Virginia Livingston
Encyclopedia
Virginia Livingston was an American
United States
The United States of America is a federal constitutional republic comprising fifty states and a federal district...

 physician
Physician
A physician is a health care provider who practices the profession of medicine, which is concerned with promoting, maintaining or restoring human health through the study, diagnosis, and treatment of disease, injury and other physical and mental impairments...

 and cancer researcher who advocated the unsupported theory that a specific species of bacteria she named Progenitor cryptocides was the primary cause of cancer
Cancer
Cancer , known medically as a malignant neoplasm, is a large group of different diseases, all involving unregulated cell growth. In cancer, cells divide and grow uncontrollably, forming malignant tumors, and invade nearby parts of the body. The cancer may also spread to more distant parts of the...

 in humans. Livingston's theories about Progenitor cryptocides have not been duplicated by researchers, and a clinical trial of her therapy did not show any efficacy in the treatment of cancer.

Life

Virginia Livingston was born Virginia Wuerthele in Meadville, Pennsylvania in 1906. Both her father and grandfather were doctors and she also pursued a degree in medicine. Prior to attending medical school, Livingston earned three BA degrees in English, history, and economics from Vassar College. She then attended New York University, Bellevue Medical College and in 1936, received her degree in medicine with an interest in internal medicine. She was one of four women in her graduating class.

Shortly after graduation, Livingston became the first female resident physician at a New York hospital where she was assigned to treat prostitutes infected with venereal diseases. While there, Livingston became interested in the study of tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

 and leprosy
Leprosy
Leprosy or Hansen's disease is a chronic disease caused by the bacteria Mycobacterium leprae and Mycobacterium lepromatosis. Named after physician Gerhard Armauer Hansen, leprosy is primarily a granulomatous disease of the peripheral nerves and mucosa of the upper respiratory tract; skin lesions...

, and later scleroderma
Scleroderma
Systemic sclerosis or systemic scleroderma is a systemic autoimmune disease or systemic connective tissue disease that is a subtype of scleroderma.-Skin symptoms:...

, a disease affecting the tissues and skin. After studying scleroderma tissues with the darkfield microscope, she claimed to find an acid-fast
Acid-fast
Acid-fastness is a physical property of certain bacteria, specifically their resistance to decolorization by acids during staining procedures.Acid-fast organisms are difficult to characterize using standard microbiological techniques Acid-fastness is a physical property of certain bacteria,...

 organism that consistently appeared in her slides. Thinking that scleroderma had some characteristics that were like cancer, Livingston then began studying malignant tissues and subsequently claimed to find evidence of acid-fast organisms in every sample. It was this early research that prompted the young physician to devote her career to the study of a specific microorganism involved in cancer.

Early research

In 1946, Livingston published a paper in which she stated she had established that a bacterium
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...

 was a causative agent in scleroderma. In 1947, she cultured a mycobacteria-like organism in human cancer and, according to her peer-reviewed paper, fulfilled Koch's postulates
Koch's postulates
Koch's postulates are four criteria designed to establish a causal relationship between a causative microbe and a disease. The postulates were formulated by Robert Koch and Friedrich Loeffler in 1884 and refined and published by Koch in 1890...

 establishing an apparent cause and effect. In 1949, Livingston was named chief of the Rutgers-Presbyterian Hospital Laboratory for Proliferative Diseases in New Jersey where she continued her cancer research. It was during this time that Livingston formed a lifetime association with Dr. Eleanor Alexander-Jackson of Cornell University. Jackson's specialty was the study of mycobacteria and particularly, the species responsible for tuberculosis. Jackson had developed specific culture media for growing the microbe and a technique for observing it known as the "triple stain" because she felt this microbe wasn't amenable to conventional modes of culturing and microscopy.

Livingston and Jackson also collaborated on work on the Rous sarcoma virus
Rous sarcoma virus
Rous sarcoma virus is a retrovirus and is the first oncovirus to have been described: it causes sarcoma in chickens.As with all retroviruses, it reverse transcribes its RNA genome into cDNA before integration into the host DNA.-History:...

 (RSV) at Lederle Laboratories. Livingston claimed that when RSV cultures were passed through special filters designed to hold back all but the smallest virus particles, she was able to grow bacteria; this was considered a controversial claim since bacteria are considerably larger than viruses and are not supposed to exist in filtered RSV serum. After healthy animals were exposed to the Rous bacterial filtrates, Livingston and Jackson claimed that cancerous lesions developed. This finding led to speculation that such bacteria could be transmitted from poultry to humans and this became a primary reason Livingston ordered her cancer patients to not eat poultry while they underwent her treatment. Scientists have since rejected Livingston findings, arguing there is no evidence supporting her claim.

In 1956, Livingston published a paper suggesting a causative bacterium in Wilson's disease
Wilson's disease
Wilson's disease or hepatolenticular degeneration is an autosomal recessive genetic disorder in which copper accumulates in tissues; this manifests as neurological or psychiatric symptoms and liver disease...

