General Articles

CANCER CAN BE BEATEN

There’s hopeful news about cancer. One authority predicts: "The cure will come and, I believe, well within our time.”

C. FRED BODSWORTH April 15 1948
General Articles

CANCER CAN BE BEATEN

There’s hopeful news about cancer. One authority predicts: "The cure will come and, I believe, well within our time.”

C. FRED BODSWORTH April 15 1948

CANCER CAN BE BEATEN

There’s hopeful news about cancer. One authority predicts: "The cure will come and, I believe, well within our time.”

C. FRED BODSWORTH

NEVER had the elevator cage of a Canadian mine carried so strange a company of passengers. Past the 1,000-foot level it plunged without slackening speed, past the 2,000foot level. At 3,000 feet the mine cage stopped and into the rock corridor opposite the shaft were unloaded 200 wire pens. Each pen contained 10 lively scampering white mice—but not ordinary mice, for these pink-eyed little animals were representatives of a carefully bred strain whose pedigrees were known for 25 generations back.

Those 2,000 purebred mice, scuttering about their cages in the dank gloom of a Northern Ontario mine, are being reared in Canada’s first underground laboratory for cancer research.

Strange proceedings, indeed! Yet out of that Northern Ontario mine may come a new clue in science’s quest for a cure to halt the ravages of mankind’s second deadliest killer. Have cosmic rays, those mysterious radioactive emanations bombarding the earth from the sun, anything to do

with causing cancer? Two years from now those 2,000 mice, sheltered by the mine’s depth from the rays, may provide the answer.

The mice-in-the-mine episode is but one small phase of a world-wide campaign in cancer research which has scientists delving more deeply into the secrets of life itself than ever before.

Their battle line extends far beyond the realm of medical science alone. The research is so interwoven with problems of physics, chemistry, biology and the allied sciences that the layman can get

merely a glimmer of understanding here and there of what is going on. For cancer is not an ailment of any single body organ or tissue that follows a readily understood disease pattern. It is merely the growth of one of the body’s microscopic cells that has gone completely wild. Why these growth processes go berserk is a secret that is locked within the complex biochemical workings of the cell itself, the smallest body unit of growth.

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Cancer Can Be Beaten

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removed from the human anatomy. They are studying the manner in which cells divide in sprouting barley and rice, peering into the embryonic development of salmon eggs and the rate at which food is absorbed by growing yeast cells and probing into the chemical secretions which make minute insect larvae at a certain stage of their life turn into flies. For growth, be it in a grain of sprouting rice, a hollyhock flower or a man, follows the same basic pattern. And what science learns from a grain of rice or a cell of yeast may have a definite application to the function of cells in the human body.

Where is the research battle getting?

One of Canada’s leading cancer researchers told me: “The outlook is

hopeful. No one is likely to pull a cancer cure out of the hat, but the cure will come and, I believe, well within our time.”

Gradually researchers are accumulating a knowledge of how the normal body cell functions and of what happens when the normal cell goes wild and becomes a cancer cell. This is the basic knowledge out of which a cure for cancer will come.

The Mice in the Mine

But first, let’s go back to our 2,000 mice in the Northern Ontario mine.

Since the infancy of cancer research, irradiation such as ultra-violet light, X-rays and gamma rays has been known to induce cancerous growths when absorbed in excessive quantities. Before this danger was recognized, numerous cases of cancer developed among X-ray technicians who had been subjecting themselves constantly over a period of years to the rays of their apparatus. Cosmic rays, which are believed to be the radioactive emanations thrown off by atomic disintegration of the sun, belong in this same class of irradiation. And they are showering the earth in a never-ending cloud, piercing the walls of our buildings and penetrating deep into the earth itself. Could they be the trigger which sets off that abnormal cell development we know as cancer?

Scientists in Switzerland have tried to answer this question by conducting cancer experiments high in the Alps, where cosmic radiation is more intense than at lower altitudes. Dr. William R. Franks, director of cancer research at the University of Toronto’s Banting Institute, decided to approach the problem from a different angle. Could he get deep into the earth beyond the range of cosmic rays and conduct experiments on cancer there?

From the Carnegie Institute of Washington he borrowed a MillikanNeher cosmic-ray electroscope, a cumbersome $50,000 apparatus weighing 600 pounds (there are only three of them in the world), capable of measuring the strength of cosmic rays. Last summer he took this instrument into a Northern Ontario mine and found that the cosmic-ray radiation 3,000 feet below the ground was only one twentythousandth of what it is at the surface.

