Cancer Patience

Can an experimental gene therapy effectively treat a malignant brain tumor? Doctors at Houston’s M.D. Anderson are taking it one day at a time.

IN NOVEMBER 1995, PAUL MADISON, a retired state tax examiner from Northport, Alabama, learned that the strange speech problems he had been having were the result of a brain tumor. Over the next several months, he began an exhausting schedule of radiation and chemotherapy. His wife, Alligene, who now has half a dozen spiral notebooks full of handwritten observations on his condition, accompanied him on every appointment. On April 12 the Madisons drove to the Kirkland Clinic at the University of Alabama in Birmingham to see whether the tumor’s rampant growth had been arrested. But Paul’s doctor gave them disheartening news: It was growing again. “It’s very aggressive,” he said. “It has changed quite a bit since the last scan.”

Before the appointment, the Madisons had read an article about suicide gene therapy, an experimental remedy that alters the genetic makeup of a tumor’s cells so that the tumor stops growing. In desperation the Madisons seized on the possibility that the therapy—which was being tested at several clinics around the country, including the University of Texas M. D. Anderson Cancer Center in Houston—might be Paul’s salvation. They didn’t have much time, because the kind of tumor that afflicted Paul is almost always fatal and grows very quickly, and his first symptoms had appeared eight months earlier. “Mother, pack your bags,” the Madisons’ daughter Denese said when she heard the test results from Birmingham. “We’re going to Houston in the morning.”

Paul, who is 68, began the treatment at M. D. Anderson in May, and since then, tests have shown no signs of growth in his tumor. The Madisons are convinced that he has been cured. They talk about gene therapy with the fervency of religious converts describing their faith—or rather, Alligene does, as Paul still has trouble speaking.

She …” Paul begins, and then he gets stuck.

Speaks for me?” Alligene asks.

He nods.

The good Lord opened the doors and windows for us,” says Alligene. “We are just so grateful that the tumor is not growing anymore.”

Yet Alfred Yung, the neuro-oncologist overseeing the clinical trial at M. D. Anderson, is more measured in his assessment of the therapy’s possibilities, for he knows firsthand that it doesn’t always work. Of the three patients in his care who received the treatment, only Paul Madison has survived. And that, in a nutshell, is the state of gene therapy today: wildly promising but still far from reliable. While the public seems to expect doctors to be able to fix chronic medical problems by tinkering with genetic material like a mechanic under the hood of a car, years of research need to be done before gene therapy fulfills its potential. Then again, if it can someday be perfected, it will indeed resemble a miracle—it will be an alternative for people who cannot be treated by more-conventional means.

Like most other patients

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