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Closing In on a Killer : THE TRANSFORMED CELL: Unlocking the Mysteries of Cancer, By Steven A. Rosenberg, MD, Ph.D., and John M. Barry (G.P. Putnam's Sons: $24.95, paper; 343 pp.) : WHO SURVIVES CANCER?, By Howard P. Greenwald (University of California Press: $25; 304 pp.) : THE TYPE C CONNECTION: The Behavioral Links to Cancer and Your Health, By Lydia Temoshok, Ph.D . , and Henry Dreher (Random House: $23; 432 pp.) : CANCER THERAPY: The Independent Consumer's Guide, By Ralph W. Moss, Ph.D. (Equinox Press, 331 W. 57th St., Suite 268, N.Y, N.Y., 10019: $19.95; 522 pp.)

October 25, 1992|Lois Wingerson | Wingerson, author of "Mapping Our Genes: The Genome Project and the Future of Medicine" (New American Library), writes often on medicine and molecular biology

Twenty years ago, in a cancer-research lab, I got to know a remarkable mouse. She had conquered so many massive tumors that we called her "Old Brinksmanship."

Brinksmanship was an inbred BALB/c house mouse, the star of our experiment in tumor immunology.

Our theory was that a prior "insult," an injection of cells from a mouse of a different strain, would somehow get a BALB/c mouse's immune system hopped up enough to attack and conquer cancer cells injected a few days later. Often the strategy worked. Tumors grew more slowly in "insulted" mice than in the untreated controls, and pre-treated mice usually survived longer.

Among the survivors, Old Brinkmanship was singular. Time after time, her tumor injection would grow to a lump the size of a dried prune. It was a tremendous burden, covering most of her flank. Yet she would always defeat it. I well remember the professor, stroking her belly afterward in search of the vanquished lump, shaking his head in wonder. What was it about Brinksmanship? If we could only know.

In 1968, Dr. Steven Rosenberg met a human version of Brinksmanship, a man he calls DeAngelo. While Rosenberg was working in a Massachusetts VA Hospital, he recalls in "The Transformed Cell," DeAngelo showed up with a gallbladder problem. Records showed that 12 years earlier a cancer surgeon had admitted defeat and sent DeAngelo home to die, riddled with tumors. Yet here he was again, untreated yet cancer-free, wearing an impish, sardonic smile and an "aura of secret triumph."

The encounter with DeAngelo triggered in Rosenberg an obsession: to discover how the human immune system can fight cancer, and thus to find a cure. Today Steven A. Rosenberg is a name you encounter in nearly every news article about cancer or gene therapy. Over two decades he has done to humans approximately what we tried with mice, but much more elegantly. He has found a factor that stimulates human immune cells, isolated immune cells that kill cancer cells and, most recently, injected patients with immune cells genetically altered to provoke an anti-cancer response.

"The Transformed Cell" is a misnomer. The book is not really about cells, but about Rosenberg himself. He regards cancer with an intimate and personal loathing, as a metaphor for the Nazis who killed some of his forebears in concentration camps. "The way cancer gradually takes over one's body and forces its victims and their families to watch impotently as it grows and spreads makes it hateful," he writes. "Cancer murders innocents. It is a holocaust."

Rosenberg portrays the history of his research on several levels: as a glimpse into the minds of scientists and doctors (Rosenberg is both), as the progress of a scientific concept, and as an account of bureaucratic struggles in medical science. It's fascinating reading, as well-paced as a detective novel, albeit tender rather than tough.

Rosenberg and co-author John M. Barry have taken the methods-and-results structure of a scientific report and fleshed it out with everything an average reader would like to know: personalities, emotions, irrelevant but interesting details. It is an achievement many science writers strain toward but can't attain, because they aren't inside the researcher's head. Describing an experiment on pigs, Rosenberg recalls the stench and the slippery, bloody mess--as well as the embattled antagonism of a junior colleague. He shows us a tumor, held in the human hand. It has "an unnatural, alien appearance. . . . The black color is unrelieved, not shiny and reflective, like obsidian, but dull, as if it absorbs all things into itself."

A novel would have Rosenberg succeed gloriously in his cancer crusade, or fail tragically. He has done neither, and he tells us so. In some patients, the experimental therapy has achieved astounding results; he has cleansed bodies riddled with tumors that other doctors had given up on. Many other patients have died, despite the best of hopes and efforts. He portrays them individually and with evident pain.

What distinguishes the survivors from the vanquished? This scientist also stands aside and shakes his head. He can tell us what their immune cells did, but not why their immune cells did it. In one sense, we have progressed very far from the professor and Old Brinksmanship. In another, we have not.

In "Who Survives Cancer?," Howard P. Greenwald addresses the issue head-on. The book is Greenwald's formal report of a study he carried out among 536 cancer patients in Seattle--enough people to allow him to address many issues pivotal to his central question. Greenwald looked at the social class of his subjects, their personalities, how their cancers were diagnosed, their treatments. Who survived? The single most important contributor, he found, was having cancer discovered before it was even suspected, during an ordinary checkup.

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