“It’s CANCER folks. You’re the Roman armorers and the Visigoths have knocked down the walls of the city and they are a block away from you and your family. Get with it, folks. It’s WAR!”
—Dr. Larry Norton
By all odds, they should not have met. It took the conviction of a man whose success taught him to rely on instinct. In 1988, when Leonard Lauder’s wife, Evelyn, was diagnosed with breast cancer she had made the decision to begin treatment with a well–reputed oncologist who offered time- tested conventional therapy to his well-reputed patients. Conventional therapy?
A vibrant mosaic of intellect and impulse, Evelyn was far from “conventional.” There could only be one answer. She was scared.
Leonard and Evelyn Lauder had built their cosmetics business on innovations that were pushing The Estee Lauder Companies onto the international stage. Perhaps for the first time in their 30-year marriage, Leonard knew he had to intervene. His wife had not survived the holocaust and the London Blitz to be snuffed out by a few mutant cells. After casting a wide net to seek alternatives, Leonard went to see Dr. Larry Norton, a breast oncologist, then at Mt. Sinai Hospital in New York. A prudent man, Leonard went alone.
Young and iconoclastic, Norton was determined to find a new way of treating the disease that was taking the lives of more than 46,000 women a year. During the 1970s and ’80s, he and his colleague at the National Cancer Institute, Dr. Richard Simon, had applied an eighteenth-century mathematic model of population growth to breast tumor biology. They theorized that small tumors, like populations, would grow slowly until they reached a critical mass, which would trigger unbridled growth. By subjecting small tumors to intense chemotherapy (short of toxicity) and reducing the time between treatments, they could control their growth and complexity. Despite its validation, their theory was heralded as ‘blasphemy’ by the medical establishment. Objects of fierce hostility, Norton and Simon would have to wait decades before their treatment would become accepted protocol. But in 1995, it was hailed by oncologists as “the greatest clinical trial innovation in 20 years.”
In 1988 it was still considered radical, yet Leonard Lauder was certain he had met the right man for the job—someone as creative and daring as he. Now all he had to do was to convince Evelyn.
Their conversation lasted all afternoon, beyond the dinner hour, and well into the night. At 2 AM, perhaps out of exhaustion, as much as conviction, Evelyn finally said yes.
With the soft acquiescence of a woman facing a life-threatening disease, a transformative philanthropic partnership was born.
Hungry for knowledge about the non-profit that would become the largest breast cancer research foundation in the world, I went to meet the physician who had now become a medical legend—Dr. Larry Norton. Epithets like “austere, yet compassionate,” “provocative, yet reflective” were tagged to Norton’s name. But the one word that stuck on everyone’s tongue was “brilliant.
The person who emerged, make that catapulted, through the door was short, bespectacled, white-coated, and frenetic. I had caught him in emergency mode, he explained, juggling a terminally ill patient, routine necessity, and me.
After setting the ground rules—no recordings and no personal information—he settled in.
A master of metaphor and myth, Norton threw words like “magic” and “God” around as if they were medical jargon. He described himself as “a deeply religious man,” who had chosen a life of service. Larry Norton believes in, craves, intensity.
“I think of myself as the March Hare,” he said. “I like working underground amid the dark chaos of illness, helping my patients find their way out.”
“Finding the way out” in the ’80s had been a frustrating and heartbreaking task. “Compared to today,” said Norton, “our knowledge was primitive.” Breast cancer was no longer the impenetrable “black box” of ignorance that it was in the ’60s and ’70s, which rendered it a “death sentence” for those women who endured earlier forms of surgery and radiation. But in the absence of precision technology, physicians often diagnosed patients at later stages when metastasis was rampant. Medical knowledge of the genetic and biologic processes of breast disease was embryonic.
His meeting with Evelyn Lauder, however, gave him hope that together they might find a way to hasten the path from lab to clinic, and slow the pace of dying.
“We had a deep and immediate friendship,” he said, “that would later evolve into a kind of marriage.”
“I brought scientific and medical experience and leadership skills, along with a network of colleagues renowned for their work in basic science and clinical research. Evelyn, too, had premier leadership skills, and a first-rate mind,” he said, “along with access to an amazing pool of talent at the Estee Lauder Companies, and connections to the world of the arts, industry, media, and government.”
“Of course,” he admits, “Evelyn had the financial means and the social connections to get the foundation going, but she was not a figurehead, and I was not a physician who was looking for celebrity gold dust. I needed an experienced marketing entrepreneur who could guide me through the process of building an organization and fundraising. And Evelyn was all that and more. She exercised great judgment and steered the foundation in the right direction. Moreover, she had interpersonal and networking skills beyond anyone I had ever met. When you were around Evelyn, you wanted to please her. That’s a rare gift. And she loved the science, immersing herself in medical journals. She understood a lot, and what she didn’t understand, I taught her.”
