Medicine: Frontal Attack

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Differential Effect. Surgery cannot help the other 9,000,000. Many cancers involve vital organs that cannot be disturbed, or metastases which spread so quickly and widely throughout the body that the surgeon cannot find and remove them all. To deal with such cancers some agent is needed that has a strong "differential effect," i.e., that kills cancer cells without hurting normal tissue. A few such drugs are already known, but they are only a start, and not good enough.

The trouble is that cancer cells are very like normal cells. An agent that hurts one generally hurts the other. Still, the gangster cells have differences. The very fact that they grow rapidly in a chemical medium, the blood, in which normal cells grow slowly, is sufficient proof that they are different. To find and exploit the differences is the chief goal of Sloan-Kettering Institute. The problem is being attacked at all levels—from simple testing of promising drugs to long-range exploration of the internal workings of cells.

Every week dozens of new chemicals come to Sloan-Kettering from commercial laboratories, chemical houses, university scientists and medical men. Each is catalogued and given a number (to head off charges of favoritism). The more interesting ones, thought to have strong biological effects, are tried on experimental cancers planted in white mice.

Girls & Mice. This testing is a mass-production process which would be impossible on such a scale in a smaller laboratory. Girls in white uniforms sit at a table with cages of mice before them and bits of mouse cancer in glass trays.

Deftly a girl picks up a cancer fragment with a trocar (a tubular needle with a plunger inside). She grabs a faintly squeaking mouse, holds it by the scruff of its neck, efficiently jabs the trocar into the skin of its belly and up under a front leg. She plants the cancer by pushing it out with the plunger. Then she reaches for another mouse.-

When the cancer has had time to "take," the mouse is injected with a just-under-killing dose of the chemical to be tested. After a week or so, a girl kills the mouse by crushing its fragile skull. Then she slits open its belly skin and measures the cancer, which is usually by this time a grey-pink, rounded mass as big as a thumbnail. If the tumor has disappeared or has not grown as much as expected, the chemical is listed as promising enough for further testing.

Eggs & Tubes. Another type of testing is done on eggs. A girl technician examines a fertile egg under a strong light, finds the developing embryo, and cuts a square hole in the shell above it. She plants a bit of cancer on the embryo, and seals the hole with a glass window stuck on with wax. The egg is put in an incubator. As the embryo grows, the cancer grows too. The embryo's blood vessels turn aside to supply the cancer, which frequently grows until it is nearly as big as the chick. Drugs are tested by injecting them into the egg yolk, and noting through the window what they do to the cancer.