FRII-14 HUBERT HUMPHREY'S BLADDER CANCER

Abstract

You have accessJournal of UrologyHistory of Urology II (Moderated Poster)1 Apr 2014FRII-14 HUBERT HUMPHREY'S BLADDER CANCER Christopher Hartman and Robert Moldwin Christopher HartmanChristopher Hartman More articles by this author and Robert MoldwinRobert Moldwin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1752AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail Introduction and Objectives Hubert Humphrey began serving in the United States Senate in 1948 and acted as Vice President from 1965-1969. We aim to examine his battle with bladder cancer, from which he died in 1978. Methods A thorough review of the medical literature, including PubMed, biographical sources, and periodicals was undertaken to examine the Urologic history of Hubert Humphrey. Results Hubert Horatio Humphrey was born on May 27, 1911 in Wallace, South Dakota. He assumed an early role in politics, first serving as the mayor of Minneapolis from 1945 to 1948, and then in the US Senate from 1948 to 1964. Under President Lyndon B. Johnson, he served as Vice President of the United States from 1965-1969. In May 1967 Humphrey noticed blood in his urine. This prompted a work up which included a cystoscopy, revealing findings consistent with cystitis, and a urine cytology. While a number of renowned pathologists analyzed the cytology, all but one, Dr. John K. Frost of Johns Hopkins University, believed it to be benign. It was on the basis of Dr. Frost’s analysis that Humphrey underwent a hematuria work up every 6 months. In 1969 a bladder biopsy revealed CIS, though no treatment was given at this time. Four years later, after returning to the Senate, biopsy of a suspicious lesion in his prostatic urethra revealed CIS with a small focus of microinvasive TCC. He therefore underwent treatment with radiation and intravesical thiotepa, often being severely plagued by the pain from the treatments, yet continuing to serve in the Senate. In 1976 Humphrey again had an episode of gross hematuria, and biopsy this time revealed infiltrating bladder cancer. Because of this, he underwent radical cystectomy at Memorial Sloan Kettering Cancer Center on October 5, 1976. While he recovered well from surgery, the pathology revealed diffusely infiltrative TCC with metastases to the pelvic lymph nodes. Just over 15 months after undergoing cystectomy, on January 13, 1978, Hubert Humphrey died at the age of 66 while still serving in the Senate. In 1994, the pathology slides from Humphrey’s 1976 cystectomy were analyzed for a number of genetic mutations. This analysis revealed a mutation in the p53 gene at codon 227, resulting in a truncated p53 protein. While this genetic defect was found in tumor cells, normal muscularis did not show the same mutation. Probing of the first 1967 cytology specimen revealed that a number of cells in his urine had harbored the same mutation as well. These findings suggest that tumor had already been present and had given rise to his first episode of hematuria in May 1967. Conclusions A well-respected politician, Hubert Humphrey struggled with bladder cancer for the last 10 years of his life. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e632 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Christopher Hartman More articles by this author Robert Moldwin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...