Innovations & Innovators:
Dr. Emil Freireich’s work changed the course of history for cancer treatment.
Emil Freireich had already made his groundbreaking discoveries about treating cancer before he came to Houston.
He remembers being dubious at first about the move, unsure about going from the National Cancer Institute in Washington, to the fledgling MD Anderson Cancer Center to set up a chemotherapy program.
“You have to move to Texas, a place which was the last place in the U.S. to get rid of malaria, an ugly place, to a hospital that is a teeny, tiny hospital with 100 beds, very small staff, no resources, no research,” Freireich, 89, recalled in an interview.
But eventually he did move, convinced by MD Anderson’s first president, R. Lee Clark, that Freireich’s and others’ talents and discoveries in combining chemotherapy drugs to successfully treat acute childhood leukemia could help shape what’s now become the country’s foremost cancer hospital.
“That whole group of folks, they were the founding fathers of a medical discipline — the discipline of medical oncology,” said Otis Brawley, chief medical officer of the American Cancer Society.
The son of Hungarian immigrants, Freireich traces his persistence in the face of adversity to growing up in a tough neighborhood in Chicago.
It’s a bit like the story of David and Goliath, Freireich says. His father died when he was 2, and his mother was seldom seen, working long hours in a sweatshop. He said he was mostly raised by a maid.
He used to regularly cross from the west side of Humboldt Park to the east side to go to high school, crossing through tough neighborhoods, during the throes of the Great Depression. He said he was lucky he wasn’t confronted or worse.
“My upbringing was an important factor in making a personality that faces challenges and is persistent,” he said. “I think that people who grow up in tough environments have that advantage.”
Inspired by a physics teacher, he attended the University of Illinois when he was 16. A local Hungarian woman gave him $25 for tuition and other college costs.
Freireich graduated sixth in his medical school class, then headed off to Cook County Hospital, where he delivered babies.
Freireich initially wanted to be a family doctor, but after publishing a noteworthy paper, he got hired at the National Cancer Institute. That’s where he made his mark.
At the cancer institute, Freireich had a ward full of patients who were children with childhood leukemia. Most of them died within months.
The disease was ugly. Kids would bleed from their eyes, ears, nose and other parts of their bodies. Parents were terrified of both the disease and potential treatments, Freireich says, but were willing to try anything.
Freireich drew on others’ success in fighting tuberculosis to develop a novel approach to attacking leukemia: combining more drugs than had ever been done before, in order to debilitate the cancer on multiple levels.
“It demonstrated we could cure any systemic cancer if we had drugs that were potent enough and specific enough,” Freireich said.
It was a daring move, one that was discredited by prominent researchers of the time, Brawley said. Combining the drugs meant the children got sicker from the side effects, shocking some in the medical community.
Freireich said he had to make a case to his superiors that trying this treatment, however risky and dangerous, was better than the inevitable: death in a few months.
Brawley said major journals published articles saying Freireich and his team “were going to poison these people, they were going to kill these folks.”
But the treatment worked, and kids began surviving.
Freireich would keep working, improving the treatment, which he continued for a year after the cancer was in remission to prevent relapse.
Today, the cure rate is more than 90 percent.
Brawley estimates that the discovery by Freireich’s team has saved the lives of at least 100,000 children with childhood leukemia in the United States. That also doesn’t count the impact that the team’s approach has had on thinking about how to treat cancer — radiation these days is often combined with other treatments.
“I think the phrase ‘attacking on multiple fronts,’ it’s incredibly appropriate,” Brawley says. “It’s a mindset of how you actually attack cancer.”
After Freireich and others joined the new MD Anderson Cancer Center in the mid-1960s, patients and doctors began flocking to Houston. His first leukemia patient there was another physician who had read their publications in academic journals about leukemia treatment.
“We were just growing leaps and bounds,” Freireich said.
He helped set up the first training program, bringing in ambitious doctors to help turn MD Anderson into a premier cancer research institution.
“We needed to grow young people to become scientists like we were,” he said.
They launched a developmental therapeutics program and attracted critical grant money from the National Cancer Institute. They published important abstracts on cancer and its treatment.
Freireich, 89, lives in Houston now, with his wife. He has four kids — none are doctors — and six grandkids. He stopped seeing patients one year ago, but still makes his way to MD Anderson Cancer Center regularly to participate in research and talk with other doctors, many who learned under him.
He doesn’t hesitate to talk about his achievements.
“It’s established scientifically that if a person discovers something that no human being ever knew before, it is the most gratifying sensation that man can experience,” Freireich says. “There’s no food or drink or comfort or massage or sex that is better than discovering something that no one knew.”
By most accounts, Freireich possesses to this day significant amounts of optimism and energy. That’s how he was able to do what he did for leukemia research, even in the face of warning and opposition, Brawley said.
But Brawley believes that was only possible because Freireich, and the team he was with, were unique.
“It was a net positive partially because these guys had a good moral compass,” Brawley said.