Contested cumulations: Configurations of cancer treatments through the twentieth century

Bulletin of the History of Medicine

Volumn 81, Issue 1, 2007, Pages 164-196

  Pickstone, John V ^a  

^a UNIVERSITY OF MANCHESTER   (United Kingdom)

Author keywords

Cancer treatments; Contested cumulations; National differences; Path dependency; Specialization; Ways of knowing

Indexed keywords

EID: 34047099207     PISSN: 00075140     EISSN: None     Source Type: Journal    
DOI: 10.1353/bhm.2007.0011     Document Type: Conference Paper

References (113)

1. Cancer history has benefited of late from a series of excellent review articles that build on each other, and that include treatment as well as research: David Cantor, "Cancer," in Companion Encyclopedia of the History of Medicine, ed. W. Bynum and R. Porter (London: Routledge, 1993), pp. 536-60;
2. Ilana Löwy, "The Century of the Transformed Cell," in Science in the Twentieth Century, ed. J. Krige and D. Pestre (Amsterdam: Harwood, 1998), pp. 461-78;
3. Patrice Pinell, "Cancer," in Medicine in the Twentieth Century, ed. Roger Cooler and John Pickstone (Amsterdam: Harwood Academic, 2000), pp. 671-86;
4. Jean Paul Gaudillière, "The Cancer Century," in The Cambridge History of Science, vol. 6, The Biomedical and Earth Sciences since 1800, ed. Peter Bowler and John V. Pickstone (New York: Cambridge University Press, forthcoming).
5. For another example of how history may allow doctors to appreciate the contingencies of divisions between specialisms, see Jeffrey P. Baker, "Historical Adventures in the Newborn Nursery: Forgotten Stories and Syndromes," in Clio in the Clinic: History in Medical Practice, ed. Jacalyn Duffin (New York: Oxford University Press, 2005), pp. 105-15, esp. pp. 107-9.
6. John V. Pickstone, Ways of Knowing: A New History of Science, Technology and Medicine (Manchester: Manchester University Press, 2000; Chicago: Chicago University Press, 2001);
7. Pickstone, "The Biographical and the Analytical," in Medicine and Change: Innovation, Continuity and Recurrence, ed. I. Löwy (Paris: Libbey, 1993), pp. 23-48.
8. In Pickstone, Ways of Knowing (n. 2), there are historical chapters on the meanings of nature and artifacts, and on natural history as a tradition; both are treated as constitutive of "science, technology, and medicine" generally.
9. See Rosemary Stevens, Medical Practice in Modern England: The Impact of Specialization and State Medicine (New Haven: Yale University Press, 1966);
10. Stevens, American Medicine and the Public Interest (New Haven: Yale University Press, 1971), For paramedical,
11. see Gerry Larkin, "Health Workers," in Companion to Medicine in the Twentieth Century, ed. Roger Cooter and John Pickstone (London: Routledge, 2003), pp. 531-42.
12. A major work appeared too late to be used here: George Weisz, Divide and Conquer: A Comparative History of Medical Specialization (New York: Oxford University Press, 2005).
13. See also the articles edited by Patrice Pinell in "La spécialisation de la médécine, XIX-XX siècles," Actes de la recherche en sciences sociales, 2005, 156-57.
14. For professional jurisdictions more generally, see Andrew Abbott, The System of Professions: An Essay on the Division of Expert Labor (Chicago: University of Chicago Press, 1988).
15. See the ASCO and ASTRO Web sites.
16. Patrice Pinell, The Fight against Cancer France, 1890-1940 (London: Routledge, 2002).
17. James T. Patterson, The Dread Disease: Cancer and Modern American Culture (Cambridge: Harvard University Press, 1987), pp. 137-70.
18. Barron H. Lerner, The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America (New York: Oxford University Press, 2001), pp. 69-91.
19. The First Twenty Years of the University of Texas M. D. Anderson Hospital and Tumor Institute (Houston: University of Texas M. D. Anderson Hospital and Tumor Institute, 1964). For information on the MDA, I am also indebted to Helen Valier and Emm Barnes.
20. Juan A. del Regato, "The Unfolding of Therapeutic Radiology in the United States: A Participant's View and Autobiographical Essay," in del Regato, Radiation Oncologists: The Unfolding of a Medical Specialty (Fairfax, Va.: Radiology Centennial, 1993), pp. 197-209, on pp. 201-2.
