Full Circle

“Not only did Neil face the extreme physical burdens of living with daily pain, fatigue, nausea, and anorexia, but perhaps, at times more difficult, was the emotional and spiritual distress that we were both immersed in,” shared Dr. Spector’s widow, Denise Spector, an oncology nurse practitioner and nursing educator. “I recognize that for some, caring for Neil as a patient was particularly difficult as they also cared about him as a colleague and mentor in some cases.”

Matthew McKinney, MD, was his primary oncologist. He recalled when Dr. Spector was first recruited to Duke in 2006 by H. Kim Lyerly, MD, to join DCI’s breast cancer program and Dr. Lyerly “couldn't stop talking about how excited he was Neil was coming to Duke.” A few years later, Dr. Spector would be Dr. McKinney’s clinical supervisor for his hematology/oncology fellowship at the Durham VA Medical Center.

“Once I remember needing advice with one of my patients and Neil jumped up from his seat, grabbed his stethoscope, ran over to the exam room, examined then talked through things with my patient, and I knew that patient was in good hands,” said Dr. McKinney, a cell therapy and hematologic malignancies specialist and assistant professor of Medicine. “I learned countless lessons from him, many of which are valuable to me to this day.”

Including the days the mentee found himself providing cancer care for his mentor.

“Taking care of a colleague, mentor and friend for advanced cancer in the age of COVID-19 was harrowing,” shared Dr. McKinney. “On more than one occasion late at night or over a weekend, we had to direct Neil to 9100 for inpatient care because of some medical emergency, knowing that he would be isolated from Denise and his family, and I am sure that was terrifying for them. Medical decisions were somewhat less difficult as Neil and Denise would also get advice from all the oncology colleagues they were familiar with around the world, particularly from the Dana-Farber Cancer Institute.”

“The staff on 9100 were sensitive to the fact that Neil was dealing with a range of health challenges along with tremendous fear, in part due to COVID-19, although Neil tried very hard to show optimism about his treatments and disease outcome,” said Denise.

As a medical oncologist with Duke Cancer Institute and the Durham VA Medical Center, Dr. Spector knew all too well what he was up against, explained Denise, which made facing his situation, in some ways, even more challenging.

Lymphoma was the disease he’d focused on early in his career as a scientist and medical oncologist at Dana-Farber Cancer Institute. In fact, Dr. Spector’s initial laboratory research there was on B cell lymphomas and his clinical practice was directed at taking care of patients undergoing bone marrow transplants to treat blood cancers. Later in his career he would direct the Bone Marrow Transplant Unit at the University of Miami’s Jackson Memorial Hospital.

While at DCI, Dr. Spector’s research and clinical interests would broaden to breast cancer, and, in recent years, investigations, with DCI chemical biologist Timothy Haystead, PhD, into potential treatments to target tick-borne pathogens linked to Lyme Disease using lessons learned from cancer biology.

“The researcher within him, as well as the strong desire to not give up, kicked in and led him to a clinical trial of a T-cell targeted therapy against his EBV- infected B cells,” recounted Denise “While he clung to the hope that this therapy would eradicate the disease, the PTLD was far too aggressive and widespread, which led to multi-organ failure rather quickly.”