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FILE NAME Newspaper & Magazine Articles NMA DATE 1949 June 26 DOC NMA104 DOCUMENT DESCRIPTION NYT - What We Know About Cancer What We Know About Cancer By WALDEMAR KAEMPFFERT New York Times Current file Jun 26 1949 ProQuest Historical Newspapers The New York Times 1851 - 2003 pg SM14 Pathfinder Charles B. Huggins who developed the new serum test for What We Know About Cancer An appraisal of medicine's most challenging mystery reveals increased but incomplete knowledge and a wide area of hope ANCER is as old as life Plants animals and men have died of it for thousands of years Yet exper- imental research in cancer research that deserves to be called scientific began only fifty years ago The knowledge acquired in those fifty years is enormous gratifying and perplexing It is gratifying because tumors can now be removed with safety from parts of the body that no surgeon would touch only twenty years ago and because we are now entering the chemotherapeutical or medical stage of treatment so that injections or pills will accomplish as much as WALDEMAR KAEMPFFERT science editor of The Times since 1931 has written on scientific and medical matters for over forty years in preparing this article he consulted with experts of three national cancer research institutions By WALDEMAR KAEMPFFERT rays and radium and sometimes more And it is perplexing because so many contradictions so many observations manifestly related await magic touch that will make them click into significant patterns like the colored bits of glass in a kaleidoscope TH perplexities are naturally the di- rect concern of science Here are a few In a mixed population of an island in the Netherlands East Indies Malays and Chinese eat the same food but the Chinese are subject to cancer of the stomach whereas the Malays are virtually free from it Why Does cancer run in families The authorities say that only a susceptibility is inherited A Madame Z comes down in medical literature be- cause out of twenty members of her family sixteen died of cancer Out of 174 members of the G family of Michigan forty succumbed to can- cer There are striking cases of identical twins who developed tumors in the same period of life and occa- sionally in the same site Some types of cancer appear generation generation families after Malignant tumors have been known to shrivel and disappear spontaneous- ly in a few cases Why Nobody knows Why should excessive rays radium and other cite cancers but proper doses agents doses of inde- stroy them Cancers of the skin mouth esoph- agus and stomach are more frequent in the poorly paid than in the wellpaid and well classes A matter of nutrition perhaps Reproduced with permission of the copyright owner Further reproduction prohibited without permission A diet lower in calories than is considered necessary for the maintenance of good health reduces the incidence of cancer in both animals and man But why should restriction of calories have little if any effect when a malig- nant tumor is well started Why is cancer more prevalent in the temperate climate There is no pneumonia stage no diphtheria stage no indication in the body that a particular infectious disease is about to gain a hold But there is a cancerous stage Why? T are several hundred of these puzzles Fifty years of research have not solved them so that there is no cure for cancer Meanwhile the scourge exacts an increasing toll of life In 1930 it killed 117,800 in the United States this year it will kill well over 190,000 in 1980 unless some spectacularly successful treatment is discovered statisticians estimate that of the 58,731,000 Americans who will be over 45 it will kill 288,500 These statistics are not as gloomy as they look Though cancer spares neither children nor octogenarians its victims are chiefly those who have reached and passed middle age Because of the advance in medical science we live longer than did our grandparents The dreadful increase in cancer mortality is therefore what statisticians expect and Yet if you ask experimenters and investigators where the treatment of cancer stands after fifty years of research the answer is bright with hope Even in the backward present 65,000 of the 190,000 who are doomed to die of cancer this year can be saved if they have the benefit of the best surgical and medical skill in time What is cancer A disorderly usually rapid abnormal growth of tissue that destroys life if allowed to run its course Because there is as yet no cure for cancer in the medical sense malignant tu- mors must be cut out or destroyed a way not yet understood rays or by the rays given off by radium So blunt a summary does scant justice to advances in surgery or radiology No one would have dared to remove'a cancerous lung twenty years ago Now it is done Sufferers from cancer have had fifths of the stomach part of the colon and the whole spleen cut out and lived for years As for the ray machines of today they are marvels of power and ingenuity in . the dosages delivered Besides we have the radioactive isotopes which are now so plentiful that whatever place they may have in the