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VOLUME 20, NUMBER 42
OCTOBER 19. 1973
DURHAM, NORTH CAROLINA
Successes Encouraging Chemotherapeutic Research
Drugs Thrown into Great War on Cancer
America has assigned a top priority
to the conquest of cancer. The
National Cancer Institute has chosen
Duke as the site for a Comprehensive
Cancer Center, one of the regional
facilities that will lead the all-out
effort to conquer this disease.
This is the second in a series of four
articles by Miss Yvonne Baskin,
medical writer in the Office of Public
Relations, exploring the status of
cancer research and treatment, with
particular emphasis on some of the
work under way at Duke.
This article deals with
chemotherapy—the role drugs play in
cancer treatment. The first article, in
the Oct. 12 INTERCOM, dealt with
surgery and therapeutic radiology.
Subsequent articles will examine
immunotherapy and research with
viruses.
A North Carolina man came to Duke
in 1965 with acute leukemia. He was
treated with two experimental drugs and ■
the signs of cancer disappeared.
For five years he continued on the
drugs, remaining healthy and active and
watching his children graduate from high
school and leave home. In 1970 the
doctors decided to stop the drug
treatments because of possible long-term
toxic effects.
For three more years he continued
healthy and disease-free. Then last spring
his leukemia recurred, he did not respond
to drugs and he died.
The man's case reflects both the
progress and the limitations in the use of
chemotherapy in the treatment of cancer.
"In 1965 we were only using one or
two drugs and getting about 10 per cent
of our adult patients into remission," said
Dr. John Laszio, professor of medicine at
Duke. "Now we're using a combination
of five drugs and 40 per cent are going
into remission, and today these people
have a better chance of this remission
lasting longer.
"We say now that if a person survives
for five years after diagnosis with no signs
of cancer, he is cured," Laszio said. "But
a cure is hard to define because the cancer
may recur years later. I don't think we
should be discouraged by this, though.
Fifteen years ago these people wouldn't
have lived but a few months. We have to
be thankful for what we've gained."
In the past 25 years, more than 40
drugs have been developed that are useful
in the treatment of some type of cancer.
Duke is one of 200 medical centers in the
United States doing clinical investigations
of drugs developed by the National
Cancer Institute, by pharmaceutical
research teams and by other researchers.
"Basically there are three situations in
chemotherapy now," Laszio said. "First
there are the diseases which we know will
respond to drugs. Prominent among these
examples are various types of leukemia
and lymphomas.
"Then there are the kinds of tumors
"PHOTOGRAPHING" A TUMOR—Dv. Jack Goodrich, director of iMuciear i'viedicine, operates the controls of one ot the
department’s gamma ray cameras. The patient is given a dose of radioactive tracer material, then a gamma ray picture, similar to an
x-ray, is taken of the area where a tumor is suspected. The technician here is positioned for phtographing of a brain tumor. (Photo
by Jim Wallace)
for which we can't predict the response.
Sometimes they will respond to drugs and
sometimes they won't," he said. "These
include recurrent and widespread breast
cancer, colon and prostate cancer.
"Four or five of 10 may respond to
drugs, and we don't know why," Laszio
said. "This is an area that needs research
and it's one project that will be going on
under the new Comprehensive Cancer
Center.
"The third situation is the tumors that
very rarely respond to drugs, and
unfortunately, this is the most common
classification," Laszio said. "This includes
such cancers as those of the lung and
kidney. Surgery and radiation are still the
major treatment for these tumors."
Since 1956, one type of tumor has
stood as the "bright, shining light" in the
field of chemotherapy. This is
choriocarcinoma, a rare malignancy
which arises from placental tissue—the
"afterbirth"—after pregnancy. If untreated
it rapidly spreads from the uterus to
other parts of the body and is quickly
fatal.
A 10-year clinical trail by the National
Cancer Institute which ended in 1966 has
shown that choriocarcinoma was
uniquely sensitive to two drugs—an
antibiotic called Actinomycin D, and
Methotrexate, a "metabolic antagonist"
designed to starve cancer cells by
interfering with vital life processes.
In 1966 a center was set up at Duke to
(Continued on page 3)
Dr. Aniyan To Lead AAHC
Duke's vice president for health affairs
is the new president-elect of the
Association for Academic Health Centers
(AAHC).
Dr. William G. Aniyan will become the
fourth president of the organization next
fall. Its membership is made up of
persons at the vice president or chancellor
level who have senior administrative
responsibility for academic health
centers.
Aniyan has been on the AAHC Board
of Directors since it was established in
1971. The current president is Dr.
Edmund D. Pellegrino, vice president for
health sciences at the State University of
New York in Stony Brook.
AAHC membership represents most of
the nation's 114 schools of medicine and
42 schools of dentistry, 32 schools of
allied health and 58 baccalaureate schools
of nursing, plus schools in other health
fields including optometry, pharmacy,
public health, veterinary medicine and
graduate medical science education.
"The comprehensive scope of
responsibility for health professions
education represented by .the
membership, makes the AAHC uniquely
qualified to address itself to many of the
problems in health education which in
turn affect the delivery of health care
throughout the country," Aniyan said.
The association's objective, Aniyan
said, "is to maintain active
interrelationships among all of the health
professions," adding that special liaison
committees have been appointed to work
with separate health professions
associations.
For example, he said, the Liaison
Committee for Public Health is chaired
by Dr. Cecil G. Sheps, vice chancellor for
health sciences at the University of North
Carolina.
Major support for the association in
this organizational phase of its
development is coming from a five-year
grant by the W.K. Kellogg Foundation.
Just two years ago Aniyan stepped
down from chairmanship of the
Association of American Medical Colleges
(AAMC), the guiding organization for
medical education in the United States.
He currently is chairman of the
Coordinating Council on Medical
Education, vyhose members represent the
AAMC, the American Medical
Association, the American Board of
Medical Specialties, the American
Hospital Association and the Council on
Medical Specialty Societies.