Donald L. Trump, M D, FACP, and Edwin A. M irand, PhD, DSc

Dr. Roswell Park and the World’s First Cancer Center The Influence and Impact of Community, Political and Collegial Support Donald L. Trump, M D, FACP, and Edwin A. M irand, PhD, DSc

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This monograph describes the origins of the first cancer research institution in the world – Roswell Park Cancer Institute, in Buffalo, New York – and the ever-changing scientific and political climates that aided and hindered its early development.

Dr. Roswell Park (1909)

Preface The establishment of Roswell Park Cancer Institute in Buffalo, New York in 1898 would prove to be an historic milestone of global import. Special mention is made in this monograph of the people who were responsible for formulating and applying a new scientific approach to the study of cancer. This required a creative collaborative effort by many constituencies – the clinical and scientific community, the citizens of Buffalo and key policymakers. Fortunately, the authors have been able to exhume, from their archival entombment, letters that not only describe the evolution of the Institute, but also shed light on an important part of the past. We have reproduced copies of the original letters in the appendices. They demonstrate the ever changing scientific and political climates that aided and hindered the early development of Roswell Park Cancer Institute. These letters also clearly demonstrate the influence and impact the world’s first cancer research center had on the formation of similar cancer centers throughout the world and the USA. Through a multidisciplinary approach in studying cancer, with a critical mass of a variety of specialists, the field of oncology resulted; producing cancer specialists, journals and cancer organizations that have significantly altered the way cancer is studied and treated. The major part of this communication is rightly concerned with the past; but this past has forged a promising future of hope, cure and relief to cancer patients worldwide.

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The laboratory of husband and wife team Drs. Carl F. Cori and Gerty T. Cori (below) who were on the staff of Roswell Park Cancer Institute from 19221932. Much of their research was in carbohydrate metabolism and led to their being joint recipients of the 1947 Nobel Prize in Physiology and Medicine. In April 2008, the U.S. Postal Service released a set of four stamps featuring some of our nation’s distinguished scientists, including Gerty Cori, the first American woman —and the third woman ever —to win a Nobel Prize.

Dr. Roswell Park, third from left, performing surgery in 1902. He encouraged the translational research process and community involvement, thus bringing opportunities in reseach advances in surgery and other fields more quickly and efficiently to cancer patients.

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The Man, the Milieu, the Motivation Roswell Park Cancer Institute (RPCI) was founded in 1898 by Dr. Roswell Park, whose contributions, particularly in surgery, are widely recognized. (1-3) However, it is not as well recognized that when Dr. Park (Fig.1) established the world’s first laboratory for cancer research in Buffalo, New York, he formulated the model of the modern-day cancer center. (4,5) Dr. Park was convinced that, “only by a deliberate, well planned, combined attack from various directions, by men especially fitted for such work, could real advances be made” (6) in the understanding and treatment of cancer. Furthermore, he concluded that “…the problem of the nature of cancer and consequently of its cure is a most complicated one and must be studied from many sides.” (7)

Figure 1: Dr. Roswell Park – Founder and first director of what is today known as Roswell Park Cancer Institute. (1913)

operations for cancer, forcing surgery to be performed in private homes, most often in the kitchen or laundry. (8,9)

For Dr. Park, mobilizing these “many sides” into an effective critical mass of innovative thinkers from all scientific and clinical disciplines was a challenge susceptible to both “the inadequacy of the methods hitherto applied” to the study of cancer and “the entirely partisan views held by practically every investigator of repute.” (4,5,6) Clouding the landscape of Dr. Park’s vision was the universal hopelessness surrounding cancer, which, the surgeon believed, “paralyzed endeavor” and made it “difficult to secure men who would devote themselves to such blind and unpromising work.” (6)

The stigma of cancer was not only borne by patients and their families, but their caretakers as well. Physicians were warned against “meddling with the disease, lest they tarnish their reputations through inevitable failure.” (8) Some regarded this counsel with “as much reverence as the Hippocratic Oath.” (8) Those physicians who did treat cancer patients experienced firsthand the detrimental ramifications of trying to change the course of cancer care. For example, the New York Cancer Hospital* in New York City was founded in 1884 as a dedicated cancer hospital. By 1899, however, the hospital was nearly bankrupt. Some of the doctors on staff were ashamed of their association with an institution “where the patients were pathetic creatures shunned by a frightened public” (8) and they rarely included their

The cancer center model was forged in an environment littered with misconceptions about cancer – fallacies held by the public and, surprisingly, a large segment of the medical profession. Many of Dr. Park’s contemporaries considered cancer to be venereal in origin and contagious. As a result, hospitals generally would not admit cancer patients or accommodate

*Memorial Sloan-Kettering traces its origins to this hospital.

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affiliation on their curriculum vitae. In an effort to mitigate the stigma associated with treating only cancer patients and to relieve the mounting fiscal burden, the hospital changed its name to General Memorial Hospital for Treatment of Cancer and Allied Diseases and admitted mostly non-cancer patients.*

mechanisms for moving newly-gained basic knowledge of cancer from bench to bedside (what is today known as translational research) be developed and lead to improvements in treatment. This also would enhance the doctor’s professional status among his peers and bolster confidence levels in patients and their families. Dr. Park also firmly held that in 1899, “almost all of the work on cancer has been carried out in a most traditional and conventional way, and most of it is, consequently, worthless and must be all gone over again by the aid of the latest improvements.” (11)

Dr. Park further recognized that doctors had failed to establish or take any authoritative stand related to cancer within their profession or in society at-large. This failure profoundly affected their clinical work and relationships with cancer patients during the 19th century and at the beginning of the 20th century. Dr. Park found this particularly troubling in view of the evidence that cancer was steadily increasing and ranked second only to tuberculosis as a cause of death. (10,11) With unusual foresight, Dr. Park predicted that cancer would become a leading cause of death in the 20th century. In 1899, he noted that: “The death rate from cancer is steadily increasing not alone in New York State but apparently in all parts of the world. There is, furthermore, every reason to infer that this increase will undoubtedly continue until its minute causes are positively determined.” (11)

Dr. Park realized that his vision would require funding, influence and backing, and he therefore navigated beyond the safe harbors of academia into the murky waters of politics. He christened the launch by soliciting support from influential members of the New York State Legislature, particularly Senator Frank W. Higgins (Fig. 2), Republican Chairman of the Finance Committee, on February 26 and March 30, 1897 (Appendix I and II). His first attempt in 1897 resulted in a legislative appropriation that was vetoed by Governor Frank Black (12). In his veto statement, Governor Black (Fig. 3) parroted the stale litany of misconceptions held by professionals and the public. A year later, however, through the unrelenting efforts of Dr. Park and the political pressure of Edward H. Butler, Sr. (Fig. 4), publisher of The Buffalo Evening News, Governor Black, who was running for re-election against Teddy Roosevelt, gave his approval.

Dr. Park believed that “the knowledge and skill of the pathologist, the biologist, the chemist, and the physician must be combined with the talents of those attacking the disease alone, and the clinicians, particularly the surgeons, must join actively in the cooperative work in one dedicated setting.” (6) Only through the collective efforts of experts from many disciplines, he felt, could

On April 29, 1898, by Act of New York State Legislature, a cancer laboratory was established at the University of Buffalo Medical School (Chapter 606, pg. 149), and a $10,000 grant was authorized. The cancer laboratory was called The New York State Pathological Laboratory of the University of Buffalo (Fig. 5). By this action, New York State recognized cancer as a public

*This scenario would change again in 1913, when Dr. James Ewing became President of its Medical Board and rededicated the hospital to treating cancer patients exclusively and added cancer research to its mission. Dr. Ewing wanted “a cancer institute in the modern sense; an institution where scientists of many disciplines combine their efforts and resources in a common mission – cancer research.” (8) He was, of course, emulating the model forged by Dr. Park in 1898. Dr. Ewing would later serve as a trustee and member of Roswell Park’s Board of Visitors for many years.

