An important history of the development of cancer centers of excellence and the revolution in cancer treatment.
In the 1960s a coalition of concerned citizens, scientists and politicians joined forces to convince the federal government to focus its efforts on conquering cancer. The National Cancer Act of 1971 resulted and was signed into law on December 23, 1971 by President Nixon. The national “War on Cancer,” was declared with some leaders naively arguing that the disease would be conquered by the nation’s bicentennial—a mere five years in the future.
Over the next five decades scientific discoveries demonstrated the great complexity of what had formerly been thought of as a single disease – with the advent of the genetic characterization of cancers, it is now recognized that there are almost an infinite number of cancers as defined by their many genetic mutations. The National Cancer Act established the infrastructure for the designation of centers by the National Cancer Institute (NCI) and these centers have evolved into models of multidisciplinary, collaborative cancer research, treatment and prevention contributing to a reduction in cancer mortality and increase in quality of life and survival that has translated into more than 17 million cancer survivors in the United States in 2021.
Centers of the Cancer Universe: A Half-Century of Progress Against Cancer tells the story of how cancer research was not front and center at most universities and research institutions before the National Cancer Act of 1971, and why many physicians were reluctant even to treat patients with cancer in the early 20th century. It follows the behind-the-scenes lobbying, resistance and negotiating that preceded signing the Act into law, and how the cancer centers of today came to fruition, and shaped how cancer research, clinical trials and treatment would be conducted.
Donald L. “Skip” Trump, MD, has been an active clinician and investigator throughout his career in oncology. Prior to retiring from his position as founding CEO of the Inova Schar Cancer Institute (ISCI), in Fairfax, VA where he led development of large community health system cancer program, Trump was President and CEO of the Roswell Park Cancer Institute (RPCI), an NCI-designated cancer center. In addition to his 13-year career at RPCI, Trump held leadership positions at NCI centers at the University of Pittsburgh, Duke and the University of Wisconsin. He lives in Oakton, Virginia.
Eric T. Rosenthal is an award-winning independent journalist who has covered issues, controversies and trends in oncology for more than three decades for a number of news media outlets. He founded the National Cancer Institute-Designated Cancer Centers Public Affairs Network in 1990; has cochaired numerous conferences on cancer or medicine and the media; and served on several national cancer committees, including the NCI-Director’s Consumer Liaison Group. He lives in Audubon, Pennsylvania.
Foreword by Nancy G. Brinker
Chapter 1-- The State of Cancer Research and Care: Before the National Cancer Act of 1971
Chapter 2-- Developing a National Cancer Program
Chapter 3-- Creating the Cancer Centers: The Legacy of the “Yellow Berets”
Chapter 4-- Building the Network of NCI-Designated Cancer Centers --A Few at a Time
Chapter 5-- The Newest Kids on the NCI-Designation Block
Chapter 6-- The Role of Pediatric Oncology and Pediatric Cancer Centers
Chapter 7-- Medicine or Marketing? Keeping True to the Mission and Balancing Hype and Hope
Chapter 8—The Rise of Oncology Specialties and Professional Societies
Chapter 9-- Progress in Cancer Research and Cancer Care Since the National Cancer Act: According to the Experts
Chapter 10-- Where is the Best Place to Go When You Learn that You Have Cancer?
Chapter 11--Future Challenges for Cancer Centers: Funding and Finances, Community Cancer Centers, and Addressing Cancer Disparities
About the Authors
Looking back over the past fifty years, authors Dr. Skip Trump and science journalist Eric Rosenthal together recall their memories of the advances made against the dreaded diagnosis of hopeless cancer… The remarkable progress that resulted, from early application of chemotherapies against pediatric leukemias to the current range of available medical treatments, is retold here, along with mentions of the myriad physicians, researchers, philanthropists, politicians, and patients recognized as the infantry in the quest to conquer cancer. The narrative features specifics about medications currently used and in development, the NCI, the current role of public information and advertising, and challenges still facing both patient and oncologist. This absorbing book records a half-century's details of accelerating inroads in battling metastatic disease. Highly recommended. All readers.
An important historical look at what went on behind the scenes to implement the National Cancer Act of 1971, and how it revolutionized cancer research and care. Centers of the Cancer Universe will be of interest to both experts and anyone touched by cancer.
This is a very important book that highlights the astonishing progress in prevention, diagnosis, and treatment of cancer since the passage of the National Cancer Act of 1971. The book provides important insights on how cancer research and the modern network of cancer centers have evolved, and at the same time conveys important, practical information to cancer patients and their families today.
This book by Trump and Rosenthal is an interesting and provocative compilation of the history of our cancer centers over the past 50 years. Indeed, since the National Cancer Act was initiated, much of our progress in reducing incidence, mortality, and suffering due to cancer can be ascribed to basic discoveries and clinical translation at our nation’s cancer centers. Smoking cessation, colonoscopy screening, targeted antibodies such as Herceptin®, immunotherapies such as ipilimumab, and signal transduction inhibitors such as Gleevec® all came from laboratories and clinics in our cancer centers and have provided major benefits to society. More basic and translational cancer research is needed, and more nimble and inclusive cancer clinical care approaches should be implemented. We should now consider new structures for cancer centers that can deliver sophisticated care to large communities at an affordable price to ensure that the best cancer research can provide the biggest benefit to all members of our society.
