Thalidomide for Cancer?

Last week, only a few months after thalidomide was denounced as the cause of the worst medical disaster in history, the drug was being hailed in Israel as a possible treatment for cancer.

The Israeli case history began in 1955, when widowed Bluma Bursi, now 78, developed a swelling on her hip that grew as big as a grapefruit. Laboratory pathologists in Tel Aviv examined the lump after it was removed and declared the growth malignant--a fat-cell cancer. After an apparent recurrence, Bluma Bursi's leg was amputated in 1960. Late last year, she developed severe pain, an abdominal swelling of a type often caused by cancer, along with a suspicious lump, and coughed up blood. Morphine lost its power to ease her pain; doctors gave her only ten days to live.

Even Calfs-Foot Jelly. When the patient's son-in-law, Russian-born Dr. Arieh Rapoport, came to visit her, instead of more morphine or barbiturates he prescribed thalidomide, hopeful that it might prove to be a better sedative. He had no thought that it could have any effect on the disease. "After the first pill," says Mrs. Bursi's daughter, "mother had her first good night's sleep in weeks. Next day, she talked coherently. In a month, she was able to eat by herself. Now she eats everything--even her favorite, calf's-foot jelly."

Dr. Rapoport stopped the thalidomide in April, when he learned of its undesirable effects, which sometimes include a generalized neuritis, regardless of the sex and age of the patient. But last week Bluma Bursi was pink-cheeked and hearty. Said her daughter: "If she had her leg, she'd be able to do housework."

An expert general practitioner, Dr. Rapoport, 57, is frightened by the attention being paid to this one unusual but not unprecedented case.* He is confident that Mrs. Bursi had cancer in her lungs last year, but admits there is no laboratory evidence to prove it.

Wait for Evidence. Medical scientists' best guess as to how thalidomide damages the fetus is that rapidly dividing cells mistake it for either glutamic acid or a B vitamin, absorb it, and fail to develop normally. In theory, thalidomide might block the metabolic processes of rapidly dividing cancer cells by the same mechanism. But thalidomide failed dismally in its first routine trials against animal cancers in the U.S., and has shown no promise in more detailed tests now in progress.

Though supplies of thalidomide for testing as a tranquilizer-sleeping pill were called in from U.S. investigators last April, cancer researchers may still use it --certainly in male patients and women beyond child-bearing age. It is not available to physicians generally, and even the few qualified cancer investigators who can get thalidomide will probably wait for it to show results in animals before they give it to patients.

* U.S. researchers keep a register of unexplained recoveries from proven cancer, now have a total of 119 accepted as genuine.

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