Music Is Medicine

No, the title is not a cliche.  It's the name of a fabulous organization founded by the daughters of one of my colleagues here at Johns Hopkins.  Leora and Ariella are musicians themselves, and they firmly believe that music can truly help in the healing process.  Founded when the girls were still teenagers, Music is Medicine is now an organization with national reach.  Quite a feat for two sisters from Baltimore.

Last year, I wrote about a visit one of my patients had from Drew Seeley, her favorite singer.  He wrote her a song, and I'll never forget the look on her face when he showed up in her hospital room to sing it for her.

Yesterday, lightning struck twice, when my patient, Bo, received a visit from Savannah Outen, who flew to Baltimore to serenade him with a song she wrote just for him.

 Bo is a musician himself.  In fact, I've seen him play at a fundraiser to help raise money to cover some of his medical costs.

So after Savannah played, Bo picked up the guitar, and in a truly priceless moment, played for her as she sang his requests.  Her version of Landslide (performed here by Fleetwood Mac and here by Smashing Pumpkins) was absolutely beautiful.  Moments like this, unscripted and real, remind me of all that is good in people.

I was there to hear the music, but Bo and his family had a surprise for me, too.  A framed picture of me and Bo... in one of my... uh... better moments in clinic.  Yes, that's me, hard at work curing cancer!

The song Savannah wrote and sang for Bo, "Brave and True," will be available soon on iTunes.  If you can't wait that long, check out this song to hear what a beautiful voice she has.

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Childhood Cancer Awareness Month

September is Childhood Cancer Awareness Month.  If you are a regular reader of my blog (even if I'm not a regular writer), you are already aware of childhood cancer.  But perhaps you didn't know that cancer is the Number 1 disease killer of children.  The only more frequent cause of death in childhood is trauma.  Or perhaps you didn't know that 10,400 children will be diagnosed with cancer this year in the US, but that many women will be diagnosed with breast cancer every 2 weeks.  This might be why a paltry 4% of the National Cancer Institute's annual budget goes to pediatric cancer research.

So now you're aware.

But here's a more important thing to be aware of:  pediatric cancer is weak; although it can kill the body, it can't kill the spirit of childhood.  Don't believe me?  Check out the spirit of the kids I take care of every day.

Music Can Heal

Well, maybe music can't cure cancer, but it can certainly heal the spirit.

Drew Seeley released a new song today that he wrote for my patient.

Watch the video here.

If you buy the song on iTunes, the proceeds go to support childhood cancer research.  Even if you don't buy the song, watch the video and enjoy the bliss on Brooke's face when Drew came to sing for her.

Priceless.

The Emperor's New Book

It may not be a new book anymore, and I actually read it a few months ago, but I would like to share my thoughts on Siddhartha Mukherjee’s The Emperor of All Maladies.  Dr. Mukherjee subtitled his book, “A Biography of Cancer.”  Much has been made in other reviews about the significance of this subtitle, and what it means to the approach he took to his topic – the history of cancer therapy.

I am fascinated by the history of medicine.  When I teach residents about current sarcoma therapy, I always teach them the history of how we got to where we are.  Dr. Mukherjee took this approach to its logical extreme, beginning with the first known record of the disease in ancient Egypt all the way to the present.

The main theme coursing its way through the book is the evolution of our therapies from radical to targeted.  Mukherjee starts with the 4^th century BC Persian Queen Atossa, who commanded her servant to cut her breast from her body, and traces the evolution of surgery up through Halsted’s radical mastectomies in the early part of the 20^th century and then to our current practice of lumpectomy, showing along the way how medicine is shaped by the personalities of those who set the standards of care.

Dr. Mukherjee gives chemotherapy a similar treatment, tracing the evolution of systemic therapies from the use of single chemotherapy drugs (beginning with nitrogen mustard-derivatives and anti-folates), through high dose chemotherapy with stem cell support, and back to the current vogue of molecularly targeted therapies.

