From the Desk of Dr. Louis M. Weiner

See you next week!

Greetings from a train this Sunday evening, heading south somewhere between Wilmington and Baltimore. Harriet and I scooted up to Philly and back today to visit Ella, Sarah and Ken – he has a strep throat, and while improving, he really needed to rest. Sarah needed some time to study, so we jumped at the chance to spend time with the baby. Ella’s not such a baby any more; she has a huge vocabulary, though she deploys it in one-word sentences, and knows her letters, numbers and a huge variety of exotic animals. How time flies; but I can’t think of a better way for it speed past me. Speaking of speed, I can tell you that the trip by train is a whole lot less stressful than the I-95 trek, which can take anywhere from 2 1/2 to 5 hours, depending upon traffic. And, I can get some work done on the train, to boot.

The prior work week was highlighted by Monday’s meeting of the NCI Board of Scientific Counselors. It was a long, hard but fruitful day. I came back invigorated to carefully review the Lombardi External Advisory Committee’s recommendations. The EAC strongly encourages us to create a Strategic Plan focused on our science. As many of you know, we had a formal Strategic Plan prior to our CCSG submission, but that Plan did not really dive into the scientific meat, so to speak. The more I think about it, the more excited I am to create a scientifically focused Strategic Plan that fits into our existing Plan, and thus into the GUMC Plan, and also can guide our actions with respect to resource allocation, new initiatives and external collaborations.

You can expect us to hold an “all hands” Scientific Retreat in early 2015, with the explicit goal of identifying our major scientific themes, and seeing how those themes can intersect with our CCSG program structure, shared resources, plans for recruitment and allocation of seed funds. This should be an exciting and rewarding exercise, and I look forward to broad participation that will include our collaborations with GUMC, MedStar Health and HUMC. This Retreat will kick off a formal Strategic Planning activity focused on our science.

The rest of the week was routinely eventful. Perhaps most poignantly, I saw a new patient from Virginia, a 33 year old man with a pregnant wife and metastatic adenocarcinoma of the appendix (or perhaps proximal colon). He reminds me so much of the young man I cared for who just succumbed to his colon cancer. Anybody who thinks we spend enough money on cancer research in this country should spend a few weeks in our clinics, taking a look at what cancers, the ultimate terrorists, can do when we don’t have the necessary suite of tools to prevent, detect, treat and cure these diseases. Our doctors, scientists and health professionals do wonderful jobs and create miracles every day, and we are doing better than ever before. But we still have a long way to go. I for one am determined to keep chugging away.

I won’t have a blog next week, as I expect to have ingested too much L-Tryptophan from turkey prepared 100 ways over the weekend to write sensibly. Hopefully, when the blog returns the Eagles will have feasted on the Cowboys on Thanksgiving and then won the battle of the Birds against the Seahawks the following weekend. I will spare those of you who root for the Washington team the pain of reading any further comments about them, at least for now.

Have a very happy Thanksgiving.

Greetings on a rainy Sunday evening, mirroring the moods of football fans in Washington and Philadelphia. Brutal losses cause no joy, little anxiety (no cause for tension) but more angst, I suppose. Fortunately, there will be games next week, so the roller coaster will continue.

The rest of the weekend was lovely. Elana and Isaac spent a few days with us while Ben was out of town, and we had a great time with them. Ken, Sarah and Ella had planned to come down on that weekend, but sadly had to euthanize one of their dogs (he was 13 years old, and was really suffering) on Saturday, and decided to stay in Philly. Harriet and I stole some time on Sunday to see an interesting exhibition on birds at the Museum of American Art. As almost always happens when we go to a great museum to see a specific show we stumbled into another astonishing exhibition – the work of Richard Estes, whose photo-realistic paintings are quite remarkable.

The prior week was busy, and was highlighted by my participation in the NCI Clinical Trials Advisory Committee (CTAC); I am an ad hoc member of the Committee pending my formal appointment. The world of clinical research is transforming at an astonishing rate; old mechanisms of collaboration – such as the traditional cooperative groups – have already been supplanted by new mechanisms, while the Cancer Therapy Evaluation Program (CTEP) of the NCI now solicits, handpicks and assembles investigator teams from diverse cancer centers and universities to evaluate new and existing drugs in its portfolio. The long established approach of writing a Letter of Intent to CTEP in order to gain access to new agents is going to be a thing of the past. For Lombardi to remain relevant heading into the future we need to figure out how we want to fit into these structures and where we might be able to take leadership roles.

This must be my season for NCI committee participation, as I will spend Monday at a meeting of the NCI Board of Scientific Counselors, reviewing elements of the NCI intramural program. I will spend some other time during the week poring over the details of the report of our own Lombardi External Advisory Committee, which met last month. They were very positive but have a lot of ideas that I plan to review, and in many cases, implement.

