatens research into low-cost, off-patent treatments that only government or charitable funding supports, since pharmaceutical companies have no profit incentive to develop them. With federal funding uncertain and charitable giving potentially affected by recent tax law changes, a critical gap has emerged in research that could benefit patients most economically. Patient support groups like the IPCSG can play vital advocacy, education, and coordination roles during this crisis.

Understanding the Changes

The relationship between federal research funding and university-based medical research underwent dramatic changes in 2025. According to a STAT analysis of nearly 750,000 grants over the past decade, the National Institutes of Health made 11.6% fewer grant awards in the first nine months of 2025 compared to the same period in 2024, despite spending a similar total amount of money.

This reduction occurred because the NIH shifted to paying for many multi-year grants entirely upfront rather than in annual installments—a change that left funding available for fewer total projects. The cuts affected research across all disease areas, including cancer, Alzheimer's disease, and HIV/AIDS.

The Multi-Year Funding Problem: Less Accountability, Fewer Projects

The shift to upfront multi-year funding represents a significant change in how biomedical research accountability works, with concerning implications for research quality and responsiveness.

How NIH Funding Traditionally Worked

Historically, the NIH awarded multi-year grants (typically 3-5 years) but funded them incrementally, usually one year at a time. This approach had several important advantages:

Annual Progress Reviews: Each year, researchers submitted progress reports demonstrating their accomplishments, preliminary data, and continued productivity. The NIH program officers reviewed these reports to ensure the research was progressing as planned.

Course Corrections: If research wasn't producing results, was moving too slowly, or if preliminary findings suggested a different direction would be more productive, the NIH could work with researchers to adjust the project or, in extreme cases, decline to continue funding.

Responsive to New Discoveries: When breakthrough findings emerged in a field, the NIH could redirect upcoming funding toward the most promising new directions rather than being locked into commitments made years earlier.

Protection Against Non-Performance: If a principal investigator became unable to complete the work (due to illness, career change, ethical violations, or simply losing interest), the NIH could terminate funding rather than paying for years of unproductive work.

Budget Flexibility: Annual funding allowed the NIH to adjust its portfolio based on congressional appropriations, emerging health priorities, and new scientific opportunities.

The New Upfront Funding Model

By paying entire multi-year grants upfront, the NIH has effectively eliminated these accountability mechanisms:

Reduced Oversight: Once the money is distributed, the NIH has limited leverage to ensure continued productivity or quality. While researchers still submit progress reports, there's no annual funding decision that depends on satisfactory progress.

Locked-In Commitments: The NIH cannot easily redirect funds from underperforming projects to more promising ones because the money has already been distributed.

Decreased Portfolio Agility: When new scientific opportunities emerge—such as a breakthrough discovery that opens new treatment possibilities—the NIH has less flexibility to quickly support follow-up research because funds are already committed.

Fewer Total Grants: Most critically, paying three to five years of funding upfront means the same annual budget supports only 60-80% as many research projects. This is the mathematical reality behind the 11.6% drop in grant awards: the total dollars spent remained similar, but paying grants entirely upfront meant fewer projects received funding.

Why This Matters for Research Quality

The scientific research process is inherently unpredictable. Experiments often don't work as planned, hypotheses prove incorrect, and unexpected findings emerge. The traditional annual review process allowed the research enterprise to remain flexible and self-correcting:

Promising preliminary results could lead to expanded funding or spin-off projects
Disappointing results could trigger thoughtful discussion about whether to pivot or terminate
Program officers could identify when researchers needed additional support, training, or collaboration
The broader research community could see annual progress and build on each other's work

By eliminating annual review points, the upfront funding model reduces the NIH's ability to ensure taxpayer dollars support the most productive research. It also reduces transparency—there are fewer opportunities for the research community to learn what's working and what isn't.

Administrative Efficiency vs. Scientific Effectiveness

Proponents of upfront funding argue it reduces administrative burden: fewer annual reviews mean less paperwork for researchers and NIH staff. In theory, this could allow scientists to spend more time conducting research and less time writing reports.

However, critics note that this "efficiency" comes at a steep cost:

Scientific accountability decreases
Overall research productivity may decline
The total number of research projects shrinks dramatically
The NIH loses its ability to adapt quickly to new discoveries

For prostate cancer research specifically, this means fewer total projects studying the disease, and potentially years of funding locked into research directions that may prove less promising than new approaches that emerge during the grant period.

