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Brian Lehrer: Brian Lehrer on WNYC. Now and for the rest of the show, a special edition of our series, 100 Years of 100 Things. It's thing number 98, 100 Years of Cancer Research. First, we'll trace the century of developments in identifying, preventing, and treating different cancers. Then we'll convene a discussion of what should happen now at a time when cancer research funding is being cut, as you all know, as a policy of the Trump administration. The American Cancer Society put out a release just the other day saying cut by 37%. The context for this is that each year, WNYC's local news division, which includes us, hosts a health convening with support from the Alfred P. Sloan Foundation.

The convening has typically been an opportunity for healthcare experts and practitioners to inform WNYC's health reporting in an off the air briefing and interaction. This is the second year that we're bringing it onto the air as we think it'll be a service for you to hear the briefing, too. For the deepest possible background on where we are now with cancer treatment and prevention, we begin with 100 Years of 100 Things. Thing number 98, 100 Years of Cancer Research. Joining us to walk through some of that history is Paul Goldberg, editor and publisher of The Cancer Letter and co-editor of the Cancer History Project. Paul, thanks so much for joining us for this. Welcome to WNYC.

Paul Goldberg: Thank you for inviting me, Brian. It's great to be here.

Brian Lehrer: When was cancer discovered and named?

Paul Goldberg: Oh, gosh. That goes back to Egypt. Ancient Egypt. As far as the naming, I do not know, but the discovery goes way back.

Brian Lehrer: As far as early advancements, one thing that we saw in our research is, from around near the turn of the previous century, according to cancer.gov, in 1898, Marie and Pierre Curie. I went to Marie Curie Junior High School.

Paul Goldberg: Oh, cool.

Brian Lehrer: Discovered the radioactive elements radium and polonium. I was always very thrilled to go to a middle school that was named after a female scientist, once I became old enough to realize that that was a rare thing. Anyway, within a few years, the use of radium in cancer treatment began. In 1928, the Pap test, used to detect abnormal cervical cells, was invented. That early period, let's say 1898 to the 1920s, before we get into the 100 year period, was that important in the development of cancer detection and treatment?

Paul Goldberg: Yes, of course, it was. I think you've just covered it, basically. I think we have so much to talk about the past 50 years or so. Really, a little bit more than that. You certainly have covered that.

Brian Lehrer: All right. Let me work our way towards the last 50 years with at least one more step in 1937, because I want to bring federal government anti-cancer funding and other research into it, because that's the context for today. In 1937, President Franklin Roosevelt signed what was called the National Cancer Institute Act. It created the National Cancer Institute under the umbrella of the National Institutes of Health, which had been around in some form since the late 1800s. Here is FDR dedicating the official building for the National Cancer Institute on October 31st, 1940.

President Franklin Roosevelt: Among the buildings of the National Institute of Health to be dedicated here today stands the National Cancer Institute. Created through provisions of the Act, which I signed on August 5th, 1937, the work of this new institute is well underway. It is promoting and stimulating cancer research throughout the nation. It is bringing to the people of the nation a message of hope, because many forms of the disease are not only curable, but even preventable. Beyond this, it is doing research here and in many universities to unravel the mysteries of cancer. I think we can all have faith in the ultimate results of these great efforts.

Brian Lehrer: FDR, in 1940. Did that establish or change the federal government's role in cancer research to a meaningful degree?

Paul Goldberg: Yes, it focuses that, but the bigger change comes with World War II, when the government becomes very active in funding research. The only way to win the war was to do a lot of research in physics. The Manhattan Project is a part of that. Also, there were these very practical matters, such as malaria. The GIs were not taking their malaria preventive drugs. There was also a shortage of them, because the raw materials were controlled by Japan, and the company making the old preventive drugs was in Germany. So Americans had to adapt.

There was created a malaria program, which actually operated from Welfare Island. It's kind of an amazing piece of it, but the reason it becomes very important is that the guy who-- one of the people who ran it later did more than anyone to design the National Cancer Program, a guy named Gordon Zubrod. Yes, the government becomes a major player in funding research during World War II.

