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search workers that money is available and that support will increase, I feel certain we will make far greater progress than we have been able to do in the past. I think the time has come for this kind of program and I would hope it would be with congressional blessing.
Dr. RAVDIN. There is already a breakthrough in this field in the study of choriocarcinoma, which has been a very serious tumor in the female.
Mr. FOGARTY. Where?
Dr. RAVDIN. In the uterus, and there is an excretion of a certain chemical compound with this. When the tumor is completely eradicated there is failure of the excretion and with the first signs of recurrence, even before any diagnostic method can pick it up, this agent again appears in the urine. Work of this type is of tremendous importance to ascertaining the recurrence or spread of the cancer.
Dr. FARBER. May I bring this budget discussion to an end and go on to an unrelated area but very closely related to cancer. Dr. Ravdin has already spoken in favor of the general principle of the world program I would like to present to you in the field of cancer, and this does not come in the cancer budget.
You, Mr. Chairman, have spoken concerning your deep interest in the Brussels Fair and the very fine suggestion you have for improving America's participation in that fair and demonstration to the 30 million people who supposedly will visit that fair.
Mr. FOGARTY. I had also in mind the World Health Organization and also the fact that the President, in his state of the Union message, mentioned that this is one area in health—he mentioned cancer and heart—where we ought to expand. Also, it was called to my attention that this was one area of his state of the Union message that Mr. Khruschchev agreed with.
Dr. RAVDIN. He mentioned cancer in his message.
Mr. Chairman, would you object if I left at this time? I am due in Philadelphia.
Mr. FOGARTY. Before you leave, I believe Mr. Denton has a question he wanted to ask.
Mr. DENTON. Can you see this cancer virus with a microscope?
Dr. RAVDIN. There are certain ways of determining viruses. There is no complete assurance just what a virus may be. It may be just a chemical entity. But viruses play a certain part in the growth of certain lesions. Even a wart is of viral origin. With a microscope you can see what you are dealing with. There are many different types of viruses. Polio viruses are not the same in all cases. But we do know that these viruses, or that certain viruses, play an important part in certain types of growths, abonormal growths, and it was this that led Dr. Stanley in Detroit last June to say there was nothing he saw that was incompatible with the concept that many, if not all, human cancers might be viral in origin.
Mr. DENTON. You cannot see it under a microscope?
Dr. RAVDIN. Not the ordinary microscope; no, you cannot. With an electron miscroscope you can. One of the kinds, cancer of the kidney, you can. I have seen it many times.
Mr. DENTON. Is it infectious or contagious ?
Dr. RAVDIN. You can take this virus as a filtrate without any tumor cells and inject it in another leopard frog which has this cancer of the kidney and this frog will develop a cancer identical with that.
Mr. DENTON. It looks like it is contagious, then?
Mr. FOGARTY. The amount that is being asked for cancer this year is $55,900,000?
Mr. DENTON. $55,923,000.
Mr. FOGARTY. This is a reduction of what was available in 1958, and if we take into consideration that in this $55 million there is included the 10 percent increase for overhead, that would be a couple million more, so this budget that the President has given to us is going backward and not ahead. Would you care to comment on that?
Dr. Ravdin. Yes, I would appreciate commenting on it. I seems this is deficient in several respects. It does not take into account the fact that we are now spending the money which was appropriated by Congress last year and in a lesser sum of money they have added a io percent overhead, which would decrease the amount of money available for research grants.
In addition, it has a second fallacy and that is that it does not take into account any increase in salaries or any increase in the cost of supplies for research. So that if we put those three things together you greatly reduce the effort that is now in existence.
Mr. FOGARTY. And what does that mean so far as the general public is concerned?
Dr. RAVDIN. It means a great impediment to the progress in the field of cancer.
Mr. FOGARTY. I thought it was worse than that.
personally consider it catastrophic. Mr. FOGARTY. Proceed, Dr. Farber.
