Breaking barriers: women in oncology, learning from survivors, and keen-eyed pioneers

Philadelphia, where Fox Chase is located, has long been a center for scientific and medical education and research. The first medical school in the United States opened in 1765 at the College of Philadelphia and eventually evolved into the University of Pennsylvania’s Perelman School of Medicine. Scientists and physicians have long used the city as a starting point or a home base for their endeavors.

“The fact that a woman could get a PhD degree and then get a job was really different than in other parts of the world,” said Marilyn Bailey Ogilvie, professor emeritus in the Department of the History of Science at the University of Oklahoma. She is coeditor of “The Biographical Dictionary of Women in Science,” and the author of several books on the history of women in science.

Another unique thing was that women researchers at Fox Chase were being paid the same as their male counterparts. In a 1985 interview, Patterson said, “There was no discrimination whatsoever. Salaries were the same.”

Ogilvie said that pay equity is “very surprising” for its time. She also noted that generally, once women got into the laboratory, they trained other women to do the same work. “That’s the pattern that I’ve seen,” she said. That pattern of handing scientific knowledge down would recur throughout the history of Fox Chase, with one generation of women researchers passing their knowledge along to the next.

When researchers at Rutgers Cancer Institute of New Jersey learned of Marcia Bird’s response to investigational treatment for a recurrence of endometrial cancer, they were intrigued. “We saw the response, then asked the question—and found out more than what we were looking for,” recalls Janice M. Mehnert, MD, director of the Phase I/Investigational Therapeutics Program at Rutgers Cancer Institute of New Jersey. What they learned was that the presence of a particular mutated enzyme may help identify a subset of cancers that are more responsive to new forms of cancer treatment known as immunotherapy.  

Shridar Ganesan, MD, PhD, chief of molecular oncology, associate director for translational research, and Omar Boraie Chair in Genomic Science and a professor of medicine and pharmacology at Rutgers Robert Wood Johnson Medical School, Janice M. Mehnert, MD, former director of the Phase I/Investigational Therapeutics Program at Rutgers Cancer Institute of New Jersey along with members of the Gynecologic Oncology team at Rutgers Cancer Institute worked together to find the right clinical trial for Bird.

In 1971 President Nixon signed the National Cancer Act, greatly boosting funding for cancer research. Still, for those on the ground, progress was maddeningly slow. While he and two other medical oncologists cared for their patients in the hospital, Engstrom thought there was more that could be done.

“It was clear to me we weren’t making much progress in treating patients with advanced cancers,” Engstrom said. “That has, of course, changed now with new science and the development of new treatments. But at the time I saw this need and I saw how we could correct it.”

Engstrom began thinking about a summer during medical school when he had a public health fellowship at the California Department of Health. His work had nothing to do with cancer but everything to do with his eventual career in cancer prevention and control. At the epicenter of the mosquito-borne equine encephalitis outbreak, Engstrom’s job was to cross-check mosquito levels and death certificates of children who died of suspicious diseases, and pull records to see if any blood tests had been done that would indicate encephalitis.

By tracking mosquito levels and zeroing in on populations hit the hardest, it was possible to take precautions to prevent the disease from spreading. He had learned some of the most important lessons in epidemiology, and he wanted to employ that same logic in studying cancer.

At Fox Chase, he focused on cancer screening, creating one of the nation’s first cancer prevention and control programs.

“Most doctors and oncologists in the 1970s were training to treat cancer, not necessarily to prevent it,” said Carolyn Fang, co-leader of the Cancer Prevention and Control Program at Fox Chase. “He was one of the first to recognize that prevention was important. While this concept may seem obvious today, it was considered ground-breaking 40 years ago.”

Sixty years ago, a landmark discovery at Fox Chase Cancer Center changed the direction of cancer research and paved the way for a new approach to cancer treatment.

The finding came to light when the keen eye of predoctoral fellow David A. Hungerford detected a tiny flaw in chromosomes from the blood cells of patients with a type of leukemia. It was the first genetic defect linked with a specific human cancer.

In 1959, tools did not yet exist to analyze individual genes. Scientists had only crude techniques for studying chromosomes, the 23 pairs of rod-shaped packages of genes at the heart of every blood and tissue cell.

For Nedra Bonds, a cancer diagnosis was never part of the plan. But then again, the Kansas City artist, educator and community activist is pretty good at improvising.

When she was diagnosed with triple-negative breast cancer – a less common and more aggressive form of breast cancer – her reaction of a simple “OK” left her physician speechless.

“I was uniquely calm. These twists and turns, they are all part of the journey,” Nedra says. “I could have cried and screamed and thrown myself on the floor, but it would not have changed anything, and I would have been behind in my planning.”