Cause for cancer?

Johannes Fibiger's main contribution to science, and indeed to humanity, was his groundbreaking discovery that cancer could be caused by external influence, in 1907-1913. At the time, many researchers believed that cancer was a result of various purely internal complications of the system typically resulting from old age, and Fibiger's discovery not only proved them wrong, but brought the study of cancer a proverbial giant leap ahead. He received the Nobel Prize in Physiology or Medicine in 1928 for his work in cancer research. He also has the dubious honour of being one of the scientific Nobel Prize recipients whose experimental results were later proven to be flawed, although his work was a vital first step in understanding cancer without which much of the knowledge we have about the disease could not have been gained. More on this later in the writeup (HA! You just have to keep reading now).

So who was this Fibiger dude?

He was born Johannes Andreas Grib Fibiger in Silkeborg, Denmark, on April 23rd, 1867. His mother was a writer, and his father was a doctor of medicine. Fibiger went to the University of Copenhagen, from which he gained his bachelor's degree in medicine in 1883, and became a qualified doctor in 1890, starting his medical career as a bacteriologist. He wrote his doctorate thesis while serving as a military reserve doctor at Blegdam Hospital (a hospital for infectious diseases in Copenhagen). His thesis was an extensive study of diphtheria, in which he proved the helpful effects of diphtheria-antiserums. Between his qualification for medical practice in 1890 and the publication of his thesis in 1897, he had studied under the two German physicians Emil Adolf von Behring and Robert Koch (who, themselves, became Nobel Prize recipients, in 1901 and 1905, respectively), and formed a personal friendship with both. He was appointed professor of pathological anatomy (which is a branch of medicine that deals with the changes of tissue and organs resulting from disease) in 1900, from the University of Copenhagen. Throughout his career he held a large number of honourary titles at his university, and also was a quite active journalist.

His thesis itself included the procedure for growing the diphtheria-causing bacteria in a laboratory, as well as a study in an antiserum for them (the antiserum itself was discovered by Emil Adolf von Behring). It was mostly groundbreaking in its methodology: It was the first use of a so-called control experiment. At the army hospital, Fibiger only treated half of his patients with the antiserum (using the rest as a control group), thus proving that the antiserum was effective. Control experiments didn't become commonplace until around the 1950's, and Fibiger's methodology was thus quite ahead of his time.

From Tuberculosis to Cancer

He gravitated into cancer research through another pathological area: Tuberculosis research. His first well-published research in this area was his 1902 discovery (along with researchers from a school of agriculture) that bovine tuberculosis could be transmitted to humans. He proposed heightened control of meat, milk and cattle to combat bovine-to-human tuberculosis infections, and his work ended up eliminating this transmission of the disease in most of the Western world. He conducted extensive research in tuberculosis in both humans and animals, and accidentally discovered cancerous growths (tumors) in the stomachs of some tuberculosis-infected rats he was dissecting in 1907. Curious about how some of his rats had developed cancer, he started some quite intensive research into the phenomenon. It would be this research that eventually landed a Nobel Prize in his hands.

What did happen to those rats? After a good deal of slicin' and dicin', Fibiger concluded that he couldn't find anything anatomically different between the rats with cancer and those without. Well, apart from the fact that weird stuff was growing in the stomachs of those with cancer, obviously. He then decided to pursue the possibility that their cancer was caused by some outside phenomenon, and he turned his attention to the rats' diet. The three rats that had cancer were wild-caught rats who had had the tumours (which almost completely filled the stomachs of the rats) since they were caught, so he turned his attention to what those rats had likely been eating. He found that cockroaches had been a large part of their likely diet, performed some investigation of these insects, and eventually realized that a significant number of wild cockroaches (tame cockroaches?! Not exactly. A "non-wild" cockroach is one bred captively, usually to feed to insectivorous animals. Your friendly pet lizard may eat them, for example) were infected with the parasitic roundworm Spiroptera neoplastica. Eying a possibility for a cause, Fibiger realized that the cancerous growths seemed to follow inflammations of the rats' stomach tissue caused by the activity of the roundworm larvae. Fibiger had thus experimentally discovered not only that eating cockroaches is stupid, but that cancer could indeed be caused by an outside phenomenon.

HOWTO: Cause cancer in rodents

By 1913, he had learned how cancer could be induced consistently in mice and rats by feeding them cockroaches infected with the parasitic worm, and he published his discovery of Spiroptera carcinoma (roundworm cancer) the same year, adding support to the theory that cancer was caused by tissue irritation. He proved that the cancerous growths were able to spread to unconnected organs (metastasis) without transferring parasites or microorganisms, in this case the lymph glands and lungs of the rats. His discovery led to massive research being done in carcinogens (which were indeed exactly what he had discovered -- although not quite how he thought! Keep reading!). One of the first results of this was when the Japanese pathologist Yamagiwa Katusaburo, inspired by Fibiger's work, discovered that tar was highly carcinogenic. Damn science freaks, not only do they take from us the joys of eating cockroaches, next is the cigarettes and the time-honoured tradition of tarring and feathering.

Most Ironic Death Ever

In 1927, Fibiger received the Nobel Prize in Medicine and Physiology after having been nominated for it 16 times in 6 years (the Nobel Committee wasn't sure if his work was sufficiently original). He died in Copenhagen on January 30th on the next year, after a short illness resulting in cardiac failure. Ironically, the autopsy of his body showed massive cancerous growths in his colon.

The Real Story

What really happened to those rats? Other scientists had difficulty reproducing his results (doesn't the concept of scientists actively trying to cause cancer seem a little morbid?), which was one of the reasons that some within the scientific community came to regard his Nobel Prize as an error. The reason might well have been all the work Fibiger did to balance the rats' diets just right to get his results: It has since been proven that parasites are an insignificant cause of cancer, and that what happened was that the roundworm larvae living in the rats' stomachs fed on the food the rats had been eating, which ended up causing vitamin A deficiency -- which is now known to be a major cause of cancer. Even from beyond the grave, a scientist's power to annoy and hassle should never be underestimated: Eat your damn carrots!

Some Nobel Prize winners have great monuments, scientific institutes and the like named after them. Fibiger's name has been attached to a sort of tumor ("Fibiger's Tumor", the tumor found in the stomachs of his rats), and to an adrenogenital salt loss syndrome (the Fibiger-Debré syndrome). A more conventional thing named after him is a street in Aalborg, Denmark.

The study of the manifold problems presented by cancer has, in recent years, seemed to offer many more riddles than were previously thought to exist; but the history of medicine has never known a period in which problems could be attacked in so many different ways as those made accessible today by the working methods now at our command.
--Johannes Fibiger, 1927, during his Nobel Prize lecture

References:

  • http://www.um.dk/english/danmark/danmarksbog/kap3/3-7-10.asp
  • http://www.stenomuseet.dk/saerud/nobel-fibiger.htm (Danish language)
  • http://www.nobel.se/medicine/laureates/1926/fibiger-bio.html
  • http://www.whonamedit.com/doctor.cfm/1443.html