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Others who have been heard at these hearings are in a better position than I to testify concerning the type of agency which should be set up to administer and distribute the funds that are asked for in this bill. In cannot refrain, however, from adding a footnote to their more seasoned opinions. It is my impression that the purposes of the American people would be served best by concentrating cancer research in a few strongholds of science, rather than in diluting the effective force which $100,000,000 could exert in the fight against cancer. A sum of $1,500,000 might be allocated during the first year to each of 10 academic institutions or scientific organizations that are in a position to extend existing facilities to undertake this gigantic task. This money could be spent for setting up the proper physical facilities and scientific equipment and for engaging the well-paid services of competent research workers in biophysics, biochemistry, bioligy, bacteriology, immunology, and the neighboring sciences that have a bearing on this problem.

Funds amounting to $850,000 a year for a period of 10 years might then be allocated to each of these institutions in order to finance their projects on the gigantic scale that the situation demands. This action would have the effect of striking hard and often in a coordinated fashion at the very heart of the cancer problem.

There is an urgent need for taking action on the Pepper-Neely bills at this session of Congress. The history of the evolution of the Kilgore-Magnuson bill, which has our complete support, suggests the desirability of avoiding the many vicissitudes to which the various initial legislative efforts were subjected.

Senator Kilgore first introduced a bill for the mobilization of science in the fall of 1942. It appeared during a period of unprecedented national emergency. For this reason, as well as others which are now well known, the bill did not survive. It was not until 1945 that a number of other bills, S. 825, S. 1248. S. 1285, and S. 1297 were proposed in rapid succession for the same general purpose. The overlapping objectives of these four Senate bills necessitated their further study and coordination. It then took about 7 months or more to compose a bill that met with the approval of scientists, Government agencies, and a group of Senators actively interested in science legislation, and to get this bill, S. 1850, through committee. And now H. R. 6448 is delaying favorable action on S. 1850.

For similar reasons there could be comparable delays in the consideration of the Pepper-Neely bills. The experience which has been gained in preparing and perfecting S. 1850 should stand us in good stead now. A delay in acting on the Pepper-Neely bills must be avoided, if it is at all possible, because the need for legislation is imperative. Time passes all too quickly for those who feel the heavy hand of cancer.

It is well for us to think of death at the hands of cancer in terms of murder—not in the abstract as a disease which is fatal.

Cancer differs from all other afflictions of men. Cancer is a dynamic. living force that grows at the expense of the man, woman, or child of which it becomes a part. The only thing it lacks is the brain with which to plan its deadly advance. That is the edge we have on cancer,

if we will but use that brain without the handicaps that have fettered it heretofore.

In conclusion may I say that the foregoing is a summary of the formal statement which I have in mind. I shall be glad to answer any questions.

Senator PEPPER. Have you anything more to say about the exact organization? Have you any impressions of your own as to whether it should be a commission, the majority of which should be non-Government people, or the National Academy of Sciences functioning through its Research Council, or what?

Dr. FRIEDGOOD. I have given considerable thought to that particular

matter.

Senator PEPPER. Or should it be under the Public Health Service or the National Cancer Institute?

Dr. FRIEDGOOD. All of us, of course, have given a great deal of thought to that particular point, because the way the bill is administered, if and when it is passed, will mean the difference between success and failure. I hesitated to say anything about it during my statement, because this is a problem that requires a great deal of deliberation. I do not think any of us have thought that through adequately enough to make a final statement. But informally I would be very happy to tell you what I have been thinking, for what it is worth.

I certainly agree with General Bayne-Jones that it should not be put into the hands of any organization or group which now has a "monopoly" on scientific research. I think its purpose would be best served by arranging it so that the President can appoint a full-time administrator, preferably a layman, and the President should also appoint a board of 8 or 10 full-time leading scientists from all branches of science, and not be limited to cancer specialists, who would act as an advisory board. I am emphasizing the other deliberately, because the problem that we face is not one which will be solved by those who are entitled to call themselves cancer specialists. The problem will probably be solved by fundamental research scientists.

The chief administrator and this board of 8 or 10 scientists might then select a commission of approximately 60 specialists from all branches of science having to do with the various aspects of the growth problem. It might be well to point out that there are a great many capable scientists who would be especially qualified for those posts and who are not now in charge of the distribution of research funds from a variety of organizations who now control such matters.