Reading the novel as a oncologist who treats children, I was, of course, thrilled with the center stage given to pediatric oncology, especially the focus on childhood acute lymphoblastic leukemia as the first example of the successful use of chemotherapy to cure cancer.  Given the importance cooperative groups have played in the development and dissemination of cancer therapies over the past 40 years, I was a bit disappointed at how little attention was paid to the role of these organizations in advancing cancer treatment.  Reading this book, you would get the impression that most important clinical trials were run by small groups of physicians at their own hospitals.  The staggering successes seen in pediatric oncology over the past 30 years have come about almost entirely as a result of pediatric oncologists working together across the country to perform the kind of trials that would otherwise be impossible.

My other problem with the book is a common problem among medical oncologists – a marginalization of the successes of pediatric oncology.  In his effort to support the thesis that radical treatments (radical surgery, high dose chemotherapy…) are of little value, and that the future of cancer treatment is molecularly targeted therapies, Mukherjee substantially downplays diseases where high dose chemotherapy has been shown to make a difference.  Randomized trials have demonstrated superior survival for children with neuroblastoma if they have high dose chemotherapy with stem cell support compared with standard chemotherapy.  Neuroblastoma is the most common solid tumor of childhood, so this is not an insignificant finding.  High dose chemotherapy clearly improves the survival of both children and adults with relapsed leukemia.  Sure these diseases are not as common as breast cancer, but they serve as stark examples of how in some cases, the radical treatments Mukherjee deplores clearly improve survival.

Certainly childhood cancer is biologically distinct from the common adult tumors (breast, prostate, lung, colon), and what works for kids may not work for adults.  But the paradigm pioneered by pediatric oncology – the cooperative group – is responsible for some of what Mukherjee proposes are the most important advances in adult cancer (such as the National Surgical Adjuvant Breast and Bowel Project).  As I have said before, I think the medical oncology world has a lot to learn from the advances made in treating and curing cancer in children, and I wish that high profile works like this one did more to emphasize that point.

Nevertheless, I really enjoyed this book.  It makes the history of medicine an easy read, and its focus on the personalities of some of the giants in our field was truly fascinating.  If you have even a passing interest in oncology (and if you’re reading my blog, you must), you’ll enjoy this book.

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David's First Book Review: The Immortal Life of Henrietta Lacks

I've discovered reading again.  Or maybe what I've done is made a conscious decision to set aside time to read.  Some books I've recently read have nothing to do with cancer, like Cloud Atlas.  Then there's The Immortal Life of Henrietta Lacks.

Rebecca Skloot did a marvelous job telling the story of Henrietta Lacks, a woman from Baltimore whose cervical cancer cells became the very first immortalized cell line.  I think this book is a "must read" for anyone engaged in cancer research, if for no other reason than it reminds us that every cell line we work with was once a tumor growing in an individual... a person who had a family and friends, a person who suffered and probably died of cancer.  Each of these people has a story, and knowing that story can inspire us to work harder to find better treatments with fewer side effects.

But aside from the human interest angle, the book is an interesting study in the evolution of medical ethics.  When Mrs. Lacks was treated, in 1951, there was nothing "unethical" about taking some of the cells that were removed from her during the course of her treatment and trying to grow them in the lab.  She did not give informed consent for her cells to be cultured, but the very concept was not a part of medical research at the time.

Times have changed.  Just last week I was getting informed consent from a woman one of whose children was going to donate bone marrow to another.  Our cancer center has a "leukemia bank," a freezer full of bone marrow removed from patients with leukemia, frozen away for future research.  As I explained to her, it can be hard to tell what is abnormal about the leukemia cells if we don't have normal cells to compare them to.  So we ask each normal bone marrow donor to allow us to freeze a teaspoon or so of marrow for comparison studies.  In order to do this, we have to get approval from an Institutional Review Board and the donor (or the donor's guardian, in the case of a minor) has to sign a statement asserting that he or she consents to having this normal marrow stored away.