Since Evelyn had died of ovarian cancer in November of 2011, I could no longer hear the story in her own voice. So, I did the next best thing. I met with Leonard Lauder, entrepreneur extraordinaire, and her husband of 52 years.
Leonard met me in a small private club in mid-town Manhattan. Ever the gentleman at 83, he rose to greet me, and kissed me on both cheeks. He has the air of a patriarch, and yet the shadow of humility that comes from being a boy from Queens, surprised by his own success. We liked one another. We liked one another enough for me to ask an honest question.
“What made Evelyn run? “Why her driving ambition? I asked. His answer was stunningly logical. “I think it was the Holocaust,” he said. “She always wondered why she had survived, and others hadn’t. She felt she had been saved for a reason. She wanted to leave something big behind.”
Evelyn was born in Vienna in 1936 to Mimi and Ernest Hausner on the cusp of Hitler’s consolidation of power. She and her parents escaped to Belgium and later to England, arriving in New York City in 1940. Successful merchants in Vienna, the Hausners eventually opened five clothing stores. One might say that Evelyn’s survival instincts, as well as her entrepreneurial skills were her parents’ legacy to their only child.
In 1958, Evelyn earned her B.A. degree at Hunter College, majoring in anthropology and minoring in education, intending to teach in the public New York City school system. But that year proved pivotal to the future of this bright and ambitious 22- year-old. She met Leonard Lauder on a blind date. Dashingly handsome in his Navy uniform, he was a scion of his eponymous family cosmetics company.
Embraced by the Lauder family, Evelyn married Leonard in 1959. She harnessed her educational skills and entrepreneurial instincts toward expanding Estee Lauder’s six-product cosmetic line, later becoming heir to her mother-in-law’s cosmetic throne. Alongside Leonard, she would make the company into a global force.
One might say that Evelyn was a character in search of an author, and the author was her breast cancer. She told her friend, future colleague, and now the President of BCRF, Myra Biblowit: “There is no nonprofit focused exclusively on breast cancer research. I need another job like a hole in the head, but if I can do it, it would be a sin if I didn’t.”
“Sin”—if that’s what drove her, expiation became her obsession.
At the time she and Norton were formulating their strategy, there were two privately funded organizations dedicated to breast cancer, the Susan G. Komen Foundation and the North American Breast Cancer Organization.
Komen, established by Nancy G. Brinker in honor of her sister, Susan G. Komen, who had died of the disease, was founded in 1982. Devoted to educating the public about breast cancer, and at the time peripherally involved in research, Komen was highly successful in its core mission: the establishment of clinical diagnostic and health facilities.
The other, NABCO, now defunct, was founded in 1986, as a coalition of small organizations whose mission was to educate breast cancer patients and provide diagnostic and treatment services, and to lobby the federal government for research funding.
Evelyn was right. She had not only unearthed the missing piece in the war against breast cancer, but her raison d’être.
In 1991 Evelyn Lauder and Larry Norton met around the pinewood kitchen table in the Lauder’s home on the upper eastside of Manhattan. Both Larry and Evelyn harbored notions about the way “medicine ought to be,” and the idea of a breast center based on their common vision came into focus.
“The Breast Cancer Research Foundation, a community of clinical and scientific researchers dedicated to discovering new drugs and diagnostic technologies was our goal from the beginning,” says Norton, “but we decided to take it one step at a time, starting with a breast center at Memorial Sloan Kettering.”
Neither Lauder nor Norton wanted to build their “house” on Lauder money. A broad base of support would demonstrate its legitimacy and ensure its impact. Neither did they want an endowment fund, believing it would thwart their efforts to innovate. They wanted progress now. Their mantra: “A Cure in Our Lifetime.”
“Do you know Evelyn’s favorite saying?” Norton said, with an air of veneration: “I’ve been around creative people all my life and they need two things: Freedom and security. You give them a job, and let them run with it, knowing that failure is just a winding path that takes you closer to success.”
While Norton formed a medical team, Lauder began her “awareness campaign,” with the Estee Lauder staff behind her. In truth, however, they were flying by the seats of their pants. Neither had an infrastructure or an administrative staff.
As a cosmetic marketer—a dream maker—Evelyn knew they needed a logo. She and her friend, Alexandra Penny, the editor of Self Magazine, came up with the idea of a pink ribbon, patterned on the successful red ribbon symbol of the AIDS campaign.
