City of Hope has received a $150 million gift from entrepreneurs and philanthropists A. Emmet Stephenson Jr. and his daughter Tessa Stephenson Brand to create a program focused on pancreatic cancer research.
The centerpiece of this gift is the $1 million Stephenson Prize, which will be awarded annually to a scientist or team judged to be making the most promising advancements in pancreatic cancer research, treatments, and cures.
The prize is open to individual investigators and teams worldwide, and the first prize will be awarded in 2025.
The $150 million gift from the Stephensons will fund and support research initiatives, including:
- A Pancreatic Biorepository at City of Hope to enhance genomic-informed patient care, aid in early detection, deepen understanding of cancer biology and immune response, and contribute to developing innovative therapies,
- The Stephenson Fellows Program, which will award grants to researchers and support their work in pancreatic cancer research,
- An annual Stephenson Pancreatic Cancer Research Symposium that, together with grants awarded through the Stephenson Fellows Program, will support innovative ideas and promote scientific collaboration,
- Immediate funding to advance novel immunotherapies and support groundbreaking clinical research in pancreatic cancer, and further investment in City of Hope’s Toni Stephenson Lymphoma Center.
The Stephensons’ investment is in honor of Toni Stephenson who, after surviving lymphoma, died of pancreatic cancer in 2020.
“The history here, my wife survived a battle with lymphoma seven years before she died, and recovered nicely, and lived a good life for those seven years,” A. Emmet Stephenson Jr., senior partner and founder of Stephenson Ventures, said to The Cancer Letter.
Said Stephenson:
And then, when pancreatic cancer hit, it was advanced before we even knew she had it. And that’s when I learned how deadly this disease is. Only 13% of the people survive five years with the treatments that are available today. And it was all downhill in four months, basically.
And so, my idea was to offer a program that would stimulate research worldwide and hopefully bring other people’s research programs into the effort and magnify what we could accomplish with the funds that we had to contribute to the cause.
And I think that the prize is a way to do that, because it focuses on the disease.
It’s a tough disease. There are other research programs around the world working on it. But we thought that anything we could do to stimulate additional interest and bring additional resources and additional bright researchers to the cause would give us the best chance of finding a cure for this disease.
The Stephenson family had previously given City of Hope $10 million to establish the Toni Stephenson Lymphoma Center.
The latest $150 million gift equals nearly two-thirds of the total annual research budget for pancreatic cancer from NCI and is intended to drive the trajectory for pancreatic cancer early detection and treatment.
Usually, research is funded by the government, foundations, and other charities, but housing a major worldwide research program at an NCI-designated cancer center is an unusual move.
“I think it’s something that has never been done before, and it’s certainly not the way things are usually done, and there are a couple of reasons for that,” Robert Stone, CEO of City of Hope, said to The Cancer Letter.
Said Stone:
We’ve had a model of both inviting other organizations to contribute and avoiding getting caught up in the academic infrastructure that, at times, at other academic organizations doesn’t move as quickly as we would all like.
So, Emmett and I decided that City of Hope would form a new company. And that the efforts that we’re talking about now would come through a wholly owned subsidiary of City of Hope, but something that was designed to both tie the efforts to the organization and the expertise that we bring, but also give it a level of independence that, again, allows it to move with less bureaucracy, red tape, and to focus on speed and collaboration.
And, of course, that is, I think, a relatively unique concept, adding a scientific advisory board that isn’t limited to City of Hope experts.
But really, being willing to be open to experts around the country and around the world was another thing that was attractive to both Emmet and to me as we set this up.
The company, Stephenson Pancreatic Cancer Research, is a not-for-profit limited liability corporation governed by a five-member board. The board will include Emmet and Tessa Stephenson, two City of Hope directors, and an independent director.
“There’s just five of us. So, it’s small and nimble, which is a good idea, in my opinion, for getting things done,” Stephenson said.
Said Stephenson:
This was really designed, and why we made it the nonprofit track of an LLC, is we wanted to be able to move quickly.
We wanted to be able to streamline decision-making, and we wanted to invite others to participate in a way that is tied to City of Hope, but isn’t directly under the City of Hope umbrella.
Because, again, pancreatic cancer’s the competition.
And I think the entirety of this is, how do you raise awareness and invite more people into this fight?
That’s why it’s unusual.