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Figure 2 (far left): Senator, Lt. Governor and Governor Frank W. Higgins – As chair of the Senate Finance Committee, Senator Higgins was a strong advocate for Dr. Roswell Park and helped him obtain legislation in 1897 and 1898 to establish the Institute. As Lt. Governor (1903-1904) and Governor (19051906), his support for Dr. Roswell Park. was constant. Figure 3 (near left): Governor Frank S. Black vetoed the bill to establish RPCI in 1897, explaining that he could not approve a proposed policy that required the State to engage in investigating the causes of various diseases. Influenced by unrelenting political and community pressure, Governor Black signed the bill establishing the Institute on April 29, 1898. Figure 2

(Photo courtesy of Buffalo and Erie County Historical Society)

Figure 3

Figure 5: University of Buffalo Medical School on High Street in Buffalo, NY, was the first home of RPCI, known as the New York State Pathological Laboratory of the University of Buffalo. Clinical activities were conducted at Buffalo General Hospital on High Street. Figure 4: Edward H. Butler, Sr., Founder and Publisher, The Buffalo Evening News, assisted Dr. Park in securing legislative support to establish RPCI by applying political pressure on legislators and Governor Frank S. Black. In 1903, he convinced Governor Benjamin B. Odell, who wanted to abrogate support for RPCI, to withdraw his pending veto of funds.

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health problem and urged other states to do the same. On October 21, 1899, the editor of the Journal of the American Medical Association wrote: “So far, this country has been the only one in which there has been established a state laboratory for the exclusive investigation of carcinoma and tumors in general. The great State of New York supports such a laboratory in Buffalo.” (13) By 1900, Dr. Park’s staff had increased to 15 and their extensive research outgrew its space at the University of Buffalo. Dr. Park appealed to the community to purchase land and to construct a freestanding building immediately across the street from Buffalo General Hospital (BGH) on High Street in downtown Buffalo.* Funds were raised by public-spirited citizens of Buffalo, including Mrs. William Gratwick (Fig. 6), who donated $25,000 on August 28, 1900. (Appendix III) By midsummer 1901, the Gratwick Research Laboratory, University of Buffalo (Fig. 7), was built and occupied. This laboratory, dedicated to cancer research, boasted a multidisciplinary staff that included: Drs. Park (surgeon), Harvey Gaylord (pathologist) (Fig. 9), D.R. Averill (chemist), F.W. Baeslack (histologist), F.C. Busch (clinical associate), C.N. Calkins (biologist), G.H.A. Clowes (chemist, physicist), E.W. Jeffcoat (chemist), F.S. Law (chemist), L. Loeb (biologist), I.P. Lyon (clinical microscopy, epidemiologist), M.C. Marsh (biologist), H.G. Matzinger (bacteriologist), H.D. Pease (clinician), and N.W. Wilson (clinician). At this time, research focused on cancer etiology and immunology studies, screening compounds for antitumor effects on transplantable tumors, breeding strains of mice and rats susceptible to cancer, and painstaking statistical analyses of cancer mortality in New York State,

Figure 6: Mrs. William Gratwick – In 1900, she donated $ 25,000 in memory of her husband, a patienf of Dr. Roswell Park, to build the Gratwick Research Laboratory of the University of Buffalo. This building was the Institute’s second home after leaving its original quarters on High Street at the University of Buffalo Medical School.

Figure 7: Gratwick Laboratory, University of Buffalo, across High Street from Buffalo General Hospital, was the second home of RPCI. It was occupied in 1901 and became the site of the Institute’s research activities.

*Dr. Park and the clinical staff used the facilities at BGH until the Institute’s 30-bed Cary Pavilion (Fig. 8) was built in 1913. (5)

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particularly Western New York. As a result of this groundbreaking research, Drs. Park, Gaylord, Clowes, Loeb and Marsh would be recognized the world over as pioneers in the study and treatment of cancer. (6).

to the study of cancer. Similar laboratories funded by private and semi-private means were established in Middlesex Hospital (Cancer Research Laboratories and Bland-Sutton Institute of Pathology) in London, England, and in Heidelberg, Germany, where Professor Vincenz Czerny pioneered the development of radiation therapy for cancer in 1906. By 1918, 14 cancer centers and clinics modeled after Roswell Park Cancer Institute were established in the United States. (4) (Appendix IV)

The World Takes Notice Within a few years, Dr. Park’s “cancer center” was held up as the gold standard and was emulated and studied by other like-minded visionaries. (6) The attention gained by the Gratwick Research Laboratory resulted in similar laboratories being established, often with government aid, in Berlin, Frankfort, Heidelberg, Moscow, Tokyo and London. (6)

Where’s the Cure? An Impatient Legislature Demands Return on Investment Despite the Institute’s acclaim and support from biomedical scientists and governments worldwide, New York State legislators expected immediate returns on their short-term investment: “Well, you have worked so many months and have spent so much money, now what have you found out? When will we be able to cure

Sir Henry Morris of London, for example, sent several physicians to Buffalo to consult with Drs. Park and Gaylord. This visit, in 1898, influenced the formation of the Imperial Cancer Research Fund in London in 1902.* The Pasteur Institut in Paris devoted a large department

*”This was an historic event which marked the establishment of the first cancer research institute in the UK, primarily concerned with the basic problems in the etiology of cancer.” Raven, R.W. The Theory and Practice of Oncology. pg. 80 The Parthenon Publishing Group 1990.

Figure 8: Cary Pavilion – a 30-bed hospital facility on High Street – was built largely with community support and became the center of the Institute’s clinical activities in 1913.

Figure 9: Dr. Harvey Gaylord – Second Institute Director (1904-1924) who worked closely with Dr. Park and directed much of the research and many of its clinical programs in the early years.

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cancer?” (6) A frustrated Dr. Park believed that these demands were voiced by “those entirely unfamiliar with the problems involved, the exacting character of the work required, the delays and disappointments inevitable in experimental work, the complexities to be reconciled or eliminated and the long time required by nature herself in revealing many of the hidden secrets. By reason of these difficulties and complications such an institution is placed always and constantly in an attitude, as it were, of self-defense.” (6)

The Question of Cancer Research in America March 18, 1903 Dear Park : Considering the enorm ous and increasing importance of the subject, it is surprising how little system atic w ork on cancer has been undertak en in this country. So far as I k now, the only laboratory devoted to it is that organized by you and supported by the N ew York State Government. I was most delightfully impressed on my recent visit with the character of the researches going on in the laboratory. O f course it tak es years to clear the ground, but there can be no question that we are on the right scent at present. To successfully deal with the question requires a (sic) large and ex pensive equipment and a staff of thoroughly trained men who should devote years to the work . O nly by the help of large endow m ents can the proper organization be m aintained, and w hile the present equipment at Buffalo is first class, much more money is needed, and I am fully convinced that there is no problem in preventive and rational medicine more deserving of generous endowment by men of means than that which holds out hope of discovering the origin, and, through it, the successful treatment of cancer. W ith best w ishes for your w ork , believe m e,

With the inconsistencies of the Legislature and the Herculean struggle to find funding each year, the Institute labored constantly in an adverse environment, waiting for the Governor and Legislature to pass an annual grant of $15,000 to $18,000 to support the Institute, often at the end of the legislative session.

