The American Cancer Society
The American Cancer Society
Incorporated: 1913 as American Society for the Control
Sales: $538 million
SICs: 8099 Health & Allied Services, Not Elsewhere Classified
The American Cancer Society (ACS) is a not-for-profit organization whose mission is to eliminate cancer. With a highly professional staff comprised of not-for-profit administrators and fundraisers, and personnel from the medical healthcare field including doctors, nurses, and technicians, plus more than two million volunteers at community locations throughout the United States, the American Cancer Society is one of the most effective organizations in the fight against the disease. The ACS designs and supports a number of educational programs for both the medical professional and general public, provides large amounts of money for cancer research, and also offers direct patient services such as transportation for treatment, assistance in obtaining home medical needs such as wheelchairs, and emotional support for newly diagnosed cancer patients. The ACS has recently decided to add a new component to its activities by becoming an advocate for public policy initiatives that directly affect the prevention of cancer and the welfare of cancer patients.
The roots of the American Cancer Society can be traced back to 1912. In that year, the American Gynecological Society met in Washington, D.C., and discussed how a greater control of cancer could be achieved through a campaign to educate the general public. A committee was appointed to draft a plan for the implementation of a comprehensive cancer education program, which was endorsed at the Society’s meeting one year later. Having endorsed the establishment of a national society to prevent cancer through education, an organizational meeting was held in May 1913 at the Harvard Club in New York City, and the American Society for the Control of Cancer was formed. With a budget of $10,000, the Society helped place the first article on cancer published in a popular woman’s magazine, the Ladies’ Home Journal.
From the middle of the decade onward, the organizers of the American Society for the Control of Cancer engaged in a concerted effort to inform the general public about the disease. Mrs. Robert G. Mead, the Chair of the Ways and Means Committee of the Society, was instrumental in coordinating this highly successful effort. Public meetings about the danger of cancer were held in Chicago, New York, St. Louis, Boston, and New Orleans. In 1914, the Society began to print pamphlets on cancer and one in particular, entitled “Facts About Cancer,” was mailed to approximately 14,000 people. Posters, exhibits, lantern slides, and newspaper articles on cancer began to appear regularly, and doctors reported that as a consequence patients were showing up earlier for diagnostic assessments.
At the same time, the Society began to focus specifically on educational programs for women, and enlisted the support of the Ladies’s Home Journal for disseminating a host of information on the warning signs and possible treatments for the disease. When the United States entered World War I in 1917, the Society reached an agreement with the National Safety Council to circulate more than six million bulletins on cancer to working men and women throughout the country. By the end of the decade, the Society had helped to establish a National Cancer Week, had started publishing pamphlets in foreign languages at the request of the League of Red Cross Societies, and had been instrumental in convincing the U.S. government to publish its first pamphlet on cancer, more than 250,000 copies of which were distributed in 1919 alone.
By 1922, the Society had grown so large that its budget was increased to $60,000. Nearly 700 cancer committees had been formed throughout the United States, and the organization estimated that half the country’s population was aware of cancer and its dangers. In 1924, while continuing to educate, the American Society also established cancer clinics to provide early diagnosis and treatment for patients, and to fight fraudulent cancer cures. During the decade, “What Everyone Should Know About Cancer,” a pamphlet published by the organization, had grown to become one of the most popular and widely circulated medical handbooks in the country. The not-for-profit agency was growing at a dizzying rate, and generous people throughout America opened up their pocketbooks to help the cause. John D. Rockefeller contributed the sum of $125,000 in 1926, substantially helping the Society toward its goal of $1 million for an endowment campaign. Not surprisingly, the goal was reached just one year later. In 1929, the organization published one of its most influential booklets, “What Every Woman Should Know About Cancer,” while an earlier released pamphlet, the “Danger Signals of Cancer,” had become so popular that it was being published in 22 languages.
The Great Depression and World War II
When the stock market crashed in the fall of 1929, every institution within the United States was affected. Businesses went bankrupt, banks closed their doors forever, and many people found themselves standing in bread lines for something to eat. The American Society for the Control of Cancer was also hit hard by the depression, with a dramatic drop in contributions which led to extensive salary reductions and staff layoffs. Doctors were compelled to augment the wages they received from medical practice with other work, and consequently had less time for volunteer activities associated with the Society. In addition, all the plans that had been laid for new cancer clinics around the country had to be indefinitely postponed.
