A doctor's undying quest to find a cure for cancer

December 13, 1992|By Gerri Kobren


343 pages. $24.95. Twenty-four years ago, Dr. Steven Rosenberg encountered the medical miracle that would direct the rest of his professional life.

As a resident in surgery at the veterans' hospital in West Roxbury, Mass., he met a man who had been declared terminal 12 years earlier. Hospital records contained incontrovertible evidence that he had had widespread cancer. But there he was, not only alive but also cancer-free, having had no other treatment, and suffering from nothing more severe than gall bladder disease.

"Something began to burn in me, something that has never gone out," writes Dr. Rosenberg, chief of surgery at the National Cancer Institute since 1974.

That ambitious flame has created an unusual job description: Although he was the focus of publicity in 1985 when called to Bethesda Naval Hospital to join the team that removed President Reagan's colon cancer, Dr. Rosenberg is as involved in basic non-surgical research as he is in delivery of care; at NCI, his office, laboratories and patients are all in a row, in the same building, on the same floor.

Bucking the traditional wisdom that declared cancer outside the reach of the immune response, he has devoted himself to finding a way to make cancer patients' immune systems release an army of terminators to attack and destroy malignancy without damaging other, healthy tissue.

This description of that quest, co-authored by John M. Barry, holds out a vision of a cancer-vanquished tomorrow; at the same time, it is a catalog of the almost unbearable frustrations of research and treatment today.

Dr. Rosenberg and his staff of scientists have pushed the envelope of knowledge outward -- but with excruciating slowness. By comparison, getting a man on the moon was easy, he writes, a feat of engineering based on principles already understood. Winning the war on cancer is something else altogether: It requires scientific discovery, facts not yet known.

This is not an easy book. It can break your heart, as enthusiastic scientific beginnings crumble in the laboratory or in human trials.

For the non-scientist, it can be technically difficult; narrative bogs down in an alphabet soup of T-cells and laboratory tumors from the MCA line, immunologic factors abbreviated to Il-2 and rIl-2 (Interleukin-2 and recombinant-produced Interleukin-2), cancer-killing LAK and TIL cells, and the molecule known as TNF -- for tumor necrosis factor.

But there's excitement, too, as experiments seem to work in mice, and then in men. And, eventually, there's the story of Linda Granger: She is 33 years old when she is referred to Dr. Rosenberg in Nov. 1984, with a widely disseminated melanoma and a life expectancy of three months.

She is treated with infusions of Il-2 and LAK and nearly dies; but two months later all of her dozen tumors are gone. Seven years later, she remains free of cancer.

And Nancy Burson -- five years past the point where other doctors were so sure she was dying they wouldn't give her a prosthesis for her leg and hip, which had been amputated because of cancer.

And Edwina Schreiber, left with some bluish spots on her body, reminders of the 30 tumors that put her on the edge of death more than two years ago.

Dr. Rosenberg and his team have administered immunotherapy to more than 1,200 terminal patients. In the past year, they've added genetically modified cancer-killing cells to their arsenal. Ten percent of the patients have no evidence of cancer; up to 40 percent have had at least some relief.

"We have not cured cancer," Dr. Rosenberg writes. ". . . But I believe we have made a start in a direction that holds immense promise." Readers will happily agree.

Ms. Kobren is a copy editor at The Sun.

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