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< I / a Suri7(iwt uY DR. sFfeaAOM C. 3aMHLra I as Sheldon C. Scis.ra, a phTsician, pnaral patholorist intarestad in tissua diagooais and an .>p.riauntal p.tholedist .n=apd for e.er 20 Pears in in.astid.tind o.chanisas of disease. Pd collap and .edioal school education vere at tbrvsrd, aad I practiced aad taught pstho- 1op in Boston !or 15 7ears• Ia 1960 1 vas President of the Mev E2nQland Soci.ty of Pathologists. Presently I m /asoclate Profssaer of Pstholop at Coluabia Uai..rsitP College of Physiciaes and Surpe.s in Mev Sesh, snd slse Cliaical Prof.Ner of Pstholop at University of Southera Californis School of Msdioiae, Los Aagelss. !{y present hospital .ppointsrat i• •ssooiats Dirsctor of Lsboratoriea, Del.risld Hospital, Mer ?esiv !d chief research iateresta in p.tholop are hiasa cancer, heart and Kidnq disssse, .ndnoriae abeenaslitiea aad paecolep. Ca these aad related subjects I have vrittea about 170 publicetions, aad ss a wmbsr ef nine professional soeisties ea well as the Plute Club, sa saaoeiatiea liaited to 35 active uni.ersity eapesiasotsl patlwlodieta. !1/ eiarioulua vitee aad list of publieaticas sre attsehed. Toor eowRittee say be iatere.ted ia q studiss ef host facters ta huass cancer e.de over ths past 15 7esrs with the help of dr.ots fros the O.S. Publie Health Serviee. The aim vss to deteradae vhst attributes there ars vdthis hussn beiads that wq affect their susceptibility to de.elep a certain ldad of cancer, or pre.ide resistaace to de.aleping canosr. these peenlLritSes of individusle, se.etiaes called constitutional fsetdrt, has beea la.estigatad from the autopsy aaterial and clinical records ef about 2,500 patieaN. Ceaoers of the breast, prwtate, liver, stoaseti, lueK, cervix sad endam.triua of utsrus, ieidaq and large intestiae ha» been snelpsed, cosparing the chaaies fouad ia all iaportant body tissues with thue la persoeu of aiailar agss who disd vitla ut aaaoer. - coatiaued - 0 T05~~,~E CTR HIN 0149-16

© ...' In reference to lung cancer, a sari,a of 210 •utopai•d c•ss• w• .xdaed froe four hoepitals in the Bostoa •rs•. Of these 168 were sen, . y'.. •.•le pradeainaac• found in .ost series of lung cancer. In th• a.n with , equeaous c•rciao.as, which is the wost carm aicroscopic type, 57% were haa.q oipretta a•at.re, 18% vere awdoolc.rs with lung caaeer and had •n eoeapstiowl sspoaur+ Iciown to be assooi•ted with an inor•asad iaaidaace ef luas caneer. anotber 19% wre ligAt a.aK•re with occupationsl t•otors. lbur t4a p.rasatap of s•oh.re ia tlsis series of lung Caacer casea / • •ppaared ti be about the sss aa ia tAe 6soerVl populstioe. .. ., ~, . . I The .r with lasg oaae.r else had rre oowroa than axpect.d histories ef aeriow rrital problar, .eaare•1 diea•aee, alcodolism and ss.ere trauo•. '!Lor iaaluded a arber of mea with svideaee of esoassire nervous •aerp expressed by o.erstreiaisg their plpaiaal eap•oities in various Nye. Malrtdar. • Harvard pqobelegist, fran his .ierpoiat Aas found the ssm fa•turee ie lung o•aosr patieate, aw of dwm he described •e 'li.iat in e..rdrive•. An emellaat description of suah a person, nasly Ross, the f•.eer ellter of the Mwr Tericer rpaiaa, who died of lung oaocer, is in the betk "fte ?wre with AeN• bT Jsrs 2hurber. Moet of tEa a.. bed ..idaoce af l•eu sentiae,•d iafl•w•tim with infection of the brmeld snd loag. Ae etrar findtag io the arp with epuaou• lung caae.r that elstiyalsMd tJter frm othar Qoupe ws a per.istsaca of norral tasticular ad preaLet3e etnmter i.te late .d8dls •p, Waa .ost .ea show ao.e t.a- tieoler atrapW and preetatie salargameat. t"rla- f•ater lcag r.aepisad in lung eaNae eaaeed to involve a eootlawd active production of a•la se: herraN befod the erar•p. Sae fe. toosa with tMa cancer tfpe rere asilable for adequate aa•ly.ie. T083057 0 CTR HN 014919