21. See R. Lee Clark papers at the McGovern Archive, Houston, Tex., esp. ser. 4.
22. Del Regato, Radiation Oncologists (n. 10), pp. 201-2.
23. See Leonard G. Wilson, Medical Revolution in Minnesota: A History of the University of Minnesota Medical School (Minneapolis: Midiwiwin Press, 1989).
24. For comparisons and relationships of industrial and surgical research, see Thomas Schlich, Surgery, Science and Industry: A Revolution in Fracture Care, 1950s-1990s(Basingstoke: Palgrave, 2002).
25. Caroline Murphy, "Cancer and Radiotherapy in Britain 1850-1950" (Ph.D. diss., University of Manchester, Faculty of Technology, 1986), p. 326.
26. Caroline Murphy, "From Friedenheim to Hospice: A Century of Cancer Hospitals," in The Hospital in History, ed. Lindsay Granshaw and Roy Porter (London: Routledge, 1989), pp. 221-41.
27. Eileen Magnello, in association with the Wellcome Unit for the History of Medicine, University of Manchester, A Centenary History of the Christie Hospital, Manchester (Manchester: Christie Hospital MHS Trust, 2003), pp. 23-35.
28. See Ornella Moscucci, "The 'Ineffable Freemasonry of Sex': Feminist Surgeons and the Establishment of Radiotherapy in Early Twentieth-Century Britain," in this issue.
29. Lerner, Breast Cancer Wars (n. 8), pp. 33-37.
30. Carl R. Bogardus, "Intersociety, Government, and Economic Relations," in Radiation Oncology, ed. R. A. Gagliardi and J. F. Watson, vol. 3 of the X-ray Centenary History volumes of the American Radiological Society (Fairfax, Va.: Radiology Centennial, 1996), pp. 201-29, on p. 218.
31. See Pickstone, Ways of Knowing (n. 2), esp. pp. 181-82;
32. Olga Amsterdamska and Anja Hiddinga, "The Analytical Body," in Cooter and Pickstone, Medicine (n. 1), pp. 417-34.
33. A Policy Framework for Commissioning Cancer Services: A Report by the Expert Advisory Group on Cancer to the Chief Medical Officers of England and Wales (known as the Caiman Hine report), Department of Health, London, 1995.
34. Pinell, Fight against Cancer (n. 6), pp. 106-42.
35. Lars-Gunnar Larsson, "Organisation of Radiotherapy and Clinical Oncology in Sweden: A Historical Review," Acta Oncologica, 1995, 34: 1011-15.
36. The conference is discussed in Charles Hayter, An Element of Hope: Radium and the Response to Cancer in Canada (Montreal: McGill-Queens University Press, 2005), pp. 81-84.
37. Murphy, "Cancer and Radiotherapy" (n. 15), chaps. 4-5.
38. Magnello, Centenary History (n. 17), pp. 23-34.
39. Biography of Paterson in del Regato, Radiation Oncologists (n. 10), pp. 155-66.
40. Magnello, Centenary History (n. 17), pp. 49-70.
41. David Cantor, "The MRC's Support for Experimental Radiology during the Interwar Years," in Historical Perspectives: Essays on the Role of the MRC, ed. Joan Austoker and Linda Bryder (Oxford: Oxford University Press, 1989), pp. 181-204.
42. R. Paterson, "Radiotherapy 1925-59," Brit. J. Radiol., 1973, 46: 168-70;
43. Murphy, "Cancer and Radiotherapy" (n. 15), p. 7.41.
44. Obituary of Stanford Cade, Lancet, 1973, 302: 745-46. The Wellcome Contemporary Medical Archives Collection, London, includes a useful transcript of its interview with some of Cade's younger colleagues (from 13 October 1993).
45. See the X-ray Centenary History volumes of the American Radiological Society;
46. and esp. three chapters in Radiation Oncology, ed. Gagliardi and Watson (n. 20): James D. Cox, "Clinical Practice," pp. 21-41;
47. Nancy Knight, "Training and Education," pp. 165-84;
48. and Bogardus, "Intersociety" (n. 20).
49. See del Regato, Radiation Oncologists (n. 10), for the collection of biographies, esp. those of Ewing (Memorial Hospital), Paterson (Christie/Holt, Manchester), and Fletcher (MDA); and the biographical notes on Desjardins of the Mayo.
50. See "Report of a Visit to Canada and the United States by a Delegation from the British Empire Cancer Campaign, July 1948," pp. 5 and 36, in the F. P. Spears Papers, ser. E, box 14, Wellcome Contemporary Medical Archives, London.
51. Bogardus, "Intersociety" (n. 20), p. 218.
52. David Cantor, "Radium and the Origins of the National Cancer Institute," The DeWitt Stetten Jr. Lecture given at the National Institutes of Health, Bethesda, Maryland, 28 June 2001.
53. Mac Cahal, executive secretary, to the ARC Board of Chancellors, 19 August 1937, quoted in Bogardus, "Intersociety" (n. 20), p. 215.
