The American Cancer Society stands ready to furnish you or your committee any additional information you feel may be needed for your consideration of this important measure.

Very truly yours,

JAMES S. ADAMS.
ALBERT D. LASKER.

Senator PEPPER. Now, Mr. Albert D. Lasker.

STATEMENT BY MR. ALBERT D. LASKER, MEMBER, EXECUTIVE COMMITTEE, AMERICAN CANCER SOCIETY, INC. (NEW YORK CITY)

Senator PEPPER. Mr. Lasker, we welcome your presence here. You have been one of the builders in this field-part of the generous and grand work that you are constantly carrying on; so we will welcome. your statement on the subject.

Mr. LASKER. The chairman of our executive committee has largely covered the ground, but I would like to give a little background as to the amounts of money that have been spent on cancer, why we believe there has not been more spent on cancer research up till now, and why the American Cancer Society has been able within the last 15 months to receive a million dollars a month from the American people. Had we asked for more, I am sure we could get more. I also want to cover why the American Cancer Society, though it has the largest pool of funds for cancer research in the world at this moment, heartily endorses the proposed Government effort. I will cover the last point, first.

The only way the American Cancer Society can really be fully successful is when there is no need for it any more; and the only way there will be no need for it any more is if the causes of cancer are discovered so that specific cures may be applied.

A Government fund of $100,000,000 appropriated here and now would give a capital acount that would justify men and institutions in dedicating themselves to this work in a way that they would not and could not, if they did not know that the funds were continuing and assured. A society such as ours cannot accumulate such capital funds. We need currently the moneys we currently raise, because we have to operate Nation-wide educational-lay and professional-programs plus extensive service programs in addition to our research program. For that reason we are strongly for this appropriation; furthermore, we are for it because the Government appropriation would be sufficient to draw in world-wide collaboration; in short, make a pattern for world-wide cooperation.

Now, the background that I want to give you is why Mr. Adams and the rest of us who are laymen feel we have a right to testify here, and why we have a right to make a suggestion for amendments to implement this bill to make it work.

Ι very briefly want to give you the history of how those of us who are with the American Cancer Society newly, in the last 18 months, came there. About 21⁄2 years ago a group of us who were interested in medical research of all kinds had some astounding statistics on the subject put before us, and strange as it may seem these statistics

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which obviously should have been in existence, had not been in existence before-to wit, for instance, in cancer, how much money was being spent in research? We were as amazed, as I take it you will be, when we tell you those figures were not collated in one place, and we all thought, all of us, that there were millions spent annually by foundations in cancer research. Much to our surprise, when we got the information together from all sources, the total amount spent in cencer research by private institutions, was found to be within $600,000 a year-not millions! What had been in everyone's mind was that there was for instance one foundation to whom a capital account of $2,000,000 had been left; but that would yield only at present interest rates, $60,000 or $70,000 a year less operating expenses; but in the general mind we were thinking of this $2,000,000 as being spent every year! That is where the confusion arose.

Senator GURNEY. Mr. Lasker, is that $600,000 a year?

Mr. LASKER. Yes, sir. Private funds spent on cancer research were about $600,000 a year.

Senator GURNEY. Is that all that has been spent recently, until you started in?

Mr. LASKER. Yes, until the American Cancer society went to the public for larger appropriations to include research.

There was also spent on cancer research in Government funds, or appropriated, approximately $500,000; but for pure basic research of which I am talking I do not know how much of the $500,000 was spent, because they had to have statistical research in other efforts which would come within the framework of a Government effort. But surely, with Government money and private money, there was not over a million dollars being spent a year-that would be the top-up until say 18 months ago or 2 years ago.

About a year before this our group went to see Dr. Rhoads, the director of Memorial Hospital, in New York, which has been mentioned often in this testimony, because it is the largest and oldest research hospital on cancer in America and, I believe, in the world. And yet I doubt whether at this time it has over 250 beds—maybe 300; I would not know for sure.