A .+ , 3 In roran •nd soae sso adanocarcincnas of ths luog appeared to ariso iron abnorul inttrwl procass•• that in.ol.W abaormal •strotanic hanonsl sti.ulatioo. This losd is presently being follorod by • furth•r stud'y of 50 •utopslod cas•• of rc..n wdth lung cancer fro. u.1.flold Ho•pital, Nw tork. SubosQusatlT, Lr. Mbrjorio J, 61i11ias, thon patholorist at T•.p1• p Csnt•r •nd nr. Chi•f of th. Patlwlop So0ticw at VA Co.tral , '. I . Offieo, aad I.ado a siailar atudy of 100 .om with luni c>ncor sutopsio• ~~ from To.pl•, Texas. Their •n.iron.ental exposures wr• not anslysad. Aa w• ps•Mousls found, most shaMd svidsnc• of uadorlyin* cAsaeic lofl.sastory . / . ; t•ed•aoy to pros•r.•tioa of the normal t••ticular structure in l•t• siddlo age. tloot factors wro thus fou.d to be isportant in roopsat to the d•.•lop- '~ .oat of tho ttpo of lued cancer aacrib•d by .oi• to cis•rstt• Mouiad. lMrr recently ia a stody •f the doe•a•r•ti.o lml disoas• •qitps.r, which •ocardisi to J,t. Mt•tt, • 1.•diod authority, pr•doainst.s ~ .•rhsdy la ar, hsot f•etors wro tousd. There were oadoeriao eb.nps in . ,• • lueg di•osso. The sa wdth sQuo.ous lueg cancers again showd the grssts t .a i f o•a with oopb,OO.• asseci•tod •ith•s vitb ossgewth of bro•at tissue dars•cep- iul]•Y or with lt• prewr+ation ia a aora•1 stats. In coetrut apr oth•r .•e had br•avt atroplV. TD•.o host f•otor atudl•• sro r•l•.aut to th• iasstiistioa• of rslatiso•Idp• b•twson oitar•tt• •moldn and lueg caac.r in the foll wMr vwTs, t.oa if •e. aceopt. a ho•q ina•latiea osposero at the rat. , of 2 p•oia p•r day t•r ?u T.•r•, oni7 ••.•11 minority of .•1• cigarott• smcksrs o•ettSsu•d T085u58 I CTR-N HN 01492-0

a I : . ~ ~ i„r. ~I . .. ~ . ~ ~ . . l •. ,. .I / ' .1 a .. 4 (s.sutiat lsss than 3 por 100 .aa-lssrs) developed fatal lung cancer. ss with all factors suapsetod of boirr< weak carcinogens, a..riotf of aipilficaet contributing factors sro likolp. Nat faeter studiod previously described Aa.e indicatsd at least tyoi (1) chronic inflawtory lu.g disssssl probably bacterial, viral or bstbt (2) Aoimsnal faotors, particularly o.idoacs of persistent wls $si borNons produotim into lats siddls ags. The rjor point is that the danger of cancer is not apparently aprssd avsnk areag heavy swoksrs. It affsets psrtieularlf wn, saw with szesssivs asrvous sarp, often Ktb chrosdaally leflwd bronchi and luets, ae; sar with evident abuodant aals hotsaoaal produetioa. kasrn, aom with dsersasift ..ls sss bersess sad certain other grouqs are lsss sffsotsd. In surrP, thses is evidence for s,ulttOls factors ia lung oaacsr dn.lepsot, and sztsasis scientific isastigatioa should continue to dstsratns uhst roL, it ay, all the fsat'rs including cigirstts awohiag aaT play. The sublset of tlr esuss of t!e long oamsr la not olossd but just barely O\ra.r". 41 v • ..r - SMldsa C. Sarrs,M.D., •sssoiate, Pathologist fsb., 8, 1965 TOSi -a59 . I I I CTR- ["N 0149-221 I I