Next—those mice. Through years of selective breeding—mating cancerous mice with cancerous mice repeatedly—scientists have developed strains in which 99 out of 100 are certain to develop and die of cancer. A few weeks ago mice from one of those highly cancerous strains were taken down into the Northern Ontario mine. More of the same strain will be kept under identical conditions on the surface for comparison purposes. Two years from now, will those mice-turned-miners be

freer of cancer than their brothers and sisters on the surface?

If they are, science will have a clue that cosmic rays are among the villains in cancer. What then? We can’t all go underground to get away from cosmic radiation. But scientists can conduct further investigations underground knowing that one causative factor has been eliminated. And, having eliminated one, they will have a cleaner slate on which to study the other known causes.

What Cancer Is

Each year more than 14,000 Canadians die of cancer. It is the second killer in our Canadian mortality statistics, exceeded only by diseases of the heart and arteries. Canada’s dead and missing in the Second World War numbered 38,834; during the same period almost 80,000 Canadians died of cancer.

Yet cancer, one of the most deadly and excruciating of fleshly afflictions, is human flesh itself. Cancer, which down the years has been regarded practically as a synonym for death, is life—the life of one minute body cell gone wild.

All parts of the human body—bone, flesh, skin—are composed of these infinitesimal cells. Life starts as a single cell when a male sperm and a female ovum unite. This original cell divides and becomes two, the two become four and the chain goes on and on, some of the cells forming bone, some muscle and so on, until the body is fully formed and functioning and ready for birth. All growth—in plants as well as animals—is accomplished by this pattern of cell division.

But hidden somewhere in the biochemical make-up of the.se cells is a substance which puts on the brakes when the proper amount of growth has been reached. The embryo bud cell which formed your hand divided and divided until the hand was complete with five fingers and then the division halted. Cash one of those fingers and the growth mechanism in the surrounding cells goes into operation again, but when the newly formed cells have produced a scar which closes the wound the brakes go on and the growth stops.

Cancer occurs when, anywhere in the body, one tiny cell shakes itself free of the braking influence which halted its growth and starts growing all over again abnormally. It splits into two, into foflr, into eight. It invades neighboring tissues. If left to itself the cancer will grow on and on by cell division until it blocks off or interferes with the function of some vital organ and causes death to the victim.

Although we know few of the fundamental why’s and how’s of cancer growth, medical science nevertheless has two effective means of dealing with it. Cancer can be removed by surgery or the cancer cells can be killed by radiation from X-rays or radium. But for either of these treatments to be successful, they must be performed while the cancer is still at an early stage of growth, for cancer’s most venomous trait is that it won’t stay put in one place. Once the cancer has broken through into a blood vessel or lymph channel some of its cells may be broken off and carried to other parts of the body. And wherever they lodge, these hitchhiking cancer messengers start new cancers growing. This spread is what doctors know as metastasis.

If a cancer is eradicated by surgery, radium or X-ray before metastasis has begun, the cure is complete and final. Skin cancer, when treated early, is cured in 95% of cases; if the treatment is delayed, it Is only 30% curable. Early cancer of the breast is 75%

curable, late cancer of the breast 20%. The Canadian Cancer Society claims that half of Canada’s 11,000 cancer deaths each year could be prevented if people understood the nature and symptoms of the disease and sought, early treatment.

Why then is so much effort being expended in cancer research? Because X-ray, radium and surgery are all indirect approaches at treatment. They are merely means of removing the result, instead of getting at the basic cause. Cancer researchers are looking for the agent which turns a normal, properly functioning cell into a berserk unit which quits its appointed job and throws all its energy into the building of new growth. When they find it, they are sure it will point a way to a remedy.

Who Is the Murderer?

Researchers KNOW that there is a remedy, for they have seen t.'nat remedy at work. On very rare occasions, there have been cancers in humans and in animals which have cured themselves spontaneously. These cases are so rare that there are not more than three or four in all the millions of human cancer cases on the medical records of the world. Yet they are proof that the body, unaided, can, under some unknown conditions, produce its own cancer cure.

The story of cancer research, as it stands today, is like a detective story whose author has stopped with the : story half written because he has • forgotten whom he intended as the murderer.

