T HE E MP E R OR OF ALL
CAST OF CHARACATERS
Sidney Farber (1903–1973)
A pioneer of modern chemotherapy, Sidney Farber was
among the first to use chemicals to kill cancer cells,
focusing initially on leukemia in children. His cancer clinic
at the Children’s Hospital in Boston was one of the first of
its kind. In the mid-1970s, Farber joined forces with Mary
Lasker to spearhead a national “War on Cancer.”
Rudolf Virchow (1821–1902)
A German physician who coined the term “leukemia,”
he played an important early role in characterizing cancer
as a disease caused by uncontrolled growth of the body’s
own cells.
Yellapragada Subbarao (1895–1948)
A pioneering biochemist who synthesized the folic acid
for Sidney Farber’s first antifolate clinical trials.
Claudius Galen (ad 129–199)
A Greek physician and philosopher who practiced among
the Romans theorized that diseases were caused by an
imbalance in the body’s four “humors.” Cancer and
depression were due to excesses of black bile. Galen’s
ideas influenced medical thought, rightly or wrongly, for
centuries after his death.
Andreas Vesalius (1514–1564)
An anatomist whose detailed maps of the human body
advanced medical understanding and challenged the
Galenic theory that cancer was caused by black bile.
Matthew Baillie (1761–1823)
An anatomist who published a text cataloging and
depicting in detail various diseases and tumors.
M AL ADIES
Joseph Lister (1827–1912)
A Scottish surgeon who pioneered the use of antiseptics
in modern medicine. His discoveries allowed for more
advanced surgical procedures.
Theodor Billroth (1829–1894)
A Viennese surgeon who meticulously explored
techniques for removing a wide variety of tumors,
focusing particularly on abdominal tumors.
William Stewart Halsted (1852–1922)
Pioneer and early proponent of the “radical” mastectomy.
With this method, not only the tumor was removed, but
a large amount of the surrounding and underlying tissue
as well.
Paul Ehrlich (1854–1915)
A German biologist and chemist who proposed the
notion of specific affinity—that biological molecules work
by virtue of binding other molecules with specificity.
Ehrlich synthesized chemicals with specific affinities for
certain microbes, including those that cause sleeping
sickness and syphilis. This discovery opened the door for
later advances in chemotherapy. Ehrlich also coined the
phrase “magic bullet” to describe specific cancer therapy.
Alfred Gilman (1908–1984)
American chemist who, working with Louis Goodman
at Yale University, used a variant of mustard gas to treat
lymphomas. Gilman and Goodman’s work was kept
secret for several years because it was performed under
contract with the wartime Office of Scientific Research
and Development.
Louis Goodman (1906–2000)
Chemist who, working with Alfred Gilman at Yale
University, used a variant of mustard gas to treat
lymphomas in the early 1940s.
Jimmy (Einar Gustafson) (1935–2001)
A young patient of Sydney Farber’s, he became the face
behind the “Jimmy” Fund and helped create a new public
interest in the fight against cancer.
Mary Lasker (1900–1994)
An influential fundraiser and activist. Together with
Sidney Farber, she helped launch the “War on Cancer” by
providing crucial energy, direction, and funding.
Clarence Cook Little (1888–1971)
A one-time president of the American Society for the
Control of Cancer, Little eventually headed the Tobacco
Industry Research Committee and became a prominent
tobacco apologist.
Vannevar Bush (1890–1974)
Director of the Office of Scientific Research and
Development and author of the influential report Science
the Endless Frontier. He helped to transition American
scientific research from a wartime footing to a focus on
less-targeted general research investigating fundamental
questions.
Emil Frei
A researcher at the National Cancer Institute who, along
with Emil Freireich and Gordon Zubrod, performed
trials of combination chemotherapy for childhood acute
lymphoblastic leukemia.
Emil Freireich
A researcher at the National Cancer Institute who, along
with Emil Frei and Gordon Zubrod, performed some of
the first combination chemotherapy trials on children
with lymphoblastic leukemia.
Gordon Zubrod (1914–1999)
Director of the National Cancer Institute’s Clinical
Center. He helped direct important early research for
childhood leukemia.