The objective of the City of Hope program is to focus on the entire landscape of pancreatic cancer, said Marcel van den Brink, president and chief physician executive of City of Hope Los Angeles and City of Hope National Medical Center.
Said van den Brink:
We need to undertake new efforts to screen earlier and better. And that spans the whole spectrum, from imaging to biomarkers, to whatever else we come up with in terms of screening. One of the foci for this program will be definitely in that area.
I also definitely think that immunotherapy is one of the areas where there’s a lot of promise. Also, I’m sure you know, Paul, about some of the work with vaccines and CAR cell research.
And at our own center, we’re also working in that area.
So, I think those are two areas where I see promise.
But there are, of course, many other areas which are more in the precision medicine area, where there’s also progress coming. But the two areas where we should specifically focus is the early detection and novel strategies for immunotherapy of cancer ranging from vaccines to CAR cells.
Stephenson, Stone, and van den Brink spoke with Paul Goldberg, editor and publisher of The Cancer Letter.
Paul Goldberg: First of all, congratulations on this incredible development, and thank you for finding the time to talk to me about it. How is this approach and this program different from what’s being done by others? By which I mean there’s Stand Up To Cancer, Lustgarten, PanCAN, Breakthrough Cancer, the Mark Foundation. There’s also ACS and NCI, but this is different. We should focus on that first.
Robert Stone: Well, I think it’s something that has never been done before, and it’s certainly not the way things are usually done, and there are a couple of reasons for that, Paul.
Taking a step back just ever-so-briefly, you know us and you know City of Hope so well, so I don’t have to give you as much of a background on why City of Hope.
You know about the history of synthetic insulin, monoclonal antibodies, the fact that 86 million people live within driving distance of a City of Hope facility.
From day one, this will be one of the largest privately funded scientific awards for individual investigators in the US.
Robert Stone
But most importantly, what we’ve done in areas like bone marrow transplant and cell therapy, we want to do now for people with pancreatic cancer.
And it’s absolutely devastating, because so many families are left with long-term scars, because this disease hits so quickly and has such a low survival rate, yet research into it is underfunded and progress is really slow.
So, what we’ve decided to do, by partnering with the Stephenson family, you’ve met Emmet and his daughter, Tessa Stephenson Brand, is launch the Stephenson Prize for innovation in pancreatic cancer research.
And it really is a first of its kind initiative, and it’s fueled by collaboration.
The idea is we are going to award annually to a leading scientist or team a $1 million award for making the most promising advancements in pancreatic cancer research, treatment and cures.
And it’s open to individual investigators and teams driving institutions anywhere in the world.
We’ll award the first prize in 2025. From day one, this will be one of the largest privately funded scientific awards for individual investigators in the US.
And you asked about the others who are fighting pancreatic cancer. From my perspective, that’s wonderful. These are organizations and individuals who are joining us in this fight against the disease.
Remember, cancer is the competition, not others. This prize is distinct, however, because it’s not run by a private nonprofit charity.
The partnership between the Stephenson family, Emmet and Tessa, is with a National Cancer Institute-designated Comprehensive Cancer Center that also knows firsthand the impact of pancreatic cancer.
What can you do that a foundation can’t?
RS: We’ve been on both sides of this fight, Paul.
We have cared for the patients and their families that have gone through our clinics in our hospitals. We have researchers who know what it means to look for that next discovery.
And we also have the spirit, if you will, to rally, use our experience in the field to bring collaboration together with other organizations. It doesn’t have to be either City of Hope or others, it’s City of Hope and others who are joining in this fight.
And Emmet, I don’t want to speak for you, but I’d love your take on this. The idea when we first began talking about this gift was, how do we leverage City of Hope’s expertise and invite other organizations into this fight and raise awareness for pancreatic cancer?
And maybe you want to tell the story about Toni and what motivated you, and the idea that the disease is at the center, not just in a particular organization.
Yes. And please tell us how this came about and how you decided on the number, too.
A. Emmet Stephenson Jr.: The history here, my wife survived a battle with lymphoma seven years before she died, and recovered nicely, and lived a good life for those seven years.
And then, when pancreatic cancer hit, it was advanced before we even knew she had it. And that’s when I learned how deadly this disease is. Only 13% of the people survive five years with the treatments that are available today. And it was all downhill in four months, basically.
