NEW YORK, N. Y., June 29, 1946. JULIUS JAY PERLMUTTER, Chairman, Sponsors of Government Action Against Cancer, Shoreham Hotel, Washington, D. C.: I regret that I am unable to appear at the hearings being conducted on the Neeley-Pepper cancer bill. Press of work makes that impossible, but the aims of this legislation are so important and urgent that I can assure you that our organization fully supports those aims and purposes. We particularly favor the size of the appropriation as a minimum. We feel this is such important work the sum will not be enough, but will be a start. We favor the bill because of its simplicity and the fact that it allows the President to appoint an independent commission fully representative of all groups to carry out purposes of the bill. The importance of solving the cancer problem makes it necessary for all to advocate passage of this legislation as rapidly as possible without any confusing or crippling amendments. You may be assured of our continued support in every way possible for the passage of this very excellent legislation. JOSEPH CURRAN, President, National Maritime Union. Mr. JULIUS JAY PERLMUTTER, New York, N. Y. BEVERLY HILLS, CALIF., June 26, 1946. DEAR MR. PERLMUTTER: Replying to your telegram of June 24, 1946, regarding the Neely-Pepper cancer bill. I wish to state that prevention and cure of cancer can be accomplished if sufficient funds can be appropriated so that the best investigative minds can be employed for its study. I am in favor of a bill such as the Neely-Pepper cancer bill if funds can be appropriated for research and study. I favor the appointment by the President of the United States of a new and independent commission representative of all interested groups and individuals to plan such an undertaking and to its com pletion. I also favor that the bill be reported out quickly and favorably. The study of cancer should be undertaken by pathologists, biochemists of scientific integrity and judgment, and should not be hampered by financial limitations. I regret that it is impossible for me to accept your invitation to personally appear before the Senate Foreign Affairs Subcommittee hearing on the Neely-Pepper cancer bill. Yours very truly, MAURICE A. BERNSTEIN, M. D. NEW YORK, N. Y., June 27, 1946. JULIUS J. PERLMUTTER, Chairman, Sponsors of Government Action Against Cancer, New York, N. Y.: Illness prevents my making the trip to Washington to testify in favor of immediate passage of Pepper-Neely bill. May I, as a member of Sponsors of Government Action Against Cancer, ask you to state on my behalf for the record (1) that I favor the appropriation of 100,000,000 as a minimum fund cancer research; (2) that I favor the enactment of the bill in its present simple form without complicating amendment; (3) that the intent of the bill be clear in its authorization to the President of the United States to appoint a new and independent commission representative of all interested persons and groups. I personally feel that when such a method of research is adopted we are certain to make more progress in a few years than we can now in 20 or even 50 years. LADY MARGARET ARMSTRONG, President of Ladies of Catholic Charities, New York City. STATEMENT ON THE NEELY-PEPPER CANCER BILL BY JOHN W. WINGATE, HEAD OF THE DEPARTMENT OF RETAILING, WASHINGTON UNIVERSITY, ST. LOUIS, AND NEWLY APPOINTED PROFESSOR OF BUSINESS ADMINISTRATION, COLLEGE OF THE CITY OF NEW YORK May I add my voice in urging that the Neely-Pepper cancer bill be reported favorably to the Senate, immediately and unanimously. The cost of less than $1 per capita is the minimum that should be appropriated for this organized fight on a disease that has caused much more misery than war. Our success in solving the problem of the atomic bomb, when the entire resources of science and industry were mobilized under national leadership, gives good reason to believe that the cancer problem can also be solved, if similarly attacked. The simplicity of the present bill is to be especially recommended, in that the details of administration and execution will be in the hands of an independent commission, representative of all interested groups. Complicating amendments should be avoided so that the commission may not be handicapped in taking any action that in its judgment may lead to a solution of this major social problem. There is no matter involving the public interest that will bring more lasting recognition and acclaim to the Congress than the application to this major problem of the biological sciences the same techniques used in solving the major problem of the physical sciences. The country not only wants this program but as the Gallup poll reveals is also willing to pay the cost for an all-out fight against cancer now. WRITTEN EXPRESSIONS ON THE S. 1875 BILL, BY IRA I. KAPLAN, M. D., DIRECTOR, RADIATION THERAPY DEPARTMENT, BELLEVUE HOSPITAL: CLINICAL PROFESSOR OF SURGERY, NEW YORK UNIVERSITY MEDICAL COLLEGE, NEW YORK, N. Y. I am a clinician actively engaged for the past quarter of a century in caring for and treating cancer patients, therefore, my recommendations are not based on hearsay or theory but upon solid facts experienced in my daily work. The cancer section of Bellevue Hospital, the largest municipal hospital in the world, has been