January 19, 2007

‘Fibre Man’ had inspiring impact

Featured Image

Robert Collins, M.D., at last week’s lecture.
Photo by Anne Rayner

‘Fibre Man’ had inspiring impact

Robert Collins, M.D., taught medical students and faculty about “The Fibre Man” — a virtually unknown doctor with an inspiring story — during last week's Dean's Hour lecture.

Collins, the Shapiro Chair in Pathology and a 50-year Vanderbilt faculty member, first delivered his lecture about Denis Burkitt, M.D. at the dedication of the Henry-Joyce Cancer Center in 1988.

Burkitt had no training in research but showed it is possible to make great discoveries using simple methods, Collins said.

“His first great discovery was to identify the most important human cancer,” Collins said.

Burkitt's Lymphoma was the first human cancer associated with viral infection, the first to be cured with chemotherapy, and the first in which a chromosomal abnormality was associated with deregulation of growth factors.

A man who characterized himself as an “obscure hack surgeon seconded to Uganda,” Burkitt was appointed to Kampala in 1957, where he saw a young boy with a jaw tumor. Three weeks later he found a young girl with the same tumor and made the diagnosis of a clinical syndrome.

He used a $75 research grant to distribute a leaflet with a picture of the boy to physicians across Africa, asking if they had seen the condition. Burkitt soon discovered this type of tumor was very common in Africa and published his findings in 1958 in the British Journal of Surgery, a paper that went virtually unnoticed.

Shortly thereafter he received a $1,500 grant and purchased a Ford Jubilee for a long safari to perform a 'geographical biopsy' that catalogued the distribution of diseases over a 10,000-mile area. He visited 57 hospitals spanning 12 countries during the 70-day trip.

Burkitt found the geographical edges of areas with the tumor present, the Lymphoma Belt, and noticed the tumor occurred in moist environments with an average temperature above 60 degrees.

He was the first to document that a biological agent was involved in the distribution of a lymphoma when he published his findings in the journals Cancer in 1961 and Nature in 1962.

Later research that built on Burkitt's findings would discover a worldwide distribution of the same antibodies. In 1968, a husband-and-wife research team proved that the same virus responsible for lymphoma caused mononucleosis.

Burkitt, a humble doctor and researcher, would later say he had “built a platform for a rocket to be launched by others,” but his work was not only revolutionary in cancer.

In 1974 Burkitt and colleagues published a paper in the Journal of the American Medical Association based on extensive epidemiological studies in Africa which concluded that the Western diet caused many diseases due to a lack of fiber.

Despite strong opposition from groups including the food industry, Burkitt's research led to a permanent change in the Western diet, and his nickname, “The Fibre Man.”

“Burkitt determined that fiber helps avoid many of the most common diseases,” Collins said.

“More importantly, his belief that prevention of disease should be the central activity of medicine is just one reason he was 'the' model physician.”