- The word 'cancer' is of Latin derivation and means "crab".
- Today cancer "cure" is a vast industry.
- But by the turn of the 20th Century organized medicine
had come to the conclusion that it was not a matter of whether infectious
disease caused cancer, but which one. For over two hundred years a cancer
germ had been discovered and rediscovered, named and renamed, each scientist
adding to the knowledge, but to no avail. Then, in 1910, certain American
medical powers did a 180-degree rotation, deciding that cancer was not
caused by a microbe, and that anyone who thought otherwise was a heretic,
a charlatan or a quack. But Dr. Virginia Livingston and her network were
none of the above, their meticulous peer-reviewed research and publications,
done at the height of US post World War II technology. And Dean Burk, Head
of Cell Chemistry at the NCI went so far as to say that Livingston's cancer
germ was as real and certain as anything known about cancer. Researcher,
MD Alan Cantwell Jr. grew up thinking that all germs responsible for the
important diseases were supposed to have already been discovered. But much
to his dismay, he found one that was left out: the cancer germ.
- Cantwell already knew that for finding this, Livingston
had already been branded by traditional medicine, leaving what he thought
to be perhaps the major discovery of the 20th century largely discredited.
The striking analogy between cancer and tuberculosis was noticed long before
the tubercle bacillus was discovered. In 1877, Sir John Simon clearly pointed
out the similarity and in fact argued very strongly in favor of a microbial
origin for cancer. But Simon's vindication would have to wait for Livingston's
germ, which although tuberculosis-like, was not tuberculosis but an atypical
form of this mycobacterium, melded from the mycobacterium and other related
Actinomycetales. Had medical science, and the powers that be, spent as
much time in investigating and destroying Livingston's germ as they did
in attacking her and those around her, cancer might be curable today.
- Hodgkin's cancer under attack
- When Virginia Livingston was a student at Bellevue Medical
College her pathology teacher mentioned, rather disparagingly, that there
was a woman pathologist at Cornell who thought Hodgkin's disease (a form
of glandular cancer) was caused by avian tuberculosis . This lady had
published, but no one had confirmed her findings. Afterwards, Livingston
compared slides of both. In Hodgkin's, the large multinucleated giant cells
were called ReedSternberg cells. They were similar to the giant cells
of tuberculosis, which formed to engulf the tubercle bacilli. Livingston
stored away in her memory that this lady pathologist was probably right
but she would have a difficult time in gaining acceptance.
- By 1931, Pathologist Elsie L'Esperance was seeing 'acid
fast' tuberculosis-like bacteria riddling her Hodgkin's cancer tissue samples.
And that germ, once
- injected into guinea pigs, caused them to come down with
Hodgkin's too, fulfilling Koch's postulates. L'Esperance brought her stained
slides to former teacher and prominent Cornell cancer pathologist James
Ewing. Ewing initially confirmed that her tissue slides were indeed Hodgkin's.
But when he found out that her slides came through guinea pig inoculation
of the avian (fowl) tuberculosis she had found in humans with Hodgkin's,
Ewing, visibly upset, said that the slides then could not be cancer.
- It betrayed his checkered history of high-placed medical
politician. In 1907, you could have approached Dr. James Ewing about a
cancer germ, and he would have embraced you over it. At that time, both
for he and the rest of the nations medical authorities, it was not a question
of whether cancer was caused by a germ, but which one. Was not it Ewing,
at one time, who had proclaimed that tuberculosis followed Hodgkin's cancer
"like a shadow"?
- But shortly after, James Ewing, "the Father of Oncology",
sent a sword thru the heart of an infectious cause of cancer with "Neoplastic
Diseases" , becomingfan ambitious zealot for radiation therapy
with the directorship of what would one day be called SloanKettering
squarely on his mind. His entry lay in prominent philanthropist James Douglas.
A vote for Ewing, Douglas knew, was a vote for continued radiation and
James Douglas began sizeable uranium extraction operations from Colorado
- thru his company, Phelps Dodge, Inc. .
- Soon Sloan became known as a radium hospital and went
from an institution with a census of less than 15% cancer patients, separated
- lest their disease spread to others, to a veritable cancer
center. But the very history of radiation revealed its flaws, and by the
early 1900s nearly 100 cases of leukemia were documented in radium recipients
and not long thereafter it was determined that approximately 100 radiologists
- contracted that cancer in the same way .
