Interview With Sarcoma Specialists – Dr. Miller & Dr. Milhem
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As we round out the end of Sarcoma Awareness Month, we decided to bring you an interview with two very well respected sarcoma specialists. They are based in Iowa and were so gracious in taking the time to tell us about some of the important work they are doing in the fight against sarcoma and to help those battling this disease.
Please allow us to introduce you to Mohammed Milhem, MD (Mo) Medical Oncologist, Deputy Director for Holden Comprehensive Cancer Center, University of Iowa, and Ben Miller, MD, MS, Orthopaedic Surgeon, Musculoskeletal Oncology, Department of Orthopaedics and Rehabilitation, University of Iowa.
Eric D. Davis Sarcoma Foundation (EDDF): Tell us about your educational/professional path leading up to this role.
Ben Miller (Ben): I grew up in Iowa City, IA and attended Cornell University with a major in chemical engineering. I later returned to Iowa for medical school and then did my orthopedic residency at Rush University in Chicago. I spent one year working overseas in Africa and Asia as a general orthopaedic surgeon in regional hospitals after residency. I then completed an oncology fellowship at the University of Florida and joined the faculty at the University of Iowa in 2010.
Mo Milhem (Mo): I was born in Kuwait, my parents are Palestinian by origin and I carry a Jordanian passport, for ease I tell people I am from Earth. My medical schooling was interrupted due to the gulf war (started at Kuwait University then finished in Jordan University). I did my residency and fellowship at the University of Illinois at Chicago and then went home to Jordan and developed the very first cancer center in a third world country. I helped establish the first Sarcoma Multidisciplinary team in Jordan, Amman. In 2007 I came back to the United States and joined the University of Iowa as an active researcher on a multidisciplinary team. I helped build a sarcoma program and a tissue bank- one of a kind in the Midwest. This tissue bank has greatly facilitated our abilities to do meaningful research in the basic science of sarcomas. I also teach residents and students throughout the University. I participate in many committees and serve on a sarcoma research panel.
EDDF: Tell us about some of the work you are doing right now.
Ben: My work right now primarily involves the surgical treatment of sarcomas. Using modern diagnostics and surgical technique, we are able to treat patients with a limb salvaging surgery well over 90% of the time. I am the head of a multidisciplinary sarcoma team that meets on a weekly basis to discuss the treatment of sarcoma patients. I am both an active participant in sarcoma research, my most exciting project currently is the implementation of a sarcoma registry to measure functional outcomes after surgery, as well as a collaborator with basic scientists and other professionals involved in the treatment of sarcoma.
Mo: My work right now involves participation in a myriad of trials for sarcoma and I’m a part of larger groups (the SARC – Sarcoma Alliance for Research through Collaboration, the P2C – Phase 2 consortiuum, The Alliance and the Midwest Sarcoma Trials Partnership). I have tried to offer my patients options other that that available through the innovative science that is coming for this disease.
EDDF: Why did you choose to specialize in sarcoma?
Ben: I was initially drawn to the field of orthopedics because this specialty is so focused on daily quality of life (trying to minimize pain and maximize function). I found that the opportunity to assist and provide care to people who have cancer was very challenging and rewarding on a daily basis; it made me feel like a doctor. Specifically sarcoma patients have held my greatest interest and passion, and the rewards have not stopped.
Mo: As a fellow in the sarcoma clinic, I became very interested in the diversity of this particular tumor type and the fact that it was rare. During my fellowship I had the privilege of working with one of the best sarcoma mentors (Dr. Brian Samuels) who enlightened me about this disease. And I was given an opportunity to do a specific fellowship for this and was trained for over 2 years.
EDDF: Do you work in any specialized areas of sarcoma?
Ben: I treat all bone and soft tissue sarcomas of the extremities and pelvis.
Mo: I work mostly in collaboration with surgeons in the adjuvant setting of sarcoma as well as the metastatic setting when the disease has spread offering treatment to patients including clinical trials, the delivery of chemotherapy as well as exploring new agents and innovative techniques in targeting this cancer.
EDDF: What are some of the first steps a newly-diagnosed sarcoma patient should take?
Ben and Mo: There is a clear benefit for patients to be seen by a sarcoma specialist as soon as possible when a sarcoma is suspected. They should be evaluated at a sarcoma center by a multidisciplinary team trained in the diagnosis and treatment of sarcoma.
EDDF: What is new in sarcoma research?
Ben and Mo: At the University of Iowa, we have several areas that we focus on:
1) The exploration of new immune mechanisms that may play an important role in the development of sarcoma. Treatments thus far have used conventional chemotherapy and outcomes have been poor at best. Exploring innovative approaches is our motto and immune strategies are one of the mainstays in the treatment of sarcoma.
2) We have developed a prospective registry that addresses functional outcomes of patients after sarcoma surgery. After working out the details here at Iowa, we hope to be able to expand the opportunity to participate to all sarcoma patients. Besides exploring this we have created a unique tissue bank that gives us an opportunity to obtain tissue, DNA, RNA and serum from patients with sarcoma that have allowed us to interface with researchers helping elucidate further pathways.
3) One relatively unexplored topic is Epigenetic mechanisms that may affect both the sarcoma and host. This treatment may augment chemotherapy and or immunotherapy. Our hope is to use the Tissue bank to drive many of our decisions in exploring different ways of targeting these tumors. We collaborate nationally and locally to achieve some of the most exciting treatments.
EDDF: What is new in sarcoma treatment options?
Ben and Mo: This is an exciting time for research in clinical trials. There are a variety of new trials that could have an effect on sarcoma treatment and prevention. Again we participate nationally and locally on many aspects of the varying biologically pathways that influence sarcoma formation and spread.
EDDF: Why are you active in social media?
Ben and Mo: Given the rarity of this disease, social media allows people to interface and gives others help in identifying treatment options. Patients can connect to each other and have an avenue to discuss things with doctors. It also allows us to connect with our patients as well as our community and improve education and communication as well as provide our patients with access to us. It is the perfect medium for the exchange of ideas, thoughts and practices.
EDDF: Why do you believe it is important to spread awareness of sarcoma?
Ben and Mo: Although it’s a rare disease, early and appropriate treatment is critical in optimizing the best outcomes. The more we can make people aware of it, the better the chances of curing it. Even though it is a relatively uncommon diagnosis, many people have been touched by sarcoma through friends and family members. It is important for all those affected by this disease, either personally or through a loved one, to understand that they are not alone, and to have the opportunity to join the fight in whatever way they can.
EDDF: Have you done anything to honor Sarcoma Awareness Month?
Ben and Mo: Every day is sarcoma awareness for us. Every day we are fighting the battle against sarcoma. We have very active sarcoma fundraising events that are completely tied to sarcoma awareness month (Ride it Out for Amber, Courage Ride Wine Tasting, Courage Ride Parking Lot Party). We have been working hard to build relationships with others on social media to build a stronger alliance against this disease. One of our team members has been working actively with Miles 2 Give on their social media to help build their brand and bring more awareness to sarcoma.
EDDF: Anything you’d like to add?
We appreciate the opportunity to answer these questions for the EDD Foundation. We humbly thank your organization for its great work and we look forward to furthering communication with you in building a greater sarcoma community together.
Additional information on the above events:
Ride It Out for Amber: www.rideitoutforamber.org
Courage Ride: www.courageride.org
Miles 2 Give: www.miles2give.org
Dr. Milhem’s blog (Dr. Miller is also a contributor): http://doctormoiowa.wordpress.