under my jurisdiction for over 20 years. This has permitted me to see patients previously treated or cared for in practically every hospital of the city or by physicians throughout the country. Several thousand patients pass through our service yearly and based on the knowledge acquired from caring for them I have formed the following conclusions: Cancer is no longer a local, private, or municipal responsibility; it is a national burden. Funds available for cancer have always been inadequate and divided in such manner as to inhabit coordinated effort. As a remedy the proposed national cancer bill offers a beginning toward a real effort proposing the greatest possibility of producing results. I do believe if a group of trained scientists are mobilized in a coordinated effort to attack the cancer problem, we will see the achievement we have all been looking forward to. As I already stated, I am a practical clinician mainly interested in practical matters associated with the active care and treatment of cancer and so I am anxious that certain conditions be provided for in the implementing of the cancer bill. Millions of our citizens are preyed upon by medical quacks of all sorts, but in no field of disease is their activity so pitifully scandalous as in cancer. But how are the poor victims to know whether a supposed cancer remedy is safe and effective. I suggest that under the cancer bill there be set up an organization that shall investigate proposed cancer cures and to make definite pronouncements as to the worth of all remedial methods to the public for cure of cancer and to have the power to ban all fraudulent propositions. All too often because of the blandishments of quacks proper care is delayed and even avoided beyond the time when acknowledged therapeutic measures are possible and in some instances this has been the direct cause of the victims death. One of our most difficult problems is the caring for chronic cancer patients, especially those in the middle-class economic level. With few exceptions the homes and institutions under voluntary auspices refuse admissions to applicants suffering from chronic illness such as cancer. Over one-third of all chronically ill cancer cases are receiving totally inadequate care, and only about one-fifth receive a modicum of efficient care. The governmental agencies as at present constituted offer little more. I propose that under this bill provision be made to care for in a proper manner the chronically ill cancer patient in centers especially established for this purpose throughout the country, the cost to the patient to depend upon his economic ability to pay. Cancer care and treatment is costly and uses up no matter what accumulated savings a victim and his family have. Only under a sympathetic Government agency can hopeless cancer victims receive humane and hygienic care until the Lord sees fit to end their misery. One further point. To seek the cure of cancer we should know its cause. This requires intensive research by trained scientists and clinicians whose coordinated efforts are left untrammeled by the absence of worry about economic security. If As you also no doubt know, cancer is best controllable in its early stage. we can have some means of early diagnosis, some test that will enable us to recognize the earliest signs of cancer or the possibility of cancer development, then we can defeat cancer. Combined concentrated efforts of a group of trained scientists unworried by economic factors under Government auspices will provide the certainty of such achievement. In this care and treatment aspect of cancer social service is a real necessity. Providing for a national social service and visiting nurse department, covering the care of patients and their families throughout the Nation, will be of immeasurable aid in relieving the misery usually associated with cancer. Supplies and dressings are costly where cancer is concerned. National provision for the victims worthy of charitable assistance is necessary. This, too, should be included in the provisions of this bill. To sum it all up, if we are to succeed in conquering this dreadful cancer scourge a coordinated effort is necessary under national auspices. The appropriations should be made without restrictions so that actual work can be carried on unrestrained by rules and regulations, aid given unstintingly—— used when and if needed-at once or over a period of time, depending on the exigencies of conditions determined by a group of selected scientists chosen for their knowledge and experience in cancer. I trust this explains to you my thoughts in this worthy matter. It is along the lines of action proposed by the Sponsors of Government Action Against Concer, with whom I associate myself for support of the cancer bill now before your committee. I hope that this data will help you decide to act favorably on the S. 1875 bill, which I am convinced is one of the most worth-while life-saving acts possible for the Government to carry through. The objectives of any cancer-control program are the cure of existing cancer and the prevention of cancer. To realize these objectives, a completely integrated program including hospitalization facilities, approved tumor clinics, tumor diagnosis service, detection clinics, an educational program, research