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So there are a lot of problems connected with this, and I should like to assure you gentlemen who have rendered such a great service to us today in coming here at such great inconvenience to yourselves that this committee is conscious of a lot of these problems and is endeavoring to give them its best consideration with the hope that some day maybe we will be able to give the relief that so many of us feel should be granted.

Dr. Wright, speaking to you and to each of the others who has appeared here today I do not know how to find words which will adequately express our feelings of thanks and appreciation to you and those who have assisted you today in presenting this matter to this committee. You have performed not only a fine service to the profession that you honor but you have performed, in my opinion, a very fine patriotic service in your willingness to come here and give this committee the benefit of your thought in these matters. It is for that reason that I feel that any words I can utter are very inadequate in expressing to you and those who have come with you our thanks and our appreciation for the help you have given to us today.

I do not want to preclude anybody else from saying anything they wish or asking any questions they wish, but I did want to have you know, speaking not only for myself but for the committee, how much we appreciate the help you have given this committee.

Dr. WRIGHT. May I reply by saying we have been very deeply appreciative of the fine spirit of friendship and kindness with which you have received what we have had to say. I have been in many hearings here, but I must say that our reception today is an all-time high in that regard. It has been very fine, and I am sure we are all very grateful indeed.

The CHAIRMAN. Any further comments or questions, gentlemen? Mr. CARLYLE. Mr. Chairman, I would like to say that the hearing today has been very, very wholesome and helpful.

The CHAIRMAN. I am glad to hear it. I am sure that is true with all of us.

Is there anything further? Well, then, I suppose that concludes the hearing on heart disease for today. It may be that we will be calling for some additional service, especially from some committees that you may have at work who can give us answers to some questions which may arise in our minds as we go on with this study the next 2 or 3 weeks; and I am certain you will be glad to help us in that respect. Dr. WRIGHT. I am sure that the American Heart Association and all of its facilities are at your service, sir.

The CHAIRMAN. Thank you. I hope we have not kept anybody from keeping his transportation assignment.

Dr. WRIGHT. I think not.

(Thereupon, at 4: 10 p. m., Thursday, October 1, 1953, an adjournment was taken until 10 a. m., Friday, October 2, 1953.)

HEALTH INQUIRY

(Cancer)

FRIDAY, OCTOBER 2, 1953

HOUSE OF REPRESENTATIVES,

COMMITTEE ON INTERSTATE AND FOREIGN COMMERCE,

Washington, D. C.

The committee met pursuant to adjournment at 10 a. m. in the committee room of the House Committee on Interstate and Foreign Commerce, Hon. Charles A. Wolverton (the chairman), presiding.

The CHAIRMAN. The committee will come to order.

This hearing has been arranged for the purpose of reviewing and considering the progress that has been made in the investigation and control of cancer. This is one of the most serious diseases with which the human race is afflicted. I am told that it is the second leading cause of death from disease in the United States; second only to heart disease, which we discussed yesterday. This committee intends to find out what has been done about cancer in the past, where we stand on this problem today, and what can and should be done from now on in order to achieve effective control of this disease in the shortest possible time.

We

The members of this committee are not medical scientists, nor are they engaged in any other way professionally in cancer work. have, therefore, called upon a number of eminent people in that field to tell us what is being done about cancer and to consult with us and advise us on this problem as one of common concern which affects all of us individually either directly or indirectly.

These people are scientists, public health administrators, physicians, and lay professional workers in both Government and voluntary agencies and organizations. This is their work, and they are best equipped to tell us about it. During the time available to us today the committee is looking forward to having an intensive discussion on all aspects of the cancer problem. We want to know what the magnitude of the problem is, how many people get cancer, what the financial drain is on the families of cancer victims, and what this means to the Nation in terms of lost production. We want to know what is being done to discover cancer cases early enough to treat them successfully, and what progress has been made in methods of treatment. We would like to know whether cancer can be prevented, and how. We want to hear the story of cancer research by both Government and nongovernment institutions, organizations, and individuals; and what the prospects are for learning more about this disease and developing better methods of dealing with it.