The Critical Gap: Research Big Pharma Won't Fund

A particularly concerning aspect of these federal funding cuts involves research that pharmaceutical companies have no financial incentive to pursue—studies of generic drugs, repurposed medications, lifestyle interventions, and other approaches that cannot be patented or exclusively marketed.

Why This Matters for Prostate Cancer Patients

Many potentially effective prostate cancer treatments receive little attention because they offer no profit potential:

Off-Patent Medications: Generic drugs like metformin (a diabetes medication), statins (cholesterol drugs), and aspirin have shown potential benefits in prostate cancer outcomes in observational studies, but rigorous clinical trials require funding that pharmaceutical companies won't provide since these drugs are already generic.

Repurposed Drugs: Medications developed for other conditions might benefit prostate cancer patients, but without patent protection, companies have no incentive to fund the expensive clinical trials needed for FDA approval for a new indication.

Nutritional and Lifestyle Interventions: Studies examining diet modifications, exercise programs, stress reduction, or supplements like vitamin D, omega-3 fatty acids, or curcumin typically rely entirely on government or charitable funding. While these may never replace standard treatments, they could potentially improve outcomes or quality of life at minimal cost.

Combination Approaches Using Generic Drugs: Researchers have theorized that combinations of inexpensive, off-patent drugs might create synergistic effects against cancer, but testing these combinations requires significant funding with no commercial payoff.

Diagnostic and Monitoring Approaches: Simple, low-cost methods for tracking disease progression or predicting treatment response may not attract industry funding if they compete with expensive proprietary tests.

According to health policy researchers, this creates a systematic bias in cancer research toward expensive, patentable treatments rather than potentially effective, affordable alternatives. The NIH and other government funding agencies have historically filled this gap, making the current funding cuts particularly problematic.

The Charitable Funding Squeeze

Compounding the federal funding crisis, charitable research funding—the other major source for studies pharmaceutical companies won't support—may also be under pressure.

Recent Tax Law Changes and Charitable Giving

The Tax Cuts and Jobs Act of 2017, which remains in effect, significantly reduced the tax incentive for charitable donations by nearly doubling the standard deduction. Economic research has shown this change reduced itemized charitable deductions and overall giving patterns. With fewer taxpayers itemizing deductions, the tax benefit of donating to medical research foundations has diminished.

Additionally, economic uncertainty in 2025 has affected philanthropic giving across many sectors. Major research foundations report increased competition for limited charitable dollars, with donors potentially prioritizing immediate patient services over long-term research investments.

Impact on Prostate Cancer Research Foundations

Organizations like the Prostate Cancer Foundation, ZERO Prostate Cancer, and smaller patient advocacy groups fund research projects that NIH or pharmaceutical companies won't support. These foundations often focus on:

Pilot studies for novel concepts that need preliminary data before qualifying for NIH grants
Research into health disparities and underserved populations
Quality of life studies
Patient education and support programs
Studies of complementary approaches

When both federal and charitable funding sources contract simultaneously, research into affordable, non-patentable treatments faces a particularly severe crisis.

Impact on Prostate Cancer Research

For prostate cancer patients, these funding changes matter because breakthrough treatments typically follow a long path from basic laboratory research to clinical trials to FDA approval. This pipeline depends on consistent, predictable funding:

Basic Research: Scientists studying cancer biology, metastasis mechanisms, and treatment resistance need multi-year grants to complete their work. Interruptions can set projects back significantly or force them to shut down entirely.

Translational Research: The crucial step of moving laboratory discoveries into potential treatments requires sustained funding and often involves high-risk experiments that may not succeed. These "high-risk, high-reward" grants saw a decline from 406 awards in early 2024 to 364 in early 2025.

Clinical Trial Development: Before new therapies reach patients, researchers must design and conduct safety studies and early-phase clinical trials. Universities and medical centers typically rely on NIH funding to support the infrastructure for these trials.

Early-Career Researchers: The number of grants awarded to graduate students and postdoctoral researchers—tomorrow's leading cancer researchers—fell to its lowest level since 2016. PhD program enrollments in life and biomedical sciences flatlined in fall 2025, potentially creating a gap in the research workforce that could affect prostate cancer research for years to come.

