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The Pivotal Leadership of Doctors R. Lee Clark and Murray M. Copeland in Transforming the Commission on Cancer (1955–1965)

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Abstract

In September 1959, Dr. Clark was appointed as Chair and Dr. Murray M Copeland as Vice Chair of the Committee on Cancer. With their typical leadership style to improve the functions and value of organizations, they reorganized and revitalized the Committee on Cancer during the next 6 years. Thus, Drs. Clark and Copeland and the Committee members developed more uniform standards of cancer registries, implemented the American Joint Committee on Cancer Staging and End Results Reporting (with Dr. Copeland as Chair), published a revised Manual for Cancer Programs (which defined minimum standards requisite for approval of a cancer service), established a new regionalization program (with liaison surgeons from each state), and planned all the cancer educational programs for the College’s annual Clinical Congress and Sectional Meetings. Importantly, Clark and Copeland led a 10-year strategic plan (called the “Program of the Sixties”) to expand and revitalize the scale and scope of the Committee’s activities and to reorganize the Committee structure by including liaison members from other physician, oncologic, and hospital organizations. As Dr. Clark completed his 5-year tenure as Committee Chair in October 1964, he formally recommended a reorganization of the Committee on Cancer to assume an even greater role in the cancer community as the Commission on Cancer. As the new Committee Chair, Dr. Copeland shepherded this recommendation to the ACS Board of Regents, which was approved and implemented in July 1965. The Regents emphasized that the functions and activities of the Committee on Cancer had become so complex and far reaching (under Clark’s and Copeland's leadership) that its many subcommittees had already assumed duties of committee stature. Dr. Copeland thus became the first Chair of the Commission on Cancer until October 1965, when Dr. John Cline became Chair. For his contributions to the cancer field and to the College of Surgeons, Dr. Clark received their Distinguished Service Award in October 1969 “for his life-long devotion to the treatment of patients and to research in cancer, for notable service to this College, particularly as Chairman of the Cancer Commission from 1960 to 1964.”

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Notes

  1. In addition to Dr. Clark as Chair of the Executive Committee, the chairs of the subcommittees included Dr. Murray Copeland (Budget and Education Subcommittee), Ian Macdonald (Registries and Central Registries Subcommittee), Dr. Charles Eckert (Chemotherapy Subcommittee), and Dr. Howard Snyder (Regionalization Subcommittee). Dr. Danely P. Slaughter served as Chair of the Committee on Cancer, and Dr. James B. Mason served as the Administrative Secretary19 (Fig. 2, Supplementary Figure S2).

  2. The subcommittee was composed of Drs. Daland (Chair), MacDonald, Copeland, Martin, and Dorn.

  3. At the time, the American College of Radiology was the professional organization for both diagnostic radiologists and therapeutic radiologists.

  4. After working closely together on the Committee on Cancer for 13 years, Dr. Clark recruited Dr. Copeland to join the MD Anderson Cancer Hospital faculty as Professor of Surgery and as Associate Director for Education in 1960, where he served with distinction until 1983.

  5. Isidor S. Ravdin, MD (1894–1972) was the John Rhea Barton Professor and Chairman of the Department of Surgery at the University of Pennsylvania from 1945 to 1960 and the Vice President for Medical Affairs from 1960 to 1964 (Fig. 1). Dr. Ravdin was President of the American College of Surgeons in 1960, having been Chairman of its Board of Regents from 1954 to 1960. He also was President of the American Surgical Association (1958) and the American Cancer Society (1963).

  6. This remarkable “turnaround” would not be surprising to those who knew Dr. Clark. He had used bold strategic planning that transformed the University of Texas MD Anderson Cancer Hospital and Research Institute (as it was named in 1960) into nationally recognized leadership. For his first construction project, he built a major cancer hospital described to be “as modern a cancer station as any in the U.S.—very probably the most modern. American hospital planning is not likely to be quite the same after Anderson opens its doors.”28,49 Indeed, a plaque on Clark’s desk embodied his visionary leadership style, which stated: “MAKE NO SMALL PLANS.”