The basic clue is that scientists have discovered three general means of producing cancer in experinu ntal animals. These methods are: 1. The

application to the skin or injection into the tissue of certain chemicals which scientists call carcinogens; 2. By irradiation—ultra-violet, X-ray, radium and others; 3. By the injection of a virus filtered out of other cancerous tissue. Presumably all three work in the same manner—they release one or more of the body cells from the brakes which hold their growth in check and permit the cells to start a wild rampage of division and growth. The chief effort of modern cancer research is to find out why. And since the ordinary microscope reveals only the anatomical structure of the cell, and not its chemical constitution, the researchers are delving into a hidden world.

But the clues are piling up rapidly. Those carcinogenic (cancer-producing) chemicals, for instance. Scientists have now classified more than 300 of them. They are working backward in the hope that learning how to cause cancer may teach them how to prevent it.

A few weeks ago Dr. Franks sat behind his desk in a Banting Institute office and picked up a small jar containing not more than a dozen tablespoonfuls of a grey powder. “That chemical is di-benz-anthracene,” he said. “There is enough in that jar to produce cancer in every man, woman and child in the city of Toronto.”

The commonest carcinogenic chemicals are coal-tar derivatives. Recently, in Britain and the U. S., researchers have been trying to determine whether there is any relation between sooty atmosphere and cancer. Surveys have shown that cancer of the lung is commonest in cities where smoke and automobile fumes are densest.

Does smoky air carry carcinogenic chemicals into the lungs and thereby cause or increase the chances of cancer? The evidence is far from complete, but at least the suggestion has arisen that this may be true.

But out of the study of carcinogenic

chemicals has come a far more signiI ficant clue. Scientists have classified ! a large group of these chemicals as sharing the same type of molecular base. That is, the atoms of carbon, hydrogen and oxygen linked together in each molecule are linked together according to a pattern which is true of all the carcinogenic chemicals in that group. When scientists started looking for this same molecular pattern elsewhere, they found it in several of the hormones, particularly the sex hormones, which are produced in the human body.

Hormones are chemicals manufactured in the endocrine glands—the thyroid, pituitary, pancreas, sex glands and otherswhich are picked up by the blood stream and carried throughout the body, where each has its own role to play in influencing the activities of tissue cells. The hormone of the pancreas, for instance, is insulin, necessary for proper formation and use of j sugar in the body.

Now cancer research was on a new track. If certain of the body’s own hormones and those carcinogenic chemicals were next-docr neighbors so far as t heir molecular structure was concerned, could something occasionally go wrong with the body’s manufacture of hormones so that what is produced is not I a true hormone at all but a related chemical which bears a cancer-producing tendency?

Out of this have come several interesting experiments, which show that the sex hormones produced by the ovaries and testes bear a close relation to cancer of the breast and cancer of the prostate gland. Several experimenters have actually induced cancer in female mice by merely injecting excess quantities of the female sex hormone, estrone. And these cancers do not appear at the site of injection, as they would with other carcinogenic materials, but always in the breast. These findings suggest that cancer of the breast, the second commonest type of cancer in women, might be associated with an overfunctioning of the ovaries which produce the hormone estrone.

It is suspected that the male sex hormone, testosterone, may play a similar role in cancer of the prostate in men. This belief has led to a new treatment for this type of cancer— removal of the testes to block off the hormone’s source, or the injection of female sex hormone which reduces the hormone-producing activity of the testes. Prostate cancers have' been forced to regress by this means, but the work is yet too new for doctors to determine whether such treatment results in permanent benefit.

If further investigations prove that sex hormones are responsible for these cancers, science may some day find a way of measuring the rate of hormone production so as to detect in advance whether a person is likely to develop cancer of the breast or prostate. Then a means may he developed to control this hormone production and eliminate the cancer danger in such persons.

The Opposing Hormones

Other researchers are working on the theory that somewhere there may be a hormone powerful enough to check the advance of cancer anywhere in the Ixidy. The co-workers for one of these projects which is being conducted in Toronto are tens of thousands of the small iridescent blue variety of housefly. These flies, in a life cycle of 21 days, go through all the cellular development that in a human being takes 70 years.

Specifically, the Toronto researchers are investigating the hormones which cause the flies at a certain stage of their

development to change in a day from active ravenous larvae (we call them maggots) into dormant pupae.