Austin Bradford Hill (1897–1991)
An influential English statistician who devised the
randomized clinical trial, whereby patients were assigned
to either the placebo or study group at random. Along
with Richard Doll, Hill also devised a seminal study
linking smoking and lung cancer.
Min Chiu Li
An NCI researcher who treated choriocarcinoma with
the antifolates and documented striking response rates. Li
used a hormonal fingerprint in the blood to direct chemo.
Howard Skipper (1915–2006)
The self-professed “mouse doctor” who provided the
animal model of combination chemotherapy that would
lead to the work of Frei and Freireich.
Thomas Hodgkin (1798–1866)
A British pathologist and anatomist who discovered and
characterized Hodgkin’s lymphoma.
Henry Kaplan (1918–1984)
An American radiologist who pioneered the use of
extended field radiation to treat Hodgkin’s disease. Kaplan
launched serial and comprehensive clinical trials using
X-rays, resulting in the cure of localized Hodgkin’s disease
by the mid-1960s.
Vincent DeVita (1935– )
A colleague of Frei, Freireich, and Zubrod at the
National Cancer Institute, he led intensive combination
chemotherapy trials for advanced Hodgkin’s disease.
DeVita, working with Canellos, also pioneered the use of
combination chemotherapy for breast cancer.
Donald Pinkel (1926– )
An oncologist and protégé of Sidney Farber, Pinkel
advanced leukemia chemotherapy by using combinations
of drugs, X-ray therapy, and direct injection of
chemotherapy into the spinal fluid to obtain striking
response rates and cures in children.
Peyton Rous (1879–1970)
A researcher at the Rockefeller Institute who discovered
the first cancer-causing virus. His work laid part of the
foundation for the modern genetic understanding of
cancer.
Geoffrey Keynes (1887–1982)
A British surgeon (and the brother of John Maynard
Keynes), Keynes doubted Halsted’s method of radical
mastectomy. Keynes used a combination of local surgery
and radiation to treat breast cancer.
George Barney Crile (1907–1992)
A surgeon who, with the help of data from Geoffrey
Keynes, cast doubt on Halsted’s theory of radical surgery.
Crile found that local surgery, even without radiation, was
just as effective as radical surgery.
Bernard Fisher (1927– )
A surgeon who launched a comprehensive clinical trial
to investigate the efficacy of various treatments for breast
cancer. He found that the radical mastectomy provided
no benefits at all with regard to survival rates, recurrence,
or mortality.
Charles Huggins (1901–1997)
A urological surgeon who established the link between
prostate cancer and testosterone. This laid the groundwork
for hormonal therapy for breast and prostate cancer.
Elwood Jensen (1920– )
A chemist and colleague of Charles Huggins, he discovered
the estrogen receptor. Jensen’s work provided the scientific
basis for the use of tamoxifen in breast cancer.
George Beatson (1848–1943)
Scottish surgeon who surgically removed ovaries in a
cohort of women with breast cancer and observed striking
remissions. Beatson was inspired by tales from Scottish
highland farmers who had shown that ovarian removal in
cows caused changes in breast tissue.
Mary (“Moya”) Cole (1918–2004)
A British oncologist and radiotherapist at Christie
Hospital in Manchester who launched the first tamoxifen
trial for breast cancer, with great success.
Paul Carbone
An oncologist who worked with colleagues at the NCI
to develop “adjuvant” chemotherapy, where the patient
is treated with chemotherapy after tumors had been
successfully removed via surgery.
Gianni Bonadonna (1934– )
An Italian oncologist who carried out the first large-scale
trial for adjuvant chemotherapy for breast cancer. The
treatment greatly reduced the prevalence of relapse.
Cecily Saunders (1918–2005)
A former nurse and physician who launched the palliative
care movement, emphasizing the role of palliative
medicine for terminally ill cancer patients.
John Cairns (1922– )
A Harvard biologist who penned an influential article for
Scientific American quantifying cancer-related deaths in
the United States. He found that while modern treatment
had made some advances, treatment still could only
benefit about one in twenty cancer patients.
John Bailar
A Harvard statistician who, along with Elaine Smith,
undertook a comprehensive mathematical analysis of
cancer mortality over three decades.
