- Email: [email protected]
A trip down memory lane
Media Watch
Book A trip down memory lane For nearly 200 years, The Lancet has been one of medicine’s pre-eminent journals. First published in 1823, it has produced an astonishing array of seminal articles and clinical observations. Vintage Papers from The Lancet is a collection of some of the journal’s more fascinating landmark papers. Complied and edited by Ruth Richardson, a scholar in the history of science at Cambridge University, UK, the book is divided into four sections, which cover an interval of roughly 40 years: the 1820s to 1860s, 1870s to 1910s, 1920s to 1950s, and 1960s to 2005. The book is full of amusing tales, such as Queen Victoria’s description of the use of “blessed chloroform” with the delivery of her latest child, and the mysterious death of Prince Albert that led to an editorial demand for increased public disclosure (some things never change). Major medical advances are included, such as the early stethoscope and otoscope, Joseph Lister’s discourse on antisepsis, James Paget’s discussion of osteitis deformans, Louis Pasteur’s address on the germ theory, Robert Koch’s “remedy” for tuberculosis, Ernst Chain and Howard Florey’s discussion of penicillin’s therapeutic potential, and John Charnley’s initial description of hip-replacement surgery, and endoscopy, brain MRI, and ova cryopreservation. These historical articles also contain other delightful and perhaps surprising tidbits, such as a modest letter to the editor from a so-called lowly family practitioner suggesting that aspirin might prove useful “for the treatment of coronary thrombosis”. Enthusiasts of the English language will find much to admire in these pages. The early days of medical writing were much more literary than the prosaic, highly stylised,
and sterile medical writing in today’s medical journals. For example, in his 1896 description of hormonal therapy in metastatic breast cancer, George Thomas Beatson begins: “I have no doubt it has fallen to the lot of nearly every medical man to have been consulted from time to time by patients suffering from carcinoma so widely spread or so situated that it has been quite apparent that nothing in the way of operative measures could be recommended”. Beatson would spend his spare time wandering pastures and making observations on gravid sheep and cows that he later applied to the human condition. Who writes like this today? What journal would allow it? Perhaps not even The Lancet, with the following introduction from a recent article on breast cancer: “In early breast cancer, surgery can remove any disease that has been detected in or around the breast or regional lymph nodes, but undetected deposits of disease may remain either locally (ie, in the residual breast tissue, scar area, chest wall, or regional lymph nodes) or at distant sites that could, if untreated, develop into life-threatening recurrence”. The habitué of medical libraries, rare books, and manuscript rooms should thoroughly enjoy this selection of perceptive articles from The Lancet’s history. The book can be enjoyed on rainy weekend days as readers can imagine how medicine used to be compared with how medicine is today, which is all well-chronicled in the pages of The Lancet. Richardson’s book makes the journey exceedingly enjoyable.
For doctors and biomedical scientists, this book, which compiles publications from The Lancet from 1823, is both interesting and entertaining. It gives a rare insight into how a uniquely prestigious journal was established in the early 19th century, and which editorial considerations were given to style, content, and high standards for medical publishing. Furthermore, this selection gives a highly readable, first-hand impression of medical milestones in the past two centuries. Richardson’s book shows the tremendous effect that ionising radiation has had on modern medicine during its 110-year history. In 1896, 1 year after the discovery of radiographs by Wilhelm Conrad Röntgen, The Lancet reported their use to find a bullet in a shot wound that could not be located by surgical exploration. More than a century later, readers can appreciate the excitement of the pioneers of radiology to explore this new technology and revolutionary diagnostic potential. The Lancet was among the first to warn against the potential long-term harm of radiography by
describing the development of radiation-related carcinoma, and later the development of cancer in childhood after diagnostic radiation in utero. Other selected articles cover the development of diagnostic ultrasonography and MRI. Parallel to diagnostic radiology, radiotherapy was established as a new, rapidly evolving science. The first successful therapeutic use of radiography in a large naevus piliformis was published by Leopold Freund in Wiener Medizinische Wochenschrift (1897). First cures of cancer were later reported by Tor Stenbeck (1900) and Tage Sjögren (1901). Further breakthroughs came with the introduction of brachytherapy (1901), exact dosimetry, and radiobiological understanding of the importance of fractionation in the early 20th century. X-ray tubes were replaced by megavoltage machinery, which was later accompanied by computerised treatment planning, modified fractionation, radiochemotherapy, and conformal and image-guided radiotherapy.
http://oncology.thelancet.com Vol 7 June 2006
Vintage Papers from The Lancet Ruth Richardson (Ed) Elsevier, 2006 £32·99 (US$59·03, €47·71), pp 488 ISBN 0 08044 683 3 David Johnson (VanderbiltIngram Cancer Center, Nashville, TN, USA) is the immediate past president of the American Society of Clinical Oncology (ASCO; 2004–05).
