Behind the Breakthroughs: A Candid Physician-Patient Conversation

Mar 07, 2019

Season 2 of the Your Stories: Conquering Cancer podcast series debuted in January 2019. Among the ASCO members featured is Conquer Cancer grant recipient Jason Luke, MD, FACP, who got the rare chance to ask candid questions of a former patient who had melanoma, Ms. Addison Brush. Read an excerpt of their interview below and listen to the full podcast online, on iTunes, or on Google Play to hear why “Ice Cream Helps Everything.”

JL: I was thinking about talking about something that happened before I even knew you, when you received your melanoma diagnosis.

AB: At 21, when I received that diagnosis, I didn’t really know what melanoma was. I had a mole removed from my back, and it was sent down to the University of San Francisco, because I was home in Northern California. I got a call, and we had people over, so I went to my room, and the nurse told me that I had melanoma, stage IB. It didn’t hit me that anything serious was going to happen.

JL: And so, you went forward and had standard treatment with surgery and they took out a lymph node.

AB: I don’t remember feeling like it was any sort of life-threatening or life-changing event at that time. It wasn’t until way later that I felt that way, and maybe I was just young and naive at the time.

JL: So, you were kind of just going along with your thing and then, things changed?

AB: My boyfriend, Nathan, and I were on our second date. Earlier in the week, I had this tongue flutter. We’re making dinner at Nathan’s house, and he’s outside getting the grill ready, and my tongue starts fluttering again, and I’m chopping up something in the kitchen. I’m like, how embarrassing if he comes in and I can’t talk to him? So, I head to his bathroom to just wait it out, thinking that it’ll pass again in another 15 seconds, like last time.

I had a seizure in his bathroom… I don’t remember any of this, but he called 911. [At the ER] they found a brain bleed but didn’t see a tumor. I was in the hospital there. I felt like I was on [the TV show] House. They didn’t know what was wrong with me. When I went back 3 weeks later, they found a tumor the size of a walnut in an area of my brain that controlled my speech, and that, I think, is when it hit me that this is for real. This is serious.

JL: So how did how did you process that? I mean in that moment. Was it just a gradual sense?

AB: There was a little hope left in me that it wasn’t cancerous, and then, after brain surgery, I remember waking up in the bed and asking if it was indeed melanoma. My parents were in the room and nodded their heads. That was a hard moment, because I knew I was in for a long haul.

JL: How did you decide who your doctors were going to be? Can you talk about that a little bit in terms of what it was in the interactions that mattered to you, and how did you feel more confident?

AB: I think we found you through a coworker’s husband’s friend. I can’t exactly recall, but it was originally a referral and then a ton of research online.

You came into one of our appointments and told my parents and me that you had been thinking about the treatment plan, and you were 100% certain to go with this combination, and it was that trust we had in you that is so important. You made the decision that ultimately is credited for saving my life. You’re younger than a lot of the doctors that I had seen, and you talk very quickly. You’re clearly incredibly smart and up on your research. And we all admired your hair because you have some flow…

JL: [laughs] Well, I am glad to know these are elements of decision making.

AB: When I received my remission diagnosis you were on paternity leave. I’ve always wondered, do you feel like you missed out on telling me about remission?

JL: The answer is definitely yes.

The Your Stories: Conquering Cancer podcast series is a set of unscripted conversations with doctors, patients, and caregivers.

Conquering Cancer With Dr. Jason Luke

How does the immune system interact with a tumor? And what does the tumor do back?

These are the questions that motivate Dr. Luke.

He began his career working on sarcomas and melanomas, but the University of Chicago assistant professor of medicine has shifted his focus fully to immunotherapy. He meets patients when they have exhausted most all other options. Time in the lab lends confidence to his bedside manner as he guides patients through difficult decisions.

“I try to think about how I actually tell the person and get the information to them in a way that they’ll actually be able to hear it,” said Dr. Luke. “Some things that we say aren’t hearable, and nobody wants to hear them.”

Though he considers himself a doctor first and a researcher second, his work is fueled by searching out the breakthroughs that patients need.

“All this research in clinical trials is to get new drugs. In the end, this is the piece that is most important to me,” he said. “The biggest success in my career has been contributing to the massive improvements in the treatments available for patients with advanced melanoma. Since 2011, there have been 13 FDA approvals of new drugs or new combinations of drugs. As someone who works on drug development from first-in-human all the way to approval, it’s been tremendously satisfying to see the science from the laboratory become treatments for patients. And I don’t really know what’s more meaningful than getting years out from that and realizing that it really did work.”

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