We found from Dr. Rhoads that this great research hospital known all over the world had at that time-which was approximately 3 years ago—an annual research budget of about $85,000. We laymen would have thought that it was $850,000. Since then, because of the awakening that has been given to the public as to the opportunity for cancer research, I am sure that the research funds of Memorial-though it has never received one dollar from the American Cancer SocietyDr. Rhoads having, to our view mistakenly, refused to take money from us, because he is also chairman of our committee on growthhave risen to many times that amount of money; Mr. Alfred Sloan, of the General Motors, alone, has lately given them $4,000,000 to extend their research operations-$2,000,000 for a research building and $2,000,000 for research work. Memorial has also raised over $3,000,000 in the last year from a campaign to the public.

After seeing Dr. Rhoads and others our group looked into the whole field as to why there had been this apathy and why there was not more money; and was there need and opportunity for the expenditure of more money? We found that within the last 10 years there had

been enough advances through this comparatively meager research and other work that would be normally done in unrelated fields (but still would give knowledge in this field) to hold forth the promise for the first time that there were enough leads that cancer research if attacked on a very large scale might bring forth results of a major nature. Therefore, the opportunity was wide open to any group of citizens to awaken the American public. It was not the men and women who reorganized the American Society for the Control of Cancer into the American Cancer Society so as to include a research program who are responsible that all this money was raised and given. The American people were waiting to give it. Any group could have gotten it, or any group of responsible people; but this was the only group who had voluntarily studied and gone into the matter with a view to finding what should be done.

The American Society for the Control of Cancer to which I have just referred had been in existence about 30 years. Two years ago our group went to them and found the society limited in funds, doing some good work on alleviation and education, with no great financial backing, but enlisting the work of many doctors and many women who were very dedicated. We made the proposal to them-their board consisted with two exceptions of doctors that if we would agree to finance a national campaign to raise money, would they be willing (a) to put the control of the expenditure of the moneys in the hands of laymen so that what the scientists initiated and did would be reviewed, because those who raised the money have to have the trusteeship and final responsibility for its expenditure; and (b) would they agree that, say 25 percent of the moneys raised should be spent on research. They did so agree, and I believe we have testified here at length on the results.

Well, we are the only group in the world-comparatively new at it, and our experience may not be much-but we are the only group in the world with a large sum of money to spend on cancer research. In 15 months, the percentage of money that we have raised that would go to research is something over $3,000,000. Taking the Government money and private money that was spent before in the same period, the total amount that would have been available was less than half; so that we have more than trebled the amount of money available for cancer research.

We thereupon, having the trusteeship of this money, studied the best way to expend it, and we arranged with the National Academy of Sciences, through its medical branch, to create a committee on growth, and to this committee on growth were called, as Mr. Adams has testified, 90 of the leading scientists of America to form themselves into panels. It is our experience there that led us to these amendments which are proposed.

We claim not that we are the wisest men, not that other people might not have gotten even more results out of what has been entrusted to us than we, but we claim we are the only ones who have had a wide experience in the expenditure of sums for research in cancer; and we know that, so limited is the number of scientists who can be called on in Cancer research that we must call in other talents in order to help multiply the facilities. For instance, this is a shocking fact, that in years there have been only 100 teachers of cancer turned out in the

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United States in our medical schools, and that of those 100, it just happens' they are practically all, if not all, from Memorial Hospital of New York.

The need for fellowships to educate experts is overwhelming; we feel that it requires not only that this money be spent by a commission composed of scientists, but that we also use the talents of men who have been experienced in great industrial researchthe same type of people that the Government called in all during the war to accomplish a purpose.

You will note in the amendments proposed for your consideration it says:

No funds made available under this act would be expended except with the approval of the Commission.

Well, whoever has the final say on the spending of the money is the "boss of the show" in any effort, anywhere, where money is involved.

