On December 23, 1971, President Richard M. Nixon signed the National Cancer Act into law. At that time, cancer was the nation’s second leading cause of death; only about one of two people diagnosed with cancer survived at least 5 years—compared with two of three people diagnosed with the disease today.
The unprecedented legislation granted sweeping authority to the director of the National Cancer Institute (NCI) to develop a national cancer program that included the NCI, other research institutes, and federal and nonfederal programs; funding to establish 15 new cancer research centers and local control programs; and an international cancer research databank. It also provided the director with direct access to the President of the United States and empowered the agency to make long-term public investments to advance cancer control and care delivery research throughout the cancer care continuum.
The increased funding for the NCI amounted to nearly $700 million during the first 7 years following implementation of the law (currently, the NCI budget is $6.56 billion). It established the first NCI-designated cancer centers, which today number 71, located across 36 states and the District of Columbia, and expanded the National Clinical Trials Network to focus scientific efforts on the understanding, prevention, detection, and treatment of cancer.
The Impact of Patient Advocacy on Cancer Progress
Arguably, the most important person in propelling the passage of the National Cancer Act of 1971 was Mary Lasker, a philanthropist and longtime activist for cancer research as well as the widow of Chicago advertising executive Albert Lasker, who died of colorectal cancer in 1952. Dubbed the “fairy godmother of medical research” by Businessweek magazine, Ms. Lasker used her political skills and contacts to lobby Congress to increase federal expenditures for medical research. Her considerable power and influence helped convene a Senate panel of 26 experts to survey the progress being made in cancer research and make recommendations for how to speed advances, which ultimately resulted in the development of the framework of the National Cancer Act.
Andrew C. von Eschenbach, MD
Andrew C. von Eschenbach, MD, talked with The ASCO Post about the influencers, including Ms. Lasker, behind the passage of the legislation and the Act’s impact on cancer research today. Dr. von Eschenbach is President of Samaritan Health Initiatives, Adjunct Professor of The University of Texas MD Anderson Cancer Center, and former Director of the NCI and former Commissioner of the FDA.
How influential was Mary Lasker in raising funds for cancer research, increasing the public’s faith in medical science, and promoting the idea that research could find a “cure” for cancer?
Dr. von Eschenbach: This question brings home the convergence of policy and politics and the important role of advocacy in getting legislation passed. There is a lot of political history surrounding how the National Cancer Act came together. There were key people in the Senate, including Ted Kennedy, and Paul Rogers in the House, and people in the Nixon administration working to develop the bill; and in the center of all that political drama was Mary Lasker and leaders from the cancer community, including the American Cancer Society. Mary Lasker was the catalyst dropped into this chemical reaction; by enhancing public awareness and using all her influence with policymakers who were going to be shaping this legislation, she made cancer a national cause. Advances in cancer research were no longer answers for the very few, but the hope for the many. Mary Lasker was pivotal to cancer research 50 years ago, as are other patient advocates today.
Scientists now know that cancer is hundreds of diseases, with complex causes and triggers, and that there will not be one single cure for all cancer types. Is this latest national effort to “cure” cancer once again raising unrealistic public expectations?
Dr. von Eschenbach: No, it’s not. However, the problem in the beginning was that we didn’t understand cancer. The word “cure” was a word that resonated with people and one they understood. Quite honestly, it was a political word. At the outset, we thought the only option for cancer was to cure it. What has happened over the past 50 years is that we changed the taxonomy of cancer, and now we need to change the terminology. We should never use the word “cure” regarding cancer.
What we are actually talking about is eliminating cancer as a threat to someone’s life. We want to eliminate cancer as a cause of suffering as well as premature and unnecessary death. As a result of the National Cancer Act, we have learned how to prevent cancer, how to detect it at its early stage of development, and how to eliminate early-stage cancer, so in that sense, you might want to call it a “cure.” Today, we can also modulate or control cancer, so many people live with—but don’t die of—cancer.
Is it rational today, given our 50-year history of cancer progress, to say we can eliminate cancer as a threat to human life? Absolutely, yes, we can, because we now recognize cancer not as an event, but as a process in someone’s life. “Cure” is a 1971 word. In 2021 and beyond, we are learning how to solve the problem of cancer. We are not finished. A war is not won in one battle, but by a series of battles, and sometimes those battles don’t go well.
We are not finished with cancer, but we are in a much different place than we were 50 years ago. We need another version of the National Cancer Act, but this time, the starting place is light years ahead. In the next 50 years, we will not just be talking about the elimination of disease, we will be talking about the restoration of health. We will apply the tools of cancer research not just to eliminating the cancer cell, but to modulating and enhancing normal cells and restoring health.
The door that cancer research has opened will lead us to amazing new places.
Editor’s Note: Adapted from Cavallo J: How the National Cancer Act of 1971 revolutionized cancer care and what lies ahead. The ASCO Post, May 25, 2021. View the full report at https://bit.ly/30VB99I.