David H Johnson [email protected]
Michael Baumann (University of Dresden, Germany) is the current president of the European Society for Therapeutic Radiology and Oncology (ESTRO; 2005–07).
463
Media Watch
Pages from The Lancet articles depicting the use of Röntgen radiographs, 1896 (left), and Nitze’s examination of bladder tumours, 1888 (right)
Early seminal articles in radiotherapy were published mainly in French or German journals. Nevertheless, The Lancet has published several important studies that not only record
William Gullick (Department of Biosciences, Kent University, Canterbury, UK) is the current president of the European Association for Cancer Research (EACR; 2004–06).
464
For a basic scientist, The Lancet is not often the first point of reference for molecular research. However, while reading this historical selection of notable publications of the journal’s history, I was struck by the relevance of many Lancet reports to issues in current research. Although oncology does not overtly appear until Max Nitze’s work on endoscopic examination of bladder tumours in 1888 and Stephen Paget’s report on the distribution of secondary growths in breast cancer in 1889, the book has early reports on medical statistics (ECHA Louis, 1834), organic chemistry (Justus Leibig, 1844), and antibodies (Bence Jones, 1847)—subjects essential to modern oncology. George Thomas Beatson’s 1896 paper on inoperable carcinoma of the breast is fascinating to read again, to see the foundation of a clinical and academic specialty as well as an industry. Pharmacology reports gradually emerge, with the discovery of heroin in 1898 and aspirin in 1899, and entertaining analytical reports on “very old pale cognac” and “scotch whiskey” (for which the motivation was not stated). In addition to new drugs, methods of clinical investigation and treatment begin to be represented—sometimes rather tragically, such as a 1910 report describing the “pitiable” state of two pioneers of radiograph technology as a consequence of radiation overexposure. We then encounter Austin Bradford Hill’s paper on the principles of medical statistics in 1937, but see a notable gap before the next paper germane to
the progress made by radiotherapy for patients with cancer, but also shed some light on general concepts in oncology. Examples include the work of Saunders and colleagues in 1997, showing that modification of radiotherapy, based on biological knowledge of the mechanisms of radioresistance in tumours, could improve survival in lung cancer; and research by Overgaard and co-workers in 1999 of the importance of improved locoregional tumour control by radiation on overall survival in breast cancer—a disease widely perceived to be largely systemic. The importance of modern conformal radiotherapy was shown by Dearnaley and colleagues in 1999. The Lancet has also published several meta-analyses that have had an important effect on modern radiotherapy, such as radiochemotherapy in head and neck cancer (Pignon and colleagues, 2000) and the treatment of early breast cancer (Clarke and co-workers, 2005). Radiotherapy is still important in cancer treatment; it is given to more than 50% of patients in developed countries, and given as the sole or main component of treatment to more than 40% of patients cured from cancer. I look forward to many more Lancet articles recording the enormous advances in radiation technology and biology achieved to develop successful cures with preservation of organ function.
Michael Baumann [email protected]
oncology on malignant diseases of childhood and diagnostic radiation in utero (Stewart and colleagues, 1956). What of the beginnings of chemotherapy and radiotherapy? In 1954, we find an article on smoker’s cough, which begins with the prescient sentence: “Tobacco smoking is a hazardous pastime”, as Richard Doll and Austin Bradford Hill’s paper on the risks of smoking was published in the BMJ in the same year (a loss to The Lancet). In a 1958 article of cytological screening of 1000 women for cervical cancer, researchers note rather dryly, but importantly, that screening was “not resented by the patients”. The most recent group of papers include studies on Epstein-Barr virus in Burkett’s lymphoma in 1964, simple versus radical mastectomy in 1973, breastcancer screening in 1990, and breast cancer and hormonereplacement therapy in 2003. Overall, I was left with two impressions from this book: first, that among busy researchers of the present day, the history of medicine is almost universally ignored yet still is of interest and has examples to follow; second, how oncology has a relatively recent history compared with that of other research areas such as infectious disease. What place oncology will hold in the next 200 years of research published in The Lancet will be interesting for future readers to observe.
