Physicist, Oceanographer, Aerospace Technologist, Rancher, Land Developer and Lecturer
National Cancer Institute (NCI)
National Institutes of Health
On the previous page of this web site of mine, I made mention of the fact that I was not looking for a job at the National Cancer Institute when this opportunity came along. Rather, I was recruited in an unusual manner by a friend, who happened to also be one of the Scientific Advisors to the President of the United States. The White House had begun developing a plan for implementing a war against a terrible disease affecting the United States,Cancer! They were looking for a few people who had experience in developing a brand-new program from scratch that could put together what they had begun calling the National Cancer Program Plan. I guess I fit that description to my friend, Snowden Williams. He started the ball rolling without my knowing it for me to reenter public service as a Civil Servant at the NCI.
I was just getting into gear at Wolf Research, in fact was spending a good part of my time during the early weeks of being at Wolf Research trying to help those people out that were working with the NCI under contract. Our task was to take all the demographic data being collected on the etiology of cancer to see if we could figure out what patterns might exist that might lead the researchers to understand better how cancer developed in different population zones in United States. As a result of this contract, I had developed a good working interface with the director of the NCI and many of his staff people. Thus the stage was set for making a transition into this organization without my having tried to develop that situation.
Mission Statement for the National Cancer Institute
The National Cancer Institute (NCI) is part of the National Institutes of Health (NIH), which is one of 11 agencies that compose the Department of Health and Human Services (HHS). The NCI, established under the National Cancer Institute Act of 1937, is the Federal Government's principal agency for cancer research and training. The National Cancer Act of 1971 broadened the scope and responsibilities of the NCI and created the National Cancer Program. Over the years, legislative amendments have maintained the NCI authorities and responsibilities and added new information dissemination mandates as well as a requirement to assess the incorporation of state-of-the-art cancer treatments into clinical practice.
The National Cancer Institute coordinates the National Cancer Program, which conducts and supports research, training, health information dissemination, and other programs with respect to the cause, diagnosis, prevention, and treatment of cancer, rehabilitation from cancer, and the continuing care of cancer patients and the families of cancer patients. Specifically, the Institute:
Supports and coordinates research projects conducted by universities, hospitals, research foundations, and businesses throughout this country and abroad through research grants and cooperative agreements.
Conducts research in its own laboratories and clinics.
Supports education and training in fundamental sciences and clinical disciplines for participation in basic and clinical research programs and treatment programs relating to cancer through career awards, training grants, and fellowships.
Supports research projects in cancer control.
Supports a national network of cancer centers.
Collaborates with voluntary organizations and other national and foreign institutions engaged in cancer research and training activities.
Encourages and coordinates cancer research by industrial concerns where such concerns evidence a particular capability for programmatic research.
Collects and disseminates information on cancer.
Supports construction of laboratories, clinics, and related facilities necessary for cancer research through the award of construction grants.
Dick Holt sitting on the curb with the Director of the NCI, Dr. Frank Rauscher, during a lull in the hearings concerning the establishment of the National Cancer Plan. This was the way a lot of things got done in these early days. Dr. Rauscher would bounce ideas off me, and I would give him my thoughts on the issues.
Note: I am including the following material taken directly from the NCI website to make you more aware of how the NCI operates.
The 2014 Report by the director of the National Cancer Institute: The following comes directly from the National Cancer Institute and their annual report. Please note the comment at the bottom of this material. This year marks the 75th anniversary of the founding of the National Cancer Institute, the first so-called “categorical institute” of what has become the National Institutes of Health, with its 27 Institutes and Centers. Over the years, the Congress and the public have generously supported the NCI—and the NIH generally—with sustained budgetary increases. This was especially true for the NCI during the rapid expansion of its budget following the National Cancer Act of 1971 and for the NIH, including the NCI, during the five-year doubling of its budget, launched in 1998. Both of these eras of rapid growth were remarkably fruitful. The first launched the pursuit of cancer genes and the molecular basis of oncogenesis, laying the foundation for the transformation of clinical oncology that is now occurring. The latter accelerated the completion of the human genome project that now guides the study and control of all diseases, including cancers...........
