Former US President Jimmy Carter suffered from advanced melanoma. A new immunotherapy drug has been claimed to be helpful in treating this condition. These drugs work by boosting the immune system rather than killing cancer cells directly.
Immunotherapy is a revolutionary treatment for cancer, but it is not something new. It has been there for over a century, having been discovered by a young surgeon who was ready to think differently.
It was in 1890 that William Coley, the surgeon, was about to examine one of his new patients in New York City. He never thought that the young patient he was about to see was going to change not only his life but cancer research as well.
According to Dr. David Levine (Director of – the Hospital for Special Surgery, New York), the patient was Elizabeth Dashiell (or Bessie). Bessie was a 17-year-old girl who came with the complaint of having some issues with her hand that looked like a small injury. Even a tiny bump would hurt and it didn’t get better. She came to this surgeon after seeing so many other doctors.
Initially, Dr. Coley thought that Bessie was suffering from some infection. However, on biopsy, he found that it was a malignant and advanced cancer known as sarcoma.
A century ago, it was not possible for doctors to do much to treat Bessie. There was no chemotherapy or radiation. The only thing the surgeon could do was to amputate the arm below the elbow so that the disease could be prevented from further spreading into the body.
But after the surgery, he realized that it was a futile treatment. According to Dr. David Levine, cancer had already reached the girl’s liver, lungs, and entire body.
The girl didn’t live long. She spent the rest of her days in pain and struggling. Dr. Coley was alongside her when she passed away in January 1891. According to Stephen Hall (the author of A Commotion in the Blood: Life, Death and the Immune System focused on Coley), the girl’s death left the surgeon shocked and inspired him to do something.
Because there was not much information about cancer then, Coley began by going through all the old records available at New York Hospital. He had a strong desire to understand this destructive and cruel disease.
According to Hall, Coley remembered something he read from Charles Darwin’s work as a student – to never ignore if there is a biological exception to the rule.
He was successful in discovering one such biological exception. This ‘exception’ was Fred Stein, an immigrant from Germany. He was a patient at the New York Hospital around 8 years ago. The doctors made multiple attempts to remove his tumor from the neck. His tumor kept returning and the doctors were certain that he would die.
Stein soon contracted a severe skin infection due to the strep bacteria. With this disease too, it was certain to the doctors that Stein would die soon. Surprisingly, that didn’t happen. To the shock of everyone, his tumor vanished and the hospital discharged him. Now after 8 years Coley wanted to know if Stein was still around.
In 1891, the same year Bessie died, Coley set out for the dwellings of the Lower East Side in Manhattan to look for Stein. This was where the German immigrant community was living at the time.
He moved from one door to another enquiring about Fred Stein who could be recognized by a unique scar along his neck. It took him many weeks but he eventually found an alive Fred Stein who was now free of cancer.
Power of The Immune System
So how did the bacterial infection help Stein get rid of cancer? According to Coley, the Strep infection must have reversed Stein’s cancer. He was curious now to see if he could reproduce the same effects through deliberate injection of the bacteria into cancer patients.
He came up with the idea of testing those who were critically ill. He started with Zola (an Italian immigrant), who also had sarcoma, like Bessie Dashiell. This man also had tumors in his throat. His health was so bad that could hardly speak, eat or breathe.
According to Hall, Coley spent months trying to make the patient sick from a Strep infection. He could create these tiny cuts on his skin and rub the Strep bacteria. He would get only a minor response but it was not satisfactory.
After these initial attempts and not getting the desired results, Coley came across a far stronger strain of these bacteria. When infected with them, Zola fell badly ill and the infection seemed it could have just killed him. But to the amazement of Coley, the tumors which were the size of orange started liquefying and disintegrating within 24 hours.
According to Hall, this was something that was very rare, but if you were to see it you would be completely dumbfounded.
Zola made an astonishing, complete recovery and Coley was now sure that he had something in his hands. He continued with his experimentation and kept refining how he used the bacteria.
Then, he named his cancer treatment as Coley’s Toxins.
The medical community was excited by Coley’s findings and results. He was achieving bigger and bigger successes and his work became famous not only in the U.S. but in other countries too. However, according to Bradley Coley Jr. (grandson of Dr. William Coley), the American medical establishment was highly skeptical at the time. The medical community had no idea how Coley’s Toxins actually worked and why they were effective at times and not at other times. In fact, even the surgeon himself couldn’t provide a convincing explanation.
The reason was that not much was known about the power of the immune system at the time. It would be a few more decades until it remained so.
Radiation therapy was introduced during the early part of the 20th century. This new therapy entirely sidelined Coley’s Toxins and decreased any existing interest in it. According to Bradley, all interest in the treatment vanished with his grandfather’s death.
That could actually have been the end of Coley’s legacy. But it was not to be so. Coley died in 1936. NPR, Coley’s daughter started work on his biography. She searched through all his papers. She came across a thousand files of patients who were treated by Coley using Coley’s toxins.
She studied those papers for several years and realized that he had achieved high rates of success in reversing certain cancerous tumors. Because she couldn’t find anyone who showed any interest in his work, she began studying it herself. Helen Coley Nauts received a minor grant and she used it to establish the Npr, in 1953. It was devoted to understanding the power of the immune system and how it was related to cancer.
It has been 60 years since its inception, it has helped researchers in gaining an in-depth understanding of the immune system. Today, all those decades of work and the understanding of the power of the immune system are eventually beginning to pay off.
Today, there are so many treatments that make the most of the power of the immune system in treating various kinds of cancers. They are commonly used for treating stomach cancer, leukemia, kidney cancer, melanoma, and lung cancer.
According to Jedd Wolchok, the credit for all the treatments available today that use the power of the immune system for treating cancer goes to the research and experiments done by William Coley more than a century ago. Jedd Wolchok is the head of the Memorial Sloan Kettering Cancer Center’s melanoma and immunotherapeutics service.
Via NPR