By Jocelyn Selim
The Cancer Man's Cancer
In the early 20th century, a pioneering researcher uncovered a new pediatric cancer
By Jocelyn Selim
In 1918, a 14-year-old girl was brought to Memorial Hospital in New York City with a large bony tumor on her arm. Amputation had been recommended, but James Ewing, the doctor who examined her, balked at the suggestion. Ewing had seen a lot of suffering in his life, yet the prospect of adolescent amputation hit particularly close to home. At 14, he had experienced an ice-skating accident that left him with a recurring bone infection in his leg. The horror the young Ewing felt when he overheard a surgeon discussing amputation had left a lifelong impression. He got to keep his leg but was reminded of the incident by chronic pain and a limp for the rest of his life.
Ewing, who would later recount the girl’s case at academic meetings and in research journals, listened carefully to her history. She had been pulling on a rope when her ulna, the longer bone in her lower arm, had “spontaneously fractured.” Eventually, the fracture healed and the swelling subsided. But two months later, the area swelled again. A distinct tumor appeared, and oddly, it seemed to fluctuate in size.
The girl had come to the right doctor. In 1918, Ewing was 51 years old. A pathologist at Memorial Hospital, he was also a co-founder of both the American Association for Cancer Research and the American Society for the Control of Cancer, an organization that later became the American Cancer Society. In fact, Ewing may well be the most famous oncologist you’ve never heard of. It’s often true in scientific progress that few visionaries get the accolades they deserve during their lifetimes. Ewing’s case proved to be just the opposite. While his name has largely been forgotten with the passing years, at one point his fame was so great that, dubbed “Cancer Man Ewing,” he graced the cover of Time magazine, preceded by Mahatma Gandhi and Pope Pius XI and followed, of course, by all manner of sports heroes, pop stars, presidents and luminaries.
Known less grandiosely as “The Chief” in the halls of the hospital, Ewing was anything but glamorous. He was well-off but lived a simple lifestyle in a mid-Manhattan hotel that came to be known as rather seedy. He was so frugal that he saved envelopes to reuse as notepaper. But Ewing was also known to hand out signed blank checks to the especially needy. A widower after only three years of marriage, Ewing felt the emotional shock of losing his wife from complications during pregnancy and became something of a scientific recluse, wholly consumed by a dedication to improving the lot of cancer patients.
At the time he met his 14-year-old patient, Ewing was well on his way to transforming what had been a haven for late-stage cancer patients into a research-oriented cancer center. Ewing, who became the director in 1931, helped the hospital to become a model of modern cancer treatment—an experimental powerhouse of research and new therapies that gave its patients the best possible chance of recovery from what had historically been an effectively untreatable disease. Ewing’s legacy still survives today: Memorial Hospital is now Memorial Sloan-Kettering Cancer Center.
Early in the 20th century, Ewing’s hospital was one of the first to explore the medical potential of radiation for cancer treatment, by treating tumors with radium, the radioactive element discovered in 1898 by Marie and Pierre Curie. Upon hearing of the success of radiation therapy in some cancer patients, Ewing traveled to Europe in 1913 to investigate radium with James Douglas, a mining engineer and philanthropist whose daughter was dying of breast cancer. Four years later, Douglas donated 375 grams of the element to Memorial Hospital.
With Ewing, his young patient with the bony tumor was in good hands. The next year, he would publish a 1,027-page medical textbook, Neoplastic Diseases, a compendium of everything known about cancer. The girl’s tumor could easily have been mistaken for osteosarcoma, the most common type of malignant bone tumor and one that had been well-documented for a century. If anyone was in a position to recognize that her tumor was not osteosarcoma, that person was Ewing.