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During World War II, naval personnel who were exposed to mustard gas during military action were found to have toxic changes in the bone marrow cells that develop into blood cells. During that same period, the US Army was studying a number of chemicals related to mustard gas to develop more effective agents for war and also develop protective measures. In the course of that work, a compound called nitrogen mustard was studied and found to work against a cancer of the lymph nodes called lymphoma. This agent served as the model for a long series of similar but more effective agents (called alkylating agents) that killed rapidly growing cancer cells by damaging their DNA.
Not long after the discovery of nitrogen mustard, Sidney Farber of Boston demonstrated that aminopterin, a compound related to the vitamin folic acid, produced remissions in children with acute leukemia. Aminopterin blocked a critical chemical reaction needed for DNA replication. That drug was the predecessor of methotrexate, a cancer treatment drug used commonly today. Since then, other researchers discovered drugs that block different functions in cell growth and replication. The era of chemotherapy had begun.
Metastatic cancer was first cured in 1956 when methotrexate was used to treat a rare tumor called choriocarcinoma. Over the years, chemotherapy drugs (chemo) have successfully treated many people with cancer. Long-term remissions and even cures of many patients with Hodgkin disease and childhood ALL (acute lymphoblastic leukemia) treated with chemo were first reported during the 1960s. Cures of testicular cancer were seen during the next decade. Many other cancers can be controlled with chemo for long periods of time, even if they are not cured. Today, several approaches are available to improve the activity and reduce the side effects of chemo. These include:
Early in the 20th century, only cancers small and localized enough to be completely removed by surgery were curable. Later, radiation was used after surgery to control small tumor growths that were not surgically removed. Finally, chemotherapy was added to destroy small tumor growths that had spread beyond the reach of the surgeon and radiotherapist. Chemo used after surgery to destroy any remaining cancer cells in the body is called adjuvant therapy. Adjuvant therapy was tested first in breast cancer and found to be effective. It was later used in colon cancer, testicular cancer, and others.
A major discovery was the advantage of using multiple chemotherapy drugs (known as combination chemotherapy) over single agents. Some types of very fast-growing leukemia and lymphoma (tumors involving the cells of the bone marrow and lymph nodes, respectively) responded very well to combination chemo, and clinical trials led to gradual improvement of the drug combinations used. Many of these tumors can be cured today by appropriate combination chemotherapy.
The approach to patient treatment has become more scientific with the introduction of clinical trials on a wide basis throughout the world. Clinical trials compare new treatments to standard treatments and contribute to a better understanding of treatment benefits and risks. They are used to test theories about cancer learned in the basic science laboratory and also test ideas drawn from the clinical observations on cancer patients. They are necessary for continued progress.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
American Society of Clinical Oncology. Clinical Cancer Advances 2009: Major Research Advances in Cancer Treatment, Prevention and Screening. Accessed at www.cancer.net/patient/ASCO%20Resources/Research%20and%20Meetings/CCA_2009.pdf on June 8, 2012.
American Society of Clinical Oncology. Clinical Cancer Advances 2010: ASCO’s Annual Report on Progress Against Cancer. Accessed at www.cancer.net/patient/Publications%20and%20Resources/Clinical%20Cancer%20Advances/CCA_2010.pdf on June 8, 2012.
American Society of Clinical Oncology. Clinical Cancer Advances 2011: ASCO’s Annual Report on Progress Against Cancer. Accessed at www.cancer.net/patient/Publications%20and%20Resources/Clinical%20Cancer%20Advances/CCA_2011.pdf on June 8, 2012.
American Society of Clinical Oncology. Progress & Timeline. Accessed at www.cancerprogress.net/timeline/major-milestones-against-cancer on June 12, 2014.
CureToday. Timeline: Milestones in Cancer Treatment. Accessed at www.curetoday.com/index.cfm/fuseaction/article.show/id/2/article_id/631 on June 7, 2012.
Devita VT Jr, Rosenberg SA. Two Hundred Years of Cancer Research. N Engl J Med. 2012;366(23):2207-2214.
Hajdu SI. A Note From History: Landmarks in History of Cancer, Part 4. Cancer. 2012;118(20):4914-4928.
Hajdu SI, Darvishian F. A Note From History: Landmarks in History of Cancer, Part 5. Cancer. 2013;119(8):1450-1466.
Hajdu SI, Vadmal M. A Note From History: Landmarks in History of Cancer, Part 6. Cancer. 2013;119(23):4058-4082.
Last Revised: June 12, 2014