By Jocelyn Selim

The Cancer Man's Cancer

In the early 20th century, a pioneering researcher uncovered a new pediatric cancer

By Jocelyn Selim

Prognoses didn’t improve much for the next 30 years or so. While advances in surgery and radiation helped eliminate the original tumors, there was no way to wipe out metastasized cells, so the tumors nearly always returned, taking their young patients' lives with them. Then, in the 1950s, methotrexate—one of the first chemotherapeutic agents used to treat cancer—began to be used for Ewing sarcoma patients, as well as for the leukemia patients for whom researchers originally developed it. The treatment wasn’t as successful for Ewing sarcoma patients as it was for leukemia patients, “but it was the beginning of the road to success,” says Meyers.

Over the next few decades, more drugs followed. Now, says Meyers, the standard of care is a combination of five chemotherapy drugs given in 14 cycles, with the entire course taking about 42 weeks. Because of the combination of chemotherapy and other treatments, nearly two-thirds of Ewing sarcoma patients now survive for at least five years after diagnosis, but more research into better treatments is ongoing. “Where we’re really focusing attention now is on targeted therapy,” says Stanford University pediatric oncologist Neyssa Marina. “We know that these cancer cells, because of the translocation, have distinct characteristics that normal cells don’t. We’re looking at what other genes are activated by the translocation and looking for new drug targets.” As is the case for most patients with rare pediatric cancers, nearly all Ewing sarcoma patients see specialists at academic medical centers, where many are able to take part in clinical trials.

This continual research into the disease that bears Ewing’s name is especially apropos, given his leading role at the first hospital dedicated to cancer research. And cancer patients with Ewing sarcoma aren’t the only ones who have benefited from such academic medical centers. Ewing’s obsessive dedication to cutting-edge care—and his belief that research and patient care both benefit when brought together—laid the foundation for a century of advances in cancer treatment.

Ewing died of bladder cancer in 1943, a decade before the U.S. Food and Drug Administration’s approval of methotrexate ushered in the era of chemotherapy. It’s possible that he never saw a single patient survive the disease that bore his name—or many of the other cancers he devoted his life to treating.

“In Ewing’s day, most cancer was a death sentence,” says Meyers. If Ewing could see what certain treatments can do today, Meyers believes, the pioneering pathologist would no doubt be gratified about how far research has come.