Duke Cancer Institute Donor Blog http://dukecancerinstitute.org/nursingblog/rss.xml en “Oncology Jedi” Joseph Moore Retires From Clinical Practice http://dukecancerinstitute.org/your-gifts-at-work/oncology-jedi-joseph-moore-retires-clinical-practice Sat, 09/28/2019 - 23:19 Julie Poucher Harbin /donors/your-gifts-at-work/oncology-jedi-joseph-moore-retires-clinical-practice “Oncology Jedi” Joseph Moore Retires From Clinical Practice http://dukecancerinstitute.org/your-gifts-at-work/oncology-jedi-joseph-moore-retires-clinical-practice (be sure to click through all 16 slides above, which include photos and tributes)  On June 28, Joseph Odell Moore, MD, celebrated his 75th birthday. On June 30, the Duke Cancer Institute hematologic oncologist, after 44 years, retired from clinical practice. “At the end of June, I took a deep breath. I was exhausted,” smiled Moore. “Totally exhausted. And I said to myself, “I’m doing the right thing.”” In early August, Moore had an ablation to treat atrial fibrillation. It went well and the prognosis is good. A couple weeks later, the distinguished professor of Medicine was back at his office on a two-day-a-week schedule slowly getting things in order for the final year of his research career. Moore was born in 1944 in the city of Greenville, South Carolina, when his father was in flight training there. He grew up in Rochelle, Georgia with his mother, stepfather, and three half-brothers. “My father,” Moore shared, pointing to a Martin B-26 Marauder model plane by the window, “was a World War II bomber pilot. He was killed in action when I was less than a year old.” Not far from the plane, a treasured pair of angels from Venezuela and an intricate wooden owl carving — both gifts — were on display. Angels are said to be benevolent beings that guide and protect. Owls, of course, are wise. Moore’s legacy of service to patients at Duke — combining compassionate care and medical wisdom — would no doubt make his father proud. The self-described “southern boy” earned his BS degree at Emory University in Atlanta, then ventured north — earning his MD at Johns Hopkins University in 1970. He would complete a three-year medical residency there with a two-year gap serving in the Public Health Service Commissioned Corps in Hawaii. Moore “solidified” his interest in cancer when he was assigned to an NIH-funded epidemiology study in Hawaii — the Japan-Hawaii Cancer Study — comparing cancer in Japanese immigrant men in the state to cancer in Japanese men in Japan. Still depressurizing from a “very intense internship” at Hopkins fueled by coffee, and with more free time in this new post, his wife Alice, whom he’d met and married while in medical school, pushed him to find a hobby. Moore joined a marine diving club, mixing with marines who went back and forth to Vietnam, an air force colonel, a couple of Phantom jet pilots and one nuclear submarine officer. He also came to enjoy playing handball, often with “Odd Job” from Goldfinger. “Hawaii was a great place to be, and a good cultural experience,” reflected Moore, who also developed other hobbies, including collecting the Japanese Sumida pottery and Chinese Mud Men figurines that today occupy his office shelves, and finding and trading cowrie shells. Once his tour of duty in Hawaii was finished, he returned to Hopkins to complete his medical residency and in 1975 came to Duke for his Hematology/Oncology fellowship. The Dark Ages “That was back in the dark ages,” Moore half-joked. At that time, there were very few cancer centers in the U.S. The Duke Comprehensive Cancer Center, now known as the Duke Cancer Institute, had been recognized as one of the National Cancer Institute’s eight original comprehensive cancer centers in 1973. Moore began his medical practice in the Division of Internal Medicine, a late ‘70s through ‘80s multi-specialty group of clinicians at Duke. Concurrently Moore participated in two large cooperative groups — the Southeastern Cancer Study Group and then the national Cancer and Leukemia Group B — where his main focus was leukemia protocols. “Chemotherapy had begun to come into its own,” he explained, “as not only a treatment but a potentially curative modality, sometimes in concert with radiation, which had been around for a while. While effective, the side-effects of chemo were toxic.” For example, chemotherapy regimens being used to treat Hodgkin Lymphoma and other cancers were tough to take. It wasn’t until 1991 that the first anti-nausea drugs and drugs to boost white blood cell counts were introduced into the clinic; making treatment more comfortable and safe. “These were major changes,” said Moore. “I can remember one sarcoma patient I