A former teacher, Evelyn believed that educating women about the latest facts in the prevention, diagnosis, and treatment of the disease was crucial to her fundraising campaign. It would later become the alchemy through which they would fund their research.
Employing this strategy, she and her staff raised $18 million, $5 million more than they needed for the breast cancer diagnostic center at Memorial Sloan Kettering, which they squirreled away for later use.
The Breast Center opened on September 30, 1992. It was a 40,000-square foot state-of-the-art operation in the basement of a building on East 64th Street that not only conformed to their vision but was the largest breast cancer diagnostic facility in the country, and the cutting-edge prototype on which others would be built.
One month later, Evelyn conceived a new tactic to broaden the reach of her awareness campaign and pressure the federal government to raise its funding for breast cancer research. Her idea was to disseminate 1.5 million pink ribbons through 12,000 beauty advisors at 2,500 Estée Lauder counters nationwide, along with petition cards for those customers interested in promoting government funding.
With these ribbons on store counters, and the vendors signed on, the campaign was off to a heady start. By May of 1993, Estée Lauder’s vendors had collected more than 200,000 signatures. These in hand, she and two colleagues met with the new First Lady, Hillary Clinton, at the White House demonstrating grassroots support for increasing federal funding for breast cancer research.
Evelyn was part of a movement driven by a generation of women comfortable fending for themselves in the public arena. While a direct line cannot be drawn from Evelyn’s efforts, and those of other nonprofit entities to the rise in federal funding for breast cancer research, the statistics reveal that during the Clinton administration, Congress boosted NIH annual funding by 40 percent over that of the Reagan administration, and by the time Clinton left office in 2000, federal funding had grown by 50 percent, the highest level of funding ever given for research on health and disease.
In 1993, with the Breast Center in place, Lauder and Norton would initiate their goal of fueling innovative research by granting seed money directly to reputable physicians and researchers whose theories were too “risky” for government funding. As a result of Norton’s ingenious innovation for distributing funds, BCRF was able to cut through federal and institutional red tape by paring down the application for grants from hundreds of pages required by government agencies to 15. He appointed a medical review committee that set high standards for grantee accountability, including the submission of semi-annual progress reports.
Pooling the $5 million excess money they had raised for the Breast Center with customer donations and corporate funding, the foundation was able to offer eight research grants at $20,000 each in 1994.
It is important to note the critical impact of digital innovation on the operating costs of BCRF and all private no-profit foundations during the past 25 years. While the Foundation’s total revenue in 1994 was $643,000, one third of it was spent on overhead. Before email and other forms of social media, digital and 3-D printing, the nonessential costs of running private foundations were not only enormous, but a waste of manpower and time.
The eight investigators who received awards in 1994 were the first of hundreds chosen to receive support for their research. While these awards have risen from $20,000 to $250,000 in 2018, all the investigators interviewed agreed: It was the foundation’s seed money that allowed them to do their pre-clinical and pre-testing work, enabling them to validate their theories and apply for government grants along with others from nonprofit organizations.
This paradigm of direct financing of investigators was rare, but the idea of creating a national breast cancer research community was unprecedented. To sustain their work, however, they needed wealthy donors to “buy in.”
Lauder and Norton decided to assemble their best scientists and clinicians to meet with potential donors. It would be helpful, of course, if these donors were high-minded and philanthropic.
Evelyn’s marketing instincts kicked in. The setting she chose was the magnificent dining room of the Lauder home in Manhattan.
Reclining in reverie, Norton quoted his hero, Quincy Jones, “one of the all-time great Jazz musicians: ‘You get the right people in the right room at the right time, and then you leave room for God to walk in.’”
Well, God must have arrived, because they inspired enough high-minded donors to expand their community of grantees.
By 2001, Evelyn’s friend Myra Biblowit, who could not join the Foundation in 1994 because she was the dean of external affairs at New York University Medical Center, was ready to come on board as president of BCRF. Myra, in turn, recruited her superb administrative assistant Margaret Mastriani to join her. Together they were exactly what the foundation needed to grow. As chairman emeritus, Evelyn would no longer oversee daily operations, but she continued to determine the policy and trajectory of the foundation.
This marked the beginning of an extraordinary 12-year partnership between Evelyn, Larry, and Myra that would transform BCRF into a global operation that fueled a broad range of research projects that reflected new genomic and technological advancements in the prevention, screening, diagnosis, treatment, and long-term survivorship.
Evelyn’s passing in November of 2011, after a long struggle with ovarian cancer, inspired Mayor Bloomberg of New York City to honor her efforts to wage war against breast cancer by emblazoning the Empire State Building in ribbons of pink light.