treatment of cancer should soon be established BOTH surgery and powerful rays are of no avail if a malignant growth is detected too late or malignant cells have been carried to distant vital organs there to start secondary cancers Hence for decades efforts have been made to find a chemical test for incipient cancer just early cancer but the deep hidden cancer that is just starting and that es- capes the best diagnostic skill In other words a chemical test as good as a Wassermann in syphilis is wanted There are urine tests violet tests tests with such dyes as methylene blue and cresyl blue electrical tests and a score or so of blood tests Some of these are about 80 per cent accurate but they are com- plicated and they can be made only by trained technicians Also they indicate too much Nearly all are positive for diseases other than cancer and usually for pregnancy Continued on Page 24 What We Know About Cancer Continued from Page 25 sient beneficial effect in about 15 per cent of breast cancers Giving extracts of female sex hormones combats the male sex hormone that stimu- lates male duces malignant growth in prostates and so pro- much the same result as castration Later it was found that breast cancers in women stop growing for months and even shrink when male sex hormones are given Not only this but the spreading of cancer to the bone is slowed down and damage to the bone is repaired fifth of the first group of men who were treated for cancer of the prostate in accordance with Huggins method were alive seven and a half years later The record for cancer of the breast is not so striking The hormone treatment of cancer of the prostate and of the breast is now officially ap- proved so that it stands on as firm a footing as treatment by rays and radium This is no high praise for _ rays and radium have thus far disposed only of skin can- cers But the use of sex hor- mones to check some forms of cancer if only for months or a few years is a milestone in medical progress For the first time it becomes possible to cause .some tumors to shrivel merely by taking pills or receiving injections Thus with Huggins begins the chemical and hence the med- ical treatment of cancer Some credit must also be given to the late Dr. W. B. Coley who used a toxin made from bac- terial products He checked the development of bone cancers temporarily with his preparations THE CHEMICAL APPROACH URING the recent war it was discovered that a score of chemicals have strik- ing temporary effects on various types of cancers Nearly all these chemicals are deadly poisons handicap that may be overcome so that larger and probably more effective doses can be given without toxic results Most important are the nitrogen mustards which are related to the mustard gas of evil military reputation and which are at least as effective as the rays in prolonging the life of sufferers from leukemia in which white blood cells multi- ply so abundantly that they invade important organs Then there are urethane also a palliative in leukemia the sugary chemicals produced by some germs three antibiotics the generic name of chemicals which like penicillin and strep- tomycin are extracted from mold organisms in the soil aminopterin an antago- nist of folic acid which is one of the complex of vitamins podophyllin obtained from mandrake root colchicine ex- tracted from the autumn cro- cus and used for centuries as a remedy for gout Fowler's solution or potassium arsenite What of the radioactive iso- topes now obtainable at low cost from Oak Ridge As yet they have cured nothing So far radioactive iodine is the only one that has a pro- nounced selective action it goes straight to the thyroid gland in the neck sometimes with remarkable temporary benefit Radioactive arsenic shows promise in the treatment of leukemia and radioactive phosphorus also does some temporary good in one type of leukemia The radio- Dr. John J.Bittner - active isotopes are and no worse than no the that have been used better drugs THE STUDY OF GROWTH LL the work so far de- scribed does not touch fundamentals Every cancer originates in a normal cell which goes wild What keeps a normal cell normal This is the profoundest of all questions that research must answer A tumor is a useless shapeless mass that penetrates tissues and organs an arm or a leg is a shapely and useful member Normal cells multiply by division and grow into hearts livers lungs skins eyes in the right locations and stop growing when organs and tissues are of the right size Cancer cells do not specialize in this way No longer subject to restraint they multiply with frightening rapidity and take possession of the tissue or organ where they grow The end is death Often a few of these unruly cells find their way into the bloodstream to lodge in distant parts of the body there to start new malig- nant growths process tech- nically meta called meaning metastasis later and stasis meaning place or stand It is plain enough that the problem of cancer is the problem of growth normal and abnormal and it is for this rea- son that the National Re- search Council has appointed a Committee on Growth which passes on all