And so, my idea was to offer a program that would stimulate research worldwide and hopefully bring other people’s research programs into the effort and magnify what we could accomplish with the funds that we had to contribute to the cause.
And I think that the prize is a way to do that, because it focuses on the disease.
It’s a tough disease. There are other research programs around the world working on it. But we thought that anything we could do to stimulate additional interest and bring additional resources and additional bright researchers to the cause would give us the best chance of finding a cure for this disease.
How did you decide to do this with City of Hope? I know you’ve given them money for lymphoma before.
ES: Yes. They treated my wife for lymphoma, and did a wonderful job, and I think have attracted some of the brightest people in the industry to join them, and they know the other players in the cancer research world.
I have a lot of confidence in them because of my experience with them in two different cancer fights where her health was concerned. And I gained a lot of respect for the people there. And I needed a partner because I’m not a doctor, I’m not a medical researcher, and I don’t really know how to judge these things.
So, I needed a partner who was expert in evaluating these programs to help me evaluate.
And in the case of the prize, to attract a group of scientists from around the world to act as the judges for this. And I needed someone who was prominent in the industry to help me do that.
That’s why I chose City of Hope. I have enormous respect for them.
RS: Emmett, just to pick up on that, one of the things I love about you… I loved Toni very much, and she was an inspiration to all of us who got to know her.
And certainly, your relationship with her going back to kindergarten is deeper than we would ever have. But I loved Toni, and I think that there’s a humility about you, that I’m going to make you uncomfortable for just a second by sharing with Paul.
But my mind goes why there’s a connection so much between you and Tessa and City of Hope, and it’s because you and Toni, and in her own right, Tessa, are entrepreneurs at heart, and I think successful, incredibly successful entrepreneurs.
It’s a tough disease. There are other research programs around the world working on it. But we thought that anything we could do to stimulate additional interest and bring additional resources and additional bright researchers to the cause would give us the best chance of finding a cure for this disease.
A. Emmet Stephenson Jr.
And when we’ve talked about, how do you make a dent in pancreatic cancer, and how do you honor the fight and the contributions Toni has made, you talk to me a lot about the desire to disrupt, the desire to disrupt the status quo, to have a cancer center that focuses and has the value of having less bureaucracy and red tape and to move on speed and collaboration.
I don’t think there is a conversation you and I have had that does not involve, “How do we go faster?”
Because ‘wait’ is a four letter word for a cancer patient and particularly a pancreatic cancer patient.
I think at the end of the day, there’s a matching between your entrepreneurial spirit and City of Hope’s uniquely independent model values and its own entrepreneurial spirit that brought us together.
Emmet, is that fair?
ES: Yes. That’s certainly fair. I don’t think you can be outstanding and do things the way everybody else does them.
You’ve got to be different, to be unique and outstanding. So, anyone who approaches things creatively and with a different mindset, I think, has a better chance of true innovation.
And certainly City of Hope is unlike any other place, any other cancer center in the world. Picking up on something you said, Robert… Maybe it’s a question for Marcel.
And maybe it’s a question for Emmet as well, but where are the opportunities in terms of, where can you disrupt? Is it early detection? Is it new treatment? Is it immunotherapy? Is it vaccines? What is it? Do you have a focus that you can speak of right now?
ES: I think early detection is essential, given that you don’t typically know about pancreatic cancer until it’s stage 3 or stage 4. It’s too late by the time you find out that someone has it.
So, there’s certainly an emphasis on early detection, and any way to find it in an earlier stage would give you a better chance of treating it successfully.
Marcel van den Brink: I think Emmet is absolutely right, that pancreatic cancer is one of those cancers which we, in most cases, find too late. It has already spread. It’s no longer surgically resectable.
So, Emmet is absolutely right that we need to undertake new efforts to screen earlier and better. And that spans the whole spectrum, from imaging to biomarkers, to whatever else we come up with in terms of screening.
One of the foci for this program will be definitely in that area.
I also definitely think that immunotherapy is one of the areas where there’s a lot of promise. Also, I’m sure you know, Paul, about some of the work with vaccines and CAR cell research.
And at our own center, we’re also working in that area.
So, I think those are two areas where I see promise.
But there are, of course, many other areas which are more in the precision medicine area, where there’s also progress coming. But the two areas where we should specifically focus is the early detection and novel strategies for immunotherapy of cancer ranging from vaccines to CAR cells.
