The modern history of cancer care features many physicians, scientists, researchers, and lay champions, many of whom are deservedly famous and many of whom deserve to be much more widely known. Last month I wrote about Paul Ehrlich, one of the early developers of chemotherapy—the use of drugs and chemicals to treat various diseases—and a founder of the medical discipline of hematology. His studies in drug therapy concentrated on infectious diseases, particularly syphilis. Two more generations passed before cancer researchers found effective drug treatments, having to overcome certain professional opposition along the way. Today I tell the story of a most remarkable figure in oncology history, that of Jane Cooke Wright (1919-2013).
Prior to the 1940s and the Second World War, surgery and early radiation techniques constituted the principal methods of cancer treatment. But these are chiefly effective against localized cancer. Once the disease spreads beyond its site of origin, it escapes the application of limited treatment methods except as means of palliation of specific troublesome spots. For example, radiation remains quite useful to treat painful tumors in bone even if other sites of involvement in a particular patient are not subject to the use of radiation. Serendipitous wartime experiences with American sailors accidentally exposed to nitrogen mustard gas, a chemical weapon used extensively in Europe during the First World War but hardly at all in the Second, suggested uses against certain cancers. But clinical applications were slow to come.
Dr. Wright was born into a New York City family with solid academic medical credentials. Her father, Louis T. Wright, was one of the first African American graduates of Harvard Medical School. She received early encouragement to pursue premedical studies and graduated with honors at the top of her class at New York Medical College, one of the oldest medical education institutions in the country. After postgraduate training in surgery at Bellevue and Harlem Hospitals, she joined her father’s work in cancer research at Harlem Hospital, where she became head of the Cancer Research Foundation in 1952. She turned her attention early to the potential uses of drug therapy. In the late 1940s, physicians in Boston and New York worked with nitrogen mustard compounds and an emerging class of drugs called anti-folate agents, drugs which impair the ability of a cancer cell to make building blocks for nucleic acids, crucial to the cell’s ability to divide and carry on normal function. One such compound, methotrexate, caught Dr. Wright’s attention. She successfully applied it against breast and prostate cancer, publishing reports in 1951 that helped pave the way for further research and development of cancer chemotherapy. Methotrexate remains to this day an active agent, useful in sarcoma therapy as well as advanced breast and ovarian cancer.
By 1967, Dr. Wright was involved in cancer medicine on a national level, advising President Lyndon Johnson on health policy. That year she was the highest-ranking African American woman in any US medical institution. Four years later, she helped found the American Society of Clinical Oncology (ASCO), the premier professional organization dedicated to the furtherance of cancer medicine, the sole woman to be so involved. The annual meeting of ASCO attracts clinicians and researchers from across the globe. Its main publication, the
Journal of Clinical Oncology, stands alongside the
New England Journal of Medicine as the journal of record for cancer research and policy dissemination. Dr. Wright’s titanic influence in medical oncology has only grown over time. We owe her a great debt.