Healing Heat: Harnessing Infection to Fight Cancer
Modern immunology plus historic experiments suggest a better way to gear up the human immune system to battle malignant disease

Uwe Hobohm

Conventional wisdom long held that the human immune system was no match for cancer. Born of native cells, the logic went, cancer fooled the immune system into concluding it was harmless. Thus protected from attack, cancer easily thrived until its host died.

A deeper understanding of our biological defenses has changed that. The human immune system does battle cancer. But we could better optimize our defenses to fend off malignant disease. That’s clear from cancer treatments attempted in New York City and Germany as early as the 19th century. Those experiments and other undervalued evidence from the medical literature suggest that acute infection—in contrast to chronic infection, which sometimes causes cancer—can help a body fight tumors.

It’s not the pathogens that do the good work. But the way our bodies respond to the pathogens is key. Infection events, especially those that produce fever, appear to shift the innate human immune system into higher gear. That ultimately improves the performance of crucial biological machinery in the adaptive immune system. This lesson comes, partly, from doctors who risked making patients sicker to try to make them better.
Toxin Therapy


Elisabeth Dashiell was 17 years old when she entered New York Hospital in the autumn of 1890 with severe pain in her hand but no sign of infection. Her newly trained surgeon, William B. Coley, saw no improvement after a period of observation. In November 1890, a biopsy revealed round-cell sarcoma, a relatively rare form of cancer originating in soft tissue and bone.

Shortly after the biopsy, Dashiell’s arm was amputated below her elbow, but her cancer still spread ferociously. In December a tumor was detected in her right breast; within days, nodules appeared in her left breast. By January a huge tumor swelled in her abdomen and her heart began to fail. On January 23, 1891, Dashiell died.

Medicine back then offered little more than amputation and morphine to cancer patients such as Dashiell. Shocked by his ineffectiveness, Coley dove into hospital records and the medical literature for clues to how to help more. He found about 90 sarcoma case reports. About half contained follow-up histories. The one that grabbed him most involved Fred Stein.

Stein, a German immigrant, had been diagnosed with cheek sarcoma in 1884. Despite four operations, his cancer kept recurring. He was considered a hopeless case. However, in late 1884 Stein developed high fever from erysipelas, a postoperative skin disease common in that era. To the great surprise of his physicians, his tumor disappeared. Stein was discharged from the hospital in February 1885.

Five months after Elisabeth Dashiell died, Coley tracked Stein to New York City’s Lower East Side. Photographed and examined, Stein showed no trace of residual cancer six years after his puzzling recovery. That drove Coley to dig deeper for records of similar cases. The young doctor, who had studied some German at Yale University, likely encountered a report published more than two decades earlier, in 1868, in the journal Berliner Klinische Wochenschrift.

The German physician W. Busch reported that he had observed a patient’s tumor “re-absorbed” after a high fever. Unconstrained by modern ethics rules, Busch tested for some connection himself. That summer, by coincidence, a patient with a mild erysipelas infection that followed an injury and a 19-year-old girl with a huge sarcoma of the neck entered Busch’s clinic at around the same time. Over five months, the sarcoma had grown to the size of a child’s head. The young woman’s breathing was threatened; she could not completely close one eye.

Before antibiotics, erysipelas was one of the leading causes of death from postoperative infections in hospitals. Still, Busch burned a small piece of skin over the girl’s tumor and attached a cotton pad taken from the erysipelas patient onto her wound. The surrounding skin developed signs of erysipelas and the patient developed a high fever—104 degrees Fahrenheit. Her tumor, which had been tight and dense, softened and shrank rapidly. Within two weeks it reached the size of a small apple. She could close her eyes and breathe freely. Unfortunately, the young lady developed circulatory problems, and steps had to be taken to strengthen her weak condition. With the disappearance of the skin inflammation, the tumor reached its prior size. How she fared after leaving the clinic is not known.

In his literature search, Coley found more than 40 cases of disappearance of malignancies during an erysipelas attack. He came across another medical pioneer, Friedrich Fehleisen, also in Germany, who was the first to use cultured bacteria in related experiments. After successes and failures, Fehleisen discontinued the work. Still, Coley decided to try for himself.

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