On that same flight home from Houston after being told that I was cured, I tried to figure out what avenues, in addition to the Hot Line, I could pursue. Thinking back again to my personal experiences, I realized that I was here and alive because I went to Houston. If I had stayed in Kansas City and listened to the original doctor, I might not be alive today.

Many people, because of time, money or poor advice, are unable to go to a major cancer center. These individuals are entitled to a chance at life. The resources are available in every major town. All it would take is the proper structuring of these resources. This thinking would eventually lead to the establishment of the second part of my project-the Cancer Treatment Panel.

I discussed these ideas in their embryonic stage with an acquaintance. She had had cancer and had completed some six years of chemotherapy. She arranged a luncheon with a top surgical oncologist.

He listened to my idea that the average Kansas City resident should be able to get the best advice for the treatment of cancer without having to leave the city. He liked the idea of a group of oncologists to prescribe treatment. He was in the process of building a new building next to a hospital for his own cancer clinic. He wanted to house this panel in his building. Furthermore, he said that oncologists would be happy to donate their time without charge and serve on a panel like this to help others. If I would agree to house this panel in his clinic, he said, he would get the doctors to staff the panel.

This surprised me for many reasons. First, I did not think the first person I talked to would be so enthusiastic about my idea. Second, I had no thought that doctors would donate their services. This, in itself, meant that great things were possible.

I explained to the surgeon that one of the fundamental requirements for the panel to be successful was to meet in a neutral place. This was necessary so that doctors could refer the patients without fear of losing them. For the patient to walk through a door with an oncologist's name on it, or for the panel to meet in the same hospital each time, would keep doctors from referring their patients. Even though the luncheon ended without anything tangible accomplished, I felt good about the prospects. I decided to arrange to have lunch every day with someone who could help to establish these cancer programs.

At a noon meeting with an oncologist at a major teaching hospital, I told my story. His response was, "When your doctor told you that you were malignant, he of course arranged for you to come before the tumor board that we used to have." I said, "What tumor board?" He said the hospital had had the finest tumor board in the Midwest until the government recently took away the funding.

After relating my story to the head of a medical society, his response was that it was fortunate the biopsy had been done in the right hospital; he assumed that the doctor had immediately taken my case to the tumor board. Again my response was, "What tumor board?"

This made me realize two very important basic facts: many doctors will not voluntarily recommend a patient go elsewhere, and, as with the Cancer Hot Line, publicity would be the key to the success of this program.

Most cancers are diagnosed by doctors other than oncologists. They are diagnosed by family doctors, gynecologists, ear-nose-and-throat doctors, and so on. Some of these doctors do not want to take the chance of losing revenue, do not want to take the chance of having their patient believe some other doctor is more knowledgeable than they are, do not want to fool around with the inconvenience of a consultant, or honestly believe that they know everything there is to know about cancer. The patients of these doctors probably are most in need of a second opinion. Therefore, we must get the patient to demand a second opinion, since we can't always rely on the doctor to recommend it. The way to do this is through publicity.

At lunch with another medical oncologist, I asked how often he treated a patient for cancer without a second opinion. This man, in his sixties, replied that he had never in his career treated a cancer patient without a second opinion. Furthermore, he always insisted on a second opinion from someone other than an associate of his. This was for four reasons:

o Cancer is a very serious disease that grows geometrically. If it is not treated properly the first time, there is often no second chance.

oHe is human and could make a mistake.

o Someone else could see something that he doesn't see.

o Someone else could know something that he doesn't know.

I thought this was a profound statement. I wished that every doctor treating a cancer patient could hear this. My conclusion from this statement is that any doctor treating a cancer patient without a second opinion is not practicing medicine, but trying to play God. I thought it was only God who was supposed to be perfect, know everything and never make a mistake.

Another doctor told me about a sizable clinic in a small town in Missouri that treats people from a wide area. It has no scanner with which to give a bone, brain or liver scan, vital to the determination of the extent of many cancers. Yet, this clinic diagnoses, treats and buries many cancer cases.

From all this information and other conversations too numerous to mention, the plans for the Cancer Treatment Panel were formalized. I decided to have the first panel meet on September 2, 1980. My wife and I invited forty-four top oncologists and other doctors directly working against cancer to our home one evening for cocktails. Thirty-five of these doctors and their spouses accepted our invitation. I felt that this was a good turnout.

After I presented the plans, hopes and dreams of this Cancer Treatment Panel, their reaction was elicited. One surgeon felt that it was ridiculous that I insisted on no fees, because doctors had to get paid. One medical doctor was opposed to it, because he had no time to become involved in it, and he was opposed to anything in which he could not become personally involved. A third doctor thought we should do it by closed-circuit TV.