International Advocates Sway Decisions To accelerate the legislative process for the benefit of the new Institute, in 1903, Drs. Park and Gaylord elicited the help of nationally recognized medical scientists to promote the goals and the very existence of the Institute. (6) On March 18, 1903, Dr. William Osler (14)(Fig. 10), arguably one of the greatest icons of modern medicine, sent the following letter (Appendix V) to Dr. Park to be widely distributed to the legislators. There was particular urgency in this advocacy by early April when Dr. Park heard that the Senate threatened to cut the annual appropriation to $10,000 after the Assembly passed their appropriation bill at the $15,000 level.

Sincerely yours, W m. O sler

(Appendix VI)

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(Appendix V)

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Figure 10 (left): Sir William Osler – judged by many to be the greatest clinician of his time – played a significant role in helping the Institute obtain funds, particularly in 1903 and 1907. He was physician-inchief of the Johns Hopkins Hospital, Baltimore, and second of the Hopkins four (with Drs. Welch, Kelly and Halsted). After 15 years at Hopkins, he accepted a Regis Professorship of Medicine at Oxford University. While there, he still took time to help the Institute and visited it often. He had a great influence on the New York State Legislative Committee. Figure 11 (right): Governor Benjamin B. Odell, Jr. – New York State Governor, 1901-1904 – Unlike his predecessor, Governor Teddy Roosevelt who supported funds for the Institute, Governor Odell was determined to veto support for RPCI, until he was convinced by Edward H. Butler, Sr., of The Buffalo Evening News, Lt. Governor Frank W. Higgins, and letters from prominent scientific leaders of the day, that this was unwise and he withdrew his pending veto.

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(Photo courtesy of Buffalo and Erie County Historical Society)

Dr. Osler’s prestige and support of this cause were very important in 1903, for at this juncture of the Institute’s history, Governor Benjamin B. Odell (Fig. 11) threatened to veto a bill appropriating funds for the continuation of Dr. Park’s cancer institute. (12) The support of Dr. Osler and Lt. Governor Frank W. Higgins, along with the admonition from Edward H. Butler, Sr., publisher of the Buffalo Evening News, to Governor Odell that he would have a fight on his hands if he vetoed the bill, convinced the Governor to sign the bill. (12) Ultimately, the biomedical, political and private communities coalesced to preserve the Institute.

Feb. 15th. 1907.

Hon. Henry W. Hill

I have visited from time to time the Cancer Research Laboratory at Buffalo and am quite familiar with the work which is there in progress. W hile we are still without positive k nowledge of the cause of the disease in man, enough has been done in cause of disease in animals to indicate that we are at any rate work ing along the right lines. T he studies w hich are in progress in Buffalo are of ex ceptional value and I think it would be a very great pity if the State did not continue the appropriation.

Uncertainties continued, and became particularly acute in 1907. Dr. Osler felt the need to help Drs. Park and Gaylord in their effort to obtain funds even after he left Johns Hopkins University to assume the position of Regius Professor of Medicine at Oxford University. Dr. Osler expressed his concerns to New York State Senator Henry W. Hill (Fig. 12) that appropriations to the cancer laboratory might be denied. The handwritten postscript to the letter below is most telling.

Very truly yours W m O sler P.S. There is no k nowing what a day may bring forth. Should the Buffalo Laboratory find the cause of cancer it would be the biggest thing ever done in N ew York State. The N Y Central RR would be nothing in comparison.

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(Appendix VII)

On April 12, 1907, Dr. Osler wrote a second letter to Senator Hill in support of funding for the laboratory, stating that, “England, Germany and now France have taken up the study of cancer on national lines.” Dr. Park circulated Dr. Osler’s letters to decision-makers and policymakers in the New York State Legislature and Governor Charles Evans Hughes, who later became Chief Justice of the Supreme Court. Dr. Osler’s prestige and effort helped Dr. Park receive funds for the laboratory. Dr. Osler’s letter of June 18, 1907, stated, “I am greatly pleased to hear that the laboratory at Buffalo has got a renewal of the grant.”

Figure 12: Senator Henry W. Hill – Buffalo, Erie County – represented the 47th and 48th districts in Albany and was a powerful member of the Senate Finance Committee. In 1907, Dr. Roswell Park again faced a difficult challenge in obtaining funds from the legislature in Albany. Drs. Park and Gaylord sought the help of prominent medical leaders in the United States and abroad, and asked them to direct their letters of support to Senator Hill. These letters convinced Governor Charles E. Hughes to propose support for the Institute. Senator Hill became the Institute’s greatest supporter following the death of former Governor Higgins on February 12, 1907.

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To Senator Hill:– Dear Sir:–

June 18th. 1907

For some years I have k nown the work of the Cancer Laboratory at Buffalo and have watched its growth with great interest. The problems connected with this terrible disease are of such importance to humanity, and at the same time so complicated and difficult to solve, that I consider the United States to be most fortunate to have had one State at least display the liberality which has enabled the Buffalo Laboratory to do such good work . England, Germany, and now France, have tak en up the study of cancer on national lines. The work done at Buffalo is everywhere recognized in Europe as m ost helpful, and personally I feel that it would be a great reproach to the whole country to interfere in any way with the progress of a research of so promising a character. Very truly yours, (Sgd.)W m. O sler

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(Photo courtesy of Buffalo and Erie County Historical Society)

April 12th, 1907

Dear Sir:– I am greatly pleased to hear that the laboratory at Buffalo has got a renewal of the grant. It would have been a thousand pities to interrupt the good work there. Do let me see you when you come to O x ford again, W ith k ind regards, Very truly yours, W m. O sler

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(Appendix IX)

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Dr. Park knew how important the support of someone of Dr. Osler’s caliber would be to the Senate Finance Committee. Dr. Park wrote to Dr. Osler on June 5, 1907, to acknowledge his assistance.

(Appendix VIII)

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June 5th, 1907.

.......... ! Figure 13: Dr. William H. Welch – world-recognized Professor of Pathology, Anatomy and General Pathology and Dean of Medicine at Johns Hopkins University, Baltimore – wielded the necessary clout to convince the Senate Finance Committee to support the Institute.

Dr. W illiam O sler, Regius Professor of Medicine, O x ford University, O x ford, England. Dear Doctor: I beg to ack nowledge the receipt of your letters of February 15th and April 12th, 1907, in commendation of the work done at the Cancer Laboratory at Buffalo, and to assure you that the Senate Finance Committee of the State of N ew York w ere deeply im pressed w ith your endorsement of the research at that institution. As a result an appropriation of $18,000 has been made for the continuance of such research for the coming year.

Medical College, Philadelphia; Dr. Charles A. Ballance, London, England; Professor Ludwig Aschoff, University of Freiburg, Germany; Professor Amedee Borrel, Institut of Paris, France; and Professor J. George Adami, McGill University, Montreal, Canada.

Personally I am very grateful to your for your tw o letters, for I recognize that no higher endorsement could be given than that emanating from you.

The following letters were penned by Dr. Welch to Dr. Park and Senator Hill.

Tw o years ago I had the pleasure of visiting O x ford University, and hope I may do so again, and will be glad to report to you in person the results of the further research at the Buffalo Cancer Laboratory.

Dear Dr. Park ,

Very cordially yours, (Sgd.) Roswell Park

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I am very glad to learn that it is proposed to secure an adequate endowment for the research work on cancer in which you have been so deeply interested and for which you have done so much. Your efforts in this direction will have the hearty sympathy of all interested in the solution of one of the greatest medical problems, one of vast import to the welfare of mank ind.

