300 Migration into and out of the city: See, for instance, Scandinavian Journal of Gastroenterology 30 (1995): 33–43.
300 In 1976, forty-two thousand women enrolled: Ingvar Andersson et al., “Mammographic Screening and Mortality from Breast Cancer: The Malmö Mammographic Screening Trial,” British Medical Journal 297, no. 6654 (1988): 943–48.
300 “There was only one”: Ingvar Andersson, interview with author, March 2010.
300 In 1988, at the end of its twelfth year: Andersson et al., “Mammographic Screening and Mortality.” Also Andersson, interview with author.
300 When the groups were analyzed by age: Ibid.
301 In 2002, twenty-six years after the launch of the original: Lennarth Nystöm et al., “Long-Term Effects of Mammography Screening: Updated Overview of the Swedish Randomised Trials,” Lancet 359, no. 9310 (2002): 909–19.
301 Its effects, as the statistician Donald Berry describes it: Donald Berry, interview with author, November 2009.
301 Berry wrote, “Screening is a lottery”: “Mammograms Before 50 a Waste of Time,” Science a Go Go, October 12, 1998, http://www.scienceagogo.com/news/ 19980912094305data_trunc_sys.shtml (accessed December 29, 2009).
302 “This is a textbook example”: Malcolm Gladwell, “The Picture Problem: Mammography, Air Power, and the Limits of Looking,” New Yorker, December 13, 2004.
303 “All photographs are accurate”: Richard Avedon, An Autobiography (New York: Random House, 1993); Richard Avedon, Evidence, 1944–1994 (New York: Random House, 1994).
304 “As the decade ended,” Bruce Chabner: Bruce Chabner, interview with author, August 2009.
STAMP
305 Then did I beat them: 2 Samuel 22:43 (King James Version).
306 Cancer therapy is like beating the dog: Anna Deveare Smith, Let Me Down Easy, script and monologue, December 2009.
306 “If a man die”: William Carlos Williams, The Collected Poems of William Carlos Williams: 1939–1962 (New York: New Directions Publishing, 1991), 2: 334.
306 In his poignant memoir of his mother’s illness: David Rieff, Swimming in a Sea of Death: A Son’s Memoir (New York: Simon & Schuster, 2008), 6–10.
306 “Like so many doctors”: Ibid., 8.
308 “To say this was a time of unreal”: Abraham Verghese, My Own Country: A Doctor’s Story of a Town and Its People in the Age of AIDS (New York: Simon & Schuster, 1994), 24.
308 “There seemed to be little that medicine could not do”: Ibid., 24.
309 E. Donnall Thomas, had shown that bone marrow: E. Donnall Thomas, “Bone Marrow Transplantation from the Personal Viewpoint,” International Journal of Hematology 81 (2005): 89–93.
309 In Thomas’s initial trial at Seattle: E. Thomas et al., “Bone Marrow Transplantation,” New England Journal of Medicine 292, no. 16 (1975): 832–43.
310 “We have a cure for breast cancer”: Craig Henderson, interview with Richard Rettig, quoted in Richard Rettig et al., False Hope: Bone Marrow Transplantation for Breast Cancer (Oxford: Oxford University Press, 2007), 29.
311 “It was an intensely competitive place”: Robert Mayer, interview with author, July 2008.
311 In 1982, Frei recruited William Peters: Shannon Brownlee, “Bad Science and Breast Cancer,” Discover, August 2002.
311 In the fall of 1983, he invited Howard Skipper: William Peters, interview with author, May 2009.
312 a “seminal event”: Ibid.
312 George Canellos, for one, was wary: George Canellos, interview with author, March 2008.
312 “We were going to swing and go for the ring”: Brownlee, “Bad Science and Breast Cancer.”
312 The first patient to “change history” with STAMP: Ibid., and Peters, interview with author.
313 “The ultimate trial of chemotherapeutic intensification”: Peters, interview with author.
314 “Suddenly, everything broke loose”: Ibid.