William Gullick [email protected]
http://oncology.thelancet.com Vol 7 June 2006
Media Watch
The Lancet, with its long history and prestigious articles, is a constant reference to the evolution of scientific thought. Richardson’s book, which covers the history of modern medicine, will impress readers with the experiences and research of the authors, who have been the articles’ main characters. Such personalities include Joseph Lister, Stephen Paget, Louis Pasteur, Robert Koch, Basil Hirshowitz, Michael Epstein and Yvonne Barr, and Robin Warren and Barry Marshall—the 2005 Nobel Prize winners. Although the book does not contain many papers on surgical oncology, the articles presented on these surgical perspectives are impressive. In response to the question: “What is it that decides what organs shall suffer in a case of disseminated cancer?”, Stephen Paget considers “metastasis” in his 1889 article on the distribution of secondary growths in breast cancer. Paget shows evidence of predisposition with respect to metastasis, observing how frequently the liver and the bones are affected by secondary cancer. With respect to bone, he comments that “it is not a matter of chance what bone shall be attacked by secondary growth”, and that overall “the disease has its ’seats of election’”. Although we now know that host factors and local tissue components are probably the major factors that define which organs are affected in neoplastic development, we can agree with Paget that “all show the dependence of the seed upon the soil”.
In George Thomas Beatson’s 1896 paper on the treatment of inoperable carcinoma of the breast, he underlines two different opinions regarding the nature and cause of breast cancer. The first states that the carcinomatous growth has a local origin, and that the best treatment is complete removal of the disease by surgery. The second opinion stresses the idea that carcinoma of the breast is a blood disease, and that the tumour is only a local manifestation of a blood-related effect. In fact, the nature of breast cancer is still difficult to understand now, especially with respect to the biological processes that determine the behaviour of any individual breast cancer, but biological predeterminism has become the basis for management of breast cancer. If a tumour cannot be removed in a young patient with advanced disease, Beatson suggests that the tubes and ovaries should be removed to stop cell proliferation. As a testament to Beatson’s findings, the notion of the uselessness of local treatment in advanced disease and the role of endocrine treatment in breast cancer were already known by the end of 19th century. In conclusion, this compilation of clinical and scientific articles shows how important and necessary it is to learn from lessons of the past.
Luigi Cataliotti (University of Florence, Italy) is the current president of the European Society of Surgical Oncology (ESSO; 2004–06).
Vintage Papers from The Lancet and The Lancet Oncology are both published by Elsevier Ltd.
Luigi Cataliotti luigi.cataliotti@unifi.it
Film Lion-hearts
http://oncology.thelancet.com Vol 7 June 2006
their unimpeachable courage and strength? Possibly. I am inclined to go for the cancer: nature’s cold, unfeeling killer, laying waste to the vulnerable with brutish efficiency. The clumsy grace of Alex Lougheed, 7 years old and having had leukaemia since she was 5 years old, seems to be no match for the overpowering illness that has cruelly swollen her face and left her bedridden.
A Lion in the House By Julia Reichert and Steven Bognar, 2006, 220 min Screening on US television network PBS on June 21–22 http://www.pbs.org/ independentlens/lioninthehouse
Steven Bognar
After a brief introduction, A Lion in the House cuts to the Salvation Army Community Centre, Cincinnati, OH, USA. A group of children are playing basketball. Enter Tim Woods, 15 years old with a featherweight frame and a ready supply of wisecracks. He does not join the game, but stands on the sidelines pointing out his buddies. There’s Russell, the team captain, and an unnamed gentleman who, Tim assures us, was raised by wolves. A toothy young lady appears, Tim gleefully claims her as his girlfriend, and she rushes off trilling with feigned indignation. High-spirited teens in the heart of middle America. But Tim’s teenage years have been stolen. Diagnosed with Hodgkin’s lymphoma the previous year, his life is in stasis. Until he beats cancer, basketball with wolf-boy and the others will have to wait. Filmed over 6 years, A Lion in the House follows the progress of five families affected by cancer during childhood. The film premiered at the Sundance Film Festival (Park City, UT, USA) in January, 2006, but the subject matter really demands the intimacy of the small screen, where it makes its US debut in June. The title comes from the author of Out of Africa, Isak Dinesen: “you know you’re truly alive when you’re living amongst the lions”. But who is the lion? The children, with
Tim Woods and his mother Marietha, on his 16th birthday
465