- Still, Ewing, by now an Honorary Member of the American
Radium Society, persisted.
- Elise L'Esperance was anything but alone in linking Hodgkin's
to a germ called Avium or fowl tuberculosis. Historically Sternberg himself,
discoverer of Hodgkin's trade-mark ReedSternberg cell, believed Hodgkin's
was caused by tuberculosis. Both Fraenkel and Much  held, as L'Esperance,
that it was caused by a peculiar form of tuberculosis, such as Avium or
Fowl tuberculosis, and of all the cancers, debate over the infectious cause
of Hodgkin's waxed the hottest.
- Into this arena L'Esperance stepped in 1931, with few
listening. She would publish Studies in Hodgkin's Diseases  in an issue
of Annals of Surgery. It proved to be the one legacy that no one, not even
Ewing, who would soon die from a self-diagnosed cancer, could take away.
- Dr. Virginia Livingston
- "Our (cancer) cultures were scrutinized over
- and over again. Strains were sent to many laboratories
- for identification. None could really
- classify them. They were something unknown.
- They had many forms but they always grew up
- again to be the same thing no matter how they
- were cultured. They resembled the mycobacteria
- more than anything else. The tubercle
- bacillus is a mycobacterium or fungoid bacillus."
- Virginia Livingston,
- Virginia Wuerthele-Caspe Livingston was born in Meadville,
Pennsylvania and went on to obtain impeccable credentials. Graduating from
Vassar, she received her M.D. from N.Y.U. The first female medical resident
ever in New York City, with time Livingston became a Newark school physician
where one day a staff nurse asked medical assistance.
- Already diagnosed with Reynaud's syndrome, the tips of
this nurses fingers were ulcerated and bled intermittently. Livingston
diagnosed Scleroderma. But upon further examination there was a hole in
the nasal septa, something
- that Livingston had previous seen in the mycobacterial
diseases TB and Leprosy.
- So Livingston approached dermatologist Eva Brodkin and
- for confirmation, all the while convinced that mycobacterial
infection was causing the Scleroderma. She then preformed cultures from
a sterile nasal swab mycobacteria appeared, everywhere . Injected
into experimental chicks and guinea pigs, all but a couple died. Upon autopsy,
the guinea pigs had indeed developed the hardened skin patches of Scleroderma.
. . some of
- which were cancerous.
- Momentum builds
- Livingston, now possessed, solicited fresh sterile specimens
of cancer from any operating room that would give them to her. All cancer
- the same acid-fast mycobacteria. New Jersey Pathologist
Roy Allen confirmed her findings. Livingston and Allen then found that
they could actually differentiate malignant from benign tissue by their
mycobacterial content . But still the explanation for why the cancer
germ showed so many different forms was elusive.
- Try as she might, part of Virginia Livingston's problems
in an American validation of her multi-shaped cancer germ lay firmly entrenched
- history of medicine, especially in the constantly changing
field of microbiology. Louis Pasteur could handle being quickly rushed
off a Paris Academy of Sciences podium to escape harsh reaction to his
suggestion that children's milk be boiled first, but he could not tolerate
his rival Pierre Bechamp's statement that a single bacteria could assume
many, many forms. On his deathbed, Pasteur was said to have changed his
mind when he said: "The terrain is everything", meaning the culture
or milieu that bacteria grew on or in could change their shape or characteristics.
But it was too late and even today, most conventional microbiologists deny
the existence of such form changing (or pleomorphic) germs.
- Robert Koch, Father of Bacteriology and discoverer of
tuberculosis, could have helped. When he first worked with the bacteria
anthrax, he noticed
- that anthrax's classical rod shape became thread-like
inside the blood of laboratory mice. And then, after multiplying, they
changed again, into the same assumed spore-like forms he later documented
in tuberculosis as well.
- Aware of what she faced, yet undismayed Livingston
methodically went about proving cancers true cause. First in her line of
attack were the long suspected and well-publicized tumor agents of Rous,
Bittner and Shope. By photomicrographs, Livingston and her group demonstrated
acid-fast mycobacterial forms in each of these so-called "viral"
cancers. This included
- the famed Rous chicken sarcoma.
