An Insider’s Guide to Choosing a Cancer Charity

Note: This article first appeared on Medium in 2017.

You want to make a difference in the fight against cancer. You are motivated enough to volunteer your time or make a donation, but where do you begin? There are scores of cancer-related organizations all claiming to do important work. So how do you choose?

This isn’t a stinging expose about waste, fraud, or scandal. It’s a practical tip sheet from a 30-year veteran fundraiser and nonprofit marketing professional, offering you an insider’s take on the vast network of cancer charities.

I began my career in the nonprofit sector straight out of college in the late 1980’s doing grassroots fundraising in rural Tennessee for the American Cancer Society. It was a fascinating introduction to the world of charities. One of my volunteer groups would meet monthly at a meat-and-three restaurant in the town square in Centerville, TN. The chapter president would call the ACS meeting to order by instructing members to put out their cigarettes. I learned quickly to place the most important items at the top of our agenda, because when someone in the group starting jonesing for a smoke, the meeting would abruptly adjourn. This little chapter would organize a variety of fundraisers to benefit the ACS, from producing local talent shows to canvassing door-to-door. They would work their tails off and donate about $5,000 per year to the cause.

A few years later, I witnessed the extreme opposite in philanthropy. I was working for the Vanderbilt Cancer Center when the Ingram family, a prominent force in Nashville, steered a sizable portion of their historic $300 million charitable gift to Vanderbilt University in our direction, resulting in a name change for the center: the Vanderbilt-Ingram Cancer Center. At that time, the Ingram’s donation was the largest single philanthropic gift ever given to higher education.

At the helm of Kent Creative, my small firm in Nashville that specializes in fundraising marketing and communications, I’ve done creative and consulting work for a number of cancer-related organizations, like MD Anderson Cancer Center, the Aspen Cancer Conference and Gilda’s Club Middle Tennessee.

For three decades, I’ve been privy to the inner workings of cancer charities of all sizes and scopes. Tapping my personal experience, I want to help you make an informed choice about where to invest your resources — whether that be in time, talent, or monetary contributions.

When most people consider joining the fight against a disease like cancer, their first inclination is to give or raise money to support research for cures. Charities are quick to tell you that every research dollar counts, but you should be aware of how the medical research enterprise is funded before investing your hard-earned dollars.

Because cancer and other disease research is vital to our national interest and exorbitantly expensive, the federal government funds ongoing medical research through the National Cancer Institute (NCI), an affiliate of the National Institutes of Health (NIH). In 2017, the NCI’s cancer research budget was roughly $5.8 billion. Scientists from major research universities and private research institutes — like Harvard, the Salk Institute, Memorial Sloan Kettering Cancer Center, St. Jude’s Children’s Research Hospital, and many others — compete for NCI funding through a highly competitive, peer-reviewed grant process. The NCI ensures that our nation’s cancer research agenda has focus, continuity, and substantial resources.

MD Anderson Cancer Center in Houston, TX, is widely regarded as the top cancer center in the United States. Pictured here is Lauren Byers, M.D., a young physician-scientist I photographed a few years back.

When charities like the American Cancer Society or the Susan G. Komen Foundation raise money for research, it’s to provide supplementary funding to the same scientists supported by the NCI. Their aim is to jumpstart new lines of inquiry, support young investigators who are navigating the career hurdles of academic medicine, or spur other special research initiatives. Because research funding from private charities represents such a thin slice of the cancer research pie, these organizations must be highly strategic in how they leverage this investment. In 2017, the American Cancer Society contributed $151 million to cancer research — a mere drop-in-the-bucket relative to the NCI’s budget.

Does this make your donation to cancer research pointless? No. Your money can make an important difference, but you have to invest strategically. My advice is to contribute directly to the source. Invest where the research is actually happening — the research universities and private research institutes themselves. Skip the “middle men” the ACS and Susan G. Komens of the world, and avoid your gift being cannibalized by their administrative costs or other programmatic priorities.

Here’s why even small gifts to academic cancer centers can have big payoffs. While funding from the NCI may be robust, it is also highly restrictive. When a scientist has a bold, new idea, she typically cannot pursue it if it is outside the scope of her federal research grant. Discretionary funds — the kinds of dollars individual donors like you provide — are a precious commodity for academic researchers. These funds can be leveraged in many helpful ways, like fueling proof-of-concept work (or preliminary data) that later attracts big dollars from the NCI.

So if you want to donate straight to the source, here’s a list of NCI-funded cancer centers to choose from.

Another thing to bear in mind is that medical research plods along at a very slow pace. Cancer isn’t one disease; it’s more than 100 different diseases of varying complexity. Despite all of the hype you read online or see on television about new immunotherapies or CRISPR gene editing, new treatments and therapies evolve slowly over many years.

If you want to see your efforts make more of an immediate impact, you might want to consider supporting quality of life initiatives for cancer patients and their families — support groups, palliative care programs, pediatric cancer summer camps and other activities that make living with cancer a little easier. In 2014, there were 14.7 million Americans fighting cancer. Anyone familiar with cancer knows that it’s a disease that affects an entire family.

Quality of life programs are where the local or grassroots charities really shine. Whether you choose to provide funding, volunteer your time or do both, there are many opportunities to support these types of vital cancer programs in your area.

In terms of evaluating specific cancer charities, you might want to begin your search by consulting online charitable rating services, like Charity Navigator, but I would advise you to take their assessments with a fairly sizable grain of salt. These rating services employ strict formulas, and savvy nonprofits and their accountants know how to frame information to exploit the criteria. Specifically, they know how to deflate the apparent costs associated with fundraising and administration, since a nonprofit’s reputation for efficiency hinges mightily on keeping overhead percentages as low as possible.

If you want to really get into the weeds, you can pull up any nonprofit organization’s IRS form 990, which is a sort of tax return for nontaxable organizations. But again, be mindful that the numbers being reported may be misleading. A 2012 Scripps Howard News Service report found that almost half of all U.S. charities bringing in a million dollars or more in revenue reported zero fundraising expenses on their 990. This isn’t just implausible, it’s impossible. Nonprofit organizations are loosely regulated, mainly by their respective states, and seldom punished for “creative accounting.” A nonprofit’s 990 will tell you how much the top executive staff is paid, which can be a useful indicator of an organization’s values.

My advice is to explore your local, small to midsize cancer-related charities. Often times a hospital or cancer center’s social workers have valuable insight as to which organizations are providing the most helpful valuable services for the cancer community. Don’t be conned by the slickest website or brochure. Whenever possible, visit charities in person — set up a tour or talk with volunteers and staff — just to get a sense of the place and listen to your instincts.

If you find one you like, conclude a little test. Start with small donations or light volunteer work, and see how they respond. Are they good stewards of your time and resources? Do you receive timely acknowledgements of your gifts? Do they keep you adequately informed about how they are accomplishing their mission? If so, amp up your involvement accordingly.

Finally, if this all seems like too much work or you can’t seem to find the right charity for you, try GoFundMe or similar sites for medical crowdfunding. Search for a story that moves you and give directly to that individual. This is one of the purest forms of charitable giving available today.