Again, we take it that the type of people the President would appoint on such a commission would be such that no governmental department would interfere with its operations unless they were on very sure ground, and then that would not be interference; that would be constructive. But we, in the American Cancer Society, believe that all work, no matter whom you entrust it to, should be checked and double-checked-I mean, in this type of scientific work. Personally, I wish that there were some independent national health movement who would check on the work that we in the American Cancer Society do, because it is a purely arbitrary thing; even if vested rights do not come in, mistakes can be made.

For that reason, we feel very warmly that the type of amendments proposed is the best insurance that this money will be spent to the greatest advantage.

Senator PEPPER. Mr. Lasker, would you comment on Senator Neely's apparent fear that the bringing of the Public Health Service or the Surgeon General into this matter, although in a limited administrative capacity, would tend to strangle the widest latitude that the commission could have?

Mr. LASKER. For the commission to really accomplish its best purpose, you would be unable to get the best of America's experienced men at full time, for they are engaged full time in our leading hospitals and medical schools, whose vast existing facilities are at their disposal. You want the richness of their experience from the work they are now engaged in. You would have an eminent paid chairman and a paid technical staff subject to the commissions direction. Somewhere down the line there has got to be auditing, there have to be budgets, there have to be all details of stenographers and clerks. For that alone you would either create a new bureau or put it in an existing one.

The Public Health Service of the United States may not be the most perfect institution, or a perfect one; I would know nothing about that, but I do know that it has charge of the public health of the United States, and therefore we felt that these administrative things which would divert a commission should be in the hands of an existing agency. You will notice we did not provide that any member of the Public Health Service be on the commission. We

did provide that the Veterans' Bureau, for reasons given by Mr. Adams, be on the commission. The commission would be the body that made plans and programs and that saw to their carrying out. That is, they would not be a full-time paid body. Somebody has to look after these administrative details.

Furthermore, there is already in the Public Health Service a Cancer Institute, and it would be a duplicate work. You notice the Public Health Service really surrenders power. They do not get power, they surrender power over this to the commission; but it is very important that the commission have its time free to plan, to program, and to coordinate, for with the limited number of people trained in cancer research, and with the knowledge needed all over the world, there will be confusion, on the one hand, if there is bidding between different Government and/or private agencies for the same talent; on the other hand, maybe the commission would decide that it would be wise to duplicate work on certain phases of research in several places; maybe they would decide on certain things there should be no duplicate work. Their time should be free for that. I was, for one, deeply moved by Senator Neely's appeal, and there is nothing that he said with which I would not agree, excepting that I do not have his fears on the proposed amendments, for this reason: The President is very busy, there are a lot of things he has to look after, and he would have to give much time to study how this should be set upwhether it is a separate institution or whether the administrative end is in a bureau or a department of the Government, the commission is a Presidentially appointed one, and what it will accomplish and can accomplish is dependent on two things: (1) That they have the final say, and they alone, on the expenditure of money; (2) on the type of men the President appoints. If the right type of men are appointed, the commission will function in or out of a Government department. We merely say from our experience that in order to get the maximum results and in order to safeguard in every way what is done we believe the procedures proposed represent the best way to go ahead. I believe that if Senator Neely had time to study and review at length with us, he would see that we are after the same thing he is, only we want to make sure that it is done in an orderly way.

Now, Senator Neely estimated that in the past it cost $1,000 a year for a cancer patient in his last year, including funeral expenses. Present figures indicate that the average cost of all cancer cases is $1,000 per patient annually-that is taking in those who die, and those who do not. We have just made an appropriation in the American Cancer Society to make a study of this by taking care of a group and finding out what the actual figures are; but $1,000 is the generally accepted figure, I believe. Now, there are 500,000 sufferers from cancer, in addition to the 170,000 who die annually, so that taking the $1,000 figure you see we would get into astronomical figures as to what cancer is costing now-between 600 and 700 million a year. Surely no one will question that half a billion is the figure that it costs. But that half-billion does not take into consideration the economic loss; that figure does not take into consideration the emotional effect on the family. Cancer is acknowledgedly the second largest cause of death, but it is also acknowledgedly the No. 1 torturous killer. Not only the suffering of the patient, but the emotional upset to the