Normal Routines Dramatically Altered In Days Since Sept. 11 Terrorist Attacks.

On the morning of Tuesday, Sept. 11, cancer researchers, administrators, clinicians, and activists were going about their usual business. Some had just settled in at conferences, or had begun work in their offices.

Over the next few hours, their normal routines would be altered dramatically.

—In his apartment across the street from 7 World Trade Center, Gilles Frydman, founder of the Association of Cancer Online Resources, was sleeping late after a long night of fixing a computer. “All of a sudden, I heard a sound, an incoming sound,” Frydman said. “I knew instantly it was not OK. I thought it was a plane that was going to crash, and crash on me, and I would never see my children again.”

—At the NIH campus in Bethesda, members of the National Cancer Advisory Board had just heard NCI Director Richard Klausner describe a technical advance in molecular epidemiology. A staff member handed Klausner a note. There was a “situation,” Klausner said. “Two planes have crashed into the World Trade Center, which appears to possibly be a terrorist attack.” He apologized for the interruption, and went on to announce his resignation.

—In a conference room at the Bethesda Holiday Inn, the FDA Oncologic Drugs Advisory Committee was in the midst of hearing data on a new drug for non-Hodgkin’s lymphoma. The committee decided to continue the meeting. “I made the announcement that if we were to stop the meeting, then the terrorists have won, because routine business couldn’t get done,” said Committee Chairman Stacy Nerenstone.

—In Milan, Peter Boyle, director of the epidemiology and biostatistics at the European Institute of Oncology, was working in his office when he received an email about the attack. He tried to switch from the BBC Health Web page to News, but was unable to connect. “I was kept up-to-date by telephone by my daughters who were watching events evolve on television in France,” Boyle said. “It was impossible to connect to any news Web site for several days. It took two days to find out whether my friends in Manhattan were safe.”

—In Seoul, Korea, Wuan Ki Hong, head of the Division of Cancer Medicine at M.D. Anderson Cancer Center, was wrapping up a scientific conference and planning to catch a plane back to Houston. He was stranded in Korea for several days.

—Brian Druker had landed at Washington Dulles Airport about half an hour after the plane that would crash into the Pentagon took off. Not long after, from his taxi into Washington, he saw black smoke billowing from the Pentagon.

This week, The Cancer Letter devotes its pages to the stories, thoughts, and fears of individuals in the cancer research community as they experience this national crisis and suddenly confront an uncertain economy, with possible implications for federal research funding, and a difficult climate for travel and international communication.

Eyewitness At “Ground Zero”

Gilles Frydman, president of the Association of Online Cancer Resources, spent the night of Sept. 10 working to recover data from a failed hard drive in a server at ACOR headquarters in Queens.

He arrived home at 5:30 a.m. and went to bed. A few hours later, his wife, Monica, took their children to school on the subway. “I remember seeing them go, then fell asleep again,” he said.

“All of a sudden, I heard a sound, an incoming sound,” Frydman said. “I lived in Israel next to an airport. I knew instantly it was not OK. I thought it was a military plane, but then I thought it was a plane that was going to crash, and crash on me, and I would never see my children again. That sound threw me out of my bed.

“One second later, I heard—Boom! I looked in front of my window and saw it. The World Trade Center was just in front of us. My building on 173 Duane Street is yards from what the journalists are calling ‘ground zero.’”

Frydman called his mother, then went outside to take pictures. “I got some pictures of the plane’s tail coming out of the World Trade Center. That was before the fire.” He went inside to call his mother again.

“We spoke for two or three minutes. Then I heard another boom, and saw flames coming out of the other tower. I said, ‘I’m sorry, our conversation is over. I have to leave the neighborhood instantly.’”

Frydman turned on the television. “I heard the word ‘terrorist,’ which was what I had thought. I knew from living in Israel that they create a huge commotion, and then do something else that harms more people. I was concerned about biological agents.”

Moments later, Monica returned, and they left by car, heading uptown to their children’s school. “When we got to the school, my mother called on the cell phone and said one tower has fallen,” Frydman said. “I didn’t realize what had happened was like a pinpoint nuclear blast.”

There was no way of going back home, Frydman said.

