The Masters of Medicine by Andrew Lam

Author:Andrew Lam
Language: eng
Format: epub
ISBN: 9781637742648
Publisher: BenBella Books
Published: 2023-01-18T00:00:00+00:00

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A doctor like Papanicolaou could take pride in creating a tool that helped identify cancer early, but his work had done nothing to explain why cervical cancer began in the first place. It would have shocked him to learn what we know now, that it is caused by the human papillomavirus (commonly known as HPV), which is transmitted via sexual intercourse. For those seeking to understand the origin of cancer, the knowledge that it could stem from carcinogens, viruses, sexually transmitted diseases, or arise spontaneously—and be influenced by hormones, blood vessel growth factors, and conceivably many other factors yet to be discovered—presented a bewildering panoply of possibilities that could only increase skepticism that cancer might ever be tamed.

The gripping idea that cancer might actually be an infectious disease, caused by viruses, was one that captivated both scientists and the general public in the twentieth century. In 1911, a thirty-one-year-old virologist named Peyton Rous did something that threw contemporary theories about cancer’s cause into grave doubt. At the Rockefeller Institute in New York City, Rous was studying a rare type of sarcoma—a malignancy of connective tissues like muscle and tendon—found in chickens. He excised a tumor, ground it up in fluid, and put the mixture through a series of filters to remove all cells, bacteria, and contaminants, until the only thing left was the liquid filtrate that the cells had resided in. When he injected this cancer-cell-free fluid into a chicken, the animal developed cancer.

This was a surprise.

Here was evidence that the cause of cancer did not necessarily dwell within the cancer cell. The only organism small enough to pass through Rous’s filters was a virus. He hypothesized that a virus caused cancer, an idea that contradicted every prevailing theory at the time. But Rous was correct. The virus that causes this type of cancer was later named the Rous sarcoma virus (RSV).

Those who recognized this began to wonder—was all cancer caused by viruses? Was cancer an infectious disease? It seemed entirely possible, since viruses were mysterious, poorly understood, and had not even been visualized yet—a fact that added to their mystique. Researchers began to look for viral causes of human cancers.

The search was fruitless until 1957, when an Irish surgeon named Denis Burkitt began to encounter children with terribly deforming jaw tumors while working in Uganda. Burkitt recognized this as an extremely aggressive form of lymphoma, one not previously studied in the West. By surveying doctors all over Africa, Burkitt discovered a pattern. All the cases appeared to occur in a defined geographic area, a band across sub-Saharan Africa. There were no cases in South Africa, and none in northern Africa. The pushpins covering Burkitt’s map, each representing a case, covered the middle of the continent in a horizontal stripe. This inexplicable finding spurred Burkitt and two colleagues to embark on a ten-thousand-mile trek, driving a used station wagon to visit scores of hospitals and mission outposts in twelve different countries. Burkitt sought out anyone who had seen children with

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