Before the 1950s, most attempts to culture cells in the lab did not produce viable cells for study. It wasn’t until Henrietta Lacks and her “immortal” cervical cancer cells that researchers had access to durable, dividable cells fit for long-term study.
Henrietta Lacks—or “HeLa”—cells are the oldest line of human cells used for study due to their ability to divide over and over again. A look at the history of HeLa cells shows progress in the expectations that patients may have of their care providers, the influence of a single person in medical research and development, and the work that is being done to properly honor her legacy.
Henrietta Lacks was an African American woman, born Loretta Pleasant on August 1, 1920. She and her nine siblings were raised by a single father after her mother died during childbirth. Following their mother’s passing, Pleasant and her siblings were split among relatives in Clover, Virginia. She was raised by her maternal grandfather in a log cabin on a tobacco farm. Their home was repurposed from slave quarters on a plantation owned by Pleasant’s white great-grandfather and great-uncle. Pleasant dropped out of school in sixth grade to support her family on the farm, where she met her first cousin—and future husband—David "Day" Lacks (1915–2002). They were married in 1941 and moved to Dundalk, (previously Turner Station) Maryland. Together they had five children. Lacks was diagnosed with cervical cancer only a few months after the birth of her last child.
After feeling a “knot” in her womb—which she believed to be the related to another pregnancy—Lacks went to the Johns Hopkins Hospital, the only hospital in the area that treated Black patients at the time. To her surprise, the “knot” turned out to be a cancerous mass on her cervix. During her treatment, cells were taken from her cervix for study – without her consent or knowledge. These cancerous cells were then used by George Otto Gey, a researcher and physician at Johns Hopkins who discovered the cells’ “immortal” nature. Unaware that her cells were being used and replicated for research, Lacks continued to receive routine treatment at Johns Hopkins until her cancer metastasized, leading to her death on October 4, 1951.
HeLa cells have been instrumental to medical research and have led to thousands of medical advancements. For example, the polio vaccine was developed by studying the growth of the virus in HeLa cells. Because they originated from cancer cells, HeLa cells have been particularly valuable to cancer research. The genome sequence for HeLa cells was published in March 2013 and has helped researchers study the mutations that caused the cells to be cancerous. Using HeLa cells, Harald zur Hausen, a German virologist, discovered the link between HPV-18—a form of human papillomavirus found in HeLa cells—and cervical cancer. This discovery, which won Hausen a Nobel Prize in 2008, in conjunction with the HPV antibody work of Dr. Douglas R. Lowy, principal deputy director of the National Cancer Institute, and his colleague, Dr. John T. Schiller, deputy chief at Laboratory of Cellular Oncology, informed the development of vaccines for HPV. Among other accolades, Dr. Lowy was recognized for his role in HPV vaccine development with the 2019 AACI Distinguished Scientist Award winner. HPV vaccines have seen great success, reducing infections of the virus in teens and young adult women by over 80 percent. HeLa cells have also led to developments in drugs to treat cancer, like irinotecan and topotecan.
Outside of medical research, the HeLa case has spurred policy changes related to patient rights, medical accountability, and racial exploitation in medicine. At the time the HeLa cells were collected, it was routine to take cells from patients—especially those from marginalized groups—without consent or an understanding of potential risks. Without informed consent, patients are unable to participate in important decisions surrounding their treatment. The Lacks family was not made aware of the HeLa cells and their origins until 1973, when researchers requested additional DNA samples after the original cell line was contaminated. Since then, the Lacks family has worked to regain decision-making authority regarding the use and distribution of HeLa cells and ensure that the family is properly credited for their role in the research. They have reached settlements for compensation with biotechnology companies that have profited from the usage of HeLa cells and have collaborated with the National Institutes of Health to help determine how research is conducted with the cells. The family has also developed a HeLa genome data usage agreement to make sure that researchers’ usage of HeLa cells is aligned with their wishes and contemporary ethical practices.
Though progress is slow, the impact of HeLa cells on medical ethics is becoming evident in policy decisions. AACI has highlighted Cancer Patients’ Bill of Rights, a piece of legislation passed in California that lays out key rights that patients should be entitled to in the state of California. Lacks has been honored in her home state of Virginia with September 23-29 being proclaimed “Henrietta Lacks Legacy Week.” Virginia also formed a commission in 2018, comprised of members of the Lacks family and stakeholders in the state’s health care and research institutions, to develop a business plan for a Life Science and Cancer Treatment Center dedicated to Henrietta Lacks. Legislation has also been put forward in Congress to posthumously award Henrietta Lacks with a Congressional Gold Medal, the highest award a civilian can achieve in the United States.
Henrietta Lacks’ “immortal” cells have and will continue to lead to breakthroughs in cancer research and medicine. The controversy surrounding the procurement of her cells has led to important advocacy to protect patient autonomy and increase medical accountability, to immortalize Henrietta Lacks, the person, instead of HeLa, the cells.