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Pale, lethargic and feverish, 2-year-old Robert Sandler was brought to Boston’s Children’s Hospital, where the diagnosis was dire. He had acute lymphoblastic leukemia, a deadly cancer of the blood.
In 1947, no consent was needed to run clinical trials, and Sidney Farber, the hospital’s pediatric pathologist, had just started to experiment with a new kind of treatment for the disease.
Hoping it would block the reproductive capacity of cancer cells, Farber began injecting Robert in September with an antifolate, pteroylaspartic acid or PAA. There was little response, and by December, Robert was swollen, in excruciating pain and near death.
When the lab sent Farber aminopterin, another antifolate with a slight change in its structure, he rushed to inject the boy. The results were dramatic: Robert’s white-cell count dropped, he could walk on his own and he began to eat ravenously.
Robert’s remission lasted but a few months and he died in 1948, but his case proved for the first time that in addition to surgery and radiation, chemicals could be used to combat cancer.
I spoke with Siddhartha Mukherjee, author of “The Emperor of All Maladies: A Biography of Cancer,” on the following topics:
1. 2500 B.C. First Description
2. Invasion From Inside
3. From Dread to Hope
4. Crucible of Chemotherapy
5. Future: Chronic Disease?
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(Lewis Lapham is the founder of Lapham’s Quarterly and the former editor of Harper’s magazine. He hosts “The World in Time” interview series for Bloomberg News.)