Monday, June 18, 2007

Who am I and why am I here?

My name is David Loeb, and I’m a pediatric oncologist.

Whenever I say that, I’m reminded of how people introduce themselves at AA meetings. Unlike being an alcoholic, being a pediatric oncologist is not a problem, really. You might think so from the looks I get when I meet someone and tell them what I do for a living. “You do what?” “That must be so hard!” “How can you do that every day?”

I’ll tell you… I can’t imagine doing anything else with my life. I have a fabulous job. I have a lab, where we study cancer at the molecular level and are trying to understand how good cells go bad and do bad things to kids. I see patients, too, and they provide me with the inspiration to go back and work harder in the lab to find new ways to treat them.

I love kids. They tolerate so much while we treat them. And yet, no matter how miserable we make them, all they want to do is be kids – to run and jump and play. It energizes me to walk into clinic and feel the joy emanating from the kids.

How did I get to where I am? Well, I studied biology in college and then went to medical school at Columbia University in New York. I earned my PhD at the same time, and after graduation I moved to Baltimore to do a residency in pediatrics at Johns Hopkins. I haven’t left. After all, how can you leave America's #1 hospital?

This is my 7th year on the faculty as a pediatric oncologist. Last October I was appointed the Director of the Johns Hopkins Sarcoma Center. Sarcomas are rare tumors of the bone, muscle, fat, and other connective tissue (connective tissue is what holds our bodies together). Because they are rare, they are not mentioned often in the newspaper, there is not enough research funded for sarcomas, and because of this much less is known about how best to treat these awful diseases. Patients and their families often feel alone when they get a cancer diagnosis, and it’s even worse when it’s a kind of cancer they’ve never even heard of.

Why, at this point, am I starting a blog? My goal with this blog is to provide support and information for patients with cancer and their loved ones. I’ll tell stories about my patients… mostly good, but not always. I’ll highlight news related to cancer research, including reports of new drugs and new treatments. I’ll discuss new clinical trials. And most importantly, I hope get to know the the people who are reading my blog - and that we will learn from each other.

15 comments:

Anonymous said...

Hi Doctor David,

Just found your blog, and wanted to say, I'm glad you are here! I'll look forward to keeping up with your blog.

I'm the mother of a 21 year old with a low grade brain tumor. He had surgery at Hopkins 4 years ago.

He's doing great!

I'm so grateful for doctors who care like you,

Susan

"Elizabliss" said...

About Newspapers not publishing much about Sarcomas: If there is a patient being interviewed, or the family of a deceased patient, it is up to them to press for the name of the sarcoma to be included in the article. I wish we could get that word out. Newspapers will often just call it cancer rather than take the time to call it Sarcoma and add a little bit about it. Ewing's sarcoma seems to be the one written about the most. Among our attempts for Sarcoma Awareness this is one area that can help make it more public.

Anonymous said...

Hi Doctor David,
I am a sixteen year old grade ten student. For a careers project, we had to research a job that intrested us and put together a pamphlet on it. I have alwasy wanted to be a doctor, and i find cancer fascinating. I also love kids and want to work with them, so i chose to do my project a paediatric oncologist.
I just wanted to let you know that I found your blogs really intresting, and they have let me see exactly what your job is like. I now know that I would love to follow your career path.
Thank you so much for taking the time to post these blogs, they have taught me alot and I have enjoyed reading them!
-Emily

Catherine said...

Hi Doctor David,
I'm Catherine, 20 years old, from Indonesia. Now, I'm a medical student. In my opinion, oncologists are the difficult projects in medical sciences. So, maybe you can give me the solutions how to study oncologists easily.
I'm glad and very appreciated you visit my blog and add my blog in your blogroll.Please give me feedbacks in my blog.Thank you.I'm sorry I can't write English well.

Charmaine Chen said...