Real-World Examples of Threatened Research

Several types of prostate cancer research face particular vulnerability in this funding environment:

Metformin Studies: This inexpensive diabetes drug has shown potential benefits for prostate cancer outcomes in observational studies, with possible mechanisms including effects on insulin signaling and cancer cell metabolism. Definitive clinical trials require millions in funding with no commercial sponsor.

Exercise Interventions: Research has suggested that regular physical activity may improve outcomes for men with prostate cancer and reduce treatment side effects. Rigorous studies quantifying these benefits and establishing optimal exercise protocols depend entirely on government or charitable funding.

Dietary Approaches: Studies examining how specific dietary patterns—Mediterranean diet, plant-based eating, caloric restriction—affect prostate cancer progression require long-term follow-up and careful monitoring, representing substantial costs with no profit potential for industry sponsors.

Repurposed Medications: Drugs like disulfiram (an alcohol deterrence medication), mebendazole (an anti-parasitic), and others have shown anti-cancer properties in laboratory studies but lack funding for human trials.

Biomarker Validation: Simple, inexpensive blood tests or imaging approaches that could help personalize treatment might not receive industry support if they compete with expensive proprietary tests.

What Led to These Changes

The funding disruptions stem from broader policy conflicts between the Trump administration and research universities. According to former Princeton president Shirley Tilghman, quoted in STAT's investigation, "The intention was to punish elite universities, it was not to destroy the scientific capacity of the United States, but that's what they're doing."

Several factors contributed to the situation:

Political targeting: Some institutions lost funding over allegations of "woke" thinking or antisemitism
Policy changes: The NIH indicated some research cuts related to diversity, equity, and inclusion criteria
Administrative uncertainty: Shifting policies and funding freezes created a "volatile funding climate"
Institutional responses: Universities responded defensively by freezing hiring, laying off staff, and scaling back training programs

Courts have intervened to restore billions in terminated grant funding, and Congress has so far rejected White House proposals for steep NIH budget cuts in 2026 and a plan to consolidate the agency's 27 institutes.

Broader Context: The Research Funding Ecosystem

Understanding the full impact requires recognizing how different funding sources complement each other:

Federal Funding (NIH, DOD, VA): The NIH's $47 billion budget (fiscal year 2025) represents the largest single source of biomedical research funding globally. The Department of Defense also funds prostate cancer research through its Congressionally Directed Medical Research Program, which has awarded over $1.4 billion for prostate cancer research since 1997. The Veterans Administration conducts prostate cancer research given the disease's high prevalence in veterans.

Pharmaceutical Industry: Companies invest heavily in drug development but focus almost exclusively on patentable compounds with significant profit potential. Industry-sponsored clinical trials for new prostate cancer drugs like novel hormone therapies, radioligand treatments, and targeted therapies represent billions in investment—but only for commercially viable products.

Charitable Foundations: The Prostate Cancer Foundation has awarded over $1 billion in research grants since 1993, often funding innovative early-stage research or studies that fall outside NIH priorities. Patient advocacy organizations fund research specifically addressing patient concerns and quality of life.

Academic Medical Centers: Some institutions use clinical revenue to support research infrastructure, but this model has become increasingly strained as healthcare reimbursement has declined.

When federal funding becomes unreliable, the entire ecosystem suffers because each source plays a specific role. The gap is especially acute for research that only government or charitable sources will support.

Real-World Consequences for Patients

While existing treatments remain available and ongoing clinical trials continue, the research disruptions may affect the future treatment landscape in several ways:

Delayed Innovation: Promising research directions may be abandoned or significantly delayed. For prostate cancer, this could affect work on new targeted therapies, immunotherapy combinations, imaging techniques, or treatments for castration-resistant disease.

Widening Treatment Cost Gap: If research increasingly focuses only on expensive patentable drugs while affordable alternatives go unstudied, treatment costs will continue rising, potentially pricing some patients out of optimal care despite insurance coverage.

Missed Opportunities for Combination Benefits: Patients might benefit from combining standard treatments with inexpensive adjunctive approaches (exercise, diet modifications, repurposed drugs), but without research proving these benefits, oncologists cannot confidently recommend them.

Talent Loss: Experienced researchers may leave academic science for industry or other careers. Early-career scientists may choose different professions entirely, reducing the pool of talent focused on prostate cancer.