Brian Lehrer: Listeners, as we work our way through some of the significant discoveries made in cancer research in the past 100 years, I wonder if any of you listening right now have some oral histories to contribute. Did you have a family member, as far back as you want to go, who was involved in cancer research or benefited from cancer research? Clinical trials or whatever. 212-433-WNYC, 212-433-9692. It's 100 Years of Cancer Research in 100 Years of 100 Things series. Then we're going to do a long Part 2 later in the eleven o'clock hour on the current state of cancer research and the implications of the cancer research funding cuts coming from the Trump administration.

As our 100 Years of 100 Things guest is Paul Goldberg, editor and publisher of The Cancer Letter and co-editor of the Cancer History Project. Jumping ahead to 1964. The focus on cigarette smoking. That's the year the US Surgeon General, Luther Terry, at the time, I believe, released his landmark report, Smoking and Health. That declared cigarette smoking is a health hazard and a major cause of lung cancer. Can you talk about the significance of that report at that time and the fact that it came from the federal government?

Paul Goldberg: Well, yes. Suddenly, the government throws its weight to confront the epidemic of smoking. Smoking has been going down ever since. The battle with the tobacco companies continues. That war is still going. It's also interesting to go back a little bit. I keep going back to World War II. The Nazis, one of the things they actually did pretty well was run an anti-smoking campaign, which has sort of [crosstalk]-

Brian Lehrer: [crosstalk].

Paul Goldberg: Yes. In fact, there are a couple of studies that are quoted in the report that come from Germany. There was this incredible little study done of zip code study looking at who died of what. It pretty much shows that there is a link. It took a while. It's a battle that's ongoing with tobacco, and we're seeing it in the statistics. It shows that prevention does work. Yes, it's huge.

Brian Lehrer: On the timeline to December 23rd, 1971, when President Richard Nixon signs the National Cancer Act, calling his bill the start of America's war on cancer. That was the Nixon phrase, war on cancer. Here he is speaking from the White House shortly before signing the bill.

President Richard Nixon: More people each year die of cancer in the United States than all the Americans who lost their lives in World War II. This shows us what is at stake. It tells us why I sent a message to the Congress the first of this year, which provided for a national commitment for the conquest of cancer. To attempt to find a cure.

Brian Lehrer: Paul, what was some of the things that that bill established that perhaps we still have to this day?

Paul Goldberg: Oh, well, it set up the National Cancer Program as it existed as this landmark law that shows how the conquest of cancer, as he puts it, becomes one of the top priorities of the US government. It also perhaps even-- perhaps as importantly as that, establishes cancer and the fight against cancer as a top priority and kind of a pillar of the American identity. Who are we as a people? We are people who are fighting a war on cancer. What's really interesting is that there has not been another war declared by a country against the disease.

What's coming down right now, what's being dismantled is a part of the American national identity and also, I might add, a part of the Kennedy family history that could be honored or taken apart.

Brian Lehrer: Or dishonored. Yes. We'll talk more about that in Part 2, with our subsequent guest, including one of your colleagues from the Cancer History Project on, yes, how is this consistent? This dismantling, this defunding of a lot of research with RFK Jr.'s stated priority in fighting to fight chronic diseases, which cancer is one of. That's for later. We're still doing the 100 year timeline.

Paul Goldberg: Right.

Brian Lehrer: At that Nixon moment, I think there was news at the time that was predicting, wrongly, as it turned out, very wrongly, that cancer would be cured by the country's bicentennial in 1976. Want to reflect a bit of the rhetoric around cancer research at the time?

Paul Goldberg: Yes. What was very interesting with that is it was a campaign set up by-- orchestrated by Mary Lasker, whose husband, Albert Lasker, is really one of the founders of the American public relations industry. She ran a campaign like no other. Prior to that, actually, she was also running campaigns to put more money into NIH. Finally, she-- well, prior to that even, she bought, took control of the American Cancer Society. Over the organization that became the American Cancer Society. A lot of things are happening before 1971 that are codified into the National Cancer Act of 1971. Then, of course, the Kennedy angle of it is also very, very important. I'm going back. I'm really sorry.

