|
||||||||
|
 |
 |
 |
 |
 |
 |
 |
 |
 |
 |
The unique power of audio was recently reinforced when I picked up my teenage daughters from the airport for winter break. Hopping into the car, they commandeered the sound system and in an instant, a song I had never heard before was emerging from within.
 |
Listen up ya’ll, cuz this is it. The beat that I’m bangin’ is de-li-cious. I’m Fergalicious. |
Strangely enough, I was captivated by the hypnotic sound and, just like thousands of other Fergie fans, still can’t seem to get the tune out of my head. When I finally realized I was hooked, I wasn’t all that surprised. Through my unpredictable career as producer of our unique oncology-focused record label, I have come to learn that some “acts” just have a certain magic that pulls us in and won’t let go. This program includes interviews with three new talents making their Breast Cancer Update debuts, Dr Robert Marx and Dr Allan Lipton, AKA “The Bone Brothers,” and the oncofireball Dr Frankie Holmes. Within the first 30 seconds of each of these chats, I knew we had stumbled onto “stars.”
Dr Marx is the first DDS I have interviewed, and from the moment he opened his mouth, I was riveted. A self-described “bone scientist,” Dr Marx is chief of maxillofacial surgery a few miles away at my faculty alma mater, the University of Miami. Several years ago, this astute clinician began to observe an unusual syndrome characterized by open lesions in the mouth that were exposing mandibular bone.
Perplexed by the increasing number of such cases, Dr Marx and his dental colleague Dr Salvatore Ruggiero from the Long Island Jewish Medical Center began the medical detective work needed to uncover the common thread. They soon realized that all of these cases were cancer patients receiving intravenous bisphosphonates for metastatic disease to the bone. Dr Marx named this new entity osteonecrosis of the jaw, or ONJ, and published the first case series in 2003. When he arrived at our offices for the interview, this highly articulate and thoughtful investigator plopped down an impressive new paperback that he had just authored on ONJ (Figure 1). The book is filled with amazing photographs and artwork, which clarify what we currently understand about this strange clinical syndrome.
The practice implications of Dr Marx’s comments are straightforward yet mind-boggling to contemplate. The most critical point is that dentists and, more specifically, oral surgeons must now be quickly integrated into the oncology treatment paradigm, specifically for any patient beginning intravenous bisphosphonate therapy. How this will occur in an expeditious manner is another question, but a good place to start might be to invite interested oral surgeons to participate in tumor board meetings and to obtain their thoughts about recommended protocols and indications for dental referrals.
Another brilliant BCU neophyte featured on this issue is Dr Allan Lipton, who further discusses the enormous clinical impact of bone and breast cancer. According to Allan, an estimated 400,000 patients in the United States are diagnosed annually with bone metastases resulting from a variety of different primary tumors. The vast majority of these individuals are of course receiving intravenous bisphosphonates, which the “bone people” now clearly believe are behind the rare, or maybe not so rare, ONJ syndrome.
The final “new” soloist featured on this program is Dr Frankie Holmes, whose passion for her work and vast knowledge base follow in the footsteps of other US Oncology breast cancer investigators who have worked with us on many of our programs, including Drs Joyce O’Shaughnessy, Stephen Jones, Nicholas Robert and Joanne Blum.
For some time now, I have been trying to interview the profoundly busy Dr Holmes to provide our listeners with full access to the energetic clinician who regularly offers provocative questions and comments during the Q and As for breast cancer sessions in large scientific meetings. As expected, her interview did not disappoint.
Dr Holmes showed up at our temporary recording studio in San Antonio wearing a bright, multicolored outfit with a matching tote bag that was overflowing with papers and posters. Behind her cheerful attire was one of the most serious scientific minds I have encountered in a long while. During the time we chatted, Dr H flitted from topic to topic like a hummingbird, and her comments were punctuated by highly entertaining sound bytes that came forth in rapid staccato. Her analogy of pregnancy and chemotherapy-induced GI toxicity came complete with the type of demonstrative gagging sounds that told me she truly understands what her patients go through.
She then drew the analogy of Rapunzel in the tower and the lonely tumor cell seeking angiogenesis, and in the next sentence...well, you listen:
When I think about fine needle aspirations, I think about those last days in Vietnam — the pictures that we saw of those refugees clinging to the ruts of the helicopters that went off. It was just jam packed, and when you think about an FNA, that needle goes in there with tremendous suction. It sucks up cells, and you get a lot higher yield of tumor cells than you do of stroma.
Prior to the days of the web, portable electronics and megatelecommunication, attending physicians who had a unique talent to teach clinical medicine in a captivating manner would influence only a few house staff members on rounds. Today, not only can Fergie become a household name in a few weeks, but we can also “discover” great teachers and motivators like the three new stars and two veterans (Drs Andrew Seidman and Terry Mamounas) on this action-packed issue.
It’s delicious.
— Neil Love, MD
NLove@ResearchToPractice.com
February 28, 2007
Select Publications
Lipton A. Biochemical bone markers in breast cancer. Cancer Treat Rev 2006;32(Suppl 1):20-2. Abstract
Marx RE. Oral & intravenous bisphosphonate-induced osteonecrosis of the jaws: History, etiology, prevention, and treatment. Quintessence Publishing Company LTD, December 1, 2007. No abstract available
Marx RE et al. Bisphosphonate-induced exposed bone (osteonecrosis/osteopetrosis) of the jaws: Risk factors, recognition, prevention, and treatment. J Oral Maxillofac Surg 2005;63(11):1567-75. Abstract
Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: A growing epidemic. J Oral Maxillofac Surg 2003;61(9):1115-7. No abstract available
 |
 |
