Richard L. Holt

NIH National Cancer Institute Cancer Program

Well, by now in my working life I am no longer astonished at the tasks I am asked to take on.  Here again, somebody wants me (doesn't really ask me) to jump into an area of science and technology that I know almost nothing about.  Cancer.  I knew it was a disease, a bad one at that.  But beyond that, I knew very little about the research that was going on to find the cause of cancer.  But I was soon to find out.  And would you also believe that I started out as an Assistant to the Director of the National Cancer Institute.  They had to teach me how to spell "cancer" first, but I quickly applied myself and learned! 

Cancer is a vicious killer that strikes humans of all ages.  My association with the National Cancer Program exposed me to the tragedy of this terrible disease.  I didn't know much about the disease when I joined the NCI, but since then I have learned plenty, even in my own life.  I had my first cancer, Malignant Melanoma, in 1976.  My next bout with this disease was in 1993 when I was diagnosed with Prostate Cancer and had major surgery for that problem.  Then a few years later, I developed a bladder cancer, Transitional Cell Carcinoma.  Would you believe that I have had three of these and have had three surgeries, the latest being on June 13, 2007.  I am still working on that problem with chemotherapy which goes on for six weeks.  So cancer became a real disease to me long after I was at the NCI.  I'm what's called "a survivor". 

This is one of my favorite photos of all times even though both myself and my boss, Dr. Rauscher looked bombed out.  I even have my eyes closed.  But it is the only one I have that has this much meaning and emotion all bundled up in it.  This was taken during one of our early planning sessions when the National Cancer Plan was just starting to take shape in 1970.  We had been in working sessions for many hours and maybe even days before this photo was snapped, and were taking a short break outside before getting back to the business of deep discussions as to what the National Cancer Plan was going to be.  The only place to sit was on the steps or curb.  So that's what we did. 

Dr. Rauscher really wanted to get me alone to go over some of my ideas for specific things we had just been talking about in the large meeting.  What better place than on the curb where no one else would want to sit?  As usual, I had been pretty vocal during the session prior to this photo being taken, and was loaded for bear with strong opinions as I usually was.  Dick Rauscher wasn't about to let that moment pass.  I can still remember him prodding me for more in private so that he could go back into the large meeting and carry on with our ideas.

It might be interesting to note that Dr. Rauscher some years later was to become the Director of the American Cancer Society based in New York City.

January 22, 1971.  In his State of the Union Message, President Nixon announced that he would ask for the appropriation of an additional $100 million to launch an intensive effort to control cancer, and that he would ask later for whatever additional funds could be effectively used.  The President said:  "The time has come when the same kind of concentrated effort that split the atom and took man to the moon should be turned toward conquering this dread disease.  Let us make a total national commitment to achieve this goal." 

http://rex.nci.nih.gov/massmedia/CANCER_RESRCH_WEBSITE/1971.html

The URL above outlines the elements of the National Cancer Act of 1971.  It was because of this Act that the Director of the National Cancer Institute was told to bring on new people into the Institute that had experience in planning for and setting up major government programs.  Obviously these people did not exist in the biomedical research field, so with help from White House Staff, the NCI started bringing in people to help in carrying out this new mandate. 

This resulted in the preparation and publication of the National Cancer Plan.

Dr. John Schneider, NCI, Dick Holt, NCI, Dr. Snowden Williams, Nixon White House staff, Dr. Barbara Murray, Chief of Chemotherapy, NCI

Snowden and I had known each other for years outside the cancer business.  He was the one responsible for naming me to join the National Cancer Institute.  Dr. Schneider became an assistant to me at the NCI, responsible for developing such key programs that we use today, as CancerLine, and other cancer information systems.  Barbara Murray was a tremendous help to me in taking a practical approach to how the complex test and evaluation of cancer drugs could be carried out within the rules and limitations established through other governmental agencies in the U.S.  We went to Europe to accomplish what we couldn't in the U.S. and were able to show how this approach could rapidly make available cancer drugs in the U.S. that in the past had gone through many years of testing, never reaching the patient who needed the drug therapy.

Dr. Abraham Cantarow

Dr. Cantarow, a 1924 graduate of Jefferson Medical College and Professor at Jefferson until 1966 was a godsend to me.  Dr. Cantarow had retired and NCI hired him to head a program branch at the Director's office.  He became my mentor and tutor on cancer.  He made sure I understood what I was into.  He contended that a physicist could learn about biochemistry and cancer, and proved it to me.  I participated in all kinds of learning experiences, not the least of which was even autopsies on people who had died from cancer, to show me the awful effects of this disease.  Quite an education for a aerospace guy.

By 1973, the first eight comprehensive cancer centers were established and recognized as part of the National Cancer Program. Today, there are 26 NCI-designated comprehensive cancer centers that support a strong core of research in several fields, community-based cancer prevention programs, training and continuing education programs for health care professionals, and studies offering patients access to new therapies. In addition, there are 10 basic cancer centers, 18 clinical centers, and a single consortium center specializing in cancer prevention and control research.

One of the major tasks I assigned both NCI staff to as well as contractors that I had brought on board was to begin the design of an information network that could carry information from the research environments to those that were using the information to diagnose and treat cancer victims all over the world.

As soon as I was established at the NCI, I began negotiations with the National Library of Medicine to help in the development of an information system set up just for those directly involved in the medicine and the practice thereof.  By 1974 CANCERLINE was established. This national computerized service was developed by NCI and the National Library of Medicine for scientists to access the latest research findings from the current literature.

By 1976 the Cancer Information Service (CIS) opened. I had already left the NCI when this date finally came for the full implementation of the system, but through my association with the contractor team (a Division of SAIC - JRB Associates) allowed me to stay with the development until its successful entry into the biomedical world of cancer diagnosis, treatment and research.  CIS is a nationwide telephone information and education network. Today, CIS receives about 2,400 calls a day, or 600,000 every year, from cancer patients, their families, and the public, and brings NCI messages to underserved and minority communities through its outreach program.