Dr. Bernard Fisher is Distinguished Service
Professor of Surgery at the University of Pittsburgh
Because of the far reaching changes he has brought about in the understanding of cancer and its treatment, Bernard Fisher has sometimes been described as an iconoclastic figure. But, he didn’t start out that way. After graduation from medical school at the University of Pittsburgh in 1943 he completed a surgical residency. Two additional years of fellowship in surgical research at Penn were a bit unusual but when he returned to the University of Pittsburgh and was appointed as an assistant professor some might have predicted that he was destined for a conventional career. Something about the young surgeon made his university predict otherwise. It chose him over other young faculty in all other medical school departments to be the school’s single candidate for a Markle Scholarship which he then won over serious competition from candidates from other U. S. medical schools. This elite group of Markle scholars were expected to do research and mandated to become the next generations’ leaders in American Medicine. After another year of training in London, Dr. Fisher returned to Pittsburgh to do just that. For starters, he founded and directed the department’s laboratory of surgical research. His research interests were very broad. He studied liver regeneration with complex models such as transplantation of accessory livers in inbred rats. He investigated the physiologic effects of hypothermia. He studied the impact of ablating the thymus on the immune system and transplant rejection. He was also an active clinician practicing general and vascular surgery. In the early 1960’s he performed the first human kidney transplants in Pittsburgh.
During this early stage of Dr. Fisher’s career the study of malignant disease was not the major focus. But in 1959, with his brother, a member of in the pathology department, he began laboratory investigation of the biology of tumor metastases. Eventually this work would lead him to the hypotheses that cancer was a systemic rather than a local and regional disease.
In 1958 he was persuaded by a former mentor to participate in the early trials of chemotherapy for cancer. At first he did this with some reluctance but by 1967, he accepted the chairmanship of the group conducting these clinical trials, the so-called NSABP. Over the next three decades he directed clinical trials that would entirely change the treatment of breast cancer.
With information obtained from these studies Dr. Fisher would overturn the paradigm established a century ago by the surgical god, William Halsted, i.e. that the successful treatment of a cancer was entirely determined by the magnitude of the operation done to remove it. This principle had established radical mastectomy as the standard in treating breast cancer.
Dr. Fisher designed and implemented the first studies for scientific testing of this doctrine. Perhaps even more importantly the approach he pioneered and utilized, the multicenter randomized clinical trial set a standard for the scientific evaluation of therapy for many other diseases. For breast cancer it completely changed the treatment.
Dr. Fisher is one of the most honored surgeons and physicians of our time. I’ll mention only a few of his awards from a probably outdated list of more than 30: a Fulbright fellowship, the General Motors Cancer Research Foundation’s Kettering Prize, the Bristol-Myers Squibb Award for Distinguished Achievement in Cancer Research, the American Cancer Society Medal of Honor, the Memorial Sloan-Kettering Cancer Center’s C. Chester Stock Award, the James Ewing Award of the Society of Surgical Oncology. The Sheen Lifetime Achievement Award of the American College of Surgeons, the Distinguished Service Award from the Friends of the National Library of Medicine, the Lifetime Achievement Award of the American Association for Cancer Research, honorary doctorates from Yale, Carlow University, the Mount Sinai School of Medicine, of the City University of New York, and the University of Pittsburgh. The list goes on: The Man of the Year Award of Pittsburgh, The Medallion for Scientific Achievement of the American Surgical Association, the Lasker Award, sometimes called the U.S. version of the Nobel Prize and most recently just last month the Jacobson Innovation Award which is the highest research award of the American College of Surgeons.
Dr. Fisher is a member of the Institute of Medicine of the National Academy of Sciences. He has served on many scientific advisory committees and, by presidential appointment, on the National Cancer Advisory Board and the President’s Cancer Panel. He has been a member of some 25 editorial boards, a member of the most important academic, medical, surgical, and scientific societies and an officer of many of them such as the American Society of Clinical Oncology which he served as president.
What is to me just as remarkable as Dr. Fisher’s scientific contributions is that some 60 years into his career as a surgeon scientist he remains actively involved not just with accepting awards (which alone would keep him busy) but with adding to his bibliography of over 600 papers and with continuing to analyze and review the broad implications of his studies in the treatment of human disease. I had the opportunity to visit him a few months ago. I was struck with the obvious activity in his office and especially with the stacks of paper on his desk which to me are the surest signs of ongoing scholarly activity.
The reasons for Dr. Fisher’s initial involvement in cancer studies, the evolution of his hypothesis and the testing of it I will leave to him. It would be a mistake for me to preempt his telling of this story. It is one of the great stories not only of surgery but of all clinical medicine. Suffice it to say, that his work has not only changed for countless women the course of their treatment and their survival but also their quality of life.