Tomorrow, December 23, marks four decades since President Nixon put his pen to paper and signed into law the National Cancer Act of 1971, which marks one of the most important and imperishable legacies of his Administration. It dramatically increased funding to the National Cancer Institute and provided for programs in collaboration with other state and local agencies in the medical field.  It also created the 18-member National Cancer Advisory Board to help ensure that needed funds went to programs and studies that held promise of developing new methods to combat the range of cancer and cancer-related diseases.  The enactment of this legislation was hailed in the press as marking the beginning of a “war on cancer,” evoking comparisons to the “war on polio” declared by Franklin D. Roosevelt which, after decades of research, culminated in the vaccine that obliterated that illness worldwide.
Four decades later, although a lot remains to be learned about the causes of cancer and its cures, progress has been spectacular.  An article by Vicki Rock in the Somerset County, Pennsylvania, Daily American, published to mark the anniversary of the Act, explains:

Forty years ago a diagnosis of cancer was a death sentence. Oncologists only had two or three drugs to use in treating patients. Fewer than one-third of patients with a diagnosis of cancer lived five years. Almost no children with a diagnosis of the most common form of childhood cancer, acute leukemia, lived five years. There were no CAT or MRI scans. Many cancers were only detected during autopsy. In those days every patient who died in a hospital had to be autopsied.

“I have memories of patients — I would think he doesn’t look that sick and I knew this patient is going to die and I can’t do anything about it,” [Dr. Aiman] Daghestani [of the Somerset Oncology Center] said. “We couldn’t treat them much; we didn’t have anything. Family members came to me and asked me not to tell the patient he had cancer. I told them I wouldn’t lie, but I would say tumor or mass and it depended on what the patient understood or what he asked.”

Now all cancers are treatable. In 2011 nearly 90 percent of children diagnosed with acute leukemia will be cured and nearly two-thirds of all people diagnosed with cancer will live at least five years. Still about 600,000 Americans die every year of cancer, second only to heart disease.

“I believe every patient should have the possibility of a cure,” Daghestani said. “I believe hope is important. We work for a cure. We never guarantee an outcome — the final outcome is in God’s hands.”

He has had patients referred to him whose family physicians have said will only live a few months and those patients have been treated and lived for several years.

Millions of patients have now benefited from continued advances in cancer research. There are advances in early detection, improved therapies and a better understanding of the genetics driving different forms of cancer. Prevention and early detection are still the keys.

Another important article about this anniversary, by Amanda Gardner, is at USA Today’s site.  This stirred my interest because it opens by describing a Bostonian, Jack Whelan, who learned in 2006 that his frequent nosebleeds were signs that he had developed a form of non-Hodgkin’s lymphoma affecting the bone-marrow cells, Waldenstrom’s macroglobulinemia. The disease is little known to the general public, partly because it is so uncommon – about fifteen hundred new cases are diagnosed in the United States every year.

However, I did not have to consult the Online Dictionary to spell Waldenstrom’s macroglobulinemia, because I was diagnosed with it in March 2009.  Had I received this diagnosis forty years ago, as the article points out, my chances of survival past five years would have been almost impossibly remote.  But today, thanks to advanced treatments such as the chemotherapy I periodically undergo, the prognosis of survival in my case stretches up to two decades or more given the current state of research into Waldenstrom’s, and may lengthen as new therapies are discovered.

Further on in Ms. Gardner’s article, the most pressing problem involving cancer treatment today is summarized:

Doctors now also know that “multi-modality” therapy — meaning the combined use of surgery, radiation and drug therapy — “has given people the best chance for good outcomes for particular kinds of cancer,” said Benz.

But while there’s been undisputed progress, “it’s very incomplete progress,” Benz and others acknowledged.

“If you look over the past 40 years, on some fronts we’ve actually been winning and on some fronts we’re losing terribly,” said Brawley. “We are our own worst enemy in terms of battling cancer with tobacco control, diet and exercise and getting everybody adequate preventive screening and treatment.

“In excess of 200,000 of the 500,000 lives that will be lost from cancer this year could have been avoided if we simply adopted all the cancer-control technologies that we’ve learned over the last 40 years,” he added

Yes, research over the last forty years has shown that the surest way of preventing most cancers is to get the tests done that detect them early enough for effective treatment, and not to indulge in the kind of habits that may increase the risk for them.  (However, it’s hard to speak of preventing Waldenstrom’s, since its cause is still rather a mystery – though, as the USA Today article reports, only this month researchers at the Dana Farber Center in Boston learned that a gene mutation is present in 90 percent of those with the disease.)

Vermont Public Radio’s site has a long podcast concerning the anniversary; its page features a photo of RN signing the Act.

Finally, the Annapolis, Maryland Capital has an article by Erin Cox. It concerns Patti DiMiceli, a citizen of that city who, thirty years ago, lost her four-year-old daughter Amber to a rare muscle cancer that tore through the child’s skull and into her brain before killing her.  On Friday, Ms. DiMiceli will pace back and forth in front of the White House – on a day when the temperature is expected to go no higher than 45 degrees – for twenty-two hours, to commemorate the 22 million Americans who have died since the National Cancer Act was signed into law.

Ms. DiMiceli will be carrying a poster asking for an end to the “war on cancer.”  By that, she wants more funding for programs to prevent cancer from developing, and less money directed to drug companies chasing that elusive “cure” for the disease.

Science still has a long way to go in terms of learning all the causes of the multifold forms of cancer, and coming decades may bring new ways of preventing and treating them that we can only dimly envision now.  But this is a case where I feel rather in the same mood as Ben Stein when he concludes one of his “Diary” posts at the American Spectator’s site by thanking Richard Nixon, as he so often does.  Mr. President, thank you for signing the National Cancer Act of 1971 into law and for beginning a process which has helped give me hope that I can reach threescore and ten, and hope to go beyond that.

Photo: President Nixon with Dr. Averill Letton, President of the American Cancer Society, in the White House East Room during the signing ceremony of the National Cancer Act of 1971 on December 23, 1971.