1. Well actually how business changed at NCI when the War on Cancer passed is interesting. In 1971, I was Chief of Medicine at the time. I was taking care of the person, in about 1969, who was the lobbyist who worked for the philanthropist, Mary Lasker, and actually wrote the Cancer Act and actually picked the witnesses of it.
So I saw it being built. And like most of NIH I didn't like it; I thought it was intrusion and so forth. When it was passed, though, it changed the mission not only of the NCI but of the NIH. The mandate of the Cancer Act was to support research and the application of the results of the research to reduce the incidence, morbidity and mortality from cancer. The NIH never had had a mission beyond supporting basic research.
So all of a sudden we now had to look at the practical application of what was going on. It was not an easy thing to do and you know, everybody, virtually, was against it. If it wasn't for the fact that Mary Lasker and her friend Ann Landers could manipulate the public opinion superbly, the Act would never have passed.
Academia was against it, the NIH was against it, the AMA was against it. So it changed. It took a while for the changes to sink in but it changed immediately what the NIH was sort of expected to do and that was good in the end.
2. You hear about the War on Cancer not being a success. And you have to understand, and one of the reasons why I avoid criticizing any of my successors, is that when you're outside you don't have all the information. Critics tend to be devoid of necessary information. There was an article in Fortune Magazine not too long ago saying "War on Cancer a Failure" or "War is Being Lost". It was an interesting article except that in the first 10 pages everything was wrong.
The people predicted that cancer incidence and mortality would rise like a straight line right through the year 2000. Starting in 1990, cancer and mortality and incidence has come down every year about 1.2% per year and is starting to accelerate. So obviously the trend of rising incidence of mortality has been reversed, and that can be directly accounted for by the programs that were in the War on Cancer.
3. I reorganized the Institute completely. What I found was, I read the Cancer Act, and said "Here's what the Cancer Act said you should do." I looked at the Cancer Institute, and I said, "We don't look alike."
So I took the Cancer Institute and I shaped it the way it was supposed to be in the Cancer Act. There were many, many thrilling experiences along the way: developing the PDQ system, using supercomputers in research, all of which I had to fight a lot for with the NIH. NIH just didn't like any of these things. And when you won these battles it was really quite thrilling. We shaped, we shaped the cancer program and made an instrument to do what it was supposed to do.
The National Cancer Act of 1971 had a tremendous impact on the NCI. In terms of our own program, in a very practical sense, the budget increased very substantially, which meant that at least for a few years the number of compounds submitted for testing increased significantly.
And I think as a result of that there was an increase in the number of drugs that came through the screen and then were developed for clinical trials. An additional part of that Cancer Act effort included the establishment of laboratories and many facilities at Fort Detrick, which was converted from a biological warfare facility for the armynot completely, but certainly significantlyinto an arm of the National Cancer Institute.
And many of our activities were carried out in collaboration, together with the people at the Frederick facilities. As a matter of fact, when the in vitro screen, the 60 cell line screen was initiated in 1990, the screening was done in the laboratories at Frederick.
I think the Cancer Act really did allow the country and many organizations to begin to partner and to develop new strategies and new approaches to cancer research and ultimately develop new agents, and many of those of course began their development process in the '70s and many have them only reached the clinic in the late '80s and early '90s.
I think enabling the magnitude of development that we were able to do was a consequence of the National Cancer Act. Especially some of the screening and toxicology programs and drug development programs that were actually unique to the NCI in the '80s especially were very, very important in terms of developing new drugs for cancer.