314 The woman was thirty-six years old: Ibid.
314 “the most beautiful remission you could have imagined”: Ibid.
315 In March 1981, in the journal Lancet: Kenneth B. Hymes et al., “Kaposi’s Sarcoma in Homosexual Men—a Report of Eight Cases,” Lancet 318, no. 8247 (1981): 598–600.
316 “gay compromise syndrome”: Robert O. Brennan and David T. Durack, “Gay Compromise Syndrome,” Lancet 318, no. 8259 (1981): 1338–39.
316 In July 1982, with an understanding of the cause: “July 27, 1982: A Name for the Plague,” Time, March 30, 2003.
316 In a trenchant essay written as a reply: Susan Sontag, Illness as Metaphor and AIDS and Its Metaphors (New York: Picador, 1990).
317 For Volberding, and for many of his earliest: See ACT UP Oral History Project, http://www.actuporalhistory.org/.
317 Volberding borrowed something more ineffable: Arthur J. Amman et al., The AIDS Epidemic in San Francisco: The Medical Response, 1981–1884, vol. 3 (Berkeley: Regional Oral History Office, the Bancroft Library, University of California, Berkeley, 1997).
317 “What we did here”: Ibid.
318 In January 1982, as AIDS cases boomed: “Building Blocks in the Battle on AIDS,” New York Times, March 30, 1997; Randy Shilts, And the Band Played On (New York: St. Martin’s Press).
318 In January 1983, Luc Montagnier’s group: Shilts, And the Band Played On, 219; F. Barré-Sinoussi et al. “Isolation of a T-Lymphotropic Retrovirus from a Patient at Risk for Acquired Immune Deficiency Syndrome (AIDS),” Science 220, no. 4599 (1983): 868–71.
318 Gallo also found a retrovirus: Mikulas Popovic et al., “Detection, Isolation, and Continuous Production of Cytopathic Retroviruses (HTLV-III) from Patients with AIDS and Pre-AIDS,” Science 224, no. 4648 (1984): 497–500; Robert C. Gallo et al., “Frequent Detection and Isolation of Cytopathic Retroviruses (HTLV-III) from Patients with AIDS and at Risk for AIDS,” Science 224, no. 4648 (1984): 500–503.
318 On April 23, 1984, Margaret Heckler: James Kinsella, Covering the Plague: AIDS and the American Media (Piscataway, NJ: Rutgers University Press, 1992), 84.
318 In the spring of 1987: Steven Epstein, Impure Science: AIDS, Activism, and the Politics of Knowledge (Berkeley: University of California Press, 1998), 219.
318 “genocide by neglect”: Ibid., 221.
318 “Many of us who live in daily terror”: “The F.D.A.’s Callous Response to AIDS,” New York Times, March 23, 1987.
318 “Drugs into bodies”: Raymond A. Smith and Patricia D. Siplon, Drugs into Bodies: Global AIDS Treatment Activism (Santa Barbara, CA: Greenwood Publishing Group, 2006).
318 “The FDA is fucked-up”: “Acting Up: March 10, 1987,” Ripples of Hope: Great American Civil Rights Speeches, ed. Josh Gottheimer (New York: Basic Civitas Books, 2003), 392.
318 “Double-blind studies”: “F.D.A.’s Callous Response to AIDS,” New York Times.
318 He concluded, “AIDS sufferers”: Ibid.
320 By the winter of 1984, thirty-two women: Peters, interview with author.
320 “There was so much excitement within the cancer community”: Donald Berry, interview with author, November 2009.
320 Peters flew up from Duke to Boston: Peters, interview with author.
The Map and the Parachute
321 Oedipus: What is the rite of purification?: Sophocles, Oedipus the King.
321 Transplanters, as one oncologist: Craig Henderson, quoted in Brownlee, “Bad Science and Breast Cancer.”
321 Nelene Fox and bone marrow transplantation: See Michael S. Lief and Harry M. Caldwell, And the Walls Came Tumbling Down: Closing Arguments that Changed the Way We Live, from Protecting Free Speech to Winning Women’s Sufferage to Defending the Right to Die (New York: Simon & Schuster, 2004), 299–354; “$89 Million Awarded Family Who Sued H.M.O.,” New York Times, December 30, 1993.
