Certain types of cancer, particularly
Until about 30 years ago, physicians surgically treating breast tumors in advanced stages would remove many nearby lymph nodes in an effort to forestall such spread. That could involve removing 20 to 40 lymph glands in the axillary lymph system under the armpits, a procedure that in itself could produce many adverse effects, including fluid retention and tissue swelling.
Moreover, microscopic analyses indicated that as many as 80% of the removed nodes had not been infiltrated by tumor cells.
In the 1970s,
This lymph node could be surgically removed during the same operation that removed the tumor and examined for traces of cancer cells. If no malignant cells are present, there is a very high probability that the cells have not migrated to other lymph nodes and no further surgery will be necessary.
If malignant cells are identified, however, then other lymph nodes can be removed.
This procedure not only allows time for a more careful and thorough examination of the sentinel lymph node, but it also prevents large numbers of unnecessary surgeries. By some estimates, the use of sentinel lymph node evaluation saves the U.S. healthcare system more than $3.8 billion per year in the treatment of melanoma and breast cancer.
Morton, who also spent more than four decades attempting to develop a therapeutic
"Don Morton was one of the most famous cancer surgeons in the world and was instrumental in changing the face of cancer and cancer research," said Dr. Anton J. Bilchik, chief of medicine at the
In a 2011 editorial in the Journal of Surgical
Donald Lee Morton was born Sept. 12, 1934, in the small coal-mining town of Richwood, W.Va., and grew up in poverty. He enrolled at Berea College in Kentucky, which provided free enrollment to disadvantaged students. He completed his undergraduate education at
"For me," Morton once said, "I think the greatest accomplishment was making it from rural West Virginia to the Westside of Los Angeles. I grew up during the Depression in a house that my dad built. We had no running water, no indoor plumbing and no electricity."
After a fellowship at the
Ten years later, seeking more space, Morton and some of his associates moved to Saint John's, establishing the John Wayne Cancer Institute there.
Early on, Morton developed an interest in melanoma, the most lethal form of skin cancer. Believed to be caused by
Researchers had observed that — rarely, perhaps once in every 2,000 to 5,000 melanoma cases — the cancer would regress spontaneously. Frequently, this occurred after an unrelated bacterial infection. Morton reasoned that the body's immune system could fight off a melanoma if it could be stimulated to attack.
Initially, he hoped to take tumor cells from a patient, irradiate them so they could no longer replicate, and inject them back in the body to provoke an immune response. That immune response would be accelerated by injecting a weakened bovine
University officials were reluctant for him to inject the tumor cells, however, so he began by injecting BCG directly into tumors. In many cases, it appeared that the tumors regressed and were destroyed.
Eventually, Morton developed three separate lines of melanoma cells that displayed the most common antigens, or surface proteins, found in human tumors. The three types of cells were combined with BCG in a therapeutic vaccine called Canvaxin, which seemed to prolong lives in early trials at Saint John's.
The National Cancer Institute funded early trials of the vaccine, which appeared promising, but researchers were concerned that the vaccine may have been given to patients who were most likely to survive. In 1998, Morton founded the private company
Those trials were abandoned in 2005 when an independent data review committee concluded that the vaccine did not produce lengthened survival. CancerVax subsequently merged with the German company Micromet, which was then purchased by
In 1989, Morton noticed a mole on his abdomen that turned out to be melanoma. It was caught early, however, and successfully removed surgically. He did not take his own vaccine. "If the chance of a cure is 90% with surgery," he told the
Morton co-wrote more than 1,000 research papers and received numerous scientific awards.
His first wife, the former Wilma Miley, died in a car accident in 1982. He is survived by his second wife, Lorraine, whom he married in 1989; daughters Danielle Morton, Christin Kazmierczak, Laura Morton Rowe and Diana Morton McAlpine; son Donald L. Morton Jr.; eight grandchildren; a brother, Patrick; and a sister, Carolyn Morton Karr.