St. Jude and the next ‘cancer moonshot’
Donald Pinkel was about to take a job at Colorado University when board members at the proposed St. Jude Children’s Research Hospital in Memphis reached out to him. The year was 1961 and what happened in the ensuing decades became the first “cancer moonshot” in the medical world.
Actor Danny Thomas, of course, was the driving forces behind the new hospital complex in town. The “Make Room for Daddy” TV star had vowed to build a shrine to St. Jude Thaddeus if his career ever took off. When it did, close friends urged him to build a hospital instead.
Decades later, looking back on his move to Memphis, Pinkel says the situation was “a very iffy proposition.” By the time he arrived, the new project was running low on money and local blood banks were charging exorbitant prices.
Pinkel appealed to commanders at Millington Naval Air Station, urging that personnel there become regular blood donors to St. Jude. A system was worked out in which men in uniform received weekend passes to Memphis for every blood donation they gave.
The new doctor in town also recruited local college students and inmates at local prisons. In doing so, he formed a volunteer donor system in western Tennessee that “broke the back of the local blood banks,” Pinkel says.
Yet such victories were few and far between in the efforts against childhood leukemia more than a half-century ago. Much of the medical community considered cancer too difficult to take on, leaving only a handful of institutions (St. Jude, Roswell Park in Buffalo, MD Anderson in Houston and the National Institutes of Health outside of Washington, D.C.) to take up the fight.
“A sense of hopelessness pervaded the entire field,” Pinkel recalls. “To the point that many in the medical community thought, ‘Why bother to take on leukemia?’ Nothing appeared like it was going to change, ever, and
those of us battling to do something different? Well, lots of people thought we were nuts.”
So much so that Pinkel and his peers with the Acute Leukemia Group B, the first cooperative group in the field, were labeled killers, poison pushers, misfits and one nickname they somewhat embraced, the Cancer Cowboys. Under the direction of James Holland at Roswell Park, the ALGB initiated clinical trials in acute leukemia and met regularly to share information.
Despite having patients at multiple institutions, the leukemia doctors followed standardized protocols, which had as many as 28 different categories. They soon discovered that one drug couldn’t destroy all the cancer cells. There was no magic bullet. As a result, they began to deploy chemotherapy drugs in combination.
“Using them two, three, four at a time,” Pinkel recalls. “That was a very fundamental observation and fundamental insight. It became key to our progress moving forward.”
Despite much of the medical world opposing or ignoring their efforts, the Cancer Cowboys made amazing progress. In the mid-1960’s, only 10 percent of children suffering from Acute Lymphoblastic Leukemia lived more than a few years. In other words, it was a death sentence.
Today, more than 90 percent of kids with ALL survive to be adults.
With the medical world on the cusp of another cancer moonshot, thanks to advances in immunotherapy and other fields, we need to remember the determination, even the chutzpah of the Cancer Cowboys.
One of Pinkel’s favorite stories from the early days of cancer research involves the blood centrifuge machine. One evening in Buffalo, after a day-long meeting at Roswell Park, many of the leukemia doctors gathered at Holland’s house.
Out of the blue one of them said wouldn’t be great if we had some kind of machine that could “spin” the donors’ blood. Separate out the platelets, which would be much more beneficial to young patients.
As Pinkel and others recall, the notion didn’t disappear overnight. Even though the Cancer Cowboys had little background in machinery or engineering, they began to build such a machine.
The story of the blood centrifuge machine, the IBM 2990 and 2991, underscored their work ethic and ability to regularly think outside the box.
“Cancer is a formidable foe,” says Pinkel, who will turn 92 in September and now makes his home in San Luis Obispo, Calif.
“Having the best equipment, stateof-the-art hospitals, the necessary funds are certainly important. But what you dare do with what you have? That’s always the most important thing.”
Tim Wendel is the author of several books, most recently “Cancer Crossings: A Brother, His Doctors and the Quest to Cure Childhood Leukemia.”