A curious tale, lost in the mists of time

The second last medical history we are doing is on tamoxifen, which is a synthetic structural variant of naturally occurring estrogen. But, tamoxifen mysteriously has a completely different effect on breast tumors. Simply put, tamoxifen disrupts the tendency of estrogen to “nourish” breast tumors.

Research on “sex-hormones” like estrogen was triggered by their identification in the 1930s. Yet for some reason a Scottish surgeon, Beatson, had attempted to treat breast cancers in the late 1890s by removing ovaries which produce estrogen though this was not known at the time.

I was curious why the surgeon would have even thought of this, so I asked the research associate to dig up the original article, that Beatson had published in the Lancet reporting his results. It’s a most engaging account of creative sleuthing. To summarize:

When Beatson was working on his MD (a post-graduate, rather than the basic medical degree in the UK) in the 1870s he had thought of writing a dissertation on lactation. At the time it was believed lactation was controlled by the brain but there was no evidence for this. Beatson hit upon the idea that the controlling organ was the ovaries (rather than the brain) from his observation that farmers often spayed their cows to maintain their lactatation. Of course this was the beginning rather than the end point of Beatson’s reasoning and experiments but I don’t have the space here to describe the many logical steps and leaps he took that culminated in his ovary removal operations. (Read the full article if you are interested)

Noteworthy as well: Beatson’s operations are now simply a historical curiosity and had little actual impact in the development of tamoxifen. This also seems to be a common pattern in our case studies: interesting observations made, forgotten, “rediscovered” but with no practical effect. Science and technology are accretive but not always or in a tidy predictable way.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5518378/