Reduced Collaboration: The uncertainty has damaged trust between researchers and federal funding agencies. As one NIH official told STAT: "Why would anyone trust the NIH ever again?"

Infrastructure Strain: Universities have scaled back core facilities, research support services, and training programs that benefit all researchers, including those studying prostate cancer.

What This Means for Current Patients

For men currently living with prostate cancer, several points deserve emphasis:

Your current treatments are not affected: FDA-approved therapies remain available, and your care team's ability to treat you has not changed.

Ongoing clinical trials continue: Trials already underway, including studies of novel treatments like radioligand therapies (Pluvicto, experimental Actinium-225 approaches), targeted therapies, and immunotherapies, are proceeding.

The pipeline still exists: Despite the disruptions, pharmaceutical companies, academic medical centers, and remaining NIH-funded programs continue developing new treatments.

Consider evidence-based complementary approaches: While awaiting formal research, patients can discuss with their oncologists evidence-based lifestyle modifications—exercise, diet, stress management—that may offer benefits at low cost and minimal risk.

Recovery is possible: Historical funding disruptions have been followed by recovery periods. Congress has shown bipartisan support for NIH funding, refusing proposed cuts.

What the IPCSG and Other Patient Support Groups Can Do

Patient support groups occupy a unique position in the healthcare ecosystem—they represent the voices and interests of those most affected by research funding decisions. Groups like the Informed Prostate Cancer Support Group (IPCSG) can take several important actions during this crisis:

Immediate Actions

1. Advocacy and Education

Congressional Outreach: Support groups can organize coordinated letter-writing and calling campaigns to congressional representatives. Key messages should emphasize:

The importance of stable, predictable NIH funding for cancer research
The need for research into affordable, off-patent treatments that serve patients' interests
The critical role of annual review mechanisms in ensuring research accountability
How funding disruptions affect real patients' future treatment options

Member Education: Keep members informed about research funding issues through newsletters, presentations at meetings, and website updates. Help members understand:

Why government-funded research matters for treatments that industry won't develop
How to effectively communicate with elected representatives
Which specific bills or appropriations measures affect cancer research funding
The connection between today's research funding and tomorrow's treatment options

2. Strategic Research Support

Identify Priority Research Gaps: Work with medical advisors to identify high-priority, underfunded research areas in prostate cancer, particularly:

Repurposed drug studies with strong preliminary evidence
Quality of life research
Studies of exercise, diet, and lifestyle interventions
Research into treatment side effects and their management
Health disparities affecting underserved prostate cancer populations

Connect Researchers with Funding: Create a clearinghouse connecting researchers working on patient-priority projects with potential funding sources, including:

Other charitable foundations
Philanthropic individuals
Corporate social responsibility programs
Community fundraising opportunities

3. Collaborative Initiatives

Coalition Building: Join forces with other prostate cancer support groups, patient advocacy organizations, and broader cancer coalitions to:

Amplify advocacy messages
Share resources and reduce duplication
Present a unified patient voice to policymakers
Coordinate fundraising efforts

Partnerships with Research Institutions: Develop relationships with universities and medical centers conducting prostate cancer research to:

Understand specific funding challenges they face
Identify research projects most at risk from funding cuts
Facilitate patient input into research priorities
Organize facility tours and researcher presentations for members

Medium-Term Strategic Actions

4. Direct Research Funding

While individual support groups may lack resources to fund major research projects, collaborative efforts can make meaningful contributions:

Seed Grants for Pilot Studies: Small grants ($25,000-$50,000) can help researchers generate preliminary data needed to compete for larger NIH or foundation grants. These are particularly valuable during funding crunches.

Support for Unfunded Research Components: Fund specific aspects of larger studies that lack full support:

Patient recruitment and retention activities
Quality of life assessments
Extended follow-up periods
Analysis of patient-reported outcomes

Research Coordination Costs: Support the administrative costs of organizing multi-site studies or patient registries that might otherwise lack funding.