- Early on, Virginia Livingston had decided that she needed
help in validating her cancer germ and nobody knew the shapes and staining
- mycobacterial-related germs better than Dr. Eleanor Alexander-Jackson
of Cornell. As far back as 1928, Eleanor Alexander-Jackson, bacteriologist,
had discovered unusual and to that point unrecognized forms of the TB bacillus,
including its filterable forms. By 1951, Alexander-Jackson was considered
the expert TB microbiologist at Cornell.
- In the same year, another American, H.C. Sweany proposed
that both the granular and other forms of tuberculosis that passed thru
a filter caused Hodgkin's cancer . This was subsequently supported by
studies by Mellon, Beinhauser and Fisher [7,8]. Mellon prophetically warned
that tuberculosis could assume both its characteristic red acid-fast forms
as well as blue nonacid-fast forms indistinguishable from common germs
such as Staphylococci, fungi and the Corynebacteria and that this would
surely perplex modern microbiologists.
- When organized medicine choose to ignore these studies,
Jackson warned that a so-called cure for TB could be as short-lived as
it took classical TB rods, for the moment gone underground as a nonacid-fast
form, to resurface one day and spring back towards destruction. Although
American medicine had no serious time for Alexander-Jackson or her discoveries,
it would not disturb her for as long as she focused on tuberculosis and
its cousin, leprosy. But when her focus shifted towards Livingston's cancer
germ, it would move to destroy her. She simply posed too great a threat.
- By December of 1950 Livingston, who would go on to write
over 17 peer reviewed articles by the end of her career, wrote, together
with Jackson and four other prominent researchers, what still stands as
a milestone on the infectious nature of cancer .
- At the AMA's 1953 New York exhibit, participants interest
was particularly riveted towards an exhibit of Livingston's cancer germ,
live. The press, muzzled by Sloan Kettering's head, Cornelius Rhodes, was
not allowed to interview or report on this exhibit. Above, the cancer germs
seemed indestructible, surviving a five-day experience of intolerable heat
from closed-circuit microscopy .
- As Livingston and Jackson's work on the cancer germ became
more and more convincing, her opponents surfaced and became more and more
- Also with recognition, came visitors. One a pathologist
from Scranton, Dr. George Clark, told Livingston he had cultured Dr. Thomas
Glover's famed cancer germ from human cancer and developed metastasizing
tumors in animals from it.
- Clark assured Livingston that Glover was on to the same
bacterial pathogen that she was. For more than two hundred years, the same
organism had been discovered and rediscovered, named and renamed, each
discoverer adding to what was known about the cancer germ, but thus far
to no avail.
- US studies take hold
- Clark knew Glover as part of an investigative team of
the US Public Heath Service headed by George W. McCoy in 1929. Glover had
just become too well known to be ignored. His cancer serum was working.
- Much was at stake. The Country was already committed
to the idea that cancer could not possibly be an infectious disease, and
Glover was saying that he had already isolated the cancer germ.
- Actually, he had not, but few would believe that it was
really his young, tobacco-chewing assistant, Thomas Deaken who had isolated
- worked his way up New York's health and hospital system
from the most menial positions to laboratory assistant. With neither formal
medical or scientific training, this laboratory assistant nevertheless
- protocol . Incredibly Deaken engineered a geranium
based culture medium, managing to grow out acid-fast, tubercular bacteria.
Then he inoculated mice and dogs, producing cancer with metastatic spreadin
every case . Sometime between 1917 and 1918 Thomas Daeken, laboratory
assistant, produced a specific anti-cancer sera by injecting horses with
the human cancer germ. Moreover, the sera worked whether in prevention
or cure of his cancerous laboratory animals. But Glover had come to the
point where he needed someone to lend credibility to his work, and that
someone, came in the form of Dr. Thomas J. Glover of Toronto.
- It will always be to Glover's credit that he saw the
importance and application of Deaken's work from day one. A contract was
quickly drawn up and executed. Glover rushed back to open a Canadian cancer
clinic in Toronto. The serum worked in many but not all cases; but as Glover's
reputation grew, so to did the interest in him of Canada's organized medicine.
A subpoena giving him 21 days to submit a full presentation of his treatment
was issued. But Glover was not cooperating. Glover was in trouble
- and would soon be chased out of Canada .