To take the place of diminishing contributions from both the general public and private enterprise, many people within the organization began to look toward the government for help. In 1937, the National Cancer Institute Act was signed by President Roosevelt, stating as its intention to “provide for and to foster the continuous study of the cause, the prevention, the diagnosis and the treatment of cancer.” On its six member National Advisory Council, there sat four of the Society’s directors. But many doctors interpreted the Society’s alliance with the government as a harbinger of its support for socialized medicine, and thus became suspicious of its intentions for educating the public. As a result, donations from many doctors who had given in the past also began to trickle away
With its donor base shrinking, and more staff cuts inevitable, the Society focused on what it could reasonably expect to fund, namely, bringing the message of cancer control to doctors throughout America. During the entire decade of the 1930s, the Society focused on professional education, including publishing professional literature, sending speakers to professional meetings, and arranging for lectures to be given at medical schools. This effort allayed the fears of doctors that the Society was advocating socialized medicine, and convinced them that a more comprehensive and intensive program to educate the public about cancer was necessary.
The turning point for the Society, both in terms of heightened publicity and financial stability, occurred during the years of World War II. In 1943 Mary Lasker, the wife of Albert Lasker, who was the president of the renowned advertising firm of Lord & Thomas, was informed that her housekeeper had been diagnosed with cancer. Shocked when the doctors told her nothing could be done, Mrs. Lasker was appalled that there was practically no research conducted on the disease. When she called the American Society on Cancer Control, Mrs. Lasker learned that the Society had no money for research. She then asked her husband to help the Society make public the need for cancer research funds, and her husband delegated one of his younger associates, Emerson Foote, the man who became one of the famous founders of Foote, Cone & Belding Advertising Agency, to create a publicity and fund-raising campaign. Foote immediately suggested a name change for the organization, to the American Cancer Society (ACS), and embarked upon a comprehensive advertising strategy to raise funds for cancer research, including appeals for money on early radio shows such as “Bob Hope,” and “Fibber McGee and Molly.” The first fund-raising campaign conducted by the American Cancer Society in 1945 garnered more than $4 million, of which 25 percent was set aside for research. Since the federal government was only spending a total of $750,000 for cancer research during the same year, the amount raised by the ACS was significant. A director of research was hired at the national office, and from that time forward the ACS designated 25 percent of all funds raised annually to be used for cancer research.
The American Cancer Society is the nationwide, community-based, voluntary health organization dedicated to eliminating cancer as a major health problem by preventing cancer, saving lives and diminishing suffering from cancer, through research, education, advocacy and service.
The Postwar Era
During the late 1940s, the American Cancer Society began to share, with other national health organizations in such countries as England and Sweden, accumulated evidence regarding the relation between tobacco smoking and cancer. Spurred on by this evidence, the ACS funded a case-control study of lung-cancer patients and patients without lung cancer at the Washington School of Medicine in St. Louis, Missouri. The study found that 94 percent of the patients diagnosed with lung cancer were smokers of cigarettes. Following up on the conclusions to this study, a more comprehensive investigation was conducted during the early 1950s involving over 200,000 interviews, questionnaires, and clinical research. On June 21, 1954, a representative of the ACS told the American Medical Association convention in San Francisco that those people who smoked two packs of cigarettes a day were 25 times more likely to get lung cancer than nonsmokers and, in addition, that smokers were twice as likely to have a heart attack as nonsmokers.
The report created front page news not only across the United States but in Asia and Europe as well. Cigarette sales dropped precipitously. The tobacco companies responded by developing and marketing a safer product, namely, filter-tipped cigarettes. But the die had been cast, so to speak, and the ACS and tobacco firms began the fight that lasts to this day. In 1959, the Society tried to use its influence to persuade the U.S. Surgeon General to warn smokers about the risk of cancer, but bureaucratic red tape prevented a statement from being given, and two years later a version which was summarily ignored appeared in the Journal of the American Medical Association. The ACS would not give up, however, and was instrumental in the Surgeon General’s Report that was published in 1964, which stated that “cigarette smoking is a health hazard.” As its influence began to spread around the world, the ACS was active in promoting government campaigns against smoking in England, Sweden, and Norway. In 1965, the ACS won a hard-fought battle in convincing the U.S. Congress to pass the first law regulating the labeling of cigarettes, including the now ubiquitous warning: “Caution: Cigarette smoking may be hazardous to your health.” By 1971, Congress was persuaded to prohibit all cigarette advertising on both radio and television.
