The White House last week announced its intention to appoint Harold Freeman as chairman of the President’s Cancer Panel, and named Nancy Brinker and Geza Jako to fill the panel’s two other seats.
Freeman, director of surgery at Harlem Hospital Center and professor of clinical surgery at Columbia Univ. in New York. served as president of the American Cancer Society in 1988-89.
The White House made the new appointments in a relatively short time, only four months after the death of Armand Hammer, who served as Panel chairman since 1981. The term of panel member John Montgomery had expired in 1989 and that of William Longmire ended in February.
In announcing the appointments, the White House officially named Freeman to succeed Longmire, but said that upon appointment, Freeman will be designated Panel chairman. Brinker was named to succeed Hammer, and Jako to succeed Montgomery.
Presumably this was done to give Freeman the longest term of the three appointments. His term expires in 1994, Brinker’s in 1993, and Jako’s in 1992. However, the law creating the panel allows members to serve until they are replaced.
Freeman could not be reached for comment by The Cancer Letter’s presstime this week.
‘New War Against Cancer’
During his tenure as ACS president, Freeman emphasized the issue of cancer as it affects socioeconomically disadvantaged Americans, an area that has interested him throughout his involvement with the society.
In an editorial in the April 17 “Journal of the National Cancer Institute,” Freeman calls for greater funding of cancer research and treatment as it relates to the poor.
“Poor Americans constitute a high risk group for developing and dying of cancer,” Freeman wrote. “Accordingly, substantial resources should be directed toward prevention, detection, diagnosis, and treatment of cancer in the economically disadvantaged.”
To accomplish NCI’s “Year 2000” goal of a 50 percent reduction in the cancer mortality rate, Freeman wrote, “we must declare and conduct a new kind of war against cancer–a guerrilla war to tear down the economic and cultural barriers to prevention, early detection, and treatment of cancer. This hand to hand combat must be carried out in the neighborhoods of America where people live and die. Therefore, the designated battlegrounds for waging such a guerrilla war should include geographically and culturally delineated areas of high cancer incidence and mortality. Such areas should be targeted with an intense approach to providing culturally relevant education, control of tobacco use, appropriate access to early diagnosis and treatment, and an improved social support network.”
A native of Washington, D.C., Freeman received his MD from Howard Univ. and completed his residency in surgery at Howard Univ. Hospital and Memorial Sloan-Kettering. He has been affiliated with Columbia Univ. since 1967, and became a full professor in 1989.
He has held many other appointments, and is currently a senior member of the American College of Surgeons Commission on Cancer, a member of the Executive Council of the Society of Surgical Oncology, and on the board of directors of the New York City division of ACS.
Brinker: Cancer Work A ‘Mission’
Brinker started the Dallas-based Susan G. Komen Foundation for the Advancement of Breast Cancer Research in memory of her sister, who died of the disease in 1980. Since its founding in 1982, the Komen Foundation has grown to a major national organization that funds breast cancer education programs and supports breast cancer research projects.
Brinker is not the first woman to be appointed to the Panel. That distinction belongs to the late Elizabeth Miller, an eminent scientist from the McArdle Laboratory at Univ. of Wisconsin, who was on the panel in the late 1970s.
“I am terribly interested in cancer as it concerns women and minorities, and vitally interested in the work of the National Cancer Institute, seeing that the institute is well funded and appreciated,” Brinker told The Cancer Letter. “I am very interested in seeing advances move from bench science to the ·bedside.”
Brinker was appointed to the National Cancer Advisory Board in 1986 and still has more than a year of her term to serve. She said she did not know whether she would have to vacate her NCAB seat, but it is not likely that would be the case. The White House named her to succeed Armand Hammer, who as Panel chairman also served on the NCAB.
Brinker emphasized the Panel’s role in drawing attention to the National Cancer Program.
“I hope the panel will continue to take the important work of the Cancer Institute to the public and that way generate more support from the public,” Brinker said.
“Whatever issues we mutually agree upon to bring to the public, I can tell you I will not be sitting on my hands, and I’m not one to be quiet. I take this responsibility very seriously. My work in the cancer field has always been a mission to me.”
Brinker has been successful in capturing the attention of politicians to her cause. Barbara Bush was an honorary speaker at the foundation’s Women’s Leadership Summit in 1989, and in 1990, Vice President Dan Quayle and Marilyn Quayle chaired the foundation’s “Race for the Cure” in Washington, in which many members of Congress participated. The foundation holds an annual awards luncheon during which former first lady Betty Ford presents the Betty Ford Award. Recipients have included Nancy Reagan, Happy Rockefeller, Selwa Roosevelt, Barbara Bel Geddes, and the late Jill Ireland.
The foundation also has funded $9 million in cancer research grants to 15 institutions, including many based in Texas, such as M.D. Anderson Cancer Center, the Dallas Public Library, Univ. of Texas Health Science Center, Southwestern Medical School, Parkland Memorial Hospital, as well as other institutions in the U.S., including Johns Hopkins Medical School, The Betty Ford Center, Lombardi Cancer Center at Georgetown Univ., Univ. of Illinois, the National Alliance of Breast Cancer Organizations, and NCI.
Brinker, a native of Peoria, IL, received a BA in liberal arts from the Univ. of Illinois. After graduating, she moved to Dallas and entered the executive training program at Neiman Marcus. She was a radio reporter and talk show host at WRR-AM Radio in Dallas from 1973-75, and then worked in public relations. She was active in fundraising for the American Cancer Society during her sister’s illness, serving as volunteer public relations director for the Cattle Barron’s Ball.