- By 1926, and now in the US, Glover published Progress
in Cancer Research, presenting over 50 cases, most of which went into remission
with Glover's Serum . It sparked additional notoriety, both here and
abroad. In 1929, Livingston's friend Dr. George Clark joined Dr. George
McCoy, then head of the Hygienic Lab of the US Public Health Service. Their
intended destination: Glover's laboratory, now at New York's Murdock Foundation.
Glover was under investigation and McCoy wanted him to repeat his work,
this time under Health Service surveillance and in Washington.
- Glover complied, and he and his team went to the nations
capital to prove their case at what was to one day become the National
Institute of Health.
- McCoy, the investigator, impressed by Glover's work,
rather than come down on Glover, instead issued a 1937 letter to Surgeon
- which spoke in glowing terms of the great importance
and significance of Glover's cancer findings.
- Soon thereafter, McCoy was abruptly and mysteriously
replaced by Dr. R.H. Thompson. Parran, a product of organized medicine,
had a definite agenda. The question before him was whether to publish Glover's
now finished Washington report or not and Parran, despite continued committee
approval, was not about to, sending Glover into a cold rage which ended
- walking away from Washington to publish independently.Meanwhile,
Glover's serum, which had helped and saved so many was subjected to cursory
- animal studies and a review without clinical trials before
being condemned by Government agencies.
- Glover would eventually return to Canada, but he would
never again answer questions as to just what had happened in America.
- Focus on breast cancer
- Virginia Livingston now went specifically after breast
cancer. Thirty sterile cancerous breasts were transported from operating
room to lab. Cancers
- were isolated from each breast and when axillary tissue
from under the arm was supplied, the cancerous portion was cut from this
too. Livingston and Jackson found the cancer germ everywhere, and in the
case of underarm glands, even when the pathology report was negative, the
cancer microorganism surfaced .
- Champion of toxic chemotherapy, Cornelius Rhoads replaced
Ewing at Sloan. Rhoads, head of chemical warfare during the Korean war,
was deeply committed to chemotherapy and the huge grants it brought from
the pharmaceutical industry.
- It is poorly recognized that the chemotherapy or "chemo"
used against cancer began as a weapon of mass destruction par excellence
. When the Axis folded, nitrogen mustard, declassified, first came
under real medical scrutiny for cancer. Initially evaluated for lymphosarcoma
in mice, human
- studies soon followed as more and more variants of nitrogen
mustard were concocted and tried .
- Other related classes of chemotherapeutic agents followed
and so did their repercussions. Most had the potential to cause a second
entirely different cancer . Even tamoxifen for breast cancer was associated
with a two to three-fold increased risk of cancers of the lining of the
uterus (endometrial), some of which were high grade with a poor forecast
- Nevertheless, Cornelius Rhoads remained committed to
the treatment, and at the same time prepared a series of major roadblocks
to stop Livingston.
- In 1950, he barred her from presenting her paper on the
cancer germ at the New York Academy of Sciences by discrediting Irene Diller,
the symposiums sponsor, chief-editor of the respected journal Growth, and
a prominent cancer researcher. Diller, like many, had accepted a gift from
a pharmaceutical house at one point. Livingston came across Diller in a
Life Magazine article which talked about a Philadelphia cancer researcher
who was observing strange fungus-like filaments protruding from cancer
cells. Livingston and Alexander-Jackson convinced her that her fungal forms
(the prefix myco in mycobacteria denotes a germ with fungal properties)
were part and parcel of the cancer microbe, and that crucial to its identification
was acid-fast staining.
- Dr. Eleanor Alexander-Jackson's elation over the groups
infectious breast cancer findings came to an abrupt halt when she was informed
by her private physician Frank Adair that she too had it. A radical mastectomy
was done at Sloan on Adair's advice.
- While anxiously waiting for the outcome, Dr. Virginia
Livingston heard her name paged on Sloan's overhead. Rhoads wanted to speak
to her regarding
- Jackson's ongoing surgery. It was urgent. Alexander-Jackson
was still in the operating room and the radical mastectomy had been done.
- office, the two adversaries faced off. incredibly, Rhoads
was after permission to go after a cancerous lymph node deep in the middle
of Eleanor's chest. Livingston bristled.
- "We have been looking for a tumor such as she has."
