At the time, Dr. Elizabeth Jaffee didn’t worry much.

The world-class pancreatic cancer researcher at the Johns Hopkins University had been through plenty over the years as she marshaled her team against a disease that kills almost everyone who gets it.

So in January, when she heard that President Donald Trump paused biomedical grantmaking, Jaffee thought the new administration was just gaining its footing. The directives, however, kept coming.

And soon, one hit home on the fourth floor of her Hopkins building in East Baltimore.

Cost cutters slashed so-called indirect funds attached to grants from the National Institutes of Health, the country’s main funder of biomedical research. The money — now the subject of an ongoing lawsuit by Hopkins and others — maintains the lab where Jaffee was developing a way to treat, and perhaps also prevent, pancreatic cancer.

At stake for Jaffee and her colleagues is about $20 million in annual grants for Hopkins’ researchers tackling pancreatic, colon and other cancers using immunotherapy.

“The biggest stress is that we are waiting for the hammer to hit us. We are all worried on a daily basis,” said Jaffee, the deputy director of Hopkins’ Sidney Kimmel Comprehensive Cancer Center. “I have never experienced this in my over three decades of working with government funding.”

Jaffee’s fears are rippling across campus. Ron Daniels, Hopkins’ president, wrote in a letter to staff and students last month that potential cuts could jeopardize Hopkins’ “research ideal.” Half of the university’s revenue comes from federal research dollars.

Millions in Hopkins NIH grants have already been canceled. On top of slashed indirect funding and grants to affiliated aid groups, total potential losses could exceed $1 billion.

Nationwide, the NIH has terminated about 30 cancer-related studies and thrown a wrench in the system for new grants. It also slashed 1,200 workers, including its own scientists working in cancer immunotherapy.

Despite the uncertainty, Jaffee still works to improve her promising, but experimental vaccine, which still needs federal approval. Jaffee worries that young scientists she has trained may be reevaluating their careers. She also worries about pancreatic cancer patients, most of whom die within five years and have few alternatives to medical trials.

“If our funding is cut, it will occur fast; these cuts are made in one day,” Jaffee said. “I would try to find funding for patients already enrolled, but this is not a certainty.”

Jaffee’s latest vaccine is in the first year of testing in people. She hopes it will prevent cancer in those at high risk, like a traditional vaccine, and treat those with late-stage cancer.

“We still haven’t shown it works in most patients,” she said “But we’re getting there.”

The money

Scientific discovery is costly but Jaffee is good at fundraising despite the long odds. Fewer than 10% of NIH applications are approved.

Her work comes with a big price tag. Intense data analysis costs $40,000 to $50,000 a patient, with the NIH covering half to three-quarters. Philanthropic groups help fill gaps, as does Hopkins, but neither can replace NIH funding.

With funding losses looming, Jaffee dropped her normal evenings of Pilates for off-hours meetings with cancer center colleagues.

They’ve brainstormed ways to belt-tighten: Could they share more lab and office space? Forgo more maintenance?

Plenty was already going undone in the cancer building and its brightly lit labs; no one remembers when most equipment was purchased.

Jaffee and the others approached the cuts scientifically, collecting and analyzing data to determine how much each cutback would save before presenting findings to Hopkins leadership.

Jaffee, once selected to work on former President Joe Biden’s Cancer Moonshot Initiative to cut cancer death in half, wouldn’t shy away from a challenge to save the vaccine.

The research

Jaffee has always had an aptitude for numbers.

In grade school, a female math teacher encouraged her. Reading the biography of Marie Curie, a two-time Nobel Prize winner for physics and chemistry, cemented her interest in science.

She joined Hopkins faculty in 1992 with her late husband, Dr. Frederick L. Brancati, a diabetes and obesity expert who led the Hopkins division of general internal medicine. In 2013, he died at 53 from Lou Gehrig’s disease. Jaffee believes he would have had better treatment options for the muscle-crushing disease if the Bush administration hadn’t restricted stem cell research in 2000.

It’s a “great example of how politics’ involvement in science prevents progress in deadly diseases.”

Jaffee’s 28-year-old twin daughters followed their parents’ lead: Francesca to emergency medicine and Madelena to cancer research like her mom.

Oncology research became Jaffee’s focus after a beloved uncle was stricken with cancer. A Hopkins colleague steered her toward pancreatic cancer, though she understood it would be tough.

Since then, she’s led a small army of scientists and students working to get the vaccine to market, first testing it on mouse cells and then with people.