WORLD CANCER CHEMOTHERAPY PROGRAM
Dr. FARBER. Mr. Chairman, may I speak to a proposal for something which I will call a world cancer chemotherapy and epidemiology program. The proposal made by the President of the United States concerning a “deeds for peace” program with Russia has been taken up by many people, particularly since he gave reference to studies in cancer, malaria, and heart disease.
There are two points which I would like to make concerning that proposal. The first is that unfortunately there has been nothing provided to implement such a proposal; second, it is unfortunate particularly to a doctor and a scientist, to have any proposal or any plan for research confined to interchange between two countries, Russia and the United States. Medicine is a world problem, and the United States, particularly, has taken the lead in furnishing the results of its medical research freely and completely to all of the countries of the world just as rapidly as such research results were available.
For this reason I would like to propose that there be a world cancer chemotherapy program with epidemiology included in it. I will explain that in a moment. I say that because we have the machinery set up for the expansion into such a program with very little difficulty, and because of the tremendous importance of what this con
tribution might mean to world peace with the United States taking the leadership.
I would have three parts to this program. The first concerns the provision of the anticancer chemicals we are presently employing in the treatment of human beings in this country, to research centers and all countries of the world.
I would like to just mention the anguish which is experienced by families in Italy, France, Poland, Spain, China, Japan, or anywhere else in the world when a member of the family is found to have cancer which is too far spread to permit cure by any of the conventional means, when the doctors tell such a family that there are available in the United States chemicals which at least can prolong life and diminish suffering in certain kinds of cancer.
If these are not available in such countries there is built up something which I think all of us can readily understand. The United States would be an innocent victim of additional anti-United States feeling.
I would suggest that we could supply all of the chemicals, hormones and antibiotics we are presently employing for patients in this country to research centers in all parts of the world with very little difficulty. The results would be tremendously good, not only for our world peace and our position in the world but also for the good of science because we would get in return for such scientists and research centers information which would join with the information we are getting in our own cities and centers in this country.
Mr. FOGARTY. What machinery would you use?
Dr. FARBER. We have a list of all research centers now in the National Cancer Institute. We have contacts with scientists throughout the world, particularly in this field through our cancer chemotherapy national program.
Mr. FOGARTY. You mean through the machinery of the National Cancer Institute you can arrive at it that way?
Dr. FARBER. Yes, sir. The second part of the program would be provision of funds for research contracts with research workers in all countries of the world.
Here you must remember that about one-third of the anticancer chemicals and hormones now in use have come from countries outside of the United States, notably England, Germany, France, and Japan.
Mr. FOGARTY. What has come out of Japan?
Dr. FARBER. Antibiotics. The greatest program in antibiotic research in the field of cancer in the world, except for the United States, is in Japan. They have developed this one field remarkably. They are badly in need of funds. Their work is being handicapped and going along at a slow pace because of a lack of money, and I think support by research contracts governed in any safe manner for the good of the program would increase our progress in this field of chemotherapy of cancer enormously.
I think it would be important, also, to open up chemical laboratories which are doing such extensive work, in Western Germany where they have the great chemical industries, before the war perhaps as great as anything we had in this country.
We could increase the splendid work which already is going on in England, the beginnings of work in many places in France and the
Scandinavian countries, in Italy, and in Spain, and we could support research of great value to our cancer chemotherapy program in a number of countries I have not mentioned.
I think this is a kind of practical move which will not only help achieve our goal in cancer more rapidly but will also have very fine return in the good will of these countries toward the United States.
There is a third part of the program which includes epidemiology, or the detective study of the occurrence of various forms of cancer in different countries of the world. We could set up programs in a number of countries where they have forms of cancer very commonly which we do not have so commonly, where the opportunity for study is therefore increased.
For example, in Egypt in the Near East bladder cancer is extremely common in association with a parasite which is found in the bladder, the schistasoma hematobium. That correlation has been known for a long time. More intensive study of it in those countries with the aid of scientists from this country would perhaps help us learn a great deal more about bladder cancer in this country.