- Apparently a radical was not enough. He was seeking permission
to try a new surgical technique which went after the deep chest node. Livingston
- had had enough. Just the thought of the cruel, disfiguring
procedure made her sick.
- "Not on your life." She shot back, as she left
- The single most convincing study of how bacteria causes
- By 1965, Edith Mankiewicz, Director of labs at Montreal's
Royal Edward Chest Hospital and assistant professor of bacteriology at
McGill, by examining human cancer tissue, established mycobacteria-like
germs inside cancer . In the bibliography of one of her landmark papers
is reference to a personal communication with Dr. Eleanor Alexander-Jackson.
One of the cancers under Mankiewicz's trained eye was lung cancer. Lung
cancer,or bronchogenic cancer, was first reported in the nineteenth century
at a time when it was practically unknown-while mycobacterial disease of
the lung, primarily tuberculosis, was so rampant as to be called 'white
plague' or in certain circles: 'captain of the men of death.' By the middle
of the seventeenth century, one in five deaths was due to tuberculosis
and at the end of the nineteenth century, there was fear that it would
destroy the very
- civilization of Europe. So difficult was it to differentiate
tuberculosis from the newly discovered bronchogenic cancer that it was
only after cases first mistakenly diagnosed as lung cancer were operated
on that the benefits of surgical resection of tuberculosis were recognized
- Mankiewicz not only showed the cancer germ in malignant
tissue but significantly demonstrated how it probably evolved from tuberculosis
and related microorganisms when some of the viral phages that lived in
them jumped germs, bringing genetic materials which altered the target
- virulence and made them drug resistant. In fact beneath
her microscope lay a pictorial of how the cancer germ emerged from TB-like
bacilli to create pre-malignant change in mammalian tissue .
- By 1970, Sakai Inoue, a PhD from Maebashi, Japan and
Marcus Singer, a doctor at Case Western's Developmental biology, completed
the single most
- convincing study of how bacteria cause cancer altogether,
with TB-like mycobacteria. Supported by grants from the American Cancer
Society and the National Institute of Health, their study used cold-blooded
animals, namely the newt or salamander and thefrog. But similar studies
showed its applicability to mice  and humans [18,19]. Inoue:
- "An organism similar to the mycobacterium
- Described here has been isolated and cultured
- from tumors and blood of tumerous mammals,
- including man, and when injected into mice
- and guinea pigs, has been reported to yield a
- chronic granulomatous disease, neoplasm
- (cancer), or some intergrade."
- Inoue and Singer, 1970
- Back in the spring of 1953, Sakai Inoue noticed an adult
salamander with a hard mass on its stomach. He removed the mass, which
turned out to be malignant. Then he injected tissue from the mass into
healthy animals. Again, cancer developed.
- In the work that followed, Inoue and Singer, from electron
micrographs, knew that bacteria were involved, bacteria which stained acid-fast..
- mycobacteria . Inoue inoculated three other types
of mycobacteria, into healthy animals. All came down with cancer, something
that did not happen when other germs such as staphylococcus or streptococcus
were used. Amazingly Inoue and Singer even noted regressions in some of
the cancers, especially if very dilute solutions of the germs were used
to initiate them. Furthermore, since cancers stemming from 'carcinogens'
were structurally identical to mycobacterial induced cancers, the investigators
results suggested that such 'carcinogens' might merely be factors that
activate preexisting infection. The phages inside mycobacteria are viruses
known to be activated by carcinogens such as UV light and chemicals .
- Mankiewicz, five years previously, had shown that these
- activated, could cause pre-malignant changes in mammalian
- Sakai Inoue and Marcus Singer's study should have once
and for all convinced Virginia Livingston's opponents of the veracity of
her results, and
- that she was not mistaking common contaminants such as
staph. or strept. for the cancer germ. . .but it did not.
- The politics of cancer
- It was public knowledge in early 1951 that the Black-Stevenson
Cancer Foundation intended to award two huge Black grants of $750,000 towards
- cancer research and that the first would go to Livingston's
group at Newark's Presbyterian; with an equivalent amount to go to The
Memorial Center for Cancer (now Sloan-Kettering), which Rhoads headed.
The trustees having already decided this, the actual allocation was left
in the hands of Newark lawyer Charles R. Hardin, but fate intervened.
