I love stories about quacks who become prophets. Medical breakthroughs are often made by doctors who are first ridiculed by their peers. In 1890, Dr. William Coley, a bone surgeon in New York City, found the medical records of a patient who was dying from cancer that had spread through his body and he suddenly developed an infection that made him very sick. After the patient recovered from the infection, the cancer disappeared. Dr Coley spent the rest of his life being called a quack by many members of the medical profession because he claimed that he was curing cancer patients with bacteria that stimulate the body’s immune system.
Can you imagine the incredible courage Dr. Coley showed when he continued his treatments after some of his cancer patients died from the infections? When Coley died in 1936, at age 74, he was still considered a quack. In 1968, doctors discovered an immune protein that can attach to and kill cancer cells and called it Tumor Necrosis Factor-alpha. Many other immune proteins have since been discovered that can kill cancer cells. This year, former President Jimmy Carter announced to the world that his malignant melanoma skin cancer, which had spread to his brain, had disappeared after he was given one of the new immune therapy drugs, Keytruda.
Treating Cancer with Live Bacteria Dr. William Coley was born in 1862 into a very old and wealthy Connecticut family. He went to college at Yale and was graduated from Harvard Medical School in 1888. He then joined the staff of the New York Hospital which, partially due to his daughter's efforts, is now Sloan Kettering Memorial hospital, one of the leading cancer centers in the world. At that time there were no effective treatments for cancer and he watched patient after patient die.
In 1890, he had a 17-year-old patient named Bessie Dashiell, who was the girlfriend of John D. Rockefeller, Jr. Her biopsy showed that she had an osteosarcoma in her hand, one of the most malignant and rapidly-spreading bone cancers. He removed her arm up to the elbow, but she died from widespread cancer a little more than a month later. Coley was devastated and began to search for similar cases. He reviewed the medical records of a patient named Fred Stein, who had had a tumor on his neck removed several times seven years before. Stein had developed a horrible strep infection that turned most of the skin on his body a deep red and purple, caused every muscle and joint in his body to hurt severely, and his fever to shoot up over 105 degrees. Everyone expected him to die. Miraculously, he survived the infection and when he went home, his tumor was gone. Coley searched for Stein and confirmed that he was still cancer-free after seven years.
Soon after learning about Mr. Stein's cure, Dr. Coley saw a patient who also came in with a huge cancerous sarcoma on his neck. With the greatest courage, Dr. Coley gave the strep germ to this patient. The patient became very sick and almost died, but after he recovered, his cancer disappeared (Ann Surg, 1891;14:199–220). Dr. Coley noted that cancer patients who got infections after surgery seem to do better than those who do not get infections (Iowa Orthop J, 2006; 26: 154–158), so he started to inject live bacteria into cancerous tumors. All of the patients became very sick, some died, and some appeared to be cured (Am J Med Sci, 1893 May;105:487–511).
Injecting Killed Bacteria He learned that injecting live streptococcal bacteria into people made them very sick and sometimes killed them, so Dr Coley made a vaccine from: • erysipelas-causing strep bacteria that were killed by heating to 70 C, and • a newly-discovered bacterium, Seratia marcescens, that was thought incorrectly at that time not to cause disease in humans. He called the combination "Coley's Toxins." In 1899, Parke Davis & Company made Coley's Toxins available for all physicians and they were used all over the world for the next 30 years (Israel Med Assoc J, June, 2002;4(6):1–472). By 1952, Parke Davis Company no longer produced Coley's Toxins, and in 1962 the Food and Drug Administration stated that Coley's Toxins had not been shown to cure cancer.
In his lifetime, Coley treated more than 1,000 cases with his Coley's Toxins and wrote more than 150 papers on his results. He used his toxins on hopeless cases of inoperable bone and soft-tissue sarcomas. He continued to give killed bacteria to patients and publish the results, but the medical community was more interested in his patients who died after his treatment and less interested in his apparent cures.
