Int. J. Cancer: 18, 132-133 (1976)
LETTER TO THE EDITOR
Dear Sir, Oncolozy at the Bicentennial of the United States of America A Colloquium on the Bicentennial of Medicine in the United States, 1776-1976, was held at theNationa1 Institutes of Health, Bethesda, Maryland, on May 6 and 7, 1976. The Colloquium was arranged by the National Library of Medicine and the Josiah Macy Jr. Foundation. The essays prepared for the occasion have been published elsewhere [J. Z . Bowers and E. Purcell (ed.), Advances in American Medicine: essays at the Bicentennial, 2 vols., fosiah Macy Jr. Foundation, New York (1976)l. The oral presentations and discussions expanded the topics, one of which was neoplasia.
Some historical mileposts Twelve events or developments during the past 200 years were presented as mileposts of progress in oncology: ( I ) 200 years since the first description of an occupational, environmental cancer ( P . Pott, England, 1775): ( 2 ) 140 years since the first histological studies on cancer ( J . Muller, Germany, 1838) ; ( 3 ) 100 years since the first successful transplantation of cancer in animals (M. Novinsky, Russia, 1876); ( 4 ) 100 years since the introduction of modern surgery for cancer ( T . Billroth et al., Austria, 1880’s); (5) 6.5 years since the discovery of the first virus-induced cancers ( P . Rous, USA, 1911); ( 6 ) 69 years since the first chemicallyinduced (tar) cancers in animals ( K . Yamagiwa, Japan, 191.5); ( 7 ) 55 years since the initiation of genetic studies of cancer (C. C. Little et al., USA, 1920’s) ; ( 8 ) 5.5 years since the beginning of modern radiotherapy for cancer ( H . Coutard and C. Regaud, France, 1922); ( 9 ) SO years of modern biochemistry in cancer ( 0 . Warburg, Germany, 1926); (10) 3.5 years since the inception of modern chemotherapy f o r cancer (C. Huggins et al., USA, 1940’s); (11) I5 years since the modern period of immunology of cancer (G. KIein et al., Sweden, 1960); ( 1 2 ) 10 years since the application of molecular bioIogy to cancer ( H . M . Temin et a!., USA, 1960’s). Scientific progress is achieved by individual investigators, ojien by several simultaneously, when the accumulated information reaches a critical mass. But of importance equal to the genius and devotion of individual scientists is the program against cancer conceived and developed in the United States. This program was written into law in 1937 and in 1971, as the National Cancer Acts, proclaiming that the cancer problem can and will be solved by scientific research, and cotnmitting national treasure toward the goal. What is cancer ? Our present knowledge regarding neoplastic diseases was sutnmarized in five broad statements: ( I ) Cancer is a great group of diseases, characterized by changes in somatic cells that are transmissible to daughter cells. ( 2 ) The basic cellular change that eventuates in the clinical manifestations of cancer involves the genetic component, the desoxyribonucleic acid moiety, of’the nucleus. ( 3 ) The cancerous change can be triggered by a wide variety of environmental stimuli, including physical, chemical and viral agents. ( 4 ) The cancerous process is usually manifested after prolonged, repeated exposures to the carcinogenic stimulus, and evolves through a series of changes. ( 5 ) The cancerous process is influenced by many host factors, including heredity, nutrition and immunologic status.
What can be done anainst cancer ? Knowledge regarding cancer has led to the following practical applications: ( I ) In prevention, hundreds of defined environmental carcinogens have been identified. Tobacco smoking, industrial chemicals and ionizing radiation are man-made hazards; apatoxin is an example of a natural carcinogen, Avoidance or elimination of
133 exposures to carcinogens would prevent a significant proportion of cancers in man. ( 2 ) In diagnosis, pathology remains supreme, the biopsy being the basis, and microscopic designation of histogenesis, staging and grading leading to the determination of prognosis as well as of diagnosis. ( 3 ) In treatment, surgery remains the most definitive approach, aiming at total removal of the cancer. Radiotherapy is curative in cancers responsive to host-tolerated doses and encompassable by the beam. Chemotherapy cures some rapidly-proliferating cancers. Combinations of all three modalities are of increasing importance. ( 4 ) In prognosis, the salvage rate of all patients with cancer approaches 40% at 5 years a/rer treatment. Improvements in salvage rates for patients with some cancers are insufficient to reverse rising mortality rates from other cancers. ( 5 ) Real victory over cancer is still in the future, requiring better application of available knowledge and discoveries of new preventive and therapeutic methods through research. Yours sincerely MICHAELB. SHIMKIN La Jolla, California
LETTER TO THE EDITOR
Dear Sir, Oncolozy at the Bicentennial of the United States of America A Colloquium on the Bicentennial of Medicine in the United States, 1776-1976, was held at theNationa1 Institutes of Health, Bethesda, Maryland, on May 6 and 7, 1976. The Colloquium was arranged by the National Library of Medicine and the Josiah Macy Jr. Foundation. The essays prepared for the occasion have been published elsewhere [J. Z . Bowers and E. Purcell (ed.), Advances in American Medicine: essays at the Bicentennial, 2 vols., fosiah Macy Jr. Foundation, New York (1976)l. The oral presentations and discussions expanded the topics, one of which was neoplasia.