research projects submitted by the American Cancer Society The problem many aspects few have been of growth has So far only a studied Drs Warburg and Meyerhoff have focused on enzymes which are substances that bring about chemical reactions in the body yet themselves remain intact Without enzymes the fermen- tation of beer and wine would be impossible Without the ' enzyme familiar to us as pep- gin we could not digest a piece of meat I turns out that there is in- deed a difference in the chem- ical mode of life of normal and cancer cells difference in enzymes Both types of cells ferment and thus utilize sugar With the aid of en- zymes the normal the sugar down cell breaks into lactic acid the substance that gives sour milk its taste Then fol- lows a second stage in which lactic acid is further broken down into carbon dioxide the gas that bubbles in ginger ale and beer and that we exhale when we breathe A normal cell needs oxygen to burn up sugar completely and leave only carbon dioxide But the cancer cell keeps on breaking down sugar into lac- tic acid and never reaches the second stage in which oxy- gen is necessary A tumor can grow just by splitting lactic acid into sugar without oxygen but normal tissue dies if it is deprived of oxygen All this means that normal _ cells ferment much as beer does in the brewer's vat or hard cider in a farmer's barrel in the process of changing sugar into alcohol Cancer cells also ferment but not in the normal way Warburg found out that no fewer than eleven enzymes working in relays are required to ferment sugar into lactic acid enzyme A preparing the way for enzymB e B for C and so on Suppose the chain were broken If only one enzyme could be inactivated a tumor would stop feeding on sugar and die of starvation Here we have what may well be the best of all clues to the conquest of cancer Ir will may be that somebody stumble in the darkness of his ignorance on a discovery that will rob cancer of its terror but it is more likely that such a success will be scored when the fundamental problem of growth is more systematically attacked than it has been and when groups of scientists representing different disciplines are organized for the attack It was thus that we developed an atomic bomb and thus that scientists in industrial laboratories gave us filament lamps television synthetic rubber It is thus that planes that will fly faster than sound are being developed Let no one answer that it is easier to produce inventions than to evolve and prove theories of growth Theories are also inventions Reproduced with permission of the copyright owner Further reproduction prohibited without permission What We Know About Cancer Continued from Page 14 which is not astonishing when it is remembered that an embryo and a new growths tumor are both LIAST March Dr. Charles B. Huggins of the University of Chicago one of the most distinguished of American scientists who have devoted their professional lives to the study of malignant growths pub- lished a paper in which he de- scribed what may be the long- hoped reasonably simple serum test serum being the clear from liquid that separates clotting blood It has been that known for twenty years normal serum and the serum of a sufferer from can- cer differ in their albumin Al- bumin most familiar as white of egg coagulates when heat- ed Huggins pulled together all that was known about the relation of albumin to cancer added information that he and his colleagues had gathered at a cost of 160,000 and came forth with a synthesis which is a brilliant contribution of its kind to of cancer the early detection The serum albumin of a healthy person coagulates more readily than that of a sufferer from cancer Posi- tive results do not appear in pregnancy but they do appear in tuberculosis and massive infections Such false posi- tives can be ruled out one by one leaving only the dread inescapable diagnosis of cancer There is chemical as yet test for no specific cancer All the tests so far devised are only indicators of abnormality All this being so the im- patient practical man reasons that every disease has its cause and that when this has been found a scientific treat- ment usually follows not concentrate on the Why cause of cancer T question is meaning- less because there is no one cause of cancer as there is of smallpox infantile paralysis typhoid typhus or any infec- tious disease Moreover can- cers differ The ultraviolet rays of the sun rays irritations hormones arsenic nickel carbonyl chromium cobalt mesothorium extracts of diseased tissues asbestos a few viruses mineral oil pitch tar soot creosote parasitic worms smoking heaat ll these can incite cancers So can any chemicals one of derived about 300 from coal- tar and oil many of them syn- thetics with no counterpart in nature How then can we talk of the cause of cancer Scientists are trying to find out what happens when a nor- _mal cell changes into a cancer cell and why the changed cell remains malignant There are many ways in which the prob- lem is approached in the labo- ratory but these four have the strongest experimental evidence in their favor 1 Cancer is a