Michael Milken, a summa cum laude graduate of the University of California at Berkeley and a graduate of the Wharton School of Business, rose to billionaire prominence in the 1980s as the Wall Street ''king of junk bonds,'' high-yield debt securities. Rudy Giuliani, then a New York prosecutor, went after him for securities fraud, and Milken eventually pleaded guilty to six counts of violations related to market manipulation.4 He paid $600 million in fines and spent twenty-two months in prison. Ironically, both Giuliani and Milken were subsequently diagnosed with prostate cancer and became friends and national advocates for prostate cancer sufferers.
Milken was diagnosed with prostate cancer in 1993, shortly after his release from prison. Just 46 years old, he had a Gleason score of 9, a PSA of 24, and the cancer had already spread to his lymph nodes. He was treated with beam radiation and hormones and began a very strict diet; thirteen years later he remains in remission.
Milken approached prostate cancer in the same manner he had approached Wall Street securities. ''I decided that I had to change the course of history,'' he recalls, and proposed ''a Manhattan Project'' for prostate cancer to discover the causes and better treatments.5 He pledged $25 million of his own funds and in 1993 began CaPCURE (cancer of the prostate cure), a foundation that in 2003 was renamed the Prostate Cancer Foundation (PCF).
Milken has accomplished a remarkable amount in pursuit of his goals. Between 1993 and 2003, his foundation raised $230 million and funded over twelve hundred prostate cancer research projects. In contrast to the National Cancer Institute, where getting a research grant funded often takes eighteen months or more, Milken's awards are given in three months. Also in contrast to the NCI, the research projects funded by the foundation are more focused on finding better treatments and less oriented toward basic cellular research.
Milken's foundation has coordinated a prostate tissue bank to distribute tissue to researchers and has set up a genetics project to collect blood from families with three or more members who have prostate cancer. It has also put together a consortium of eight leading prostate cancer research centers and holds an annual meeting to bring leading researchers together to exchange ideas. Perhaps most remarkably, his foundation requires its grantees to cooperate with one another and to openly discuss their research findings, a true accomplishment in a field that has at least its share of prima donnas.
In addition to his research efforts, Milken has attempted to raise the profile of prostate cancer. He has lobbied Congress and worked with other advocacy groups, such as the National Prostate Cancer Coalition, to organize public events. Since 1996 the Prostate Cancer Foundation has worked with major league baseball teams to
Cancer is a harsher teacher than inspirational bestsellers or ads for vitamin-mineral supplements. It reminds us that we are not immortal, that our time is limited, that disease and death are still out there waiting for us. . . . Cancer is the worm in the apple of jaunty optimism about life; the banana peel on which even the healthiest and fittest of us slips; a great teacher, if you're lucky enough to survive the lesson.
—Michael Korda, Man to Man sponsor a PCF Home Run Challenge that raises public awareness and generates research funds. A laudatory article in Fortune in late 2004 concluded that ''Milken has, in fact, turned the cancer establishment upside down.''6
The National Prostate Cancer Coalition (NPCC) is the foremost advocacy organization on prostate cancer. It began in 1996, when a group of men who had prostate cancer met in Texas and decided to form an organization modeled after the women's advocacy groups for breast cancer. Mary Lou Wright of the Mathews Foundation for Prostate Cancer Research, a pioneer in the field, was instrumental in getting it started; Michael Milken, the American Cancer Society, and Zeneca Pharmaceuticals (which later became part of AstraZeneca) were also helpful.
Located in Washington, D.C., the NPCC has a staff of twelve and operates with a combination of corporate sponsorship and donations. Its twofold mission is promoting research on, and awareness of, prostate cancer. To accomplish the first, it is active on Capitol Hill and has close relationships with many members of Congress who have prostate cancer—some of whom have publicly acknowledged their illness and others who have not. Senator Ted Stevens of Alaska and former Senator Bob Dole have for many years been the leading congressional voices on prostate cancer.
Both the Senate and the House of Representatives have informal caucuses composed of legislators who have family members with some form of cancer. Members of Congress who have been consistent supporters of prostate cancer research include Senators Michael Crapo (Idaho), Byron Dorgan (N. Dak.), Diane Feinstein (Calif.), Tom Harkin (Iowa), Kay Hutchinson (Tex.), Harry Reid (Nev.), and Jeff Sessions (Ala.), and Representatives Sherrod Brown (Ohio), Lois Capps (Calif.), Jesse Jackson (Ill.), Peter King (N.Y.), Kendrick Meek (Fla.), and Deborah Pryce (Ohio).
In a variety of ways NPCC attempts to increase awareness of prostate cancer, and especially of how important it is that men be tested. It has worked with major league baseball on an education campaign, ''Take a Swing Against Prostate Cancer''; with the National Hockey League on a ''Hockey Fights Cancer'' program; and with NASCAR drivers such as Dale Earnhardt, Jr., and Jimmie Johnson on a ''NASCAR Young Guns Consumer Challenge,'' in which fans can donate at NASCAR races to fight prostate cancer. The NPCC has promoted September as Prostate Cancer Awareness Month, an extension of work by the Prostate Cancer Education Council, a smaller advocacy group in Denver. In many of these activities, NPCC works with other organizations, including Us Too and Milken's Prostate Cancer Foundation.
Much of NPCC's influence comes from ''Aware,'' its free biweekly on-line newsletter, which has over forty-five thousand subscribers. The newsletter includes summaries of breaking news on prostate cancer research and links to the stories. Despite the fact that it carries pharmaceutical company ads and thus cannot be truly objective on drug developments, ''Aware'' is the most useful and widely read online news source for men with prostate cancer.
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Since World War II, there has been a tremendous change in the makeup and direction of kid baseball, as it is called. Adults, showing an unprecedented interest in the activity, have initiated and developed programs in thousands of towns across the United States programs that providebr wholesome recreation for millions of youngsters and are often a source of pride and joy to the community in which they exist.