The National Cancer Institute -- billion-dollar-a-year giant of the National Institutes of Health crusader against the nation's most feared disease -- faces what promises to be the harshest investigation in its 44-year history. -
For three months, Sen. Orrin Hatch (R-Utah), chairman of the Labor and Human Resources Committee and a leader of the conservative Republican majority in the Senate, has had investigators seeking what he calls unacceptable "abuses and shortcomings" in the way NCI manages $274 million a year in contracts, mostly with medical laboratories and investigators.
Hatch, whose committee monitors health agencies, says some contractors have falsified data and one important NCI program -- development of "bioassays" to detect cancer-causing substances -- is in "substantial long-term disarray."
These preliminaries have already triggered a complaint from Dr. Vincent DeVita, cancer institute director, that "conclusions have been drawn that we're guilty" before the investigation has been completed. He also has expressed concern about the institute's ability to function as a result.
The congressional probe comes as many leading cancer centers have begun to report the first real progress in extending life or even curing many long-recalcitrant cancers.
Hatch has scheduled hearings on May 26 and 27 to air the mismanagement charges. Simultaneously, Sen. Paula Hawkins (R-fllla.), head of Hatch's oversight subcommittee, is planning hearings on why NCI hasn't been more successful in finding cancer cures.
"We've spent a lot of money on cancer in this country," she told a reporter. "Why isn't the cure around the corner a la polio?"
Hatch's chief cancer investigator, Frank Silbey, promised a "fair and objective" but searching hearing that will reveal "an overwhelming body of factual material."
Silbey also called it "outrageous" for DeVita to allege any premature verdict when Hatch has "again and again" ordered his staff to be fair and objective and conduct no "witch hunts."
DeVita has complained twice about the Hatch inquiry's thrust or extent. He wrote his advisory board members on March 28 that the investigators were seeking so much information that "I am now having serious concerns about the ability of the institute to function."
He also said "I am afraid [investigators'] view of the NCI may be a distorted one." He added that the investigtors had requested and been given 50,000 documents.
In interviews, Silbey said there have been no unreasonable requests for information, considering the cancer program's size, and cancer institute officials said information requests have abated.
DeVita acknowledged that there was too little supervision of contractors during an explosive growth period.
"I don't see any evidence of fraud" he said. "I do see some waste. . . . [But] as I look over [past criticisms] all the things I see have either been corrected or are on their way to beng corrected by changes we've made."
Hatch is expected to say otherwise. For the past three years the General Accounting Office, congressional watchdog agency, has found abuses, defects and laxity in NCI supervision of expensive contractors. Last year the Department of Health and Human Services' inspector general found many continuing problems. Sibley says Hatch will reveal more.
Just one may be that DeVita is NCI's fifth director or acting director since 1971.
The current "cancer crusade" began then. Congress boosted NCI's annual budget from $230 million in 1971 to $761 and an even billion in 1980.
Many critics have changed that the crusade was premature and has failed to produce great changes in survival expect in a few cancers, mainly lymphomas and childhood leukemia.
But DeVita, a leading architect of current cancer chemotherapy, says, "There is plenty of movement now and we've got a lot to be proud of." He calculates that 44 percent of all cancer patients now survive at least five years, with 41 percent permanently cured. He believes cures will reach 50 percent in less than five years.
It will take years before nationwide statistics, always years behind, tell whether this is true. But in recent cancer meeting, there has been a surge of improved statistics -- in breast cancer, in small-cell lung cancer (15 or 20 percent of all lung cancer), in cancer of the testes (the leading cancer in young men), in stomach and rectal cancers and others.
Most gradually seem to be yielding to combined treatments inventive mixes of surgery, radiation and several anti-cancer chemicals, given in sequence to keep any from losing their potency.