  7. Clark also understood that the composition and motivation of the Committee members would be key to planning and then making major policy changes, as he mused in a private planning memorandum: “Many committees either lose members or reduce motivated people to “dead wood” as a result of poor leadership and poor program planning. Conversely, programs which are over-ambitious, no matter how good they may be, will cause loss of interest and withdrawal because the volunteer has neither the time, money, nor energy to bear the share of effort assigned to him. A median ground—which need not be lacking in appeal or dynamism—must be sought. The Committee ought to become an “all-year action group.”52

  8. Eugene W. Bricker (1908–2000) was a “master cancer surgeon” who served on the Washington University surgery faculty for 37 years, practicing at Barnes Hospital and Children’s Hospital in St. Louis. He also was the founding Chief of Surgery at Ellis Fiscal State Cancer Hospital in Columbia, Missouri. Dr. Bricker was a Governor and second Vice President of the American College of Surgeons (1968–1969), President of the American Surgical Association (1984–1985), and Chair of the American Board of Surgery.

  9. The American College of Radiology had a very active role in the planning and participation for a Commission on Cancer under the American College of Surgeons. Dr. Clark was formally appointed as a Liaison Member to the Commission on Cancer of the American College of Radiology. Dr. Justin Stein, Chairman of the Commission on Cancer of the American College of Radiology, invited Dr. Clark and Dr. Copeland twice to present this proposal to their leadership. At that time in history, the College of Radiology was the professional organization for both diagnostic and therapeutic radiologists.

  10. The American College of Physicians was the professional organization for hematologists and internists who were treating cancer patients. Internists were termed “chemotherapists.” The American Board of Medical Oncology did not exist at the time. The American Board of Medical Oncology was approved in 1972 and gave the first exam in 1973.

  11. John W. Cline (Fig. 1) was a member of the Committee on Cancer from 1962 to 1970. He became the second chairman of the newly reorganized Commission on Cancer from October 1965 until October 1959. He also was President of the American Medical Society (1951–1952) and President of the American Cancer Society (1960–1961).

  12. The Committee on Cancer formally thanked Dr. Ravdin for his support through the years with a resolution in October 1964: “Be it resolved that the Committee on Cancer thanks Dr. I. S. Ravdin for his vision concerning the cancer program of the American College of Surgeons and the charge that he gave to the Committee on Cancer for implementation.”94

  13. The Committee on Cancer gave an enthusiastic vote of appreciation to Dr. Copeland at its 3 October 1964, meeting as follows: “Dr. Copeland has served on the Cancer Committee for 23 years. His loyalty, devotion to duty, and prodigious labors are exemplary. He will be abundantly occupied with another “labor of love” as the incoming President of the American Cancer Society.”94

  14. The Distinguished Service Award was established by the Board of Regents in 1957 for a recipient who has been a distinguished contributor to the College. In addition to Dr. Clark in 1969, Commission on Cancer Chair John W. Cline received the Award in 1972.

  15. Dr. John Paul North was Chief of Surgery at the Dallas VA Hospital from 1955 to 1960 and Professor of Clinical Surgery at the University of Texas Medical School in Dallas since 1946. He served as Director of the American College of Surgeons from 1 January 1961, when he replaced Dr. Paul R. Hawley, until 1986.

References

NOTE The historical documents, including the R. Lee Clark Jr. papers, from the McGovern Historical Center, Texas Medical Center can be sourced by their location in the Series MS 070 papers. For each document, the Series, Box, and File numbers are listed.

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  53. Minutes of Executive Committee of the Committee on Cancer. Dr. R. Lee Clark Chairman in absence of Dr. Murray Copeland. Los Angeles California, May 31, 1960. Dr. Clark presented these long-range goals entitled, “Committee on Cancer Program for the 1960s.” After considerable discussion of the many items, the Executive Committee recommended that Clark's agenda should be presented to full Cancer Committee and then to the Board of Regents for approval (Series IV, Box 2, File 4).

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  59. Minutes of Annual Meeting of Committee on Cancer, October 9, 1960, San Francisco CA (Series IV, Box 2, File 1).

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  63. American College of Surgeons Memorandum of Information and Guidance on The Manual for Cancer Programs. December 1, 1960 (Series 4, Box 1, File 9).

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  69. American Joint Committee publication, “Reporting of Cancer Survival and End Results,” July 1963 (Series IV, Box 5, File 7).

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  71. Clark RL. Annual Report of the Chairman to the Committee on Cancer, October 1963. Series IV, Box 3, File 13).

