Malignant Growth: Creating the Modern Cancer Research Establishment, 1875–1915 by Alan I. Marcus

Abstract

Reviewed by: Malignant Growth: Creating the Modern Cancer Research Establishment, 1875–1915 by Alan I. Marcus Ornella Moscucci Alan I. Marcus. Malignant Growth: Creating the Modern Cancer Research Establishment, 1875–1915. Tuscaloosa: University of Alabama Press, 2018. x + 312 pp. $59.95 (978–0–8173–1979–3). Cancer and cancer research are topics that attract considerable attention in our society. Cancer affects a large number of people who have to cope with its social, emotional, and financial effects. At the same time, large sums of money are being invested not only in improving therapeutic facilities for sufferers, but also in medical and basic research to identify its causes and develop strategies for prevention, diagnosis, treatment, and hopefully, cure. In the past two decades cancer has also become the subject of a growing body of historical research. Recent historical [End Page 709] accounts have discussed cancer as a research question, policy problem, and public threat. The bulk of this work, however, has focused on the twentieth century. Less attention has been devoted to earlier periods. Works that attempt to redress the balance are thus particularly welcome. In Malignant Growth historian Alan Marcus turns his attention to the origins of experimental cancer research in the late nineteenth century and the international effort to illuminate cancer’s etiology. During the nineteenth century, cancer research had been dominated by pathologists. After decades of morphological research, however, pathology seemed to have come to an impasse with regard to the etiology of cancer. The successes achieved by Louis Pasteur and Robert Koch in the 1870s and 1880s raised hopes that the germ theory of disease might help elucidate the problem of cancer, in the same way as it had done for tuberculosis, cholera, and the bubonic plague. Many medical commentators believed that the discovery of cancer’s microbial/parasitic cause would eventually lead to a cure. Marcus charts the quest for the cancer microbe from the establishment of the first laboratories at the turn of the century to the outbreak of the First World War. He describes in great detail the staggering amount of work that went on in these institutions, against a background of heated debates about the role of endogenous and exogenous factors in the genesis of cancer, doubts about the applicability of animal research to humans, and tensions between laboratory workers and clinicians. Cancer researchers studied the transmission of cancer from animal to animal, as well as from dead human to animal. A large number of microbial and parasitic agents were also cultivated to fulfil “Koch’s postulates” and establish a causal relation. Although none of these agents were ultimately validated as a cause of cancer, cancer research continued to prosper, stimulated first by a turn to the (ultimately disappointing) study of the therapeutic effects of chemical substances on human cancer, and later by the view that cancer was not one, but many diseases, each with its causes and therapeutic possibilities. The pressure to find an immediate solution to the cancer problem was thus transformed into a more deliberate, systematic investigation into the minutiae of each of its manifestations. This is an impressive study, marred however by what has been termed “hindsight bias”: the tendency to see events as having been predictable, despite there having been little or no objective basis for predicting them. According to Marcus, early twentieth-century cancer researchers were destined to fail, because of “their unquestioned devotion to analogies derived from a theory of disease that could not be fruitful” (p. 7). Social historians of medicine will no doubt observe that the volume pays insufficient attention to the broader social and institutional context of cancer research. In the concluding chapter, Marcus asserts that “the institutions erected during the world’s first war against cancer have clearly failed. . . . We have gambled and gambled wrongly. We now must continue to feed the behemoth or abandon the patina of hope” (p. 232). Yet we are given little insight into the dynamics that have kept the monster alive, and how the situation might be remedied. It is also unfortunate that a number of typographical and factual errors have slipped through the copyediting and proofreading process: for example, “morality” [End Page 710] in lieu...