Chair, Committee on Cancer, 1954–1959
The journey of a thousand miles must begin with a single step.
In defining the components of any new cancer program, Danely P. Slaughter, MD, FACS, emphasized that any program wishing to be a true cancer program needed more than a cancer registry alone to qualify. Dr. Slaughter led the committee to consensus that although registry programs would be critical, they were only one of the many necessary components of a true cancer program. He pushed initiatives whereby the cancer registry extended beyond the local hospital level and would become a repository of data on a national level, in order that data could be incorporated into state-wide central registries for purposes of studying cancer trends and outcomes.
In his role as Chair for the Committee on Cancer, Dr. Slaughter continued the work of the committee to establish a central cancer registry. He would establish the American College of Surgeons as supervisory in this initiative. He explained that because the College was responsible for initiating the individual hospital registry program, it would be best suited to supervise a central cancer registry. The concept of a central registry was formed, to be supervised by the Committee on Cancer, in order to set minimum standards for central registries with a goal of achieving uniformity in reporting from all registries. A Subcommittee on Registries and Central Registries would agree on minimum standards for central registries and achieve uniformity in case reports. The College would additionally be responsible to survey central registries on a voluntary basis by request, with Committee on Cancer oversight.
Interestingly, while Chair of the Committee on Cancer in 1954, Dr. Slaughter cautioned the Committee on Cancer regarding a platform, which aimed to restrict Head and Neck Cancer surgery to only those with training in General Surgery. He was requested nonetheless to transmit a letter to the Board of Regents, despite his precautionary warnings, stating that the Committee on Cancer believed the techniques of major Head and Neck Cancer surgery were developed by General Surgeons, and by and large, only those with adequate training in General Surgery were capable of performing such procedures. Further, dental surgeons, oral surgeons, maxillofacial surgeons, plastic surgeons, and otolaryngologists should be restricted in the arena of head and neck surgery on the basis of being unqualified. It was only one year prior that Dr. Slaughter’s landmark paper on field cancerization and oral cancer was published. His work recognized significant advancements in the field of otolaryngology. Dr. Slaughter critically demonstrated that carcinogen exposure led to “condemned mucosa,” within which multiple cancers emanated. Slaughter introduced the term “field cancerization” over six decades ago in the setting of oral cancer. In a review of the origin of multiple tumors in an individual, Slaughter first recognized a phenomenon when studying oral cancer: “Even in the far advanced and hopeless cases, tumors that had overgrown and destroyed all evidence of their origins, the majority still had wider horizontal spread than infiltration in depth—a growth by a process of lateral cancerization .“ The damaged field concept of cancer development and multiple sites of premalignant change in the oral cavity, first introduced by Slaughter, brings us to our current understanding of the treatment of oral cancers.
Sir Stanford Cade (left) and Danely P. Slaughter
Dr. Slaughter died at the age of 58. Professor of Surgery at the University of Illinois, he had served as Chief of the Department of Surgery and Director of the tumor clinic at St. Francis Hospital in Evanston, IL, and at the University of Illinois Hospital. He graduated from the University of Illinois in 1932 and received his medical degree from the University of Chicago in 1936. He served as President of the Society of Head and Neck Surgeons in 1959.
Dr. Slaughter received a distinguished service award from the Illinois division of the American Cancer Society in 1964 and a citation from the American College of Surgeons for his service as Chairman of its Committee on Cancer.
Written by Maria Castaldi, MD, FACS