Bernard Fisher (medical doctor)

Bernard Fisher (ca.1980)

Bernard Fisher (born August 23, 1918 in Pittsburgh ; † October 16, 2019 there ) was an American doctor, scientist and pioneer in the research and treatment of breast cancer . He was the chairman of the National Surgical Adjuvant Breast Project at the University of Pittsburgh Medical School .

His research has led to the fact that early stages of breast cancer are rarely treated with radical mastectomies and more with breast-conserving lumpectomies in combination with radiation , chemotherapy and hormone therapy . The oncology journal The ASCO Post described Fisher's research as “groundbreaking”. It is thanks to Fisher, according to another trade magazine, that breast cancer survival rates have risen sharply worldwide.

Life

Fisher attended Taylor Allderdice High School through 1936 . He completed a medical degree at the University of Pittsburgh by 1943 and then trained as a surgeon. Fisher became an assistant professor at the University of Pittsburgh and founded the Institute for Surgical Research, of which he became director. His early research interests included liver regeneration in rats, the physiological effects of hypothermia, and transplant rejection. In addition to research, he worked as a general and vascular surgeon. He was one of the first surgeons to perform liver transplants.

Between 1950 and 1952 he was a Fellow in Experimental Surgery at the University of Pennsylvania . In 1955 he was a visiting researcher at the London Postgraduate Medical School at Hammersmith Hospital , where he was able to expand his knowledge in the field of transplants in particular.

In the spring of 1957, his former mentor Isidore Schwaner Ravdin asked him to return to the University of Pittsburgh. Ravdin was then chair of the Clinical Studies Panel of the Cancer Chemotherapy National Service Center at the National Institutes of Health (NIH). Fisher was to discuss with 22 other surgeons the establishment of a project that would combine chemotherapy and surgery for breast cancer, which was later established as the National Surgical Adjuvant Breast and Bowel Project (NSABP).

Fisher later said that he originally had no interest in breast cancer at all. After the NIH meeting, however, he noticed how little information there was on the biology of breast cancer and how little interest there was in understanding breast cancer. He saw the importance of randomized clinical trials and statistical analyzes to evaluate the studies. He gave up liver and transplant research and began studying the biology and metastatic growth of breast cancer intensively with his brother Edwin, a pathologist .

In 1958, Fisher took part in the first randomized clinical trial to investigate the success of systemic therapy in breast cancer after mastectomy . The study with more than 800 participants showed that chemotherapy with thiotepa significantly increased survival rates in women before menopause.

On May 9, 1967, Fisher was appointed chairman of the NSABP. In the following time he devoted himself entirely to research into breast cancer and examined the effectiveness of lumpectomies , mastectomies and lumpectomies after chemotherapy and radiation in studies. The Fishers team also looked at the biology of metastases. This refuted William Stewart Halsted's thesis that tumors spread into surrounding tissue and it was possible to prove that cancer cells are distributed through the blood and the lymphatic system. In the late 1960s, Fisher demonstrated that radical mastectomy was no more effective than simple mastectomy, and total mastectomy was no more effective than lumpectomy.

Fisher consistently encouraged his colleagues to use radical mastectomy only in exceptional cases, but met resistance. Surgeons accused him of his team endangering women's health. Fisher later repeatedly described this resistance as "significant". It was not until the 1970s that Fisher's arguments were increasingly heard, especially among women's rights activists. They accused the doctors of the mastectomy being a typical example of sexism in the US health system. Fisher's ideas were supported by the women's rights activists and thus also became a political issue. Ultimately, Fisher's treatments became standard in the 1980s after the New England Journal of Medicine published two studies by Fisher that supported his earlier theses.

In 1986, Fisher was named a Distinguished Service Professor of Surgery . In 1994 he gave up the chairmanship of the NSABP.

