John Colebatch - a pioneering cancer researcher

Tuesday 23 June, 2020

 

John Colebatch (centre) in the 1970s with (L to R) Geoff Tauro, Margaret Horan, Wendy Bissett Johnson, Tessa Spatt, Rae Matthews and Alison Crawn. Photo supplied.

Until the mid-20th century, to diagnose a child with cancer was to pronounce a death sentence. There was no known cure, and medical opinion was that to attempt one simply prolonged the child’s suffering. Most children died within weeks of diagnosis.

Today most children diagnosed with cancer in Australia survive. But it took years of relentless toil, of trial and error with many casualties, to produce this revolution in outcomes.

A man of conviction

John Colebatch (1909–2005) was the pioneer of paediatric chemotherapy in Australia. He, and the talented team who grew around him, made the Royal Children’s Hospital one of the world’s leading centres for paediatric haematology, saving the lives of hundreds of children, and turning cancers from implacable killers into treatable diseases.

An ambitious, driven, hard-driving man, Colebatch held to his conviction – through years of slow progress and disapproval from colleagues – that cancer could be cured. He was backed by a few influential supporters, and the parents of his patients, as slowly their progress proved him right.

His perfectionism on the job made him a challenge to work with. When he retired from the Royal Women’s Hospital in 1959 to focus on haematology, the nurses presented him with a banner reading: “A paediatrician is a man with little patients”. He hung it in his study.

Early discoveries

Colebatch was raised in country South Australia. His fascination with leukemia began in 1938, when he was a dapper, earnest, prodigiously hardworking postgraduate in London. He threw himself into studying the new discipline of haematology (blood diseases) on top of his training in general paediatrics.

But returning to Melbourne in 1939, he found there was no interest in paediatric haematology, and in any case he was soon off to war. For five years, his patients were convalescing soldiers.

In 1946 he returned to Melbourne’s Children’s Hospital as an honorary general paediatrician. Two years later his life changed when, from Boston, Sidney Farber reported trials of a drug, aminopterin, that caused leukemias to go into temporary recession. While the drug was highly toxic, and no patients survived long, Colebatch persuaded the hospital to allow him to carry out the world’s first controlled trial of aminopterin.

 

Showing hospital fundraisers around the ward circa 1970. Photo supplied.

To him, the results were encouraging: patients on the drug survived 21 weeks on average, twice as long as those left untreated. But to colleagues, he was just prolonging the suffering of doomed children. The advent of new and better drugs did not change their view. Only the strong support of the hospital’s president, Lady Ella Latham, and its visionary medical doctor, Vernon Collins – and the patients’ parents – enabled Colebatch’s work to continue.

A compromise was reached: doctors who endorsed Colebatch’s work could refer their cancer patients to him; those who opposed it could ignore him. Most chose the latter. Even in 1956, only one in four of the hospital’s cancer patients was given the option of treatment.

But gradually the resistance folded. By 1960 the average patient lasted more than a year, and the first patients in the clinic went into remissions that became permanent cures. In 1959 the Anti-Cancer Council (now Cancer Council Victoria) intervened to help fund his work, appointing Colebatch a research fellow.

On the outer

Peter Campbell, who joined the hospital around that time, recalled it as “a very exciting place to be. Everybody was young, ambitious, enthusiastic, and wanting to learn as much as they could. Gifted individuals like John built up around them teams of experienced and enthusiastic people. We all worked terribly hard; hours didn’t matter.”

 

John Colebatch with haematology clinic staff, Royal Children’s Hospital, 1970. Photo supplied.

The dissension about their work, however, did. Henry Ekert, his colleague and successor, recalls Colebatch as being “on the outer, and having a very tough time combining his clinical work with research into the treatment of leukemia. If not for his obsessive drive, I don’t believe that the prospects for (those) children, which were regarded as hopeless, would have improved as far or as fast as they did.”

But the tide was turning. In 1963, Colebatch chaired the first national controlled trial, with 12 paediatric hospitals collaborating in a nine-year trial of different treatments. Their results attracted worldwide attention, overturning accepted global knowledge in two important areas and above all establishing that there was a drug, vincristine, that could lead to long-term remissions.

By the end of the 1960s, one in three patients with acute lymphatic leukemia went into remission for at least five years, and most of them ended up cured. In 1967 the Anti-Cancer Council took over paying his salary, and the hospital formally established a haematology clinic to be his sole focus. In 1971 the Australian Medical Association recognised the team’s achievement work by awarding Colebatch its triennial prize for “his outstanding work on leukemia in childhood”. 

John and his wife Betty as guests at a dinner with medical staff in Manila in 1965. Photo supplied.

Cancer Council years

In 1974 Colebatch reached the hospital’s retiring age, handed over to Henry Ekert, and went to work for the Anti-Cancer Council on a range of projects, including setting up what is now the Victorian Clinical Oncology Group. He retired from the council in 1982, and his work was recognised by him being made an Officer of the Order of Australia, and awarded the Gold Medal of the Australian Cancer Society.

The rapid progress continued under Ekert. In the 1970s, almost half the patients diagnosed with cancer at the now Royal Children’s Hospital were cured, and by the 1980s, two-thirds. That improvement has continued over recent decades, so that now more than 80 per cent of childhood cancers are cured.

Community and family

In retirement Colebatch threw his relentless energy into community activities, especially the Australian-Asian Association, where he ran a program to help Asian students settle into Melbourne, and the Studley Park Association, his local resident group in Kew, where he campaigned to preserve the historic Willsmere hospital building and the Abbotsford convent on the Yarra, and to block the SEC from running high-voltage transmission lines alongside Merri Creek and the Yarra.

His most personal campaign, however, was for Betty, his wife of 52 years, who had almost single-handedly raised their four children while he was preoccupied with fighting cancer. When she became a victim of Alzheimer’s disease and had to go into a nursing home, John visited her almost every day for 12 years, doing everything he could to keep her flame burning.

John Colebatch died in his sleep in Melbourne in 2005, aged 96. Cancer Council Victoria has honoured his work by establishing a Colebatch Fellowship to help young researchers carry on the war against cancer. He was the pioneer who had opened the way to show how cancers in childhood could be cured. The war on cancer continues, and new researchers are ensuring that more or more of us will survive it.

 

- Tim Colebatch

Tim Colebatch is the youngest son of John Colebatch, and a former economics editor and columnist with The Age. This is an updated version of an obituary published in The Age on November 30, 2005.   

 

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