Saving Lives in the 1970s and 1980s
During the 1970s and 1980s, the ACS was involved in researching and teaching the public about many other forms of cancer as well. Bladder cancer, gastric cancer, mouth, colon, and kidney cancers were studied and the results developed into major breakthroughs for the medical professions’ understanding and treatment of the diseases. Perhaps the two most researched types of cancers during the 1970s and 1980s, in addition to lung cancer caused by tobacco, were cervical cancer and breast cancer. During the 1950s, the ACS had implemented a comprehensive public awareness campaign to encourage women to ask their doctor for a pap smear. In 1960, only 30 percent of American women had been given a pap smear, but by the mid-1970s the number had increased to over 50 percent, and by 1980 the figures had jumped to 80 percent. Early diagnosis was necessary for avoiding death from the disease, and the pap smear was overwhelmingly successful. In fact, this was widely regarded as the American Cancer Society’s first mass cancer-prevention program, and the Society could justifiably claim that the death rate among women with an early diagnosis was substantially reduced.
During the 1970s, the ACS had issued a formal statement in favor of annual mammography screening for women over 35 in order to diagnose breast cancer. However, the ACS was intensely criticized for its position due to the discovery that radiation used in the mammography x-rays were found to cause cancer or result in adverse side effects. The ACS revised its position in 1980 and advocated annual mammography screenings only for women over 50, and continued to work with experts to lower the radiation dosages and sharpen the x-ray images. As the criticism subsided, by the end of the decade the ACS claimed that mammography screenings were one of the most important diagnostic tools in the treatment of breast cancer.
In addition to its focus on the diagnosis and treatment of both cervical cancer and breast cancer, during the 1970s and 1980s the ACS initiated numerous programs which were meant to reduce or avoid known carcinogens. The most prominent of these programs was the one against cigarette smoking, well known as the most dangerous cause of lung cancer. Other programs concentrated on carcinogens confined to the workplace, including asbestos, uranium, aromatic amines used in the dye industry, and a variety of chemicals used in the production of artificial rubber and plastics. The public awareness campaigns of the ACS were significant factors in convincing the American government to enact legislation that protected employees from carcinogens found in the workplace.
The 1990s and Beyond
The ACS has led the fight against cancer in the decade of the 1990s by engaging in extensive research projects in the fields of cancer genetics, cancer vaccines, monoclinal antibodies, rational drug design, angiogenesis inhibitors, oncolytic viruses, chemotherapy, and cancer survivorship. In 1997, the ACS received $488 million from the American public for its cancer control programs. The most important development for the organization during the 1990s, however, has been its focus on advocacy, especially regarding the legislative proposals and tobacco settlement debated in the U.S. Congress. Positioning itself as a third-party watchdog, the ACS has actively and aggressively lobbied key policymakers in the White House and Congress to prevent the tobacco industry from marketing its products to children and to enact comprehensive national policies that will reduce the number of deaths caused by the use of tobacco. The ACS strongly advocates that the U.S. Food and Drug Administration (FDA) be given the unfettered power to regulate nicotine and require tobacco firms to stop marketing cigarettes to teenagers.
With a budget of over $500 million, the ACS is well-positioned to advocate public policy initiatives affecting the welfare of cancer patients, the protection of the public from cancer risks, access to healthcare, and also engage in cutting-edge research into the cause and treatment of the many forms of the disease. Undoubtedly, though, the ACS views its most important role to be played in the heated debate surrounding tobacco control, and will use every resource at its disposal to fight the tobacco industry.
Brewster, Elizabeth, “Battle of the Binge: New Diet Guidelines Streamline Healthy Eating Advice,” Food Processing, December 1996, p. 98.
Brooks, Warren T., “The Wasteful Pursuit of Zero Risk,” Forbes, April 30, 1990, p. 161.
“Cancer Society’s Deal to Sell Its Name Sparks Protests,” Marketing News, September 23, 1996, p. 5.
Carey, John, “So Many Chemicals, So Few Answers,” Business Week, March 13, 1995, p. 98.
“Estrogen and Cancer,” Time, June 14, 1976, p. 65.
Gross, Neil, “Quiet Strides in the War on Cancer,” Business Week, February 6, 1995, p. 150.
Nash, Madeleine, “Stopping Cancer,” Time, April 25, 1994, p. 54.
“A Potential Tool Against Cancer,” Business Week, May 18, 1981, p. 154.
Ross, Walter, Crusade: The Official History of the American Cancer Society, New York: Arbor House, 1987.