had, who every time I treated him he would be terribly sick. We’d give him just enough medicine that he went to sleep. He stayed asleep, basically, through his whole treatment and he always came back in with neutropenia (low white blood cell count). Then he started receiving the anti-nausea medicine and the G-CSF. He was wide awake, he didn’t get sick, and he was never readmitted with neutropenia. He eventually died of cancer, but the ability to make his life better during his treatment was pretty dramatic.” Treatment Evolution In the ‘90s, Moore was one of four physicians that made up the Hematology Oncology Associates group. They treated not only leukemias and lymphomas, but many solid tumors as well. As knowledge about cancer grew and available treatments advanced and expanded, cancer physicians at Duke who were previously generalist oncologists became subspecialized. One of Moore’s mentors at Duke was Joseph Sokal, MD, who joined Duke in 1979 as a scholar-in-residence and stayed until his death in 1988. “He was one of the grand old men in blood cancers who treated a huge number of patients with CML at a time when it was more of an art and well before the study for Gleevec came around in 2000,” said Moore. “Gleevec, a targeted therapy, changed everything. Leukemia went from a fatal disease, unless you went to transplant, to a disease that can now be treated with any one of five or six drugs.” Moore was the Duke site principal investigator for the International Randomized Study of Interferon and STI571 (IRIS) (2010-2019), which found that CML could be treated effectively with one of several TKI inhibitors, including Gleevec. Subsequently he was also involved with the LAST Study; monitoring CML patients who’d benefited from TKI inhibitor drugs and were able to stop therapy and remain off medication. He followed a few of these patients off-therapy until his retirement. Gleevec was just the first of many targeted therapies. “There are all kinds of ibs, abs, zols, and virs now,” explained Moore, referring to the ending letters of small molecule, antibody (immunotherapy), antifungal, and antiviral drugs now on the market. Numerous other therapies, including like CAR-T cell therapy and TIL (tumor-infiltrating lymphocytes) therapy are also options for some cancers. While chemotherapy still has a very important role in treatment, Moore said, there are some cancers that can be treated with non-chemotherapy regimens and still be cured. “It’s a fantastic evolution!” he said. Continuum of Care Moore said he’s cared for hundreds of patients, many of whom he’s followed for more than 30 years. Phil Austin, BSN, RN, a nurse at Duke for 33 years, was treated by Moore for aplastic anemia in 1992. At the time, he was told his blood disease was harder to treat than cancer.   “I honestly did not think I would live out that year, nor see my 3-year-old and 6-year-old grow up,” said Austin, an apheresis nurse. “It was actually my biggest fear that my wife would be a single mother of our two kids. The grace of God, the prayers of the faithful, and the excellent care by Dr. Moore and the 9100 team of caregivers is why I am here to tell about it.” Jennell Abrahamsen, a Wilmington, North Carolina resident was first treated by Moore 18 years ago for non-Hodgkin lymphoma, and returned last year when it recurred. “We love him. We would do anything for him,” said Abrahamsen, who cried at her appointment last May when he told her he was retiring. “He has healed and helped and saved so many people that I just am at a loss for words. He is so, very humble. I feel like he’s one of us even with all the education that the good Lord gave him.” Dozens of patients, over many years, have paid tributes like these to Moore. “No one wants to be told he has cancer. However, those terrible, frightening words are far easier to handle when your care is provided by Dr. Joseph Moore,” read a comment on Moore’s Duke Health page from a four-year CML survivor. Some might find it hard to care for cancer patients at all, never mind for four decades. “What you really have to realize is that they come to you for help and that you (the doctor) don’t have the disease,” reflected Moore. “And if you internalize the disease, that will harm you. That doesn’t mean you can’t take it seriously or can’t be specifically focused on anything that goes on.” An “Oncology Jedi” Brilliant, dedicated, considerate, gentle, strong, calming, thoughtful, distinguished, intellectual, collegial, motivational, extraordinary, inspiring, reassuring, gifted, and “an oncology Jedi”, are some of the ways his colleagues across Duke describe him. (see above slideshow for tributes) At an interview last month, Moore