- "Hardin, the lawyer in charge of allocation,
- soon would lie dying of cancer at Memorial
- and while still alive was prevailed upon by design
- of Rhoads to sign a paper giving Rhoads
- power over how Presbyterian's grant was to
- be spent. And that wasn't going to include further
- research towards an infectious cause for
- cancer." Livingston, 1972
- Still Rhoads was not finished. Livingston, already world-recognized,
took her cancer microbe and a guest named George Clark to Rome's Sixth
International Congress for Microbiology, a trip paid for by her husband's
firm as a consultant to British industry. In Rome, Livingston met Emy Klieneberger-Nobel
at the Lister institute. Klieneberger-Nobel was a pioneer uncovering bacteria
without cell walls which led them to assume many forms . She called
them 'L-forms' in deference to the Institute at which she worked. Her exploration
also covered bacteria with cell-wall breeches. In either case, the resulting
germs, called 'cell-wall-deficient' assumed many forms (pleomorphic). Livingston
immediately saw Klieneberger's work as clearing a large part of the confusion
over her many-formed cancer germ.
- Livingston's trip to Rome's Congress of Microbiology
was punctuated by a stop to visit von Brehmer in Frankfort. Von Brehmer's
vaccination techniques, long respected throughout Europe, were now licensed
by the German government.
- During the war, Wilhelm von Brehmer's scrimmage with
the Nazi medical establishment went right to the top. Severely criticized
for saying that cancer was an infectious disease, the struggle eventually
found its way to Hitler himself, who, puzzled, yet interested, ordered
an inquiry on the matter at the 1936 Nuremberg Party Conference. Subsequently,
the committee formed came down hard on von Brehmer's views. Nevertheless,
unperturbed, he somehow persisted into the legendary status he now maintained.
- Big names began to join the conference, including Nobel
Laureates Fleming and Waksman. By the time Virginia Livingston returned
to the States, the Rome conference had been highlighted by several news
services. Beginning with the New York Times and The Washington Post, other
papers quickly followed suite: the cancer germ had been found. Reaction
quickly followed. At The New York Academy of Medicine, spokesman Iago Gladston,
fresh from executive session, held his own sort of news conference:
- This is an old story and it has not stood up under investigation.
Microorganisms found in malignant tumors have been found to be secondary
invaders and not the primary cause of malignancy. Livingston, 1972 Livingston
returned to Newark. Her Chief, James Allison, contacted her with the bad
news. Since they had lost Black-Stevenson funding, he wanted her to close
up Presbyterian's research and move back to Rutgers's home campus in distant
New Brunswick. And in still another cost-cutting gesture,
- she was informed that her close friend and associate
Eleanor Alexander-Jackson would have to go. Shocked, Livingston made arrangements
to leave Rutgers altogether. Barely unpacked from Europe, Livingston's
husband would now be hounded by the IRS regarding where they got the funds
for the European trip.
- Someone had implied the money came from his wife's grants.
This did not bear out and the couple demanded to know who had instigated
- "Someone high up in New York in cancer." The
IRS agent replied .
- Parallels with plant cancer
- By 1925 Mayo's Charles Mayo became interested in Erwin
Smith's discovery of cancer in plants, called crown gall. Livingston and
Jackson, sensing a possible link between Smith's work and their own, went
to the Bronx Botanical Garden to request cultures of Bacterium tumefaciens,
- cancer germ he had discovered. No mere accident led Virginia
Livingston towards Smith's work. Smith stained his plant cancer germ with
Fuchsin, long used to spot tuberculosis. And Smith's bacteria, like Livingston's,
had many shapes. He had stumbled across B. tumefaciens in 1904, when he
received some New Jersey daisies with overgrowths superficially resembling
olive tuberculosis, a known disease of plants, but which proved to be plant
- Smith had long suspected a bacterial cause for human
cancer and criticized pathologists for drawing:
- "Too sharp a demarcation between malignant
- tumors, on the one hand, where the cells of
- the animal or human host, acting under some
- unknown stimulus are responsible for the tumerous
- growth and granulomata (benign tumors)
- on the other hand, such as tuberculosis and
- actinomycosis, where a visible microbe is
- responsible for the primary tumor, and the direct
- migration of this microbe for any secondary
- tumors that may appear." -Rogers, 1952
- Smith's conclusion:
- "At the bottom, I think the distinction between
- such a disease, for example as tuberculosis or