Henrietta Lacks: The Woman Who Saved Millions of Lives

Perhaps most people unfamiliar with medical research have never heard of Henrietta Lacks. For sixty-six years since her death, her story has been largely unknown. Ironically, her real name was not Henrietta; her given name was Loretta. But her sacrifices have resulted in inestimable good for humankind.

Her story is about racism, medical ethics, medical research, and patients' rights. It has been portrayed in TV dramas, documentaries, a movie, a book, and many articles, yet her name is all but unknown.

This blog is an attempt give Henrietta the belated credit she deserves.

Loretta Pleasant was born on August 1, 1920 in Roanoke, Virginia. For reasons unknown even to her family, she came to be called Henrietta or just Hennie.

When Henrietta was 21 years old, she married her 1st cousin, David "Day" Lacks, with whom she was raised. Henrietta bore 5 children, Lawrence, Elsie, Sonny, Deborah, and Joseph. Her last child, Joseph, was born 4 months before Henrietta was diagnosed with cervical cancer.

On January 29, 1951, Henrietta went to Johns Hopkins University Hospital, one of the few hospitals in the area that would treat African-Americans, complaining of a "knot" in her uterus. She had heavy blood discharges outside of her normal period. Upon self-examination she found a lump on her cervix.

Her doctor, Howard W. Jones, biopsied the cervical tumor; the diagnosis was malignant squamous cell (a.k.a. epidemoid) carcinoma. Nineteen years later, the diagnosis was corrected to malignant cervical adenocarcinoma. This correction is testament to the importance of the cell line derived from Henrietta's tumor.

In an effort to shrink the tumor, tubes filled with radium were inserted into Henrietta's vagina. During one of these procedures, a sample of the tumor was taken without her knowledge or consent, a practice common at the time. The sample was given to Dr. George Gey, a physician and cancer researcher also at Hopkins.

There is an ethical issue of performing a procedure without the patient's consent. The point is that the patient usually is put at risk when a medical procedure is performed. In Henrietta's case, the biopsy was risky but medically necessary to determine a diagnosis/prognosis and to create a treatment strategy. Taking tissue samples for research has no direct medical benefit to the patient. With malignant cancer, tampering with a tumor could "unleash hell". It is unclear whether that hastened Henrietta's demise, but it certainly did not help her condition.

The picture above shows the cells that Gey received. They are known as HeLa for Henrietta Lacks. Most human cell cultures survive for a day or two before dying. Not so for HeLa; they continue to survive, thrive, and divide indefinitely! This robustness is why HeLa came to be known as "immortal".

Why do HeLa cells continue to divide? The chromosomes in most human cells have a repeating sequence of bases at the end of each DNA strand (i.e TTAGGG or the complement AATCCC). This repeating sequence is called the telomere from Greek for "end part" ( see figure above). With each cell division, the telomere shrinks until the cell no longer can divide. Normal human cells divide 40 to 60 times before stopping (i.e. the Hayflick limit).

HeLa cells have a particularly active form of telomerase, the enzyme that lengthens telomeres. Consequenly, HeLa cells' telomeres never become so short that cell division stops. It is estimated that the weight of HeLa cells produced since initially extracted from Henrietta's tumor is 40,000 lbs!

The HeLa genome has been mapped, however, because of confidentiality issues it is not readily available. Requests for the HeLa genome must be approved by a panel of experts representing the medical, scientific, and bio-ethics communities, as well as members of the Lacks family.

Her cancer apparently was caused by an infection of human papillomavirus 18 (HPV 18). This virus added genetic material to Henrietta's genome. The HeLa cells have 76 to 80 chromosomes rather than the normal 46 chromosomes. Twenty-two to twenty-five of these extra chromosomes constitute the HeLa signature.

Henrietta did die an agonizing death. She suffered excruciating pain despite being on analgesics, mainly morphine. The pain was so intense she had to be restrained to her bed lest her writhing should cause her to fall. Upon a partial autopsy, it was found that her body was riddled with tumors.

Henrietta Lacks died on October 4, 1951. Her husband, Day, buried her in an unmarked grave in Clover, Virginia near to where she grew up and worked the tobacco fields.

Ironically, George Gey, who discovered HeLa, died on November 8, 1970 of pancreatic cancer.

The legacy of Henrietta Lacks is astounding. HeLa was used in the development of the polio vaccine by Jonas Salk. Her cells have flown in outer space and have been exposed to the radiation of a nuclear blast. HeLa cells were used in the development of a rabies vaccine, numerous pharmaceutical products, and even cosmetics. They have been used in cancer and AIDS research resulting in countless publications.

Although Henrietta Lacks may have been an unwilling and unwitting participant in what followed her death, the impact she had and continues to have is undeniable.