54. Ibid.
55. For Canada, see Hayter, Element of Hope (n. 25);
56. Antonia Maioni, Parting at the Cross-roads: The Emergence of Health Insurance in the United States and Canada (Princeton: Princeton University Press, 1998).
57. Cantor, "Radium" (n, 37).
58. For example, see the Minutes of the National Advisory Cancer Council for its initial meetings on 9 and 27 November and 13 December 1937, U.S. National Archives, Washington, D.C., RG G443, box 6;
59. and the biography of Albert Soiland in del Regato, Radiation Oncologists (n. 10), pp. 77-86.
60. Joan Austoker, A History of the Imperial Cancer Research Fund 1902-1986 (Oxford: Oxford University Press, 1988), pp. 69-90.
61. Clinical Research in Britain, 1950-1980, vol. 7 of Wellcome Witnesses to Twentieth Century Medicine (London: Wellcome Centre for the History of Medicine, 2000).
62. See Garsten Timmermann, "As Depressing As It Was Predictable? Lung Cancer, Clinical Trials, and the Medical Research Council in Postwar Britain," in this issue.
63. Lerner, Breast Cancer Wars (n. 8), pp. 93-101.
64. See Knight, "Training" (n. 33), pp. 176-82;
65. Cox, "Clinical Practice" (n. 33), pp. 28-36.
66. See the biographical notes on Kaplan, Fletcher, and del Regato himself in del Regato, Radiation Oncologists (n. 10), pp. 246, 237-38, and 259.
67. Cox, "Clinical Practice" (n. 33), pp. 35-36.
68. Bogardus, "Intersociety" (n. 20), pp. 225-27;
69. Cox, "Clinical Practice" (n. 33), pp. 30-36;
70. Jean B. Owen et al., "Recent Patterns of Growth in Radiation Therapy Facilities in the US: A Patterns of Care Study Report," Internat. J. Radiat. Oncol. Biol. Phys., 1992, 24: 983-86.
71. Bogardus, "Intersociety" (n. 20), pp. 205-6.
72. E. J. Maher et al., "Treatment Differences in Advanced and Metastatic Cancer: Differences in Attitude between the USA, Canada and Europe," Internat. J. Radiat. Oncol. Biol. Phys., 1992, 23: 239-44.
73. For the cancer-screening programs, see R. Bud, "Strategy in American Cancer Research after World War II: A Case Study," Soc. Stud. Sci., 1978, 8: 425-59;
74. G. Zubrod, "Origins and Development of Chemotherapy Research at the National Cancer Institute," Cancer Treat. Rep., 1984, 68: 9-19;
75. John Laszlo, The Cure of Childhood Leukemia: Into the Age of Miracles (New Brunswick, N.J.: Rutgers University Press, 1996).
76. For experimentalism in biomedicine generally, see Ilana Löwy, "The Experimental Body," in Cooler and Pickstone, Medicine (n. 1), pp. 435-50. For clinical trials as a new form of medicine, see Peter Keating and Alberto Cambrosio, "Cancer Clinical Trials: The Emergence and Development of a New Style of Practice," in this issue.
77. For an excellent account of medical oncology in the United States, Britain, and France, see Ilana Löwy, Between Bench and Bedside: Science, Heating, and Interleukin-2 in a Cancer Ward (Boston: Harvard University Press, 1996), pp. 36-83.
78. See also W. G. Jones, "Cancer Chemotherapy," in Cancer Topics and Radiotherapy, ed. C. A. F. Joslin (London: Pitman, 1982), pp. 31-45.
79. Cristelle Rigal, "Contributions à l'histoire de la recherche médicale: Autour des travaux de Jean Bernard et de ses collaborateurs sur la leucémie aiguë, 1940-1970" (doctoral diss., Universitë Paris 7 - Denis Diderot, 2003).
80. "Alexander Haddow," Biog. Mem. Fell. Roy. Soc., 1977, 23:138-91, on pp. 153-60.
81. See J. S. Tobias et al., "Who Should Treat Cancer," Lancet, 1981, 1: 884-86, on p. 885;
82. Gareth J. G. Rees, "What Is Best for the Patient? A European View," in Cost and Benefit in Cancer Care, ed. Basil Stoll (Basingstoke: Macmillan, 1988), pp. 31-38, esp. pp. 34-35.
83. Tobias et al., "Who Should Treat" (n. 58); Rees, "What Is Best" (n. 58);
84. J. Peckham, "Clinical Oncology: The Future of Radiotherapy and Medical Oncology," Lancet, 1981, 1: 886-87.
85. Also see the editorial in Lancet, 1981, 2: 674;
86. and David Galton's comments on a period of hostility from radiotherapists, in D. A. Christie and E. M. Tansey, eds., Leukaemia, vol. 15 of Wellcome Witnesses to Twentieth Century Medicine (London: Wellcome Centre for the History of Medicine at UCL, 2003), p. 23.