322 On June 19, a retinue: Lief and Caldwell, And the Walls Came Tumbling Down, 310.
322 “You marketed this coverage to her”: Ibid., 307.
323 In August 1992, Nelene Fox: Ibid., 309.
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br /> 323 “The dose-limiting barrier”: S. Ariad and W. R. Bezwoda, “High-Dose Chemotherapy: Therapeutic Potential in the Age of Growth Factor Support,” Israel Journal of Medical Sciences 28, no. 6 (1992): 377–85.
323 In Johannesburg, more than 90 percent: W. R. Bezwoda, L. Seymour, and R. D. Dansey, “High-Dose Chemotherapy with Hematopoietic Rescue as Primary Treatment for Metastatic Breast Cancer: A Randomized Trial,” Journal of Clinical Oncology 13, no. 10 (1995): 2483–89.
324 On April 22, eleven months after: Lief and Caldwell, And the Walls Came Tumbling Down, 309.
324 In 1993 alone: Papers were assessed on www.pubmed.org.
324 “If all you have is a cold or the flu”: Lief and Caldwell, And the Walls Came Tumbling Down, 234.
324 On the morning of December 28, 1993: Ibid.
324 That evening, it returned a verdict: “$89 Million Awarded Family,” New York Times.
325 In Massachusetts, Charlotte Turner: “Cancer Patient’s Kin Sues Fallon” and “Coverage Denied for Marrow Transplant,” Worcester (MA) Telegram & Gazette, December 7, 1995; Erin Dominique Williams and Leo Van Der Reis, Health Care at the Abyss: Managed Care vs. the Goals of Medicine (Buffalo, NY: William S. Hein Publishing, 1997), 3.
325 Between 1988 and 2002: See Richard Rettig et al., eds., False Hope: Bone Marrow Transplantation for Breast Cancer (New York: Oxford University Press, 2007), 85, and Table 3.2.
325 “complicated, costly and potentially dangerous”: Bruce E. Brockstein and Stephanie F. Williams, “High-Dose Chemotherapy with Autologous Stem Cell Rescue for Breast Cancer: Yesterday, Today and Tomorrow,” Stem Cells 14, no. 1 (1996): 79–89.
325 Between 1991 and 1999, roughly forty thousand: JoAnne Zujewski, Anita Nelson, and Jeffrey Abrams, “Much Ado about Not . . . Enough Data,” Journal of the National Cancer Institute 90 (1998): 200–209. Also see Rettig et al., False Hope, 137.
326 “Transplants, transplants, everywhere”: Robert Mayer, interview with author, July 2008.
326 As Bezwoda presented the data: W. R. Bezwoda, “High Dose Chemotherapy with Haematopoietic Rescue in Breast Cancer,” Hematology and Cell Therapy 41, no. 2 (1999): 58–65. Also see Werner Bezwoda, plenary session, American Society of Clinical Oncology meeting, 1999 (video recordings available at www.asco.org).
326 three other trials presented that afternoon: Ibid.
326 At Duke, embarrassingly enough: Ibid.
326 “even a modest improvement”: Ibid.
326 A complex and tangled trial from Sweden: Ibid.
326 “My goal here,” one discussant began: Ibid.
327 “People who like to transplant will continue to transplant”: “Conference Divided over High-Dose Breast Cancer Treatment,” New York Times, May 19, 1999.
327 Investigation of Bezwoda’s breast cancer study: Raymond B. Weiss et al., “High-Dose Chemotherapy for High-Risk Primary Breast Cancer: An On-Site Review of the Bezwoda Study,” Lancet 355, no. 9208 (2000): 999–1003.
328 Another patient record, tracked back to its origin: “Bezwoda,” Kate Barry (producer), archived in video format at http://beta.mnet.co.za/Carteblanche, M-Net TV Africa (March 19, 2000).