paged through a booklet about Duke Cancer Institute’s history. Many of those featured are colleagues he “grew up with” in his clinical practice and academic career. There, he pointed out, was William Shingleton, MD (1952-1987), the founding director of Duke Comprehensive Cancer Center. “Bill was a good friend to me and in his way, a mentor,” said Moore of the master cancer surgeon who passed away in 1987. “Even though I wasn’t going to be surgeon, he was very good to me personally.” And there was O. Michael Colvin, MD, a physician scientist and friend who directed the cancer center between 1995 and 2002 and passed away in 2013. There was Jon Gockerman, MD, who earned his medical degree in 1967 and was a long-time hematology/oncology colleague. He’s now retired. "Joe's contribution to patient care, teaching and research has been legendary these past decades," said Gockerman, a professor emeritus of Medicine. And there was William Fulkerson, MD, another of Moore’s earliest colleagues. “I worked with Joe caring for patients together for over 30 years,” said Fulkerson, who’s now executive vice president of Duke University Health System and a nationally recognized specialist in pulmonary and critical care medicine. “He’s one of the most caring and committed physicians I have ever known.” If Joseph Odell Moore, MD, could have had any career, he said he’d have still chosen medicine. “There are still things I can do in medicine,” said Moore, who’ll stay on faculty for another year. “I’m taking a little time off to decompress and think about it some… And sleep late.” He’ll also have more time to do other things he loves, including reading historical fiction, catching up on “The Americans” on Netflix, and working in the garden with his wife Alice. The couple, who will celebrate 50 years of marriage next March, are looking forward to traveling, relaxing at the beach, and seeing more of their three daughters, sons-in-law, and five grandchildren. Three lab coats, at least one with an ink-stained pocket, still hang on the back of his office door awaiting their fate. “They probably ought to be burned, but they’re kind of fun,” laughs Moore, who’s worn dozens over the years. “I’ll probably keep one just to use here so I have some credibility at least and don’t get tackled when I go up and down the employee elevators.” Moore will be presented with the Shingleton Award for Caregiver Partnership at the DCI Development Office’s annual Shingleton Society luncheon, to be held on October 11. Moore plans to continue his fundraising work for DCI Development as well as for the V Foundation. The V Foundation, established by ESPN and legendary basketball coach Jim Valvano "to achieve Victory Over Cancer,"  has awarded hundreds of grants nationally since its formation in 1993, including grants for young investigators and translational grants for established faculty. Moore is a member of the board of directors and scientific advisory committee of the V Foundation and has been with the foundation since its beginnings.   Sat, 09/28/2019 - 23:19 Julie Poucher Harbin /donors/your-gifts-at-work/oncology-jedi-joseph-moore-retires-clinical-practice “Oncology Jedi” Joseph Moore Retires From Clinical Practice http://dukecancerinstitute.org/your-gifts-at-work/oncology-jedi-joseph-moore-retires-clinical-practice Bob Porter (photo by Bob Leverone Photography) In gratitude for the care he has received, Bob Porter of Greenville, South Carolina, made a gift to establish an endowed fund in honor of Joseph Moore, MD — the Duke Cancer Institute Leukemia/Lymphoma Endowed Research Fund. Porter and other donors have continued to make contributions to the endowment. Upon Moore’s full retirement, the fund will be named for him. Sat, 09/28/2019 - 23:19 Julie Poucher Harbin /donors/your-gifts-at-work/oncology-jedi-joseph-moore-retires-clinical-practice #MyDukeCancerStory: I’m Glad You Asked… http://dukecancerinstitute.org/your-gifts-at-work/mydukecancerstory-im-glad-you-asked Fri, 07/19/2019 - 09:20 Julie Poucher Harbin /donors/your-gifts-at-work/mydukecancerstory-im-glad-you-asked #MyDukeCancerStory: I’m Glad You Asked… http://dukecancerinstitute.org/your-gifts-at-work/mydukecancerstory-im-glad-you-asked In 1956, long before Patrick Plumeri was born, his grandmother passed away from cancer. By the time she’d been diagnosed, the cancer had spread to other parts of her body. At such a late stage, no one even bothered to ask where it originated. The family, Plumeri said, was resigned to the fact that “she was going to die.” “My father considered it an open and shut case,” said Plumeri, 47, a medical family therapist. “Now, because the treatments have gotten so much better, we