The Emperor of All Maladies: A Biography of Cancer (89 page)

Between 1800 and 1900, surgeons devised increasingly aggressive operations to attack the roots of cancer in the body. In the 1890s, William Stewart Halsted at Johns Hopkins University devised the radical mastectomy—an operation to extirpate the breast, the muscles beneath the breast and the associated lymph nodes.

“The patient was a young lady whom I was loath to disfigure,” Halsted wrote. In this etching, Halsted presented an idealized patient. Real cancer patients tended to be older women with larger tumors, far less able to withstand this radical attack.

When radium was discovered by Marie and Pierre Curie, oncologists and surgeons began to deliver high doses of radiation to tumors. Yet radiation was itself carcinogenic: Marie Curie died from a leukemia caused by decades of X-ray exposure.

During World War Two, hundreds of tons of mustard gas were released on the Bari harbor in Italy during an air raid. The gas decimated normal white blood cells in the body, leading pharmacologists to fantasize about using a similar chemical to kill cancers of white blood cells. Chemotherapy—chemical warfare on cancer cells—was inspired, literally, by war.

In 1947, Sidney Farber discovered a folic acid analog called aminopterin that killed rapidly dividing cells in the bone marrow. Using aminopterin, Farber obtained brief, tantalizing remissions in acute lymphoblastic leukemia. One of Farber’s first patients was two-year-old Robert Sandler.

From her all-white apartment in New York City, Mary Lasker, a legendary entrepreneur, socialite, lobbyist and advocate, helped launch a national battle against cancer. Lasker would become the “fairy godmother” of cancer research; she would coax and strong-arm the nation to initiate a War on Cancer.

Farber’s patient, Einar Gustafson—known as “Jimmy”—a baseball fan, became the unofficial mascot for children’s cancer. The Jimmy Fund, founded in 1948, was one of the most powerful cancer advocacy organizations, with Ted Williams a vocal supporter.

Sidney Farber, Lasker’s confidant, mentor and co-conspirator, provided medical legitimacy to the War on Cancer and oversaw the building of a new cancer ward in Boston.

At the National Cancer Institute (NCI) in the 1960s physicians Emil Frei

Emil Freireich forged a strategy to cure acute lymphoblastic leukemia using highly toxic drugs.

Henry Kaplan, a physician-scientist, used radiation therapy to cure Hodgkin’s lymphoma. The cures of lymphoblastic leukemia and Hodgkin’s lymphoma invigorated the War on Cancer, raising the possibility of Farber’s “universal cure.”