Lester Breslow
An epidemiologist who critiqued the Bailer-Smith analysis
of cancer mortality. He found that while mortality
remained high, treatment was still creating gains in terms
of “years of life saved.” voluntarily eliminating all cigarette ads from broadcast
Percivall Pott (1714–1788)
An English surgeon who deduced the link between the
prolonged exposure to chimney soot and scrotal cancer. He
was one of the first to tie cancer to an environmental cause.
Ernst Wynder (1923–1999)
An American epidemiologist who, along with Evarts
Graham, produced one of the first studies finding a
correlation between smoking and lung cancer.
Richard Doll (1912–2005)
A British epidemiologist who, along with Bradford Hill,
produced an influential study linking smoking and lung
cancer. Doll and Hill devised the “prospective” study, in
which a control and test population (e.g., smokers versus
non smokers) is studied forward in time.
Evarts Graham (1883–1957)
Coauthor with Ernst Wynder of an important early study
linking lung cancer and smoking. A long-time smoker, he
died of lung cancer himself.
Oscar Auerbach (1905–1997)
An American lung pathologist who studied the
progression of lung cancer through its various stages.
Auerbach’s results suggested that cancer develops through
multiple stages in a step-wise progression.
Luther Terry (1911–1985)
The Surgeon General of the United States, Terry
appointed an advisory committee to study the links
between lung cancer and cigarette smoking. After a long
and broad survey, the committee produced a definitive
1964 Surgeon General’s Report that clearly identified
smoking as the major cause of lung cancer.
John Banzhaf (1940– )
An American attorney who used the so-called fairness
doctrine of broadcast media to battle cigarette ads
on television. Cigarette manufacturers responded by
media in 1970.
Rose Cipollone (1926–1984)
A lifelong smoker whose death from lung cancer spurred
a Supreme Court case over the liability of cigarette
manufacturers. While her widower gained only a small
settlement, the case opened the door for other lawsuits.
Marc Edell
The New Jersey attorney who plead Rose Cipollone’s
Supreme Court case. Though he won only a relatively
small damage settlement, the case opened the door to
similar lawsuits and a settlement agreement between the
cigarette manufacturers and forty-seven states.
Bruce Ames (1928– )
A bacteriologist who developed a method to test
chemicals for the mutation rate they induced in bacteria.
Substances that induced a high rate of mutations proved
frequently to be carcinogens as well.
Baruch Blumberg (1925– )
A biologist who discovered the hepatitis B virus, which
proved to be a cause of liver cancer. This was one of the
viral carcinogens that the NCI had fruitlessly searched for.
Barry Marshall (1951– )
An Australian physician who proved that peptic ulcers
were caused by the bacterium Helicobacter pylori by
intentionally infecting himself. The bacterium also proved
to be a preventable cause of stomach cancer.
George Papanicolaou (1883–1962)
Inventor of the Pap smear, one of the first tests able
to detect cancer in its earliest stages, where it could be
excised with relatively simple surgery.
William Peters
A New York doctor who, under the guidance of Emil Frei,
created the STAMP regimen, where chemotherapy was
combined with bone marrow transplantation.
Nelene Fox (1953–1993)
A schoolteacher with advanced breast cancer, she was
refused a bone marrow transplant treatment by her
insurance provider because it was not yet clinically
proven. She raised money to pay for the procedure
herself but still died less than a year later. Her case led to
litigation in the California courts, where her family was
awarded $89 million in damages.
Werner Bezwoda
A South African physician who reported amazing success
with megadose chemotherapy treatment. His trial turned
out to be a fraud.
Maggie Keswick Jencks ( –1995)
An artist stricken with breast cancer, she underwent
high-dose chemotherapy coupled with bone marrow
transplantation that failed to save her life. She wrote
the essay A View from the Front Line to describe her
experiences.
Theodor Boveri (1862–1915)
A scientist and former assistant of Rudolf Virchow, he
put forth a chromosomal theory of cancer, whereby
abnormalities in chromosomes caused normal cells to
become malignant.
