Efforts to control cancer are being made in many other ways. They include development of a camera so small that it can be swallowed and provide pictures of the gastric area; evaluation of the potential of cryosurgery, which excises tissue by freezing; and the development of platelet banks. In the field of education, Federal funds are being spent for strengthening and expanding the teaching and demonstration of cancer detection, diagnosis, and treatment within general community hospitals, and for incorporating such teaching in their regular education activities; increasing the number of cancer registries; providing training for medical technologists and their supervisors in university medical centers and similar institutions; and affording education in various cancer specialties (such as maxillofacial prosthetics and pediatric oncology) to physicians, dentists, and other medical people.
An up-to-date profile of cancer in the United States will soon be drawn through a national survey of cancer cases. This study by National Cancer Institute epidemiologists is just getting started but will ultimately include 11 geographic areas of the country. Information will be collected on all cancer cases occurring from 1969 to 1971 among an estimated total population of more than 22 million. The data obtained will provide local, State, and Federal health officials reliable answers to important questions. For example:
Breast cancer is the leading cause of cancer death in women today. Are new detection techniques finding widespread use?
Lung cancer is increasing in men at an alarming rate. What is the cost of this disease to a community in terms of manpower lost?
The "Pap" smear for detecting cancer of the uterine cervix is credited with a dramatic impact on the death rate from uterine cancer in this country. Is the decrease in mortality continuing?
A national survey of cancer cases will be conducted by the National Cancer Institute during the period 1969-71. Data on cancer occurring among an estimated population of about 22 million will provide Government health officials reliable answers to questions about malignant disease and the cost of cancer to a community. The participating cities are Atlanta. Georgia: Birmingham. Alabama; Detroit, Michigan; Dallas and Forth Worth. Texas; Minneapolis and St. Paul, Minnesota; Philadelphia and Pittsburgh. Pennsylvania; and San Francisco and Oakland, California. The other survey areas are Iowa, Colorado, and Puerto Rico.
Although a complete understanding of the nature of cancer has not been achieved, science can be expected to continue to vigorously prosecute efforts to find solutions to discrete segments of the problem. As stated at the beginning of this part of the report, the ultimate criterion for measurement of progress against cancer is the control of cancer in man. This demands a high priority for lines of investigation related to diagnosis, treatment, and prevention, while recognizing the importance of fundamental research.
The continued improvement in outlook for cancer patients has come about through a coordinated national effort in cancer research, medical education and training, and patient care.
There is no doubt that continued improvement in the outlook for the patient under treatment has resulted largely from the gains made in institutions staffed and equipped so that teams of specialists can combine their skills to produce optimum results from accurate diagnosis and effective therapy. Such accomplishments are brought about when research, medical education and training, and patient care are coordinated and directed toward the common goal of preserving and extending life.
At the present time there are perhaps fewer than two dozen institutions, concentrated mainly in the northeastern region of the United States, that can approach the ideal of a cancer center combining research, training, and patient care in good balance. Others need to be provided and so distributed throughout the country that the advancements attained in the medical management of malignant diseases will become available to people everywhere as rapidly as possible. The effectiveness of some institutions of this kind will undoubtedly be enhanced through their participation in the regional medical programs now being drawn up under Federal legislative authorization.
The highly sophisticated research approaches that can be formulated within the cancer center concept also include fundamental studies on the cancerous process and the tumor-host relationship, out of which continued advances toward understanding the nature of cancer can be expected. Clinical studies will draw upon the growing store of fundamental knowledge and will in turn stimulate further basic research, in a continuum of well balanced scientific investigation.
Progress against cancer can be assured by undiminished support, from both public and private sources, of clinical and fundamental research, and of education and training to build up and improve our scientific manpower, and by increased cooperation between the medical profession and an informed public for the prevention, detection, and treatment of malignant diseases through programs of control that make the results of research available to the largest number of people with the least possible delay.