ES: One of the other elements of the gift that we’ve made to City of Hope is the biorepository.
It’s like a tissue bank where we’re going to gather tissue, which will then become the raw material, so to speak, of the research. Because if we could detect it from blood samples or tissue samples that were part of a routine health checkup, then we might be able to find it at an earlier stage and have a better chance of winning the battle.
MvdB: I absolutely feel what you’re saying and your vision about a centralized biobank and how incredibly important that is for progress in cancer and the research is absolutely spot-on. And that is indeed.
So, Emmet’s gift is critical for us to build a centralized biobank, which will span all tissues—from blood, to urine, to stool, to, of course, tumor—and will help us in many ways to bring research, as much as possible, into human cells, human tissues.
What also is linked to that immediately, and some people sometimes forget that, is better collection of clinical data and analyzing that. Because, of course, all of these samples are worthless if they’re not annotated, linked to clinical data.
So, we have a huge effort in clinical data science also, which is directly linked to centralized banking.
RS: Marcel, taking one step back from that… I mean, I think that’s spot-on and it’s one of the real reasons for excitement from the gift.
But think of it this way, Paul, the gift is nearly 2/3 of the annual research budget for pancreatic cancer from the NCI.
I mean, it has such a huge magnitude. And I don’t think we’ve talked about it yet. I think of it as having four different categories.
The gift has really been broken up into large categories.
One is the million-dollar Stephenson Prize that we’ve talked about.
Two, it does have the pancreatic biorepository that Marcel and Emmet discussed.
Three, it’s funding research of the future. It will award grants for innovative research that is looking at pancreatic cancer in new ways.
And then, fourth, it will bring people together on an annual basis, worldwide experts to share ideas and to raise awareness for pancreatic cancer.
So, to put into context what both Emmet and Marcel are talking about, it fits into that larger gift.
I guess, Emmet, I have a question about how you designed this thing. Everybody is brilliant there, because it’s City of Hope, but a lot of the vision had to have come from you on how to stimulate research. Do you do it with grants? Do you do it with challenges? How did you approach what to do with the $150 million?
ES: Well, the prize was my idea. But as you can tell, from the diversity of the things that we’re talking about, the other ideas came from other people.
And it was a result of discussions that have gone on for a number of months that pulled the entire program together.
This was really designed, and why we made it the nonprofit track of an LLC, is we wanted to be able to move quickly. We wanted to be able to streamline decision-making, and we wanted to invite others to participate in a way that is tied to City of Hope, but isn’t directly under the City of Hope umbrella. Because, again, pancreatic cancer’s the competition.
A. Emmet Stephenson Jr.
It’s multilayered, and it’s an all-out effort to attack the disease and the problem in as many ways as possible.
The biorepository idea is something that offers opportunity across the industry, so to speak, the entire research industry.
City of Hope had already been working on that idea, but a close friend of mine also advocated that particular part of the gift with me.
Robert encouraged the grant program where we’re going to identify promising avenues of research and make these grants as needed.
And then, along with the prize, the symposium came out of the idea of the prize. If we’re going to present a prize each year, then doing it at a symposium where we bring together the best and brightest people around the world to present their research was an offshoot of the prize idea.
So, it was really a collaboration of a lot of good-hearted people that want the same objective, which is to defeat this disease.
RS: I agree with everything Emmett just said, but to add to it, one component that is very unique here…
Your readers are probably familiar with AccessHope, where leading NCI-designated cancer centers collaborate.
We’ve had a model of both inviting other organizations to contribute and avoiding getting caught up in the academic infrastructure that, at times, at other academic organizations doesn’t move as quickly as we would all like.
So, Emmett and I decided that City of Hope would form a new company. And that the efforts that we’re talking about now would come through a wholly owned subsidiary of City of Hope, but something that was designed to both tie the efforts to the organization and the expertise that we bring, but also give it a level of independence that, again, allows it to move with less bureaucracy, red tape, and to focus on speed and collaboration.
And, of course, that is, I think, a relatively unique concept, adding a scientific advisory board that isn’t limited to City of Hope experts.
But really, being willing to be open to experts around the country and around the world was another thing that was attractive to both Emmet and to me as we set this up.
Is it a for-profit subsidiary?
RS: It is not. It is a not-for-profit.
