Chapter 3: Diagnosis and Treatment

When Henrietta went to John Hopkins they took a biopsy, a sample of living tissue, from the lump in her cervix. A few days after she left the results came back that she had "Epidermoid carcinoma of the cervix, stage 1", which is really just a fancy way of saying she has cervical cancer. All cancers start out from one cell that goes wrong- the cancer type is categorized by the type of cell it originated from. Cervical cancers are often called carcinomas, which grow from the epithelial cells that line and protect the cervix. At the time Henrietta came in Howard Jones, the gynecologist who saw her, and Richard Wesley TeLinde, one of the best cervical cancer experts in the country and an amazing surgeon, were in a debate about the two types of cancer and how to treat them most effectively. The two types of cervical cancers are invasive and noninvasive or carcinoma in situ. Invasive cervical cancer penetrates the surface of the cervix while noninvasive types grow in a type of layered sheet across the surface of the cervix. By 1951 most doctors believed that noninvasive cervical carcinoma wasn't deadly and thought it couldn't spread. They generally treated invasive cervical cancer aggressively and didn't treat noninvasive cervical cancer at all but later studies showed that 62% of patients with noninvasive types ended up developing invasive types when left untreated. TeLinde believed that noninvasive cervical cancer was really just an early stage of invasive cancer. Soon after a researcher named George Papanicolaou found a test, now called a Pap smear, to find precancerous cells in the cervix doctors thought that cervical cancer would be almost entirely preventable. This was a time when 15,000 women a year died from it! Unfortunately that wasn't the case, most doctors couldn't read the results of the Pap smears correctly and ended up diagnosing their patients incorrectly, causing many of them to die. This is where TeLinde comes in. He wanted to document what WASN'T cervical cancer by having doctors double check the smears with biopsies. What he needed was cell samples. So TeLinde began to take samples from patients who went to the public ward, they thought that it was okay because most if the patients from those wards were treated for free so using them for research was a type of payment. After he took the samples he would send them to George Gey, who had been trying, unsuccessfully, to grow immortal human cells- cells that continuously kept dividing and growing. Jones called Henrietta in for treatment and told her about her condition. When she went to the hospital they gave her a surgery where a plaque filled with radium* was sewed to the outer surface of her cervix; however, before he put in the plaque he took two tissue samples. Dr. Lawrence Wharton Jr., the surgeon on duty, took two dime sized samples from her cervix without her knowledge, one from the cancer and one from the healthy tissue nearby. These samples were sent to Gey's lab and would change the lives of millions. * radium was discovered in France by Marie and Pierre Curie who found that it destroyed cancerous cells. they didn't know, however, that too much exposure to radium could kill OTHER cells, cause cancer from mutations and literally burn your skin off. one doctor named Howard Kelly, who traveled the world collecting radium and carrying it in his pockets, died of cancer- probably from his regular exposure to it. although it isn't the best thing to be around regularly, radium was proven to be the safer treatment for invasive cervical cancers when compared to surgery.