The Emperor of All Maladies: A Biography of Cancer (98 page)

195
In August 1924, Keynes examined a patient:
“The Radiation Treatment of Carcinoma of the Breast,”
St. Bartholomew’s Hospital Reports
, vol. 60, ed. W. McAdam Eccles et al. (London: John Murray, 1927), 91–93.

195
“The ulcer rapidly heal[ed]”:
Ibid.

195
“extension of [the] operation beyond a local removal”:
Ibid., 94.

196
the lumpectomy:
Roger S. Foster Jr., “Breast Cancer Detection and Treatment: A Personal and Historical Perspective,”
Archives of Surgery
138, no. 4 (2003): 397–408.

196
George Barney Crile: Ibid.; G. Crile Jr., “The Evolution of the Treatment of Breast Cancer,”
Breast Cancer: Controversies in Management
, ed. L. Wise and H. Johnson Jr. (Armonk, NY: Futura Publishing Co., 1994).

196
Crile’s father. George Crile Sr.:
Narendra Nathoo, Frederick K. Lautzenheiser, and Gene H. Barnett, “The First Direct Human Blood Transfusion: the Forgotten Legacy of George W. Crile,”
Neurosurgery
64 (2009): 20–26; G. W. Crile,
Hemorrhage and Transfusion: An Experimental and Clinical Research
(New York: D. Appleton, 1909).

196
Political revolutions, the writer Amitav Ghosh writes:
Amitav Ghosh,
Dancing in Cambodia, at Large in Burma
(New Delhi: Ravi Dayal, 1998), 25.

196
Crile Jr. was beginning to have his own doubts:
Foster, “Breast Cancer Detection and Treatment”; George Crile,
The Way It Was: Sex, Surgery, Treasure and Travel
(Kent, OH: Kent University Press, 1992), 391–400.

197
Crile soon gave up on the radical mastectomy:
George Crile Jr., “Treatment of Breast Cancer by Local Excision,”
American Journal of Surgery
109 (1965): 400–403; George Crile Jr., “The Smaller the Cancer the Bigger the Operation? Rational of Small Operations for Small Tumors and Large Operations for Large Tumors,”
Journal of the American Medical Association
199 (1967): 736–38; George Crile Jr.,
A Biologic Consideration of Treatment of Breast Cancer
(Springfield, IL: Charles C. Thomas, 1967); G. Crile Jr. and S. O. Hoerr, “Results of Treatment of Carcinoma of the Breast by Local Excision,”
Surgery, Gynecology, and Obstetrics
132 (1971): 780–82.

197
two statisticians, Jerzy Neyman and Egon Pearson:
J. Neyman and E. S. Pearson, “On the Use and Interpretation of Certain Test Criteria for Purposes of Statistical Inference. Part I,”
Biometrika
20A, nos. 1–2 (1928): 175–240; J. Neyman and E. S. Pearson, “On the Use and Interpretation of Certain Test Criteria for Purposes of Statistical Inference. Part II,”
Biometrika
20A, nos. 3–4 (1928): 263–94.

198
“Go thou and do likewise”:
Haagensen,
Diseases of the Breast
, 674.

198
It took a Philadelphia surgeon:
Kate Travis, “Bernard Fisher Reflects on a Half-Century’s Worth of Breast Cancer Research,”
Journal of the National Cancer Institute
97, no. 22 (2005): 1636–37.

199
“It has become apparent”:
Bernard Fisher, Karnosfky Memorial Lecture transcript, Rose Kushner papers, Box 4, File 62, Harvard University.

199
Thalidomide, prescribed widely to control:
Phillip Knightley,
Suffer the Children: The Story of Thalidomide
(New York: Viking Press, 1979).

199
In Texas, Jane Roe:
Roe v. Wade
, 410 U.S. 113 (1973).

199
“Refuse to submit to a radical mastectomy”:
“Breast Cancer: Beware of These Danger Signals,”
Chicago Tribune
, October 3, 1973.

199
Rachel Carson, the author of
Silent Spring: Ellen Leopold,
A Darker Ribbon: Breast Cancer, Women, and Their Doctors in the Twentieth Century
(Boston: Beacon Press, 1999), 199.

200
Betty Rollin and Rose Kushner:
Betty Rollin,
First, You Cry
(New York: Harper, 2000); Rose Kushner,
Why Me?
(Philadelphia: Saunders Press, 1982).

200
“Happily for women,” Kushner wrote:
Rose Kushner papers, Box 2, File 22; Kushner,
Why Me?

200
In 1967, bolstered by the activism:
See Fisher’s NSABP biography at http://www .nsabp.pitt.edu/BCPT_Speakers_Biographies.asp (accessed January 11, 2010).

200
“The clinician, no matter how venerable”:
Bernard Fisher, “A Commentary on the Role of the Surgeon in Primary Breast Cancer,”
Breast Cancer Research and Treatment
1 (1981): 17–26.