When the National Cancer Act was signed in 1971, the NCI Director was deemed to be the leader of the National Cancer Program, the totality of the nation’s efforts to combat cancer. We now recognize that efforts to control cancer and its effects—through science, medicine, and social programs—are now so vast, conducted by so many people, and funded by so many organizations that leadership in any strict sense is not possible. Still, the NCI and its Director have enormous potential to lead the nation’s efforts through the NCI’s “convening power”—the ability to bring people together from all sectors working on cancer and to think cooperatively about how to solve our most difficult problems. In that spirit, the NCI makes frequent use of its many well- established external committees—the National Cancer Advisory Board, the Board of Scientific Advisors, the Clinical and Translational Advisory Committee, the Director’s Consumer Liaison Group, and others—to discuss new programs and obstacles to progress. In addition, especially over the past two years, the NCI has been convening a large number of workshops and creating new advisory groups to seek broad counsel on a variety of important topics.
Budget issues of the National Cancer Institute:As a federal agency, NCI receives its funds from Congress. These funds support research at the Institute’s headquarters in Bethesda, MD, and in laboratories and medical centers throughout the United States and in other countries.
The cancer research program coordinated by NCI investigates the causes, prevention, detection, diagnosis, and treatment of cancer through various research projects and clinical trials.
In the National Cancer Act of 1971, NCI was given the authority to prepare and submit an additional annual budget proposal directly to the President for review and transmittal to Congress. This authority is unique to NCI, and the budget proposal created in response to it is often referred to as the “NCI Professional Judgment Budget.” The NCI Professional Judgment Budget is submitted to the President before the President’s Budget proposal is submitted to Congress and may be considered by OMB in preparing the President’s Budget proposal.
NCI’s budget for FY 2013 was $4.8 billion. Overall, NCI’s budget has been relatively flat in recent years. During the period from 2005 through 2013, the NCI budget averaged $4.9 billion per year.
This text may be reproduced or reused freely. Please credit the National Cancer Institute as the source.
The National Cancer Program Plan
The President of the United States had decided to leave his mark on the healthcare of Americans and had chosen to declare a war against cancer. He and his staff had determined that it would require a considerable budget to carry out the Program as he saw it. In order to justify the budget that was going to be required, a Plan would have to be generated that would delineate the various elements of this war against cancer and the budget required for each. The Congress of the United States backed the President in his quest of conquering cancer, and passed the National Cancer Act of 1971 to support that effort.
It was known that those who were working in the area of biomedical research knew very little about developing this kind of a plan. As a result, the scientific advisory staff sought out some people that could write a plan that would justify the budget. I was one of those “people”, and even though I had never worked in any kind of cancer effort, and my experience was entirely in the aerospace industry with missile systems and the space program, I seem to fit the requirements for the type of person they were looking for.
Two of us were chosen for this job, Jack McShulskis who came from a management consulting firm working with development of business plans, and myself who had come out of technology development. Neither one of us had any experience in medical applications.
Because of this lack of experience in the biomedical field, the Director of the National Cancer Institute enlisted others that we could bring on as staff to the two of us that would supplement our lack of knowledge of cancer work. I had as my special assistant, a retired professor, in his early 70s, from the Jefferson Medical College in Philadelphia, Dr. Abraham Cantarrow, a well-known biochemists who had spent much of his career in cancer research. Dr. Cantarrow was to spend the next year connected to my elbow, so that everywhere I went, he went. When in meetings, he would explain in detail anything that was being discussed so that I could understand it. He arranged for me to attend autopsies of people who had died from cancer so that I could see firsthand the effect of the tumors on the human body. When I traveled overseas for meetings, Dr. Cantarrow went with me. What an education!
In addition to him, I also was given two other people to work with me, one a specialist in cancer information collection who had a PhD in biochemistry, and the other a specialist in developing computer programs that could take this information and file it in a useful manner. These two individuals proved invaluable in the development of the National Cancer Program Plan.
