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fic~R Ir riEDiA1'E- RE;.Ek p ~ t~[lY- 5, 1972 -- oF F'ICE OF TI:E =`r7iiI'TE HOUSE :'PLSS SECRETARY THE S1IfI I T E I1GL S^ - PRESS CONFERENCE OF SECRETAW OF HEW ELLIOT L. RICHARDSON N AND - - DR. FRANK j. RA;1SCHER, JR., DIRECTOR, NATIONAL CANCER INSTITUTE 11'50 Azfd. EDT THE BRIEFING ROOM _ -- MB. BAJ.L a You sre - receiving a release on the - appointment of Dr. Fran;c J. P.auscher, Jr., to- th-e directorship of the National Cancer ?ns*_itute3 -:"T:ere also is a Fact Sheet on the cancer program in gener3l= The PrzOSdent :riakes this appointment under authority of the car.cer-bill_-wh=ch he si-gnad on Deoember 23, 1971. Secretary Richardson and-Dr. g,auscher have just - met with- the president and we have asked them to -co:..e out to -take some of-youa questions. I-_believe some- of you met Dr. Rauscher last fall when we went to Fort Detrick and he briefed me-mbers`of the press at that time. I know the President expressed his great pleasure -, that Dr. Raussher is aceeating this assignment. The appointment cocres_ after an exhaustive review of canaidates, 2ane in whir.'-^h the President h'imself haa_ take+r- gieat-peraora1 interest because -of_his desire that the program be led-by men of outstanding- ~~.~;~~__~ DR. RAUSCHER: Good morning. - I have just- met with the President and, as-on other occasions, notably at Fort.. Detrick, he reiterated to me again his very strong and very serious and very sincere commitment to-aetting the cancer program-going, and to committing-those necessary-resour-ces that can be effectively_used- lie makes this a very top priority, and I think-with justification. -Rs most of you know, we have a very good scientific base in this country for getting on with the cancer program, with specific goals in mind, of course: the prevention of cancer in man,_and, short of that. the effective treatment of cancer in people not only throughout this countr7, but, as the President spoke at Fort Detrick, he hopes to see this as a model for international cooperation and collaboration.- In particular at Fort Detrick, for example, we are moving ahead very _quick_ly with plans for making this an inter- national center where people from all over the world, scientists in particular, can Loxee.. - I mentioned ta the President that I am most grateful for his confidence in me and his confidence in American - science and-international science. I mentioned also I as~-very much aware of the enorr,tity of the challenge, of the problems that we face, but also very much aware of the enormity ofthe opportunities that this increased, new Presidential initietiv6 for cancer research can pravidc to our people. -_ -

~ _ 2 _ I-believe I will -just- stoy- there and try to field any questions you m3,2?t have. Q -Do you fcrresev a breakthrough at some tire in tt P future, ar._d- when-,= on a= cancer -oure? DR.° R:&JSC!-IER:-°--I certainly do- for-esbe breakthroughs. - These are -some things that do_ not -happer overnight, as you know: - tt takes~3- greatt deal_ o-f tir,~_to amass- the. data_-t.'s~st=- - soonex or later may be described as a breakthrough. Q- Can vou tell tis what it is that makes you see this breakthrough? ~ DR. ~St'FtE~, ~ do ncst see any sirgle bsea!cthrough, -but az=-accumulatian of inforsatian wh-ich -sooaet or later willl ripen--- and_=in.-many casea_this will be soan_~- for developing me-asss for cancer -prevention- as weli_ as_ ;,=eat€sent. As an example, we, know, for- ins tance, that of the 100 cancers-that-af#lict man_,_about _ls.peroeot_o€ these can be treateu extremely well, to the- poln~ Qf at _ least 50 percent 5-year suryivals-~_ -i~e -see a~jor c~:alleng€ s~w of providing this kind og *-eatr;ie~;~=to_°people -ail-ov_er the _coun_ _tr-y, - rather _ than just at -four or~ five-majos elinicai-centers, predominantly in the East. This_can Le-described, I-s~ppose, as ar*'eakthroug~, --but it is_ the _ utiliaation _of_-ex:isti;ia kr.ow-ledge thatT think we can-do-much better, now -t-hat we have e:cpahded_ resources. 0 Is tii•=. :r: ;jd^.