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Pathways to Discovery: Fall 2012

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Unmatched Expertise Offers Hope for Patients with Mesothelioma

Six years ago, San Francisco Bay-area resident Elizabeth Rulfo-Smith experienced a build-up of fluid around her lungs. A biopsy revealed she had malignant mesothelioma, a rare cancer with a low survival rate that attacks the layer of cells lining internal organs, including the lungs, heart, and abdomen.

She turned to Stanford Medicine Cancer Institute and met with the same specialist who treated high-profile patients Patrick Swayze and Steve Jobs. When surgery was ruled out as a treatment option, Rulfo-Smith began chemotherapy. When she asked for a second opinion, the oncologist referred her to Hedy Lee Kindler, MD, associate professor of medicine at The University of Chicago Medicine, and a specialist in mesothelioma.

Reason to Hope
Dr. Kindler and University of Chicago (UChicago) Medicine colleagues felt that Rulfo-Smith’s case would likely be cured with an aggressive treatment regimen. Rulfo-Smith and her family stayed in a Chicago hotel for 6 weeks while she underwent surgery to remove the affected lung and its lining, followed by 30 days of radiation therapy.

Although Rulfo-Smith struggled through radiation, she resumed normal activity following treatment and showed no signs of cancer. However, 5 years later in June 2011, a computed tomography scan revealed that the cancer had come back. Rulfo-Smith underwent a second surgery, but this time, the surgeon was only able to partially remove her tumor.

She investigated the possibility of proton therapy treatment at The University of Texas MD Anderson Cancer Center, but the radiation oncologists there told her that the tumor was too close to her heart, and that she was too healthy to put herself at risk. “It was kind of a relief, actually,” Rulfo-Smith said.

Dr. Kindler’s team has been monitoring her closely, knowing that at some point, she may need treatment again. “The way to treat it–– at least for now––is to live with it,” Rulfo-Smith said. Dr. Kindler sees patients like Rulfo- Smith from across the United States who come for UChicago Medicine’s clinical trials and expertise. “Patients are so pleased to finally meet an expert who truly understands their cancer,” Dr. Kindler said.

The UChicago Medicine team comprises oncologists, radiologists, pathologists, radiation oncologists, and surgeons who treat many cases of mesothelioma each year. The team uses advanced imaging techniques, developed on campus, to precisely measure the irregular borders of mesothelioma tumors and monitor treatment most effectively.

The Need for Research
Dr. Kindler and colleagues are conducting research to understand the biological underpinnings of mesothelioma and are translating their findings to clinical trials of new treatments for this disease.

Rulfo-Smith and her husband, Gordon Smith, have expressed their gratitude to The University of Chicago Medicine through a gift of $100,000 to support its mesothelioma research program. “With limited drug company interest in rare diseases and cutbacks in government funding, researchers rely on philanthropy for seed money to jumpstart clinical trials, and for early laboratory research that ultimately helps us obtain grants,” explained Dr. Kindler.

The Smiths’ donation laid the groundwork for the U.S. Department of Defense to award Dr. Kindler and thoracic cancer specialist Ravi Salgia, MD, PhD, professor of medicine, a $310,000 grant to understand the biology of mesothelioma, which will help them develop a clinical trial for a promising new therapy. These studies may lead to treatment options which have less severe side effects than current therapies and improve outcomes for mesothelioma patients in Chicago and beyond.   

Ernst Lengyel

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