Georgetown Lombardi Founder Reflects
on 40 Years of the ‘War on Cancer’
In light of the 40th anniversary of the National Cancer Act, Georgetown Lombardi Founding Director John F. Potter, MD, discusses how far cancer treatment and research has come since he began as an oncologist in 1957 and how far it has to go.
The state of cancer therapy well before 1971 is best summed up by knowing that John F. Potter, MD, wanted to perform cancer operations not because they were the best option, but because they were essentially the only option. And they were a real test of skill.
“I went into surgical oncology because the operations were very challenging. And I’ve always reacted to challenges,” says Potter, who trained at the Georgetown University School of Medicine and was a surgical resident from 1953 through 1957.
Back then, radiation therapy was sometimes used if surgery failed, but it was inexact, if not dangerous. Chemotherapy was in its infancy.
Potter did a number of operations that involved heroic cutting in order to save lives. For example, women with advanced cervical cancer would have what is known as a pelvic clean-out: a patient’s uterus, tubes, ovaries, and everything south of that, including the colon and rectum, would be removed. “It was brutal; only 15 percent of women survived their cancer,” he says.
He did a number of these surgeries at the National Cancer Institute (NCI), where Potter spent several years after his residency. He also remembers seeing children battling cancer at the NCI. One of his roles in the pediatric cancer clinic was to perform what was called a “cut down,” a minor surgical operation to open up a vein in order to put in a tube and tie it into place so that children could receive the fledgling chemotherapies of the day.
“There would be dozens and dozens of kids in the clinic — and some of them very young — and all but about 10 percent would die. This was staggering to me, and it was why I stayed in oncology,” Potter says.
A Fledgling Cancer Center
In 1960, Potter returned to Georgetown with a mission to start a center to treat cancer patients. He found that that there were 1.5 full-time oncologists — and he was the “one.” The “half” was a part-time medical oncologist. Neither a cancer radiotherapy program nor an organized chemotherapy program existed. Even in 1967, the treatment budget was as low as $35,000, which was given to Georgetown for its “tumor clinic” by the American Cancer Society.
By 1968, Georgetown was awarded a planning grant to set up a cancer center, which was formally established in 1970, the same year that Vince Lombardi, who coached the Washington Redskins from 1969 to 1970, came in for treatment of colorectal cancer. In 1974, the cancer center was designated a comprehensive cancer center by NCI — the 16th one in the country — and from that point on it carried the name of Coach Lombardi.
The National Cancer Act
When President Nixon asked for $100 million to launch a campaign against cancer, only 50 percent of cancer patients survived their disease, Potter says. There was no early detection, no program for cancer prevention, most treatments were toxic and the roles of the environment and genetics were a mystery.
President Nixon’s proposed “war against cancer” was reassuring to oncologists, Potter says. “We were delighted to hear it. We knew that the cancer problem needed big dollars and this was an indication that the President felt the same way.”
Support mounted for Georgetown Lombardi’s increasing cancer research and treatment expertise. By the time Potter left in 1987, Georgetown Lombardi had been awarded more than $98 million in federal grants. The number of patients seen had risen from 376 in 1967 to 1,350 new patients in 1987. Publications rose from 14 in 1967 to 190 in 1987. Staff went from 1.5 to 85. “It’s fair to say that Georgetown Lombardi was very successful,” he says.
And it is even more so today, adds Potter, who left Georgetown Lombardi in 2000 to head the U.S. Military Cancer Center. Today, 68 percent of cancer patients are now survivors, and the number of survivors now is over 12 million in the U.S.
Mammography machine (c. 1980)
Still an Uphill Battle
But cancer remains a tricky business, he says. It is still the second most common cause of death in the US. This year, nearly 1.6 million new cancers will be diagnosed in the United States, and 571,000 patients will die. Treatment costs are also a cause of concern, which are estimated to top $268 billion in 2011, Potter says.
Still, more and more cancer is being prevented, or caught early and successfully treated. More advanced cancers are also becoming treatable, he says, although progress in this area is still too slow.
“There is no doubt that personalized medicine — based on the molecular characteristics of the tumor and also of the patient — is the wave of the future,” Potter says. “But we know that we have a lot more work to do because the more you learn about the molecular biology of cancer, the more complex it all becomes. That’s why centers like Georgetown Lombardi are so important — it has the scientists and the clinicians that are necessary to make major improvements in cancer treatment.”
Potter returned to Georgetown Lombardi in December to support its annual Ruesch Center for the Cure of Gastrointestinal Cancers Symposium. This year’s three-part symposium explored the concept of personalized medicine and linking policy to the patient.
Potter remembers one of the first symposia he held at Georgetown Lombardi called “The Successfully Treated Cancer Patient — New Problems and Challenges.”
“And at the time — this is in 1974, a long, long time ago — a conference like this was a striking thing because it went into the medical, psychological, social and economic problems of cancer and its treatment. We hoped we might see cancer become a chronic disease [that could be managed over the long term].”
“More and more discoveries are coming out every day, especially at the molecular biology level. And they are going to translate into cures for a large number of patients” says Potter.
Louis M. Weiner, MD, current director of Georgetown Lombardi, inherited an entirely different Lombardi than the one Potter started 41 years ago. From his own, vastly different perspective, Weiner, reflects on the progress made since the National Cancer Act was passed.
By Renee Twombly, GUMC Communications