5. Patient Engagement in Research

Clinical Trial Recruitment: Help researchers overcome recruitment challenges by:

Educating members about clinical trial opportunities
Addressing fears and misconceptions about trial participation
Connecting interested members with appropriate studies
Providing peer support for trial participants

Patient-Reported Outcomes: Establish mechanisms for collecting and sharing patient experiences:

Standardized quality of life surveys
Treatment side effect tracking
Patient experience databases
Real-world evidence that supplements clinical trial data

Research Priority Setting: Ensure patient perspectives shape research agendas by:

Conducting surveys to identify patient-priority research questions
Participating in research funding organization advisory boards
Presenting patient perspectives at scientific conferences
Publishing patient preference studies

6. Information and Resource Sharing

Research Translation: Help bridge the gap between research findings and patient understanding:

Translate complex research into patient-friendly summaries
Explain how specific studies might affect future treatment options
Provide context for research news and breakthroughs
Combat misinformation about cancer treatments

Treatment Decision Support: Provide evidence-based information to help members make informed decisions:

Comprehensive treatment option summaries
Side effect profiles and management strategies
Quality of life considerations
Cost implications of different treatment approaches

Long-Term Structural Actions

7. Policy Advocacy

Research Funding Reform: Advocate for structural changes to research funding:

Dedicated funding streams for off-patent treatment research
Tax incentives for charitable giving to medical research
Mechanisms ensuring research accountability without eliminating projects
Programs supporting clinical trials of repurposed drugs

Access to Affordable Treatments: Push for policies that improve access to both established and emerging treatments:

Medicare coverage for evidence-based preventive interventions
Insurance coverage for clinical trials
Compassionate use programs for promising treatments
Price negotiations for expensive cancer therapies

8. Building Sustainable Support Infrastructure

Endowment Development: Work toward building sustainable funding sources:

Planned giving programs
Memorial donation options
Annual fundraising events
Partnership with corporate sponsors

Knowledge Repository: Create lasting resources that benefit the patient community:

Comprehensive online library of research summaries
Video library of researcher presentations
Treatment decision tools
Caregiver resources

9. Measurement and Reporting

Document Impact: Track and publicize the support group's contributions:

Number of members participating in clinical trials
Research projects supported
Legislative advocacy outcomes
Member education reach

Transparency: Maintain clear communication about:

How donated funds are used
Progress toward advocacy goals
Research projects supported and their outcomes
Challenges faced and lessons learned

Practical Examples for IPCSG

Specific Action Example 1: Congressional Advocacy Campaign

The IPCSG could organize a "Research Funding Awareness Month" where:

Members receive template letters to send to their representatives
The group coordinates Capitol Hill visits (in person or virtual)
Members share personal stories about how research has affected their treatment
Social media campaign highlights the connection between research funding and patient outcomes

Specific Action Example 2: Research Priority Survey

Conduct a member survey to identify:

Most concerning treatment side effects needing research
Interest in clinical trial participation
Preferred research directions (basic science vs. clinical trials vs. quality of life)
Willingness to contribute to research funding

Share results with research funders and institutions to influence research priorities.

Specific Action Example 3: Researcher-Patient Forum

Host quarterly events (in-person or virtual) where:

Local researchers present their work in patient-friendly terms
Members ask questions and provide patient perspective
Researchers learn what matters most to patients
Connections form between researchers and potential trial participants

Specific Action Example 4: Targeted Research Support

Identify a specific underfunded research area (e.g., exercise interventions for men on ADT) and:

Partner with a local research institution
Raise targeted funds for a pilot study
Recruit member volunteers for the study
Track and report outcomes to demonstrate impact

Looking Forward: What Needs to Happen

Addressing this crisis requires action on multiple fronts:

Federal Level:

Restore predictable, sustained NIH funding with bipartisan support
Maintain annual review mechanisms to ensure research accountability while reducing administrative burden
Create dedicated funding mechanisms for research into off-patent treatments
Reform grant administration to reduce unnecessary bureaucracy
Establish programs specifically supporting clinical trials of repurposed drugs

Charitable Sector:

Restore tax incentives for charitable giving to medical research
Coordinate foundation efforts to avoid duplication and maximize impact
Educate donors about the unique value of funding research industry won't support
Develop new funding models for long-term research support

Academic Institutions:

Develop more efficient research administration systems
Create partnerships to share resources and reduce overhead costs
Advocate collectively for stable research funding
Maintain annual progress review practices even with upfront funding

Patient Advocacy:

Support organizations funding prostate cancer research
Contact congressional representatives about NIH funding and research accountability
Participate in clinical trials when appropriate
Advocate for research into affordable treatment approaches
Coordinate efforts across patient organizations to maximize impact

The International Context

It's worth noting that other countries face similar challenges in funding research that lacks commercial appeal. However, several nations have developed models worth examining:

United Kingdom: The National Institute for Health and Care Excellence (NICE) considers cost-effectiveness when approving treatments, creating incentive for research into affordable approaches. The UK also maintains robust annual grant review processes to ensure accountability.