Ridicule from His Peers An early editorial in the Journal of the American Medical Association was very critical of Coley and said that his killed bacteria did not cure cancer (JAMA. 1894;24:919). Throughout his lifetime, most doctors were highly critical of Dr. Coley because of his belief that he carried to his grave that most cancers are caused by infectious agents. He could still be correct. Long after Coley's death, research began to find infections that can cause cancers: • Viruses: human papillomavirus (squamous and cervical cancers), Epstein-Barr virus (B-cell lymphoproliferative disease and nasopharyngeal carcinoma), Kaposi's sarcoma herpesvirus (Kaposi's Sarcoma and primary effusion lymphomas), hepatitis B and hepatitis C viruses (hepatocellular carcinoma), and Human T-cell leukemia virus-1 (T-cell leukemias). • Bacteria: Helicobacter pylori (stomach cancer), and • Parasites: Schistosoma hematobium (squamous cell cancer of the bladder) and liver flukes, Opisthorchis viverrini and Clonorchis sinensis (gall bladder cancers).
By the time Coley died in 1936, the medical profession had lost interest in the concept of immunization treatments for cancers and most doctors considered Coley a quack rather than giving him his rightful place as a brilliant and courageous doctor who may yet be considered one of the pioneers of modern cancer cures.
Enter His Daughter, Helen Coley Nauts After Coley's death, his daughter, Helen Coley Nauts, decided that she would write his biography. She found files on more than a thousand of his patients who had been treated with Coley's Toxins, and she wrote 18 articles claiming that more than 500 of these patients had near-complete regression of their cancers (Adv Exp Med Biol, 1990;267:483). In 1953, she founded the Cancer Research Institute, which is dedicated to understanding the immune system and its relationship to cancer. Today, it is a leader in funding research in immunology and tumor immunology at universities and hospitals all over the world. Nauts also helped the New York Cancer Hospital become the Memorial Sloan-Kettering Cancer Center. Her efforts are at least partially responsible for current immunological treatments for cancers, particularly for those of the stomach, lung and kidney, and of leukemia and melanoma.
Why Coley's Theory Made Sense Your immunity is a collection of cells and proteins that analyze anything made up of proteins and nucleic acids that get into your bloodstream. Your immunity allows germs to live outside your bloodstream: in your intestines, colon, lungs, mouth, nose and skin. However, it should not allow any germs to live in your bloodstream. If the surface proteins of a cell look like your own surface proteins, your immunity is supposed to let these cells grow. On the other hand, if the surface proteins of a cell are not the same as those on your cells, your immunity is supposed to attack and kill those cells. Cancer cells have different surface proteins than your normal cells do. So every day, your body makes millions of cancer cells and every day, your immunity removes these cancerous cells from your body. Cancer cells are allowed to exist and spread through your body only when your immunity fails to recognize that they are different from normal cells.
How Coley's Theories May Still Lead to Cures for Many Cancers Today, many mainstream scientists believe that a cure for cancer will come from getting a person's immune system to do a better job of killing cancer cells in the same way that it kills germs. This research focuses on stimulating the immune system with: • antibodies and other agents made from animals, humans or in the laboratory to attack and kill cancer cells without also killing normal cells, • natural bacteria or genetically modified bacteria, • drugs to stimulate the immune system to destroy cancer cells, or • bacteria and viruses made to carry cancer treatments into cancer cells. Cancer research now involves many immune hormones and cytokines such as tumor necrosis factor, interferons and streptokinase. Vaccines are being developed for treatment of colon, melanoma and other cancers. The injection of the tuberculosis vaccine called BCG is used to treat bladder cancer. Scientists still have not found a safe way to stimulate the immune system to kill cancer cells permanently without also harming the patient.
Coley's misfortune was that he was so far ahead of everyone else that it has taken more than 100 years for the rest of the world to catch up with him.
William Coley, M.D. January 12, 1862 – April 16, 1936
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