He died on the evening of October 16, 2019 at the age of 101.

meaning

Fisher's work fundamentally changed the way we deal with breast cancer. The laudation for the presentation of the Albert Lasker Awards praised Fisher's research, which had shown “that regional lymph nodes are not a barrier to the spread of tumor cells, as was previously assumed, but are crossed by tumor cells and gain access to the blood and the lymphatic system. "

Fisher was the first to prove that the less invasive lumpectomy is as effective as the radical mastectomy in most cases. He also showed that postoperative chemotherapy and hormone therapy can be effective postoperative treatments. Fisher discovered that breast cancer metastases do not depend solely on anatomical features, but also on the biological activity of the tumor and the body. "He was the first scientist to reject the thesis that cancer is" autonomous from the body "and argued that" solid tumors such as breast cancer are likely to be systemic [...] and potentially cause metastases. " Fisher also organized the first study to investigate the benefits of tamoxifen, which showed that the risk of disease in high-risk patients decreased by 50 percent.

Fisher not only made a decisive contribution to the treatment of breast cancer, but is also considered a pioneer in the use of randomized controlled trials as a means of clinical trials. His early work on metastases is considered to be groundbreaking for later research on the spread of breast cancer.

Memberships

Fisher had been a member of the Institute of Medicine at the National Academy of Sciences since 1985 . In 1991 he was elected a Fellow of the American Association for the Advancement of Science . The White House appointed him to the National Cancer Advisory Board and an advisory team to the US President. He was President of the American Society of Clinical Oncology in 1992/93 and a board member of the American Association for Cancer Research from 1988 to 1991 .

Awards and honors

Fisher received the 1985 Albert Lasker Clinical Medical Research Award for research into breast cancer. In 2006 he received the American Association for Cancer Research Award for Lifetime Achievement in Cancer Research and the Jacobson Innovation Award. Fisher also received the Dr. Josef Steiner Cancer Research Prize , 1993 the Kettering Prize , 2003 the Medallion for Scientific Achievement of the American Surgical Association , 1986 the Medal of Honor of the American Cancer Society and many other awards from surgical and oncological societies.

In 2005 the University of Pittsburgh hosted the “Dr. Bernard Fisher Professorship in Surgery ”. He received an honorary doctorate from Yale University (2004), of Carlow University , the Mount Sinai School of Medicine of the City University of New York and the University of Pittsburgh.

Individual evidence

1. ↑ Dr. Bernard Fisher . National Cancer Institute. Retrieved February 24, 2015.
2. ^ ^{A b c} 2006 Bernard Fisher Lecture To Feature Larry Norton, MD, Oncologist Known for Innovative Cancer Drug Strategies , Oncology Practice
3. ↑ Oncology Luminaries: Dr. Bernard Fisher cancerprogress.net March 3, 2014
4. ↑ ^{a b c d e f g h i j k l} Dr. Bernard Fisher's Breast Cancer Research Left a Lasting Legacy of Improved Therapeutic Efficacy and Survival . In: The ASCO Post . Retrieved February 24, 2015.
5. ↑ Steve Hecht: Comedian Marty Allen part of Allderdice's first hall class . In: Pittsburgh Post-Gazette , August 27, 2009. Retrieved February 24, 2015. 
6. ↑ ^{a b c d e f g} Dr. Bernard Fisher is Distinguished Service Professor of Surgery at the University of Pittsburgh ( June 20, 2010 memento in the Internet Archive ), Penn Surgery Society
7. ↑ ^{a b c d e} Bernard Fisher receives AACR Lifetime Achievement Award , Psych Central
8. ↑ ^{a b} Bernard Fisher Reflects on a Half-Century's Worth of Breast Cancer Research , Oxford Journals (PDF)
9. ↑ ^{a b c d} Cancer Researcher No Longer The Hero Bernard Fisher Was Fired Amid Allegations Of Faulty Research philly.com, July 7, 1994
10. ↑ History of the NSABP (Part One) , NSABP (PDF)
11. ^ ^{A b} First Bernard Fisher Professor Of Surgery Appointed At University Of Pittsburgh School Of Medicine , University of Pittsburgh
12. ^ How Clinical Trials Saved Women With Breast Cancer From Disfiguring Surgery , The Atlantic
13. ^ Bernard Fisher, MD, Pioneer in Breast Cancer Research, Dies at 101. Retrieved October 19, 2019 . 
14. ^ ^{A b} Bernard Fisher: Rethinking Cancer Care , University of Pittsburgh, accessed February 24, 2015
15. ^ ^{A b} Albert Lasker: Clinical Medical Research Award , Lasker Foundation