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Temi Linzner wheels her sleek, cobalt blue Mercedes into a parking lot near Holy Cross Hospital.Dark glasses shroud her intense brown eyes; a round-brimmed straw hat covers her sparse crop of short, silver hair. When she first started chemotherapy for her lymphatic cancer in the late 1970s, all her hair fell out. Linzner was mortified. While she waited for her hair to grow back, she tried covering her baldness with a wig but hated it.
"I am very vain," admits the 70-year-old former fashion model and professional bridge player. "But I refuse to wear a wig now. People will just have to accept it or not. I don't have time to worry about that."
Her headgear today is both practical and aesthetic, shading her from the noontime September sun as she steps onto the blacktop. The sprawling, four-story hospital complex overlooking North Federal Highway in Fort Lauderdale looms before her; rising circles of steel form the skeleton of the new wing at the Michael and Dianne Bienes Comprehensive Cancer Center. She walks across a side street and enters an adjacent medical building where about 20 doctors maintain offices. One of them is Dr. Howard R. Abel, her Harvard-educated hematologist and oncologist.
Linzner enters the elevator, where she presses a button for the second floor. She's made this trip periodically for four years. The visits have become more frequent as her disease has progressed; Since July she's been forced to see the doctor weekly. After nearly two decades of remission, her cancer reappeared in 1996, first as a low-grade sarcoma -- a malignant tumor -- and later in a more aggressive form. She now harbors a grape-size tumor close to her heart.
Linzner takes a seat with about ten other patients in Abel's nondescript waiting room. They are men and women, mostly Linzner's age or older, all but one of them white. They wear resigned expressions; though they are at various points in their treatment, they know that the long-term odds are against them. As a veteran of this war, Linzner maintains an outward calm, but she knows the enemy is close, and she's low on ammunition.
Six weeks ago Abel prescribed a regimen of Rituxan injections, which contain cancer-fighting antibodies. This treatment is the latest option the federal Food and Drug Administration has approved for combating Linzner's particular form of lymphatic-system cancer.
Linzner feels better for the first time in months, but today she will schedule a series of tests to determine if the antibodies are actually working to eradicate her cancer. If they are, she will likely continue taking them. If not, she might still have one final hope.
This month Holy Cross will become the first community hospital in the United States to conduct clinical trialsof cancer vaccines created by federal researchers, using local patients. The vaccines are the newest and most promising treatment in the fight against many forms of the deadly disease. In testing the effectiveness of these vaccines, patients and doctors at Holy Cross will work directly with researchers at the National Cancer Institute (NCI), part of the National Institutes of Health in Bethesda, Maryland, through real-time computerized links.
Linzner knows she could become a candidate for the trials if the Rituxan fails her or shows only limited success. No one with cancer can be considered truly lucky, but she is nevertheless grateful that she has ended up in Abel's care right now. "This is the greatest thing, the greatest," she says of the research. "I mean, I hope I don't have to use it, but if I do, I won't have to travel."The idea of a cancer vaccine is nearly 30 years old, growing with a generation of research born when the federal government began pouring money into medical research. In the early '70s in Albany, New York, doctors discovered that lung-cancer patients who developed infections following surgery, despite the apparent danger, tended to live longer. Physicians theorized that the infections triggered an attack by the body's immune system, which killed both bacteria and cancer cells.
Meanwhile the NCI, benefiting from Pres. Richard Nixon's "war on cancer," led a broad-based, well-funded research assault that included the training of many young doctors who subsequently staffed the country's university research hospitals. The offensive also included generous government funding for those hospitals.
Before the war on cancer, Abel recalls, very few medical students sought careers in oncology. "It was depressing, there was little progress, and it was a field in which the patients always died," Abel says. "And the universities just weren't interested."
Then the money came, and so did the interest and the research.
In cancer vaccines, noteworthy advances have occurred only recently, explains Dr. Ralph Volgler, an Atlanta-based spokesperson for the American Cancer Society. "They've now identified a protein that's unique to cancer cells and [have] been able to link it to antibodies," he says. "These research studies use it as a vaccine, applying it earlier and earlier [in the course of the disease]."
The term cancer vaccine is a bit misleading: No cancer vaccine has yet been developed to prevent the disease. Instead the injections are often used in conjunction with traditional chemotherapy or radiation treatments in patients who already have cancer. The vaccines appear to work better, says Volgler, on smaller tumors or in patients whose disease has been reduced by other therapies.