Thanks for your kind generosity - sharing your knowledge with all of us

Warm regards,
Charmaine Chen

Arps said...

hi doctor david..
i've been a visitor to your blog for the past few days. I love the stories you put up there.
the reason i'm leaving a note here is coz i recently had an encounter with a AML patient who cannot afford medications! This is a 13y/o boy with poor prognosis AML & parents who cannot pay for the medications!!
the boy is my dad's patient (who's a hematoncologist) & since i found out his story, i haven't been at ease with myself. I've this feeling of guilt where i feel that while i'm living a content life, there are pple who cannot buy the medications they need!!

Being in a position where u face such situations everyday, how do u deal with it??
yes, there's the happiness of saving lives, but how do u deal with situations where u are helpless, & have to see a patient progress to further stages??

Thanks for providin a platform to let out steam.
Even Just writing here helped.

Arpita

Amanda Davis said...

I'd like to thank you for focusing on sarcoma. My son was only 3 years old when diagnosed with metastatic Ewing's Sarcoma. Unfortunately, he relapsed nine months after he was declared in remission. We sure do need more research on this cancer. The statistics given to us parents just seem so unacceptable!

seliena said...

Hi Doctor David,
I just stumbled upon your blog and wanted to thank you for the wonderful work you're doing. It's nice to see doctors out there that are passionate about their patients and what they do.

On a side note, while doing some web surfing I came upon a pretty cool site that sells organic cotton children's wear. One of their designs is a stethoscope around the neck. If you get a chance check it out: www.funnyhunnybunny.com

Thanks again for everything you do!

Tiffany said...

I just found your blog and have to say it's doctors like you that make my life possible:-)I am an 11 year suvivor of Osteosarcoma. It was a hard road but I am lucky to be still here!I developed a close relationship with all my care givers while going through treamtemt and they make such a difference in the lives of all childhood cancer patients. Hats off to you! Keep up the good work! If you want to check out my blog its about my journey through living with cancer and beyond!
http://ialwayswantedtoshavemyhead.blogspot.com/

Rochelle Lea said...

Your blog is such an adventure to read. I am a Certified Child Life Specialist and Licensed Professional Counselor- I work in a Cancer resource center in Chicago and am the Program Coordinator for the children and family programs. It's wonderful to read these stories from the physicians prospective. Keep up the great work!

Dakota said...

Hello Dr. David,
Like pretty much everyone else here, I wanted to thank you for taking the time to post such inspirational stories and useful information. Your blog has been one of the factors that has inspired me to become a pediatric oncologist. I just wanted to know--how hard and expensive was it to get to where you are (referring to your studies)? I realize that this career is academically demanding, so I was just curious about that. Thank you!

Anonymous said...

Wow! Such a wonderful blog! Thank you!

Leo Voisey said...

David Summers, a 37 year old MS patient from Murfreesboro, Tennessee was a score of 8.0 on the Expanded Disability Status Scale (EDSS) when he had the Combination Liberation Therapy and Stem Cell Transplantation at CCSVI Clinic in March of 2012. Having been diagnosed in 1996 he had been in a wheelchair for the past decade without any sensation below the waist or use of his legs.
“It was late 2011 and I didn’t have much future to look forward to” says David. “My MS was getting more progressive and ravaging my body. I was diagnosed as an 8.0 on the EDSS scale; 1 being mild symptoms, 10 being death. There were many new lesions on my optic nerves, in my brain and on my spinal cord. My neurologist just told me: ‘be prepared to deteriorate’. I knew that he was telling me I didn’t have much time left, or at least not much with any quality.” David had previously sought out the liberation therapy in 2010 and had it done in a clinic in Duluth Georgia. “The Interventional Radiologist who did it told me that 50% of all MS patients who have the jugular vein-clearing therapy eventually restenose. I didn’t believe that would happen to me if I could get it done. But I have had MS for 16 years and apparently my veins were pretty twisted up”. Within 90 days, David’s veins had narrowed again, and worse, they were now blocked in even more places than before his procedure.
“I was so happy after my original procedure in 2010. I immediately lost all of the typical symptoms of MS. The cog fog disappeared, my speech came back, the vision in my right eye improved, I was able to regulate my body temperature again, and some of the sensation in my hands came back. But as much as I wanted to believe I felt something, there was nothing below the waist. I kind of knew that I wouldn’t get anything back in my legs. There was just way too much nerve damage now”. But any improvements felt by David lasted for just a few months.
After his relapse, David and his family were frustrated but undaunted. They had seen what opening the jugular veins could do to improve him. Because the veins had closed so quickly after his liberation procedure, they considered another clinic that advocated stent implants to keep the veins open, but upon doing their due diligence, they decided it was just too risky. They kept on searching the many CCSVI information sites that were cropping up on the Internet for something that offered more hope. Finding a suitable treatment, especially where there was no known cure for the disease was also a race against time. David was still suffering new attacks and was definitely deteriorating. Then David’s mother Janice began reading some patient blogs about a Clinic that was offering both the liberation therapy and adult autologous stem cell injections in a series of procedures during a hospital stay. “These patients were reporting a ‘full recovery’ of their neurodegenerative deficits” says Janice, “I hadn’t seen anything like that anywhere else”. She contacted CCSVI Clinic in late 2011 and after a succession of calls with the researchers and surgeons they decided in favor of the combination therapies.For more information please visit http://www.ccsviclinic.ca/?p=904

