It was only a week after his sheva berachos, and Leiby Feder was davening Shacharis in a local shul in Monsey when he suddenly felt faint. Hatzalah was called, and the 21-year-old was rushed to hospital for scans. The ultrasound results were grim: the doctors detected a tumor.
Leiby was operated on by Dr. Joel Sheinfeld at the Memorial Sloan Kettering Cancer Center in Manhattan, but tests later showed that the cancer was still spreading. He then traveled to Indianapolis to meet with Dr. Lawrence Einhorn, an expert oncologist at the Indiana University School of Medicine’s Cancer Center, who prescribed a BEP protocol—a chemotherapy treatment that includes bleomycin, etoposide and platinum.
Leiby flew back to New York, where the treatment was administered by Dr. Abraham Chachoua at NYU Langone’s Perlmutter Cancer Center. A few months later, the treatments were over and the scans came back clear. More recently, after undergoing five years of annual checkups, doctors informed Leiby that he need not return.
Today, Leiby Feder is a successful social worker and the father of two beautiful children. With Hashem’s help, he is cancer free and grateful to one particular agency that played a large role in his cure: the National Cancer Institute.
A National Effort
President Richard Nixon was in a jubilant mood as he handed out the pens.
It was December 23, 1971, and the president had just signed the National Cancer Act in the White House. The first pen, with which he had signed his first name, was given to activist Benno Schmidt Sr., while the pen with which he signed “Nixon” was gifted to Dr. Alva Letton, the head of the American Cancer Society.
“[W]hen we consider what cancer does each year in the United States,” Nixon had told the assembled before signing the landmark bill, “we find that more people die of cancer each year 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 that provided for a national commitment for the conquest of cancer, to attempt to find a cure.”
The senators, congressmembers and activists in attendance then jostled around the table for a picture, where the newly-signed legislation lay face up. It began by saying that the act was intended “to amend the Public Health Service Act so as to strengthen the National Cancer Institute and National Institutes of Health in order to more effectively carry out the national effort against cancer.”
The bill couldn’t have come at a better time.
The Scourge of Cancer
Although cancer seemed to have increased in incidence over the last couple of centuries, the disease was hardly a new one. Examinations of mummies unearthed in Egypt show evidence of cancerous tumors, and descriptions of their removal are found in papyri. Ancient healers often discussed the disease; the word itself is derived from how Greek physician Hippocrates described the tumors as resembling crabs.
While the disease was known throughout the ages, the great leaps in medicine, science and technology in the 19th and 20th centuries led to bigger breakthroughs than ever before, such as the fact that certain chemicals could cause cancer. This coincided with a rise in its incidence, which some attributed to increased tobacco use and more exposure to pollution.
When radiation was discovered in the 1890s, a new non-surgical treatment for cancer became available. (In fact, the first cancer patients to be cured with radiation were treated in 1903 by Semyon W. Goldberg and Efim London, two Jewish doctors in St. Petersburg.) More options followed in the next century, including bone marrow transplants and various medications.
In 1937, President Franklin D. Roosevelt established the National Cancer Institute (NCI), which later became part of the National Institutes of Health. The institute was expected to break new ground by conducting its own research, promoting research in other institutions, and coordinating cancer-related projects and activities.
But by 1970, cancer had become the second leading cause of death in the United States right behind heart disease, with some 330,000 people dying from it. More needed to be done, leading to a proposed amendment to the Public Health Service Act to “strengthen the National Cancer Institute in order to more effectively carry out the national effort against cancer.”
One primary lobbyist for the passing of the National Cancer Act was socialite and philanthropist Mary Lasker. The wealthy widow of New York advertising executive Albert Lasker, she had long been a proponent of medical research; she and her husband had headed the Lasker Foundation, which rewarded people for their efforts.
One of Mrs. Lasker’s areas of interest was cancer. Starting in the 1940s, she’d lobbied for increased funding for the National Cancer Institute, and by 1972, funding for the agency had grown to over $1.4 billion. But she still felt that it wasn’t enough.
