One very bad day almost three years ago, Michael Milken learned he had prostate cancer.
It was the very day he got out of the Vinewood Community Correctional Center, a shabby halfway house in Los Angeles where he finished up his two-year prison stretch for securities fraud. He had paid $1.1 billion in fines and civil settlements. He was banned for life from the securities business. His name was a synonym for '80s greed.Now this.
Soon, he would learn just how much worse things could get. It turned out the cancer had already spread away from his prostate gland. It was an especially aggressive form and too late for surgery. At this stage, the cancer was incurable. Treatment could only delay the inevitable.
His doctor told him the odds: There was about a 30 percent chance he'd be dead within two years.
He was 46.
Three months later, Milken knew what he wanted. He went to a conference of urologists in San Antonio, Texas, and invited Dr. Patrick Walsh of Johns Hopkins University, perhaps the best-known prostate surgeon in the country, and some other big-name specialists to a 6 a.m. breakfast.
What he proposed was pretty simple - an all-out "Manhattan project" to cure advanced prostate cancer. Milken asked the doctors to come up with their best ideas, and he'd do the rest. He'd bring in the brightest minds in the business;
he'd supply the money; he'd get rid of the paperwork.
"Our feeling was: Let's go out and recruit great thinkers who might be able to help us and ask them to work for a year or more on cancer," Milken said in a recent interview. "We wanted to see what we could do in a few years, not a few decades."
Some hesitated at first. This was, after all, the man the media call "the disgraced junk bond king." Did they really want to link their reputations to his?
In time, many did. In a dozen interviews, researchers told of being impressed by Milken's determination, his intensity, his intellect. And, of course, his money: Mil-ken's fortune has been estimated at $550 million.
"I've seen a lot of celebrities develop prostate cancer and be told good treatments are not available, and I've seen their reactions," Walsh said. "Michael's is very unusual and positive. He really is trying to change the world."
Since that meeting in May 1993, Milken has founded a prostate cancer foundation. He has spent $20 million of his own money on research. He has attracted some of the superstars of science to his problem. And he has, to hear the experts tell it, literally galvanized the field of advanced prostate cancer.
Certainly other rich people have made grand donations to study the ills that afflict them. In October, for example, industrialist Jon M. Huntsman Sr., who has had prostate and mouth cancer, pledged $100 million to the University of Utah to study cancer genetics. But no one in science can remember anything quite like Milken's attempt to vitalize and lead the nation's effort to control his own disease.
His new organization, called CaP CURE, the Association for the Cure of Cancer of the Prostate, based in Santa Monica, Calif., is now the United States' second biggest sponsor of prostate research, behind the National Cancer Institute but ahead of the American Cancer Society.
Milken's own cancer is in remission after hormonal and radiation treatment. But many of those who have spent their careers on this disease quietly doubt that his Manhattan Project will succeed in time to help him. Curing prostate cancer, they say, is far, far harder than building the bomb. Yet they seem dazzled by the way one determined wealthy patient has refocused their field.
Dr. Howard Scher of Memorial Sloan-Kettering Cancer Center in New York calls CaP CURE's accomplishments "nothing short of miraculous."
"The energy that they have drawn to the field and the scope of the people they have attracted are unparalleled," he said.
When Milken began investigating his disease, he found a research backwater. Prostate cancer kills 40,000 men annually, almost as many victims as breast cancer, but with little of its scientific or political cachet. At last May's meeting of the American Society of Clinical Oncology, for instance, there were 112 reports on breast cancer, compared to 37 on prostate cancer.
"It was not seen as an interesting disease, because it only occurs in old men," said Dr. Harmon Eyre, the cancer society's research director. "There were no ideas about the cause. There was confusion about the treatment. And there were no new insights into what should be done in research. Then along come Bob Dole and Michael Milken."
Dole, a prostate cancer survivor, helped pass legislation that has doubled National Cancer Institute spending on prostate cancer since 1992. This year's budget is $50 million, compared with $313 million for breast cancer.
However, Dr. Stuart Holden, who is Milken's personal urologist at Cedars Sinai Medical Center in Los Angeles and CaP CURE's medical director, said he and Milken believe the problems with prostate research go beyond money.
"We tried to look at the whole field and see where the stumbling blocks were," he said.
One of the biggest was red tape. Getting money from the National Cancer Institute has turned into an almost full-time job for many senior researchers. Writing a proposal, revising it and waiting for a decision easily can take a year.
A brilliant idea alone is simply not enough. The competition is so great that the institute often demands preliminary data.
But CaP CURE is looking for brilliant ideas, ones that have no chance of backing from the cancer institute. It asks for a three-to five-page proposal and promises a quick answer.
"If I have a good idea, I write a five-page grant proposal instead of a 25- or 50-page one. It gets reviewed within six weeks, and the check is on my desk within a couple of months of when I wrote it," said Dr. William Catalona of Washington University.
In 1993, CaP CURE got 85 requests and funded 30 of them. In 1994, there were 265 requests; it funded 46. This year, 529 researchers from around the world came to CaP CURE for research support, and it is backing 62.