Cancer Prevention Strategy at the NCI
SerVaas, Cory, The Saturday Evening Post
A tough, no-nonsense, prevention-minded workaholic at the helm of the NCI teaches the cancer-causing dangers of cigarettes with a vengeance.
Dr. Sam Broder has a well-earned reputation for being brusque, brilliant, and all business. The new director of the National Cancer Institute comes by his toughness naturally. Born in 1945, he survived the waning days of World War II by hiding with his parents and his sister in the rural countryside near his native Lodz, Poland. Part of his first four years was spent in a displaced persons camp before the family immigrated to the United States and a working-class neighborhood in Detroit. Always an outstanding student, Broder attended the University of Michigan on scholarship and graduated cum laude from its medical school.
Since joining the National Cancer Institute 17 years ago, Broder has served in a variety of posts. He is best known for his recent work in introducing the drug AZT for treating AIDS. He was named by President Reagan to oversee the NCI and its budget of $1.5 billion in December 1988.
In this, the first of a twopart series, he explains to the SatEvePost his priorities as leader of the largest arm of the National Institutes of Health.
Dr. SerVaas: Dr. Broder, we were happy to read about your emphasis on prevention at the NCI. What are the prevention goals you've set for the Institute?Dr. Broder: In a certain context prevention is the most important priority of the Cancer Institute. There are a number of things that we will try. One of them relates to smoking prevention. I think not many people in this country know that lung cancer, which is one of the many diseases caused by smoking, was an exceptionally rare disease at the turn of the century.
For example, as a vignette that I might share with you, in 1919 an entire class of medical students at Barnes Hospital [St. Louis] was summoned to the autopsy room to see a postmortem examination on a man who had died of lung cancer. They were summoned because their professors felt they would not see another case in their lifetime.
So lung cancer was a rather rare disease in this country at one time, and I think it's possible for it to become a rare disease again.
The principle of smoking prevention and the importance of ensuring that all groups in society understand the risks of smoking is really going to be an important feature in what we try to do. We have to make sure that adolescents understand the consequences. We have to make sure that women understand the issues, because smoking and lung cancer, in my opinion, are women's health issues. We project that more women will die of lungcancer-related deaths than of breast cancer this year. These are important issues, and we need to address them, and we need to take appropriate steps, which we are doing.
Dr. S. Specifically, what's your antismoking agenda?
Dr. B. We're going to enhance a number of education and outreach activities. We're going to try to make sure that our office of cancer communication provides relevant information for patients to make choices. We're going to develop projects that test the effectiveness of various smoking-prevention strategies in individuals. The National Cancer Advisory Board, which .is an advisory board to us, recently issued a set of very strong recommendations that it wants to pursue for smoking prevention. That's one component of our prevention strategy.
There are other components, however. I think that we need to talk about diet as a consideration. We know that certain dietary components may play a role in certain cancers. Various immigration studies show that sometimes individuals will move from a region with a low risk of certain types of cancer, and when they [begin eating] a diet common in our society, they begin to acquire the cancers that we get. Colon cancer is a good example. I think we have to be careful in terms of fat content in the diet and in terms of overall calorie intake. …