The squeaky wheel gets the grease, my fifth grade teacher, Mrs. Ehlers, used to tell us.

As I think about cancer research funding I find I have to add a corollary to that rule: When there are lots of squeaky wheels, your wheel needs a celebrity spokesperson.

After I wrote my blog this weekend about the politics and business of cancer I got to thinking about why some cancers get more attention than others despite their relative ranking in terms of incidence. Lung cancer, for example, has been the number one killer in cancer for years–and yet it finishes third in terms of how much the government chooses to spend on it.

A friend in one of my grief groups suggested a while back that lung cancer has a blame factor attached t it: you get it because you have knowingly engaged in a habit that clearly causes cancer, so therefore it is your fault if you get it. And I think there is some truth to that. But I also think some people believe in the myth of John Wayne–who was allegedly diagnosed with lung cancer in the early 1960s, had a lung removed, and lived a long, healthy, and active life thereafter–creating the illusion that people could routinely beat the disease.

Breast cancer, when I was much younger, was a disease no one talked about. If you got it you didn’t talk about it because–well–it meant talking about a very visible piece of female anatomy that was supposed to remain hidden and private.

Then Betty Ford, the president’s wife, was diagnosed with it–and she brought it all out in the open so that it was ok to talk about it. Her celebrity status had an influence, however, not only on the visibility and acceptability of the disease, but also on funding for the disease.

Colon cancer was another cancer no one wanted to talk about. Our awareness of the disease shot up significantly when Katie Couric lost her husband to the disease. That she then went on TV and had a colonoscopy on camera suddenly made it ok to talk about both the illness and the procedure. I remember the almost hushed and embarrassed terms with which my own doctor had brought up the subject with me a few years before. I don’t think things are the same today.

You can also see this in terms of pancreatic NETs with Steve Jobs. The few people who know about NEC beyond those who have it owe what little they know to his case. Unfortunately, the press has done poor work explaining Jobs situation. They hear the word pancreatic and think NEC is just another form of pancreatic cancer.

But the Jobs case has had a significant impact on the amount of coverage his form of NEC gets. Despite the fact Jobs’ form of NEC is among the rarest of the rare, there are as many pieces written in the popular press on pancreatic neuroendocrine tumors as there are on all the other forms of the disease combined.

And the end of neuroendocrine cancer is something I suspect most Americans would have real trouble discussing. Uncontrolled, frequent diarrhea that reduces one to the status of an infant is not something anyone wants to talk about. Menopausal women are embarrassed by their hot flashes–so anyone experiencing the flushing that goes with NEC–and most women will assume it is just another hot flash–will be just as embarrassed.

The fact that many cases go undiagnosed–or are misdiagnosed as menopause or anxiety driven digestive problems, or irritable bowel syndrome–doesn’t help much either.

I am neither rich nor a celebrity–nor was I married to one. I’m just trying to be a squeaky enough wheel that someday soon we will attract a little more grease–maybe enough grease that we won’t need a celebrity spokesperson.

Because I would not wish this disease on even one of them.