The various organizations invited to be represented here today have prepared written statements, copies of which are available to

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the members of the committee, the press, and those in the audience who would like to have them. At this time I would like to have these statements officially entered in the record of the hearing.

(The statements referred to appear at appropriate points throughout the testimony.)

The CHAIRMAN. The committee has prepared a broad agenda covering cancer, as a guide to our discussion. Copies of this agenda are available to the participants in the hearing, and they have indicated their willingness to discuss the various subjects covered by it. At this time I wish to have the agenda and the list of witnesses entered in

the record.

(The information is as follows:)

AGENDA FOR THE HEARING ON CANCER-HOUSE COMMITTEE ON INTERSTATE AND FOREIGN AFFAIRS

I. Introductory remarks by the committee chairman.

II. Why cancer is a major public health problem in this country.

A. What it is, the nature of this family of diseases.

B. Who gets cancer? How many people are under treatment for it now? How many new cases this year? How many people will die of cancer in 1953? The rise of the cancer death toll during recent years? The outlook for 1965 or 1975?

C. What are the most frequent types of cancer in men, women, and children?

D. What is the cost of cancer illness to the Nation in loss of productive manpower, to communities in financial aid to families and provision of hospital care to families?

III. What is available today in the way of treatment, diagnosis, and prevention?

A. What are the accepted methods of treatment? Are many cancers cured by them? Are there any wonder drugs that can be used against cancer? Or any products of atomic-energy research? Where do we stand with regard to X-ray, radium, surgery, drugs, synthetic hormones? availability of cancer clinics?

In

B. What can doctors do now to detect cancer early? How good are present methods? Is there a reliable blood test for cancer? Where do we stand in

The detection of cancer by physical examinations, X-ray, specific tests, radioactive isotopes.

The development of blood or chemical diagnostic tests.

The use of detection centers.

Educating the public and the doctors, dentists, and nurses to the importance of early diagnosis and prompt treatment of cancer.

C. What can be done now to prevent cancers? In industries where workmen may be exposed to cancer-causing hazards? By adequate handling of precancerous lesions?

IV. What resources of skilled personnel, facilities, and funds are being devoted to the nationwide attack on cancer? What are the cooperative relationships among the various groups working in the cancer field? How are the different activities coordinated?

A. By private and voluntary organizations at the community, State, and national levels (American Cancer Society, Damon Runyon Fund, American College of Surgeons, American Medical Association, medical schools, hospitals).

B. By governmental agencies at the community, State, and national levels (State health departments, the National Cancer Institute, Atomic Energy Commission, Veterans' Administration, Department of Defense).

V. As a whole, what are the interested groups and agencies doing to improve treatment, diagnosis, and prevention of cancer?

A. In fundamental research on the cause and development of cancer? On the role of heredity, viruses, diet, various factors in the human environment? B. In clinical and basic studies to improve the treatment of cancer by the different kinds of radiation, by surgery, and by anticancer drugs and hormones?

C. In learning more about preventing cancers through studies of materials used in certain industrial processes, experimental production of cancer in animals, and of the relationships between human cancers and factors such as race, marital customs, age, and sex?

D. Through provision of skilled scientists needed to carry on research and physicians with special training to treat cancer patients?

E. To provide hospitals, clinics, or centers properly equipped to treat cancer patients and to do the necessary diagnostic procedures?

VI. What are the recommendations for strengthening the attack on cancer? A. In research, both laboratory and clinical?

B. In maintaining an adequate supply of scientists and physicians?

C. In education of physicians and members of allied professions? In public education?

D. In State and community programs?

E. In improved medical practice and medical facilities?

PARTICIPANTS

Dr. John R. Heller, Director, National Cancer Institute, Bethesda, Md.

Dr. Charles Cameron, medical and scientific director, American Cancer Society, New York, N. Y.

Dr. Cornelius P. Rhoads, scientific director, Memorial Center for Cancer and Allied Diseases, New York, N. Y.

Mefford R. Runyon, executive vice president of the American Cancer Society, New York, N. Y.

Dr. Paul L. Wermer, secretary, committee on research, American Medical Association, Chicago, Ill.

Dr. Sidney Farber, scientific director, Children's Cancer Research Foundation, Boston, Mass.

