The Emperor of All Maladies: A Biography of Cancer (101 page)

268
“never twittery, nervous or jittery”:
Redd Evans and John Jacob Loeb, “Rosie the Riveter” (New York: Paramount Music Corp., 1942).

269
Marc Edell, a New Jersey attorney:
For details of Cipollone’s case see
Cipollone v. Liggett Group, Inc.
, 505 U.S. 504 (1992).

269
“deaf, dumb and blind”:
Ibid.

269
In the three decades between 1954 and 1984:
Burson Marsteller (PR firm), Position Paper,
History of Tobacco Litigation Third Draft
, May 10, 1988.

270
“Plaintiff attorneys can read the writing”:
Burson Marsteller (PR firm), internal document, Cipollone postverdict communication plan, January 1, 1988.

270
In one letter, Fred Panzer:
David Michaels,
Doubt Is Their Product: How Industry’s Assault on Science Threatens Your Health
(Oxford: Oxford University Press, 2008), 11. Also see Brown and Williamson (B & W), “Smoking and Health Proposal,” B & W document no. 680561778-1786, 1969, available at http://legacy.library.ucsf.edu/tid/nvs40f00.

270
“In a sense, the tobacco industry may be thought”:
“Research Planning Memorandum on the Nature of the Tobacco Business and the Crucial Role of Nicotine Therein,” April 14, 1972, Anne Landman’s Collection, Tobacco Documents Online, http://tobaccodocuments.org/landman/501877121–7129.html (accessed December 26, 2009).

271
“Think of the cigarette pack as a storage container”:
“Motives and Incentives in Cigarette Smoking,” 1972, Anne Landman’s Collection, Tobacco Documents Online, http://tobaccodocuments.org/landman/2024273959–3975.html (accessed December 26, 2009).

271
Edell quizzed Liggett’s president:
Cipollone v. Liggett Group, Inc., et al.
, transcript of proceedings [excerpt],
Tobacco Products Litigation Reporter
3, no. 3 (1988): 3.2261–3.268.

271
the Cipollone cancer trial appeared before the court in 1987:
See
Cipollone v. Liggett Group, Inc., et al.
, 893 F.2d 541 (1990);
Cipollone v. Liggett Group, Inc., et al.
, 505 U.S. 504 (1992).

272
By 1994, the per capita consumption of cigarettes in America:
“Trends in Tobacco Use,” American Lung Association Research and Program Services Epidemiology and Statistics Unit, July 2008, http://www.lungusa.org/finding-cures/for-professionals/epidemiology-and-statistics-rpts.html (accessed December 27, 2009).

272
Among men, the age-adjusted incidence:
“Trends in Lung Cancer Morbidity and Mortality,” American Lung Association Epidemiology and Statistics Unit, Research and Program Services Division, September 2008, http://www.lungusa.org/finding-cures/for-professionals/epidemiology-and-statistics-rpts.html (accessed December 27, 2009).

272
In 1994, in yet another landmark case:
“Mississippi Seeks Damages from Tobacco Companies,”
New York Times
, May 24, 1994.

272
“You caused the health crisis”:
Ibid.

273
Several other states then followed:
“Tobacco Settlement Nets Florida $11.3B,”
USA Today
, August 25, 1997; “Texas Tobacco Deal Is Approved,”
New York Times
, January 17, 1998.

273
In June 1997, facing a barrage:
The Master Settlement Agreement is available online from the Office of the Attorney General of California, http://www.ag.ca.gov/tobacco/msa.php (accessed December 27, 2009).

273
Tobacco smoking is now a major preventable cause:
Gu et al., “Mortality Attributable to Smoking in China,”
New England Journal of Medicine
360, no. 2 (2009): 150–59; P. Jha et al., “A Nationally Representative Case-Control Study of Smoking and Death in India,”
New England Journal of Medicine
358, no. 11 (2008): 1137–47.

273
Richard Peto, an epidemiologist at Oxford:
Ibid.

274
In China, lung cancer is already:
Gu et al., “Mortality Attributable to Smoking in China.”

274
In 2004, tobacco companies signed:
Samet et al., “Mexico and the Tobacco Industry,”
BMJ
3 (2006): 353–55.

274
In the early 1990s, a study noted, British American Tobacco:
Gilmore et al., “American Tobacco’s Erosion of Health Legislation in Uzbekistan,”
BMJ
332 (2006): 355–58.

274
Cigarette smoking grew by about 8 percent:
Ibid.

274
In a recent editorial in the
British Medical Journal: Ernesto Sebrié and Stanton A. Glantz, “The Tobacco Industry in Developing Countries,”
British Medical Journal
332, no. 7537 (2006): 313–14.

“Curiouser and curiouser”

276
You’re under a lot of stress:
Transcript of interview with Barry Marshall and an anonymous interviewer, National Health and Medical Research Council archives, Australia.

