Advances in Anatomic Pathology:
Hoda, Syed A. MD
Department of Pathology, New York, Presbyterian Hospital, Weill Cornell, Medical Center, New York, NY
Rebecca Skloot New York: Crown-Random House, 2010. 369 pages. ISBN: 0307589382. ISBN-13: 9780307589385, $26.00
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Some 60 years ago, an African-American tobacco farmer died at the age of 31 years with cervical carcinoma. She had been treated adequately by prevailing standards of the day but rather unsuccessfully at a renowned medical institution in Baltimore. Two “dime-sized” tissue samples had been taken from her cervix, 1 malignant and 1 benign. Apparently, no patient permission had been sought and no information was provided. A laboratory assistant scribbled the first 2 letters of her name,, Henrietta and Lack, “HeLa” on the sample tubes. Today, the anonymity of tissue samples is given; however, in the 1950s it was of little or no concern to those who had been—for years—unsuccessfully trying to grow cancer cell lines for research purpose. HeLa (generally pronounced hee-lah) cells succeeded in which other cells had failed. The cells from her cancer multiplied, furiously and ceaselessly, in vivo and in vitro. Eventually, the cervical carcinoma killed her, but her tumor cells lived in laboratories around the world. It has been said that if one could pile all HeLa cells ever grown, these “would weigh more than hundred Empire State Buildings.”
HeLa cells represented the first immortal human cells ever grown in culture (this is the “Immortal Life” in the title of the book). The cells were studied incessantly and intensely, and for a variety of purposes. A “lucky accident” with the cells led to the understanding that human cells have 46 chromosomes. The first human-animal hybrid cells used HeLa cells. Vaccines against many diseases, including polio and human papillomaviruses, were developed using HeLa cells. Countless developments in immunology, oncology, radiation, and virology among other disciplines of modern medicine can be linked to HeLa cells. It has been estimated that researchers add about 10 HeLa-related studies a day to the library of more than 60,000 that already exist. There is hardly any development in medicine that does not owe something to HeLa cells. The cells have been launched into space (on board Russian and American rockets), and even been injected into human participants (shockingly enough, into inmates of prisons and patients of cancer hospitals).
This book tells at least 3 interconnected stories: 1 of professional success (of the researchers), another of personal misfortunes (of the patient and her family), and yet another of scientific ethics (and its evolution in the last few decades). The story starts with Henrietta Lacks’ “knot on my womb,” continues with that of her ill-informed (and generally ill) family, and weaves in the account of how unpoliced science can take advantage of the unfortunate congruence of ignorance, poverty, and race. The tale is unadorned nonfiction, but in some passages reads like science fiction and occasionally as Greek tragedy.
It seems, at least by current standards, that the Lack Family was terribly wronged in the pursuit of scientific research. The identity of Henrietta was made public with no thought for her or her descendant's privacy; blood samples were taken from family members after giving them the impression that they were being treated for hereditary cancer, and the family remained impoverished while science and those acting in its behalf profited (not in scientific terms alone). This book offers a nuanced account of the difficult balance that exists between the responsibility of science toward research participants and its duty to help humanity as a whole. The HeLa cells are now a biological celebrity and continue to thrive—not unlike the controversy regarding the provenance of the tissue materials of science.
The Immortal Life of Henrietta Lacks tells the fascinating, if occasionally disturbing, story of a human being who in death may have done more for the living than anyone else. This is one story that pathologists, as primary custodians of archived tissues from patients, ought to be familiar with.
Syed A. Hoda, MD
Department of Pathology, New York
Presbyterian Hospital, Weill Cornell
Medical Center, New York, NY
© 2010 Lippincott Williams & Wilkins, Inc.