Book A trip down memory lane For nearly 200 years, The Lancet has been one of medicine’s pre-eminent journals. First published in 1823, it has produced an astonishing array of seminal articles and clinical observations. Vintage Papers from The Lancet is a collection of some of the journal’s more fascinating landmark papers. Complied and edited by Ruth Richardson, a scholar in the history of science at Cambridge University, UK, the book is divided into four sections, which cover an interval of roughly 40 years: the 1820s to 1860s, 1870s to 1910s, 1920s to 1950s, and 1960s to 2005. The book is full of amusing tales, such as Queen Victoria’s description of the use of “blessed chloroform” with the delivery of her latest child, and the mysterious death of Prince Albert that led to an editorial demand for increased public disclosure (some things never change). Major medical advances are included, such as the early stethoscope and otoscope, Joseph Lister’s discourse on antisepsis, James Paget’s discussion of osteitis deformans, Louis Pasteur’s address on the germ theory, Robert Koch’s “remedy” for tuberculosis, Ernst Chain and Howard Florey’s discussion of penicillin’s therapeutic potential, and John Charnley’s initial description of hip-replacement surgery, and endoscopy, brain MRI, and ova cryopreservation. These historical articles also contain other delightful and perhaps surprising tidbits, such as a modest letter to the editor from a so-called lowly family practitioner suggesting that aspirin might prove useful “for the treatment of coronary thrombosis”. Enthusiasts of the English language will find much to admire in these pages. The early days of medical writing were much more literary than the prosaic, highly stylised,
and sterile medical writing in today’s medical journals. For example, in his 1896 description of hormonal therapy in metastatic breast cancer, George Thomas Beatson begins: “I have no doubt it has fallen to the lot of nearly every medical man to have been consulted from time to time by patients suffering from carcinoma so widely spread or so situated that it has been quite apparent that nothing in the way of operative measures could be recommended”. Beatson would spend his spare time wandering pastures and making observations on gravid sheep and cows that he later applied to the human condition. Who writes like this today? What journal would allow it? Perhaps not even The Lancet, with the following introduction from a recent article on breast cancer: “In early breast cancer, surgery can remove any disease that has been detected in or around the breast or regional lymph nodes, but undetected deposits of disease may remain either locally (ie, in the residual breast tissue, scar area, chest wall, or regional lymph nodes) or at distant sites that could, if untreated, develop into life-threatening recurrence”. The habitué of medical libraries, rare books, and manuscript rooms should thoroughly enjoy this selection of perceptive articles from The Lancet’s history. The book can be enjoyed on rainy weekend days as readers can imagine how medicine used to be compared with how medicine is today, which is all well-chronicled in the pages of The Lancet. Richardson’s book makes the journey exceedingly enjoyable.
For doctors and biomedical scientists, this book, which compiles publications from The Lancet from 1823, is both interesting and entertaining. It gives a rare insight into how a uniquely prestigious journal was established in the early 19th century, and which editorial considerations were given to style, content, and high standards for medical publishing. Furthermore, this selection gives a highly readable, first-hand impression of medical milestones in the past two centuries. Richardson’s book shows the tremendous effect that ionising radiation has had on modern medicine during its 110-year history. In 1896, 1 year after the discovery of radiographs by Wilhelm Conrad Röntgen, The Lancet reported their use to find a bullet in a shot wound that could not be located by surgical exploration. More than a century later, readers can appreciate the excitement of the pioneers of radiology to explore this new technology and revolutionary diagnostic potential. The Lancet was among the first to warn against the potential long-term harm of radiography by
describing the development of radiation-related carcinoma, and later the development of cancer in childhood after diagnostic radiation in utero. Other selected articles cover the development of diagnostic ultrasonography and MRI. Parallel to diagnostic radiology, radiotherapy was established as a new, rapidly evolving science. The first successful therapeutic use of radiography in a large naevus piliformis was published by Leopold Freund in Wiener Medizinische Wochenschrift (1897). First cures of cancer were later reported by Tor Stenbeck (1900) and Tage Sjögren (1901). Further breakthroughs came with the introduction of brachytherapy (1901), exact dosimetry, and radiobiological understanding of the importance of fractionation in the early 20th century. X-ray tubes were replaced by megavoltage machinery, which was later accompanied by computerised treatment planning, modified fractionation, radiochemotherapy, and conformal and image-guided radiotherapy.
http://oncology.thelancet.com Vol 7 June 2006
Vintage Papers from The Lancet Ruth Richardson (Ed) Elsevier, 2006 £32·99 (US$59·03, €47·71), pp 488 ISBN 0 08044 683 3 David Johnson (VanderbiltIngram Cancer Center, Nashville, TN, USA) is the immediate past president of the American Society of Clinical Oncology (ASCO; 2004–05).