. In 1965, she reported isolation of a variably acid-fast mycobacterium in patients with myocardial vascular disease. During this time, she also began a small test trial of anti-bacterial vaccines made from the body fluids of cancer patients and reported moderate success. Between the years 1965-1968, Livingston received Fleet Foundation and Kerr Grants, and continued her investigation into a bacterial cause of human cancer. She also published a paper describing the presence of a substance identified as Actinomycin-D which she said could damage chromosomes and promote cancer.

In 1969, Livingston and her husband Alfred Monk Livingston, established the Livingston-Wheeler Clinic in San Diego, California
California
California is a state located on the West Coast of the United States. It is by far the most populous U.S. state, and the third-largest by land area...

, and began formally treating cancer patients. The therapeutic program included autogenous vaccine made from killed bacteria derived from body fluids; a low sodium diet consisting of organic foods, fruits and vegetables high in a substance Livingston called "abscisic acid"; immune enhancing vaccines (gamma globulin, BCG) and antibiotics. Livingston prescribed antibiotics after cross testing them with patients' cultures to see which had the most antibacterial activity. Livingston also recommended that patients not consume poultry products based on her earlier research.

After her husband’s death, she married Owen Webster Wheeler, one of the first patients she claims to have successfully treated for head and neck cancer. Shortly after, the clinic was renamed the Livingston-Wheeler clinic. In 1970, Livingston officially named her cancer organism Progenitor cryptocides, and presented her findings to the New York Academy of Sciences
New York Academy of Sciences
The New York Academy of Sciences is the third oldest scientific society in the United States. An independent, non-profit organization with more than members in 140 countries, the Academy’s mission is to advance understanding of science and technology...

. According to her biography, Progenitor was a pseudonym meaning "ancestral" and the name was chosen because Livingston believed the microbe existed as early as the Precambrian
Precambrian
The Precambrian is the name which describes the large span of time in Earth's history before the current Phanerozoic Eon, and is a Supereon divided into several eons of the geologic time scale...

 era, and it was an endegenous component of life itself. The name "cryptocides" was a Greek and Latin word which meant "hidden killer". The microbe was classified under the order Actinomycetales
Actinomycetales
Actinomycetales is an order of Actinobacteria. They are very diverse and contain a variety of subdivisions as well as yet unclassified isolates. This is mainly because some genera are very difficult to classify because of a highly niche-dependent phenotype...

. Livingston described Progenitor as an intermittently acid-fast mycobacterium that displayed highly variable growth cycles. According to Livingston the microbe was pleomorphic, with had cell wall
Cell wall
The cell wall is the tough, usually flexible but sometimes fairly rigid layer that surrounds some types of cells. It is located outside the cell membrane and provides these cells with structural support and protection, and also acts as a filtering mechanism. A major function of the cell wall is to...

-deficient and filter-passing forms resembling viruses, with the ability to adopt a variety of shapes including spindle
Spindle
The term spindle may refer to:In textiles and manufacturing:*Spindle , a device to spin fibres into thread*Spindle , is the main rotating part of a machine tool, woodworking machine, etc...

s, rods
Rod (geometry)
In geometry, a rod is a three-dimensional, solid cylinder....

 and cocci
Coccus
Coccus can be used to describe any bacterium that has a spherical shape. It is one of the three distinct types of bacteria shapes, the other two being bacillus and spirillum cells...

.

1974-1990

In 1974, Livingston published a paper which described her isolation of human chorionic gonadotropin
Human chorionic gonadotropin
Human chorionic gonadotropin or human chorionic gonadotrophin is a glycoprotein hormone produced during pregnancy that is made by the developing embryo after conception and later by the syncytiotrophoblast .. Some tumors make this hormone; measured elevated levels when the patient is not...

 (hCG) from cancer bacteria. She then advanced one of her central hypotheses.

Livingston theorized that hCG is both a component of human cancer, but also innately involved in embryonic growth and fetal survival. She wrote that hCG is saturated in the placenta, and blocks the mothers’ antibodies from attacking the fetus, partly made of foreign DNA (and not recognized by host immunity). By the same token, hCG performs a similar function in cancer, conferring protection to malignant tissues. Livingston believed that after Progenitor hybridizes with cancer cells, it imparts an ability for them to produce hCG in a manner similar to that of the developing fetus. Based on this duality of function, Livingston called hCG “the hormone of life and the hormone of death”. She also stipulated that vaccines which target hCG-producing bacteria could also halt the progression of cancer. And she claimed that absicins could also neutralize hCG.

Controversy

Though some bacteria have been associated with cancer
Cancer bacteria
Cancer bacteria are bacterial infectious organisms that are known or suspected to cause cancer. While cancer-associated bacteria have long been considered to be opportunistic , there is some evidence that bacteria may be directly carcinogenic. The strongest evidence to date involves the bacterium H...

