Basic science and public policy.

I would like to address my attention to the Cancer Program as seen by the basic science community, not so much in terms of dollars and cents but of the objectives; i.e., where and how the basic sciences should fit and what role they have been asked to play in the Program. I am not going to deal with specifics of appropriation from the NCI budget, nor with the scientific basis of cancer control. Whatever position one takes with respect to the proper balance of effort in the Cancer Program toward basic and clinical initiatives, we must recognize that cancer is a by-product of our technologic society. We are faced with an overwhelming exposure throughout life to a growing battery of chemicals. Some estimates are that perhaps 20,000 new compounds are introduced into potential contact with human beings each year. The individual compounds would themselves pose a serious threat of recognition and detection. What then can we take to be the prospects for discerning the limits or effects of the interaction of a multitude of chemicals that we breathe, smoke, eat, drink, wash ourselves with, clothe ourselves in? There is no doubt that 5, 10, 15 or 30 years of post-World War II life has made of all of us chemical reaction flasks in which the reagents at work are largely unknown or if the reagents are known, the reactions in which they are critically involved cannot be specified. As important as the detection and elimination of these carcinogens from the environment are and must be, the diagnosis and treatment of cancer as well as prevention aimed at more than the study of chemical carcinogens must be pursued with unrelenting vigor. Cancer is already occurring via these chemicals and intervention looms as the principal instrument of effective modulation for some decades to come for all those already subjected to these carcinogens. Malignancies of all classes share in common the basic property that the malignant cells have lost contact with control devices in the host animal. Those devices serve to achieve the balanced functioning of the body. Malignant cells grow without respect for the limits set by the body for organ size or production of hormones or other pharmacologically active molecules by specific cells. The invasion of adjacent tissues, attachment to set up a focus of new growth in distant organs and vessels, special products which are released from the tumor …