One other asset that was invaluable in being able to write the National Cancer Plan was the authority and the funding to hire a management consulting firm with people who had worked in the biomedical profession that could help us with the actual composition of the Plan, and with the setting up of special meetings in different parts of the country and the world where we would be holding conferences with experts to get their opinions and inputs for the document. Most of these consultants were medical doctors who had retired, and who had extensive experience in the biomedical world of detection and treatment of cancer. Our ultimate selection of a company to do that was JRB Associates, a company that was owned by Science Applications Inc., (SAI) whose president and founder was Dr. J. Robert Beyster, a physicist well-known for his scientific accomplishments. As a result of this contract withJRB Associates, I had a lot of interface with Dr. Beyster for all four years that his company was under contract to the NCI. In a later paragraph I will mention again Dr. Beyster and where that association led me in the future. The leader of the team from JRB was a gentleman by the name of Jim Russell a descendent of the famous Charles Russell, the very famous Western artist. Jim was to have a hand three years down the road in my life. I’ll explain that later when I cover that subject under the page entitled “Idaho”.
The components of the National Cancer Plan: Very early in the planning process it was decided that a comprehensive cancer program would include all the facets needed in this battle against this terrible disease. They included: (1) the cause of cancer, (2) the detection of the disease in the population base, (3) treatment of the disease, (4) and rehabilitation after treatment. Each of these parts were further broken down into the various elements in basic research and in treatment.
A thorough review was to be conducted to identify where cancer research was being done, by whom, and how they were tied into the rest of the field. In the area of treatment, it was necessary to identify the major treatment centers, and what the doctors in the communities were doing in their effort to administer cancer care. It was also necessary to identify the techniques being employed in both research and treatment, to identify equipment being used, laboratory testing being done, and any other part of the widespread effort in research and treatment. Some important work was being done overseas, and this information is also to be gathered, and those physicians and scientists engaged in cancer research and cancer treatment would be asked to participate in this joint national program.
It was known at the start of the program that new cancer centers would have to be established to fill in holes of cancer care across our nation. And we would have to work with the existing cancer centers to help improve their capabilities in all the areas that were to be a part of the Plan.
An examination was also necessary of the methodology that was being employed to assess and award contracts for cancer efforts funded by the NCI. The peer review system being utilized to award contracts was based on some factors that had to be reviewed with the possibility that a new system would be developed for examination of work that was supposed to be done by various researchers throughout the nation. We heard at the onset many criticisms of this system, that it was a “good-old-boy” club that awarded contracts to favorites. It was our job to root this out to see if it was true. I found myself attending conferences all over the United States and abroad where researchers would get up and talk about the work they were doing, and report the same thing at every one of the conferences that they attended. It started to look to me like a travel club in the making. We knew that some of the changes that were going to take place would step on some sentitive toes, but that risk was worth it for the good that the changes would make in the effectiveness of the overall program.
One of the factors that made aerospace research and development so successful was that those who were conducting the work were open about failures and would discuss these failures so that other engineering teams could evaluate what went wrong and see if they could come up with fixes. It wasn’t this way in the biomedical field. When a researcher reached a dead end in his research, and it had been a failure, you did not hear about it. So someone else could receive the same funding for the same work and reached the same conclusion. Result – waste of time and money. There was no failure analysis that I could find in the biomedical field.
A good example of this is a failure that occurred during the flight of Apollo 13 where an explosion aboard the spacecraft caused the mission to be aborted. The analysis of the problem and the fix for the problem was done by teams of people all over the United States working to solve the problem. One of the flight directors, Gene Kranz, wrote a book after the Apollo program was completed entitled “Failure is Not an Option”. This is the way we all felt about aircraft accidents, about failures with boosters or spacecraft. Teams of engineers openly discussed what caused the failure and how to fix it. Thus in the aerospace business great success ensued.
We knew that expanded budget requirements required justifying the expenditures, and the plan was established to begin that assessment even before any budgets were prepared. The budget for the NCI during these early years (1971 – 1973) was in the vicinity of $100 million per year. The budget that was going to be required was estimated to be many times more than this total. As an example of budget growth, the budget for 2014 is about $4.5 billion. The results of the expenditures would also have to be incorporated into any budget reporting system. This would necessarily be part of the National Cancer Plan.
Part of our plan also had to be to develop an information system that would make information available to anyone, professionals as well as patients, on any kind of cancer, what to do about it, where to get it treated, or to answer any other question they might have on a potential problem or a problem that they had already.