276
In the early 1970s, for instance, a series of studies:
J. S. Harrington, “Asbestos and Mesothelioma in Man,”
Nature
232, no. 5305 (1971): 54–55; P. Enterline, P. DeCoufle, and V. Henderson, “Mortality in Relation to Occupational Exposure in the Asbestos Industry,”
Journal of Occupational Medicine
14, no. 12 (1972): 897–903; “Asbestos, the Saver of Lives, Has a Deadly Side,” New York Times, January 21, 1973; “New Rules Urged For Asbestos Risk,”
New York Times
, October 5, 1975.

277
In 1971, yet another such study identified:
Arthur L. Herbst, Howard Ulfelder, and David C. Poskanzer,
New England Journal of Medicine
284, no. 15 (1971): 878–81.

277
In the late 1960s, a bacteriologist named Bruce Ames:
Bruce N. Ames et al., “Carcinogens Are Mutagens: A Simple Test System Combining Liver Homogenates for Activation and Bacteria for Detection,”
Proceedings of the National Academy of Sciences of the United States of America
70, no. 8 (1973): 2281–85; Bruce N. Ames, “An Improved Bacterial Test System for the Detection and Classification of Mutagens and Carcinogens,”
Proceedings of the National Academy of Sciences of the United States of America
70, no. 3 (1973): 82–786.

278
So did X-rays, benzene compounds, and nitrosoguanidine
: “Carcinogens as Frameshift Mutagens: Metabolites and Derivatives of 2-Acetylaminofluorene and Other Aromatic Amine Carcinogens,”
Proceedings of the National Academy of Sciences of the United States of America
69, no. 11 (1972): 3128–32.

278
Not every known carcinogen scored on the test:
For DES, see Ishikawa et al., “Lack of Mutagenicity of Diethylstilbestrol Metabolite and Analog, (±)-Indenestrols A and B, in Bacterial Assays,”
Mutation Research/Genetic Toxicology
368, nos. 3–4 (1996):
261–65; for asbestos, see K. Szyba and A. Lange, “Presentation of Benzo(a)pyrene to Microsomal Enzymes by Asbestos Fibers in the Salmonella/Mammalian Microsome Mutagenicity Test,”
Environmental Health Perspectives
51 (1983): 337–41.

278
A biochemistry student at Oxford:
Marc A. Shampo and Robert A. Kyle, “Baruch Blumberg—Work on Hepatitis B Virus,”
Mayo Clinic Proceedings
78, no. 9 (2003): 1186.

279
The work of Baruch Blumberg: Baruch S. Blumberg, “Australia Antigen and the Biology of Hepatitis B,”
Science
197, no. 4298 (1977): 17–25; Rolf Zetterstöm, “Nobel Prize to Baruch Blumberg for the Discovery of the Aetiology of Hepatitis B,”
Acta Paediatrica
97, no. 3 (2008): 384–87; Shampo and Kyle, “Baruch Blumberg,” 1186.

279
Blumberg began to scour far-flung places:
A. C. Allison et al., “Haptoglobin Types in British, Spanish, Basque and Nigerian African Populations,”
Nature
181 (1958): 824–25.

279
In 1964, after a brief tenure at the NIH:
Zetterstöm, “Nobel Prize to Baruch Blumberg.”

279
One blood antigen that intrigued him:
Baruch S. Blumberg, Harvey J. Alter, and Sam Visnich, “A ‘New’ Antigen in Leukemia Sera,”
Journal of the American Medical Association
191, no. 7 (1965): 541–46.

279
In 1966, Blumberg’s lab set out to characterize:
Baruch S. Blumberg et al., “A Serum Antigen (Australia Antigen) in Down’s Syndrome, Leukemia, and Hepatitis,”
Annals of Internal Medicine
66, no. 5 (1967): 924–31.

279
Au
and hepatitis: Blumberg, “Australia Antigen and the Biology of Hepatitis B.”

280
“roughly circular . . . about forty-two nanometers”:
Baruch Blumberg,
Hepatitis B: The Hunt for a Killer Virus
(Princeton: Princeton University Press, 2002), 115.

280
By 1969, Japanese researchers:
Baruch S. Blumberg, “Australia Antigen and the Biology of Hepatitis B.”; K. Okochi and S. Murakami, “Observations on Australia Antigen in Japanese,”
Vox Sanguinis
15, no. 5 (1968): 374–85.

280
But another illness soon stood out:
Blumberg,
Hepatitis B
, 155.

281
“discipline-determined rigidity of the constituent institutes”:
Ibid., 72.