328 “I have committed a serious breach of scientific honesty”: “Breast Cancer Study Results on High-Dose Chemotherapy Falsified,” Imaginis, February 9, 2000, http://www .imaginis.com/breasthealth/news/news2.09.00.asp (accessed January 2, 2010).
328 “By the late 1990s, the romance was already over”: Robert Mayer, interview with author.
328 Maggie Keswick Jencks: Maggie Keswick Jencks, A View from the Front Line (London, 1995).
329 “There you are, the future patient”: Ibid., 9.
330 In May 1997, exactly eleven years after: John C. Bailar and Heather L. Gornik, “Cancer Undefeated,” New England Journal of Medicine 336, no. 22 (1997): 1569–74.
332 Pressed on public television, he begrudgingly conceded: “Treatment vs. Prevention,” NewsHour with Jim Lehrer, May 29, 1997, PBS, transcript available at http://www.pbs .org/newshour/bb/health/may97/cancer_5–29.html (accessed January 2, 2010).
332 “‘Cancer’ is, in truth, a variety of diseases”: Barnett S. Kramer and Richard D. Klausner, “Grappling with Cancer—Defeatism versus the Reality of Progress,” New England Journal of Medicine 337, no. 13 (1997): 931–35.
PART FIVE:
“A DISTORTED VERSION OF OUR NORMAL SELVES”
335 It is vain to speak of cures: Robert Burton, The Anatomy of Melancholy (: C. Armstrong and Son, 1893), 235.
335 You can’t do experiments to see: Samuel S. Epstein, Cancer-Gate: How to Win the Losing Cancer War (Amityville, NY: Baywood Publishing Company, 2005), 57.
335 What can be the “why” of these happenings?: Peyton Rous, “The Challenge to Man of the Neoplastic Cell,” Nobel Lectures, Physiology or Medicine, 1963–1970 (Amsterdam: Elsevier Publishing Company, 1972).
“A unitary cause”
340 As early as 1858: Rudolf Virchow, Lecture XX, Cellular Pathology as Based upon Physiological and Pathological Histology, trans. Frank Chance (London: Churchill, 1860). The passage on irritation appears on page 488 of the translated version: “A pathological tumor in man forms . . . where any pathological irritation occurs . . . all of them depend upon a proliferation of cells.”
340 Walther Flemming, a biologist working in Prague: Neidhard Paweletz, “Walther Flemming: Pioneer of Mitosis Research,” Nature Reviews Molecular Cell Biology 2 (2001): 72–75.
340 It was Virchow’s former assistant David Paul von Hansemann: Leon P. Bignold, Brian L. D. Coghlan, and Hubertus P. A. Jersmann, eds., Contributions to Oncology: Context, Comments and Translations (Basel: Birkhauser Verlag, 2007), 83–90.
341 Boveri devised a highly unnatural experiment: Theodor Boveri, Concerning the Origin of Malignant Tumours by Theodor Boveri, translated and annotated by Henry Harris (New York: Cold Spring Harbor Press, 2006). This is a reprint and new translation of the original text.
342 “unitary cause of carcinoma”: Ibid., 56.
342 not “an unnatural group of different maladies”: Ibid., 56.
342 In 1910, four years before Boveri had published his theory: Peyton Rous, “A Transmissible Avian Neoplasm (Sarcoma of the Common Fowl),” Journal of Experimental Medicine 12, no. 5 (1910): 696–705; Peyton Rous, “A Sarcoma of the Fowl Transmissible by an Agent Separable from the Tumor Cells,” Journal of Experimental Medicine 13, no. 4 (1911): 397–411.
342 In 1909, a year before: Karl Landsteiner et al., “La transmission de la paralysie infantile aux singes,” Compt. Rend. Soc. Biologie 67 (1909).