Dr. R. Keith Cannan, Chairman, Division of Medical Sciences, National Research Council, Washington, D. C.

Dr. G. Burroughs Mider, Associate Director in Charge of Research at the National Cancer Institute, Bethesda, Md.

Dr. Ralph G. Meader, Chief, Research Grants Branch, National Cancer Institute, Bethesda, Md.

Dr. Ira T. Nathanson, Chairman, Committee on Cancer Diagnosis and Therapy, National Research Council, Boston, Mass.

Mr. John Teeter, Damon Runyon Foundation, New York, N. Y.

Dr. Antonio Rottino, director of laboratories, St. Vincent's Hospital, New York, N. Y.

The CHAIRMAN. Because much of what we will hear today will be of a technical nature, the discussion can better be led by one of our experts than by the committee. I understand that Dr. John R. Heller, Director of the National Cancer Institute of the United States Public Health Service, will act as discussion leader for this hearing. Dr. Heller, I wish that you would kindly proceed to outline for us in more detail the plan of our discussions, and introduce those who are going to participate. I hope that you will feel free to direct the course of these discussions in such a way as to bring out the maximum amount of information within the limited time at our disposal. Members of the committee will, of course, have questions to ask from time to time. Dr. Heller, we would like you to take over at this time; and I would like those who are here to participate with you in this discussion this morning to realize that the committee greatly appreciates your presence, the thought and the attention that you have given to this matter, and your willingness to be present to assist the committee in what it considers this very important work that it is seeking to do with respect to the diseases that are common to our people and leading particularly and finally to how it will be possible through congressional action or otherwise to be helpful in the general progress of the work that is being done to relieve our people from this great disease.

We thank you for your presence. We know it has been a great inconvenience to your folks to come. All of you are busy individuals. For that reason we appreciate all the more the fact that you are here and willing to give of your knowledge, study, and experience to this committee in this important matter.

Dr. Heller.

STATEMENT OF DR. JOHN R. HELLER, DIRECTOR, NATIONAL CANCER INSTITUTE, BETHESDA, MD.

Dr. HELLER. Mr. Chairman and members of the committee, participants and gentlemen, this group represents the people who are charged with the responsibility for administration and execution of programs of cancer control and cancer research.

I should like to introduce the members of the panel and I should like each to rise, state his name, his official position, his activity with the organization with which he is connected, and any other pertinent data which the committee might find helpful.

I should like to start on my left with Dr. Rottino.

The CHAIRMAN. Will you give the name in full, please.

Dr. ROTTINO. Antonio Rottino. I am the director of laboratories and pathologist for the St. Vincent's Hospital in New York City. I am also director of Hodgkin's research at that institution. I come as one of the representatives for the Damon Runyon Foundation, being a member of the advisory committee.

Dr. HELLER. Dr. Charles S. Cameron.

Dr. CAMERON, I am medical and scientific director of the American Cancer Society and am clinical assistant surgeon at the Memorial Hospital and the James Ewing Hospital in New York City.

Dr. HELLER. Dr. Keith Cannan.

We

Dr. CANNAN. I am Chairman of the Division of Medical Sciences of the National Research Council. As such, the National Research Councils holds a general watching brief on research in general, and the Division of Medical Sciences on research in the medical field. represent the major scientific societies of the country. We have a particular interest in cancer because we are adviser to the American Cancer Society on its program of research.

Dr. HELLER. Dr. G. B. Mider.

Dr. MIDER. I am Associate Director in Charge of Research at the National Cancer Institute. With the key members of the staff I am responsible for the program of intramural research within the organization.

Dr. HELLER. Dr. Cornelius P. Rhoads.

Dr. RHOADS. I am the scientific director of the Memorial Center for the Treatment of Cancer and Allied Diseases in New York City; director of the Sloan Kettering Institute for Cancer Research, the research division of that hospital; and professor of pathology at Cornell University College of Medicine.

Dr. HELLER. Mr. Mefford Runyon.

Mr. RUNYON. I am the executive vice president of the American Cancer Society; the only layman, I believe, who so far has been. introduced.

Dr. HELLER. Dr. Sidney Farber.

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