Saul A. Rosenberg, MD, FASCO
For anacademic oncologist, there is no greater reward than to be part of the clinical research that turns a fatal cancer into a highly treatable disease. Saul A. Rosenberg, MD, FASCO, was one such researcher who pioneered advances in the diagnosis, treatment, and understanding of lymphoma, including his work in spearheading interdisciplinary clinical investigations on chemotherapy dosage and minimal radiotherapy. His innovative approach to research has been adopted by scientists around the world, and his discoveries served as a foundation for the development of new therapies for lymphoma. Dr. Rosenberg died on September 5, 2022. He was 95 years old.
A Family Doctor Serves as a Role Model
Dr. Rosenberg was born in 1928 in Cleveland and raised on the East Side, one of the poorer and tougher districts of the city. In an interview with the History Committee of the American Society for Radiation Oncology, Dr. Rosenberg was asked why he decided to pursue a career in medicine, to which he replied: “I wanted to do medicine since as long as I can remember. I don’t know why. I think it’s because nobody in my family was a professional or wealthy, and the most respected person in our family was a general practitioner named Dr. Reeger. I used to go to him for allergy shots, and he was respected by the family, and so I thought that I should be that, and my family thought I should be a doctor. I never knew of any other plan or choice.”
Determined to pursue his dream of becoming a doctor, Dr. -Rosenberg took a highly unusual path forward—during the summer of 1944, he attended both high school and college. In Cleveland, there was a summer school called John Hay High School, and it was only a mile from Adelbert College of Western Reserve, so Dr. Rosenberg convinced his high school principal to let him attend high school and college at the same time. In this way, he was able to complete his premed studies in 1944 and was eligible for medical school before he became 18, which would also prevent his being drafted into the Army.
Rejected Because of a Quota
After attaining his undergraduate degree from Adelbert College of Western Reserve—and also completing 2 years of premed, which was all that was required during World War II—Dr. Rosenberg applied to the Case Western Reserve University School of Medicine, only to be rejected on the grounds that the school’s quota of three Jewish students was already filled. Deeply discouraged, he left academics to care for his ailing father for a year, then spent 2 years as a chemist in a lead-smelting plant, testing the lead ingots (as well as testing the workers for lead poisoning).
At 22, Dr. Rosenberg reapplied for medical school but was once again rejected due to his long layoff, so instead, he was assigned by the medical school to the atomic energy research laboratory in Cleveland. His initial task was to teach radiation oncologists to use radioisotopes, which ultimately propelled his career toward radiotherapy. After 2 years in the atomic energy lab, he was finally accepted into medical school, where he would throw himself into the nascent field of radiation oncology.
After being accepted for a junior residency at what was then called the Peter Bent Brigham Hospital in Boston, Dr. Rosenberg was drafted to serve in the Korean War, where he served as a battalion surgeon. “I went to Camp Lejeune, North Carolina, and took Marine Basic Training along with 25 other doctors. That was an experience in itself, but then I was sent to Korea. I was a battalion surgeon in a tent camp in the winter of 1954 and 1955, and I was supposed to take care of the Marines there. We were on the front line that was facing the Chinese. This was during the truce, and we were just looking at each other waiting for the first one to attack the other. I spent an interesting winter in Korea,” noted Dr. Rosenberg.
Dr. Rosenberg received a fellowship to Memorial Sloan Kettering Cancer Center, where he worked under Lloyd Cramer, MD, who had the biggest lymphoma practice in the country. He spent a fruitful year with Dr. Cramer, during which he saw hundreds of patients with lymphoma. This experience would serve as a formative period in Dr. Rosenberg’s career as an internationally regarded lymphoma expert.
After his fellowship at Memorial Sloan Kettering, Dr. Rosenberg returned to Brigham for 3 years, eventually becoming the Chief Resident in Medicine. Though he later hoped to transition to University Hospitals Cleveland, there were no openings at the time, so Dr. Rosenberg reached out to noted radiation oncologist Henry Kaplan, MD, at Stanford University, whom he met while giving a lecture at the 1959 Annual Meeting of the American Radium Society Meeting.
Finding His Academic Home
Dr. Rosenberg would make Stanford his academic and research home for nearly 6 decades, during which his collaboration with Dr. Kaplan changed the treatment paradigm of lymphoma, showing that treatment for Hodgkin lymphoma could be curative rather than strictly palliative. The L-1 and L-2 studies at Stanford served as some of the earliest randomized clinical trials in cancer and found that higher doses of radiation administered to a wider field improved survival rates for patients with localized Hodgkin disease. With these data, Dr. Rosenberg and colleagues established total lymphoid irradiation as the standard of care in early-stage disease for decades.
Dr. Rosenberg’s role in oncology can best be summed up by one of his colleagues, the late oncology luminary Eli Glatstein, MD, FASCO, who noted in a paper: “Today, the vast majority of Hodgkin’s patients who are treated get cured, although there is still some room for further improvement. The strong character traits of Drs. Kaplan and -Rosenberg left lasting impressions, not only on other staff, but most especially on the young trainees who learned to accept and appreciate their efforts at excellence. Their method of approach and the gains achieved by it became the paradigm for the study of other malignant diseases.”
Encouraged to Join ASCO
Dr. Rosenberg credits Vincent T. DeVita, MD, FASCO, for “forcing” him to become an active ASCO member, and in 1982, after several years of working on various steering committees, Dr. Rosenberg was elected as ASCO’s President. About 2 years after his presidential term, Dr. Rosenberg received the David A. Karnofsky Memorial Award from ASCO and was named an ASCO Fellow in 2007.
While attending the ASCO Annual Meeting in 2018, Dr. Rosenberg was interviewed by Daniel F. Hayes, MD, FACP, FASCO, and at the close of the conversation, Dr. Hayes asked Dr. Rosenberg to describe what he feels is his legacy. He replied: “My students, whether it be medical students or postdocs or my colleagues, were my greatest contribution to the oncology community. I am so proud that so many have succeeded and gone on to eminent careers. I felt that I have been a trunk of a large tree, and every branch that comes off carries flowers and seeds that multiply what I have done, just because I started them off. Being an oncologist and caring for our patients with cancer has filled my life with joy, and there is no greater legacy than that.”