200
“In God we trust”:
“Treating Breast Cancer: Findings Question Need for Removal,”
Washington Post
, October 29, 1979.

200
“To get a woman to participate in a clinical trial”:
“Bernard Fisher in Conversation,”
Pitt Med Magazine
(University of Pittsburgh School of Medicine magazine), July 2002.

200
Fisher’s NSABP mastectomy trial: Bernard Fisher et al., “Findings from NSABP Protocol No. B-04: Comparison of Radical Mastectomy with Alternative Treatments. II. The Clinical and Biological Significance of Medial-Central Breast Cancers,”
Cancer
48, no. 8 (1981): 1863–72.

“The smiling oncologist”

202
Few doctors in this country:
Rose Kushner, “Is Aggressive Adjuvant Chemotherapy the Halsted Radical of the ’80s?”
CA: A Cancer Journal for Clinicians
34, no. 6 (1984): 345–51.

202
And it is solely by risking life:
Georg Wilhelm Friedrich Hegel,
The Phenomenology of Mind
(New York: Humanities Press, 1971), 232.

202
“large-scale chemotherapeutic attack”:
James D. Hardy,
The World of Surgery, 1945–1985: Memoirs of One Participant
(Philadelphia: University of Pennsylvania Press, 1986), 216.

202
“our trench and our bunker”:
Mickey Goulian, interview with author, December 2005.

202
“Wandering about the NIH clinical center”:
Stewart Alsop,
Stay of Execution: A Sort of Memoir
(New York: Lippincott, 1973), 218.

203
“Although this was a cancer ward”:
Kathleen R. Gilbert, ed.
The Emotional Nature of Qualitative Research
(Boca Raton, FL: CRC Press, 2001).

203
“accepted roles, a predetermined outcome, constant stimuli”:
Gerda Lerner,
A Death of One’s Own
(New York: Simon and Schuster, 1978), 71.

203
“yellow and orange walls in the corridors”:
“Cancer Ward Nurses: Where ‘C’ Means Cheerful,”
Los Angeles Times
, July 25, 1975.

203
the nurses wore uniforms with plastic yellow buttons:
Alsop,
Stay of Execution
, 52.

203
“Saving the individual patient”:
Ibid., 84.

204
In 1965, at Michigan State University:
Barnett Rosenberg, Loretta Van Camp, and Thomas Krigas, “Inhibition of Cell Division in
Escherichia coli
by Electrolysis Products from a Platinum Electrode,”
Nature
205, no. 4972 (1965): 698–99.

205
John Cleland: Larry Einhorn, interview with author, November 2009; also see
Cure
, Winter 2004; Craig A. Almeida and Sheila A. Barry,
Cancer: Basic Science and Clinical Aspects
(Hoboken, NJ: Wiley-Blackwell, 2010), 259; “Survivor Milks Life for All It’s Worth,”
Purdue Agriculture Connections
, Spring 2006; “John Cleland Carried the Olympic Torch in 2000 When the Relay Came through Indiana,” Friends 4 Cures, http://www.friends4cures.org/cure_mag_article.shtml (accessed January 9, 2010).

205
“I cannot remember what I said”:
John Cleland,
Cure
, Winter 2004.

205
By 1975, Einhorn had treated
: Einhorn, interview with author, December 2009.

205
“Walking up to that podium”:
Ibid.

205
“It was unforgettable”:
Ibid. Also see “Triumph of the Cure,”
Salon
, July 29, 1999, http://www.salon.com/health/feature/1999/07/29/lance/index.html (accessed November 30, 2009).

205
Margaret Edson’s play
Wit: Margaret Edson,
Wit
(New York: Dramatists Play Service, 1999).

205
“You may think my vocabulary”:
Ibid., 28.

206
“We want and need and seek better guidance”:
Howard E. Skipper, “Cancer Chemotherapy Is Many Things: G.H.A. Clowes Memorial Lecture,”
Cancer Research
31, no. 9 (1971): 1173–80.

206
There was Taxol:
Monroe E. Wall and Mansukh C. Wani, “Camptothecin and Taxol: Discovery to Clinic—Thirteenth Bruce F. Cain Memorial Award Lecture,”
Cancer Research
55 (1995): 753–60; Jordan Goodman and Vivien Walsh,
The Story of Taxol: Nature and Politics in the Pursuit of an Anti-Cancer Drug
(Cambridge, England: Cambridge University Press, 2001).

206
Adriamycin, discovered in 1969:
F. Arcamone et al., “Adriamycin, 14-hydroxydaimomycin, a New Antitumor Antibiotic from
S. Peucetius
var.
caesius,
”
Biotechnology and Bioengineering
11, no. 6 (1969): 1101–10.