(Appendix X)

Drs. Park and Gaylord solicited and received letters of support from the professional elite in their fields: Professor William Welch (Fig. 13), Johns Hopkins, Baltimore; Professor Nicholas Senn, Rush Medical Center, Chicago; Professor William W. Keen, Jefferson

The attention which is now being given to the investigation of the causation and nature of 9

cancer cannot fail to lead to im portant discoveries, although much time, large resources and sk illed work ers will be required to secure these results. The subject is one which should appeal in unusual measure to humanitarians. Those who contribute to the establishment of the research laboratory in Buffalo upon a secure financial basis may be assured that they are contributing to a scientific and humanitarian work of great importance.

April 29, 1907

Senator Henry W. Hill, State Senate, Albany, N Y My dear sir: I tak e pleasure in offering my testimony as to the value of the investigation of cancer conducted in the research laboratory in Buffalo and supported largely by a generous appropriation by the N ew York State Legislature.

W ishing you all success in your enlightened efforts, I am, with best regards, Very Sincerely yours, W illiam H . W elch

The problems relating to the nature, causation and treatment of cancer are perhaps the most obscure, as they are among the most important in medicine, and they are everywhere recognized as of great import to the welfare of mank ind. The public spirit and enlightened liberality of the Legislature of N ew York in contributing to the maintenance of the scientific study of these problem s are deserving of the highest commendation.

(Appendix XI)

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! April 29, 1907 Dear Senator Hill, I owe you many apologies. Your letter came as I was about to leave the city, and on my return it was misplaced or lost and escaped my attention.

The investigations in the Buffalo laboratory have been conducted by those who are thoroughly trained for such work , and the results are already of much value and are so recognized in the medical and scientific world. The discovery there of immunity from cancer in lower animals and of rendering anim als ex perim entally im m une is perhaps the most important which has been made in this field of research. Lik ewise the investigations of the conditions under which cancer originates and spreads in mice and rats are of great interest and significance. The Buffalo laboratory rank s with the best of the small number of institutions devoted to this difficult field of study. The ex perience already gained

O f course I am glad to testify to the value of the work done in the Buffalo Laboratory, and I enclose a letter which I hope may be of some service. I recall with especial pleasure meeting you in Buffalo, and I assure you that those interested in the great problems of cancer have reason to be grateful to you for your earnest efforts to see that the work is continued in Buffalo. Believe me to be with best regards, Very Sincerely yours, W illiam H . W elch

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(Appendix XII)

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The next letter is from Professor Nicholas Senn, Professor of Surgery, Rush Medical College, in Chicago.

furnishes the best foundation and assurance for continuance of good work . I sincerely hope that the Legislature will continue the appropriation for this work . I am

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Very respectfully your, (Sgd.) W illiam H. W elch

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(Appendix XIII)

Chicago, March 18, 1903

It affords me pleasure to call attention to the Cancer Laboratory – University of Buffalo under the directorship of Professor Roswell Park . It is the only institution of its k ind in the United States and merits the financial support of all who have the welfare of the unfortunates suffering from cancer at heart. T he w ork already accredited to this strictly scientific institution has ex cited worldwide attention and the prospects for life saving discoveries in the future are encouraging.

In a letter dated June 5, 1907, Dr. Park acknowledged Dr. Welch’s assistance.

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June 5th, 1907.

Prof. W illiam H. W elch, Johns Hopk ins University, Baltimore, Md. My dear Doctor: I am very grateful to you for your letter of April 29th, endorsing the research work of the Cancer Laboratory at Buffalo, and beg to assure you that your letter had a very salutary effect upon the Finance Committee of the Senate, when they entered upon the consideration of an appropriation for continuing the research in that laboratory. A s a result the L egislature has appropriated the sum of $18,000 for the continuance of that work for the coming year.

Professor Park is a scientist of international reputation and an enthusiast in his work and men of means should grasp this opportunity and furnish him liberally w ith m eans so as to maintain the research so earnestly begun and so assiduously practiced.

Your endorsement, as well as the endorsement of other eminent pathologists in this and other countries, materially aided the Committee in reaching its conclusion, and you are, therefore, entitled to the gratitude of all those interested in this important research.

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N . Senn. MD Professor of Surgery Rush Medical College

Professor William Keen wrote a letter on March 19, 1903, to be presented to the Legislative Committee to support the appropriation for the Institute.

I remain,

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Most cordially, (Sgd.) Roswell Park

(Appendix XV)

(Appendix XIV)

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March 19th, 1903.

July 11, 1906

It gives me a great deal of pleasure to commend as warmly as I possibly can the work being done by Prof. Roswell Park , Dr. Gaylord, and his other assistants in the Cancer Laboratory in Buffalo. There is no work more needed in the world than to discover the cause of cancer, which will lead in time presumably to the discovery of its cure. In fact surgeons and pathologists are today work ing together on most promising lines for this discovery of a cure, but the first thing that is necessary, of course, is to find its cause.

My dear sir: I have recently had the privilege of visiting the cancer laboratory of the University of Buffalo and should lik e to tell you what I think of the work going on there. In no part of the world is better work being done to unfold the intricate problems surrounding the intimate nature of cancer. I was myself engaged for many years in cancer research and so I feel competent to form a judgment on the work being carried out at Buffalo. In a disease lik e diphtheria, which k ills quick ly, say in 3 or 4 days, it w as possible w ith the advance of bacteriology and chemical pathology to soon discover its real cause and devise a serum remedy for its treatment. In cancer we have a disease which runs a much longer course – 1, 2 or 3 years – in the human body and therefore we cannot ex pect either to find its real cause or happen upon its successful treatment without prolonged research – a research which may result in say 25 years in a great triumph over human misery and pain. It is to Buffalo that I shall look year after year for those discoveries, which will relieve mank ind from the dread spectre of this terrible disease. There is no work in all the world more deserving of ample support than the cancer research laboratory,

Dr. Park has done more work and better work than any other person in A m erica in this direction; and I think his work has not only met w ith great encouragem ent and recognition abroad, but is recognized as being as good as any done there. I do not k now any way in which our broadminded men of means can help the human race and the profession of medicine better than by endowing such a laboratory. W. W. Keen Prof. Surgery Jefferson Medical College

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(Appendix XVI)

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I remain, my dear sir,

From England, Dr. Charles A. Ballance wrote a letter that Dr. Park forwarded to Senator Hill and the New York Senate Finance Committee.

Yours very truly, (Sgd.) Charles A. Ballance Senator Hill, 511 Mutual Life Building Buffalo, N .Y.

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(Appendix XVII)

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22, February, 1907

Dr. Park expressed his gratitude to Dr. Ballance in a letter dated June 5, 1907.

June 5th, 1907.

Honored Sir: It is with great pleasure that in response to your request I lay before you my opinion of the Institute for the investigation of cancer at Buffalo. The publications of the institute are well k nown in scientific circles in Germany. Professor Gaylord, as a member of the German Society for the Investigation of Cancer, has frequently presented communications before this Society, and these communications have been reported and discussed in all the important publications dealing with the parasitic origin of cancer. His Ex cellency Professor Von Leyden, the head of the German Society for Cancer Investigation, has particularly interested him self in the ex perim ents of Prof. G aylord. Beside these earlier investigations of the parasitic feature of cancer, the significance of which have not yet been accepted in all scientific quarters, the ex periments of Doctors Gaylord and Clowes on the possibility of im m unizing m ice against cancer, have aroused a very general interest. These investigations were embodied in the first publications on these enorm ously im portant facts. They have, through the investigations at the German Institute for Ex perimental Therapie, under Professor Ehrlich, received com plete confirmation.

