by Dr. Elizabeth Maher
Volume 2/Number 2
| Caring for patients with cancer has been a privilege and a life-shaping experience for me. As an internal medicine resident, I enjoyed the acute care of hospitalized cancer patients, feeling the impact of major advances in the symptomatic treatment of disease and complications. Despite the bonding that occurs between patients and medical house staff, long-term relationships do not develop and it remains possible to keep some emotional distance. As an oncology fellow atDana Farber Cancer Institute , I was surprised to find that I gravitated towards older patients, especially in the breast cancer clinic, subconsciously avoiding the young women with advanced disease – it seemed just too close.
However, in the lung, sarcoma, GI and ovarian cancer clinics I met and became the primary oncologist for four incredible young women, all mothers of young children who had hopes and dreams of future happiness and successes, who battled their aggressive cancers with dignity and courage but eventually lost their fights. Each in her own way, while shaping my oncology training and future career plans, had a profound impact on my life. They taught me about pain, both physical and emotional, about joy, in finding happiness in small things and quiet moments, about the meaning of true friendship and family. They all wanted aggressive treatment, clinging to the hope that cancer cure was to be theirs while knowing that our understanding of disease, treatment strategies and symptomatic management were still limited and unlikely to provide the miracle of life for them. Now as a mother myself of an 18-month-old precious little girl, Meghan, and a new baby girl soon to join us, I continue to be inspired by the way they lived their lives and how they fought their diseases. Ultimately, what emerged for me from knowing and caring for them was a renewed commitment to be part of the team of research physicians and scientists who will make cancer cure a reality.
I joined the Neuro-Oncology group at Dana-Farber for further subspecialty training, planning a career focused on patients with brain tumors, in particular those with malignant glioma, the most common and deadliest of all primary brain tumors. A significant difference between caring for these patients and those with other types of cancer was that the family became even more important in the doctor-patient relationship than I previously experienced. The challenges facing patients and their families from cancer of the brain differ depending on the location of the tumor in the brain but each faces the ultimately slow cognitive decline that is absolutely heartbreaking to watch. As many family members recount, “you lose the person you love twice during this journey – first, when they lose the essence of who they are and then again when they die.  | | Dr. Maher's pride and joy, daughter Meghan. | ” Although initially I was satisfied with providing aggressive treatment and care, the unrelenting nature of the disease and inevitable outcome despite all the best efforts of our multidisciplinary team of neurosurgeons, radiation oncologists and neuro-oncologists again focused my attention on what we were doing on the basic science front for this disease. Despite the commitment to clinical trials for patients with malignant gliomas, the drugs being tested were having no significant impact on survival.
Over the past several years, with the strong support of the visionary leaders at Dana-Farber Cancer Institute, the research mentorship of Dr. Ronald DePinho, and the partnership of my husband, Dr. Robert Bachoo, we have focused our efforts on developing a basic science research program that will address the biological questions that impede our progress in the treatment of these very special patients. We must understand why these tumors grow so rapidly and aggressively despite radiation and chemotherapy and invade so easily through normal brain. We are attacking these questions on multiple fronts, using state-of-the-art technology in areas of mouse engineering, stem transgenesis, genomics and bioinformatics. At the same time, there is an overwhelming need to improve preclinical testing for malignant gliomas so that drugs can be screened more accurately before subjecting patients to these treatments that ultimately fail. Modeling glioma in the mouse, using genes known to be involved in the disease and specifically those that are the targets of drugs in clinical trial, is our primary strategy. However, as we discover novel genes and pathways involved in gliomagenesis and maintenance, we will be able to refine these models to improve further the preclinical testing.
The pressure to improve the treatment and outcome for patients with this devastating disease was reemphasized to me recently by one of my patients as he was dying. “The time for trying is over…you must figure it out now once and for all. No other children should watch their Dad deteriorate the way I have and no one’s Dad should have to eulogize their young son because of this miserable disease. It’s your job to get the cure; just find a way to get it done.”
We are motivated by the patients, their families and the death sentence that this diagnosis imposes. It is impossible to overstate the importance of the support and partnership of The V Foundation in this struggle. The funding of our V Foundation translational grant for malignant glioma came at a critical point in the building of our program and validated the need for a combined clinical and basic science approach to the disease. Excitingly, V Foundation funding allowed us to generate the data we needed to convince the National Institutes of Health that we have a program that they can support.
For me, The V Foundation has been nothing less than visionary. Jim Valvano left a legacy of love and inspiration. He and his wonderful brother, Nick, continue to inspire – the only real difference is that now their family includes physicians, scientists, patients and families committed to cancer cure and bonded together in the belief that cancer, even Glioblastoma, can be beaten.
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Editor's Note: |  | | | Dr. Elizabeth Maher, together with Dr. Ron DePinho, is a 2001 recipient of a V Foundation Translational-Clinical Grant. Dr. Maher is an Instructor in Medicine at Harvard Medical School and a physician/scientist in Dana-Farber Cancer Institute’s Center for Neuro-Oncology. Born in Nova Scotia, Elizabeth received her Bachelor’s degree from Amherst College and both her M.D. and Ph.D. from McGill University in Montreal. She lives in Boston with her husband, fellow Dana-Farber researcher, Robert Bachoo, and her daughter, Meghan. They are anticipating the birth of their second daughter any day now. |
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My V Grant - Funded Researchers Tell Their Stories 