I would personally vote against putting it under the National Research Council, for the reason that I have already stated.

Senator PEPPER. You will send in a more complete statement? Dr. FRIEDGOOD. Yes, sir.

Senator PEPPER. If there is anything further on that particular point or on any other point, we would like to have it.

Dr. FRIEDGOOD. Thank you, sir.

Senator PEPPER. Dr. G. Failla, director of Radiological Research Laboratory, College of Physicians and Surgeons, Columbia University, New York.

STATEMENT OF DR. G. FAILLA, DIRECTOR OF RADIOLOGICAL RESEARCH LABORATORY, COLLEGE OF PHYSICIANS AND SURGEONS, COLUMBIA UNIVERSITY, NEW YORK, N. Y.

Senator PEPPER. Doctor, you have heard the discussion here this morning. Will you give us your views, please?

Dr. FAILLA. I have not had time to prepare a written statement. Perhaps I will do that later, with your permission.

I have heard the discussion this morning, and it seems to me that you are interested in finding out what sort of organization we might suggest.

I think that the bill itself should be worded as broadly as possible in order to take care of changes in conditions which unquestionably will take place.

With reference to the establishment of one cancer research center, I would avoid that and state specifically that there should be more than one; in other words, a number of cancer research centers, and not say "one or more," because that leaves the question open as to whether there should be one or more. I would say specifically in the bill that there should be a number of cancer centers established in the country.

Then I would also put into the bill that the President is empowered to appoint a cancer research commission consisting of a certain number of men. In other words, I would state the number in the bill.. The number should be large enough to include men of different experience and training in cancer research as it is understood today, and also and particularly men prominent in research in basic sciences so as to make it representative of all the different aspects of a broader field. of cancer research. For that reason I would want to see the number made, say, 9 or 11 or 15, but not so large as to make it cumbersome. Senator PEPPER. Let me ask this, not only of Dr. Failla but of you other gentlemen who have testified here. What would be your reaction to the appointment by the President of a director of this whole organization, and then the appointment by the President of an advisory council who could be the advisers and counselors of this director, and, on the council, name an eminent group of authorities, some in public and some in nonpublic places?

What I have in mind is this, that by naming a director you would leave it to the President to select some outstanding man, maybe some outstanding businessman, say, for example, a man such as Mr. Bernard Baruch, some man who would be willing to give his organizational ability to it. Or would it be better to let the council select its own executive director and let him be a paid person who would function as executive director? In other words, should the executive director be appointed by the President or be appointed by the board; and should the board have an advisory council with the central figure a director, or should authority be vested in the board or commission and the director be the agency to carry out the will of the other group? What is your answer to that question?

Dr. FAILLA. I would say that it would be better not to have a scientific director. Also, I think that this board or commission should be limited in power. It should be a coordinating body rather than a committee or a commission that would tell the centers what to do and

within what field they should operate and what should be excluded from their activities, and so on, because, so far as we can see now, we do not know in what field cancer research will be most profitable. So, I would not attach any limitation on any of these cancer centers as to the problems they would attack. If you have someone that you call a scientific director, whether he has that power or not, he may use his influence to decide that a cancer research center in California, for instance, should devote itself to a certain phase of the problem, and one in Minnesota to another phase. I think that would be fatal.

So, I would say that the members of this advisory commission, or whatever name you may give to it, should perhaps appoint their own executive officer each year; and also that the menibers of this commission should serve for a limited number of years.

Senator PEPPER. Would it burden you to send us, after you have had time to reflect upon it more, a prepared statement for the record? Dr. FAILLA. I will be glad to do that.

Senator PEPPER. We will appreciate it immensely.

Dr. FAILLA. The other question that I wanted to mention was that these funds should not be given for the treatment of patients or care of patients, but for experimental work, and that perhaps the universities or institutions to which iunds are given for this purpose should provide facilities for the care of patients to be used in conjunction with cancer research conducted along that line.

Senator PEPPER. Thank you very much. (Additional statement of Dr. Failla):

In compliance with Senator Pepper's request, I should like to discuss more in detail the matter of organization. I have already touched upon this question in my testimony before the Committee on Foreign Relations of the House.

