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Writing the Book on Cancer Care: Holland Reminisces

Gina Columbus @ginacolumbusonc
Published: Friday, Aug 04, 2017
“I’m very satisfied with the way things are evolving,” said Holland. “We have changed the concept of cancer from guaranteed death to curing a lot of people. Many oncologists have used this as their educational basis for learning about cancer. That’s been a great satisfaction—having trained a lot of people and treated a lot of patients, many of whom are cured.”

In addition to guiding the field through his writing, Holland has served in leadership roles in the most prominent oncology groups, including as president of the American Association for Cancer Research, president of the American Society of Clinical Oncology, and scientific adviser to the NCI, the World Health Organization, and the African Organization for Research and Training in Cancer. He was a special consultant for a cancer research initiative in the Soviet Union (then the USSR) from 1972 to 1973. He also has served as the scientific director of the T.J. Martell Foundation for Leukemia, Cancer and AIDS Research.

Throughout his career, Holland has been part of many game-changing endeavors, including the development of the POMP chemotherapy combination of mercaptopurine (Purinethol), vincristine (Oncovin), methotrexate, and prednisone for children with acute lymphoblastic leukemia. He has also constructed the 7 + 3 regimen for administering cytarabine and daunorubicin as treatment for adults with acute myeloid leukemia, and he identified cisplatin for the treatment of patients with testicular cancer and doxorubicin for individuals with osteosarcoma.

Today, Holland is at Mount Sinai Medical Center, where he has been since 1973. He started as the director of the cancer center there, prior to the founding of Tisch Cancer Institute. The institution, he adds, is a constellation of people of extremely high caliber. “I have had lots of friends here who are very well specialized in particular areas, such as gynecology, infectious disease, neurology, and cardiology,” he said. “My stay at Mount Sinai has been extremely interesting, provocative, and helpful.”

He still treats patients, albeit on a reduced schedule. “I don’t see as many as I used to see, and I don’t walk as far I used to walk,” said Holland, alluding to his age. “I’m an old man. But I still see patients. I deplore some of the acts and circumstances of what would be called ‘modern computer docs.’ They spend time looking at a computer, not the patient. That’s not the kind of medicine I practice.”

Aside from time spent on applying for grant funding for cancer research, Holland has also been actively studying with a virologist to explore a viral cause of human breast cancer. Thus far, evidence suggests that the human mammary tumor virus may be a causal agent for the disease.

“We found it,” says Holland, adding there is much in oncology still unknown. “Forty percent of American women’s breast cancers contain this virus. It is there before the breast cancer develops; it’s in the milk and probably infects the boys and girls who nurse. Eight percent of American women have it in their milk, and that is enough to account for the viral breast cancer. The overall community does not accept it, but before I die, we will prove that it is the case for 40% of American women’s breast cancers, which would change the entire field. This is because we would have to identify who those 40% are and, potentially, who are the ones who are going to get breast cancer because they got the virus when they were infants and nursing.”

A Key Witness to an Evolving Field

In his nearly 70 years of practicing medicine, Holland has seen quite a bit of change. For example, he has seen the demand for his field increase. At Frances Delafield Hospital, his salary was $4000 annually; that figure jumped to $7600 at the NCI and then again to $11,600 at Roswell Park Cancer Institute. “Those were fortunes of dollars in those days,” he said.

Money aside, the explosion of interest in immunology is “wonderful,” he observed. “I have been interested in it for many years, and I worked on [research] that turned out to be partially successful,” he said. “Now, people have recognized more intensely the impact of immunologic defense and the role of the T cell, which now can destroy tumors and which we suspected, but didn’t know.”

With the addition of monoclonal antibodies including the PD-1/PD-L1 checkpoint inhibitors, researchers are learning how to activate the body’s own defenses. “Activating all of the understandable components of the immune system, of which we don’t know a great deal about, is likely to become the future of oncology, and it’s nontoxic because they are T cells that you already have. Can they cause troubles? Sure. Are there side effects? You bet. Nothing is for free.”


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