The "Why,” “How,” and “What” of the 1971 National Cancer Act are appreciatively told by Trump and Rosenthal. The act generated fifty years of scientific and treatment advances resulting in decreases in cancer deaths. A chapter of this unique book even outlines how to discuss a diagnosis of cancer with an oncologist.
Through meticulous research, engaging interviews, and personal recollections, the authors trace the origins and impact of the nation’s cancer centers from their formal creation by the National Cancer Act of 1971 to the present day. What emerges is a well told story of bold vision, relentless advocacy, and extraordinary leadership by a colorful cast of characters who forged the scientific foundation and enabling infrastructure to cure cancer.
The authors provide a very special narrative regarding the origins of the “National Cancer Act” in 1971 and the 50 years of accomplishments that can be attributed to this rather unique congressional action. Centers of the Cancer Universe provides a historic review of the political controversies, the public advocacy, and the concerns of the scientific/academic leadership regarding the purpose of and value added by this transformative legislation. Of interest, the authors highlight the challenges associated with carrying out one of the mandates of the NCA, the stepwise development of the national cancer centers program, and the challenges often encountered by institutional cancer leaders as their Universities debated the purpose and value of establishing an NCI designated cancer center. A special bonus for the reader is the input of more than 60 cancer scientists and center leaders commenting on the many transformative accomplishments over the past 50 years pertaining to the growth in our understanding of the biology of the many diseases we call cancer, progress in cancer prevention, and most importantly advances in the diagnosis and treatment of cancer. The book is an engaging read.
While our journey to eliminate cancer is not yet completed, progress in understanding cancer and converting knowledge into new modes of prevention, detection, and management has been largely spearheaded by the nation’s major cancer centers. This important read captures the history and major milestones achieved, and frames future challenges for the cancer center universe toward ending cancer as we know it.
Centers of the Cancer Universe offers an engaging narrative of how we landed where we are in the war on cancer launched in 1971. Its key element was the creation of cancer centers throughout the US. The cancer center concept worked brilliantly, and today, a half-century later, we understand with great clarity how most common cancers arise, the essential prerequisite to developing cures. The cancer center recipe, as described here, was a simple one: mix together basic preclinical researchers and clinical oncologists, and extraordinary synergies would emerge, precisely the central narrative of this book!
The cancer centers program defined the silhouette of the war on cancer as imagined by the cancer act framers. This book is a riveting personal analysis of the NCI centers program and the war on cancer through the eyes of the authors who collated the diverse opinions of many past and present participating clinicians, scientists, and administrators. A very interesting, unusual, and informative read.
The half century of astounding progress following the passage of the National Cancer Act of 1971 has created a metamorphosis in medicine. With innovative authorizations and ample appropriations, the National Cancer Institute was empowered to accelerate research with a purpose and create innovative models of multidisciplinary care. Over 50 years we have unraveled many of the genetic, molecular, and cellular mechanisms of this complex disease leading to innovative targeted interventions. As we look forward to this new era in molecular medicine, it is worth this look back at the ingredients of success that can be applied to conquering all other diseases, as delineated by Trump and Rosenthal in Centers of the Cancer Universe.
In December 1971, President Richard Nixon signed the National Cancer Act. This legislation would start the greatest scientific discovery effort in history. The Manhattan Project and the Moonshot were challenges of engineering, but this was an effort of both discovery and the application of findings that would result in a greater understanding of and indeed a redefining of the disease called “the Emperor of all Maladies.” It would also provide us with a greater understanding of biology that would affect our treatment of other diseases. Indeed, the National Cancer Act is directly responsible for the development of a highly effective and safe vaccine within 6 months of the discovery of COVID-19. Rosenthal and Trump tell a riveting story of how cancer science progressed over the past half century, and they do it in a fascinating, engaging way. This is an emotional read for those of us who have been cancer patients or cared for cancer patients as well as for family members or health care providers.
7/23/21, The Cancer Letter: Authors pen an editorial on "The National Cancer Act of 1971 and the birth of NCI-Designated Cancer Centers"
10/10/21, The Asco Post: The book was reviewed by science writer Ronald Piana, who calls it "engaging and informative" and highly recommends it.
11/11/21, Johns Hopkins Kimmel Cancer Center Podcast: Dr. Bill Nelson interviewed Dr. Donald L Trump and Eric Rosenthal about the book.
12/8/21, MedPage Today: Trump and Rosenthal wrote an article about their book.
2/3/22, Healio: Donald L. Trump and Eric Rosenthal were featured in this author Q&A piece.
3/22/22, Cancer Today: Authors Donald “Skip” Trump and Eric Rosenthal were interviewed about the book.