The writing of the plan: We decided that the best way to collect the words that would ultimately be put on paper was to get the people together that were the experts in every field of the cancer work and collect their thoughts as to the approach to take in this new battle against the disease. So we had our contractor team from JRB Associates plan a whole series of conferences to be held mostly in the Washington DC area but also in other parts of the country, or even other parts of the world if that was appropriate.
Lists of potential participants were compiled and contacts were made with these potential participants to solicit their interest in helping with the writing of the Plan. We found a real eagerness throughout the medical community to help us with this new concerted effort. That was a refreshing start to this giant task that we were facing. As I learned more about what our job was, I wondered how long it was really going to take us to write a comprehensive plan with its accompanying budget. I had committed myself to four years to work with the National Cancer Institute, but during these early months I had some doubts if we could finish the task that had been set before us in that period of time.
Completion of the National Cancer Program Plan
I am happy to say that the task was completed as planned, and by late 1973 the National Cancer Program Plan was complete! Funding for new cancer centers was made available and new centers were underway in several parts of the United States. Facilities and capabilities for existing centers were also supported with additional funding. I am proud to have been part of this new effort in the biomedical world. I had been a part of a brand-new effort to get man in space, and now this new effort for me in biomedicine was a tremendous feeling of having helped people who had cancer, were going to get cancer, or were going to fight to not get cancer! And as an afterthought here I might add that I myself have had three different kinds of cancers and have fought each one of them successfully. Major surgery for one of my major cancers, cancer of the prostate, was done at one of the new cancer centers at the University of Southern California School of Medicine. I had had a hand in supporting the funding for and the planning of this center and I was really happy to have been able to be taken care of in the way that I was.
I might also add at the end of this writing that as a result of our efforts in my office at the NCI we now have an operating information system available to the whole world on the Internet called CancerLine. This system is tied in to the National Library of Medicine and is brought up-to-date constantly. Anyone anywhere in the world with access to the Internet can now get on that information net and receive a ton of information to answer any question they might have about this disease.
The end of another chapter in my life
I finished at the NCI what I came for, the writing and the implementation of the National Cancer Program Plan which resulted in cancer centers being supported all over the United States, in Europe, and in Central and South America. It took four years for me to feel that I had completed my task. At the end of this time I knew that it was time for me to leave Federal Civil Service and go out on my own to seek my own goals and ambitions.
I had reached the highest pay level of Civil Service, a GS – 16. I had accomplished a difficult task in a difficult environment, one which was totally alien to me four years before. I had discovered where I wanted to move to, but not yet what I wanted to do. With that in mind I sold everything I owned in the Washington area except for my pickup truck. One day when this was done, I got in my truck and drove west to Idaho, but not before I had implemented the two phases of my strategic plan, which I cover in the next section.
A new era began in my life at that point, the date being the and of the year, 1973.
What comes next?
I had in mind two strategic paths that I could take. First, I knew that I wanted to move to the state of Idaho and begin a search for a piece of land that I could develop. I had a list of criteria that the choice would have to meet before I settled on a given piece. Second, I knew that my financial resources were not the greatest so I had to plan on doing something to support myself while I was doing my search for land in Idaho.
I knew that there was a six state cancer center that was part of the implementation of the National Cancer Plan, and that center was to be located in Denver, Colorado. I checked with administrative staff at the NCI to see if there was any problem in my becoming associated with that particular cancer center in the future. I got their blessings to work on any part of that new development if such a position were to be made available to me. With this in mind, I contacted Dr.Beyster whose company JRB Associates had just received a contract from the Denver Cancer Center to help them establish that center. I offered my services to Dr. Beyster to help in any way that I could with their assignment in Denver. He was delighted that I was interested, because as he told me, he was hoping that I would join SAI sometime down the road. He saw this as a positive step in that direction.
I knew all the players on both sides! That made it easy for me to step in and do whatever job they thought I could help them with. I was named the Project Manager for SAI/JRB for the planning and implementation of assistance to the newly designated cancer center in Denver. So the second strategic paths that I had planned for myself was solved for some time in the future. Now for the first part of that strategic plan.
Navigation element to be added at a later date. Thank you.