206
could irreversibly damage the heart:
C. A. J. Brouwer et al., “Long-Term Cardiac Follow-Up in Survivors of a Malignant Bone Tumor,”
Annals of Oncology
17, no. 10 (2006): 1586–91.

206
Etoposide came from the fruit:
A. M. Arnold and J. M. A. Whitehouse, “Etoposide: A New Anti-cancer Agent,”
Lancet
318, no. 8252 (1981): 912–15.

206
Bleomycin, which could scar lungs without warning:
H. Umezawa et al., “New Antibiotics, Bleomycin A and B,”
Journal of Antibiotics
(Tokyo) 19, no. 5 (1966): 200–209; Nuno R. Grande et al., “Lung Fibrosis Induced by Bleomycin: Structural Changes and Overview of Recent Advances,”
Scanning Microscopy
12, no. 3 (1996): 487–94; R. S Thrall et al., “The Development of Bleomycin-Induced Pulmonary Fibrosis in Neutrophil-Depleted and Complement-Depleted Rats,”
American Journal of Pathology
105 (1981): 76–81.

207
“Did we believe we were going to cure cancer”
: George Canellos, interview with author.

207
In the mid-1970s:
J. Ziegler, I. T. McGrath, and C. L. Olweny, “Cure of Burkitt’s Lymphoma—Ten-Year Follow-Up of 157 Ugandan Patients,”
Lancet
3, no. 2 (8149) (1979): 936–38. Also see Ziegler et al., “Combined Modality Treatment of Burkitt’s Lymphoma,”
Cancer Treatment Report
62, no. 12 (1978): 2031–34.

207
“Our applications skyrocketed”:
Ibid.

207
“There is no cancer that is not potentially curable”:
“Cancer: The Chill Is Still There,”
Los Angeles Times
, March 20, 1979.

208
the eight-in-one study:
J. Russel Geyer et al., “Eight Drugs in One Day Chemotherapy in Children with Brain Tumors: A Critical Toxicity Appraisal,”
Journal of Clinical Oncology
6, no. 6 (1988): 996–1000.

209
“When doctors say that the side effects are tolerable”:
“Some Chemotherapy Fails against Cancer,”
New York Times
, August 6, 1985.

209
“The smiling oncologist”:
Rose Kushner, “Is Aggressive Adjuvant Chemotherapy the Halsted Radical of the ’80s?” 1984, draft 9, Rose Kushner papers. The phrase was deleted in the final text that appeared in 1984.

209
“Hexamethophosphacil with Vinplatin to potentiate”:
Edson,
Wit
, 31.

Knowing the Enemy

210
It is said that if you know your enemies:
Sun Tzu,
The Art of War
(Boston: Shambhala, 1988), 82.

210
a urological surgeon, Charles Huggins:
Luis H. Toledo-Pereyra, “Discovery in Surgical Investigation: The Essence of Charles Brenton Huggins,”
Journal of Investigative Surgery
14 (2001): 251–52; Robert E. Forster II, “Charles Brenton Huggins (22 September 1901–12 January 1997),”
Proceedings of the American Philosophical Society
143, no. 2 (1999): 327–31.

211
Huggins’s studies of prostatic fluid: C. Huggins et al., “Quantitative Studies of Prostatic Secretion: I. Characteristics of the Normal Secretion; the Influence of Thyroid, Suprarenal, and Testis Extirpation and Androgen Substitution on the Prostatic Output,”
Journal of Experimental Medicine
70, no. 6 (1939): 543–56; Charles Huggins, “Endocrine-Induced Regression of Cancers.”
Science
156, no. 3778 (1967): 1050–54; Tonse N. K. Raju, “The Nobel Chronicles. 1966: Francis Peyton Rous (1879–1970) and Charles Brenton Huggins (1901–1997),
Lancet
354, no. 9177 (1999): 520.

212
“It was vexatious to encounter a dog”:
Huggins, “Endocrine-Induced Regression.”

213
“Cancer is not necessarily autonomous”:
Ibid.

213
“Its growth can be sustained and propagated”:
Ibid.

213
In 1929, Edward Doisy, a biochemist:
Edward A. Doisy, “An Autobiography,”
Annual Review of Biochemistry
45 (1976): 1–12.

213
diethylstilbestrol (or DES):
E. C. Dodds et al., “Synthetic Oestrogenic Compounds Related to Stilbene and Diphenylethane. Part I,”
Proceedings of the Royal Society of London, Series B, Biological Sciences
127, no. 847 (1939): 140–67; E. C. Dodds et al., “Estrogenic Activity of Certain Synthetic Compounds,”
Nature
141, no. 3562 (1938): 247–48; Edward Charles Dodds,
Biochemical Contributions to Endocrinology: Experiments in Hormonal Research
(Palo Alto, CA: Stanford University Press, 1957); Robert Meyers,
D.E.S., the Bitter Pill
(New York: Seaview/Putnam, 1983).