^t e_vHnr"riPa you to do ame-thing to which you-replied you would do because he didn't give you- any cho-ice? -Nh-at was that all about? DR. itAUSCFER: -The President aaid, "Young man, you must put in an 18 or 20 hour day."- I said -'Mr. President, I have no choice. - _- It is ;oi:,g to tr.ke -hat kind of eoa+mitsnent.= Q -Sir, would you please explain to-us, we got the appointment of the- three men who are supposed to report to- the President, and now you. Hoa+ do you all coordinate?_ DR. RAUSCtiER:- -The- major aspect of the program, - the-panel headed by Benno Schmidt,-is to report on progress and on problecLs cr deterrents-to getting on with the job in a more speedy fashion, directly to the President.-- The board is_an accumulation of very-eminent_scientists as well as lay people, knowledgeable and interested in cancer, who are there to provide_advioe to me as to what the_n+ajor-priorities, and major opportunities are within laboratories throughout this country.- It is-then my job to evaluate this advice and to-- program it for-the task-of getting on with the prevention and cure. I see-r,o conflict here at all. As a-matter of fact, I am quite corafortable with it. Q Ds.; -Rauscher, I have read your- biography - here. I am not quite clear~ Are you an-hi.D._ or r.atF- DR. RAtSSCNER: I am a Ph.D in-_virology and microe biology i,: -gen8r° l. I_: ave sL+ent- a=wut 1? to 13 7ears at the bench in the laboratory. Since 1965 I have been lHORE

involved in rana;i ~g,- .s you k.ncwt A at- we call the Spaciai - -virua ::ancar Froerar.a WF are trying to apply thc ,e, manage-- mer:t techniquec on abr2adea ::1se to -cancer -- Q- Ar-e you going to be-based-at Fort Detrick-or, Bethesda, or both? _ bR. t.AUSCHER: _ I.will be-based _-at Be:.hesda, but-aome _ of__my - g6ople w-ill be_ at Fort Det4ick. -In-_garticular, the con- , tractor we arc- now-trying to select will be based at Detric, - - amd he w311 .y.-nerate Chat .faciiity_- for w. j7hnt is the- salary that goes with this job? - DR. iZRUSCHER,-_ =It is the -_top .of a G5-11, which is = $36,00. ~ I believe -I beard the PrcSident say sor.w- months ago that this progsars,wa.s design-ed _so there would= be no tioitle= necks-, the. structure would- work against_ bottl-enecksr= Are-- you finding *_hua true? = DR. RAtDSCHER: He_ is M-os-t sinc_ ere-. - He reiterated - this .again when I- saw him _a €e;~ -minutes -ag?o> I see no bo--tles necks yet, -va-t I ars very happy to have the knowledge that if any occur; I can -4e;tainly confer th=ough Mr. Schmidt, and others, with him. Q This is a direct line of com.mand, thee-,- between- -- you and the President, in effect, interdicted only by the gansll ie thA+t rrrror¢'> - DR. RAUSCHER: On matters of budget and access to -the President for information, it is a direct line, On matters of coordinating cancer activities with other related-activities at the NIH, I will_ relate_very closely, of course, to my-= iSirector of the_NIH, Dr. Marston. On matters as they affect the policies of IIEW, certainly, our secretary=will be very much involved. Q Then in the-process of relati..g-with Dr. Marston at NIH, if_ycu come to a disagreement, where is the-buck going to stop? - DR. RRLSCHER: Then I think Bob and I sit down-and -disbuss the matter. We conn,ur.icate very well. inere will - probably be occasions where we have differences of opinion,- but this is certainly to be expected. Q But in those cases,-is there anything written into this plan as to who this would go to for a decision? DR. RAUSCHER: This would be a cosr,bination of di.s= cussions with Hr. Schmldt,-with the President's assistants who are most concerned with-this particular program at other levels of dFcisiorn making, and with the Secretary taimself. - Q If they didn't agree with you, you aould have the last word with *.he Presdient; si-ght7 DR. RAUSCHER: Fe are going to- have to see how- this= works, but there is absolutely no dbubt that -the President says, !•iO RE

