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donald f: sarcoma

What did immunotherapy look like in 1953?

“I may be the last living survivor of anyone who received Coley's toxins.”

Donald Foley, 75, had no intention of becoming part of the medical history books. When he was diagnosed with bone cancer at the age of 13, the only thing he cared about was returning to play baseball with his friends.
His doctors tried to keep the scope of his illness a secret, but Donald learned later that he came very close to losing his right arm—and his life. In those days, amputation was a commonly employed treatment for sarcoma. Luckily for Donald, his doctor at the time knew about some unconventional research being done at Memorial Hospital in New York under the direction of Bradley Coley, M.D.
Bradley Coley is the son of William Bradley Coley, M.D., the 19th century New York surgeon widely hailed as the “Father of Cancer Immunotherapy.” Bradley’s sister, Helen Coley Nauts, was the founder of the Cancer Research Institute (CRI). Both Bradley and Helen believed strongly in the value of William Coley’s approach to treating cancer. This approach involved inoculating patients with heat-killed bacteria in the hopes of stimulating a vigorous immune response against the cancer. This bacterial concoction became known as Coley’s toxins. William Coley developed this approach after noting a striking correlation between patients coming down with a bacterial infection and their cancer mysteriously disappearing. Over the course of his 40-year career, he treated hundreds of patients—some quite successfully—with his toxin therapy. 
For Donald, the approach was a lifesaver. He went on to live a normal life, even becoming a professional firefighter. TheAnswertoCancer (TheA2C) spoke with Donald about being one of the last surviving patients treated at Memorial with Coley’s toxins—the world’s first immunotherapy.

TheA2C: When were you first diagnosed and what type of cancer was it?
Donald: It was 1953, a long, long time ago, and it was bone cancer—a sarcoma. It was on my right, the upper part of my right humerus. In that day and age, they didn't know as much as they know today and they told my parents that the diagnosis was not good and, worse than that, they said I had three months to live. So they wanted to amputate my arm. In lieu of that, there was a possibility of going down to Memorial Hospital in New York and being treated by Dr. Coley. So I did that instead.
I was told the reason for the toxin treatment was to jump-start my immune system to fight the cancer. The treatment was almost daily. I had radiation treatment in the morning and then the toxin treatment was in the afternoon. Every day I would feel my shoulder, and I could notice a difference. I could feel the tumor shrinking.
I had 21 treatments. But by the time I left the hospital, I couldn't feel any tumor on my shoulder. After 3 months, I went in and saw Dr. Coley and he examined me and he determined that I didn't need any more treatments. So that was that. I had to keep going back for examinations every three months and every six months and then the five-year period.
TheA2C: Did the cancer ever come back?
Donald: There's been no recurrence in 60 years. I'm perfectly healthy today except for aging issues. I'm 75 years old, but I don't think I really feel it.
TheA2C: What do you know about the history of Coley’s toxins?
Donald: I used to get letters from Helen Coley Nauts. We corresponded for years and years until she passed away. The story that I got from Helen Nauts was that her father had patients who had cancer—this was 75, 100 years ago. And there were instances where someone who had cancer got an infection. They didn't die from it, but they'd acquired it and came down with it and the cancer regressed. So he started putting two and two together and that's where he came up with the toxin that he developed that ultimately I received.
There was a study done of a whole bunch of patients and Helen Coley Nauts told me I was patient number 11 in there. I may be the last living survivor of anyone who received Coley's toxins in that trial.
TheA2C: What was the treatment like? Was it injected into the tumor?
Donald: No, not into the tumor. It was into a vein. It was a pretty good-size needle and it was a bluish fluid. I had the injection and what it did was it made me very, very hot. The core temperature of my body went way up. The nurses would come in with ice bags and apply them. That would last for, I believe, several hours and then gradually my temperature would revert to normal. Every day that I had a treatment, I had the spike in my body temperature. I don't understand it exactly, but somehow that temperature rise helped confront the cancer as well. Without that temperature rise, I guess they didn't feel it was really working.
TheA2C: What was it like for you, as a 13 year old, to be going through this?
Donald: Oh, God. I'll tell you this; it was like yesterday. I vividly remember how I felt. In my hospital room, I'd look out the window and I could see kids down on a playground playing. And I thought, “Why am I here and they're down there?” It was tough. It was really tough.
I didn't know everything that was going on at that point. They couldn't tell me everything. They kept things from me—my parents did, the doctors did. It wasn't until I was discharged from the hospital that my mother told me some of the things that they told her about “three months to live” and all this stuff. And that they were thinking about amputating my arm.
Each thing that I was told made me more and more aware how lucky I was. I used to think, “I don't know if I'll even live until I'm 20.” And then when I got to 20, I thought, “I don't know if I'll make it to 30.” You never really think that you're over it because it can come back and you're always looking over your shoulder. In my case, it didn't, for which I'm eternally grateful. It's a terrible disease, especially for a child.
TheA2C: Do you remember what you did when you got home? What was the first thing you did after you got out of the hospital?
Donald: I wanted to get out of the house and I wanted to go out and play with my friends. I loved sports and we used to even play in the street. I lived in a small town and I knew I wanted to get out with my friends again. I just wanted to be a normal kid. I wanted to go back to doing the things that I couldn't do when I was in the hospital.

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