And that is just to STORE the marrow.  If we want to use the marrow for research, we have to get approval from the Institutional Review Board for the research project and use the marrow anonymously.  If we need clinical information about the marrow donor (or the leukemia donor), we need to either track that person down and get informed consent for the specific experiment or we have to convince the Institutional Review Board that doing so would be an undue burden (if, for example, the patient has subsequently died or has left no contact information or the study will involved hundreds of samples and the data will be used anonymously).

None of these safeguards were in place in the 1950's.

Another fascinating question raised by Ms. Skloot is the question of intellectual property and a patient's rights to his or her own tumor.  Ms. Skloot contrasts Mrs. Lacks, whose family received nothing in exchange for her cells (although, to be fair, neither Johns Hopkins nor Dr. Gey, the man who cultured her cells, received any money for her cells, either.... they were distributed freely to any interested lab anywhere in the world), with Ted Slavin and John Moore.  Mr. Slavin was a man with hemophilia who sold his serum because it had extremely high levels of antibody against Hepatitis B and then supplied serum to Baruch Blumberg, a virologist who discovered the link between Hepatitis B and liver cancer and created the first vaccine against Hepatitis B.  Mr. Moore's spleen was removed as treatment for Hairy Cell Leukemia, and his physician grew a cell line from the spleen, which he then patented and licensed to biotechnology companies to "commercially develop."  In each of these cases, something of value was taken from a patient, sometimes with their knowledge and consent, sometimes not.  In each case, the material contributed to the development of the nascent biotechnology industry, eventually being used to generate profit.

I would love to hear my readers' thoughts on the ethics of these situations.  After all, it seems wrong for someone to profit from cells taken from my body, but the cells are not inherently valuable... it's how they are used that is valuable.  Without intellectual input from a scientist, they are just cells.  But does this mean that, as the California Supreme Court ruled, I don't have any right to profits generated from tissues removed from my body?

One final note:  Ms. Skloot speaks eloquently about how Mrs. Lacks was treated by Johns Hopkins (and subsequently seemingly forgotten).  Just recently, the Johns Hopkins Urban Health Institute announced the Henrietta Lacks Award for Community-University Collaboration, a prize of $15,000 to a community entity that collaborates with Hopkins to work to improve the health and well-being of the residents of the City of Baltimore.

Thanks to Ms. Skloot, Van Smith, and Mike Rogers (all of whom have written about her), Henrietta Lacks will achieve some level of immortality beyond the HeLa cell.

Photo Credit

The Sarcoma Program Goes 21st Century

Modern technology impacts everything we do. The very fact that you are reading these words attests to how technology touches your life.

Well, the Johns Hopkins Sarcoma Center has engaged Web 2.0, too. If you follow this link, you will hear a podcast featuring my partner, Dr. Kristy Weber, the chief of orthopedic oncology at Johns Hopkins.

Bruce Shriver, one of the founders of the Liddy Shriver Sarcoma Initiative, asked me about chemotherapy for high grade sarcomas, and you can see that video here. An article in their online newsletter, ESUN, discussing my laboratory's research, is here.

Over time our group will be producing more podcasts. I will post links to them as they appear.

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It's Wednesday... The Doctor is Playing Golf

What a horrid, 50's-era cliche!

But today, it was true. This afternoon I played golf in a fundraising tournament for the Heather Brooke Foundation. This is a foundation named in honor of a patient with Ewing's Sarcoma that I once helped care for. When Heather passed away, her mother channeled her grief into helping others. The Heather Brooke Foundation exists to help conquer childhood cancer and to help and educate the families of children with debilitating illnesses.

Today was a beautiful day for golf... if you like playing in gale force winds! Of course, if you're as terrible as I am (other than Putt Putt, today is the 3rd time I've played golf in my entire life), the wind really doesn't matter so much.

But for my buddy Dean, who really plays quite well, the wind was a problem.


We played at The Timbers at Troy, a beautiful local course. It was a fabulous day, and everyone seemed to have a great time.