Some historical mileposts Twelve events or developments during the past 200 years were presented as mileposts of progress in oncology: ( I ) 200 years since the first description of an occupational, environmental cancer ( P . Pott, England, 1775): ( 2 ) 140 years since the first histological studies on cancer ( J . Muller, Germany, 1838) ; ( 3 ) 100 years since the first successful transplantation of cancer in animals (M. Novinsky, Russia, 1876); ( 4 ) 100 years since the introduction of modern surgery for cancer ( T . Billroth et al., Austria, 1880’s); (5) 6.5 years since the discovery of the first virus-induced cancers ( P . Rous, USA, 1911); ( 6 ) 69 years since the first chemicallyinduced (tar) cancers in animals ( K . Yamagiwa, Japan, 191.5); ( 7 ) 55 years since the initiation of genetic studies of cancer (C. C. Little et al., USA, 1920’s) ; ( 8 ) 5.5 years since the beginning of modern radiotherapy for cancer ( H . Coutard and C. Regaud, France, 1922); ( 9 ) SO years of modern biochemistry in cancer ( 0 . Warburg, Germany, 1926); (10) 3.5 years since the inception of modern chemotherapy f o r cancer (C. Huggins et al., USA, 1940’s); (11) I5 years since the modern period of immunology of cancer (G. KIein et al., Sweden, 1960); ( 1 2 ) 10 years since the application of molecular bioIogy to cancer ( H . M . Temin et a!., USA, 1960’s). Scientific progress is achieved by individual investigators, ojien by several simultaneously, when the accumulated information reaches a critical mass. But of importance equal to the genius and devotion of individual scientists is the program against cancer conceived and developed in the United States. This program was written into law in 1937 and in 1971, as the National Cancer Acts, proclaiming that the cancer problem can and will be solved by scientific research, and cotnmitting national treasure toward the goal. What is cancer ? Our present knowledge regarding neoplastic diseases was sutnmarized in five broad statements: ( I ) Cancer is a great group of diseases, characterized by changes in somatic cells that are transmissible to daughter cells. ( 2 ) The basic cellular change that eventuates in the clinical manifestations of cancer involves the genetic component, the desoxyribonucleic acid moiety, of’the nucleus. ( 3 ) The cancerous change can be triggered by a wide variety of environmental stimuli, including physical, chemical and viral agents. ( 4 ) The cancerous process is usually manifested after prolonged, repeated exposures to the carcinogenic stimulus, and evolves through a series of changes. ( 5 ) The cancerous process is influenced by many host factors, including heredity, nutrition and immunologic status.
What can be done anainst cancer ? Knowledge regarding cancer has led to the following practical applications: ( I ) In prevention, hundreds of defined environmental carcinogens have been identified. Tobacco smoking, industrial chemicals and ionizing radiation are man-made hazards; apatoxin is an example of a natural carcinogen, Avoidance or elimination of
133 exposures to carcinogens would prevent a significant proportion of cancers in man. ( 2 ) In diagnosis, pathology remains supreme, the biopsy being the basis, and microscopic designation of histogenesis, staging and grading leading to the determination of prognosis as well as of diagnosis. ( 3 ) In treatment, surgery remains the most definitive approach, aiming at total removal of the cancer. Radiotherapy is curative in cancers responsive to host-tolerated doses and encompassable by the beam. Chemotherapy cures some rapidly-proliferating cancers. Combinations of all three modalities are of increasing importance. ( 4 ) In prognosis, the salvage rate of all patients with cancer approaches 40% at 5 years a/rer treatment. Improvements in salvage rates for patients with some cancers are insufficient to reverse rising mortality rates from other cancers. ( 5 ) Real victory over cancer is still in the future, requiring better application of available knowledge and discoveries of new preventive and therapeutic methods through research. Yours sincerely MICHAELB. SHIMKIN La Jolla, California