“The amount of money being spent for medical research is—well, it’s just piddling,” she once told a reporter. “You won’t believe this, but less is spent on cancer research than we spend on chewing gum.”
And so, she launched a concerted media campaign to convince Congress to find a cure for it. In the mid-1960s, chemotherapy had just become an effective way to cure pediatric leukemia, and Lasker believed that if doctors could do that, they could cure other cancers as well. Thanks to her PR prowess, over 250,000 people contacted their elected representatives to urge them to pass a bill fighting cancer.
All of this culminated in President Nixon signing the bill in the East Room of the White House to create a new infrastructure focused on finding a cure for cancer.
Waging Battle
The media soon dubbed the effort the “war on cancer.”
“President Nixon signed into law today a bill committing more than one and a half billion dollars to a war on cancer,” announced a solemn-faced newsman that night. “The three-year program includes research, diagnosis, prevention and treatment.”
The bill cemented the nation’s commitment to the eradication of the disease. The NCI director was also given the power to create new cancer centers and physician training programs, award contracts for research, conduct cancer control activities, establish an international cancer research data bank, award research grants, and collaborate with other federal, state or local public agencies and private industry.
Today, the headquarters of the NCI are located in Bethesda, Maryland, on the sprawling campus of the National Institutes of Health. This government body—one with which Americans have became all too familiar since the start of the pandemic— currently oversees over two dozen public health-related agencies and centers. It also has the largest budget of all the centers of the NIH.
“The NCI is the backbone of cancer research in America,” says Rabbi Zishe Lowy, director of the Rofeh Cholim Cancer Society, a renowned patient advocacy organization. With its encyclopedic knowledge of the latest treatments available for patients, Rabbi Lowy says that the Institute is vital to the fight against cancer.
Another important feature of the NCI is its designated cancer centers. These 71 facilities—mostly affiliated with universities—are located around the country and funded with grants from the NCI. Although they include laboratories and research centers, most of the centers are dedicated to treating patients; all three hospitals in which Leiby Feder was treated are NCI-designated cancer centers.
Many of the most prominent cancer specialists in the country are alumni of the Institute, Rabbi Lowy points out. “These people worked at the NCI for many years and are currently treating many patients from our community,” he says. “They include Dr. Howard Fine, Dr. Fabio Iwamoto, Dr. Tito Fojo, Dr. Steven Libutti and Dr. Richard Alexander.”
Thanks to the more than $5 billion it receives in federal funding each year, the NCI can also financially support third-party clinical trials and research by institutions and private firms that show promising options for diagnosing and treating cancer. (See following interview with Dr. Ned Sharpless, head of the NCI.)
New Discoveries
The NCI employs some 3,500 doctors and scientists, and many groundbreaking discoveries have been made possible by the Institute, saving thousands of lives. Two examples of popular cancer drugs being used thanks to the NCI are cisplatin and paclitaxel.
Cisplatin actually came about by accident. In 1965, Dr. Barnett Rosenberg of Michigan State University noticed that images of dividing cells resembled the pattern of iron shavings subjected to a magnetic field. He wondered if this meant that an electrical field could also affect cell division, so he devised an experiment to find out.
Because platinum was thought to have no biological activity and wouldn’t affect the experiment, Dr. Rosenberg and his team placed platinum electrodes into a solution containing E. coli. As soon as the power was turned on, the cells of the bacteria stopped dividing. When the power stopped, the cells began dividing again.
At first, it appeared that the electrical field was controlling cell division. But after two years, Rosenberg’s team realized that the division was being blocked not by the electricity but by a platinum compound released from the electrodes. They eventually identified the compound, which was later named cisplatin.
The scientific community was skeptical—heavy metals were assumed to be poisonous—but NCI officials were impressed. They continued to fund the research and began clinical trials of cisplatin in cancer patients in 1972. (One of the team leaders was the previously mentioned Dr. Lawrence Einhorn.)