87. Royal College of Physicians (RCP) Paper (78/8), to the Working Party on Oncology, 1978, Royal College of Physicians Archives, London (hereafter RCPA).
88. Minutes of the Joint Committee on Medical Oncology, meeting at Glasgow, 9 October 1974, RCPA.
89. For example: "Unlike radiotherapists, who do not expect exciting overnight improvements, the medical oncologists receive periodical bursts of enthusiasm by the perennial advent of any new drug du jour'' (Juan A. del Regato, "One Hundred Years of Radiation Oncology," in Current Radiation Oncology, vol. 2, ed. Jeffrey S. Tobias and Patrick R. M. Thomas [London: Arnold, 1996], pp. 1-35, on p. 31).
90. See Timmermann, "Depressing" (n. 45).
91. See the account of Pinkel in Laszlo, Childhood Leukemia (n. 53), pp. 31-32, 234-38.
92. In 1981, it was reported that the United States had 1,700 medical oncologists certified (about 6.8 per million) since the recognition of the specialty in 1974, and that most large hospitals had set up departments. In Britain, "by contrast, departments of radiotherapy (which have historically been related to diagnostic radiology) have usually provided an outpatient service without attempting to supervise more general aspects of cancer care" (Tobias et al., "Who Should Treat" [n. 58], p. 885). In 1985 the ratio of medical oncologists to the population in the United States was about thirty-five times that in Britain (Rees, "What Is Best" [n. 58], p. 34). In 1995 there were 81 British consultants in medical oncology, less than a quarter of the number per population that the United States had supported fifteen years previously. The number in Britain increased more rapidly over the 1990s (on NHS rather than academic research funding) to 163 by 2001 and to 220 by 2006 (about 4 per million population) (Derek Crowther, personal communication).
93. Gretchen Krueger, "The Formation of the American Society of Clinical Oncology and the Development of a Medical Specialty, 1964-1973," Perspect. Biol. & Med., 2004, 47: 537-51.
94. Rosemary Stevens, "The Curious Case of Internal Medicine: Fundamental Ambivalence, Social Success,"' in Grand Rounds: One Hundred Years of Internal Medicine, ed. Russell C. Maulitz and Diana E. Long (Philadelphia: University of Pennsylvania Press, 1988), pp. 339-64.
95. These processes can be followed in the (Annual) Reports of the Memorial Hospital (at the Rockefeller Archive, Tirrytown, N.Y.), and in those of the M. D. Anderson Hospital (in the Hospital Archive, Houston, Tex.).
96. Memorial Hospital Report, 1947-51, Section on the Department of Medicine, Rockefeller Archive, Tarrytown, N.Y.
97. R. A. V. Milsted et al., "Cancer Chemotherapy - What Have We Achieved?" Lancet, 1980, 2: 1343-46, on p. 1343.
98. See Keating and Cambrosio, "Cancer Clinical Trials" (n. 54).
99. Christie and Tansey, Leukaemia (n. 59), pp. 12-14.
100. See n. 65. For comparisons of medical oncology in France, Britain, and the United States, see Löwy, Bench and Bedside (n. 55), esp. pp. 65-71.
101. For British policy I am indebted to Helen Valier, who is investigating the international politics; Lord Zuckerman, Cancer Research (London: HMSO, 1972);
102. and, re the Manchester scene, Derek Crowther, personal communication.
103. The term was used genetically in the interdisciplinary Working Party on Medical Oncology in 1978-79 (see Minutes, RCPA); and as an alternative to developing medical oncology: see Minutes of the Joint Committee on Medical Oncology (n. 61).
104. See Minutes of the College Committee on Medical Oncology, 1986-94, RCPA.
105. Ibid., 15 June 1990.
106. Larsson, "Organisation" (n. 24).
107. Löwy, Bench and Bedside (n. 55), pp. 65-71;
108. Tobias et al., "Who Should Treat" (n. 58);
109. Gareth Rees, "What Is Best" (n. 58), p. 34.
110. Bogardus, "Intersociety" (n. 20), pp. 225-27.
111. Patrick Castel and Erhart Friedberg, "Institutional Change as an Interactive Process: The Modernization of the French Cancer Centers" (Paper delivered at Institutions Conference, Stanford University, 26-27 March 2004).
112. Larsson, "Organisation" (n. 24).
113. For the United Kingdom, see the Royal College of Physicians and the Royal College of Radiologists, Joint Council for Clinical Oncology, Report of the Working Party on Training and Education in a New Specialty of Clinical Oncology, April 1998, RCPA.