Last year's tournament raised enough money to buy a PCR machine for my lab. With the help of this machine, we generated the preliminary data that convinced the National Comprehensive Cancer Network to fund our clinical trial for patients with recurrent and refractory sarcomas. You should have heard the applause when I made that announcement at the post-tournament lunch!

Yes, it was a beautiful golfing day.

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A Famous Parent

In the past, I have blogged about patients of mine who have made the news. This past week, while I was reading the newspaper before going to work, my eye was caught by an article in the Sports section about a man with a familiar name.

(Note: All personal information in this post is also seen in the article in the Washington Post, so there is no violation of confidentiality. Also, some links will require a subscription to washingtonpost.com to see.)

The article was about the head football coach at the University of Richmond, Michael London. The article spoke about Mr. London in glowing terms, talking about how he grew up in Richmond, played defensive back for the University of Richmond, and eventually became a detective in the Richmond Police Department’s street crimes unit.

See the video here.

Eventually Mr. London left the police department and became a football coach. I met Michael London when he was the linebackers coach for the University of Virginia’s football team. At this point his daughter had been diagnosed with Fanconi Anemia and needed a bone marrow transplant. The London family investigated several cancer centers, and settled on Johns Hopkins.

The Washington Post article related the story of Ticynn’s transplant, and how Mike felt about being the donor. Reading about a transplant I had directed, but from the father’s perspective, was very moving. We doctors rarely truly know how our patients perceive what they are going through. We usually only know what they tell us. This time, I got to read how a patient’s family dealt with a transplant without the filter that accompanies talking with a doctor.

I remember Mike, and I remember Ticynn. It was an honor to take care of the London family, and I’m thrilled Ticynn did so well (and continues to do well). Reading an article like this, and seeing how our medical encounter fits into the arc of Mike London’s life was a fabulous experience. I only wish I could see all of my patients’ lives in this way.

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Team Sarcoma 2009

This weekend is the conclusion of International Sarcoma Awareness Week. We at Hopkins kicked off the week with our 2nd annual All Wheels Welcome ride down the Baltimore and Annapolis Trail. It was a marvelous event, with over 150 participants of all ages – including current and former patients, as well as their friends, families, and supporters. I think we were all amazed by Team Luca, the family and friends of a current patient of mine, who all showed up in bright red shirts and were an inspiring presence.

I want to extend a personal Thank You to everyone who helped organize the event and to everyone who participated. We raised almost $13,000 in just one day. This year’s event was larger than last year, and we hope next year will be even bigger!



The highlight of the week every year is the Team Sarcoma Core Bike Ride. This year, my home state of Maryland had the honor of hosting the Core Team, who rode from Cumberland to Washington, DC, spreading awareness and forming bonds of friendship.

I had the honor of meeting the group on Wednesday night for dinner in Shepherdstown, WV. After a fabulous meal, I spoke briefly about some of the work we have done in the lab that has led to a new clinical trial that was just approved this week by our IRB. We expect to be open for enrollment in mid-August!




After my presentation, the true fun began, as I was able to speak with the dedicated men and women who make up the Core Team. It was truly an honor, and a whole lot of fun!

The week culminated with a reception in Washington, DC, attended by representatives of several local medical centers, including our own, as well as dignitaries from each of the countries represented on the Core Team.

None of this would be possible without the leadership of Bruce and Bev Shriver. They are truly remarkable individuals, and all of us in the Sarcoma World owe them a great debt.

I don’t know about you, but I can’t wait for next year!

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Taking Control

I’ve mentioned before how much I enjoy PostSecret. This is a site that posts anonymous postcards containing about a secret about the writer. Today’s update had this postcard:

Photo Credit

This card reminded me of a topic that comes up with almost every new patient I see. I am inevitably asked, “When will my child’s hair fall out?” Both parents and children usually ask what they should do about it. Like I discussed in July, I always refer them to our Image Recovery Center, where they can learn techniques for maintaining a healthy self-image from cancer survivors.

