Denied: Cervical Cancer - Eva Peron and Henrietta Lacks
In the late 1940s, Eva Perón was the most loved woman in Argentina. Known for her beauty and grace, she was a former model and actress who then married the Argentine politician Juan Peron. While she wasn’t originally interested in politics, she was very supportive of her husband’s ambition. Her work on a weekly radio show allowed her to convince the public to support her husband’s presidential candidacy, which he subsequently won. In July 1946 Juan entered this office with Eva on her side. As the First Lady of Argentina, she quickly settled into her role and found her passions for social work and suffrage movement. The public showered her with love, adoration, and even bigger respect when in 1947 her husband signed the law granting women the right to vote.
In January 1950, Eva fainted in public and was admitted to hospital. It was reported she underwent surgery to get her appendix removed, but in fact, during this stay, she was also diagnosed with cervical cancer. Eva, however, was not aware of this diagnosis as Juan decided to hide this information from her. She stopped working on her own vice-presidential campaign and focused her energy on Juan’s re-election. Juan and his advisors agreed that Eva and the public were not to know about her condition – he didn’t want it to muddle their public persona and complicate the upcoming election.
Her cancer aggressively continued to spread towards her uterus and in 1951 she underwent a hysterectomy to remove her uterus. It was believed that she wasn’t informed about this surgery – another dated practice where doctors discuss the condition with families but choose to spare the patients. After the surgery, she received chemotherapy, a new treatment at the time, but continued to worsen. She became anxious, aggressive, and unpredictable. A 2011 medical investigation uncovered that she had had a lobotomy, a procedure to modify the part of the brain controlling behaviour and pain. Again this procedure was done without her consent. It was done not only to lessen her agony, but also to ensure she was calm and controllable during their public appearances. In the end, Eva died in July 1952 without ever knowing what killed her.
Eight thousand kilometres away in January 1951, Henrietta Lacks sought medical help for “a knot” in her stomach at Johns Hopkins Hospital in Baltimore, United States. Henrietta was a mother of five, African-American and poor, but she received treatment in their segregated wards. At that time, Hopkins was the only hospital in her area that would admit black patients. A biopsy of an abnormal mass was taken from her and she was diagnosed with cervical cancer. She received treatment in the form of a radiotherapy tube and she visited the hospital a few more times for follow-up and more biopsies. However, her abdominal pain continued throughout and she was admitted to the hospital and remained there until her death in October 1951. Her fast decline was due to metastasis – cancer had spread throughout her body.
Unbeknownst to Henrietta and her family, biopsies taken during her visit were used for research purposes. Unlike today where consent needs to be formally given, Henrietta and her family were never asked for permission nor informed about the procedures. Originally, the hospital took biopsies of the mass on her cervix for diagnosis but the researchers observed that in the laboratory setting her cancer cells kept growing and replicating, unlike other cells they had dealt with before. Her “immortal” cells were replicated and developed into a cell line which is now named HeLa, an abbreviation from her first and last names. This unique cell line is used consistently for research and drug testing.
The role of HeLa cells in medical research is enormous, and yet her family were kept in the dark about the presence and significance of these cells for two decades until 1975. The family was shocked - a part of Henrietta had been kept alive for science without their knowledge. They learned that companies make money out of these cells and yet they were never financially compensated. They protested and public support reached its peak in 2010 when the book The Immortal Life of Henrietta Lacks was published. In 2018, Johns Hopkins hospital announced that they were opening a new research building to honour Henrietta Lacks’ legacy. Hopkins also works closely with the Lacks family to organise symposiums and events. The hospital has continuously denied that they ever profited or sold these cells, declaring that they do not have the rights to the HeLa cell line. Legally the family cannot claim ownership of these cells but in 2013 they reached an agreement with the US National Institute of Health for the right to know what the cells are used for.
Cervical cancer develops in a woman’s cervix – the part between the vagina to the entrance of the womb. Almost all cervical cancer cases are caused by a group of viruses called Human Papillomavirus (HPV). While most HPV infections cause minor medical problems like genital warts, about 15 types of HPV viruses are associated with cervical cancer. The symptoms of cervical cancer are not always noticeable at first – it often starts with abnormal vaginal bleeding. Other symptoms include pain during sex, unusual vaginal discharge, or lower back pain. There are four stages of cervical cancer to indicate how far the cancer has spread throughout the body. The different stages are treated differently, combining surgery, radiation therapy, immunotherapy (using patient's own immune system), targeted therapy with drugs, or chemotherapy.
Prevention was a main focus of research in this field as cervical cancer is known to affect sexually active women aged 30-45. HPV vaccine, developed in the mid-2000s, is aimed at providing protection to younger women before they become sexually active. It is well-known that HeLa cells played a significant role in HPV vaccine development. In addition to the vaccine, it is highly advisable for women aged 25-49 to attend regular cervical screening every 3 years to look for abnormal cell changes. If the screening shows abnormalities, doctors will follow-up with colposcopies (screening using small microscopes), blood tests or scans. Diagnoses are complicated and need to be done in multiple steps, making it even more important to prevent through vaccines and cervical screening.
Cervical cancer was poorly understood in the 1950s, and treatment options were limited. Despite being rich and powerful, Eva received treatments that were influenced by her husband’s political agenda. Henrietta, being black and poor, could only get treatments in specific hospitals. Their cases raised awareness of cervical cancer but more importantly raised great concerns regarding patients' rights and consent. It took decades of investigation, but the truths can no longer be silenced. Towards the end of their lives, their rights were violated and their bodies were no longer theirs. Their stories serve as a reminder that policymakers are fallible, that they can make mistakes by denying our rights to our own bodies.