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THE UPJOHN COMPANY 7000 PORTAGE FiOAp KAWIMAZOO. MICHIGAN 49001,0199 U S A October 25, 1991 Meyer Friedman, M.D. Medical Director Meyer Friedman Institute Mount Zion Medical Center of UCSF P.O. Box 7921 San Francisco, CA 94120 Dear Dr. Friedman: TMEO00pE COOPER w10 l7wm.n d+ne Aarv ana Ohw/ fncunw daca TELEProONE 1616)323-7m Thanks very much for the October 21 recruiting update of your Coronary/Cancer Prevention Project and the news that you and your associates at the Yale-Norwalk branch have reached your 3,000 participants goal and that you have 80 percent of the 1,500 participants randomized for Type A counseling already in treatment groups. I believe that this present study of yours will be as important, or perhaps even more so, than your 1977 Recurrent Coronary Prevention Project which I am proud to have supported when I was Director of the National Heart, Lung and Blood Institute. I believe that what you and your associates did in that study clearly demonstrated that stress does play a very important part in the pathogenesis of coronary heart disease. Your ongoing study may prove to be even more important because it also will examine the possible role of stress in the pathogenesis of cancer and in a statistically decisive manner. Such a study is long overdue. So many things have been suggested as the trigger for the release of oncogenes. Stress should certainly be included among the factors involved. I know that you would iike an answer to the possible role of stress in Cance-r and' beginning heart disease. It will take not only 3,000 participants but they must be followed, as you plan, for a number of years to obtain the hard core statistics that will be required to validate whatever conclusions the study reveals. I shall come to San Francisco in the not too distant future. Meanwhile, do continue to send me ongoing data on this landmark study. Sincerely, ~ Theodore Cooper, msw .D., Ph.D.