Dr. J. Bruce Beckwith has always been an important member of the National Wilms Tumor Study. He remained the study pathologist for thirty years from the commencement of the study in 1969 until his retirement, during which time he identified exactly what type of Wilms tumor every study patient had. His work has made his name a by-word whenever the kidney tumors of childhood are discussed.
J. Bruce Beckwith was born in Spokane, Washington on November 18, 1933 and raised on an Indian reservation in St. Ignatius, Montana. The ground-breaking spirit of those lands and their broad clear skies are reflected in his pioneering research and the clarity of his publications.
One of his early contributions to childhood cancer research was the identification of the nature of a childhood tumor called neuroblastoma. He showed that in some children, it can be looked on as a developmental abnormality while in others, its behavior is that of a malignant neoplasm.
Assisted by a succession of gifted and stimulating NWTS Fellows, Dr. Beckwith clarified a confusing cluster of growths that had been considered different forms of Wilms tumor. They showed that there are indeed two types of Wilms tumor called the favorable and the anaplastic types. The former is much more responsive to therapy than the latter. Moreover, they showed there are two renal cancers that are not Wilms tumors at all, but are separate types entirely. These are the rhabdoid tumor of the kidney and the clear cell sarcoma.
This separation of specific tumor types has been extremely important in devising effective means of managing each sort.
Another important advance has been Dr. Beckwith’s study of what are called nephrogenic rests. These are groups of cells “left over” from fetal life. They can disappear entirely with time, they can grow to become benign tumors, or they can undergo malignant change and become true Wilms tumors. Nephrogenic rests can be of two major types. One of them is associated with a specific developmental abnormality named for Dr. Beckwith: the Beckwith-Wiedemann syndrome which he identified years ago. The NWTS recommends that a child found to have the characteristics of this syndrome should be screened and observed closely for the possible development of Wilms tumor. Early detection improves chances for successful treatment.
In addition the recognition of Favorable Histology (FH) contributed to the ability to reduce the amount and duration of therapy for most of the 88% of children with kidney tumors who have FH lesions. More intensive treatment must be used for the 12% of those with the more aggressive types. These discoveries would not have been possible without the NWTS which for the first time worked with a single pathologist who examined almost of all of the cases in North America. Before the NWTS, a pathologist in even the largest pediatric oncology centers would see only a few dozen in a lifetime.
In fact, though Dr, Beckwith is best known these days for his Wilms tumor work, his long-term interests have been in the field of developmental abnormalities. He has one of the largest libraries in the world devoted to these topics. Many of those reference books are in foreign, ancient tongues that he learned in order to read the texts.
He is an avid fisherman and a lover of the out-of-doors. This explains his choice of the Big Sky Country of Montana, his boy-hood home, for his retirement years with his wife, Nancy.
Dr. Beckwith is the recipient of many honors and awards going back to his college days. More recently, he was President of the Society of Pediatric Pathology, and was elected an Honorary Fellow of the British Royal College of Pathologists one of only 50 such world-wide. He received the Distinguished Pathologist Award of the Academy of Pathologists in North America and a similar distinction in Paris in 2005. In that same year, he also was the recipient of the Distinguished Career Award of the American Society of Pediatric Hematology/Oncology. In so doing, this society made up of clinicians, recognized how much his scholarship has contributed to better medical care for children.
Dr. Beckwith is remembered for many things. His colleagues and associates recall their time with him as a distinct privilege and pleasure. Their image of him is that of a vibrant, enthusiastic Scholar/Scientist, always striving to part the curtains that hide the unknown.