Canada: Provincial health systems sometimes fund pragmatic clinical trials of low-cost interventions as part of healthcare delivery. Annual progress monitoring remains standard practice.

Australia: The government's Medical Research Future Fund provides sustained research funding independent of annual budget politics, while maintaining accountability through regular milestone reviews.

These models suggest alternatives to the current U.S. approach that could preserve both research flexibility and scientific accountability.

What Patients Can Do Now

For prostate cancer patients and advocates, this situation underscores the importance of:

Supporting research funding: Contact congressional representatives to advocate for stable, predictable NIH funding with appropriate accountability mechanisms. Emphasize that research into affordable treatments serves patients' interests even when it doesn't serve pharmaceutical profits.

Engaging with patient advocacy organizations: Groups like ZERO Prostate Cancer, the Prostate Cancer Foundation, and patient support groups like IPCSG can amplify patients' voices. Consider financial support if possible, and participate actively in advocacy efforts.

Staying informed: Follow developments in research policy that may affect future treatment options. Subscribe to newsletters from advocacy organizations and medical centers.

Participating in clinical trials: When appropriate, trial participation helps ensure research continues and accelerates the path to new treatments—especially important for studies lacking industry sponsorship.

Discussing complementary approaches with oncologists: Ask about evidence-based lifestyle modifications and whether any repurposed medications might complement your treatment plan.

Documenting your experience: Patient-reported outcomes and real-world evidence become more valuable when formal clinical trials become harder to conduct.

Supporting your local support group: Participate in meetings, contribute to advocacy efforts, and help build the collective voice of prostate cancer patients.

The coming years will determine whether the American biomedical research enterprise can adapt and recover—or whether the damage to the system that has produced generations of cancer treatments proves lasting. The stakes are particularly high for research into affordable treatments that could benefit the most patients but offer the least profit. Patient support groups like the IPCSG have both opportunity and responsibility to help shape the outcome through advocacy, education, strategic support, and sustained engagement with the research community.

Verified Sources and Formal Citations

Primary Sources

Molteni, M., Oza, A., & Parker, J.E. (2025, December 4). Trump has 'shaken the hell' out of the 80-year research pact between the government and universities. What now? STAT. https://www.statnews.com/2025/12/04/trump-nih-university-research-funding-cuts/
National Institutes of Health RePORTER Database (2015-2025). NIH Research Portfolio Online Reporting Tools. https://reporter.nih.gov/
National Student Clearinghouse Research Center (2025). Life and biomedical sciences PhD enrollment data, Fall 2025. https://www.studentclearinghouse.org/
National Institutes of Health (2025). Budget information and grant award data. https://www.nih.gov/
National Institutes of Health (2024). Grants and funding: Multi-year funding policies and procedures. NIH Grants Policy Statement. https://grants.nih.gov/grants/policy/nihgps/

Research Funding and Policy

U.S. Department of Defense Congressionally Directed Medical Research Programs (2024). Prostate Cancer Research Program funding history. https://cdmrp.health.mil/pcrp/default
Prostate Cancer Foundation (2024). Research funding and impact. https://www.pcf.org/
Tax Policy Center, Urban Institute & Brookings Institution (2018). "The effect of the TCJA individual income tax provisions on charitable giving." Tax Policy Center Analysis. https://www.taxpolicycenter.org/
Giving USA Foundation (2025). Annual report on philanthropy. https://givingusa.org/
Steinbrook, R. (2009). Peer review and the distribution of federal research funding. JAMA, 302(14), 1593-1594. https://doi.org/10.1001/jama.2009.1473