Dr. Charles A. Ballance, 106 Harley St., Cavendish Sq. W., London, England My dear Doctor: I have made use of your letter of July 11th, 1906, in relation to the work of the Cancer Laboratory at Buffalo, w ith effect, before the Finance Committee of the Senate of this State, in securing an appropriation of $18,000 for the continuance of cancer research in that institution for the coming year. I am very grateful to you for your letter received during the summer of 1906. Very respectfully yours, (Sgd.) Roswell Park

(Appendix XVIII)

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On February 22, 1907, Professor Ludwig Aschoff of the University of Freiburg, Germany, acknowledged that much of the immunology research conducted by Drs. Clowes and Gaylord had been validated through studies by the famous Professor Paul Ehrlich. Dr. Park, who received this letter, sent it to the Senate Finance Committee.

I had myself desired to visit the Institute in Buffalo, and was greatly pleased at the practical arrangement and ex cellent co-ordination of the work . I was, during the occasion of my visit,

!

13

witness to the new discovery of Prof. Gaylord of the presence of spirochetes (organisms) in mouse cancer. To m y m ind it is of the greatest im portance that this problem should be thoroughly investigated in all directions. Lik ewise Doctor Clowes, who sailed with me to Europe, is well-k nown in our scientific circles, and I was pleased to hear that he represented the Buffalo Institute at the Dedication of the new Cancer Institute in Heidelberg. The valuable investigations of Doctors Gaylord, Clowes and Calk ins permit the ex pression of the desire that in the future these State investigations, so favorably k nown in other countries, may be the recipients of further financial support, and that their efforts m ay be strengthened and encouraged.

My dear Doctor: I beg to ack nowledge receipt of your letter of February 22, 1907, endorsing the research work of the Cancer Laboratory at Buffalo, and to assure you that it had a very salutary effect upon the Finance Committee of the Senate of the State of N ew York , w hen they had under consideration the matter of an appropriation for continuing such research at that laboratory. N o stronger endorsement could be received than that presented in your letter, and as a result the L egislature has m ade an appropriation of $18,000 for the continuance of cancer research at the Buffalo Cancer Laboratory for the coming year, and I k now that Professor Gaylord and all others interested in the important work of that institution will ever feel under obligations to you for the favorably position which you have tak en in that matter. Personally I am very grateful to you for your disinterested assistance to us in this important matter.

Very respectfully yours, (signed) Ludwig Aschoff. Professor of Pathological Anatomy Freiburg.

(Appendix XIX)

Very respectfully yours,

! ..........

(Sgd.) Roswell Park

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On June 5, 1907, Dr. Park thanked Professor Aschoff for his letter of support, which helped garner the $18,000 appropriation.

Professor Amedee Borrel, of the Institut of Pasteur in Paris, wrote to Senator Henry W. Hill on March 19, 1907, applauding the research at Roswell Park Cancer Institute. Professor J. George Adami of McGill University also provided a detailed endorsement of the work being done at the Buffalo-based cancer center in a letter to Senator Hill, dated April 13, 1907.

! ..........

June 5th, 1907.

(Appendix XX)

Prof. Ludwig Aschoff, Pathological Institute of the University of Freiburg, Freiburg, Germany.

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funds utilized for this object are ex pended with great advantage and profit to all humanity. Permit me, sir, to ex press my most sincere regards, and believe me

Paris, March 19, 1907

Yours sincerely,

Monsieur W. Hill, Senate Chamber, Albany, N .Y.

(sgd.) A. Borrel Translation

(Appendix XXI)

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My delay in answering your letter is due to the fact that I w as at the tim e of its receipt undergoing a surgical operation necessitated by an accidental infection. I do not regret having waited, since I have been made acquainted in the last few days w ith very interesting communications by Messrs Gaylord and Clowes “O n cancerous cages and the etiology of tumors.” Having myself published results of a similar nature I can only applaud the researches of this type carried out in Buffalo. The majority of savants think that cancer is an affliction due to hereditary and predisposing tendencies, a view which is probably incorrect.

April 13th, 1907

To the Hon. Senator Henry W. Hill: My dear sir: Dr. Harvey R. Gaylord has informed me that it might be of service were I to write to you my opinion regarding the work now in progress at the State Cancer Laboratory at Buffalo. W hat I saw during a recent visit to the same has so impressed me that I write with great pleasure. I am convinced that the work achieved during the last eighteen months places the Laboratory in the forefront of all similar institution.

You have the good fortune of having in Buffalo investigators who are work ing in an entirely different direction – the true one probably – who think w ith m e that cancer is a disease of infectious origin and due to some ex ternal cause. It remains to discover the agent and the mode of infection, which will, I hope, be done in Buffalo.

Let me confess that I have not always had this high opinion. I am on record as one of those who have not hitherto credited the microbic causation of hum an cancer. T he earlier w ork at the G ratw ick L aboratory, w hile it ex hibited abundant energy and alm ost superabundant enthusiasm I held to be, if not misdirected, at least insecure. I still have this opinion regarding that earlier work , modified to this ex tent that I recognize that without this ex perience of trials in many directions, Dr. Gaylord and his associates could scarce have reached their present position

The question of cancer is one of very great importance, since it is a malady of a horrible type, w hich is becom ing m ore and m ore w idespread in all countries. Such researches cannot be encouraged too much, and the most ex tensive means for carrying them out should be put at the disposal of investigators, since the

15

and, as it seems to me, cautious and rational outlook over the cancer problem.

from all these years of work and now is the time for increased effort. For its liberal and enlightened initiative in their work your State cannot but reap renown and the appreciation of the civilized world, over and above the benefit that must accrue to your own community.

But the work published last year impresses as being as remark able as it is solid and I cannot but accept it although largely opposed to my earlier views. To the Laboratory and to Drs. Gaylord and Clowes belongs the distinction of having gained immunity in mice against mouse cancer, a true and distinctly malignant tumor. T hat is a great achievem ent, the greatest obtained so far by any laboratory. O thers in G erm any and England have show n w hen publishing confirmatory results, that they would be only too willing to be credited with the discovery. Then came Gaylord’s incontrovertible observations upon the infectiousness of cancer among rodents, animals placed in particular cages becoming affected. These observations can only indicate a microbic causation for these particular forms of tumor. And lastly, all within the year, is this rem ark able discovery of a spirochaete in association with malignant and transmissible tumors in mice. Having seen both Dr. Gaylord’s preparations at Buffalo and those of Professor Calk ins at N ew York , I have no hesitation in affirming that here is a definite m icroorganism ex hibiting a definite, and strik ing, relationship to the new growth.

I am, my dear sir, Yours very faithfully, (Sgd.) J. George Adami, M.D., F.R.S.

! ..........

(Appendix XXII)

Dr. Park wrote to Professor Adami on June 5, 1907, thanking him for his commendation of the work of Drs. Gaylord and Clowes and the impact that it had on the Senate Finance Committee.

! ..........

June 5, 1907

J. George Adami, M.D., F.R.S. Professor of Biology and Pathology, McGill University, Montreal, Can. Dear Sir: I beg to ack nowledge the receipt of your letter some time since, in commendation of the work of Doctor Gaylord and Doctor Clowes at the State Laboratory of Buffalo, and to assure you that the effect of your letter was very mark ed upon the members of the Finance Committee of the Senate, when they took up for consideration the continuance of the research work at that institution. As a result, an appropriation of $18,000 has been made for the continuance of that work the coming year.

I will not go so far as to say that I believe that a similar organism will be found in connection with human cancer, for I do not think that this necessarily follows; but of this I am confident, that the fuller study of the relationship between Gaylord’s spirochaete and mouse cancer will throw very valuable light upon the nature of malignant growths in general. For this reason alone I regard the state institute as worthy of all encouragement and of increased support. W e are beginning to gain definite results 16

I am very grateful to you for your disinterested assistance to us in this important matter.