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  73. Minutes of the Executive Committee of the Committee on Cancer, May 31, 1960. Chaired by Dr. Clark in the absence of Dr. Copeland. Dr. Clark presented his “Committee on Cancer for the 1960s,” with the theme: “The improvement of the care of the cancer patient at the community level.” The proposal was approved for presentation to the ACS Board of regents. Also, Dr. Ashbel Williams was authorized to prepare a plan for regionalization (Archives of the American College of Surgeons, Chicago, Illinois).

  74. Report of the Subcommittee on Registries, Committee on Cancer. Committee on Cancer Annual Meeting, October 9, 1960. Harry M. Nelson, Chair (Series IV, Box 2, File 1).

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  76. Clark RL. Special Report from the Chairman to be placed with the October 1962 minutes of the Committee on Cancer meeting, including a 19-page Manual for Liaison Fellows in the Regionalization Program (Series IV, Box 4, File 4).

  77. Clark RL. Personal notes made in preparation for his acceptance of the American College of Surgeons Distinguished Service Award (October 5, 1969) (Series VI, Box 18, File 5).

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  79. Clark RL. Letter to Dr. James B. Mason, Assistant Director, American College of Surgeons, September 13, 1960). The letter outlined the organization of a Regionalization Plan. (Series III, Box 7, File 1)

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  81. Clark RL. Annual report of the Chairman to The Committee on Cancer, October 1963 (Series IV, Box 3, File 13).

  82. Report of the Subcommittee on Regionalization at the Committee on Cancer Annual Meeting, October 1960 (Series III, Box 7, File 2; also Series IV, Box 2, File 1).

  83. Manual for Liaison Fellows. Committee on Cancer Regionalization Program. Published in 1963 (Series IV, Box 4, File 6).

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  85. Minutes of the meeting on regionalization, Houston Texas, January 30–31, 1964 (Series IV, Box 5, File 9).

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  89. Minutes of First Annual Conference for Liaison Fellows Regionalization Program, Committee on Cancer, American College of Surgeons, November 4–5, 1964, MD Anderson Hospital and Tumor Institute, Houston, Texas (Series IV, Box 5, File 11).

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  93. Executive Committee of the Committee on Cancer Minutes, Murray M. Copeland, Chair, October 3, 1964. Chicago, IL (Series III, Box 7, File 1, and Series IV, Box 5, File 4). Dr. Clark presented a detailed proposal about the proposed organization and structure of a Commission on Cancer. Motion by Dr. Cline unanimously approved that Dr. Clark present this proposal to the ACS Board of Regents.

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Acknowledgment

The authors thank Sandra E. Yates, Head of the McGovern Historical Center of the Texas Medical Center Library, Houston Texas, and Matthew Richardson Archivist and Special Collections Librarian of the McGovern Historical Center for providing historical documents used in this manuscript. The authors also thank Ms. Connie Bura, Administrative Director of Cancer Programs; Melissa Leeb, Communications & External Relations Manager, Cancer Programs; Meghan Kennedy, Archivist; Michael Beesley, Assistant Archivist; and Natalie Boden, Director, Division of Integrated Communications, all at the American College of Surgeons for their assistance in accessing historical documents and photos from the College Archives, and their editorial review and fact checking. We want especially to thank Dr. Bryant Boutwell, Oslerian Professor of Medical History at the University of Texas Houston Medical School for his thorough review of the manuscript and valuable suggestions. Also, we express special gratitude to Ms. Deborah Whippen for her valuable editorial assistance.

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  1. Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Charles M. Balch MD, FACS

  2. Evanston Hospital, University of Chicago Medical School, Evanston, USA

    David P. Winchester MD, FACS

  3. Cancer Department, American College of Surgeons, Chicago, USA

    David P. Winchester MD, FACS & Edward M. Copeland MD, FACS

  4. University of Florida School of Medicine, Gainesville, USA

    Edward M. Copeland MD, FACS

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Correspondence to Charles M. Balch MD, FACS.

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Balch, C.M., Winchester, D.P. & Copeland, E.M. The Pivotal Leadership of Doctors R. Lee Clark and Murray M. Copeland in Transforming the Commission on Cancer (1955–1965). Ann Surg Oncol 29, 5401–5421 (2022). https://doi.org/10.1245/s10434-022-11923-4

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