The discovery of Ewing’s sarcoma is only a small part of his contributions to medicine.
James Ewing was a pioneer in cancer research and tumor pathology. During his
lifetime, his achievements would lay the groundwork for future progress and
discoveries in the field.
Among his accomplishments were the discovery and classification of
Ewing’s sarcoma, the recognition of radiation as a cancer treatment and
the establishment of the American Association for Cancer Research and the
American Society for the Control of Cancer — now the American Cancer
Society.
Even more importantly, Ewing is credited as having pushed the limits of
cancer treatment in the beginning of the 20th century. He was not satisfied
that surgery was the only treatment for cancer and pressed for the discovery of
alternatives. Ewing believed that better cancer research could be done in
humans instead of lab animals and wanted to establish cancer as its own medical
specialty. He opposed the idea that cancer was one disease with one
still-unknown cure. Instead, he believed it to be various unique diseases with
different tumor biologies and causes.
His contributions to the field of oncology were many and proliferative, and
even earned him the cover of Time magazine when he retired from
medicine in 1931.
|
James Ewing (center)
and other members of the first National Advisory Council at the groundbreaking
ceremonies at the NCI’s building in June 1938.
Source: NCI |
Born Dec. 25, 1866, Ewing was a Christmas present for parents Judge Thomas
Ewing and Julia Rupert Ewing. He was the third of five children born and raised
in Pittsburgh, Pa.
Ewing attended public schools until his childhood was interrupted at the age
of 14 when he was diagnosed with osteomyelitis of the femur. For the next two
years, he was confined to bed. During this time, he was tutored by Henry
Gibbons, who gave the future pathologist his first microscope.
Ewing excelled in his studies at Amherst College in Massachusetts, where he
received a BA in classics and philosophy. He was accepted into the College of
Physicians and Surgeons of New York in the fall of 1888. Following graduation
three years later, he worked briefly on the surgical service at Western
Pennsylvania Hospital. He was then given an internship at Roosevelt Hospital
and Sloane Maternity in New York, an honor only the best graduates receive.
During his internship, he produced his first medical manuscript, a description
of the role of white blood cells in pneumonia.
In 1893, he became a histology instructor at Columbia University. Then in
1897, he was promoted to assistant in clinical pathology under T. Mitchell
Prudden, whom he had befriended at Sloane Maternity.
In 1899, Ewing was appointed the first professor of pathology at Cornell
University. He held the position for 33 years. In 1900, Ewing wed Catherine
Crane Halsted, and two years later, they had their first son, James. Sadly, his
wife and unborn second child died from eclampsia during pregnancy in 1903. This
loss caused Ewing to devote more time to his work and research and may have
made him more empathetic to the loss and suffering of the patients he was
trying to help.
In 1907, Ewing co-founded the AACR. He served as the president for the first
two years of its existence. Around this time, he became acquainted with James
Douglas, a mining engineer with a medical background and an interest in the
therapeutic potential of radium. Douglas, who had lost his daughter to breast
cancer, helped Ewing in his investigations of the use of radium as a
therapeutic agent in cancer. In addition, Douglas provided financial backing in
Ewing’s effort to establish a clinical cancer research unit at Memorial
Hospital in New York. Douglas gave more than $100,000 by 1912 to finance a
20-bed unit, the purchase of X-ray equipment and clinical labs.
In 1919, after a decade of painstaking work, Ewing published
Neoplastic Diseases, a reference on the pathology of tumors. This
mammoth text with more than 450 illustrations and 49 chapters became a standard
reference for cancer physicians and was subsequently published in multiple
languages. In it, Ewing gave detailed classifications and descriptions of a
multitude of tumor types. In his preface, he wrote:
“Up to a very recent time it has been the prevailing impression that
tumors fall into a limited number of grand classes in which the forms occurring
in the several organs are so nearly related as to be virtually identical. Hence
the practical physician or surgeon has been content without regard to the organ
involved, and on this theory to treat the members of each class alike … I
believe that this point of view has greatly retarded the progress of the
knowledge of tumors, and it has been the writer’s effort to combat such a
conception, so far as present knowledge permits.”
At a New York Pathological Society meeting in 1920, Ewing presented his
research on a malignant bone tumor. The tumor had clinical symptoms of
osteomyelitis and most frequently manifested in certain bones of adolescents.
However, Ewing characterized the neoplasm by its radiosensitivity. Ewing called
his discovery endothelial myeloma, but it is still known today as Ewing’s
sarcoma.
In 1932, Ewing retired from the chair of pathology at Cornell and was made
director of Memorial Hospital until his retirement in 1939. At Memorial, Ewing
laid the groundwork for the treatment of patients with cancer and probably
helped garner much of the respect that is given to what is today Memorial
Sloan-Kettering Cancer Center.
Ewing was featured in Time magazine around the time of his
retirement from Cornell. The article discussed the decision by Annals of
Surgery to devote one entire 54-article issue to cancer. In tribute to a
great teacher, 54 of the cancer field’s foremost physicians wrote articles
compiling everything about cancer, its causes, treatment and prevention known
to date. The issue was later republished as a reference book for family
doctors.
At age 76, Ewing fractured an area of his right femur that, when examined,
revealed metastatic bladder carcinoma. On May 16, 1943, Ewing died from cancer
of the urinary bladder. During his life, Ewing did not let any of his physical
or emotional misfortunes interfere with his contributions to the field of
oncology. James Ewing’s involvement and contributions developed his repute
as one of the world’s leading cancer pathologists. – by Ashley
DeNyse and Leah Lawrence
For more information:
- Ewing J. An analysis of radiation therapy in cancer (The Müller
Lecture). Trans Stud Coll Physicians Phila. 1922;44:190-235.
- Ewing J. Neoplastic Diseases. A Textbook on Tumors.
Philadelphia: W.B. Saunders Company; 1919.
- Murphy JB. James Ewing: 1866-1943. Washington, D.C: National
Academy of Sciences; 1951.
- Zantinga AR, Coppes MJ. James Ewing (1866-1943): “The
Chief.” Med Pediatr Oncol. 1993;21:505-510.