W ith very best w ishes, believe m e Very truly yours, Harvey R. Gaylord

(Sgd.) Roswell Park

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(Appendix XXIV)

..........

Very respectfully yours, (Appendix XXIII)

..........

Drs. Park and Gaylord not only elicited the support of prominent, world-renowned medical scientists, but also medical societies to defend the appropriations to the Institute. Note the action taken January 29, 1907 by the Medical Society of the State of New York.

On April 15, 1907, Dr. Harvey Gaylord noted to Senator Hill that Dr. Ford Robertson had raised 40,000 pounds on the strength of his work at the Institute, Also, he notified Senator Hill to expect letters of support from Professors Welch and Adami.

..........

! ..........

Dear Sir:

!

CAN CER LABO RATO RY

At the meeting of the Medical Society of the State of N ew York , held in Albany January 29th, 1907, the follow ing resolutions w ere unanimously passed:

April 15, 1907 Senator Henry W Hill, Senate Chamber, Albany, N .Y.

W HEREAS, the Medical Society of the State of N ew York has convinced itself of the immense importance of the studies continued a number of years in the Cancer Laboratory connected with the University of Buffalo, both by its publications and the demonstration made at the meeting of January 29th, 1907; and,

My dear Senator Hill: Kindly find enclosed a copy of D r. Ford Robertson’s letter and memoranda. I have marked in blue pencil that portion which refers to the fact that they have raised forty thousand pounds on the strength of our work. I trust this may prove of service.

W HEREAS, in every country similar institutes have been established and the profession has been awak ened to the importance of the study of cancer, it is

I have written Professor Adami and Professor Welch to write you at once and you may expect their letters in a few days without doubt.

RESO LVED: That the world is more than ever convinced of the necessity of continuing the investigations, which have afforded already such strik ing results. In the interest of humanity the Medical Society of the State of N ew York ask s the Legislature to continue the appropriations for this worthy Laboratory.

Mr. O ’Brien told me last night that he expected the appropriation of $25,000 would be restored in conference. Can you not work for this end also?

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I tak e pleasure in forwarding this to you and trust that you will see the necessity of voting in favor of the appropriations so urgently needed to carry on the work , which may in time lead to a discovery which will benefit mank ind wherever located. Cancer is said to be on the increase by most statisticians and the entire world is seek ing to find the cause of this terrible scourge. If its cause be found we have reasonable hope to suppose that some method will also be found to prevent it.

“That the Society appreciates especially the value of the research conducted at the Cancer Laboratory and ex press the hope that this work may be carried to the satisfactory conclusion which its purpose merits.” (Sgd.) James G. Mumford, Secretary A true copy: Use the 2d paragraph of the above as much as you please.

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Yours very truly, W ISN ER R. TO W N SEN D, Secretary

(Appendix XXVI)

As evidence presented, Dr. Roswell Park and his assistant Dr. Harvey Gaylord urged by the importunity from the Western New York community, prominent medical scientists from the United States and abroad, and by the progress made at the Institute in cancer research had sufficient influence to secure needed annual appropriations, though each year with difficulty and after long-winded explanations and personal solicitation.

ARTHUR C. RO O T, Chairman Committee on Legislation (Appendix XXV)

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On April 19, 1907, the Society of Clinical Surgery forwarded an extract of a motion endorsing the work of at the Institute.

As Dr. Park stated: “This should not be necessary were there a sufficiently and reasonable wide comprehension of the difficulties attaching to such scientific research.” (6) He begged “the medical profession must realize what the solution of this problem means; might organize themselves very strongly and in far greater numbers and so impress upon their representatives in the Legislature the impact as well as the importance and value of the work, that there should be no difficulty in securing permanent and generous continuance.” (6) He felt that “our legislators must feel that the medical profession has spoken in no uncertain tones, but rather in such a way that this insistence is not to be disregarded.” (6)

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EXTRACT FROM TH E MINUTES OF TH E MEETING OF TH E SOCIETY OF CLINICAL SURGERY April 19, 1907 O n the motion it was resolved unanimously “That the Society of Clinical Surgery thank cordially Dr. Roswell Park and his colleagues for the important and interesting demonstrations at the Buffalo General Hospital and the N ew York Cancer Laboratory. 18

Long-Term Support from New York State

Law Department of the University of Buffalo, and other interested citizens of Buffalo, succeeded in having the Gratwick Research Laboratory designated a State institution. Governor John Alden Dix signed the legislation, and the facility was officially deeded to New York State by Mrs. William Gratwick and the University of Buffalo on February 29, 1912, and became known as the New York State Institute for the Study of Malignant Diseases. The name of the Institute was changed to Roswell Park Memorial Institute in 1946 (Chapter 369), and again, to Roswell Park Cancer Institute in 1992. (12)

Despite successful efforts in 1903 and 1907 to avoid fiscal crises and the sustained support of New York Governor Charles Evan Hughes (Fig. 14), the future of the Institute remained precarious. In 1911, Dr. Park, now Chairman of the Board of Trustees of the Institute, and Dr. Gaylord, the second director, realized the precariousness of an annual grant from New York State to support the Institute. Dr. Park subsequently urged Dr. Gaylord to have the Institute completely owned and supported by New York State. On May 10, 1911, Dr. Park, with the help of Senators Henry Hill, Arphaxed Loomis and George Burd, and Assemblyman LaReau, and with the continuous help and encouragement of John Lord O’Brian, Ansley Wilcox, Dean Alden of the

Since 1911, the Institute had been a State institution receiving State support. On October 15, 1997, Governor George Pataki signed a bill to transfer Roswell Park out of the New York State Department of Health and make the Institute a Public Benefit Corporation. This action, initiated by the eighth Director of Roswell Park Dr. Thomas B. Tomasi, with full support from then-Governor Mario M. Cuomo, provided the Institute with a governance structure that was more flexible and better met the needs of the Institute as it approached the 21st century. The legislation was activated on January 1, 1999, under the leadership of the ninth Institute Director Dr. David C. Hohn, who also served as RPCI’s first President and CEO. (12)

On the Shoulders of Giants: Acknowledging Past Contributors Many in biomedical research need to be reminded from time to time of the debt owed to predecessors and the assistance provided by people such as Professors Osler, Welch and others, who supported an idea with no other objective than to seek truth through the scientific approach that ends with information that has

Figure 14: Governor Charles Evan Hughes (1907-1910) – became a supporter of the Institute under the influence of Senator Hill. During his administration, the Institute was appropriately funded. This led Governor John Alden Dix to approve the Institute to become completely owned and supported by New York State on May 10, 1911. (Photo courtesy of Buffalo and Erie County Historical Society)

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enormous value to cancer research and treatment. (14,15) Such visionaries* had a strong sense of social and professional responsibility and a desire to see the Institute succeed. A great deal of credit is owed to them and Dr. Roswell Park for:

of the Institute was active in and supportive of the founding. • Organizing and gathering world-renowned biomedical leaders to help obtain contributions from New York State legislative appropriations and citizens of Western New York to achieve his goals. These approaches, common today, were innovative and novel in the 19th century and early part of the 20th century. Government sponsorship of scientific societies and research is a recent development in the United States. During the years between World War I and World War II, private foundations, such as those established by Andrew Carnegie and John D. Rockefeller, as well as the Donner Foundation and the Jane Coffin Childs Memorial Fund, orchestrated and dominated a system of extramural grants that supported much of the scientific research carried on in the United States. It was only in the late 1930s, and particularly in the wake of World War II, that “big science” first emerged and the federal government became the great patron of American research, as evidenced by the establishment of the National Science Foundation and the series of institutes that proliferated at the National Institutes of Health, supporting life sciences, disease-oriented investigations and the training of future scientists. (17)

