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The man behind the cure

The man behind the cure

At 75-years-young, Larry Einhorn, MD, has spent nearly five decades caring for the sickest of the sick while paving the way for cancer research. A trailblazer in the field of oncology, Dr. Einhorn is internationally known for pioneering the cure for testis cancer – a disease that was once a death sentence for those who were diagnosed. As a distinguished professor of medicine, the Livestrong Foundation professor of oncology at Indiana University School of Medicine and a physician-scientist at IU Simon Cancer Center, Dr. Einhorn continues to train the next generations of physicians and scientists to be thought-leaders in medical field.

Here’s the story of the man behind the cure:

Following in his Father’s Footsteps

A native of Dayton, Ohio, Larry Einhorn knew from an early age he wanted to pursue a career in medicine. His father was a family practitioner with an office attached to the family home. “When I was in high school, I used to make round with him at the local hospital in Dayton,” Dr. Einhorn says. “I admired and respected him a great deal. Even back then, I felt medicine was a noble profession.”

He left Ohio for Northwestern University, but soon transferred to Indiana University in Bloomington. It was there that he met his future wife, Claudette, when his roommate set them up on a date. She was struck by his sincerity and honesty. “And we were a couple ever since,” she says.

After attending medical school at the University of Iowa, Dr. Einhorn returned to IU School of Medicine for his internship and residency. His plan had been to focus on cardiology and move back to Dayton to work alongside his father. However, when his father had a heart attack and stopped practicing, that door closed.

Fortunately, another door opened.

During his internship, Dr. Einhorn completed an elective in hematology/oncology. “I really became seduced by the specialty,” he says. “There seemed to be an opportunity to make a difference in the field, which was really a nascent field.”

Following his residency, the Einhorns moved to Texas so he could complete a fellowship at MD Anderson, one of only a handful of places in the country that offered advanced training in oncology at the time. It was then that he first truly witnessed the tragedy of testis cancer. While in the first year of his fellowship, a third-year fellow named Jeffrey Gottlieb developed testis cancer and died from it.

“Jeff was a friend of Larry’s, a colleague of Larry’s, and I think it was a very traumatic moment in Larry’s life to see someone his age die of cancer,” Claudette Einhorn says. “I think that influenced him a great deal in terms of where he would begin to do research. The fact that this young man in his 30s died and no one could do anything about it was fairly traumatic and I think that set the course for Larry.”

Dr. Einhorn returned to the Hoosier State in 1973 as the first faculty oncologist at IU School of Medicine. He treated patients with all types of cancer, but was especially interested in tumors that had shown some response to chemotherapy: leukemia, lymphoma, testicular cancer and small cell lung cancer.

Testis cancer might not typically be a disease on which a doctor would stake his career. Though it was the leading cancer killer of young men at the time, it was rare. The average physician might have only seen patients battling the disease here and there.

Things were different at IU School of Medicine.

Young men with the disease were flocking to University Hospital from across the United States because John Donohue, MD, offered radical, heroic surgery that other urologic surgeons would not even consider. He managed to save 20 percent of patients whose disease had spread to the abdomen, although many of the patients he operated on still developed a recurrence.

“In then walked a young Larry Einhorn, who had, as John would describe him, a pimply face, a plaid shirt and paisley pants, and was a most unlikely hero,” says Patrick Loeherer, MD, director of the IU Melvin and Bren Simon Cancer. “Quickly, Larry talked to him and said, ‘I’ve got an idea for testis cancer. Would you allow me to work with some of your patients?’ That began the partnership that would change this disease forever.”

His idea involved the experimental drug Cisplatin. The drug contains the metal platinum and helps prompt the death of otherwise immortal cancer cells. When Dr. Einhorn set his sights on it, Cisplatin had been tested on a wide range of cancers as part of an early phase trial. It proved terribly toxic, and the results weren’t spectacular. It might have been permanently shelved, but Dr. Einhorn noticed that the drug was killing cancer cells in a very small subset of patients with testis cancer.

With all of this in mind, Dr. Einhorn offered patient John Cleland this brand new therapy. What Cleland didn’t know was that the only other person to try this particular combination of drugs died. “We had no idea whether this was going to help for a couple of days, a couple of weeks, a couple of months…let alone cure the disease,” Dr. Einhorn says.

Cleland had already endured four previous kinds of chemotherapy, each seemingly more brutal than the last. The new regimen was equally wretched. He would undergo five days of treatment, take three weeks off, and then do it all over again. On the first day of each course, the average patient would throw up 12 times. In fact, the very thought of coming to the hospital would cause anticipatory vomiting.

On Oct. 20, 1974 – less than a month into the treatment – it didn’t seem that it was working. Cleland felt downright awful. His fever spiked above 104, and his wife and some friends drove him from his home in LaFayette to the emergency room at IU. Doctors ordered a chest X-ray.

The next day, he saw Dr. Einhorn and his nurse, Becky, in the elevator. “I just knew from their body language that somebody had good news. They just kept coming toward my room and finally, they walked in and Dr. Einhorn said, ‘John, I think you’re gonna make it.’”

The X-rays were clear.

“When he told me, it was like I was floating in the air. I know I was touching the mattress, but it sure never felt like it,” says Cleland, who went onto have three children with his wife Judy and to work as a high school teacher for 31 years. “It felt like I was six inches off the mattress. Probably the best feeling I’ve ever had in my life. Sheer bliss.”

Of course, the response of a single patient doesn’t qualify as a cure. The cancer could have come back, and others might not have responded the same way. Dr. Einhorn continued testing the combination, usually with the same improbable results.

A few years later, Dr. Einhorn was invited to present his results at the annual meeting of the American Society of Clinical Oncology, the world’s premier organization of cancer specialists. Until then, Claudette Einhorn didn’t fully comprehend what her husband had accomplished. “I think that’s when it first hit me how dramatic this was, and that it wasn’t just a positive research study but a life-saving research study,” she says.

Dr. Einhorn had cured testis cancer. However, that wasn’t good enough for him. In the decades that followed, he continued to refine the treatment to spare patients some of the most awful side effects. He also substantially reduced the length of the treatment from two years in 1974 to a mere nine-to-12 weeks today. Cisplatin, once destined for the pharmacologic graveyard, is now used in the initial treatment for 11 types of cancer.

From Then to Now

More than 40 years after curing this deadly disease, Dr. Einhorn remains the international expert on testicular cancer, and patients seek him out from around the globe. He has inspired a legion of cancer researchers and developed a roadmap for them to follow. Dr. Einhorn has also dedicated himself to teaching as a way to influence cancer care well beyond Central Indiana, for years serving as the director of the IU School of Medicine Hematology and Oncology Fellowship Program.

“I’ve been very lucky that I’m healthy. You never know what’s going to happen from day to day, and I think oncologists recognize this more than others. I love the work I do. I really enjoy teaching, mentoring faculty and taking care of patients. For me, I have the best job in oncology, if not the best job in medicine.

Read the full story in IU Medicine.


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