Dr. Eugene Saenger, the Ohio radiologist who contributed greatly to medical knowledge about the effects of radiation on the human body, and who was sued for his role in controversial 1960s studies on cancer patients, died Sunday. He was 90 and had been battling bladder cancer.
"Eugene Saenger was one of the real pioneers in assessing the acute effects of radiation," said Dr. Henry N. Wellman of the Indiana University Medical Center. His work in the 1950s "led to an understanding of biologic indicators of dosimetry, categorization of various acute radiation syndromes, and the development of triage procedures for radiation accident victims," Wellman said.
Saenger was among the first to report on the growth of cancer cells in children following irradiation for benign conditions, and he published a landmark paper in 1968 demonstrating that, contrary to popular belief, radioiodine therapy was not associated with an increased incidence of leukemia.
That legacy was tarnished, however, by the experiments in which Saenger administered high levels of whole-body radiation to more than 90 poor, black, uneducated patients with inoperable tumors.
Saenger maintained that the tests were designed to relieve pain and perhaps shrink the tumors, but critics contended that their sole purpose was to determine the deleterious effects of radiation on the human body for the benefit of the U.S. military, which provided the bulk of the funding for the studies.
As many as 20 of the patients may have died as a result of the radiation and the majority suffered intense pain, persistent nausea and a variety of other ill effects from the radiation.
"These people were sick," Saenger said in 1993. "They had far advanced cancer. We gave them this treatment to see . . . whether we could improve their condition. It was called palliative therapy. It was not intended to be curative therapy."
He added: "These are studies of which we are very proud."
In 1999, however, a federal judge approved a $4-million settlement to the families of the patients. That settlement included the installation of a plaque at Cincinnati's University Hospital commemorating the experiment and listing the names of 70 of the patients.
"He did some great things, I think," said Dr. David Egilman of Brown University, who has studied workplace hazards such as radiation and was one of Saenger's harshest critics. "He also did some horrible things, I think."
From the mid-1940s to the mid-1970s, more than 4,000 radiation experiments were conducted on tens of thousands of Americans. Physicians viewed radioisotopes as a promising new therapy for cancer and perhaps some other diseases. Industry saw it as a potential power source, not only for the production of electricity, but for trucks, trains and even airplanes. The military saw it as an essential tool for modern warfare.
And all of those groups needed to know what would happen to humans exposed to the radiation -- either directly, in medical use and in war, or indirectly, to workers exposed inadvertently while doing their jobs.
The standards for conducting experiments were substantially different than they are today. Not until 1965 did patients have to sign a written notice of the potential benefits and risks of a clinical trial or other experiment, and only later did most institutions implement ethics boards to control and restrain human experimentation.
It was in this atmosphere that Saenger began conducting his experiments in the windowless basement of Cincinnati General (now University) Hospital -- a location large enough to hold the massive equipment and lead shielding required.
Saenger said he always explained the studies to his patients -- without mentioning the funding from the Department of Defense -- and he began collecting signed consent forms from the patients before the Food and Drug Administration began requiring them.
"I know that he felt he had acted entirely within the realm of medicinal science as it was known at that time," said Dr. Stephen Thomas, a medical physicist at the University of Cincinnati who worked with him. "He definitely felt that he had not overstepped any bounds, any ethics in the research."
The data collected in experiments by Saenger and others is still used today by industry and the military in the establishment of exposure guidelines, he said.
The data was also used to develop better techniques for bone marrow transplants, in which radiation is used to destroy the patient's own marrow in preparation for the procedure.
Eugene Lange Saenger was born March 5, 1917, in Cincinnati.
He graduated cum laude from Harvard University and earned his medical degree from the University of Cincinnati College of Medicine, then served as a radiology intern and resident at General Hospital.
Aside from his years at Harvard and two years in the U.S. Army Medical Corps in the mid-1950s, Saenger spent his entire career in Cincinnati. In 1987, the university's radioisotope laboratory was renamed in his honor.
Saenger co-founded the Society for Medical Decision Making in 1978 and served as its first president. He also won the highest honors of the Radiological Society of North America and the Society for Nuclear Medicine.
After the Chernobyl nuclear plant disaster in the Soviet Union in 1986, Saenger was one of the international experts called in to assess the hazards.
Among other conclusions, he told the military that it was not necessary to evacuate their forces from the downwind regions of Europe.
Saenger was an avid fly fisherman, and devoted countless hours to leading four successful tax levy campaigns to upgrade the facilities at University Hospital and to care for the indigent.
Saenger was preceded in death by his wife, Sue Reis Saenger, and a daughter, Katherine Soodek. He is survived by his son, Eugene L. Saenger Jr. of Cincinnati; four grandchildren; and two great-grandchildren.