can help our patients and their families adjust to living with cancer; it’s not always a matter of life or death. Patients may be functioning at a different level than before cancer, but I’m able to help them with that.” Plumeri is one of six medical family therapists with the Duke Cancer Patient Support Program. They provide individual, couples, and family therapy services at no charge — a cancer center practice, unique to Duke, that dates back more than 30 years. “Once you’ve been diagnosed with cancer, your mortality becomes very real,” said Plumeri. “Those of us who are relatively healthy go on auto-pilot. We get up, we brush our teeth, we leave the house. But when faced with your own mortality, you may question what you’re doing and whether it gives your life meaning and presence: What do I want out of my life? Why am I alive?” He guides patients and their loved ones as they explore these big life questions and helps them manage, from a practical and emotional standpoint, the daily stresses of the disease. Plumeri is always on the move — keeping daytime office hours at Duke Cancer Center locations in Raleigh, Cary and Durham, and facilitating four monthly cancer support groups: two separate mixed-disease groups for patients and caregivers; a prostate cancer group; and, with child-life specialist Hannah Sasser, the KidsCan! Wake County family support group. When cancer throws a family off kilter, Plumeri helps them adapt to their new normal. Plumeri started his counseling career helping families cope with mental illness and substance abuse. While he had no experience in oncology, he knew how to help families manage stress. “Whether the threat to family stability is drugs, schizophrenia or cancer, in any case, it’s still a threat to the family,” explained Plumeri. “Helping families adapt to these challenges is really the reward for me.” Patrick Plumeri, MS, LMFT, answers patient questions at Duke Cancer Center Raleigh's Supportive Care &amp Survivorship Day. This June, he was featured on a Survivorship Day panel discussion in which he answered questions from patients and their loved ones. “Sometimes I feel pressure from family about medical treatments, what should I do?” one patient asked the panel. “Any serious illness, not only cancer, has a way of impacting everyone in the family, whether you live together or you don’t,” answered Plumeri. “The important thing to remember is that everybody is on the same team — that they want the best health possible for the patient. It’s important to keep those lines of communication open.” Another patient queried: “I’ve been given 18 months to live. How do I prepare for what comes next?” “It’s a horrible reminder of change, but it does give us a chance to talk about what might happen tomorrow, next week, next year or next decade,” he said. “How do we plan for that? Plan for the worst, but hope for the best. And hopefully do so in a way that’s not threatening or frightening for everyone involved.” One of Plumeri’s “best memories” is having counseled a cancer patient for a brief period during which the patient was preparing to transition from the hospital to hospice. His sister and his girlfriend disagreed with each other about his care plan. The patient didn’t wish to choose sides, Plumeri said, and was “tormented.” “I had the privilege of helping him find his voice; helping him figure out what he needed, and how to express that to his loved ones, while still embracing them both,” said Plumeri. “It was my goal to help him be at peace. They reconciled enough for him to achieve that… It was a really good ending to a really sad story.” Being so close to specter of death for more than a decade hasn’t worn Plumeri down. “I’m not a robot. It can be sad sometimes,” Plumeri admits, quickly adding that “my joy in helping people compensates for any sadness I might have.” Still, knowing that “tomorrow isn’t promised to anyone,” he hugs his wife and two kids tight every night, grateful for what he has today. “I wish we could see every family that comes through our doors,” he said. “I personally can't cure cancer, but what I can do is provide support that can be life-changing to a lot of patients and families going through this.” Fri, 07/19/2019 - 09:20 Julie Poucher Harbin /donors/your-gifts-at-work/mydukecancerstory-im-glad-you-asked #MyDukeCancerStory: On Teardrop Time http://dukecancerinstitute.org/your-gifts-at-work/mydukecancerstory-teardrop-time After six weeks, she finally got on her local doctor’s schedule. He said the mole didn’t look “really bad,” but that it needed to be removed immediately and sent to the lab. “I ended up going home with 10 stitches,” remembers Karin. “I joke that they