Two glands and two hormones are involved. The hormone from one of these glands keeps the cells in line and prevents the cellular change into a pupa. Eventually, though, the second gland becomes dominant, its hormone overpowers the change-resisting effect of the first hormone, the cells’ structure alters and the insect passes into the dormant pupa state. Would that change-resistant hormone also prevent the change from normal to cancer cells in other animals? And, if so, could it serve as a serum which would prevent the inception of cancer in humans? At the present the Toronto researchers are testing the hormone on mice to observe the effect on cancer incidence.

The Virus Theory

Across a whitewashed hall from the room containing those beefsteak-fattened flies is another room filled with wire pens which house 200 chickens. This room contains one of cancer research’s biggest notes of hope, for many of those chickens have been made immune to certain types of cancer. Their story goes back to days before the war when Dr. Franks and the late Sir Frederick Banting were co-operating on this project. And it is a story apart from that phase of cancer research involving carcinogenic chemicals and hormones, a story instead which centres about the virus theory of cancer origin.

Here we bump into a brand-new theory in medical science. Until recently it was believed that viruses were living organisms the same as bacteria only a great deal smaller. Now it is known that viruses are chemical substances which can arise only within body cells. They are responsible for scores of human disease, among them infantile paralysis, mumps, the common cold and influenza.

But to understand this virus story, we must trace it back still further to the cell’s plasma genes—the microscopic units in the cell which are believed to keep cells dividing true to type. It is believed that the plasma genes are what causes a skin cell, when it divides, to form another skin cell, a bone cell to form new bone cells and so on. Now, since viruses can originate only within the body cells themselves, some researchers suspect that these plasma genes can be modified by outside influences and turn themselves (mutate, the scientists call it) into viruses which cause disease. Presumably a chill causes them to mutate into the virus capable of causing the common cold. Or the mutation may take a different form, causing mumps, influenza or one of many other diseases. In the case of cancer, the outside influence may be irradiation, carcinogenic chemicals in the dust of the air, or the body’s own hormones.

Says Dr. Franks: “All this is as yet highly theoretical, but the possibilities behind it are tremendous. A vast new vista of medical research is opening up. For if cancer research can uncover a serum, a vaccine or a drug capable of curing or preventing cancer by halting the mutation of those plasma genes, it is even possible that the same substance may turn out to be a cure not only for cancer but for all the scores of virus diseases with which humanity is afflicted.”

However, only in a few types of cancer in fowl, rabbits and mice has a virus yet been actually isolated as the cancer’s cause, which brings us back to Dr. Franks’ chickens.

The commonest virus cancer is one known as Rous sarcoma and the only animals yet found susceptible to it are

fowl. Working with Rous sarcoma in chickens before the war, Drs. Banting and Franks made a startling observation. They noticed that when a chicken with this cancer was cured by X-ray treatment and the dead cancer cells left in the body to be absorbed, that the bird became immune and could not be given a cancer a second time.

The war intervened and the two researchers wrere forced to abandon their cancer-immune chickens and devote their efforts to wartime research projects. Dr. Banting lost his life in a Newfoundland air crash in 1941 while on his way to Britain in connection with research in aviation medicine. Now, after a seven-year interval, Dr. Franks is just resuming his study of the Rous sarcoma immunity.

Is the immunity the result of antibodies which are left in the system when the dead cancer cells are absorbed? Does something like this happen in chickens alone, or do those extremely rare cases of spontaneous cancer cures or cancer immunity in humans mean that the same principle works in us as well? And does it mean that there might be a serum which could be derived from chickens or other animals that have had cancer and which would prevent the development of cancer in humans?

A survey of patients in Ontario who have been cured of cancer has been commenced to determine whether there is any evidence of cancer immunity among them.

Heredity Not a Factor

There are 20,000 such persons who have been treated by cancer clinics in Ontario and if these persons develop new cancers at the same rate as the average population, there should be 40 new cancer cases among those 20,000 each year. If they possess some degree of immunity after being cured of cancer once, the rate will be far less than 40 cases a year.

At least 400 cases will be needed on which to base a verdict, so it is expected the survey will have to continue for at least 10 years. The clinical and bookkeeping work involved will make it one of the biggest medical surveys ever conducted in Canada.

Several other researchers are seeking an answer to a problem of long standing —is cancer hereditary? Despite the fact that cancerous mice have been bred, it is now certain that heredity plays no role in cancer of humans. The reason is that we are such mongrels.

