James Stephen Ewing (1866 – 1943) was an American pathologist and pioneer in the field of cancer research
Eponymously remembered for describing a new “endothelioma” that would later be known as Ewing sarcoma. Although best remembered for his singular eponym his contributions to the research of cancer and its treatments were far-reaching. He was a pioneer in the field, being recognised in his time as laying the foundations of the importance of early cancer diagnosis. He is now attributed to three cornerstones of modern cancer care; the cancer hospital, the cancer clinic, and the public health cancer program.
He was an outspoken opponent of the idea of a one size fits all cure for cancer, and was against the common belief at the time that the best management of patients was always the surgical option. He was ground-breaking in the use of radium as a treatment for cancer.
During his time as the President of the Memorial Hospital, he attracted and built a team of specialists in numerous areas of cancer treatment, many of whom would go on to be experts in their own respective fields
- Born on Christmas Day in 1866 in Pittsburgh Pennsylvania
- 1881– diagnosed with osteomyelitis at the age of 14 leaving him bedridden for 2 years. During this time his tutor Henry Gibbs tuned his academic skills.
- 1888– BA in classics and physiology from Amherst College
- 1891– Graduates from The College of Physicians and Surgeons of New York
- 1891– Internship at Roosevelt Hospital
- 1893-1998 works at Columbia University as a tutor in histology and instructor of clinical pathology
- 1898– Becomes army surgeon
- 1899-1931 Becomes the first professor of clinical pathology at the newly formed medical college of Cornell University. During that time he is the only employed professor at the institution.
- 1901– Publishes his first book entitled: Clinical Pathology of Blood: A Treatise on the General Principles and Special Applications of Haematology
- 1902– Helps to establish the P. Huntington fund for cancer research
- 1906– Shows first-ever proof of transmissible cancer
- 1907– Founds American Association for Cancer Research
- 1910-39 Establishes clinical research facility at Memorial Hospital (would become memorial Sloan Kettering Cancer Centre)
- 1913– Visits Europe with Dr J. Douglas to investigate the use of radium as a therapeutic agent in cancer – later this year Dr Douglas founds the National Radium Institute
- 1913– Founds the American Society for Cancer Control (now the American Cancer Society)
- 1919– Publishes the first edition of Neoplastic Diseases: a Textbook on Tumours – of which he was the sole author. At the time of its publication and the decades that followed it was seen as the authoritative textbook on cancerous diseases
- 1921– Published paper ‘diffuse endothelioma of bone’ that would become Ewing sarcoma- first presented to the New York pathology society
- 1931– Formally appointed as President of Memorial Hospital
- 1931– Appears on the cover of Time magazine
- 1939– Retires as president of Memorial Hospital
- Died on May 16 1943 from bladder cancer
Ewing Sarcoma 1921
First described by Georg Albert Lücke, a German surgeon, in 1866, and later by Hidebrand in 1890. Ewing is credited as the first person to distinguish this tumour as separate from lymphoma or neuroblastoma. Initially describing it as an ‘endothelioma of the bone’ before recognising the histopathology was more complex, thus calling it an ‘endothelial myeloma’. Ewing published his initial paper ‘Diffuse Endothelioma of Bone’ in 1921 (https://doi.org/10.3322/canjclin.22.2.95) before publishing his follow up report entitled ‘Further report of endothelial myeloma of bone’.
Ewing first describes his sarcoma in a 14-year-old girl with a tumor (thought to be an osteosarcoma) of the radius – osteosarcomas were already well known to clinicians at the time, and were usually treated by amputation. For some unknown reason, she did not undergo this line of treatment and instead was given Coley’s toxin, however this treatment showed no improvement and she was transferred to Memorial Hospital for treatment under the care of Ewing. Here she was treated with radium every two weeks, having a total of three doses, and miraculously her tumor seemed to disappear. This led clinicians like Ewing to believe that this disease was separate from osteosarcoma, however, this was subject to much debate. The young girl in the report later had a recurrence of her disease and to settle the argument a biopsy was taken, which confirmed it to be histologically different to a sarcoma, with Ewing describing ‘round cell sarcoma’ and terming it a ‘endothelia of bone’, due to the blood vessel like appearance to the bone.
In his reports, he also recounted six other similar cases he had had in the preceding months, all of whom were 14-19 years of age and had presented with a primary slow-growing, vascular tumour. He was able to distinguish that “A large portion or the whole of the shaft is involved, but the ends are generally spared, contrary to the rule with osteogenic sarcoma. The shaft is slightly widened, but the main alteration is a gradual diffuse fading of the bone structure. Bone production has been entirely absent… The radiograph is therefore rather specific.”
The eponym Ewing sarcoma was first used by the esteemed Boston surgeon, Ernest Codman, who referred to the new tumor as Ewing sarcoma a few years after the publication of the initial paper.
Key Medical Contributions
- Bailey P, Ewing J. A contribution to the study of acute ascending (Landry’s) paralysis. New York medical journal July 4 and 11, 1896
- Ewing J. Notes on clinical diagnosis. 1898
- Ewing J. Clinical pathology of the blood; a treatise on the general principles and special applications of hematology. 1901
- Beebe SP, Ewing J. A Study of the so-called infectious Lymphosarcoma of Dogs. J Med Res. 1906 Sep;15(2):209-228
- Ewing J. Endothelioma of Lymph Nodes, J Med Res 1913; 28 :1-39
- Ewing J. Neoplastic diseases, a text-book on tumors. 1919 [2e 1922;
- Ewing J. Diffuse endothelioma of bone. Proc N Y Pathol Soc 1921; 21: 17-24
- Ewing J. Further report of endothelial myeloma of bone. Proc N Y Pathol Soc 1924; 24: 93-100.
- Ewing J. Causation, diagnosis and treatment of cancer. 1931
- Ewing J. Early experiences in radiation therapy. Janeway Memorial Lecture. AmJ Roentgenol Rad Ther 1934; 3: 153-163
- Ewing J. A review of the classification of bone tumors. Surgery, Gynecology & Obstetrics 1939; 68: 971-976
- Stewart FW. James Ewing, M.D. Archives of Pathology 1943; 36(3): 325-330
- Editorial: James Ewing (1866-1943) – Oncologist. JAMA. 1966; 197(3): 217
- Robbins G: James Ewing – The man. Clin Bull (Memorial Sloan-Kettering Cancer Center) 1978; 8: 10-14
- Zantinga AR, Coppes MJ. James Ewing (1866-1943): “the chief”. Med Pediatr Oncol. 1993;21(7):505-10
- Huvos AG. James Ewing: cancer man. Ann Diagn Pathol. 1998 Apr;2(2):146-8
- Brand RA. Biographical sketch: James Stephen Ewing, MD (1844-1943). Clin Orthop Relat Res. 2012 Mar;470(3):639-41.
- Bibliography. Ewing, James 1866-1943. WorldCat Identities
- Balch, C.M., Coit, D.G. & Berman, R.S. 2015 James Ewing Lecture: The 75-Year History of the Society of Surgical Oncology—Part I: The Traditional Years (1940–1965). Ann Surg Oncol 2016; 23: 16–22.
the person behind the name
Associate Professor Curtin Medical School, Curtin University. Emergency physician MA (Oxon) MBChB (Edin) FACEM FFSEM Sir Charles Gairdner Hospital. Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | Eponyms | Books | Twitter |