343 In the early 1860s, working alone: Gregor Mendel, “Versuche über Plfanzenhybriden,” Verhandlungen des Naturforschenden Vereines in Brünn. IV für das Jahr 1865, Abhandlungen (1866): 3–47. English translation available at http://www.esp.org/foundations/genetics/classical/gm-65.pdf (accessed January 2, 2010). Also see Robin Marantz Henig, The Monk in the Garden: The Lost and Found Genius of Gregor Mendel, the Father of Genetics (Boston: Mariner Books, 2001), 142.
343 decades later, in 1909, botanists: Wilhelm Ludwig Johannsen, Elemente der Exakten Erblichkeitlehre (1913), http://caliban.mpiz-koeln.mpg.de/johannsen/elemente/index.html (accessed January 2, 2010).
344 In 1910, Thomas Hunt Morgan: See T. H. Morgan, “Chromosomes and Heredity,” American Naturalist 44 (1910): 449–96. Also see Muriel Lederman, “Research Note: Genes on Chromosomes: the Conversion of Thomas Hunt Morgan,” Journal of the History of Biology 22, no. 1 (1989): 163–76.
344 The third vision of the “gene”: Oswald T. Avery et al., “Studies on the Chemical Nature of the Substance Inducing Transformation of Pneumococcal Types: Induction of Transformation by a Deoxyribonucleic Acid Fraction Isolated from Pneumococcus Type III,” Journal of Experimental Medicine 79 (1944): 137–58.
345 George Beadle, Thomas Morgan’s student: See George Beadle, “Genes and Chemical Reactions in Neurospora,” Nobel Lectures, Physiology or Medicine, 1942–1962 (Amsterdam: Elsevier Publishing Company, 1964)
, 587–99.
346 In the mid-1950s, biologists termed: See for instance Francis Crick, “Ideas on Protein Synthesis,” October 1956, Francis Crick Papers, National Library of Medicine. Crick’s statement of the central dogma proposed that RNA could be back converted as a special case, but that proteins could never be back converted into DNA or RNA. Reverse transcription was thus left as a possibility.
347 In 1872, Hilário de Gouvêa: A. N. Monteiro and R. Waizbort, “The Accidental Cancer Geneticist: Hilário de Gouvêa and Hereditary Retinoblastoma,” Cancer Biology and Therapy 6, no. 5 (2007): 811–13.
348 In 1928, Hermann Joseph Muller: See Hermann Muller, “The Production of Mutations,” Nobel Lectures, Physiology or Medicine, 1942–1962 (Amsterdam: Elsevier Publishing Company, 1964).
348 “the doctor may then want to call in his geneticist friends for consultation!”: Thomas Morgan, “The Relation of Genetics to Physiology and Medicine,” Nobel Lectures, Physiology or Medicine 1922–1941 (Amsterdam: Elsevier Publishing Company, 1965).
Under the Lamps of Viruses
349 Unidentified flying objects, abominable snowmen: Medical World News, January 11, 1974.
349 The biochemist Arthur Kornberg once joked: Arthur Kornberg, “Ten Commandments: Lessons from the Enzymology of DNA Replication,” Journal of Bacteriology 182, no. 13 (2000): 3613–18.
351 Temin was cooking up an unusual experiment: See Howard Temin and Harry Rubin, “Characteristics of an Assay for Rous Sarcoma Virus,” Virology 6 (1958): 669–83.
351 “The virus, in some structural as well as functional sense”: Howard Temin, quoted in Howard M. Temin et al., The DNA Provirus: Howard Temin’s Scientific Legacy (Washington, DC: ASM Press, 1995), xviii.
352 “Temin had an inkling”: J. Michael Bishop, interview with author, August 2009.
352 “The hypothesis”: J. Michael Bishop in Temin et al., DNA Provirus, 81.
353 Mizutani was a catastrophe: See Robert Weinberg, Racing to the Beginning of the Road (New York: Bantam, 1997), 61.
353 At MIT, in Boston: Ibid., 61–65.
353 “It was all very dry biochemistry”: Ibid., 64.
The Emperor of All Maladies Page 65