Fascinating. What is it called? Just so we would have record of it.
ES: Stephenson Pancreatic Cancer Research.
It’s interesting, because I think Mark Foundation does that as well. They can monetize or invest in these organizations and research.
RS: They can. Just to be clear, the purpose here was actually not to monetize and invest. So, if there’s an opportunity to monetize and then reinvest into the fight against pancreatic cancer, I think we’ll be open to doing that.
This was really designed, and why we made it the nonprofit track of an LLC, is we wanted to be able to move quickly.
We wanted to be able to streamline decision-making, and we wanted to invite others to participate in a way that is tied to City of Hope, but isn’t directly under the City of Hope umbrella.
Because, again, pancreatic cancer’s the competition.
And I think the entirety of this is, how do you raise awareness and invite more people into this fight?
That’s why it’s unusual.
Well, that’s unique; right? I don’t think anybody has done that.
RS: I’ve not seen this done before, and it certainly is not the typical way. If you think about what… Going back to Emmet and Toni’s and Tessa’s experience as successful entrepreneurs, focusing on speed is what’s going to ultimately save lives.
And we structured this in a way to utilize and to achieve those goals.
Emmet, do you play a role in the company?
ES: Yes, I’m on the board, and my daughter’s on the board as well. There are five of us: two people from City of Hope, the two of us, and an independent director. There’s just five of us. So, it’s small and nimble, which is a good idea, in my opinion, for getting things done.
RS: I was just going to say, and it’s so important, you can imagine, given the scope of City of Hope and how much we’ve grown as we’ve gone national, I have to pick and choose where I spend my time and what’s the greater value.
And I’m so excited about this, and the partnership with Emmet and with Tessa, that I’m one of those board members, because I so personally am caught up in believing in this and was so close to Toni as well.
So $150 million, is that the beginning? How do you see the money being invested? How much is it? Is it just a startup? Is there a round two?
ES: Well, what we hope it will be is a stimulant to attract other research programs to it. We hope it multiplies.
And we think that it can really trigger other donations to our effort and other programs for whom the grants and symposium presentations and the prize itself ultimately would draw attention to this effort and hopefully leverage it considerably.
Because I mean, in reality, $150 million in medical research is not very much money. It sounds big, and it’s big to me, but it’s not very big in the biotech research world.
So, we tried to use it as a way to stimulate other programs in this area.
RS: I understand when you say that it’s not compared to some of the investments in biotech for certain cancers—$150 million is not enough to win this fight.
But I think you’re understating the generosity and the impact that you and Tessa will have. This really is a historic gift.
And I’m convinced that when you combine it with City of Hope’s expertise in this area, and you combine our mutual entrepreneurial approach, this will have long-term impacts that we can’t even start to imagine. And indeed, will bring people together in ways that have not been done. I mean, it really is the largest privately funded scientific award for individual investigators in the U.S., and that will be incredibly impactful.
ES: That’s certainly the goal.
Also, it seems to be creating a culture around pancreatic cancer research. That’s the first thing that struck me, is it could be building on a culture of innovation in pancreatic cancer research.
RS: It’s trying to put the spotlight on it, Paul.
ES: Yes. It’s intended to highlight it, focus on it, and engender cooperation among people, researchers, and institutions around the world.
RS: It’ll bring the best minds together across different organizations and industries.
I wonder if you could help me figure out how the money is apportioned: There’s the prize, there is the biobank, the grants, and then there’s the symposium and all the other pieces. And then, there’s also the company. What’s the annual spend, or burn rate, or however you want to call it?
RS: Paul, the $1 million for the prize annually, again, is going to individual scientists or teams that make the most promising advancements, we’ve largely settled.
We’ve also settled the commitment to at least start the pancreatic biorepository that Emmet and Marcel talked about.
That desire, that need for funding, for innovation, is bigger and bigger. And I think that that is where Emmet’s gift is absolutely critical. And $150 million in any field will be a shot that will be heard all over the world.
Marcel van den Brink
And we have some ideas as to the amount of the fellowship program, the grant support annually that will go out into the future.
There are two important details that we’re still working through.
One is, we have ideas at City of Hope, Emmet and Tessa have ideas, but we want to give the Stephenson scientific advisory board an opportunity to come together and influence both the funding amounts and the ways the funding will be spent.