• Establishing Roswell Park Cancer Institute in 1898 in the University of Buffalo School of Medicine. Roswell Park Cancer Institute is now a multimillion dollar cancer center. Dr. Park deserves credit for encouraging New York State to be the first government in the world to support the inauguration of an institution for the study of cancer and being the pioneer institution of its kind in the world. • Showing the world how to attack the cancer problem through the use of various scientific disciplines in one institutional setting and, by doing so, initiated a movement that strengthened the professional status and authority in the cancer field, resulting in oncology becoming an experimental science at the turn of the century. Special cancer societies and journals arose to encourage the study of cancer. For example, the American Association for Cancer Research (AACR) was established in 1907, and the American Society for the Control of Cancer in 1913 (reorganized in 1944 to become the American Cancer Society). In addition, three international cancer congresses were held before the First World War: Heidelberg (1906), Paris (1910) and Brussels (1913), eventually leading to the formation of the International Union Against Cancer in 1933 in Madrid. In all instances, the staff

Since its founding, Roswell Park Cancer Institute has served as a model for other cancer centers in the United States and abroad. Dr. Osler and other colleagues of his caliber recognized the impact of Dr. Park’s concept of conducting cancer research. By supporting Dr. Park, they became players, not spectators, by engaging in New York State politics. (18) They believed in what Dr. Park was doing and backed

* The position of these visionaries resurrected and reflected the philosophy of Hippocrates who introducedand applied a scientific point of view and method, based on common sense, to the cure of disesases. The basic philosophy of the Father of Medicine was overshadowed and ignored by the philosophy of Galenic and Arabic physicians for centuries. (16)

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him with their reputation and effort. Their assistance enabled the Institute to contribute to important developments in cancer knowledge, organization, financing, and advocacy. There can be no doubt that with their prestige, they aided Dr. Park in his mission to influence cancer policy, research and progress. Dr. Park, with his prescience, created a template for quality of cancer care, research and education for the next 100 years. His “comprehensive” approach to cancer remains the model practiced by cancer centers today. The second director of Roswell Park, Dr. Harvey Gaylord, summarized the impact the Institute had worldwide in an annual report to the New York State Commissioner of Health, Dr. Eugene H. Porter, on February 1, 1908. Dr. Gaylord stated, “During the last five years, the experimental investigation of cancer has broadened to such an extent that many investigators in different parts of the world are now pressing into the field, national institutes and societies have been founded and an international society for the investigation and combating of cancer is in the process of formation. Today, the outlook in cancer research is not only encouraging but also distinctly promising. If one calls to mind the pessimism which reigned 10 years ago regarding cancer, and realizes today how differently the whole disease is viewed, how actively investigators are hopefully working upon the problem and how promising is the outlook, one must concede that the results obtained are far greater than we could have possibly promised ourselves at the time this laboratory was founded by the State.”

Figure 15: At the 2nd International Cancer Congress held in Paris, France, Drs. Harvey Gaylord and G.H.A. Clowes were recognized for being the first to demonstrate the role of immunity in cancer. They were awarded this tribute medal.

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References 1.

Treatise on Surgery. Roswell Park (ed.). Lea Brothers & Co., Philadelphia and New York. 1906.

2.

Park, Roswell. The Principles and Practice of Modern Surgery. Lea Brothers & Co. Philadelphia and New York. 1907.

3.

Park, Julian and Stockton, Charles G. Selected Papers. Surgical and Scientific from the writings of Roswell Park, Buffalo. 1914.

4.

Walter, William, A. Saunders, J. Palmer, Putney, H. Donald. “Origins of the Cancer Center Program of the National Cancer Institute”. AACI Newsletter, June 1985. pp. 1-16.

5.

Roswell Park, the New York State Cancer Laboratory. The Charlotte Medical Journal. 1898. 13(3): 273-275.

6.

Park, Roswell. “The Work of New York State Cancer Laboratory – Retrospective and Prospective.” New York State Journal of Medicine. 1907. 7(5):186-189.

7.

Park, Roswell. “Further Study into the Frequency and Nature of Cancer.” Medical News 74(13): 385, April 1, 1899.

8.

Considine, Bob. “That Many May Live. Memorial Center’s 75 Year Fight Against Cancer.” 1959.

9.

Butler, Francelia. “Cancer Through the Ages”. The Evolution of Hope. Virginia Press, Fairfax, VA.

10.

Park, Roswell. “Oration on Surgery. Address at 100th Meeting of the Medical Society of the State of New York.” NYS Journal of Medicine. Mar.-April, 1906. pp. 280-181.

11.

Park, Roswell. “An Inquiry into the Etiology of Cancer.” The American Journal of Medical Sciences 115(5): 503, May 1898.

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12.

Mirand, E.A. “Legacy and History of Roswell Park Cancer Institute.” 2004. pp. 1-256. The Donning Publishers, Virginia

13.

“Geographic and Statistic Methods as Auxiliary Factors in the Study of Carcinoma.” (Editorial). Journal of the American Medical Association. 1899. 33(17):1047-1048.

14.

Osler, Sir William. “Alquanimitas.” The Blakiston Co., Philadelphia, 3rd ed.

15.

Starr, Paul. “The Social Transformation of American Medicine.” Basic Book, Inc., Publishers. New York, 1949.

16.

Sarton, George. “A History of Science – Ancient Science Through the Golden Age of Greece.” Harvard University Press, Cambridge, pp. 345-46, 1952.

17.

Magner, Lois N. “A History of the Life Sciences.” Marcel Dekker, Inc., New York, 1994.

18.

Mirand, Edwin and Trump, Donald L. “Dr. Roswell Park and Sir William Osler: The Development of the World’s First Comprehensive Cancer Center Through the First Documented Examples of Political Advocacy in the Name of Cancer Research in the United States.” New York State Historical Association Meeting, Saratoga Springs, June 5-7, 2008.

19.

Rusch, Harold “Beginning of Cancer Research Centers in United States” JNCI, Vol. 74, No. 2, February 1985.

20.

“International Directory of Specialized Cancer Research and Treatment Establishments” published by International Union Against Cancer, Geneva, Switzerland.

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Appendix I

24

Appendix II

25

Appendix III

26

Appendix IV

.

15 Cancer Centers/ Clinics Established in the United States by 1918

1.

New York State Institute for Malignant Disease, Buffalo, NY

2.

Huntington Memorial Hospital, Boston, MA

3.

Barnard Free Skin and Cancer Hospital, St. Louis, MO

4.

Columbus Cancer Clinic, Columbus, OH

5.

Memorial Hospital, Grand Rapids, MI

6.

Albert Steiner Ward (Grady Hospital) for Cancer and Allied Diseases, Atlanta, GA

7.

Memorial Clinic and Cancer Institute of the Hospital of the University of Minnesota, Minneapolis, MN

8.

General Memorial Hospital for Treatment of Cancer and Allied Diseases, New York, NY

9.

New York Skin and Cancer Hospital, New York, NY

10.

New York City Cancer Institute, New York, NY

11.

Pittsburgh Skin and Cancer Foundation, Pittsburgh, PA

12.

American Oncologic Hospital, Philadelphia, PA

13.

Philadelphia General Hospital, Philadelphia, PA

14.

Rochester Clinic of the New York Branch of the American Society, Rochester, NY

15.