into the causes of the disease, improvement of methods of diagnosis and treatment, and statistical studies is necessary.' STATEMENT ON THE NEELY-PEPPER BILL SUBMITTED BY WALTER P. REUTHER, I should like to express my appreciation, on behalf of the organization which 1 represent, the UAW-CIO, for the opportunity to record our approval of the Neely-Pepper bill. The objective of this bill, the establishment of a centralized investigative agency for the study of the prevention and cure of cancer, merits the support of every serious-minded individual. The United States today is scientifically the most advanced country in the world and our technologic proclivities have culminated in the development of the atomic bomb, the most destructive weapon known to man. It is only fitting that we direct our scientific genius now against the nonhuman enemies of mankind. Cancer is second only to heart disease as a cause of death in the United States, being responsible for the deaths of more than 150,000 Americans annually. The UAW-CIO, being a progressive and democratic organization, desires to lend its support to this bill, primarily because of its potential benefits to the health and welfare of the world at large, and secondarily for reasons that affect our membership more directly. The vast majority of cancer deaths occur in people beyond 45 years of age, and the average age of the industrial worker today is much greater than in past generations, because of two factors: 1. The increased life span made possible by advances in preventive medicine and hygiene, as well as new therapeutic discoveries; and 2. The influx of older men into industry to replace the men who were required for our armed forces. Another aspect of particular interest to us working in industry is the occurrence of occupational cancers due to exposure to carcinogenic chemical or physical agents. However, such exposures are relatively rare in the automobile industry, and the major reason for our desire to lend our support to this bill is, as I said, the protential promise it holds for the good of mankind. Man is an ambitious and a reasoning animal and the fatalistic philosophy of the inevitability of disease, degeneration, and destruction is abhorrent to most of us. The unprecedented advances in medical and allied sciences made during this century in the prevention and treatment of infectious diseases, and in noninfectious disorders such as pernicious anemia and diabetes hold forth promise of still further progress in the years to come. There have been unverified news reports of the development of sera which may increase the human life span to 150 years. Such reports may seem fantastic today, yet our present life span and scientific advances would have seemed just as fantastic to the medieval mind, and it is encouraging to us that science is not dismayed by the mysteries of the degenerative diseases or of cancer. During the past few decades, we of the general public have been extensively educated with respect to the recognition and dangers of tuberculosis, yet, in our own State of Michigan, there are 35 deaths from cancer for every 10 deaths from tuberculosis. During the past few years, public health agencies and other community-minded groups have attacked the problem of cancer control by (1) a program of education of the public and of the medical profession with respect to the early recognition and nature of cancer and (2) by improving the fcilities available for early diagnosis and treatment of cancer. Such an approach, although of great public health value, does not attack the root of the problem, which is to find the cause and/or the adequate treatment for cancer. The words "and/or" are used advisedly, for if the cause can be found, then perhaps cancer may be prevented; however, the determination of the cause is not necessarily a prerequisite for finding a cure, as we may see by analogy with diabetes, where medical science has found an adequate treatment (insulin) although the cause is as yet uncertain. There are several features of the Neely-Pepper bill that we believe are particularly meritorious. The first is the simplicity of its wording, permitting the President to use his discretion in choosing capable experts to organize and administer efficiently the program proposed. The second feature is the provision for Federal support of research. We believe that the Government should subsidize research in scientific problems which are relevant to the national health and welfare, and certainly cancer is such a problem. No one will deny the valuable work in cancer research performed by such agencies as the National Cancer Institute in Washington, the Memorial Hospital in New York, and others, but such research is not centralized except within the confines of the institution from which it emenates, and there is naturally a great deal of duplication of equipment and work, much of which is probably unnecessary. Then, too, scientists are subject to the same failings as the rest of humanity, and progress in research may be impeded by almost chauvinistic adherence to the tenets of their particular university, or hospital, or group. The scope of the cancer problem is so tremendous that a solution must be approached with the same magnitude of efficiency and organization which produced