Brian Lehrer: It's okay.

Paul Goldberg: The reason this even came out, the reason this happened, had to do with the Kennedys. Going back to Jack Kennedy, there was no better personification of belief, cheerful belief in science that is part of the American identity. Then Ted Kennedy gets involved because of a professional and personal setback with Chappaquiddick. He loses his majority whip position and needs an issue. Now, at the time, he does not really know much about cancer. It just becomes an issue that Mary Lasker suggests to him. Then in order to keep Kennedy from taking control of that issue, of making it his, Nixon becomes involved in the national cancer.

There is this interplay between Kennedy plan National Cancer Act and the Nixon National Cancer Act. The result is this very interesting hybrid form of a bill which is like no other. For example, the director of the National Cancer Institute within NIH until recently was the only institute director within NIH, and still is, actually. The only person in the US government who is named by the president and does not go through confirmation. It's kind of political. Then there are a couple of boards that are set up.

One of them, called the National Cancer Panel, is there specifically in order to communicate opportunities and problems in cancer research directly to the President of the United States. That panel hasn't really worked especially well for many years. It worked especially well when Benno Schmidt was in charge of it. It was he could actually give a call to Richard Nixon personally and discuss what the problems were. Then there's also something else called the National Cancer Advisory Board, which is a board of advisors who really are overseeing the National Cancer Program. These advisors are named by the president.

There is no other advisory group within NIH that is where members are named by the president. Then there's also this selection of-- there's also structures like the cooperative groups where groups of physicians work together to enroll patients on clinical trials, or address problems of that sort. That didn't exist until then. Then there's also, of course, the cancer centers. That's probably the most important piece. The cancer centers are there to implement the National Cancer Program. They do research-

Brian Lehrer: Like Sloan Kettering in New York. Is that an example of that?

Paul Goldberg: Oh, yes. Yes. One of them. Absolutely. There are more in New York. These are the places that have done so much. There are 73 cancer centers that are designated by the National Cancer Institute. There are no such equivalents to this in any other field of medicine. The result is, cancer has driven progress in all of medicine. Taking that apart, you're taking apart a whole lot more than that. You're taking apart-

Brian Lehrer: With the '70s being so important to this 100 year history, we have a couple of good '70s related oral history calls coming in, it looks like. Let me take Vienne in Manhattan. Vienne, you're on WNYC. Thank you so much for calling.

Vienne: Hey, Brian, it's so nice to talk to you again after many years, but I listen to you every day. I'm a little shaky because I'm nervous, but I wanted to shout out to my mom and dad. My brother died of leukemia when he was 12 years old. It was in 1973. So, in 1971, my mom and dad started a group called the Candlelighters. They were a group of parents who had lost children to cancer. They worked diligently day and night. I remember, when they died, going through boxes and boxes of letters and papers and requests to President Nixon and to Pat Nixon. It was just an endless thing to create something, a legacy to remember their son and to help others who had lost children.

I just wanted to say, I don't know if he had mentioned, your guest had mentioned that there were grassroots people who were helping this happen. I happened to stand on the White House. Nixon had invited my family and others in the Candlelighters to come and a candlelight service on the steps of the White House. I remember I was nine years old. I have a very vivid memory of holding a candle and Pat Nixon coming and talking to everybody and saying that they were going to give like $9 billion or $9 million or something, some extraordinary amount of money toward cancer research.

Brian Lehrer: Can I ask, Vienne?

Paul Goldberg: Oh, absolutely.

Brian Lehrer: Obviously, it does nothing to mitigate the loss of your brother, but if I'm correct, and Paul Goldberg, you can correct me if I'm wrong. I believe advances toward a cure for childhood leukemia in particular-

Vienne: Yes.

Brian Lehrer: -has been a culmination of decades of research in the field.