“Wednesday morning, I went downtown. It took a long time, but I finally got home. I realized neighbors with children had watched the whole thing. Wednesday was absolutely incredible. It was a traffic jam of emergency vehicles, seven avenues wide, all going in one direction.”

Their apartment building was not damaged, though 7 World Trade Center eventually collapsed. “We got dust, but not as bad as some places,” Frydman said. “It’s surreal that we were so close, but it looks almost normal.”

The Frydmans have been staying with friends. “We can’t return to our apartment with the children for weeks, if not months,” Frydman said. “No one really knows how long. Access to neighborhood is very difficult. The Army taken over two blocks from our home.”

Frydman said he has sent one email a day to ACOR volunteers, but hasn’t felt like working. “I thought it was much more important to help the neighborhood, and help carrying food, carrying stuff, just helping as you can help,” he said. “I brought batteries to my neighbors, milk, and an old-fashioned phone so you can plug in easier—fundamental items.

“Our entire life is disrupted and is going to be disrupted for quite some time. My children are not sure they want to live someplace near so many bodies.”

Frydman said he is determined to stay in the neighborhood. “Terrorists are not going to destroy our democracy, our way of life,” he said. “We will rebuild, and we will stay. This is where we live.

“Now the Western world is at war with Muslim fundamentalists. It’s a much bigger problem than Osama bin Laden.

“It’s much scarier than cancer, because it’s manmade. To think that people are able to do this to people is not conceivable, though it becomes simple when you realize that people who do not respect their own lives can’t respect anyone else’s. It comes down to this: Either you let them annihilate you, or you have to annihilate them.”

“I Did Not Feel Safe Until I Was Home”

Susan Love, an NCAB member, had planned several speaking events in the Northeast last week. After the NCAB meeting was cancelled when federal buildings were vacated, she walked back to the Bethesda Hyatt and spent the rest of the day watching TV.

NCI Director Klausner called all of the board members that night and invited them for dinner. “I know we all had more wine than usual, but it was good being together,” Love said. “We were the only ones in the restaurant.

“I am very sorry to see Rick leave the NCI,” she said.

Love was scheduled to give grand rounds first thing Thursday morning in Maine. “All the rental cars were taken, so I hired a driver and we left at 6 a.m., and he drove me 10 hours to Portland,” she said.

She gave grand rounds and a talk to the public.

“Much to my surprise, the audiences were big,” she said. Then, she drove to Portsmouth, NH, gave a talk in the evening, and then got up at 4:30 a.m. Friday morning to drive to Westchester, NY, for another talk.

“My big chance to get home was the Friday evening flight from JFK to LAX where I had reservations,” Love said. “I made it to the airport at 3:30 p.m. for a 6 p.m. flight. They made me pack my Swiss Army knife in my luggage and check it, they searched both checked and carry-on luggage. Then we went through the metal detector and to the gate.

“It took an hour and a half to board, because they did it row by row. Each person was patted down and wanded before they got on the plane. Dinner was with a spoon and fork. Everyone just looked tired and dazed.

“We finally arrived home at midnight. I did not feel safe until I was back in California.”

One of Love’s classmates from business school was on the plane that hit the Pentagon. “Chris Newton was 38, a great guy at the peak of his career. He had two young kids, they are 10 and 7, and he had just moved to Virginia.”

Optimism For AACI Annual Meeting

Barbara Duffy Stewart, executive director of the Association of American Cancer Institutes, was attending the NCAB meeting.

“After it ended, I walked back to the Bethesda Hyatt with Barbara LeStage, the chairman of the NCI Director’s Consumer Liaison Group,” Stewart said. “I ordered room service lunch and watched TV for 11 hours straight. The next morning, I was going to look into getting another hotel, and I ran into Pearl Moore [executive director of the Oncology Nursing Society] and PaulaAnn Rieger [ONS [president]. They had rented a car to go back to Pittsburgh. So I hitched a ride with them.”

Stewart said AACI plans to go forward with its annual meeting Oct. 2-3 in Chicago.

“People may have to build in extra hours of travel time,” Stewart said. “I’m looking forward to having a well-attended meeting. There are only 84 cancer center members of AACI, and we were hoping to get attendance of 100 or above, of cancer center directors and administrators.”

