March 1, 2011
City Council Earmarks Flow to Brain Scan Group
By JAVIER C. HERNANDEZ

Every year, the Brain Tumor Foundation bombards the City Council with stories of loved ones lost, frightening statistics about the prevalence of cancer and pledges to “literally save the lives of your constituents.”

And each year, the Council responds, turning down food banks, after-school programs and arts groups in favor of the foundation, which provides free brain scans. The group has received nearly $2 million since 2005, making it one of the top recipients of discretionary funds, known as earmarks.

But in doing so, the Council has given the city’s imprimatur to a use of a medical tool that the National Institutes of Health has said “may not be ethical” and whose usefulness in fighting cancer scientists have passionately debated.

And the money has kept flowing, even though the centerpiece of the foundation’s work, a 70-foot tractor-trailer equipped with an M.R.I. machine, has until recently sat idle for four months.

The popularity of the Brain Tumor Foundation raises questions about whether the Council monitors earmarks as closely as it should after a series of fraud and abuse scandals.

For all their passion, lawmakers seem largely unaware of the potential downside of cancer screenings, and several said they did not realize the Council had devoted so much money to a single cause.

The president of the foundation, Dr. Patrick J. Kelly, a retired New York University neurosurgeon, acknowledged that the potential of his work, which focuses on the early detection of tumors, has not yet been proved. “It just makes sense,” he said in a recent interview. “Can I demonstrate that scientifically? No.”

Some cancer researchers oppose Dr. Kelly’s methods because of concerns that early treatment does not improve, and in some cases might worsen, a person’s health. But the Council does not seem worried: 21 of its 51 members provided $233,000 last year to support the foundation’s trailer, named for Bobby Murcer, the Yankees outfielder who died of complications from brain cancer in 2008.

Even Dr. Kelly was startled to learn that his group was one of the biggest recipients of Council money. “Is it as important as feeding people up in Harlem?” he said. “Well, probably not.”

“But,” he joked, “I won’t turn it down.”

Thousands of groups apply for a share of the Council’s discretionary money each year. The Council speaker, Christine C. Quinn, determines the size of each council member’s pot, ranging from $80,000 to more than $1 million. The Council gives out about $18 million annually.

A familiar list of organizations consistently wins a large share of the money: the Metropolitan Council on Jewish Poverty, the City Parks Foundation and the Doe Fund, a group that provides jobs to homeless people.

But there are also highly specialized organizations that are frequent recipients of earmarks, like Chess-in-the-Schools, an educational program. Some groups are so competitive that they hire lobbyists to corner council members on the steps of City Hall at the height of budget negotiations.

The Brain Tumor Foundation suggested in its application for financing last year that its trailer would operate 9 a.m. to 5 p.m., Monday through Friday, year-round.

But the foundation, an official said, could not afford to keep the trailer running on a regular basis — it costs about $25,000 a week. In total, it has visited each of the city’s boroughs about five times, sometimes staying for several weeks.

Some council members said that the oversight process should be more rigorous and that groups should be made to follow up with the Council in a detailed way.

“Moneys are being given out, but whether we’re being successful or not is not clearly measurable,” said Councilman Jumaane D. Williams of Brooklyn, who provided $10,000 to the Brain Tumor Foundation last year.

Politicians are eager to appear at the foundation’s screenings, which are so popular in some communities that waiting lists total in the hundreds. The foundation focuses on low-income neighborhoods where access to health care is limited.

James S. Oddo, a councilman from Staten Island who gave the foundation $20,000 last year, said its programs were crucial for residents who would not otherwise go to a doctor.

“I’m cognizant of the notion of too many scans and all the negatives that come with it, but right now I’m not convinced that people are better off avoiding them,” Mr. Oddo said.

Since 2008, the Brain Tumor Foundation has scanned 2,500 people in the city, meaning each scan has so far cost the city about $778. The group has found tumors in about 1 of every 100 people. By comparison, a 1999 study published in The Journal of the American Medical Association found two brain tumors in a sample of 1,000 people.

Dr. Kelly has presented his M.R.I. scans as a breakthrough, “the best-known method of treating deadly tumor growth.”

But some researchers warn about the risk for false positives, and others argue that treating slow-growing tumors aggressively can have harmful side effects. A division of the National Institutes of Health that specializes in brain tumors has stated that “early detection strategies have not been a priority and their use may not be ethical.”

And the American Cancer Society and the American Brain Tumor Association said they had concerns about Dr. Kelly’s methods because of those risks.

“This kind of public health effort gets so far ahead of the data and presumes that all you can do is help people when the reality is you can hurt them as well,” said Dr. H. Gilbert Welch, a Dartmouth professor who has written frequently about the risks of cancer screenings.

Malignant tumors that originate in the brain are rare but potentially lethal and kill about 13,000 Americans each year.

Dr. Kelly, who started the foundation in 1998, said he believed his work would provide the data to vindicate early-detection strategies. He said some doctors who had regularly frowned upon his call for screenings had warmed to the idea. “Medicine is like a big battleship,” he said. “It does not change course easily.”

The foundation sends the results of its screenings to a person’s primary care doctor or sometimes suggests visiting physicians at the Mailman School of Public Health at Columbia, which is analyzing the data to study the prevalence of brain tumors. New Yorkers 18 and older are permitted to sign up for the scans, though the foundation says they are not meant for people showing symptoms of neurological illness.

Zeesy Schnur, executive director of the foundation, said the program was popular among council members because it had a “proven track record.”

The foundation is supported primarily by private donations and operates out of Ms. Schnur’s public relations and consulting firm, Schnur Associates. Her husband, Joel Schnur, and son Ethan, who are employees at the firm, also help run the foundation.

Ms. Schnur said that her firm had been compensated for some of its work, but that city funds were never used for that purpose. Joel Schnur, a prominent city lobbyist, works on a pro bono basis.

In New York, council members said they were moved by the foundation’s sobering testimonials and grim numbers. Some also seemed acutely aware of the political benefits.

“You should print this: Councilman is saving people from cancer,” said Domenic M. Recchia Jr., the Council’s finance chairman. “End of story.”

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