The important thing is that thirty-two doctors were in favor of it. Our dream was fast becoming a reality. My wife and I sat up talking for hours that night relishing the enthusiastic support of the group.The Cancer Treatment Panel had become a reality. The Cancer Treatment Panel was composed of five doctors meeting regularly in a neutral setting-a medical oncologist, a surgeon, a radiologist, a pathologist and a psychiatrist or psychologist. In Kansas City, they met at 5 P.M. Tuesdays at a different centrally located hospital each time. The doctors worked on a rotating basis. From time to time, doctors specializing in other fields were invited to sit in. Up to four patients a week were seen. These patients were required to bring all their records, including X rays, slides and medical reports.

Technically, they were being referred to the panel by their doctor, by his giving them their records for presentation there. The purpose of the panel was to review the doctor's proposed treatment and approve it or recommend additions or alternatives. The recommendations of the panel, in addition to being fully discussed in front of the patient, were written down and sent to the referring doctor, with a copy for the patient.

This idea of holding all discussions openly and frankly in front of the patient and any relatives or friends they cared to bring was unique in the medical world. Furthermore, the psychiatrist or psychologist proved to be a key member of the panel. Not only did a majority of patients leave with a recommended improved medical treatment, but every patient left with an improved state of mind. They all felt better and had more confidence about what was ahead of them.

Two volunteers from a mental health association would sit in the waiting room with patients and their family and friends until they got to see the panel. Often these volunteers called the patients after their session with the panel to see if they could be of further assistance.

One of the reasons for family or friends being present is that the patient, being so deeply involved, may tend not to hear things as they are said. Later on, the people in attendance can present their interpretation of what was said. Furthermore, we know that the cure of cancer requires the support of family and friends.

After one of the first sessions of the panel, I wrote the following fundamental principles to guide future panels. Doctors at first had reservations about them but, after trying them, came to adopt them with respect and admiration.

o Every patient is to leave happy for having been heard by the panel.

o The patient appears in front of the panel with his or her spouse and relatives and friends.

o All discussions of treatment are held by doctors openly in front of the patient. o Recommendations are put in writing and sent to the patient's doctor, with a copy for he patient.

o Since there is always hope in psychology or prayer, no patient is ever denied hope.

In the first two sessions, in my lay opinion, the lives of two patients were saved. Both were being treated but were given no hope for recovery. After a lengthy review of each case and a considerable amount of discussion, the doctors on these panels recommended additional forms of therapy and felt that the patient had an excellent chance of being cured.

The panel reemphasized the need and importance of a prompt and qualified second opinion in cancer cases as well as the importance of psychological support. The panel planned to meet in the evening before Christmas Eve with only one patient scheduled to appear. We called the doctor who was leading the panel and asked if he wanted to postpone this patient a week. His reply was that if this man felt it was worth it for him to come before the panel the evening before Christmas Eve, then the panel would be there. And so they were. I understand that the panel proved to be beneficial for this individual. This proves to me the dedication of these wonderful doctors.

An internist told me, "As a general practitioner, I diagnose many cancer cases. Even though I don't know the latest and best treatments for many types of cancer, I must prescribe treatment, because if I send the patient to an oncologist, he'll probably get chemotherapy; if I send the patient to a surgeon, he'll probably get surgery; if I send the patient to a radiotherapist, he'll probably get radiation therapy. I have to decide the treatment for the patient, even though I'm not an expert. Now, I can send them to your panel, where they appear in front of all the disciplines, and they get the right treatment prescribed the first time."

My goals:

o Urge every doctor not to play God. See that every cancer patient receives a qualified, independent second opinion.

o Encourage every cancer patient to find a doctor and a treatment in which he can have confidence and that he will follow all the way through.

o Encourage every cancer patient to play it on the safe side, the conservative side. Often there is no second chance.

o Encourage every cancer patient to use a positive mental attitude to think away the cancer. 'Remember, even if no one can prove it will help, it can't hurt. If it does nothing but keep your mind off the alter native, that's something.'

o Encourage every cancer patient to be selfish. 'Think of yourself first and do just what you feel like doing. Talk about it openly if you feel like it. It will help to discuss your thoughts with loved ones and friends. Don't be considerate of a doctor who says you won't make it. Change and find one who says he will try to cure you.'

o Encourage every cancer patient not to turn away from his loved ones and friends. 'You have nothing contagious. You need companionship, and maybe with their help and prayers you can stick around for many years and be with them.'