Like The Plot of a Tom Clancy Novel

John Ruckdeschel, director of the H. Lee Moffitt Cancer Center and Research Institute in Tampa, was attending the NCAB meeting. He returned home by train and wrote about the experience for the Tampa Tribune (Sept. 15).

In the article, Ruckdeschel wrote that the terrorist attack reminded him of a Tom Clancy novel in which a pilot crashes a 747 into the U.S. Capitol. “It seemed implausible,” Ruckdeschel wrote. “It all rings too true today.”

Ruckdeschel said he still plans to fly to Chicago for the AACI annual meeting.

“We have had a number of meetings cancelled that we were to attend and had to cancel our educational conference in Campoinas, Brazil, due to lack of consistent flights,” he said to The Cancer Letter. “I have lots of angst about flying, but most of us who are road warriors know we have to do it. I suspect the number of ‘let’s meet at O’Hare to discuss this’ meetings will drop off for a few months.”

ASCO Cancels Meetings

At the American Society of Clinical Oncology headquarters in Alexandria, VA, all activities were cancelled last week, including a meeting of the 135- member Clinical Practice Committee.

“We’re re-examining meetings in early October, just because of the logistics of travel,” said Deborah Kamin, director of government relations. “We will either hold them by telephone, or have fewer people.”

Also cancelled this week was a seven-member ASCO delegation trip to China. “There has been a lot of anti-American sentiment in China,” Kamin said. “We were worried that even if the delegation could get there, getting back might be an issue.”

“Obviously, we’re looking ahead to ASCO’s other meetings, which are revenue sources: the fall symposium in Boston, in late October, and the annual meeting, in May, half of which are international attendees,” Kamin said. “Longer term, maybe this will cause us to examine changing practices with the thought that disruption will be with us for a while.

“We’ve talked about acquiring the equipment for video conferencing,” she said.

AACR President Cutting Back Travel

Waun Ki Hong, head of the Division of Cancer Medicine at M.D. Anderson Cancer Center and president of the American Association for Cancer Research, was stranded in Seoul after attending an AACR conference.

“I have to travel, but I’m really cutting back,” Hong said. “I cancelled a trip to Manila for the International Union Against Cancer (UICC), and a meeting in November in Asia. For domestic travel, you really have to prioritize. If it is an important meeting, you have to go. What can you do?”

Hong said he is concerned about a downturn in the economy. “At the moment, its too early to make any judgment, but we need to watch events,” he said. “Right now we’re not really developing any new initiatives. We’ll wait and see.”

In Europe, Fear Of U.S. “Introspection”

Peter Boyle, director of the Division of Epidemiology and Biostatistics, European Institute of Oncology, said he still feels “incredulous” about the terrorist attack. “My first reactions included shock, revulsion, and grief for all our society,” he said. “I hope and pray that the innocent victims find eternal rest.”

Immediately, three meetings Boyle planned to attend were cancelled, including a meeting in Dublin, of the Panel to Review Proposals for Cancer Clinical Trials Funding in Ireland, a program of the NCI-All Ireland Cancer Initiative.

Boyle said he did not miss the meetings.

“It is wonderful to suddenly find that you have seven free days in the diary,” he said. “If video conferencing became more ubiquitous, then it would be possible to avoid a large proportion of face-to-face meetings and stay at home a bit more often.”

However, meetings are important for developing personal contacts, he said. “It is truer today than ever before that progress in cancer control depends on national and international collaboration, and personal contacts and discussions are necessary,” he said. “I hope we can reduce the number of meetings without harming necessary interactions.”

Travel restrictions could isolate American specialists from their colleagues, Boyle said.

“The other fear I have is that the U.S. will become more introspective,” he said. “From my perspective, many of the major scientific meetings are American. My favorite meeting of the year is the annual meeting of the American Urological Association. I also look forward to the Annual Milan Breast Cancer Meeting.

“Both meetings could go along on their own without the presence of scientists from outside either continent,” Boyle said. “However, the AUA meeting benefits from the close involvement of Europeans (and others) and the Milan Breast meeting benefits from the close involvement of Americans.

