National Cancer Act Turns 50
Fifty years ago, President Richard Nixon delivered (https://millercenter.org/the-presidency/presidential-speeches/january-22-1971-state-union-address) his third State of the Union address to the U.S. Congress, boldly outlining audacious goals with major federal funding attached. Seeking $100 million for what he deemed “the war on cancer,” Nixon pledged his commitment to invest federal resources in the fight against cancer.
“I will also ask for an appropriation of an extra $100 million to launch an intensive campaign to find a cure for cancer, and I will ask later for whatever additional funds can effectively be used. The time has come in America 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.”
Leveraging the federal government against a single disease and creating a dynamic equivalent to military combat captured the very essence of American exceptionalism: we would beat cancer by dedicating ourselves to research and science for the greater good. Citizens rallied (https://profiles.nlm.nih.gov/spotlight/tl/catalog/nlm:nlmuid-101584665X20-doc), “Americans can do this. There is not a doubt in the minds of our top cancer researchers that the final answer to cancer can be found.”
On December 23, 1971, Nixon signed the almost unanimous, bipartisan National Cancer Act into law.
It Built Methods and Infrastructure
Among other advancements (https://www.cancer.gov/about-nci/overview/history/national-cancer-act-1971), the bill:
- Enhanced the National Cancer Institute Act of 1937 by creating the National Cancer Advisory Board, comprised of 18 presidentially appointed members; the President’s Cancer Panel to hold public hearings and review progress.
- Made the NCI director a presidential appointment and allowed them to create new cancer centers and training programs, appoint advisory committees, and explore new issues and opportunities.
- Expanded national research facilities, promoted cross-agency research collaborations, and established international cancer research data banks.
It Changed Our Definition of Cancer
Former NCI Director Harold Varmus, MD, opined in a 2014 interview (https://mosaicscience.com/story/conversation-with-harold-varmus) that our understanding of cancer is that it is not one disease, but potentially thousands. “Probably the first thing to say is that we know that every cancer is different from every other cancer. If a cancer arises in an organ like the lung, for example, to call it ‘lung cancer’ is not fair. There are many types of cells in the lung, and at least three or four are represented as different types of cancer when cells fail to obey the usual constraints.”
New models were born, the concept of precision oncology was introduced, and targeted therapy based on cancer’s genetic and genomic underpinnings rather than a tumor’s location became the future of cancer care (https://ascopubs.org/doi/10.1200/EDBK_174176).
It Drove New Discoveries
Those remarkable advancements, fueled by the research, clinical trials, and patient-centered care the act established, have changed the way we approach cancer diagnosis, treatment, and survivorship. And nurses and ONS advocacy have been involved every step of the way.
“We have a research community deeply committed to pursuing novel ideas and building on past discoveries,” NCI outlined (https://www.cancer.gov/news-events/nca50) in its 50th anniversary celebration materials. “We have oncologists and nurses and numerous other providers around the country who, day after day, devote themselves to providing the best care they can. And we have an advocacy community that is relentlessly focused on supporting these efforts and ensuring that the patient’s voice is not lost in statistical measurements or healthcare bureaucracy.”
It is a testament to progress, ingenuity, and commitment that the National Cancer Act of 1971 propelled our understanding of cancer into this new millennium. Breakthroughs, treatments, and cures are within our grasp and oncology nurses are central to that success.
It Recognized the Value of Oncology Nurses
In those 50 years, NCI has sought scientists, researchers, physicians, and oncology nurses to serve on its boards and panels—nurses, in particular, for their insight on the patient’s perspective in cancer care. Oncology nurses have also received NCI grants and worked on clinical trials to break down barriers and improve access to quality care.
Perhaps we are more mature and less naïve, but even after 50 years, oncology nurses still strive for patient-centered care as the goal. But it’s no longer a war on cancer. Regardless of the victories or setbacks, we continue to rage against cancer at every turn. As relentless as cancer is, it is no match for the indomitable human spirit. And that is a war we won a long time ago.
"We've seen so many changes in our understanding of cancer and how to treat it, but what doesn't change is the person going through it," ONS Past President Deborah Mayer, PhD, RN, AOCN®, FAAN, said (https://twitter.com/theNCI/status/1422183666286010369). "They're here now; their cancer experience is now." And their oncology nurse is right there beside them.
Join Us in the Work Ahead
The focus of future fights is breaking down barriers and overcoming disparities because those new treatments become less promising when patients can’t access or afford to pay for them.
“Today cancer has evolved beyond a health problem into a sociopolitical issue of enormous scope and impact,” authors of a National Cancer Act review (https://www.ncbi.nlm.nih.gov/books/NBK13873/) concluded.
Oncology nurses are on the front lines of treatment and care and have insight to the barriers that patients and the profession face like no other. “The world has witnessed the impact nurses have in mitigating the spread of disease and caring for patients under the most difficult circumstances,” ONS President Nancy Houlihan, MA, RN, AOCN®, said (https://www.ons.org/about-ons/presidents-message).
It is why nurses are the most trusted profession, and that’s a perspective policymakers want to hear. Join ONS in advocating for a stronger commitment to quality care (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/access-quality-cancer).