William Coley

William Coley
William Bradley Coley
Born January 12, 1862(1862-01-12)
Westfield, Connecticut
Died April 16, 1936(1936-04-16) (aged 74)
Parents Horace Bradley Coley
Clarina B. Wakeman

William Bradley Coley (January 12, 1862 – April 16, 1936) was an American bone surgeon and cancer researcher, pioneer of cancer immunotherapy. He developed a treatment based on provoking an immune response to bacteria. In 1968 a protein related to his work was identified and called tumor necrosis factor alpha.[1]

Contents

Biography

He was born on January 12, 1862 in Westfield, Connecticut to Horace Bradley Coley and Clarina B. Wakeman.

He began his career as a bone surgeon at New York Cancer Hospital (which later became part of the Memorial Sloan-Kettering Cancer Center); however, he became more interested in cancer treatment when one of his early patients died from bone cancer. While going through hospital records, Coley found a sarcoma case study of one patient named Fred Stein, whose tumor disappeared following a high fever from erysipelas infection, now known as Streptococcus pyogenes.[2] This sparked Coley’s interest and drove him to find what few examples of similar cancer treatment had been previously recorded. He discovered that other medical pioneers including Robert Koch, Louis Pasteur, and Emil von Behring, had recorded observations of erysipelas infection coinciding with cancer regression.

Coley’s first intentional erysipelas infection was performed on a patient named Mr. Zola on May 3, 1891, who had tonsil and throat cancer. Mr. Zola came down with erysipelas and his condition improved tremendously. Mr. Zola lived for another eight and a half years.[2][2]

Coley was convinced that he could effectively use bacteria to treat cancer and created a mixture of killed bacterial infusions since known as Coley's Toxins or Coley's vaccine. The infusion was administered by injection in increasing doses to induce a fever. Once stimulated, he observed, the immune system could be capable of tackling cancerous cells along with the infection. [2] The cancerous cells would then slough off.

Clinical trials

Coley developed the theory that it was the infections which had helped patients in the past to recover from their cancer. So he began to treat patients by injecting a brew of Streptococcus pyogenes directly into inoperable tumors. This met with much success, even after metastasis.[citation needed] The treatment was most effective when it provoked a fever and a full-blown infection. This observations coincided with similar observations in 1867 by the German physician W. Busch when his patient's tumor became smaller after a high fever.[3] Later, Coley decided to use a mixture of dead Streptococcus pyogenes and dead Serratia marcescens bacteria. According to Stephen Hoption Cann of the University of British Columbia, "He had successes you simply couldn't hope for today, curing even extensive metastatic disease."[4]

On January 24, 1893, the first patient to receive Coley vaccine (aka Coley's toxins) was John Ficken, a sixteen-year-old boy with a massive abdominal tumor. Every few days, Coley injected his vaccine directly into the tumor mass and produced the symptoms of an infectious disease, but did not produce the disease itself. On each injection, there was a dramatic rise in body temperature and chills. The tumour gradually diminished in size. By May 1893, after four months of intensive treatment, the tumour was a fifth its original size. By August, the remains of the growth were barely perceptible.[2]

The boy received no further anticancer treatment and remained in good health until he died of a heart attack 26 years later. Coley published his results and by the turn of the century 42 physicians from Europe and North America had reported cases of cancer that had been successfully treated with Coley vaccine.

Radiation therapy vs. Coley vaccine

By 1901, the development of x-rays as a cancer treatment showed great promise. In particular, the therapy resulted in immediate tumor destruction and pain relief. Although Coley claimed successful treatment of hundreds of patients, the absence of proven benefit or reproducibility led to broader emphasis on surgery and on the newly developing field of radiation therapy. This decision was borne out by the eventual successful treatment of millions of people worldwide with radiation therapy.

Coley arranged for a wealthy friend to provide funds to purchase two x-ray machines for his use. However, after several years of experience, Coley came to the conclusion that the effect of that primitive x-ray therapy in the untrained hands of experimenters was localized, temporary and not curative. The scientific majority disagreed, most notably his contemporary James Ewing. His contemporary critics cited the dangerous and unpredictable effects, predominantly the fever caused by the bacteria, that the vaccine had upon individuals weakened by cancer. Furthermore the vaccine had to be made to a patient's exact needs, making it more labour-intensive, time-consuming and expensive.