281
By 1979, his group had devised one:
Ibid., 134–46.

282
“Since the early days of medical bacteriology”:
J. Robin Warren, “Helicobacter: The Ease and Difficulty of a New Discovery (Nobel Lecture),”
ChemMedChem
1, no. 7 (2006): 672–85.

282
Barry Marshall and Robin Warren’s discovery of ulcer-causing bacteria: J. R. Warren, “Unidentified Curved Bacteria on Gastric Epithelium in Active Chronic Gastritis,”
Lancet
321, no. 8336 (1983): 1273–75; Barry J. Marshall and J. Robin Warren, “Unidentified Curved Bacilli in the Stomach of Patients with Gastritis and Peptic Ulceration,”
Lancet
323, no. 8390 (1984): 1311–15; Barry Marshall,
Helicobacter Pioneers: Firsthand Accounts from the Scientists Who Discovered Helicobacters, 1892–1982
(Hoboken, NJ: Wiley-Blackwell, 2002); Warren, “Helicobacter: The Ease and Difficulty”; Barry J. Marshall, “Heliobacter Connections,”
ChemMedChem
1, no. 8 (2006): 783–802.

283
“On the morning of the experiment”:
Marshall, “Heliobacter Connections.”

284
The effect of antibiotic therapy on cancer
: Johannes G. Kusters, Arnoud H. M. van Vliet, and Ernst J. Kuipers, “Pathogenesis of
Helicobacter pylori
Infection,”
Clinical Microbiology Reviews
19, no. 3 (2006): 449–90.

“A spider’s web”

286
It is to earlier diagnosis that we must look:
J. P. Lockhart-Mummery, “Two Hundred Cases of Cancer of the Rectum Treated by Perineal Excision,”
British Journal of Surgery
14 (1926–27): 110–24.

286
The greatest need we have today:
Sidney Farber, letter to Etta Rosensohn, November 1962.

286
Lady, have you been “Paptized”?:
“Lady, Have You Been ‘Paptized’?”
New York Amsterdam News
, April 13, 1957.

286
George Papanicolaou: For an overview, see George A. Vilos, “After Office Hours: The History of the Papanicolaou Smear and the Odyssey of George and Andromache Papanicolaou,”
Obstetrics and Gynecology
91, no. 3 (1998): 479–83; S. Zachariadou-Veneti, “A Tribute to George Papanicolaou (1883–1962),”
Cytopathology
11, no. 3 (2000): 152–57.

287
By the late 1920s:
Zachariadou-Veneti, “Tribute to George Papanicolaou.”

287
As one gynecologist archly remarked:
Edgar Allen, “Abstract of Discussion on Ovarian Follicle Hormone,”
Journal of the American Medical Association
85 (1925): 405.

287
Papanicolaou thus began to venture:
George N. Papanicolaou, “The Cancer-Diagnostic Potential of Uterine Exfoliative Cytology,”
CA: A Cancer Journal for Clinicians
7 (1957): 124–35.

288
“aberrant and bizarre forms”:
Ibid.

288
Papanicolaou published his method:
G. N. Papanicolaou, “New Cancer Diagnosis,”
Proceedings of the Third Race Betterment Conference
(1928): 528.

288
“I think this work will be carried”:
Ibid.

288
Between 1928 and 1950:
George A. Vilos, “After Office Hours,”
Obstetrics and Gynecology
91 (March 1998): 3.

288
A Japanese fish and bird painter:
George N. Papanicolaou, “The Cell Smear Method of Diagnosing Cancer,”
American Journal of Public Health and the Nation’s Health
38, no. 2 (1948): 202–5.

289
At a Christmas party in the winter of 1950:
Irena Koprowska,
A Woman Wanders through Life and Science
(Albany: State University of New York Press, 1997), 167–68.

289
“It was a revelation”:
Ibid.

289
In 1952, Papanicolaou convinced the National Cancer Institute:
Cyrus C. Erickson, “Exfoliative Cytology in Mass Screening for Uterine Cancer: Memphis and Shelby County, Tennessee,”
CA: A Cancer Journal for Clinicians
5 (1955): 63–64.

289
In the initial cohort of about 150,000:
Harold Speert, “Memorable Medical Mentors: VI. Thomas S. Cullen (1868–1953),”
Obstetrical and Gynecological Survey
59, no. 8 (2004): 557–63.

289
557 women were found to have preinvasive cancers:
Ibid.

290
In 1913, a Berlin surgeon named Albert Salomon:
D. J. Dronkers et al., eds.,
The Practice of Mammography: Pathology, Technique, Interpretation, Adjunct Modalities
(New York: Thieme, 2001), 256.

291
“trabeculae as thin as a spider’s web”:
H. J. Burhenne, J. E. Youker, and R. H. Gold, eds.,
Mammography
(symposium given on August 24, 1968, at the University of California School of Medicine, San Francisco) (New York: S. Karger, 1969), 109.