Traditionally, pancreatic cancer treatment relies on surgery, radiation and chemotherapy, a toxic stew that makes people feel awful — and the disease nearly always returns.

Jaffee believes her vaccine is a better approach.

Immunotherapy trains immune cells around the cancers to attack them as foreign invaders, something the cells aren’t prone to do naturally. This was the basis for the first proposed vaccine.

It didn’t work for most people. So the team returned to the lab and added so-called immune checkpoint blockages. They stop proteins that interfere with the immune system’s fight against cancer.

And in the latest advance, they targeted an inherited gene mutation called KRAS found in most pancreatic cancer patients. Muting its effects can help tackle the disease earlier and keep it at bay longer.

Such slow but steady advances have attracted other consistent funding from the Lustgarten Foundation, a New York-based pancreatic cancer nonprofit.

Linda Tantawi, CEO, credits Jaffee for relentlessly pursuing new angles to advance the science that has lagged behind work against other cancers.

Tantawi calls her a “quiet hurricane.”

Dafna Bar-Sagi, chief science officer at New York University Langone Health and a professor of biochemistry and molecular pharmacology who has known Jaffee for more than two decades, said that Jaffee is more than a pioneer in the lab.

Jaffee is a “critical thinker pushing the frontier” to give people whatever she can now.

“She gives them 12 more months so they can see a grandchild born or a wedding of son or daughter, and that’s no small feat,” she said.

The patients

It’s just a gallstone.

That’s what doctors told 50-year-old Kathy Dowell was the cause of her itchiness and jaundice. Once in the operating room, her surgeon found something much worse — pancreatic cancer. And it was already spreading.

They sent her to Johns Hopkins Hospital, where specialists recommended an improved but still radical surgery to reorder her gut known as a Whipple, plus chemotherapy and radiation. Most people still die within five years.

That was 27 years ago.

Her survival came down to a couple of shots. She was patient No. 8 of 16 in a trial that included Jaffee’s initial treatment using a vaccine.

“I’d go every few months and then every couple of years and get a good scan,” Dowell, now 77, said from her Bowie living room. “I’d high-five my husband and we’d go to lunch.”

Newer vaccines have helped more people survive longer, and patients are lining up to get into the studies. Years ago, Jaffee appeared on the “Dr. Oz Show,” hosted by Dr. Mehmet Oz, Trump’s pick to head the Centers for Medicare and Medicaid Services. Afterward, her cancer center was flooded with 1,000 inquiries.

Dowell said she didn’t hesitate to join the trial. She was so sure she was going to die that she sewed a stuffed bunny for her 5-month-old granddaughter to remember her by.

Now each of her three granddaughters — and her new great-granddaughter — have a homemade bunny.

Dowell used to think a lot about beating cancer, But those thoughts faded as life went on. With threats to scientific research, she again is pondering her survival.

She worries about how the nation will grow the next generation of Dr. Jaffees.

“I think of all the people who could come up with the magic potions who may not get the [same] chance,” she said.

The stakes

While Jaffee worries about cost-cutting politicians in Washington, the next generation of scientists keeps watch over cell samples and patients in Baltimore.

Among them is Dr. Neeha Zaidi, who oversees the trial for those at high risk for pancreatic cancer.

One day last month, two graduate students peered into trays containing samples taken from Zaidi’s patients. They pointed to dark spots forming in shallow wells, the first signs, they said, that the vaccine was producing a lasting immune response.

Such trials were stopped during the coronavirus pandemic. The pause, Zaidi recalled, was an unfathomable letdown for patients who had hope each time they traveled to Hopkins, got a shot or gave blood.

“To disrupt the trials again, when we are getting closer and closer?” Zaidi lamented.

The future

On a recent Friday morning, Jaffee tried to lift the clouds hovering over an elite scientific corps and those who hope to join them.

She had helped lined up speakers for an annual gathering of researchers, all women, held this year at Hopkins for an audience including young scientists and students. The talks were inspirational, recalling achievements in both emotional and scientific terms. Mostly left out was mention of Trump’s cuts.

“It’s a rough year this year,” allowed Dr. Kimryn Rathmell, former director of the National Cancer Institute, before encouraging the group to continue equipping themselves and pursuing their ideas.

In a lobby after the half-day event, Jaffee checked her phone.

There it was: Someone texted a photo of hundreds from Hopkins rallying in Washington in support of science.

Jaffee smiled, and then paused.

“I don’t know if it will matter.”