The successful results of these trials led to FDA approval of cisplatin in 1978 for treatment of various cancers. Cisplatin has shown phenomenal results against one particular cancer, with a cure rate of over 90% when used in combination with other drugs.
The discovery of paclitaxel also came about in an unconventional way. In the 1950s, the NCI partnered with the United States Department of Agriculture to search for cancer cures from natural plant and animal products. Over the next two decades, they tested some 30,000 samples collected from across the country.
In 1964, NCI researchers were testing samples taken from Pacific yew trees located in Washington State. They discovered that a compound extracted from its bark was toxic to living cells, and they called it paclitaxel.
More than a decade later, the NCI selected the drug as a candidate for clinical development. Thanks to a grant from NCI, Dr. Susan Band Horwitz at the Albert Einstein College of Medicine of Yeshiva University found that the compound blocked cancer cell growth by stopping cell division. But the trials were delayed due to the Pacific yew’s slow rate of growth and the large amount of bark needed to produce the drug, as well as complexities in developing a synthetic version of the compound.
In 1991, NCI partnered with a pharmaceutical company to commercially produce Taxol, using a semisynthetic form of paclitaxel, which was soon approved by the FDA. Today, Taxol remains one of the best plant-based cancer treatments available, and it is used in the treatment of many cancers, including breast cancer, non-small cell lung cancer and pancreatic cancer.
Another life-saving development helped along by the NCI is gene therapy, the result of the 13-year Human Genome Project to sequence and map human DNA. The treatment isolates and targets specific genes in the patient’s body to eradicate the disease, and NCI-funded researchers were the ones who discovered the genetic link between the HER2 gene and breast cancer.
“There’s a young woman in Israel who was cured of her metastatic cancer by targeting the HER2 gene,” Rabbi Lowy of RCCS says. “In her case, the drug wasn’t covered, and we were able to fund it for her until we were able to convince the Israeli Ministry of Health to continue paying for it, given the excellent results.”
Other treatments include immunotherapy, which harnesses the body’s immune system to fight cancerous cells.
“While the NCI didn’t invent the concept of immunotherapy, its role in getting it off the ground and expanding it to its current success is undeniable,” Rabbi Lowy points out. “One example is the phenomenal CAR T-cell treatment. There’s a young woman in England whose cancer didn’t respond to the standard care. She recently received CAR-T and is now in remission.”
The Situation Today
With such a coordinated and consolidated effort, it was only a matter of time until the country began to see results. Although a panacea for cancer has yet to be discovered, there are some very positive trends.
Cancer death rates in the US were on the rise until the early 1990s, when 215 out of every 100,000 people died from the disease each year. Since then, the death rate has steadily gone down, mostly due to reductions in tobacco use, increased screening—which allows early detection of several cancers —and improvements in treatment for specific cancers.
A few months ago, a European study found that Americans have collectively gained up to 14 million years of life since 1980 as a result of NCI-funded cancer trials.
From 1991 to 2018, the cancer death rate fell by 31%, translating to 3.2 million fewer deaths. The largest one-year drop occurred from 2017 to 2018, the last year for which there is data, with a 2.4% decline. Still, 599,265 Americans succumbed to the disease that year.
Yet while cancer mortality rates in the US are declining, diagnoses are actually on the rise, due to increased lifespans. Researchers for the American Cancer Society say that cases are projected to rise from an estimated 1.91 million in 2021 to 2.65 million in 2050.
Meanwhile, the World Health Organization reported that 9.6 million people died of cancer in 2018, with 17 million new cases diagnosed that year. And cancer is still the second-leading cause of death on the planet, right behind cardiovascular disease. The white-coated workers at the NCI apparently still have their work cut out for them.
To that end, Ami recently spoke to Dr. Ned Sharpless, the director of the National Cancer Institute, to discuss how his agency is waging this battle. ●
To read more, subscribe to Ami