“It would be a bad blow if such international interactions were harmed by last week’s tragedy,” he said.

Wither Federal Research Funding?

Robert Mayer, vice chairman for academic affairs, Department of Adult Oncology, at Dana-Farber Cancer Institute, and professor of medicine, Harvard Medical School, said his immediate concerns were safety and security.

“At Dana-Farber and other Harvard cancer research and treatment facilities, travel was strongly discouraged for the week immediately following the terrorist events, particularly because of concern about Logan Airport,” he said. “I expect that travel will return almost to normal by early October—hopefully by mid- October when we offer our annual week-long postgraduate course.”

For the longer term, Mayer said he is concerned about federal funding for research becoming a casualty of war on terrorism.

“With the economy in a downturn and unanticipated defense needs and bail-outs to the airline industry in the offing, I suppose it is possible that the NCI and NIH budgets will suffer, particularly since neither agency has a director who is empowered to make a strong case to Congress and the White House,” Mayer said.

“Robbed Us of Our Feeling of Safety”

Mary J.C. Hendrix, head of the Department of Anatomy and Cell Biology, associate director of basic research and deputy director of the Holden Comprehensive Cancer Center at University of Iowa, said she cancelled her previously scheduled trips until mid-October.

She had been scheduled to travel to Washington, DC, on Sept. 11 for the Oncological Sciences Study Section Boundary Team Meeting. “Luckily, the majority of this team were grounded,” she said. Some of the members were stuck in Washington.

“Science was undoubtedly affected by the events of the terrorist attack,” Hendrix said. “Because the performance of science is integrally connected to people, communications, deliveries of supplies, location, and travel, the business of scientific discovery was temporarily suspended as we worried about the well-being of our friends, family, and colleagues, and especially, as we mourned the loss of innocent lives.

“As a gentle and trusting society, last Tuesday robbed us of our feeling of safety and the freedom to travel without any concerns of vulnerability,” Hendrix said. “Our lives have changed dramatically, but our resilience is ongoing.”

“If Travel Isn’t Critical, I’ll Stay Home”

When he arrived in Washington Dulles Airport a little before 9 a.m., Sept. 11, Brian Druker was on the final stop of a four-city tour.

Since the approval of Gleevec, his rationally-designed drug for chronic myelogenous leukemia, the Oregon Health Sciences University hematologist had become a sought-after speaker.

Earlier on that trip, he had gone to Amsterdam, Helsinki, and Durham, NC. On that day, Druker was heading to his university’s reception for the Oregon Congressional delegation.

About a half an hour before Druker’s commuter plane touched down at Dulles, American Airlines Flight 77 lifted off from the airport runway. At 9 a.m., on the airport’s monitors, Druker saw the beginning of the attack on the World Trade Center.

With his cell phone against one ear and with the cab’s radio blasting NPR updates into the other, Druker was heading toward Capitol Hill. Meanwhile, the doomed airliner zigzagged through Washington sky.

At around 9:45, just as the cab turned off I-66, Druker’s girlfriend called to tell him that the planes that hit the World Trade Center were commercial airliners filled with fuel and passengers.

The two were still on the phone when NPR reported that smoke was rising from the Pentagon. Indeed, it was. “Just as I was talking to her, I could see big, black billowing smoke coming out of a building that was clearly where Pentagon was located,” Druker said.

Stuck in Washington until Friday afternoon, Druker found himself rethinking his travel schedule.

“I was extremely fortunate that I wasn’t on a plane that was going across the country that day,” Druker said. “The question I am trying to ask myself now is how critical it is that I travel. If it’s critical, I will do it. If it’s not, I will stay at home.”

Some trips are not essential. “I enjoy giving the talks, I enjoy meeting people, and I think people enjoy hearing the Gleevec story, but I think there are other means of communications,” Druker said.

“I recognize that people want to hear this story, and they want to hear it directly from me, but I can also write about it, and I can be available by satellite hookup,” he said. “I have work to do, and I want to make sure that the work gets done, and in order to focus on my work I need to be at home, with protected time.

“If you add that to some concerns about personal safety, it makes sense for me to try and be home a little bit more.”