Howard Temin (1934–1994)
A virologist who discovered reverse transcription, the
mechanism by which some RNA viruses can convert
their genetic material from RNA into a DNA copy and
integrate this copy into the DNA of host organisms.
David Baltimore (1938– )
An American virologist who, with Temin, independently
discovered reverse transcription, the mechanism by which
some RNA viruses can convert their genetic material from
RNA into a DNA copy and integrate this copy into the
DNA of host organisms.
Sol Spiegelman (1914–1983)
An American virologist who, inspired by Temin’s and
Baltimore’s discovery of reverse transcription, launched an
effort to find cancer-causing viruses in the 1970s.
J. Michael Bishop (1936– )
A virologist who, working with Harold Varmus at UCSF,
discovered that homologues of the src gene were present
in all cells. Bishop would thus advance the hypothesis that
viral cancer-causing genes (viral oncogenes) were, in fact,
derived from precursor genes (proto-oncogenes) present
in all cells.
Harold Varmus (1939– )
A virologist who, working with Michael Bishop at UCSF,
discovered that homologues of the src gene were present
in all cells. Bishop and Varmus would thus advance
the hypothesis that viral cancer-causing genes (viral
oncogenes) were, in fact, derived from precursor genes
(proto-oncogenes) present in all cells.
Janet Rowley (1925– )
An American hematologist who used chromosome
staining techniques to discover that cancer cells often
contain translocated chromosomes.
Alfred Knudson (1922– )
A geneticist who proposed the “two-hit” model of tumor
suppressor genes. Since tumor suppressors need to be
inactivated and since two copies of each such gene exist in
every cell, two independent mutations are required for the
development of cancer.
Robert Weinberg (1942– )
A cancer biologist who was one of the first to isolate
oncogenes directly out of tumor cells.
Thad Dryja
An ophthalmologist-turned-geneticist who discovered the
Rb gene with the help of researchers in Robert Weinberg’s lab.
Philip Leder
An American geneticist who created genetically modified
mice to demonstrate that defined genetic alterations in
mouse genes could cause cancer development.
Bert Vogelstein (1949– )
A cancer researcher, currently at Johns Hopkins Medical
School, who characterized the step-wise progression of
genetic mutations that are present in each stage of colon
cancer. This was a first step toward understanding how
cancer was caused by mutations in key biological pathways.
Zhen Yi Wang (1924– )
A Chinese researcher who led a leukemia trial combining
chemotherapy with treatment with trans-retinoic acid
(which specifically targets the mutation responsible for the
cancer). Three-fourths of patients proved to be relapse-free.
Axel Ullrich (1943– )
A researcher at Genentech whose work led to the
development of Herceptin, an antibody that targets the
breast cancer–promoting Her-2 gene.
Dennis Slamon (1946– )
A UCLA oncologist who worked with Axel Ullrich to
develop Herceptin, an antibody that targets the breast
cancer–inducing Her-2 gene. The drug was one of the
first instances of targeted therapy in cancer.
THE EMP E ROR OF A L L
SIDDHARTHA MUKHERJEE
Marti Nelson
A breast cancer patient who was denied treatment with
Herceptin because of its experimental status. After her
death, her cause became a rallying cry for activist groups
such as the National Breast Cancer Coalition.
Brian Druker (1958– )
A researcher who was crucial in the creation of Gleevec,
a kinase inhibitor extremely effective in the treatment of
chronic myelogenous leukemia.
Mary Claire-King
American geneticist who analyzed breast-cancer-linked
families to suggest the existence of distinct breast cancer
linked genes, later found to be BRCA-1 and BRCA-2.
Atossa (550–475 BC)
Persian/Achaemenid queen, wife of Darius, who is briefly
mentioned in Herodotus’ Histories. Atossa develops
a mysterious mass in her breast that might have been
inflammatory breast cancer.
Imhotep (2655–2600 BC)
Egyptian scribe and royal physician who is the purported
author of the Edwin Smith papyrus. Imhotep wrote a
description of a disease that may have been breast cancer.
Under “Therapy,” he solemnly noted: “There is none.”
Rose Kushner (1929–1990)
Prominent and outspoken journalist and breast cancer
activist who challenged the radical mastectomy.
MA LAD I ES