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An Afro-American Woman's Gift to Science
By Dr Syed Amir
Bethesda, MD
Henrietta Lacks, a poor African-American woman, has been dead for well over half a century, but her body cells still live. They have been immortalized, extensively duplicated and widely disseminated. As a result, virtually every scientist working in the field of cancer and human health has used them for research.
The fascinating story of how one woman unwittingly became the donor of such invaluable research material is told in a new book, The Immortal Life of Henrietta Lacksby Rebecca Skloot. It reads like a scientific thriller, with graphic descriptions, and highlights the unscrupulous research practices commonly applied to human subjects, especially the poor and black, in middle and early twentieth century America. During the past decades, happily, rules for conducting research on humans have been tightened, and such lapses are unlikely to occur today.
The story of Henrietta Lacks has never been told before. It started in 1951 when she was 30 years old and one day presented herself at the obstetrics and gynecology clinic at Johns Hopkins University Hospital in Maryland, having suffered bleeding and episodes of internal pain for over a year. She had concealed her symptoms from her husband and family, hoping that they would just go away. In those days, Johns Hopkins Hospital, much like the rest of the country, practiced strict racial segregation, with black patients not permitted to share waiting rooms with whites. Skloot describes in exquisite details the restrictive conditions under which Black Americans in general lived. Lacks had traveled a long way to get to this hospital, since for miles it was the only medical facility that would accept black patients; others merely sent them away, regardless of their medical condition. Most were poor, uneducated, often unable to pay their bills, and intimidated by the largely white medical establishments.
The physician who gave her an internal examination readily detected a large tumor on her cervix, the lower end of the uterus. He removed a piece and sent it for biopsy to determine if it was cancerous. A week later, the results came in. She had cervical cancer, a deadly disease. A few days later, she returned to the hospital for the treatment which in those days consisted largely of exposing the cancer to strong doses of radiation. Doctors surgically implanted a source of radiation in her cervix, while she was under anesthesia. Her cancer, however, was far too advanced to be treatable by radiation. Henrietta Lacks died at age 31, within a few months of her diagnosis.
Then, the story took an unanticipated turn, leading to consequences not foreseen by any of the doctors at the time. While under anesthesia, the doctor treating her removed a piece of her cancerous tissue for research. No one bothered to seek consent of the patient or her family members before removing the tissue, as it was not legally required. Nobody asked the doctor what he planned to do with Lack's cancer tissue: it was, however, passed on to Dr George Gey, chief of the tissue culture laboratory, who for a long time had been attempting unsuccessfully to grow cancer cells. If the cells could be grown and studied, it was argued, the doctors might be able to differentiate cancers at various stages of the disease. This information might make it possible to tailor treatment in individual cases.
Dr Gey was not alone. Many investigators had attempted to grow human cells in culture, but the rate of success had been abysmal. To start with, nobody knew what ingredients were required to promote their survival and growth. Dr Gey had persevered and was pleased to receive a new specimen of cervical tissue for his experiments. It was prepared and added to the culture medium, as many other specimens had been treated before.
This time, to the astonishment of everyone, the Lacks cells grew at a brisk rate, a phenomenon the researchers had never witnessed before. Gey's laboratory had finally achieved the distinction of being the first to grow immortal human cells successfully. Ordinarily, cells divide a certain number of times, and then seem to reach senescence and die. Cancer cells are an exception to this rule as they can continue to divide and grow indefinitely and, therefore, are described as immortal. He named the cells HeLa, abbreviated from Henrietta Lacks, but for unknown reasons never revealed the true identity of the donor. Soon, the news spread and with it came many requests for the immortal cells. Gey generously sent them to every scientist who requested them. Before long, a multimillion-dollar industry sprung up that produced these cells on a large scale, supplying them to customers around the globe.
The availability of human cells in such huge quantities made it possible to conduct a number of health-related studies. The safety of the vaccine against polio, a devastating childhood disease caused by a virus, was tested by the inventor, Dr Jonas Salk, using the HeLa cells. A number of medicines could also be tested for their safety and efficacy, using these cells, in place of humans. They were sent in a space mission to determine how zero gravity would affect them. They were also used to confirm that cervical cancer responsible for Henrietta Lacks' death is caused by a virus. Importantly, they invigorated the science of virology, and today remain one of the most highly used cell line in research.
Although science and private companies benefited enormously from the availability of HeLa cells, ironically, Lacks' own family did not share any of it. Her husband came to know about his wife's contribution to research nearly a quarter of a century after her death when some investigators contacted him to ask the family for blood samples. Her son, David Lacks, now over 63, and other family members have recently received some recognition and acknowledgment of the gift that their mother gave to medical science. Yet, the family continues to live in poverty, and has not received any monetary compensation from the biomedical companies.
Rebecca Skloot, the author of this highly readable book, has been more caring. She has started a fund to provide scholarships to support the education of five children from the Lacks family.
(Dr Syed Amir is a former Assistant Professor, Harvard Medical School, and a health science administrator, US National Institutes of Health)