"If vou tia--e problems, let nc=lcnow-about thrm,"- arid-!-will do- - this` first through tSrE Sch::ridt.,= - C- Has it beer-.= .Ennounceo =.a:terje the-se= 15- ne.z centers are-going to be for clinical research, training a.nd-dem-n- stration? DR.- RAUBCaiER: No, it has= not. We are= in- the pro- cesg n(ro of :etermir.ing tt:e appropriate geQgraptric distribu-- - tiasn=5 the apprqpria-te-balan-ce be-tween c-lin.ical_ space -aid Fe°_ search space. As I am=sure you know, as another very important earmark of the PresisientFs-=Yer;R -ap-rious . cor~. itr.*nt6_ he- .r2- ° €~uested an sdditional $40 million last weei~~ ~his t~?oney will -be used pred_oninantly for construction_in this fiscal year, as -_ well as for some training of scier.tists-.But _i_t-will be- _ coordinated-with-these centersY- _ =- ~- Do you know approximately how much th$se centers will cost, per-center? DR. RAUSCniP.R. It depends -ors the center. if- it is ~ limited center ifz- the sense_ of being -only resEagchs --without - cli»ical aaace, it would be on the order of a half million - dollars and on up. - if -it is a_comprehensive center where re- search, search, clinical back--up and the__treatment and management of patients is -.involved, tt-xis -could very well go to $3- raillio2s, $5-million,_or $10-millisn. It depends on the size. ~ What is your overall budget? How-does that -compare-with previous years? DR. RAUSCHER: The overall budget this fiscal year - is-about $377 million, which includes the President's request -for a supplemental of $40 million. The $377 million is-on the order of $140 million over last year's level-.-=:7e are speak;ng- of different budget levels, which varyt t:eey are about -?430 :".-..is le: n~:ater of discu--::,io:i n:*! witr: C:3 enG other -c•roups.- - Q_ Dr. Rauscher, could you address yourself to the layman who does-not_undersyard medicine, but who- would likQ to have a target as to-when-a solution can-be found for a - cancer, whether it be of the blood-or whatever it might be, those that the people know about? DR. RAUSCHER:- Yes, of course. I again-wQiSd shy- away- from speaking -about- a solution. - There wi13 be mar.y-- solutions. tn-point of-fact, there_are many examples_ I could give you. We know what causes many cancers rightt now.- --- -Q Let's talk about leukemia. Can you address-- yourself to that? DR. RAUSCHER: Leukemia is fast becoming one-of the most treatable diseases of any of our cazcers. If you were-= to talk about acute ly:nphocytic leukemia of-childhood, it occurs in about 15,000 of our children below the age of seven- in this country per-year. Between four and five-y-ears ago, the average life expectancy of achild presented-with-leukemia'- was on the order of four -to six months. Today, with aggressive 2 tSORE

- S - cl:emothnrapy, , the use of combinations of drugs, 85 percent of these children E an_ tsP ^ut into long-tern re?stiasian. In fact, this -is be--ominr so r,ood=_hat t:;I -liic.tables - the analysis =we- wculd do on any :one of cs if we went for a new insurance policy, as an example -- by that kind of analysis, 50 percent arA=liv%r~g-disease=€ree after-five-years F- It is-- at that point-Yiheie we are beginning to-feel con_fidance-ir say saying-that these are cures. -Q - Oo you have any charts showing the- fatality - -ratey -how it is going down in ca_ncer-through ;your research, and how it might go down in your-progtam?- = DR. R.AUSCiiER: This is very impostant. In point of fact, the mortal=ity=fatality rate is=increasing, even though we-arc making very sign:ficant_inroads into-=the treatr.~enta, far example, af the laukemins,- There are many=things that = cause this. There-is a trerendous incrPase-in lung cancer,-=ae `an example. _._ : There are 55:;,04y r.e~w cases of cancPr-that will occur in hniericans- this- year. - Of tc`ese, 310-e,000 tb--3201 ,C0^ °_ will die. If these-tr=nds are allowed to continue, based on- the last five to tens year analysis, by the year 2000 wwe will- -have over 1.5 m.iltior±new cases of cancer in thiss country, with azr equivalent ratio dying. -figaini-that-is if-thase are -allowed--to-cbntinue. °-_ - Q -what would be the fatality rate i°-it continuea? DR. RAUECkFER: If it continues,- a.baut 540,000 new dcctis : - - ....nl_t hci-...c F.3:; ^nntinue because of some of the~advances that are now being made not only-in treat- ment but in the prevention of cancer. One of the things that contributes to this, to answer your question, is that-witY,in this trend increase, by the year 2000, cancer of the lung is anticipated to increase by 54 per- cent. Cancer of the pancreas, as arn example, by about 1@0_ percent. 15,000 cases of pancreatic cancer occur in this country a year, and 15,000 of those die in that year. These are the kinds of things we must address ourse-lves to, and I think we can. Q We have had crash programs for cancer before, like chemotherapy. You have an excellent institute at Bethesda. What makes you opti^+.istic -that this new approach is going to be any different or more successful? ddORE -