Simon & Schuster published her book, “The Race Is Run One Step At A Time,” last fall.
Jako: Active In Republican Politics
Jako is professor of otolaryngology and of head and neck surgery at the Boston Univ. School of Medicine. He is also chief of ear, nose, and throat and head and neck surgery at Wakefield Hospital in Melrose. His special interest has been the development of laser surgery and of microsurgery with and without lasers.
His appointment in 1982 to the National Cancer Advisory Board, along with that of former Congressman Tim Lee Carter, prompted fellow board member Janet Rowley to write a letter to “Science” blasting political appointments to scientific review bodies.
Jako frankly admitted that his appointment to the Panel was a political one and sees nothing wrong with that. “It’s a political position, after all,” he commented to The Cancer Letter.
Jako said he has “always been involved in Republican Party politics,” and is currently vice chairman of the Republican City Committee of Melrose, MA, where he lives. In the early 1970s, he served as chairman of the Hungarian-American Republican National Federation, giving him the opportunity to become acquainted with George Bush, who was at that time chairman of the Republican National Committee.
However, “I think I have progressed scientifically with my own work. I don’t think I’m a political person who got into this only by political involvement.” He said his accomplishments in medicine include being the first to use microsurgery in treatment of soft tissue sarcoma and cancer of the larynx; and the first to use lasers for practical surgical applications.
Jako’s service on the NCAB was marked with controversy not so much because of the alleged lack of qualifications but because of his propensity for opposing NCI’s leadership and the board majority on various issues.
He infuriated then director Vincent DeVita by contending that chemotherapy of cancer was overrated and attempting to support that position with outdated survival figures. He also opposed DeVita’s eventually successful effort to bring the Organ Systems Program entirely back into NCI; and he frequently sided with outside critics of NCI such as John Bailar.
When Jako’s term on the NCAB expired in 1988, he left with a blast (in a letter to Sen. Orrin Hatch) at NCI, his fellow board members, the bypass budget, the Year 2000 goals, and the National Cancer Program in general (The Cancer Letter, April 18, 1988). His letter was denounced by NCAB Chairman David Korn, and fellow board member Helene Brown threatened legal action if Jako refused to apologize.
There was no apology (at least publicly), and no legal action. Jako says now that he has no intention of pursuing the points he made in the letter, and that he wants to leave all the previous controversy behind.
“I want to try this time to be more cooperative, with the new director, the new Panel members and the NCAB. Those old issues are passe. I want to take more of a positive attitude. I will be working with a new group of people and I hope we can push ahead and accomplish something.”
Jako said that he intends to use his position on the Panel to improve detection and treatment of lung cancer, primarily with the use of better endoscopy, microsurgery, and intraoperative ultrasound. “With better detection and better and more precise surgery, I think we can get five percent improvement in lung cancer mortality by the Year 2000,” he said.
Jako is working in Massachusetts for an additional five cent per pack cigarette tax which would be used to provide free screening chest x-rays for persons at high risk of lung cancer, as determined by age and smoking history.
“I think we can tum this around, like we did with screening mammography,” he said. “But we need to take a look at how to screen, who to screen, and how to pay for it. We owe that to the public, especially now that lung cancer is the number one cancer killer of women. The growing interest in women’s health care adds an extra dimension to the lung cancer problem.”
As for the Panel’s charge, to ascertain problems and impediments to progress in the National Cancer Program and make them known to the President, Jako said, “I hope we will have the chance to do that. I also hope we will act as a stimulant for improvements.”
Panel As Entre To White House
The President’s Cancer Panel was created by the Nationai Cancer Act of 1971 as part of the compromise that toned down the Senate bill, which would have taken NCI entirely out of NIH. Proponents of the Senate bill argued that cancer research interests frequently became submerged or ignored at NIH and department levels because the rest of the biomedical research establishment outweighed and outvoted them. The Panel was intended to give cancer (as represented by NCI) entre to the White House, along with increased public visibility.
Former Panel Chairman Benno Schmidt used that entre and visibility with great effectiveness. After department Secretary Caspar Weinberger tried to kill biomedical research training, Schmidt induced the White House to establish the National Research Service Awards. Schmidt went to the mat on other issues, and when he couldn’t get through the White House door, he either went public or went to Congress.
Joshua Lederberg’s short time as Panel chairman was uneventful, but Armand Hammer aggressively used the congressional mandate. Hammer was greatly disappointed when Presidents Reagan and Bush did not accord him the access that Presidents Nixon and Ford did for Schmidt. Hammer tried to overcome that with his own flair for publicity, by going to Congress, and by using some of his own immense wealth. He did get 15 minutes of President Bush’s time last August, in the midst of the Persian Gulf crisis, to submit in person his annual report on the Panel’s activities and a copy of NCI’s FY 1992 bypass budget.
Hammer’s most effective use of the Panel’s mandate was perhaps the forum he gave to Director Vincent DeVita. Devita took that mandate literally and never hesitated to go public at Panel meetings with his problems with the White House, Dept. of Health & Human Services, and NIH. So effective was D.eVita in using the Panel to go over NIH Director James Wyngaarden’s head that Wyngaarden publicly called for elimination of the Panel.
Director Samuel Broder so far has not made similar use of the Panel. Wyngaarden left shortly after Broder’s appointment; possibly it was either unnecessary or inappropriate for the new NCI director to take on NIH Acting Director William Raub.