But do you know what most of my adolescent and young adult patients do? Not only do they visit the Image Recovery Center, but in an effort to maintain some control over their body, they cut their hair short or shave it off altogether! What a healthy response to knowing your treatment will rob you of your hair. Taking control of whatever can be controlled is important. Feeling in control is so much better than feeling out of control – whether you are being treated for cancer or jumping out of an airplane.


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Photo Credit

It’s been a good week for Mike.

Mike is a patient of mine. Yes, this is his real name. He’s been telling me for a while that I need to blog about him.

I met Mike just after Christmas. He had been dealing with a stuffy nose all winter, and despite repeated trips to the doctor and courses of antibiotics, it didn’t seem to get better. Finally, a CT scan showed not a sinus infection, but a large tumor. Mike was diagnosed with rhabdomyosarcoma the weekend after Christmas. What a present!

Mike is a really cool kid. He plays guitar. No... I play guitar. Mike performs and makes records. In fact, when we told him he would have to get some of his chemotherapy as an inpatient, his first question was whether he was allowed to bring his guitar with him. I’ll never forget the concert he put on in his room during his second cycle of chemo.




This is a video of Mike’s band Monday’s Riot. Mike is the one with long hair singing and playing guitar.

Mike also has a band called The Grenaders, and you can hear their music here. Download whatever you want. Mike strongly believes all music should be free.

So why has this been a good week for Mike? Well, today Dr. Fernanda Arnaldez and I, who take care of Mike together, had the pleasure of showing him his MRI from last week (after 13 weeks of chemotherapy). There is no sign of his tumor anymore! He was giddy with excitement when he saw the size of his tumor in December and then how normal his scan is today.

Almost as exciting as that was the phone call he received earlier this week. Make-a-Wish came through for him. Mike’s wish was to have someone special produce and album for him. An album of his music. Mike made a wish and the wish is coming true. Todd Rundgren is going to produce his album!

It sure has been a very good week for Mike.

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It's Been A While

It's been a while since I've been able to post. There are numerous reasons, too many to list here. Life is like that sometimes. Grant deadlines come and go, manuscripts need to be written, patients need to be cared for, and of course my family needs me as well.

Sometimes, I think, people need to be reminded why we do what we do. Please watch this video. This is why I do what I do.



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Is Cancer Contagious?

This question actually comes up a lot in my practice.

When a family is first coming to terms with a cancer diagnosis, so many questions pass through their minds. Does it run in families? Do my other kids need to be checked? Is it contagious?

In humans, the answer is “No,” although now that we know cervical cancer is usually caused by Human Papilloma Virus (HPV; a sexually transmitted infection) this answer is a bit fuzzy. Although viruses like HPV that can cause cancer are contagious, cancer itself is not.

But is that true for all animals? Apparently not. Recently I came across this fascinating article about one of my favorite animals from childhood: The Tasmanian Devil.



When not chasing Bugs Bunny, Tasmanian Devils live in, well… Tasmania. They are marsupials, carrying their young in pouches like a kangaroo or opossum. They are the largest carnivorous marsupial to escape extinction.

Sadly, though, over the last decade, the population has crashed. In some areas by as much as 90%. The cause? Cancer. A cancer that is contagious!

How does that happen? The cancer, known as Devil Facial Tumor Disease, causes a tumor on the face of the Tasmanian Devil, and when an animal with such a tumor bites another Devil (which isn’t a rare event, as you might imagine), the cancer cells are transmitted to the victim and grow into a tumor. The tumor makes it hard for the animal to feed, so it starves.

Why doesn’t the animal’s immune system protect it against the cancer? In most other species, if you inject cells from one animal into another, the recipient’s immune system destroys them. That’s why organ transplants don’t work without strong immune suppressive medications. This immune defense is based on differences in a set of genes called MHC genes that are so variable that (for the most part) only identical twins share the exact same gene sequences. This holds for humans, dogs, cats, mice, monkeys, kangaroos… almost every animal.

