Dr. Loren Tschetter '64
Siddhartha Mukherje’s Pulitzer Prize-winning book, “The Emperor of All Maladies,” is often called a “biography of cancer,” a chronicle of the dreaded disease from its first documented appearance thousands of years ago to the current day.
Part biologist, part historian, part biographer, Mukherje followed cancer through the exploration, obstacles and triumphs of the 20th century, to the evolving care and advanced treatment used today.
After its release in 2010, Dr. Loren Tschetter read the book, closed his eyes, and thought, “I have lived through much of this book in my professional life.”
It offered a new perspective on the disease he’d spent the better part of his career researching.
“I’ve lived through all the things that have happened with cancer. I’ve seen the evolution. Take childhood leukemia, for example. In the 1940s and ‘50s, that was a fatal disease. Now, there’s something like a 95 percent cure rate for patients with favorable disease. That’s a major shift.”
While he’s too humble to admit it, Tschetter played a major role creating that shift in other cancers. A founding member of the oncology community practice in Sioux Falls, Tschetter led the formation of the region’s first clinical trials research program in conjunction with the National Cancer Institute, offering “investigational treatments” to help cancer patients receive better care.
He also helped establish an Institutional Review Board to ensure patient consent was given prior to participating in the trials, and that the trials were ethical and conducted according to national regulations.
A South Dakota native who grew up in California and moved back to Sioux Falls during high school, Tschetter was a chemistry major at Augustana.
After graduation, he went on to the then two-year University of South Dakota School of Medicine before earning his M.D. from the University of Kansas Medical School. He completed an internship at St. Francis Hospital in Wichita, Kansas, before beginning a fellowship in internal medicine and hematology at Mayo Clinic in Rochester, Minnesota.
He returned to Sioux Falls in 1974, joining Central Plains Clinic, where he practiced internal medicine and hematology.
He said he never planned on going into oncology; he sort of just “metamorphosed into it.”
“Shortly after I started practicing in Sioux Falls, Dr. Charles Moertel, a cancer physician-researcher at Mayo had the foresight to say, ‘you know, we’re training all these oncologists and sending them out into the region. Maybe we should set up a network of those Mayo-trained oncologists and start a cancer treatment study program.’”
“He asked seven oncologists in locations in North and South Dakota, Minnesota and Iowa if they wanted to participate. He asked me and I said ‘yes,’” Tschetter said. The group was named The North Central Cancer Treatment Group (NCCTG).
He said the ability to be involved in study groups was rewarding on a number of levels.
“It does potentially bring better care to a patient,” he said. “If you have a standard of care and then you try something different that turns out to be better, those patients have gotten the better treatment before it was accepted.”
“From a personal standpoint, it makes the practice much more interesting. It’s much more fun to be on the cutting edge of things. When the studies were positive, you achieved better results. From there, the results were published nationally; then everyone in the country began using them. That’s the fun part.”
From the studies, Tschetter said, new treatments began to bring better outcomes.
“We’ve moved from a time where, when I started to practice and someone was diagnosed with cancer, you could provide treatment and improve things for a while. But usually it wasn’t a concept of curing. It was more delaying the inevitable. That was where we were,” he said.
“We started to ask ourselves, ‘Is there anything we can do up-front to improve the cure rate of these people?’”
So Tschetter and his colleagues began studying a new technique called “adjuvant therapy.”
“If someone has a breast lump, has it biopsied and it’s a cancer, then they usually have a lumpectomy where the lump is removed,” he said. “Then doctors look at lymph nodes under the arm to see if they’re positive or negative. For those that are positive under the arm, we know they have a higher recurrence rate over time. And so, we introduced adjuvant therapy – therapy given to a patient after they recover from their surgery where they don’t have any known disease, but they have a known recurrence rate. We wanted to see if we could improve their situation to one where they didn’t recur.”
“Ultimately, it’s treating someone with chemotherapy or hormonal therapy who doesn’t have any known cancer; someone who just has a potential for recurrence to see whether we can increase their curability rate.”
Tschetter spent more than 35 years practicing medicine and conducting research in Sioux Falls, first for Central Plains Clinic, then later at Sanford Health. He retired from clinical practice in 2009 and in 2010, he retired from the principal investigatorship of the Clinical Trials Research Program. He continues to audit the medical records of clinical trials around the country through the National Cancer Institute.
Looking back on his career, he’s quick to thank others for their help in his achievements.
“There are a lot of people who have helped me accomplish what we’ve built here. Fellow physicians, clinical research associates who collect data, Central Plains Clinic, Sanford and, most importantly, the patients who were willing to go on the trials,” he said. “You have to have a team around you to help you.”
Today, Tschetter and his wife, Jean (Dahl) ’65, enjoy seeing their daughter, Ann Kelly ’95, and her husband, Dr. Patrick Kelly, and their four children who live nearby their home in Sioux Falls.
In recognition of his contributions to medical research and the practice of medicine, Tschetter will receive the Alumni Achievement Award during Viking Days this fall.