Few knew about Evelyn’s ovarian cancer and everyone at the foundation was devastated. All feared that it would not survive.
The Breast Cancer Research Foundation has not only survived; it has thrived. The Scientific Advisory Board has expanded to include a new generation of leaders in the United States and Europe. While Evelyn Lauder would not live to see the full effect of the collaborative culture she and Larry Norton created, and the fundraising model she had initiated, in 2018 alone, BCRF raised $63.8 million, an 11 percent rise from the previous year. Corporate partnerships had risen from 6 in 1994 to 150. The number of research grantees had grown from 8 to more than 300 from 14 countries spanning six continents, making it the largest breast cancer research fund in the world.
Furthermore, in 1994 only 66 percent of revenue went to research; today BCRF allocates 89 percent of revenue to research, garnering a top rating from Charity Navigator.
Its founding vision of funding innovative research continues to resonate across the spectrum of breast disease. Among the many breakthrough that BCRF’s investigators have made are:
- The genetic roots of hereditary breast cancer: Mary Claire King, at the University of Washington in Seattle, was the first to discover the hereditary breast and ovarian cancer susceptibility of the BRCA1 and BRCA 2 genes.
- The identification of breast cancers subtypes: Dr. Charles Perou, Professor of Molecular Oncology and Laboratory Medicine at the University of North, used precision technology to discover five distinct subtypes breast cancer, transforming the perception and treatment of disease.
- The discovery of new effective treatments: Gabriel Hortobagyi, at the University of Texas MD Anderson Cancer Center in Houston, in collaboration with other scientists, helped to discover Herceptin, the breakthrough drug for an aggressive form of breast cancer called HER2 positive.
- The processes by which tumors form, metastasize and resist therapy: Dr. Nancy Davidson, at the University of Washington (now retired) studied changes in epigenes, the cells surrounding the DNA that are the key enablers of cell proliferation, finding that changes can be reversed with chemical and technical procedures. Dr. Robert Weinberg, the first director of the Cancer Research at MIT, known for discovery the first cancer gene, the ras oncogene, now focuses on the biochemical and biological mechanisms that enable carcinoma cells in primary tumors to invade and disseminate, resulting in metastases in distant sites.
- Drug resistance: Dr. Jose Baselga, now retired, at the Memorial Sloan Kettering Cancer Center in New York City, focused on HER2 positive breast cancer, particularly in preventing resistance to HER2 targeted drugs and identifying molecular changes that cause cancer to metastasize. Dr. Joan S. Brugge, at Harvard Medical School investigates the mechanisms that initiate and proliferate breast tumors using three- dimensional cultures of normal breast cells and breast tumor cells to replicate their function in a natural context, in order to understand how genes alter breast tumors, and the ways in which they change during drug therapies and promote drug resistance. Dr. Martine Piccart, Professor of Oncology, Universite Libre de Bruxelles, Brussels, Belgium. In addition to analyzing the genetic composition of a sub-set of tumors, and devising treatments for patients, she is co-founder and chair of BCRF’s Breast International Group, which unites 55 academic research groups from around the world.
These researchers, along with others worldwide within and outside the BCRF community, have made 90 percent of breast cancers a chronic disease. The 10 percent of breast cancers that have been resistant to treatment are the primary focus of BCRF today.
“Scientific research,” says Larry Norton, “is not a job. It’s a calling. Our Foundation is an international community of scientific peers, which is key to progress. It’s a miracle.”
And yet, this “miracle” was the result of efforts that began around a kitchen table by a physician and a philanthropist with big dreams, and the courage to act upon them.
Call it “God,” or call it “magic,” they both believed in something ineffable. Their partnership enabled scientific discoveries that extended the lives of millions of breast cancer patients.
There will be more “miracles” to come, says Larry Norton. “I think merging the skills of biologists with mathematicians is the next Big Thing. What’s the magic bullet? It’s not going to be analytic technology, gene editing or immunotherapy. It’s not going to be any one thing. It will be a combination of processes, some of which have not yet been discovered. But in an economy in which scientific progress cannot depend on government funding, and tens of billions of dollars are being transferred from baby boomers to a new generation, we must harness the power of free enterprise. We have learned that discovery alone is not enough. We need to begin the multimillion-dollar-process of converting our laboratory findings into FDA approved drugs. That takes people who understand the potential of scientific research and are willing to invest in us. We need more Evelyn Lauders.”
Susan Hertog is the author of Anne Morrow Lindbergh: Her Life and Dangerous Ambition: Rebecca West and Dorothy Thompson.