Except, apparently, the Tasmanian Devil. Tasmanian Devil MHC genes are not very diverse, and this allows the cancer cells to evade the immune system and grow.

But the mystery does not end there. There are other animals with very little MHC diversity, like cheetahs and beavers, but they don’t have contagious cancer. Also, Devil Facial Tumor Disease is new, first spotted in 1996. This suggests that the situation is more complex than it would seem on the surface, and raises the possibility that the cancer cells have evolved in ways that make them more transmissible.

How? No one knows. It’s just one more of the many unsolved mysteries surrounding cancer and the immune system.

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Standing Up to Cancer

On September 25, an unprecedented fundraising campaign will be launched. Stand Up to Cancer is a charitable group organized by Entertainment Industry Foundation. Uniting dozens of organizations, large and small, and anchored by a TV special that will air simultaneously on ABC, NBC, and CBS, Stand Up to Cancer is aiming to raise enough money to fund so-called “Dream Teams” of translational researchers who are poised to create the next generation of cancer treatments.

Although this sounds like a massive event, like all worthwhile causes, Stand Up to Cancer relies on real people. People like Ben Teller, an 18-year old diagnosed with Hodgkin’s Lymphoma who chose to “make cancer his b*tch”, who chose not to give in to despair, and who chose to inspire his friends and neighbors (and maybe you) to stand up and fight back.

Camp Sunrise 2008

Earlier this month I had the opportunity to be “Camp Doctor” at Camp Sunrise 2008. What an experience that was!

What is Camp Sunrise? Camp Sunrise is a week-long sleepaway camp for kids with cancer, sponsored by the American Cancer Society. Every year the ACS helps rent a campground, and the doctors and nurses from Hopkins and University of Maryland provide medical staffing so that kids can go, even if they are undergoing active treatment. We can give IV fluid, antibiotics, and even chemotherapy at camp.

One of the best parts of camp is seeing my patients outside of clinic. No matter how informal I try to be with my patients, when they come to clinic they are just that – patients. But at camp, they’re kids. They run and jump and play and fall and skin their knees and do “kid stuff.” Like tie dying shirts. Or playing volleyball. Or performing in a skit. Just follow this link to the official Camp Sunrise website to see some wonderful pictures from previous years.



I also love catching up with patients I haven’t seen in a while. In the middle of the morning, I was standing near the dining hall and talking to an old patient, when all of a sudden someone crept up behind me and scooped me off my feet.



The young man holding me as if I were a rag doll was a patient of mine when I was a first year fellow, back in 1997. Obviously the chemotherapy didn’t stunt his growth! I remember him when he was 8 and his only passion was video games (he beat me repeatedly). Now he’s starting his senior year of high school and planning on college next fall. What a joy it’s been watching him grow up! Literally.



We also had our share of adventures that day at camp. Around 4 pm, the skies opened up and we were treated to a tremendous thunderstorm. Now, ordinarily, I LOVE thunderstorms, especially when I’m outdoors. But Camp Sunrise this year had only 1 road leading in and out. And lightning struck a tree. And the tree fell across that one road. And all of a sudden I was the only doctor in a camp full of kids with cancer that was cut off from the rest of the world. When the tree fell, it took a power line with it, so we also suddenly lost electricity. Evening medicines were distributed by flashlight. They had to hook up a generator to power the refrigerator that kept our medications cold.

Then a kid came to the Funny Farm (our infirmary) with a fever. That was pretty nerve-wracking, because a fever can be the first sign of a life threatening infection in our patients. Fortunately the young man was one of our long term survivors and just had a cold. Everyone was relieved when word reached camp that the fallen tree had been cleared and the road opened before anything really bad happened.

Despite the storm, my day at Camp Sunrise was amazing. I can’t wait to go back next year!

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Summer Camps for Children with Cancer

Johns Hopkins Team Sarcoma 2008

Early last month, more than 8,000 people worldwide participated in Team Sarcoma 2008, an international event designed to raise sarcoma awareness. Johns Hopkins had an event that we called All Wheels Welcome, to encourage participation whether you ride a bike, rollerblade, or have a wheelchair. This was the first year that Johns Hopkins hosted an event, and we had a great time!