Bladder cancer is one of the most miserably painful and slowly developing forms of cancer with which we are faced.
I could mention a series of them and perhaps I could include this in a statement to you and not go into it, but this opens up great possibilities.
I therefore would like to have you keep this presentation in your minds. I would be happy to make suggestions as to money if you should so desire.
Mr. FOGARTY. I think we have to have some information as to how much this would cost.
Dr. FARBER. A committee of experts in this field of cancer chemotherapy and epidemiology with whom I have discussed this have put a figure of $25 million for a world program to mark the beginning. Assessment could be made before the time of the next appropriations. What the mechanism would be I am not prepared to advise
now, but the resources of the National Cancer Institute I would hope would be employed to put this program into operation.
Every doctor and scientist with whom I have discussed this, and I have discussed it widely with men from all over the country, has without exception received this with great enthusiasm, and particularly because of the world implications of the breadth of the program.
Mr. FOGARTY. How would it affect the world siutation?
Dr. FARBER. First, as citizens and human beings, we are all very desirous in medicine and science to have the rest of the world look with good feeling upon the United States. I do not know the correct term for that, whether it be public relations of this country in the eyes of the rest of the world, but I know of no better way of making friends with people of other countries
than by helping them when they are sick, in misery, and in pain. That, certainly, would be done so effectively through the provision of anticancer chemicals.
Mr. FOGARTY. How would they know we were helping them? Dr. FARBER. I would hope that this would be publicized in the most effective and proper and dignified manner, publicized just in a way that you have suggested with the Brussels Fair, for example—through
having exhibits, publicized through actual articles in journals, daily papers, and magazines of the world.
Mr. FOGARTY. I remember being in Germany 10 years ago and being told that all the help we were giving Germany at that time was not appreciated because they did not know it was coming from this country. We might send in 40 carloads of potatoes to 1 city and Russia might send in 1 carload for 10 cities, but before they dumped it anywhere they would see to it that that car reached all of the 10 cities and the people were led to believe that Russia was really helping them.
There were many complaints in Congress about the way that program was handled at that time. That is the reason I raise the question. How would these people know that the United States was helping them in this way?
Dr. FARBER. I appreciate the logic of your remarks, and I would agree it would be sad, indeed, if the country which has led the world in telling the world about its products, on the radio, television, and newspapers, could not employ that talent in this great humanitarian effort to tell the world what this country is doing. I know, in medical circles, it is very well known, wherever we go in Europe, that a certain few institutions do have research grants through the National Cancer Institute, and the appreciation for those research grants is tremendous.
Mr. FOGARTY. It might be easier to get that information to the people through medical circles than it would other types of help that we give to countries.
Dr. FARBER. It might be the most genuine way of doing it and have the greatest results. That could be done, Mr. Chairman.
Mr. FOGARTY. It sounds worth exploring. It is something new. Do you have anything further?
GENERAL RESEARCH AND TRAINING GRANTS
Dr. FARBER. Now, if we may leave the cancer field and turn to the area of general research grants and general research training grants of the Division of Research Grants of the National Institutes of Health.
Doctor Ravdin joins with me in making the recommendations I am about to make.
This area of general, or noncategorical, grants concerns those parts of the research world which are not to be found conveniently in cancer or heart disease or neurology, blindness, arthritis, and so on.
These general grants support basic research, which we discussed before, and training programs in medical and related biological fields where the emphasis is entirely upon the successful acquisition of new knowledge for its own sake and for the training of scientists as fundamental investigators in one or another of the fields related to academic medicine.
I would make this comparison, Mr. Chairman, and think it a just one-if we were to take people in the various craft unions who are being trained to be expert in those fields, we would have carpenters or bricklayers or painters or plumbers. These would be the noncategorical research areas. When they go across the board to work together to build a house, a factory, an oil refinery, or as research