In order to obtain a strain of mice with a high rate of spontaneous cancer, selective breeding must be carried out for 20 or more generations. Brothers are mated with sisters, sons with mothers, those free of cancer are weeded out, until eventually a family strain is developed in which practically every individual born will, during its lifetime, develop a cancer. To duplicate this in mankind, we would have to have a family which has bred only among its own members since before the days of Columbus.

But, even with mice, it is now doubted that cancer is handed down in a true hereditary fashion. Dr. John J. Bittner of Bar Harbor, Me., found that if he took high breast-cancer strain mice away from their mothers as soon as they were born and let them nurse with a foster mother of a low cancer strain the mice grew up and developed no cancer. From his experiments it has been determined that the cancer susceptibility is not in the hereditary germ cell itself but is a virus agent in the mother’s milk. This, known as the “milk factor,” is the centre of another big phase of cancer research.

Radioactive isotopes, byproducts of the atom bomb, have been loudly proclaimed as offering a promising new method of cancer treatment. The isotopes are chemical elements treated in the cyclotron or atomic pile so that their atoms are breaking down and releasing radioactive rays in the process. But some cancer researchers claim their value has been overrated. Isotopes merely offer another form of the irradiation treatment which medical science has already possessed for years in radium and the X-ray.

Only in one type of cancer—cancer of the thyroid gland—have isotopes proved to be any improvement over radium or X-ray radiation. The thyroid is not a common cancer site and thus far only 15% of thyroid cancers are of a type suitable for treatment with isotopes.

Detection Saves Lives

Thousands more lives could be saved by present cancer treatment methods if more cancers were detected early while surgery, X-rays or radium could still be effective. For example, cancer of the skin or of the lip has only a five per cent death rate because it is practically always recognized and treated early. But cancer of the lung, which is no different from cancer of the skin except that it is on an interior tissue of the

body, kills 80ri of its victims simply because it has usually progressed too far for treatment before it is detected.

At least four promising developments in cancer detection have arisen in the U. S. recently. These tests depend on detecting changes which occur in the urine or blood whenever a cancer is present anywhere in the body. But, despite much publicity to the contrary, cancer exports say that all of these tests are still far from the stage of perfection and accuracy necessary before they can be put into general use.

Another method of cancer detection is the vaginal smear test in which cancer of the womb can sometimes lie diagnosed at an early stage. This cancer kills more women than any other type. The test relies on the spotting under a microscope of cast-off cancer cells in a smear taken from the mucous secretion of the vagina. It was first developed some years ago by two doctors in the U. S., but it could not be adapted for general use because only highly skilled experts in cell identification were qualified to perform it. A young Canadian doctor, Dr. J. Ernest Ayre of Montreal, improved the method by perfecting a means of fixing and staining the smears on microscope slides so that the smears were preserved long enough to be sent air mail over long distances to points where qualified experts could perform the diagnosis. Its accuracy, however, is still questioned by the majority of cancer authorities.

Research Takes Money

Canada’s contribution toward Helving the cancer riddle has already l>een an important one, but it has suffered repeated setbacks l>ecuuae of the limited funds available. (Canada in 1947 spent $200,000 in cancer research, the U. S. more than $15 millions.)

Most cancer research in Canada is financed by public donations received in campaigns conducted periodically by the Canadian Cancer Society or by branches of the Cancer Treatment and Research Foundation in the vurious provinces. Some research assistance comes from the federal and provincial governments and a few Canadian universities are financing cancer research projects from their own funds.

All Canadian scientists directing the research are men who are forced to make it a spare-time activity while they earn their livings at other work, usually university positions. And their helpers, most of them young, fully trained doctors, must remain so underpaid that the research directors are faced with a constant battle in maintaining experienced staffs.

Dr. Franks described the loss of one of his most promising assistants recently. “He wanted to get married, so he had to take another position that paid him a decent living. He held M.A. and M.I). degrees, but we could employ him only one year at a time for $200 a month.”

Cancer researchers are doing a job that is certain, eventually, to prolong and save millions of lives, yet they must go, hats in their hands, at the end of each experiment to beg funds with which to conduct their next project.

Cancer is a disease that science until recently has neglected. It is so complex and formidable that it has frightened research. Somone may stumble a croas a cancer cure tomorrow, but more likely the cure will take form like a jigsaw puzzle out of the combined work of numerous scientists in numerous countries.

And the most promising feature in the cancer-research picture is that the researchers who have had the longest experience with cancer are the men who today are most hopeful. if