Our group met on the morning of July 12 at a local mall, and we wheeled down the Baltimore and Annapolis Trail. My colleagues Dr. Kristy Weber (orthopedics) and Dr. Katie Thornton (medical oncology) were there, along with 50 participants.

Dr. Weber and I

We had young people as well as adults. We had bicycles and rollerblades and walkers.





Our research nurse, Margaret Fogle, did a great job marking the trail with both instructions and inspirational messages.





All of the participants left with a smile and a Sarcoma Knows No Borders bracelet.



Everyone is eager for an even bigger event next year!

The Joy of...

Living!

I learn so many lessons from my patients. Some of them are medical, but the more important ones are general life lessons.


This is my patient, CR. He has had a rough time with his therapy. He relapsed before his initial treatment was done, and we’ve had a hard time controlling his cancer since then.

His medical problems have not kept him down, though. He went to his prom this past spring with a beautiful young woman. He and his father have been hunting in Alaska twice this year. He has spent the summer boating and swimming on a lake in upstate New York. This picture was taken while he was skydiving this past weekend. His father tells me that this is a look of pure joy.

Clearly, having a life-threatening diagnosis does not mean your life has to end. There is still joy to be had in living!

Fundraising with Ink

The family of one of our patients just did a really cool thing to raise some money for cancer research. The patient challenged a local radio celebrity to get a tattoo, and when he accepted the challenge, so did her parents and several other members of their family. Last week they all went to a local tattoo parlor and got tattoos. When he found out about my patient, the artist refused to accept any money for his work. Instead, all of that money was donated to a lab to support cancer research! How wonderful is that?

Happy Anniversary (Well, Blogiversary)

Today is the 1 year anniversary of Doctor David’s Blog. I want to thank everyone who has ever read my blog, whether you just stopped by once or twice, or you are a subscriber. A blog is nothing without readers.

Honestly, I’m amazed at what has happened over the past year. I’m not sure I knew what would happen that day I sat down to make my first post. Certainly, I had no idea that I would have made 79 posts the first year and would have almost 100 people subscribing to my RSS feed! Even more exciting, though, are the connections I’ve made as a result of this blog. Some connections have been short-lived – a patient or parent calling or emailing and asking for advice. But some have developed into real friendships or have strengthened bonds with patients and their families (and I think you know who you are). I wouldn’t have predicted any of this, but I’m so glad it’s happened.

Anniversaries are traditionally times to reflect on the previous year, and I’ve been thinking back on some of my more popular posts. I wasn’t surprised to learn that my introductory post was one of my most popular, but it was neat to see that my post on a new sarcoma drug, trabectedin (Medicine from the Sea) was also among the most popular. Other highlights from this year included my first ever giveaway (and are those the coolest socks ever, or what?) and the (occasionally controversial) series on viruses and cancer. It has been great to hear from medical students who have responded positively to the posts about what it is like to be a pediatric oncologist.

But above all, my favorite posts to write are the patient stories. Some are heartwarming stories of triumph, while others don’t end as well. But all relate stories of patients and their families facing tremendous odds and triumphing, even in the face of death. I’d like to take a moment to update some of these stories:

K, who was the subject of my first patient story post, has graduated from college and is moving to California to take over the internet (I hope he remembers me fondly when he rules the world!).

M, who I have mentioned recently, passed away after participating in the Phase I study. His family sent me a lovely thank you note, however, and they truly were at peace with how his struggle ended.

Natalie continues to do very well.

Ben not only beat his tumor, but has become involved with Stomp Out Cancer, a group of indie musicians who create and sell CDs to raise money for Ewing’s sarcoma research. Rock on, Ben!

This has been a remarkable blog year for me. I can’t wait to see what Year 2 has in store.

I'm on Facebook!

Just wanted to let everyone know that I'm on Facebook. If you're there too, we could be friends!