DR. RAUJCIMP.: ~, acaln,_ -wouad a,ot_li}e -to call it -a -crash psoaram.- It is_ a orog-rkrr that is_-nota rz;e_ -fo*__ taking advanL=ge of _°sors of the newer ;e.adsa o€_ -thuccicntif ic ha,e th3t E;e tcave right noW. t is a_proorym that, =pier z- os it at least=in tYic-pastE has been -shown tot3A _mae aqcaole by-srme of t5e newpr °ceordination techn'aques of g?.ttinq-_scieF:La_to work ?oget"2^.er-; We have-mucR more scientific base now, for ipstance, *nat we had-when,.as you pointed out,-a crash program was= - instituted for chemotherLpvr which, incidentally, in_ my- judq- - ment, was one-_of=t.he ro-sT=-suecessfui programs we have :aad. Rince that_proa_ram was initiated,_thg physician_has-= been armed with at least 4s A=fective_drugs ior_tr-eatmenti-the a:ombinatlon -of-treatm?ntl a many __cases of cancer in-man. =-_It--iE because of--that program we ear say-today, inste$dof ~_child living aL}ou~ €ouP to six-m.~s*.t:s 'with-a^ute lymphocy-tic_ le_ukemia_r his chances of li ting a normal I ife aro now-abcut 501 percent. That is a good program. Q -- You mentioned several new leads-: Giye us some- examples of fihose, wilU -you, please? DR.- -RAbBC?IrR: - We are really talki-ngF again in-iaJ terms-, canc;er-wise, about a treiKa of approaches; that is__, i-n _ early diagnosis,in prsvention,_which in my judgment is most - important, but which is going to come somewhat later, and in therap}•. One of-the r.-2ost important things vr@ can now begin_ _ to do is to not or.ly diagno:e early disease, but to diagnose _ ,.. _ _~ _ _ s,....aF _ - .. a~ .._a -~r~ 5a1. 2.i~~ ,_ L•J L':J1 121Oa~.li.~~r -rt i.- ar. ing'to develop very good profiles on the woman who nay have-_>e a hi_=gher risk of breast cancer. There are various parameters of judgment-that go into this. If we can pinpoint, with-some degree-of de_ftn+_ty, those women who-are expected to develop can-cer-more so than other women- in dif€erent-categQries, they can then be brought-in three_tim_es a year for thermography or mammography, instead of one time a year. This-is-extremely important not only because of the obvious ad- ,_ vance here, but breast cancer is still_t.he largest killer of- wor:.en-in that particular age group of high risk. This is just one example of the_kinds of leads, if_not_ breakthroughs, that we are beginning to_ekploit now, and which we can exploit-beoause of the increased resources. We have already identified some 22 chemicals, for instance, that are- known to be cancer-causing, not only irn mics but in man, himself. Diitlr this information, we can now take steps, increased steps, that-can be taken to prevent exposure of people to these particular industrial hazards, farmers to DDT, and so forth. We expect, in being able to-do that, we will see a downturn in those particular-cancers that people deve:.op_ because of exposure to these specific-ohemicals. Q- You indicated DDT. Is that a carcfnogen-in man? - DR. RAUSCHER: DD-T is known.- and other pesticides are _ known, to induce cancers in mice. i.'hat we are trying to do now, when you have a piece of information like this, is to go into - populations of people.-that you know have-been exposed to particular chemicals and then you determine whether their ris=k or t.`:eir-ay"tual - cancer experieace is higher than-the norm.

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This 2S _tI1C OY;iy Wyy _}?Cu can C:^i_erL^,i^C_ thi3._ 3ts?di@s hi. I'G:._~ 5;o i _ e:?_.-,:t - t.!:3blet_ your 7-ike this are L3ei*S'_ dCne q C7iflC'S ti-ot1,°i3 DL': car.i *1ogt'tlfC` in- "..L^.?" 7f'_ `:31l1 3Cfiolt. _ THE gFX-3S: Thank you, Doctor.