Can-Do-Attitude and Targeted Treatment Beat Cancer

As a successful entrepreneur since age 28, Orville Middendorf, now 79, is proof that a positive, CAN-DO ATTITUDE can get you far in life—and maybe even save your life.

While in Florida in 2007, Orville struggled with nagging back pain. He finally had a CT scan that revealed enlarged lymph nodes throughout his body. So Orville headed home to St. Louis, where a biopsy confirmed non-Hodgkin lymphoma, a cancer of the lymph nodes. The first oncologist he saw suggested he wait and watch the cancer for three months.

Thankfully, Orville didn’t take that advice.

Instead, he took matters into his own hands, seeking out Nancy Bartlett, MD, medical oncologist at the Alvin J. Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine. After closely reviewing his biopsy results, Dr. Bartlett recognized that Orville had one of the more aggressive forms of non-Hodgkin lymphoma. There was no time to waste—his treatment began immediately.

Orville had introduced himself to Dr. Bartlett by saying, “I’m the guy that’s sick, and you’re the one who’s going to cure me.” That optimism drove him through five months of chemotherapy.

Orville admits that chemotherapy was difficult physically, but he maintained a strong spirit. “Attitude is everything,” he says. “The worst day was when I was diagnosed. But once I started treatment, I was totally confident that I would get better and didn’t fret about it. Dr. Bartlett is a remarkable person with so much intelligence.”

For nearly two years, Orville was in remission, but his cancer recurred in February 2010. This time, Dr. Bartlett had even more ammunition in her cancer-fighting arsenal—a new, more effective combination of chemotherapy.

“While the individual drugs weren’t new, the combination of drugs was,” Dr. Bartlett explains. “The published results about the drug combination were encouraging, and it was an ideal treatment for Orville with fewer side effects. This was not an established treatment regimen when Orville was first diagnosed. It’s exciting that new treatments are evolving all the time so we have more to offer patients.”

Orville sailed through chemotherapy the second time, Dr. Bartlett adds.

“Orville is a prime example of why it’s often important to seek a second opinion from specialists at a dedicated cancer center,” she says.

“Most of us focus on a single cancer, which allows more time to investigate the latest treatments for specific tumor types.”

Today, Orville is in remission again and is enjoying dining out with friends, spending time with his wife, daughter and grandchildren and visiting Florida.

When Orville was given the good news that he was in remission, he channeled his gratitude to support Dr. Bartlett’s research in non-Hodgkin lymphoma through making charitable gifts to The Foundation for Barnes-Jewish Hospital.

“When someone does something so important for you—like saving your life—how can you not say thanks?” Orville asks.

Donors Fund Research that Leads to More Tailored Treatments

Dr. Bartlett, The Foundation’s Koman Chair in Medical Oncology, has spent her career focusing on cancer treatment and research and today receives funding for some of her research through donations made by her grateful patients to The Foundation. As a research fellow from 1992 to 1994, she was one of the first grant recipients to be awarded funding by the Lymphoma Research Foundation.

“I always knew I wanted to work with both research and patients, testing new drugs and new combinations of drugs,” Dr. Bartlett says.

Clinical research and knowledge about the biology of cancer have dramatically evolved in the past 20 years, she adds. “This knowledge allows us to better understand what drives cancer and the mechanisms of disease and drugs. It also leads us to develop more drugs specifically targeted at cancer cell abnormalities.”

Donor support for research through The Foundation for Barnes-Jewish Hospital has played an integral role in Dr. Bartlett’s work. “These funds are critical in getting research projects off the ground,” she says. “Non-endowed funds in particular let us get research projects started quickly to keep our base of knowledge growing rapidly.”

Thanks to donor funding, in the past year Dr. Bartlett and her colleagues have worked with the Washington University Genome Institute on sequencing a part of the genome called an exome. “It’s quicker and less expensive than sequencing the whole genome, yet we can still learn a lot from the exome,” she explains. (The process of sequencing maps all the genes to detect variations from the normal sequence; these variations play a critical role in the development of cancer.)

Dr. Bartlett and her colleagues have collected lymph node tissue and performed whole exome sequencing in 25 patients with non-Hodgkin lymphoma. “The hope is to find an abnormality in the tumor that is not present in the patient’s normal cells to help better understand what causes lymphoma and identify more precisely what drugs may be more effective,” Dr. Bartlett says. “This will eventually lead to more tailored treatments.”

She says the generosity of donors like Orville has been critical for advancing this research more quickly. “Orville and other donors have paid for the initial studies that will allow us to apply for federal grant funding to do larger studies. Without donor support through The Foundation for Barnes-Jewish Hospital, these studies could not have been done.”

Dr. Bartlett says that as a result of research, several new drugs to treat lymphoma are on the horizon. “Some of the current drugs are not very specific for the different tumor types and have many side effects. The new drugs coming along are based on an understanding of what makes certain cancer cells tick. These drugs spare healthy cells while targeting cancer cells.”

Please support Siteman Cancer Center’s research by making a donation to the Kenneth B. Steinback Cancer Research Fund (#6266) at The Foundation for Barnes-Jewish Hospital. If you have questions, call 314-286-0600 or email [email protected].