Anastasios N. Karras, Joseph M. Sanzari Children's Hospital Hackensack University Medical Center, Hackensack, NJ, United States; Daniel A. Rauch, Hackensack Meridian School of Medicine, Hackensack, NJ, United States
Resident Physician Joseph M. Sanzari Children's Hospital at Hackensack University Medical Center
Background: George Herman “Babe” Ruth is considered one of the greatest American sports heroes and greatest baseball players of all time. What few people may know about Ruth is that he was also one of the first patients to receive an experimental chemotherapy drug, teropterin, a folic acid analog and dihydrofolate reductase (DHFR) inhibitor similar to methotrexate (MTX), for anaplastic epidermoid carcinoma of the nasopharynx, a rare but clinically recognizable tumor in the 1940’s. Objective: To highlight the significance of experimental treatments and their impact on modern pediatric medicine. Design/Methods: A review of historical records and medical literature was performed. Results: In 1947, after a months-long presentation of worsening dysphonia, dysphagia and unilateral facial pain and swelling, Ruth was diagnosed with cancer. His autobiography suggests Ruth was never directly informed of his diagnosis, consistent with common practice of the time. He underwent surgical excision of the mass and postoperative radiotherapy with improvement of his symptoms, but developed recurrence in June 1947, prompting medical evaluation at Mount Sinai Hospital in New York under Dr. Richard Lewisohn. It was then that Ruth agreed to daily treatment with teropterin injections, which had shown promise in treating rats but had not been shown to work in humans. Aware that the drug had rarely been used in humans before, Ruth stated, “I realized that if anything was learned about that type of treatment, whether good or bad, it would be of use in the future to the medical profession and maybe to a lot of people with my same trouble." By August 1947 Ruth showed remarkable clinical improvement without evidence of an existing neck mass. Lewisohn reported Ruth’s case at a scientific conference in St. Louis, which led to a front page story in the Wall Street Journal in September 1947 suggesting scientists were on the verge of curing cancer. In June 1948, Ruth’s symptoms recurred, and he was found to have extensive metastatic disease. He eventually died of pneumonia on August 16, 1948. In 1953, MTX was FDA approved for treatment of children with acute lymphoblastic leukemia (ALL).
Conclusion(s): While parts of his care, such as lack of informed consent and withholding the diagnosis, are inconsistent with current care guidelines, the role of a celebrity treatment success, even if temporary, is notable. MTX continues to be a critical chemotherapeutic component for children with ALL. While many of Babe Ruth’s MLB records have since been broken, his contributions to pediatric medicine cannot.