virus disease 2 excessive stimulation by sex hormones starts cancers in the male prostate and the female breast 3 some chemicals can temporarily arrest can- cers 4 normal and cancer cells differ in utilize sugar the way they THE VIRUS APPROACH FEW specialists in can- cer research now main- tain that about the it is cause right to talk of cancer and that the cause is as the cause of a virus just influenza or measles is a virus Belief in the virus theory started in 1911 when Dr. Pey- ton Rous of the Rockefeller Institute for Medical Research passed the juice of mashed chicken tumors through a fil- ter so fine that even a micro- scopic microbe was held back He injected the filtrate into healthy chickens Always a tumor grew where the needle had entered Since then it has been established that warty growths on the ears of some wild rabbits are caused by a virus and that these growths turn into cancers when trans- planted to domestic rabbits The discovery that did more than any other to strengthen the virus theory was one made in 1935 by Dr. J. J. Bittner then on the staff of the Roscoe B. Jackson Me- Continued on Following Page Reproduced with permission of the copyright owner Further reproduction prohibited without permission A laboratory at the + Continued from Preceding Paye morial Laboratory Bar Har- bor Me and now of the Uni- versity of Minnesota's faculty He experimented with inbred mice so that he knew exactly what physical defects and dis- eases were inherited and what diseases could be attributed to outside influence Genealogi- cally crats for a his mice were aristo- with lineages going back hundred genera- tions and more In some of these inbred strains of mice cancer of the breast appeared spontaneous- ly in 90 per cent and more of the females in other equally pure inbred strains breast cancer appeared in only 1 or 2 per cent Bittner transferred the young immediately after birth from the mother of a cancerous stock to foster mothers of free stock a virtually cancerThe number of ex- pected cases of breast cancers dropped to almost nothing EXT Bittner transferred the newborn young of cancerfree mouse mothers to foster mothers that were bound to generate cancer of the breast Many more than the expected number of breast cancers de- veloped If the mouse mother of cancerous stock suckled her young for only an hour or so cancer of the breast appeared in nearly all old age was when middle or reached On the other hand a whole strain of mice could be saved by feeding it on pasteurized mouse or transferring it at birth to cancer foster mothers Evidently there was an agent in the milk of some strains of inbred mouse mothers that in- cited cancer of the breast What is this inciter Be- cause it has been seen in the electron microscope because it has been inactivated by pas- teurization because it has been found in blood in the spleen in the thymus gland in the liver and in the brain because it can in the culture be neutralized tube with an immune serum and above all because it increased prodi- giously in mice to which it has been transferred it is generally regarded as a virus Is cancer of the human breast There caused by such a is no statistical virus reason to think so as yet Nor is there any evidence that dairy milk on which millions of babies have been fed contains a virus Ask geneticist is a student of heredity cancer runs in families and he will deny it What then is inherited A ity soil he answers But what susceptibil- a favorable becomes of susceptibility when even the future generations of an in- bred stock mice in which cancer of the breast is trans- mitted vertically to use a term invented by Dr. Ludwik Gross can be protected by the simple expedient of feeding them on virus milk Whether or not a infect it the stock is inbred laden milk will Are all cancers caused by a virus no matter of what type they may be Are there as many cancer viruses as there are tics cancer types The skep- in cancer circles balk at this extension of the virus the- ory Almost every virus goes to work as soon as it enters the animal or human organ- ism But not the milk virus or other cancer viruses if there are such It must be assumed that all remain latent for thirty or forty years It must also be assumed that all plants and animals man in- cluded are born with some kind of cancer virus in them and that the virus springs into action when the right condi- tions are created THE HORMONE APPROACH T was long suspected that there was a relation between some cancers and sex organs When the sex hormones were discovered and isolated it was possible to experiment Sure enough the relationship was there Dr. Huggins followed up the clue with dramatic re- sults After careful experi- menting with animals he found that when castration cut off the supply of male hormone cancer of the prostate in men was checked and pain relieved sometimes rapidly and mirac- ulously even though it had spread to other parts Cancers even disappeared entirely for a time in a few fortunates Spaying of females had a tran- Continued on Page 27 Reproduced with permission of the copyright owner Further reproduction prohibited without permission