The type of organization we should aim for is one that will bring about the solution of the problem in the shortest time, other things being equal. To those unfamiliar with the problem it seems obvious that one all-powerful scientific director is the sine quoa non of such an organization. The director, together with a small planning board, would map out the attack and would supervise its execution. This type of organization can be successful only when there is already sufficient information about a given problem to permit the formulation of a sure plan of attack. This is not the case in the present state of cancer research. Therefore, no tactical attack can be planned and we must rely on the strategy of general attack to advance the frontiers of all basic sciences.

To make the general attack effective we must draw into the field the best minds of diverse types and interests and we must attract thousands of young men and women of promise. Good research workers are not common, but they are not limited to nay particular locality. By having a number of cancer research centers distributed throughout the country we would be able to get the best from the entire population.

It seems to be the consensus of opinion of those whose testimony I have heard that a number of cancer research centers should be set up. Therefore, the bill might well specify the number within certain limits, for instance, not less than 6 nor more than 12. (I have suggested 10 in my previous testimony.) Others could be set up later by subsequent appropriations. Each center should not be too small nor too large. In my opinion a yearly budget of $600.000 for each center is about right. If the staff of a laboratory becomes too large, it is difficult to maintain the personal contacts that are so valuable to the research worker.

Now, if there are to be several cancer research centers, the director of each should have complete independence of action. It is for this reason that I do not think there should be an over-all scientific director of the whole project. The success of the project depends very largely on the freedom of choice of the problems to be investigated in each center. Therefore, the bill should

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provide specifically for complete independence on the part of the director of each center.

Lest there be any misunderstanding, I should like to state that I am not advocating "helter skelter" research. There must be organization and competent direction in each cancer research center. However, if the director of each center is subservient to a higher scientific authority his freedom of action is seriously impaired, to the detriment of progress.

Of the organizational plans mentioned in broad outline by Senator Pepper I would like to choose the following: The President should appoint one outstanding businessman, such as Mr. Bernard Baruch, as chairman of the Cancer Research Commission. The President would appoint the members of the Commission, which should consist of eminent scientific authorities and businessmen. The Commission would appoint a paid executive secretary The Commission would appoint also an advisory board of scientific specialists, including the directors of the several cancer research centers after they have become established.

The functions of the Commission should be to allocate the funds made available by Congress, to serve as a central clearing house of pertinent scientific information, to publish books or periodicals, to arrange scientific meetings, etc., but not to direct cancer research.

In my previous testimony I indicated that the cancer research centers should be located in the medical schools of first-class universities. I also stated that the funds allocated to each center should be turned over to the university without imposing too many detailed restrictions. The university should pledge itself to spend the funds only for the purpose intended and with as much care as in the case of its own funds. The procedure might be similar to that followed by a private individual in making a gift to a university for a special purpose. This is perhaps the simplest procedure, but it may not be in accordance with Government regulations. At any rate, the thing that should be avoided is indirect control by the Cancer Research Commission of the activities of the various cancer research centers, through control of funds. Once a center is established in a university, the funds should be automatically available, either in a lump sum or on a yearly basis until the money appropriated by Congress is exhausted. The next witness is Dr. Alfred G. Levin, of Miami, Fla.

STATEMENT OF DR. ALFRED G. LEVIN, MIAMI, FLA.

Dr. LEVIN. I am heartily in favor of the Pepper-Neely cancer research bill, S. 1875, and wish to strongly urge its passage in its present uncomplicated form. I feel that the size of the appropriation suggested is none too large and that certainly no reduction in this amount should be considered. Cancer is the greatest scourge of mankind today. Each year it kills 175,000 Americans. Cancer killed 607.000 of our people between Pearl Harbor and VJ-day, more than twice as many as were killed by the Germans and Japs combined. Well over half a million persons in this country are suffering from cancer today. This terrible scourge attacks all ages and kills more children each year than does infantile paralysis. It is the most common cause of death in women of middle age and is second only to heart disease as the greatest killer of American men of all ages. Among all individuals between the ages of 35 and 55 (the years of greatest productivity) one death in every six is due to cancer. This group includes thousands of fathers and mothers with dependent children, business executives, technical experts, teachers, statesmen, and countless others whose places are not easily filled.

Many cancers cause great disability and much long-drawn-out suffering. But besides the humanitarian angle, which merits first consideration, the tremendous financial losses resulting directly from cancer must also be borne in mind. It has been conservatively estimated by the American Cancer Society that the annual medical costs.

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