We’ve started recruiting for that scientific advisory board, but that’s really going to be formed after the public announcement.
So, there’s a little bit of a to be determined, because we want the ability to engage those outside experts on how to divide the funds.
And two, the LLC board that we’ve talked about, obviously, it involves Emmet, it involves me, it involves Tessa Brand, but it has two other individuals as well.
And that’s really a board decision.
And that board will meet for the first time this fall.
So, we have the big categories spelled out, but other than the $1 million prize, the rest is to be determined.
ES: I think one other thing I would add is that there’s a lot of flexibility in it.
I mean, our background is in entrepreneurship and venture capital and private equity and the like.
And what we’ve learned is that your original idea may not survive the scrutiny of time. And you have to be flexible and go where you get results, and you have to adapt to new information and new conditions.
And we’re prepared to do that.
What’s fascinating about creating something this big is that it creates stories and anecdotes. I’m wondering if there’s any story you want to share about your design of this program up to now. Any conversation, Emmet, or Robert, or Marcel? Anything, any kind of ‘aha’ moment?
ES: This whole initiative, to me, is to trigger research programs around the world. The history of cancer treatment research is one of incremental progress. What Tessa and I think is best is to have as many shots on goal as possible so that one actually scores. So the annual prize, the grants, the symposium and the biorepository; they’re all contributing to the ultimate goal.
MvdB: For me, the first thing that came to mind is the enormous impact.
And that is that the funding climate that we’re living in, and Paul, of course, have heard that from many of my colleagues, is dealing with the shrinking NCI budgets with less and less funding specifically for younger scientists with overall less chances to fund innovation either from NCI or NIH, because the grants that are being funded are mostly the ones from the respected scientists who can keep on writing powerful grants to keep their work going.
And on the other side, you have biotech and pharma, which more and more is mostly exploring what is brought to them.
So, that desire, that need for funding, for innovation, is bigger and bigger. And I think that that is where Emmet’s gift is absolutely critical. And $150 million in any field will be a shot that will be heard all over the world.
So, that’s really what I thought of when I first heard about this. And as you heard from Emmet’s personal story, and from Robert’s, pancreatic cancer is what my former mentor at Harvard used to call, that’s the cancer that gives cancer a bad name.
So, to have such an impactful gift for pancreatic cancer is absolutely spectacular.
Those are two thoughts that came to mind.
RS: Marcel, thank you for that. Paul, I’d add one thing to it, because I think you’re right, something like this does lead to stories.
And I can’t believe that I’ve now been at City of Hope for almost 30 years. And what I’ve learned, if nothing else, in that time, is that when it comes to cancer, the stories are always about patients and their families.
And I’ve heard so many and experienced so many regarding pancreatic cancer that I can’t recount them all. One of our board members on our LLC board is Norm [Norman C.] Payson, who lost his mother to pancreatic cancer and lost her very quickly. You’re going to hear all those stories.
For me, the most poignant moment through all of this is Emmet and I were sitting in his living room out in Nevada, and we talked about how we can turn this into something that nobody else has done and to really attack this disease that is simply devastating to patients and families.
And at the end, our discussion was over and I got up to leave, and Emmett and I had a moment in which I said to him, “I truly believe what we’re contemplating will change lives.”
And he looked at me and said, “That then will give my life meaning and will honor Toni.”
And that’s what this is all about.
I totally see that. When was this, by the way?
RS: It was several months ago, as we were finalizing the approach that we were going to take.
Is there anything I forgot to ask? Anything we didn’t cover?
RS: From my standpoint, I think we covered all of it. I just want to highlight two things as I leave you, Paul.
One is: Think about this as a convening moment. How are we going to convene the world in beating this disease?
And two: It’s really, really important to understand that the power of philanthropy can’t be understated.
Unconventional and forward-thinking philanthropists like Emmet and Tessa can push life-saving medicine to new heights. And the vital role philanthropy plays empowering discoveries will save lives.
Well, thank you so much. I really appreciate your time. And really, it’s an honor to be a part of telling this story.
RS: We’re grateful. I want you to know, when we talked about getting this story out there, we had an internal conversation of where we wanted to start. And you can imagine we want to talk to everybody who will listen because we want to spread the word, but we knew in cancer we had to start with you.
So, you’re the first time we’re talking to somebody because The Cancer Letter has that impact.
