Henrietta Lacks probably didn’t seem so immortal to doctors when she was first diagnosed at Johns Hopkins Hospital in 1951.
“It was generally a death sentence then,” said Patricia Eifel, a professor of radiation oncology at the MD Anderson Center in Houston.
Today, the disease is considered a cancer success story. Routine screening and improved treatment have driven its rates down from a major cause of death among women to one the rarest: Cervical cancer ranks just 14th in cancer frequency, and deaths from the disease have fallen some 70 percent since the 1950s.
But when Lacks, a mother of five, was being treated in East Baltimore during the Truman era, it was an illness clouded in secrecy, shame and dread.
It wouldn’t be until the 1980s that the sexually transmitted Human Papillomavirus (HPV) was identified as the cause of most cervical cancer, but it was still had whispered associations with sex, a disease of the poor and promiscuous.
“Nuns famously didn’t get cervical cancer, you would hear that in medical school,” said Eifel, who has worked in the field for 30 years.
Lacks, in the public “colored wards” of the world-renowned hospital, got the standard treatment for invasive cervical cancer at the time. Doctors stitched tubes and pouches filled with radium inside her cervix, sewing them and packing them in place.
At the same time, without her knowledge or consent, the surgeon snipped a sample of her tumor for a research team down the hall. Those cells grew robustly in the lab and became the famous “HeLa” line of cells that would transform medical research, even as Lacks’s children struggled to understand their mother’s fate. That story of discovery, ethics and race is told in the HBO movie debuting Saturday.
As the HeLa cells thrived, Henrietta herself failed, dying in agony a few months after the treatment. “She really had her cancer at the wrong time,” Eifel said.
One month after Lacks was buried, another woman whose name would live forever was wheeled into an operating room to be treated for cervical cancer, and she didn’t even know it. Eva Peron, the glamorous and powerful wife of Argentinian President Juan Peron, was never told she had the disease.
Evita thought she was having a procedure by a leading Buenos Aries surgeon to stop some cervical bleeding. Instead, after she was anesthetized, George Pack, a cancer specialist from New York who had been flown secretly to South America, entered the O.R. and performed a radical hysterectomy.
There was a such a taboo around cancer that many doctors didn’t want to use the C-word at all, lest the patient lose hope—or commit suicide—at a time when cancer seemed always to lead to a coffin.
“There were a lot of euphemisms used at that time: ‘You have a tumor,’ ‘You have an inflammation that we need to take out,’” said Barron Lerner, a physician and medical historian at New York University who has written about the Peron case.
With Peron, of course, politics and power also played a role in the secrecy. But even when the surgery failed to stop the cancer, and she went into a painful decline, she was kept in the dark.
Peron and Lacks fell to cervical cancer right at the beginning of a new age in fighting the disease. The biggest breakthrough was the introduction of a remarkably effective test for pre-cancerous cells developed by a Greek-born violin player and doctor named George Papanicolaou. His simple “pap smear,” which allowed doctors to treat and cure the cancer before it became established, was just coming into general use as a screening tool when Lacks fell ill.
By the early 1960s, radiation therapy was becoming more refined, too, with cobalt beams and linear accelerators allowing for targeted dosages that didn’t wreak such damage in surrounding tissue. Better anesthesia and surgical techniques boosted survival rates. Procedures that spared a woman’s ability to have children made many of them more willing to undergo treatment.
And then came the drugs. Lerner noted that Peron was given a nitrogen mustard concoction in a last-ditch attempt to arrest her cancer, reportedly making her Argentina’s first chemotherapy patient. Today, of course, the pharmacopoeia includes multiple agents capable of shrinking tumors.
Cervical cancers are now considered one of the more treatable malignancies, but not everywhere. In poor areas, where screening and treatment remain out-of-reach for many women, it’s still 1951.
Kathleen Schmeler, a gynecologic oncologist at the MD Anderson Center, often works outside the bubble of modern medicine. In the border region of Texas, cervical cancer rates are 30 percent higher than the national average. In Mozambique, Schmeler found only one practicing medical oncologist in the entire country.
“She told me no one wants to go into the oncology. ‘They say we just take care of the dead,’ ” Schmeler said. “I didn’t live in that [earlier] era, but I feel like I still see it in these countries.”
Most promising perhaps, are the vaccines that can keep people from contracting the cancer-causing HPV viruses in the first place. If enough children are immunized—something that hasn’t happened yet—doctors predict another plunge in the rates of cervical cancer in women and the HPV-related head and neck carcinomas that are the fastest growing cancers in men.
And yes, those vaccines that could have spared Henrietta Lacks were developed from her own cells.
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