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No scientist with even a rudimentary moral compass and an ounce of intellectual humility takes human experiments lightly, given how much can go wrong. But Dr. Robert Gatenby was especially aware of the stakes.

An oncologist at Moffitt Cancer Center in Tampa, Fla., he has spent years studying how tumor cells respond to chemotherapy, especially in patients whose cancer has metastasized well beyond the original tumor, as when malignant prostate cells invade bones like gang members expanding their turf. Now Gatenby was ready to put his theories to a real-world test by treating men with advanced prostate cancer in a way that broke all the rules.


Instead of administering the most chemotherapy that patients can tolerate, as is standard practice, doctors would give the men only enough drug to temporarily shrink their new tumors. They’d allow the cancer to bounce back. Then they’d punch it down for a second time, but again only partly. Gatenby’s heretical hope: Sparing millions of malignant cells wouldn’t kill the patients, as might be expected, but would keep them alive longer.

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