December 23 marks the 50th anniversary of former President Richard Nixon signing into law the The following is excerpted from ": A Half-Century of Progress Against Cancer," by Donald L. Trump, MD, and Eric T. Rosenthal.
A funny thing happened on the way to researching and writing this book: we confirmed our belief that history is often seen through the eye of the beholder but also learned, to our dismay, that in some cases history can cease to exist -- or at least the record of that history -- and its resurrection may not always reflect reality.
When we decided to work together on the history of , we did so because we knew that collectively we had a pretty good knowledge -- both first-hand and through others -- of the cancer centers program.
So, when we began this venture, we thought that through research and interviews we'd be able to answer some pretty fundamental questions, such as what was the first cancer center in the United States, and what years did certain cancer centers receive their NCI designation or, in some cases, lose it?
However, what we found was that some institutions were unaware or uncertain about significant parts of their respective histories and that many records at the National Cancer Institute were destroyed every 7 years due to a federal records management mandate, which left certain high-ranking officials unable to answer questions that may have predated their tenures.
In fact, when we asked Linda Weiss, PhD, former director of the NCI Office of Cancer Centers, about the specific chronology of NCI designation, she replied via email: "The definitive start dates for these first cancer centers have always been a bit fuzzy and when we were asked about it in the past, we tended to hedge a bit; even the initial number of centers was not entirely clear."
"Information from different sources seemed to vary a bit as I recall," she continued, "and it is probably in part due to the fact that several centers had precursor grants of varying kinds (some clinical infrastructure, some research project based, etc.) prior to the official implementation of the program."
She went on to explain that she seemed to recall "some lack of standardization historically" regarding how various grants were numbered, citing that she remembered "some evidence indicating that Fox Chase was the first center, under its old name, and that eight others followed."
Despite this, we tried to pull together as accurate a representation of the histories as we could, but also would like to issue the disclaimer that if there is some dispute over what we reported, we apologize. We hope that the history of the NCI-designated cancer centers can continue to evolve -- and be honestly and objectively chronicled -- as have their contributions to cancer research, treatment, and prevention.
Cancer Research & Care Before the National Cancer Act
Until the early 1900s, cancer was generally incurable and largely untreatable, and those afflicted were usually considered beyond help or hope.
The public's despair about cancer treatment -- and even the reluctance to mention the word -- continued well into the 20th century. Noteworthy in combating the stigma of cancer were a number of brave public figures who made known their breast cancer diagnoses. During this period, cancer was treated primarily through surgery.
Despite this despair, a number of visionary physicians, scientists, and community leaders committed to making progress and improving treatment began to establish free-standing cancer hospitals or laboratories in locations such as New York City; Buffalo, New York; and Philadelphia, as well as the Ellis Fischel Cancer Hospital in Columbia, Missouri, and the Barnard Free Skin and Cancer Hospital in St. Louis, Missouri. Many of these institutions would later become leading centers of clinical cancer care and laboratory research and would later serve as models for what was to come.
The National Cancer Institute (NCI) was established following President Franklin D. Roosevelt's signing into law the National Cancer Act of 1937.
This action culminated nearly three decades of effort to formalize and enhance the federal government's involvement in cancer research. And 4 years later, another freestanding center would open in Houston, Texas, the MD Anderson Hospital for Cancer Research of the University of Texas.
With increasing interest and attention being paid to cancer care and cancer research, in 1970 a blue-ribbon panel of physicians and scientists presented to President Richard M. Nixon and the Congress the "Report of the National Panel of Consultants on the Conquest of Cancer," which set the scientific baseline and recommended a plan for progress.
Presciently, it stated: "The long-term future may belong to the immunologist and the geneticist, the intermediate future to the chemotherapist, but the present and immediate future belong in the main to the surgeon and to some extent to the radiologist."
The report -- along with the continuing hard work and leadership of a team of influential private citizens, and passionate and articulate researchers and physicians working together with committed leaders in the U.S. Senate and House of Representatives -- led to the National Cancer Act of 1971.
This transformative bill signed by President Nixon on December 23, 1971, created the National Cancer Program, which established the authority and responsibility of the NCI director, and called for investment in basic, clinical, and cancer control research; the training of cancer specialists; and the funding of fifteen National Research & Demonstration Centers, which would soon be known as NCI-Designated Cancer Centers.
As of March 2021, numbering 71 nationwide, NCI-designated cancer centers have been the sites of many of the advances in cancer research, treatment, and prevention over the past half century.
Donald L. Trump, MD, is an oncologist who has served as the president of Roswell Park Comprehensive Cancer Center. Eric T. Rosenthal is a long-time oncology and medical reporter.