the atomic bomb. The mobilization of the world's outstanding experts on cancer for an independent coordinated attack in the problem is a proper approach. Because of the pyramiding of technical knowledge, collaboration will be necessary among clinicians, surgeons, biologists, chemists, physicists, statisticians, and technicians. Under expert guidance, the various facets of the cancer problem could be studied with the efficiency which permitted the development of the atomic bomb, and at a mere fraction of the cost. The appropriation of $100,000,000 which the Neely-Pepper bill calls for is an inexpensive price to pay for the invaluable results which may follow. It is unfortunate that in the social amnesia which has afflicted civilization since the conclusion of the recent war, the demonstration of the feasibility of atomic energy sources has assumed more the threatening aspect of a Damoclean sword to the nations of the world than the aspect of promise for the welfare of the world which is inherent in the discovery. The solution of the cancer problem would have no such political reverberations, and the entire world would benefit thereby. In summary, then, the UAW-CIO favors the provisions of the Neely-Pepper bill, particularly its simplicity and the relatively small size of the initial appropriation. It is our hope that the committee will act on the bill favorably as soon as possible, without complicating amendments, to permit the President in the near future to esablish an independent commission of experts to solve the cancer problem. STATEMENT FOR THE UNITED STATES SENATE FOREIGN AFFAIRS SUBCOMMITTEE HEARINGS ON THE NEELY-PEPPER CANCER BILL, SUBMITTED BY VERN O. KNUDSEN, PROFESSOR OF PHYSICS AND DEAN OF THE GRADUATE DIVISION, UNIVERSITY OF CALIFORNIA, LOS ANGELES "And ye shall seek the truth, and the truth will make you free." This is one of the eternal verities-in religion, in government, in science, in all the ills that plague mankind. To seek, and find, the truth about cancer is our only hope for becoming free from this malignant disease. Fragments of that truth already have been found-the clinical and anatomical investigations of Virchow gave us our first accurate descriptions of the cellular pathology of cancer, and led to the classification of different types of cancer; the life-long and epochal studies of Maud Slye on the heredity of cancer in mice have given us a glimpse of the hereditary characteristics of cancer; cancer research laboratories in New York, Boston, London, Manchester, Heidelberg and Buenos Aires, and many smaller research groups or individuals, have revealed fragmentary elements of the truth about cancer. But, although we are on the way to the truth, we are yet a long way from the whole truth. The past and present progress in cancer research is calamitously slow and deplorably inarticulate. Coordinated team research, on a large scale, offers the surest and fastest means for finding the whole truth. The extraordinary success of this method recently was demonstrated in scores of difficult problems which were submitted by the Army or Navy to the Office of Scientific Research and Development. At one time, nearly 3,000 scientists, engineers, and technicians in the OSRD, together with other large United States and British Navy groups, were working unitedly on one big problem-how to detect and destroy U-boats. Some 996 U-boats on the bottom of the Atlantic, according to a recent Navy announcement, are mute but potent evidence of the efficacy of large-scale, coordinated, team research. In the fiscal year 1943–44, the United States expended some $646,000,000 on war research, exclusive of a comparable amount expended for the atomic bomb. But this expenditure shortened the war, saved many lives, and was the best possible investment for making victory secure. How much worthier it would be to launch, whole-heartedly and on a similar scale, our research resources on the conquest disease. If you inquire respecting the peacetime benefits of the large research program during the war, you will find, no doubht, that, apart from the winning of the war, more benefits are likely to come from the researches in the life and medical sciences than from those in the physical sciences. The efforts of physicists, chemists, and engineers have been largely directed toward the development of destructive weapons; the efforts of biological and medical scientists, on the other hand, have been devoted to such life-saving discoveries as blood plasma, penicillin, DDT, antimalarial drugs, means for controlling infectious diseases, new surgical techniques, improved artificial arms and legs, and scores of other discoveries or improvements that will save lives, alleviate pain, and promote better health and happiness. I believe it is no exaggeration to say that at the end of this war, and as a result of these extraordinary discoveries, hundreds of thousands of our fighting forces are alive and restored to normal health who otherwise would have died from wounds or infectious diseases, or would have been maimed, deaf, blind, or otherwise permanently disabled. It is not improbable that in 5 years from now, as a result of these researches and developments, which were great'y accelerated by reason of the war (which offered for the first time generous sup |