Kenneth L Abbott, MD, FACP  |  4/17/2023

The First Testicular Cancer Cure

An adage in health care declares if you wish to be famous in the medical field you should discover a new disease and attach your name to it. Consequently, most of the proper names we read and hear in this discipline are those of physicians and scientists. Hence, we have Hodgkin’s disease (19th century British pathologist), Waldenström’s macroglobulinemia (20th century Swedish physician and researcher), and Huntington’s chorea (American physician practicing in Long Island around the turn of the 20th century), and many others.

Far less commonly, researchers confer the name of the patient in whom a condition was first described. Hence, Hageman factor, another name for clotting factor XII, was first found to be deficient in a man named John Hageman in the 1950s. Physicians tend to steal the glory. Patients deserve a lot more recognition for the contributions they have made to the progress of medicine. In a month dedicated to furthering awareness of testicular cancer, I can’t think of a more worthy person to acknowledge than John Cleland, the first man cured of an advanced form of this disease.

Cleland’s story resonates on an emotional as well as clinical level. A young newlywed, just starting out in life in the early 1970s, he developed testicular cancer at 22 years of age. Surgery removed the diseased organ, but the aggressive cancer had already spread, producing large tumors in his lungs. Hope faded with every failed application of existing chemotherapy drugs. His weight fell to a measly 106 pounds, a shadow of his former robust self. At the time, 19 of every 20 men afflicted with advanced testicular cancer died of their disease. Surely John Cleland would soon share their fate. Finally, he sat with his oncologist at Indiana University, Larry Einhorn, reviewed his most recent chest x-rays showing lungs almost completely taken over by the cancer, and discussed one remaining last-ditch option, a new experimental drug called cisplatin, which could be added to a couple of other drugs called bleomycin and vinblastine. Cleland, his back up against the wall, agreed, thinking even if he did not personally benefit from the new treatment perhaps other young men in the future might.

The first month was nightmarish. Cisplatin is one of the most nauseating chemotherapy drugs in use, and Cleland took the drug in the days before modern, highly effective antinausea drugs were available. Sick beyond comprehension and taxed almost beyond endurance, he battled through. When he returned to the hospital to begin his second round of treatment, he and his doctors were astonished to discover radiologists could find no traces of the cancer in his lungs. Cleland lived another fifty years after completing treatment and never dealt with the disease again, a career teacher and the father of three children who otherwise might never have existed. He is, so far as we know, the first man to be cured of a metastatic cancer arising from an organ other than the blood or lymphatic system.

In 2023, the old mortality statistic of a 95% death rate has flipped on its head. A man diagnosed with advanced testicular cancer now may expect a 95% cure rate. We rightly honor Dr. Einhorn for stepping into the unknown and achieving a landmark in modern oncology care. We owe no less recognition to John Cleland, the pioneer on the other side of the needle.
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