A History of Prostate Cancer by Helen Valier

Author:Helen Valier
Language: eng
Format: epub
Publisher: Palgrave Macmillan UK, London

The 1971 National Cancer Act and Prostate Cancer

The NCI established a Breast Cancer Task Force in 1967 but it took the passage of the National Cancer Act in 1971 for similar groups to be organized around other common solid tumours (see Chap. 6 for a discussion of the politics of breast cancer at this time). The National Organ Site Programs Branch of the NCI oversaw the creation of task forces in bladder, large bowel, and prostate cancer (with lung cancer being split between the Tobacco Working Group and the Division of Cancer Cause and Prevention). While the task force for breast cancer stayed headquartered at the NCI in Bethesda, the other programmes moved out to some of the country’s most prominent cancer research hospitals: bladder to Gilbert Friedell at St. Vincent’s Hospital, Massachusetts; large bowel to Murray Copeland’s team at the M.D. Anderson Hospital and Tumor Institute in Houston, Texas; and prostate to Gerald Murphy’s department of urology at the Roswell Park Memorial Institute, New York. This decision to locate the task forces outside of the Bethesda seems to have been inspired in part by criticisms that other NCI targeted research programmes were overly rigid and inflexible, unable to nimbly respond to unexpected findings. 63

The organ task forces shared some similarities and differences with earlier federal disease-focused programmes of the immediate post-WWII era. Whereas grants submitted to the NCI contracts programme were subject to robust oversight from salaried government scientists, grants awarded to the prostate, bladder, and bowel task forces relied on more traditional sources of academic scrutiny, especially peer-review of grants. While the requirements to follow preplanned programmes of research may have loosened somewhat because of this, some similarities did persist between the 1970s organ group and the 1940s-era task forces in that both kinds of programme were charged with an ambitiously wide remit. In the case of organ groups, this remit stretched from inquiries into epidemiological assessment of the incidence and prevalence of specific cancers, through to screening and treatment studies. For Murphy’s team in New York, fulfilling this mandate involved working with, and trying to supplement, the efforts of the VA. Given the overall chemical bent of NCI programmes it made sense that the new prostate task force would—unlike the VA—at first focus on chemotherapeutic approaches to therapy.

In the decade and a half or so of its existence, Murphy’s self-styled National Prostatic Cancer Institute and its associated National Prostatic Cancer Project (NPCP) headquartered at the Roswell Park Institute, pursued a largely chemical (and later radiological) agenda. From 1972 to 1985 the NPCP conducted twenty-four trials assessing the use of chemotherapies, and later radiotherapies, as secondary or ‘adjuvant’ interventions intended to supplement primary treatment with surgery (and) or hormone interventions. 64 That the NPCP was such a short-lived enterprise owes much to the massive reconstruction NCI programmes during the early-to-mid 1980s. Criticism of the management of the NCI, and indeed ongoing criticism of the very policy of planned research (however defined) remained fierce throughout the 1970s. In fact

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