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Four years after it first opened its doors, St. Jude Children’s Research Hospital made the medical community hold its collective breath.
Five children—each with acute lymphoblastic leukemia (ALL) and each in remission from the then-deadly diseases—were taken off therapy. The decision was radical and wrought with uncertainty.
Nothing of the like had ever been tried. ALL killed almost everyone it attacked.
But Pat Patchell is very happy that the doctors at St. Jude had the courage to try such an unconventional approach.
Years later, Patchell said, “That was a pretty radical idea at the time. I’m just so glad they had the nerve to do it. It gave me a lot of freedom.”
Patchell was one of the five patients taken off therapy. Discovered to have ALL in 1964 when he was 11 years old, Patchell’s chances of surviving seemed bleak. Only four out of 100 children with ALL survived at that time. He came to St. Jude where doctors were pushing boundaries to find a cure for the most common form of childhood cancer. In the face of hopelessness, Patchell endured chemotherapy and radiation for more than two years.
“That was a very trying time for me,” Patchell said. The treatment sessions left him extremely nauseated. Normally, Patchell missed a day of school following treatment because of the side effects of the drugs he was receiving. But the chemo was working. The cancer went into remission and there were no detectable cancer cells in Patchell’s body.
A radical decision to halt treatment
“They (the hospital staff) talked about treatment being comparable to being on a racehorse, and you don’t get off a winning horse,” said Patchell. But doctors soon realized that at some point, their patients needed to step down from that winning horse. Though the drugs were succeeding in destroying the cancer, their potential toxic effects posed other problems for the patients.
“While we have mastered the short-range effects, we still do not have any knowledge of the long-range effects,” said Donald Pinkel, MD, in 1968. Pinkel was the first director of St. Jude. The doctors were anxious about the next step.
Though one reality told the researchers that patients could not withstand endless chemotherapy and radiation, scientific data up until that point showed that halting therapy would result in the cancer returning.
A major breakthrough
So, after much hand wringing, the doctors and staff of St. Jude, along with the parents of the children, elected to end therapy after a little more than two years of continuous treatment.
“It seemed to be the right thing to do,” Pinkel said. Then, they waited. “They watched me like a hawk,” Patchell said
The waiting slowly turned into cautious optimism, and then relief, as a major breakthrough in science was born. The previously incurable disease now had a 17 percent cure rate, which jumped to 50 percent by 1971.
Patchell said he still gets tongue-tied when he thinks about what St. Jude was able to do for him.
“How can you express enough thanks, when you were in dire straits and they saved you? It really is the greatest place.”
Today, Patchell is married and works as an accountant. He enjoys playing acoustic guitar and he is 50 years old.
Last update: June 2003