Research Gaps and Off-Patent Treatments

Kesselheim, A.S., Avorn, J., & Sarpatwari, A. (2016). The high cost of prescription drugs in the United States: Origins and prospects for reform. JAMA, 316(8), 858-871. https://doi.org/10.1001/jama.2016.11237
Prasad, V., & Mailankody, S. (2017). Research and development spending to bring a single cancer drug to market and revenues after approval. JAMA Internal Medicine, 177(11), 1569-1575. https://doi.org/10.1001/jamainternmed.2017.3601
Pantziarka, P., Bouche, G., Meheus, L., Sukhatme, V., & Sukhatme, V.P. (2014). Repurposing drugs in oncology (ReDO)—mebendazole as an anti-cancer agent. ecancermedicalscience, 8, 443. https://doi.org/10.3332/ecancer.2014.443
Sleire, L., Førde, H.E., Netland, I.A., Leiss, L., Skeie, B.S., & Enger, P.Ø. (2017). Drug repurposing in cancer. Pharmacological Research, 124, 74-91. https://doi.org/10.1016/j.phrs.2017.07.013

Prostate Cancer-Specific Research

Allott, E.H., Masko, E.M., & Freedland, S.J. (2013). Obesity and prostate cancer: Weighing the evidence. European Urology, 63(5), 800-809. https://doi.org/10.1016/j.eururo.2012.11.013
Bourke, L., Smith, D., Steed, L., et al. (2016). Exercise for men with prostate cancer: A systematic review and meta-analysis. European Urology, 69(4), 693-703. https://doi.org/10.1016/j.eururo.2015.10.047
Joshua, A.M., Zannella, V.E., Downes, M.R., et al. (2017). A pilot 'window of opportunity' neoadjuvant study of metformin in localised prostate cancer. Prostate Cancer and Prostatic Diseases, 17(3), 252-258. https://doi.org/10.1038/pcan.2014.20
Kenfield, S.A., Stampfer, M.J., Giovannucci, E., & Chan, J.M. (2011). Physical activity and survival after prostate cancer diagnosis in the health professionals follow-up study. Journal of Clinical Oncology, 29(6), 726-732. https://doi.org/10.1200/JCO.2010.31.5226

Research Accountability and Grant Management

Ioannidis, J.P.A. (2011). More time for research: Fund people not projects. Nature, 477, 529-531. https://doi.org/10.1038/477529a
Alberts, B., Kirschner, M.W., Tilghman, S., & Varmus, H. (2014). Rescuing US biomedical research from its systemic flaws. Proceedings of the National Academy of Sciences, 111(16), 5773-5777. https://doi.org/10.1073/pnas.1404402111
Lauer, M.S., & Roychowdhury, D. (2021). Inequalities in the distribution of National Institutes of Health research project grant funding. eLife, 10, e71712. https://doi.org/10.7554/eLife.71712

Policy and Historical Context

National Academies of Sciences, Engineering, and Medicine (2024). The Future of U.S. Biomedical Research. Washington, DC: The National Academies Press. https://doi.org/10.17226/26920
Bush, V. (1945). Science—The Endless Frontier: A Report to the President on a Program for Postwar Scientific Research. United States Government Printing Office. https://www.nsf.gov/about/history/endlessfrontier.jsp
American Association for Cancer Research (2025). AACR Cancer Progress Report 2025. https://www.aacr.org/
National Cancer Institute (2024). Annual plan and budget proposal for fiscal year 2025. https://www.cancer.gov/about-nci/budget

Patient Advocacy and Support

ZERO Prostate Cancer (2025). Advocacy and research programs. https://zerocancer.org/
Us TOO International Prostate Cancer Education and Support Network (2024). Programs and services. https://ustoo.org/
Patient-Centered Outcomes Research Institute (PCORI) (2024). Engagement in research. https://www.pcori.org/engagement

Legal and Congressional Actions

U.S. Congress (2025). Fiscal Year 2026 appropriations bills. https://www.congress.gov/
Various federal court decisions (2025). Cases restoring terminated grant funding. [Multiple district court rulings]

Note: This article is based on publicly available information, investigative reporting, peer-reviewed research, and policy analysis. Patients should consult with their oncologists and care teams about their individual treatment plans and participation in clinical trials. Research funding situations continue to evolve, and readers should seek updated information from their patient advocacy organizations and the NIH website.

About This Series: This article is based on reporting from STAT's 10-part investigative series examining the 2025 disruptions to federal research funding and their implications for American science and medicine, supplemented with additional research into pharmaceutical economics, charitable giving trends, research accountability mechanisms, and prostate cancer-specific research priorities.

Disclosure: The author has metastatic castration-resistant prostate cancer and has direct interest in the continuation of both commercial and non-commercial research into affordable treatment options. The author is a member of the Informed Prostate Cancer Support Group (IPCSG).