William Coley
William Bradley Coley was an American bone surgeon and cancer researcher best known for his early contributions to the study of cancer immunotherapy, specifically causing infection as a way to fight cancer, a practice used as far back as 1550 BC. Coley is recognized as the Father of Cancer Immunotherapy for his contributions to the science.
Early life and career
Education
William Coley was born on January 12, 1862, in Saugatuck, a neighborhood of Westport, Connecticut. His parents were Horace Bradley Coley and Clarina B. Wakeman. He received his bachelor's degree in Classics from Yale University and his medical degree from Harvard Medical School in 1888. After his schooling, Coley began working at New York Hospital, now Weill Cornell Medical Center, as a surgical intern.Early sarcoma patients
In 1890, Coley began his first year of private practice at New York Hospital and met Elizabeth Dashiell, a 17-year-old patient who would later go on to inspire Coley to search for better methods of treating sarcoma. Dashiell visited Coley after suffering from a hand injury which he soon discovered to be an aggressive bone tumor. Treatment for sarcoma at the time was scarce; the most widely accepted form of treatment was a complete amputation of the affected limb. Despite receiving such a critical surgery as forearm amputation, Bessie died just ten weeks later due to widespread metastasis of the original cancer. Bessie's death had a profound effect on Coley's approach to practicing medicine. Coley was distressed that even modern medicine's customary procedure still could not save the life of one of his first patients. Coley then decided to take the search for new possible treatments into his own hands, soon becoming one of the medical community's model clinician-scientists.A clinician-scientist at work
After the death of Bessie Dashiell, Coley decided to review and research similar cases of sarcoma in the medical files at New York Hospital, where he found a case of interest involving a patient, a German immigrant named Fred Stein, with an inoperable tumor in his neck. To the astonishment of the doctors in the hospital at the time, Stein's round cell sarcoma seemingly vanished after being diagnosed with erysipelas, a skin infection now known to be caused by the bacterium Streptococcus pyogenes. Curious to discover the reason for the man's remission, Coley decided to search for the hospital's discharged patient, whom he eventually found in Manhattan with no trace of cancer left in his body.Developing Coley's toxins
After months of research devoted to finding the connection between cancerous patients developing infections and their own remission, Coley decided to pursue his notion that such recoveries, considered miraculous at the time, were provoked by an immune response in the body's immune system. In 1891, he began his experiments on a patient named Zola, an Italian immigrant and drug-addict with a life-threatening tumor which he described as "the size of a small hen's egg" in Zola's right tonsil. Hoping to spawn a similar case of remission that he had been studying for the past year, Coley attempted to induce a response by Zola's immune system by injecting Streptococcus, a bacterium known to induce erysipelas attacks, directly into his tumor. Five months and several trials of injection later, Zola finally developed full-blown erysipelas infection. The tumor once thought to be irreversible then began to dissolve, disappearing within two weeks. Zola recovered and lived another eight years, before eventually succumbing to a recurrence of the tumourTwo years after Zola's initial treatment, Coley treated ten more of his own patients with the same live Streptococcus bacteria. Because of the unpredictable nature of infection, which killed patients of his on two separate occasions, Coley changed the bacterial ingredients of what would be coined Coley's toxins from the live Streptococcus bacteria, to two dead bacteria, Streptococcus pyogenes and Serratia marcescens. The formula change to the use of dead bacteria drastically reduced the risk of death in patients; however, Coley's toxins still remained controversial in the medical community.
Emergence and popularity of radiation therapy
By 1901, the development of x-rays as a cancer treatment showed great promise. In particular, the therapy resulted in immediate tumor destruction and pain relief. Although Coley claimed successful treatment of hundreds of patients, the absence of proven benefit or reproducibility led to broader emphasis on surgery and on the newly developing field of radiation therapy. This decision was borne by the eventual successful treatment of millions of people worldwide with radiation therapy.Coley had arranged for a wealthy friend to provide funds to purchase two x-ray machines for his use. However, after several years of experience, Coley came to the conclusion that the effect of that primitive x-ray therapy in the untrained hands of experimenters was localized, temporary, and not curative. The scientific majority disagreed, most notably his contemporary James Ewing. His contemporary critics cited the dangerous and unpredictable effects, predominantly the fever caused by the bacteria, that the vaccine had upon individuals weakened by cancer. Furthermore, the vaccine had to be made to a patient's exact needs, making it more labour-intensive, time-consuming and expensive. Thus, the Coley's vaccine soon became obsolete due to the adoption of radiation technology in cancer treatment.