Paul Goldberg: Oh, absolutely. By the way-

Vienne: Yes.

Brian Lehrer: Let Vienne go and then I'll let her go. Vienne, go ahead. What did you want to say about that?

Vienne: Well, my brother was one of the first children to undergo chemotherapy. He did not survive, but there were people in the study that have survived. Now, there is a very high rate of cure for leukemia.

Brian Lehrer: I'm so glad you called and shared your story, Vienne. Thank you very much. Paul, did you want to add one other thing to that?

Paul Goldberg: Yes. Oh, I have a lot to say. A friend of mine, Grace Powers Monaco, one of the people who started the Candlelighters. Actually, we talked often as she was running the group. This is an example of patient advocacy being so active in-- first real major example of patient advocacy being so active in bringing about cures. It's also an example of how cures can happen. It's an early, early success that predates the National Cancer Act in part. Interestingly, some of the key work was done by these two guys, Emil Frei and Jay Freireich, at the National Cancer Institute. Actually, this was overseen and mentored by this gentleman I mentioned in the context of the malaria program, Gordon Zubrod.

Brian Lehrer: One more 1970s call. Pat in Maplewood, you're on WNYC. Hi, Pat.

Pat: Hi, Brian. My sister was diagnosed with osteosarcoma in 1974. She wound up being treated with one of the earliest chemotherapies. When she was originally diagnosed, we were told that her chances of survival were-- a five year survival were 20%. The chemotherapy that was developed over the years, which was initially funded by a National Cancer Institute grant, reversed those odds for these kids. My sister actually went on to live for 50 years. She went from 13 to living until she was 63. Our family is enormously grateful to the government of this country for funding that research. When I hear about the funding being cut, it just breaks my heart. It really does. [crosstalk] for us.

Brian Lehrer: Pat, thank you very much for your story. Again, we will get in Part 2, coming up in a few minutes, to the cuts that are being imposed right now and their implications. We just have a few more minutes for this 100 year timeline leading up to today. I want to stop in 1985 for a minute, because I think that's a significant year for a big advancement in the treatment of early stage breast cancer. A trial then showed that women with early stage breast cancer could be treated with a combination of lumpectomy and radiation, just as successfully as mastectomy alone.

Also around then, I think they were coming up with better ways to reduce the severe side effects of chemotherapy. Can you talk about how research, maybe federally funded research, contributed to those things in the '80s?

Paul Goldberg: Well, yes. This is an example of a question that probably would not have been asked by a pharmaceutical company. This is like, how do you improve the quality of life, quality of care? How do you define the disease itself? This is revolutionary. That's Bernie Fisher. This work was performed by a group called National Surgical Adjuvant Breast and Bowel Project in Pittsburgh. It's an example of something that would never have happened had there not been a National Cancer Institute. Had there not been, again, I keep coming back to Gordon Zubrod. Had he not come up with the idea of cooperative groups that answer questions. So, yes, it's-

Brian Lehrer: One more stop along the way before we get to the present with our next guest. 2006. Gardasil. When the FDA provided a major breakthrough by approving the HPV, human papillomavirus, HPV vaccine, Gardasil. How significant was that advancement?

Paul Goldberg: Well, it's enormous. It's enormous, because I don't believe we're at the level where we can show that it saves lives, but it does. We all know it does. People will not get the disease. Yes, it's also interesting that that is work that was done at the National Cancer Institute. In fact, the gentleman, one of the co-discoverers of Gardasil, one of the co-developers of it, is now the acting director of the National Cancer Institute, Doug Lowy. Again, that's an example of what NCI did. That's an example why cancer research really belongs as part of the American national identity.

Brian Lehrer: That's all the time we have for our 100 Years of 100 Things portion of this special. Number 98, 100 Years of Cancer Research. Paul Goldberg is the editor and publisher of The Cancer Letter and co-editor of the Cancer History Project. Paul, thanks so much for coming on today.

Paul Goldberg: Thank you for having me, Brian.

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