Coley died on April 16, 1936.[5]

Legacy

Coley's Toxins are currently available in several countries[citation needed]. One reformulation of Coley's Toxins is called Coley Fluid.

Drug makers including Pfizer and Sanofi-Aventis also have a renewed interest in modern versions of Coley's Toxins[6]; Pfizer has acquired the Coley Pharmaceutical Group, set up in 1997[7]

The historical results of Coley vaccine therapy are difficult to compare with modern results. Coley's studies were not well controlled and factors such as length of treatment and fever level were not adequately documented. Many of his patients had also received radiation and sometimes surgery. According to the analyses of Coley Nauts and Starnes, treatment success correlated with length of therapy and the fevers induced by the toxins. [8] The recently formed non-profit Global Cures Foundation[9] plans to fund research trials of Coley's Toxins in the near future.

There were, however, many different formulations of Coley Vaccine. These varied greatly in effectiveness, and there were many different treatment protocols that also varied greatly in effectiveness.

See also

References

  1. ^ Terlikowski SJ.: Tumour necrosis factor and cancer treatment: a historical review and perspectives.
  2. ^ a b c d e Coley WB (1893). "The Treatment of Malignant Tumors by Repeated Innoculations of Erysipelas: With a Report of Ten Original Cases.". American Journal of the Medical Sciences 10: 487–511. 
  3. ^ Busch W (1867). "Aus dersitzung der medicinichen.". Berliner Klinische Wochenschrift 5: 137. 
  4. ^ Stephanie Pain (2 November 2002). "Dr. Coley's Famous Fever". New Scientist. http://www.newscientist.com/article/mg17623675.700.html. 
  5. ^ "Eminent Authority on Cancer and Abdominal Surgery, 74, Won Many Honors". New York Times. April 17, 1936. http://select.nytimes.com/gst/abstract.html?res=F60D13F9395D13728DDDAE0994DC405B868FF1D3. Retrieved 2010-11-22. "Dr. Coley died early yesterday morning in the Hospital for Ruptured and ... known as the Mixed Toxins of erysipelas and bacillus or Coley's Toxin. was found ..." 
  6. ^ New York Times: article on Pfizer and Coley Pharmaceutical Group, 5 October 2005
  7. ^ news-medical.net: Pfizer to acquire Coley Pharmaceutical Group, 19 November 2007
  8. ^ Hobohm, Uwe (January - February 2009). "Healing Heat: Harnessing Infection to Fight Cancer" American Scientist 97 (1): 34-41.
  9. ^ Global Cures Foundation - Promising Therapies

Further reading

  • Decker WK and Safdar S (2009) "Bioimmunoadjuvants for the treatment of neoplastic and infectious diseases: Coley's legacy revisited" Cytokine Growth Factor Rev. 20(4):271-81.
  • Hall, Steven S. (1997) A Commotion in the Blood. New York, New York: Henry Holt and Company. ISBN 0-8050-5841-9
  • Hess, David J. (1997) Can Bacteria Cause Cancer? Politics and Evaluation of Alternative Medicine. New York, New York: NYU Press.
  • Hobohm, Uwe (January - February 2009). "Healing Heat: Harnessing Infection to Fight Cancer" American Scientist 97 (1): 34-41.[1]
  • Hoption Cann SA, van Netten JP, van Netten C. (2003) "Dr William Coley and tumour regression: a place in history or in the future" Postgrad Med J 79 (938): 672–680 [2] [3] [4]
  • Hoption Cann SA, van Netten JP, van Netten C, Glover DW. (2002) "Spontaneous regression: a hidden treasure buried in time" Medical Hypotheses 58 (2): 115-119 [5] [6] [7]
  • Hoption Cann SA, Gunn HD, van Netten JP, van Netten C. (2004) "Spontaneous regression of pancreatic cancer" Case Rep Clin Pract Rev 293-296 [8] [9]
  • Donald HM. (2003) "Coley" Spontaneous Regression: Cancer and the Immune System Philadelphia: Xlibris. [10]
  • Moss RW. (1996) "The Treatment of Cancer with Coley's Toxins" The Cancer Chronicles 7 (3-4) [11]
  • Starnes, C. (1992) "Coley's Toxins in Perspective" Nature 357 (6373): 11-12.

External links


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