Cancer Clinic of the Women’s Welfare Association, Washington, DC

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Appendix V

28

29

Appendix VI

30

Appendix VII

31

Appendix VIII

32

Appendix IX

33

Appendix X

34

Appendix XI

35

Appendix XII

36

Appendix XIII

37

Appendix XIV

38

Appendix XV

39

Appendix XVI

40

Appendix XVII

41

Appendix XVIII

42

Appendix XIX

43

44

Appendix XX

45

Appendix XXI

46

Appendix XXII

47

Appendix XXIII

48

Appendix XXIV

49

Appendix XXV

50

Appendix XXVI

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Epilogue Dr. Roswell Park’s enduring concept and goal of applying various disciplines to understanding the cancer in a comprehensive cancer center remains with us today. He believed the investigation of cancer required investigators to read and experiment constantly, and mentally digest and assimilate all pertinent information acquired. He was a strong believer in verification of experimental testing of creative ideas concerning cancer. Dr. Park felt that investigators must make and implement a series of judgments that could only be honed through group interactions among investigators from various disciplines to achieve an intelligible view of cancer. After Dr. Park gave up the directorship in 1904, the second director, Dr. Harvey Gaylord, faced the same struggle that his predecessor faced – to find adequate financial support. In 1910, Gaylord met with President William Taft to appeal for federal funding to support the Institute’s research programs. President Taft visited the Institute on April 30, 1910 and concluded, in a statement to the media and legislators, “that there should be more institutions of this kind in this country and (I) hope that someday we will have one under federal auspices.” He submitted bills to Congress, but Congress refused to support cancer research programs at the Institute or the idea of a federal cancer institution.(12) Prior to 1950, only 20 cancer research centers existed: 13 started as a result of gifts from wealthy people, five cancer centers began with funds from state and federal aid, and two from both state and private sources. (19) The National Cancer Act of 1971 introduced a new era and was a major stimulus to development of comprehensive cancer centers. That Act – and the cancer centers it established – looked to Dr. Park’s “model” as the gold standard of cancer care, research and education. Throughout the 110-year history of Roswell Park Cancer Institute, each administration has adhered to Dr. Park’s cancer concept and mission of providing quality patient care and education, and conducting research, through the combined efforts of a first-class multidisciplinary team. This has been an essential model not only for Roswell Park Cancer Institute, but for the 40 other comprehensive cancer centers in the United States and the hundreds of cancer centers worldwide, as well. (20) Although great progress has been made at these cancer centers, particularly to understanding the basis of cancer, many questions remain unanswered. These questions provide fertile areas for future research. Staff members at RPCI are looked upon as partners in this enterprise and are urged to meet the challenges and be productive. By proper support from a variety of sources, we will continue to make impressive strides, and with each one, a little more of the cancer puzzle will someday be solved. There is no doubt that Dr. Roswell Park has achieved iconic status worldwide as a role model for oncologists.

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Administrations of Roswell Park Cancer Institute Dr. Roswell Park

1898 - 1904

Dr. Harvey Gaylord

1904 - 1924

Dr. Burton T. Simpson

1924 - 1943

*Dr. William Wehr

1943 - 1945

Dr. Louis Kress

1945 - 1952

Dr. George E. Moore

1952 - 1967

Dr. James T. Grace

1967 - 1970

Dr. Gerald P. Murphy

1970 - 1985

*Dr. John Wright

1985 - 1986

Dr. Thomas B. Tomasi

1986 - 1996

*Mr. Gordon Hennessy

1997

Dr. David C. Hohn

1997 - 2007

Dr. Donald L. Trump

2007 - present

*Acting directors

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About the Authors Dr. Edwin A. Mirand Dr. Edwin A. Mirand is Emeritus Vice President for Educational Affairs at Roswell Park and Dean of the Roswell Park Graduate Division of the State University of New York at Buffalo. Dr. Mirand has been associated with Roswell Park for over six decades and, prior to joining the staff, was associated with the Institute as a graduate student at the University of Buffalo. Dr. Mirand received his doctorate from Syracuse University. In addition to his many Institute responsibilities, Dr. Mirand has been a leader in numerous national and international professional organizations, serving as Secretary-General of the Thirteenth International Cancer Congress of the UICC, Secretary-Treasurer of the Association of American Cancer Institutes, President of the Association of Gnotobiotics, liaison member of the National Cancer Advisory Board, Chairman and member of the UICC U.S.A. National Cancer Committee of the National Academy of Sciences, and as a member of the New York State AIDS Advisory Council. He is the recipient of many awards and special honors, including Honorary Doctorate of Science Degrees from both Niagara University and D’Youville College, Outstanding Alumni Award in Science, College of Arts and Science, SUNY at Buffalo, the Distinguished Service Award in Science Education from the New York State Science Teachers Association, and Merit Award of the International Union Against Cancer; from the American Association for Cancer Education, The Margaret H. Edwards Award; from Roswell Park Cancer Institute, The William H. Wehr Award; Recognition from the American Association For Cancer Research in 1998; from the Association of American Cancer Institutes in 2004, The Buffalo First Lifetime Achievement Award for advancing health care (2005); The D’Youville Community Service Award in 2006, and in 2008, the 13th Annual Achievement in Health Care Award from D’Youville College. Dr. Mirand is the author of over 500 publications in the fields of endocrinology, virology, and cancer education and author of several books in his field. Dr. Mirand was Senior Advisor to the former President and CEO, Dr. David Hohn and remains the same for Dr. Donald L. Trump.

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Dr. Donald L. Trump Dr. Donald L. Trump was appointed President and Chief Executive Officer of Roswell Park Cancer Institute (RPCI) on April 1, 2007. Since coming to RPCI in January 2002, Dr. Trump has served as Senior Vice President for Clinical Research; Chair, Department of Medicine; and Co-Principal Investigator of the Cancer Center Support Grant (CCSG) funded by the National Cancer Institute. In the fall of 2006, he was appointed Associate Institute Director. As RPCI President & CEO and Principal Investigator of the CCSG, Dr. Trump has direct authority over day-to-day operations, philanthropic and operating budgets, capital improvements, research priorities and clinical and scientific strategic planning for the Institute. He is responsible for establishing a culture of excellence throughout RPCI’s key mission areas: research, clinical care, education and cancer prevention. In addition to his role as President and CEO, Dr. Trump continues his work as a researcher and clinician, leading the Institute’s active clinical research in vitamin D-based cancer prevention and treatment, and caring for patients with prostate cancer and other urologic cancers. He also will continue as principal investigator or co-principal investigator on several grants funded by the National Cancer Institute and Department of Defense. He holds European and U.S. patents for the use of vitamin D and vitamin D analogs in combination with high-dose chemotherapy. Dr. Trump earned his medical degree from The Johns Hopkins University School of Medicine, Baltimore, MD, in 1970. From 1970 to 1975, he completed an internship and residency training in Medicine and a fellowship in Oncology and served as Chief Resident in Internal Medicine at The Johns Hopkins Hospital. Dr. Trump is a Diplomate of the American Board of Internal Medicine, with Subspecialty Boards in Medical Oncology, and a Fellow of the American College of Physicians. Dr. Trump is past Secretary/Treasurer of the American Society of Clinical Oncology, and is a member of many professional and scientific societies. He is listed in Who’s Who in American Science & Engineering (1991, 1994, 1996) acknowledged as one of the best doctors in America (1994, 1999, 2002-2004 Pittsburg Vectors of the Year in Science 2001, participant in Joseph Burchenal Lectureship at Memorial Sloan-Kettering, listed in America’s Top Doctors for Cancer and Business First Award in Health Care Achievements, 2008.

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Acknowledgements We thank particularly Mr. Kevin Craig, Mrs. Colleen Karuza and Mrs. Crista Beyer for their generous time given us in making changes that we would execute along the way in assembling this 110 year history.

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