David H Johnson [email protected]
Michael Baumann (University of Dresden, Germany) is the current president of the European Society for Therapeutic Radiology and Oncology (ESTRO; 2005–07).
463
Media Watch
Pages from The Lancet articles depicting the use of Röntgen radiographs, 1896 (left), and Nitze’s examination of bladder tumours, 1888 (right)
Early seminal articles in radiotherapy were published mainly in French or German journals. Nevertheless, The Lancet has published several important studies that not only record
William Gullick (Department of Biosciences, Kent University, Canterbury, UK) is the current president of the European Association for Cancer Research (EACR; 2004–06).
464
For a basic scientist, The Lancet is not often the first point of reference for molecular research. However, while reading this historical selection of notable publications of the journal’s history, I was struck by the relevance of many Lancet reports to issues in current research. Although oncology does not overtly appear until Max Nitze’s work on endoscopic examination of bladder tumours in 1888 and Stephen Paget’s report on the distribution of secondary growths in breast cancer in 1889, the book has early reports on medical statistics (ECHA Louis, 1834), organic chemistry (Justus Leibig, 1844), and antibodies (Bence Jones, 1847)—subjects essential to modern oncology. George Thomas Beatson’s 1896 paper on inoperable carcinoma of the breast is fascinating to read again, to see the foundation of a clinical and academic specialty as well as an industry. Pharmacology reports gradually emerge, with the discovery of heroin in 1898 and aspirin in 1899, and entertaining analytical reports on “very old pale cognac” and “scotch whiskey” (for which the motivation was not stated). In addition to new drugs, methods of clinical investigation and treatment begin to be represented—sometimes rather tragically, such as a 1910 report describing the “pitiable” state of two pioneers of radiograph technology as a consequence of radiation overexposure. We then encounter Austin Bradford Hill’s paper on the principles of medical statistics in 1937, but see a notable gap before the next paper germane to
the progress made by radiotherapy for patients with cancer, but also shed some light on general concepts in oncology. Examples include the work of Saunders and colleagues in 1997, showing that modification of radiotherapy, based on biological knowledge of the mechanisms of radioresistance in tumours, could improve survival in lung cancer; and research by Overgaard and co-workers in 1999 of the importance of improved locoregional tumour control by radiation on overall survival in breast cancer—a disease widely perceived to be largely systemic. The importance of modern conformal radiotherapy was shown by Dearnaley and colleagues in 1999. The Lancet has also published several meta-analyses that have had an important effect on modern radiotherapy, such as radiochemotherapy in head and neck cancer (Pignon and colleagues, 2000) and the treatment of early breast cancer (Clarke and co-workers, 2005). Radiotherapy is still important in cancer treatment; it is given to more than 50% of patients in developed countries, and given as the sole or main component of treatment to more than 40% of patients cured from cancer. I look forward to many more Lancet articles recording the enormous advances in radiation technology and biology achieved to develop successful cures with preservation of organ function.
Michael Baumann [email protected]
oncology on malignant diseases of childhood and diagnostic radiation in utero (Stewart and colleagues, 1956). What of the beginnings of chemotherapy and radiotherapy? In 1954, we find an article on smoker’s cough, which begins with the prescient sentence: “Tobacco smoking is a hazardous pastime”, as Richard Doll and Austin Bradford Hill’s paper on the risks of smoking was published in the BMJ in the same year (a loss to The Lancet). In a 1958 article of cytological screening of 1000 women for cervical cancer, researchers note rather dryly, but importantly, that screening was “not resented by the patients”. The most recent group of papers include studies on Epstein-Barr virus in Burkett’s lymphoma in 1964, simple versus radical mastectomy in 1973, breastcancer screening in 1990, and breast cancer and hormonereplacement therapy in 2003. Overall, I was left with two impressions from this book: first, that among busy researchers of the present day, the history of medicine is almost universally ignored yet still is of interest and has examples to follow; second, how oncology has a relatively recent history compared with that of other research areas such as infectious disease. What place oncology will hold in the next 200 years of research published in The Lancet will be interesting for future readers to observe.