That’s all for now. Have a great week.

Last week was highlighted by a very busy Wednesday. I attended the GUMC Convocation Colloqium and then drove downtown to the Law Center to speak before a group of law students and faculty at the O’Neill Institute seminar series. It was very interesting to hear the perspectives of the legal profession regarding the nation’s investment in cancer research. Despite the sense of urgency I feel about the need for support of cancer research (see my blog from last week for why I feel the way I do), we clearly have a lot of work to do to educate our policy makers about the magnitude of the task before us, and of the opportunities to make a difference. I then drove from DC to National Harbor to attend a meeting of the Cancer Immunotherapy Network, a national consortium I helped to get off the ground a few years ago. It is wonderful to see how that network has matured into performing high-impact, cutting edge clinical trial research with important translational endpoints.

This uplifting experience was tempered by the five separate condolence notes I had to write – a sobering reminder of why I do what I do.

The weekend brought a genuinely exhilarating personal experience. Harriet met a woman a month or two ago, and my wife recognized that this woman, whose name is Annick, shared my mother’s Belgian accent. It turned out that she was Belgian, but was actually born and raised in the Congo, where her father had worked. Annick’s mother, just like mine, had been a hidden child in a Belgian convent during the Holocaust. So, we had them over for dinner on Saturday night, and were joined by my father and brother Steve, who has written a book about my mother’s experiences as a hidden child. Needless to say, we “clicked,” bonded by our shared historical experiences.

The Holocaust survivor, Frida, now 81 years old, is simply remarkable–her stories of being in hiding are hauntingly familiar to us, having heard so many similar variations from my mother when she was alive. But, after the war, my mother ended up in the United States, while Frida ended up marrying a man whose work was in Africa. She ended up going from the frying pan of the World War II to the fire of the War for Independence in the Congo, and the chaos that followed. After making it back to Belgium, she was tragically widowed and raised five children while running her family business in Africa for a few years before she remarried and moved to the DC area with her new husband. Her mesmerizing story is truly the stuff that should be the subject of a movie. This elegant and graceful woman experienced some of the most extraordinary challenges of the 20th Century and serves as a model of humanism, strength and survival. And the Belgian chocolates she and her daughter brought as a little gift were extraordinary! We feel as if our family just got larger.

Talk about a classic DC experience!

Have a great week.

Somehow, the weekend’s pleasures of seeing a wonderful new show (Little Dancer at the Kennedy Center) and trivia of rooting for my teams (the Eagles won) rang hollow for me this weekend.

My busy week included a productive trip to Chicago for the American Association of Cancer Institutes meeting. I then returned for a dinner where I hosted our External Advisory Committee members, who met with us all day on Wednesday and gave us incredibly helpful guidance regarding our future directions.

The rest of the week’s work included making condolence calls and writing notes of sympathy for three of my patients. The first, a woman in her 40’s, died of complications of rectal cancer that presented with metastases to the liver. No treatment ever worked. It was terribly sad. The next patient, also in her 40’s, died from complications of metastatic gastric cancer; she was unable to ingest any food for the last 4 months of her life.

Finally, my young patient, about whom I have blogged for the last three years, died as well. He bravely battled his disease, but at the end, no treatments worked. As recently as two weeks prior to his death, he and his wife had attended the Blue Hope Bash to benefit the Chris4Life Foundation, a major supporter of our Ruesch Center. He was placed on hospice about a week later and rapidly deteriorated. By last Monday it was clear that the end was near. Somehow he made it to the couch, and spent the day there. While he was watched by other family members his wife left briefly to pick up their oldest child from school. When they returned he was barely responsive. So, his wife turned on the TV, and all four of them – Richard, his wife and their two little boys – snuggled together on the couch watching a childrens’ show. That is where and how he died, at the age of only 33. It was heartbreaking and beautiful.

Each of these deaths chopped a little bit out of the hearts of everyone who knew them, loved them and cared for them. I am both heartbroken and outraged. Today and tomorrow, 3,200 Americans will die of cancer–about the same number of people who perished in the barbarity of 9/11. This has happened every two days for the 43 years that have elapsed since the passage of the National Cancer Act in 1971–more than 8000 times. Each one of those deaths has been a cause of heartbreak and irreplaceable loss.

Funding for cancer research has dropped, in real purchasing power, about 20% over the past decade, with no improvement in sight. Tell me, if terrorist attacks caused 3,200 deaths every two days, every year, what would the congressional funding narrative be for homeland security? Would any amount be too high? Then, why aren’t we doing more to defend Americans, and indeed all humanity, against cancer, the ultimate terrorist? Where are the funds for lifesaving cancer research? Richard wanted to know. They all did. So do I. This has to stop.