 (for instance H. pylori
Helicobacter pylori
Helicobacter pylori , previously named Campylobacter pyloridis, is a Gram-negative, microaerophilic bacterium found in the stomach. It was identified in 1982 by Barry Marshall and Robin Warren, who found that it was present in patients with chronic gastritis and gastric ulcers, conditions that were...

has been associated with stomach cancer
Stomach cancer
Gastric cancer, commonly referred to as stomach cancer, can develop in any part of the stomach and may spread throughout the stomach and to other organs; particularly the esophagus, lungs, lymph nodes, and the liver...

) Livingston's postulated relationship between cancer and P. cryptocides was never proven in several follow up studies conducted by independent investigators. Researchers confirmed that bacteria provided by Livingston produced hCG, but several other studies demonstrated that numerous bacteria in both cancer patients and healthy individuals also produced the substance.

Occurring before the existence of techniques to analyze DNA, Livingston and other investigators' ability to differentiate bacteria based on morphology and chemical characteristics were limited. However, even given technological limitations at the time Livingston's classification methods were described as full of "remarkable errors", attributing characteristics to Actinomycetales
Actinomycetales
Actinomycetales is an order of Actinobacteria. They are very diverse and contain a variety of subdivisions as well as yet unclassified isolates. This is mainly because some genera are very difficult to classify because of a highly niche-dependent phenotype...

 (the order
Order (biology)
In scientific classification used in biology, the order is# a taxonomic rank used in the classification of organisms. Other well-known ranks are life, domain, kingdom, phylum, class, family, genus, and species, with order fitting in between class and family...

 Livingston believed P. cryptocides belonged to) shared by no other members of the order. Some evidence supports P. cryptocides is the result of a mistaken identification of a Staphylococcus
Staphylococcus
Staphylococcus is a genus of Gram-positive bacteria. Under the microscope they appear round , and form in grape-like clusters....

strain of bacteria and later studies of the samples provided by Livingston proved to be Staphylococcus epidermidis
Staphylococcus epidermidis
Staphylococcus epidermidis is one of thirty-three known species belonging to the genus Staphylococcus. It is part of human skin flora, and consequently part of human flora. It can also be found in the mucous membranes and in animals. Due to contamination, it is probably the most common species...

and Streptococcus faecalis
Enterococcus faecalis
Enterococcus faecalis – formerly classified as part of the Group D Streptococcus system – is a Gram-positive, commensal bacterium inhabiting the gastrointestinal tracts of humans and other mammals. It is among the main constituents of some probiotic food supplements. Like other species in the genus...

.

The American Cancer Society (ACS) did not support Livingston’s treatment protocol for cancer, and has categorically denied her theory of the cancer bacterium P. cryptocides the primary cause of human cancer. The ACS also challenged the efficacy of Livingston’s autogenous vaccine and concluded in its report that there was no corroboration of either P. cryptocides or the efficacy of her autologous vaccine. Since Livingston hadn’t stocked earlier cultures of her alleged microbe, it is not possible to decipher precisely what those cultures contained.

Clinical testing

A case-control study using self-selected, matched
Matching (statistics)
Matching is a statistical technique which is used to evaluate the effect of a treatment by comparing the treated and the non-treated in non experimental design . People use this technique with observational data...

 but not randomized
Random sample
In statistics, a sample is a subject chosen from a population for investigation; a random sample is one chosen by a method involving an unpredictable component...

 groups with late stage cancer
Cancer staging
The stage of a cancer is a description of the extent the cancer has spread. The stage often takes into account the size of a tumor, how deeply it has penetrated, whether it has invaded adjacent organs, how many lymph nodes it has metastasized to , and whether it has spread to distant organs...

 compared survival and quality of life between cancer patients receiving conventional treatment and those undergoing the Livingston-Wheeler therapy. The results were reported in The New England Journal of Medicine in 1991, and found no differences in survival among patients whether treated conventionally, or via Livingston's treatment. The NEJM report also stated that when comparing the two groups, the "quality of life
Quality of life
The term quality of life is used to evaluate the general well-being of individuals and societies. The term is used in a wide range of contexts, including the fields of international development, healthcare, and politics. Quality of life should not be confused with the concept of standard of...

were consistently better among conventionally treated patients from enrollment on". Based on this trial, the ACS deemed Livingston's cancer therapy without efficacy, and considered it an "unproven therapy".

Death

Shortly after speaking before an Office of Technology Assessment (OTA) hearing on alternative cancer therapies and attending her 60th reunion at Vassar College in 1990, Livingston accompanied her daughter Julie Anne Wagner on a European trip. She developed chest pains while visiting the Greek islands and then succumbed to heart failure in Athens on June 30, before being transported to a Paris Hospital. Shortly after her death, Livingston’s vaccine was banned from use by the state of California as an unproven cancer therapy.
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