William Gullick [email protected]
http://oncology.thelancet.com Vol 7 June 2006
Media Watch
The Lancet, with its long history and prestigious articles, is a constant reference to the evolution of scientific thought. Richardson’s book, which covers the history of modern medicine, will impress readers with the experiences and research of the authors, who have been the articles’ main characters. Such personalities include Joseph Lister, Stephen Paget, Louis Pasteur, Robert Koch, Basil Hirshowitz, Michael Epstein and Yvonne Barr, and Robin Warren and Barry Marshall—the 2005 Nobel Prize winners. Although the book does not contain many papers on surgical oncology, the articles presented on these surgical perspectives are impressive. In response to the question: “What is it that decides what organs shall suffer in a case of disseminated cancer?”, Stephen Paget considers “metastasis” in his 1889 article on the distribution of secondary growths in breast cancer. Paget shows evidence of predisposition with respect to metastasis, observing how frequently the liver and the bones are affected by secondary cancer. With respect to bone, he comments that “it is not a matter of chance what bone shall be attacked by secondary growth”, and that overall “the disease has its ’seats of election’”. Although we now know that host factors and local tissue components are probably the major factors that define which organs are affected in neoplastic development, we can agree with Paget that “all show the dependence of the seed upon the soil”.
In George Thomas Beatson’s 1896 paper on the treatment of inoperable carcinoma of the breast, he underlines two different opinions regarding the nature and cause of breast cancer. The first states that the carcinomatous growth has a local origin, and that the best treatment is complete removal of the disease by surgery. The second opinion stresses the idea that carcinoma of the breast is a blood disease, and that the tumour is only a local manifestation of a blood-related effect. In fact, the nature of breast cancer is still difficult to understand now, especially with respect to the biological processes that determine the behaviour of any individual breast cancer, but biological predeterminism has become the basis for management of breast cancer. If a tumour cannot be removed in a young patient with advanced disease, Beatson suggests that the tubes and ovaries should be removed to stop cell proliferation. As a testament to Beatson’s findings, the notion of the uselessness of local treatment in advanced disease and the role of endocrine treatment in breast cancer were already known by the end of 19th century. In conclusion, this compilation of clinical and scientific articles shows how important and necessary it is to learn from lessons of the past.
Luigi Cataliotti (University of Florence, Italy) is the current president of the European Society of Surgical Oncology (ESSO; 2004–06).
Vintage Papers from The Lancet and The Lancet Oncology are both published by Elsevier Ltd.
Luigi Cataliotti luigi.cataliotti@unifi.it
Film Lion-hearts
http://oncology.thelancet.com Vol 7 June 2006
their unimpeachable courage and strength? Possibly. I am inclined to go for the cancer: nature’s cold, unfeeling killer, laying waste to the vulnerable with brutish efficiency. The clumsy grace of Alex Lougheed, 7 years old and having had leukaemia since she was 5 years old, seems to be no match for the overpowering illness that has cruelly swollen her face and left her bedridden.
A Lion in the House By Julia Reichert and Steven Bognar, 2006, 220 min Screening on US television network PBS on June 21–22 http://www.pbs.org/ independentlens/lioninthehouse
Steven Bognar
After a brief introduction, A Lion in the House cuts to the Salvation Army Community Centre, Cincinnati, OH, USA. A group of children are playing basketball. Enter Tim Woods, 15 years old with a featherweight frame and a ready supply of wisecracks. He does not join the game, but stands on the sidelines pointing out his buddies. There’s Russell, the team captain, and an unnamed gentleman who, Tim assures us, was raised by wolves. A toothy young lady appears, Tim gleefully claims her as his girlfriend, and she rushes off trilling with feigned indignation. High-spirited teens in the heart of middle America. But Tim’s teenage years have been stolen. Diagnosed with Hodgkin’s lymphoma the previous year, his life is in stasis. Until he beats cancer, basketball with wolf-boy and the others will have to wait. Filmed over 6 years, A Lion in the House follows the progress of five families affected by cancer during childhood. The film premiered at the Sundance Film Festival (Park City, UT, USA) in January, 2006, but the subject matter really demands the intimacy of the small screen, where it makes its US debut in June. The title comes from the author of Out of Africa, Isak Dinesen: “you know you’re truly alive when you’re living amongst the lions”. But who is the lion? The children, with
Tim Woods and his mother Marietha, on his 16th birthday
465