In the quiet Chicago suburb of Niles, a local woman returning from her fourth funeral of a leukaemia child in the first three months of 1961 was very concerned that something unusual was happening in this small community. She contacted the Chicago American Cancer Society and enquired whether there was a “cancer epidemic or something in their area” as more than a dozen children in the town had been diagnosed with leukaemia within a short time. 

Fears quickly spread that the illness could be contagious, carried by some type of ‘cancer virus’. News coverage soon identified several other towns with apparent ‘cancer clusters’ as well. Belief that cancer was a simple contagion, like polio or the flu, kept bubbling up. 

“People wrote [to medical authorities] well into the 1960s asking, ‘I lived in a house where somebody had cancer. Am I going to catch cancer?’” remarked Prof Robin Scheffler, the Leo Marx CD assistant professor in the History and Culture of Science and Technology at MIT, and author of a new book – A Contagious Cause: The American Hunt for Cancer Viruses and the Rise of Molecular Medicine – which reconstructs the origins and consequences of a biological ‘moonshot’ aimed at finding human cancer viruses in the 1960s and 1970s. 

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Cancer virus research

Those fears that cancer might be contagious were taken seriously. The National Cancer Institute (NCI) created the Special Virus Leukemia Program in 1964 and over the next 15 years spent more than $6.5 billion (in 2017 dollars) on cancer virus research intended to develop a vaccine. That’s more than the funding for the subsequent Human Genome Project, as Prof Scheffler pointed out.

His well researched book traces the results of that funding, which were complex, unanticipated and significant. The government’s campaign merged the worlds of molecular biology, public health, and military planning in the name of translating laboratory discoveries into useful medical therapies. 

However, its expansion into biomedical research sparked fierce conflict. Many biologists dismissed the suggestion that research should be planned and the idea of curing cancer by a vaccine or any other means as unrealistic, if not dangerous. 

Although this intensive hunt was ultimately fruitless in uncovering the ‘cancer virus’, the effort of scientists nonetheless profoundly shaped our understanding of life at its most fundamental levels. As a direct result of the NCI’s funding project, the researchers discovered the existence of oncogenes – activated oncogenes can cause those cells designated for apoptosis to survive and proliferate instead, causing many forms of cancer. 

Prof Robin Wolfe Scheffler is the Leo Marx career development chair in the History and Culture of Science and Technology at the Massachusetts Institute of Technology in the US(click to enlarge)

The oncogene theory

“That investment helped drive the field of modern molecular biology,” said Prof Scheffler. 

“It didn’t find the human cancer virus. But instead of closing down, it invented a new idea of how cancer is caused, which is the oncogene theory.”

As research has continued, scientists today have identified hundreds of types of cancer, and linked many with viral origins, such as the human papillomavirus (HPV), of which at least 14 viruses in this group are cancer-causing, including cancers of the cervix, anus, vulva, vagina, penis and oropharynx. 

While there is not one ‘cancer virus’, some vaccinations reduce susceptibility to certain kinds of cancer. In short, our understanding of cancer has become more sophisticated, specific, and effective – but the path of progress had many twists and turns.

In an interview with the online Chicago Blog, published by the Chicago University Press, Prof Scheffler remarked that there was one particular revelation that surprised him the most during his research for the book: 

“Before I started work on this project, I had not thought of cancer as a viral disease, so I was very surprised to learn that today experts estimate that as many as one in six cancers around the world have links to viral infection – particularly the hepatitis B and human papillomavirus. While cancer doesn’t spread like an epidemic, this does mean that we could prevent a substantial number of deaths via vaccination. 

“What I found truly surprising was how drastically this varies around the world – in sub-Saharan Africa, where cases of cancer are forecast to rise dramatically in the next generation – the proportion of cancers linked to viral infection may be as high as four in 10. For me this highlights the importance of understanding that cancer can present a very different kind of public health problem depending on where we look.”

Less insurance, more research

As Prof Scheffler detailed in his book, fears that cancer was a simple contagion can be traced back at least to the 18th century. However, they appear to have gained significant ground in the early 20th-century US, influencing medical research and even hospital design. 

The rise of massive funding for cancer research is mostly a post-World War II phenomenon; similar to much of Prof Scheffler’s narrative, its story contains developments that would have been very hard to predict. For instance, as Prof Scheffler chronicled, one of the key figures in the growth of cancer research was the midcentury healthcare activist Mary Lasker, who with her husband Albert had founded the Lasker Foundation in 1942, and over time helped transform the American Cancer Society. 

During the presidency of Harry S Truman, however, Lasker’s main goal was the creation of universal health insurance for Americans – an idea that seemed realistic for a time but was eventually shot down in Washington. That was a major setback for the philanthropist. In response, though, Mary Lasker became a powerful advocate for federal funding of medical research, especially through the National Institutes of Health (NIH), and the NCI, one of the NIH’s arms. 

The biomedical settlement

Prof Scheffler called this trade off – less government health insurance but more biomedical research – the ‘biomedical settlement’, and notes that it was unique to the US at the time. By contrast, in grappling with cancer through the 1960s, Britain and France for example put more relative emphasis on treatment, and Germany looked more extensively at environmental issues. Since the 1970s, there has been more convergence in the approaches of many countries. 

“The term ‘biomedical settlement’ is a phrase I created to describe an idea that seems commonplace in the United States but is actually very extraordinary in the context of other industrial nations – which is, we will not federalise healthcare, but we will federalise health research,” Prof Scheffler said. “It’s remarkable to keep the government out of one but invite it into the other.”

While observers of the US scientific establishment today know the NIH as a singular research force, they probably don’t think of it as compensation, in a sense, for the failed policy aims of Mary Lasker and her allies. 

“Someone like Mary Lasker is one of the architects of the settlement out of her conviction that there were ways to involve the federal government even if they couldn’t provide medical care,” Prof Scheffler added. 

Fighting through frustration

The core of A Contagious Cause chronicles critical research developments in the 1960s and 1970s as biologists made headway in understanding many forms of cancer. But beyond its rich narrative about the search for a single cancer virus, the book also contains an abundance of material that underscores the highly contingent, unpredictable nature of scientific discovery. 

From stymied scientists to angry activists, many key figures in the book seemed to have reached dead ends before making the advances the world now recognise. Yes, science needs funding, new instrumentation and rich theories to advance, but it can also be fuelled by frustration. 

“The thing I find interesting is that there are a lot of moments of frustration,” observed Prof Scheffler. “Things don’t go the way people want and they have to decide what they’re going to do next. I think often the history of science focuses on moments of discovery, or highlights great innovations and their successes, but talking about frustration and failure is also a very important topic to highlight in terms of how we understand the history of science.”

For his part, Prof Scheffler said he hopes his book will both illuminate the history of cancer research in the US and underscore the need for policymakers to apply a broad set of tools as they guide the ongoing efforts to combat cancer. Cancer is a molecular disease, but it’s also an environmental disease and a social disease. 

“We need to understand the problem at all those levels to come up with a policy that best confronts it,” he added. 

In the pipeline

If scientific discovery can be fuelled by frustration, so too can creativity as Prof Scheffler confessed that his next project emerged from a moment of frustration when he was completing A Contagious Cause: “A chapter I drafted on connections between the war on cancer of the 1970s and the development of the biotechnology industry kept growing longer and longer as I found new material. 

“I eventually realised that this frustrating final chapter was actually the beginning of an exciting new book! 

“This second book, Genetown, will chronicle the history of the biotechnology supercluster in the greater Boston area as a case for thinking about the broader relationship between biotechnology and society.”