Pediatric Pathologist Sidney Farber, MD: The ‘Father of Modern Chemotherapy’ and Cofounder of the Jimmy Fund


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Everything that can be done with the aid of medical tools now available should be carried out for the comfort, relief of pain, and prolongation of life of the patient with acute leukemia.

In June 3, 1948, The New England Journal of Medicine published a study by Sidney Farber, MD, showing that a synthetic compound, 4-aminopteroylglutamic acid (aminopterin), could induce remissions in seriously ill children with acute leukemia.1 Although the study was small—just 16 children—10 showed clinical, hematologic, and pathologic evidence of improvement. Even though the children’s remissions were short-lived, Dr. Farber’s findings were so groundbreaking—until then, no drug had proved effective against non–solid tumor cancers—they ushered in the era of chemotherapeutics, chemical agents that could stop cancer cells from growing and replicating, in effect killing them.

Aminopterin was later replaced by methotrexate, a similar but more effective folic acid antagonist with fewer side effects, which is still used today in the treatment of leukemia and other blood and solid tumor cancers. Nevertheless, the results of Dr. Farber’s study earned him the title, the Father of Modern Chemotherapy.

Leukemia was first identified in 1845 by German pathologist Rudolph Virchow; 100 years later little had changed in the grim prognosis of the disease, and many patients died within weeks of diagnosis. In 1947, with little more than blood transfusions and general nursing care to offer young leukemia patients, Dr. Farber enlisted the aid of members of the Variety Club of New England, a charitable organization formed by people in the entertainment industry who were interested in providing financial support for scientific efforts, especially those affecting children. Early the following year, Dr. Farber and the Variety Club launched the Children’s Cancer Research Fund to raise money and advocacy efforts around childhood cancers. They also established the Children’s Cancer Research Foundation, which began funding Dr. Farber’s small, outpatient clinic at Children’s Hospital in Boston, where he was a pathologist.

The Jimmy Fund

To put a face on cancer, Dr. Farber and Bill Koster, a member of the Variety Club, scouted the wards of Children’s Hospital looking for a poster child who could take the fund-raising message to the public. They found Einar Gustafson, a young boy being treated for a rare form of lymphoma, but to protect his privacy, Dr. Farber insisted that the boy be known only as “Jimmy.”

When Jimmy was featured on the radio show Truth or Consequences in the spring of 1948, the show’s host, Ralph Edwards, asked listeners to “send in their quarters, dollars, and tens of dollars … to Jimmy for the Children’s Cancer Research Fund.” The broadcast lasted only 8 minutes but raised $231,000 for the Children’s Cancer Research Fund, later renamed the Jimmy Fund.

By the beginning of the 1950s, Dr. Farber’s work in treating children with cancer was becoming so well known, his clinic was moved to a four-story complex called the Jimmy Fund Building to accommodate the increasing number of patients. In 1969, the Children’s Cancer Research Foundation expanded its programs to include patients of all ages and later became known as the Sidney Farber Cancer Center, eventually becoming the Dana-Farber Cancer Institute.

Advent of Total Medical Care

Throughout the 1950s and 1960s, Dr. Farber continued to make advances in cancer research, including the discovery that the antibiotic actinomycin D (dactinomycin) and radiation therapy could produce remission in Wilms’ tumor, a pediatric cancer of the kidneys, and that agents such as corticosteroids were effective in treating acute leukemia. Buoyed by these discoveries, Dr. Farber told Redbook magazine in 1963, “Now we are an army on the march.” And headlines in leading papers of the day such as the Saturday Evening Post optimistically proclaimed, “Cancer Is Yielding Up Its Secrets.”

Dr. Farber’s medical innovations during that time also included the concept of what is today called “total care,” in which a variety of services for patients with cancer and their caregivers, including clinical care, nutrition, social work, and counseling, are provided in one place. He described the idea in an article for CA: A Cancer Journal for Clinicians in 1965:

“A generalization may be formulated for guidance, even in the absence of truly curative therapy: everything that can be done with the aid of medical tools now available should be carried out for the comfort, relief of pain and prolongation of life of the patient with acute leukemia.” 2

Expectation of Progress

Knowing that if cancer was to be conquered it would take a national effort and major funding commitments by the government, Dr. Farber became a frequent presenter at Congressional hearings on appropriations for cancer research, explaining that federal support was essential to reducing the death rate from cancer. Although Dr. Farber’s efforts paid off—between 1957 and 1967, the annual budget of the National Cancer Institute increased from $48 million to $176 million—he had no illusions of a quick cure for cancer. In a 1971 newspaper article, Dr. Farber wrote, “Any man who predicts a date for discovery is no longer a scientist. We have a solid basis of accomplishment in research and treatment to permit controlled optimism and expectation of rapid progress.”

On March 30, 1973, at the age of 70, Sidney Farber passed away from cardiac arrest while working in his office in the Jimmy Fund Building. In a memoriam to Dr. Farber that appeared in the November 1974 edition of The American Journal of Pathology, Orville T. Bailey, MD, an associate and Assistant Professor at Harvard Medical School from 1946 to 1951, wrote, “There can be no end to the lines of endeavor which Dr. Farber initiated. They cover the whole spectrum of effort to improve the care of children. The best tribute to him is to observe how far his vision has carried this objective and to see how others have found the path he made.” ■

References

1. Farber S, Diamond LK: Temporary remissions in acute leukemia in children produced by folic acid antagonist, 4-aminopteroyl-glutamic acid. N Engl J Med 238:787-793, 1948.

2. Farber S: Management of the acute leukemia patient and family. CA Cancer J Clin 15:14-17, 1965.



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