M said...

I seem a little late to the discussion. However, I am impacted. I'm a biology major, planning on taking my MCAT come January! And while I know this field is the one I want, it's nice to read about someone else having the same thoughts for it as I do. So thank you!

Leo Voisey said...

Chronic cerebrospinal venous insufficiency (CCSVI), or the pathological restriction of venous vessel discharge from the CNS has been proposed by Zamboni, et al, as having a correlative relationship to Multiple Sclerosis. From a clinical perspective, it has been demonstrated that the narrowed jugular veins in an MS patient, once widened, do affect the presenting symptoms of MS and the overall health of the patient. It has also been noted that these same veins once treated, restenose after a time in the majority of cases. Why the veins restenose is speculative. One insight, developed through practical observation, suggests that there are gaps in the therapy protocol as it is currently practiced. In general, CCSVI therapy has focused on directly treating the venous system and the stenosed veins. Several other factors that would naturally affect vein recovery have received much less consideration. As to treatment for CCSVI, it should be noted that no meaningful aftercare protocol based on evidence has been considered by the main proponents of the ‘liberation’ therapy (neck venoplasty). In fact, in all of the clinics or hospitals examined for this study, patients weren’t required to stay in the clinical setting any longer than a few hours post-procedure in most cases. Even though it has been observed to be therapeutically useful by some of the main early practitioners of the ‘liberation’ therapy, follow-up, supportive care for recovering patients post-operatively has not seriously been considered to be part of the treatment protocol. To date, follow-up care has primarily centered on when vein re-imaging should be done post-venoplasty. The fact is, by that time, most patients have restenosed (or partially restenosed) and the follow-up Doppler testing is simply detecting restenosis and retrograde flow in veins that are very much deteriorated due to scarring left by the initial procedure. This article discusses a variable approach as to a combination of safe and effective interventional therapies that have been observed to result in enduring venous drainage of the CNS to offset the destructive effects of inflammation and neurodegeneration, and to regenerate disease damaged tissue.
As stated, it has been observed that a number of presenting symptoms of MS almost completely vanish as soon as the jugulars are widened and the flows equalize in most MS patients. Where a small number of MS patients have received no immediate benefit from the ‘liberation’ procedure, flows in subject samples have been shown not to have equalized post-procedure in these patients and therefore even a very small retrograde blood flow back to the CNS can offset the therapeutic benefits. Furthermore once the obstructed veins are further examined for hemodynamic obstruction and widened at the point of occlusion in those patients to allow full drainage, the presenting symptoms of MS retreat. This noted observation along with the large number of MS patients who have CCSVI establish a clear association of vein disease with MS, although it is clearly not the disease ‘trigger’.For more information please visit http://www.ccsviclinic.ca/?p=978