used a melon baller to dig it out.” Three weeks later the results came in — melanoma stage 1 b. “I knew stage 1 is a good thing and that the margins were clear, and there was no further treatment needed, so I didn't totally freak out, but I just had a nagging gut feeling that something wasn't right,” she says. At David’s next oncology appointment with David Mack, MD, in Henderson, Karin asked the nurse in his office, whom she’d befriended, to give her scar a second look, just to be safe. The nurse, warning that a neighbor had died of melanoma, also had Mack check it out. “Dr. Mack said, “Oh, no, that scar isn’t near big enough; there needs to be a bigger margin and your doctor should have also checked some of your lymph nodes,”” recalls Karin. “He told me melanoma goes deep so it’s kind of a silent killer. My head was spinning, everything was going so fast. I hadn’t felt any pain and had no other signs.” Melanoma skin cancer cases represent only about one percent of all skin cancers, but they cause a large majority of skin cancer deaths. While 10 % of all people with melanoma have a family history of the disease, a well-known risk factor for melanoma is too much exposure to ultraviolet rays from the sun, tanning beds and sun lamps. Those with light colored hair, blue or green eyes, multiple moles, and/or fair skin that freckles or burns easily are at increased risk. Age adds to the risk. Karin has reddish-blond hair and a fair complexion. She’s covered in freckles and has quite a few moles. “She’s moley,” David affectionately ribs her. Though she loves the outdoors, Karin’s not what she’d call a sun worshipper. She applies plenty of sunscreen and wears hats. Growing up in the Finger Lakes area of New York State, however, she wasn’t so careful. “We used to put nickels, pennies, quarters on our arms, then lay out in the sun, then remove them later to see how much of a tan or burn we got…The things we do when we’re younger,”  says Karin, shaking her head. Tue, 05/21/2019 - 16:52 Julie Poucher Harbin /donors/your-gifts-at-work/mydukecancerstory-teardrop-time #MyDukeCancerStory: On Teardrop Time http://dukecancerinstitute.org/your-gifts-at-work/mydukecancerstory-teardrop-time Tue, 05/21/2019 - 16:52 Julie Poucher Harbin /donors/your-gifts-at-work/mydukecancerstory-teardrop-time #MyDukeCancerStory: On Teardrop Time http://dukecancerinstitute.org/your-gifts-at-work/mydukecancerstory-teardrop-time Georgia Beasley, MD, with grateful patient Karin Driver. Karin counts herself fortunate to have been referred to Duke melanoma specialist, surgical oncologist Georgia Beasley, MD, MHS, before her cancer spread. “Dr. Mack said, “She’s excellent, knows what she’s doing and is an expert in her field, and I feel very confident in sending you to her,” recalls Karin, grateful of the referral from David’s oncologist. On February 19 of this year, Beasley removed more tissue from the scar area  as well as four suspicious looking lymph nodes from under her arms. “Everything came back clear,” says Karin. “Dr. Beasley was thrilled to death. We were relieved and really thankful. I've got to stay strong because David is more important at this point.” David, unfortunately, didn’t see a doctor for his cancer until very late, she explains, turning to David. “He was a typical man,” she says. “Doctors are for wimps,” says David, who worked as a mechanical designer for Teleflex Marine, then as a teak installer for Chris-Craft Boats in Florida before retiring in 2003. “I never went to the doctor. I’ve been really healthy most of my life. I’ve never had to deal with doctors much until lately.” He’d ignored abnormal bleeding for more than a year, believing that he’d developed kidney stones. He waited for them to pass. One morning, Karin says, she found him laying across a footstool to get comfortable. She forced him to see a doctor. “I wasn’t happy about it,” grins David. Nine years later, David’s prostate cancer is now in the lymph nodes under his arm and in his groin and he has some suspicious looking spots in his lungs. Duke Cancer Institute medical oncologist Tian Zhang, MD, who’s consulted on David’s case, said for the moment he’s responding to a new targeted therapy regimen prescribed by Mack. “We’re just waiting and praying,” says Karin. “It’s been really hard to absorb everything, for me anyway. We thank God that, you know, he's still here.” Tue, 05/21/2019 - 16:52 Julie Poucher Harbin /donors/your-gifts-at-work/mydukecancerstory-teardrop-time #MyDukeCancerStory: On Teardrop Time http://dukecancerinstitute.org/your-gifts-at-work/mydukecancerstory-teardrop-time Tue, 05/21/2019 - 16:52 Julie Poucher Harbin /donors/your-gifts-at-work/mydukecancerstory-teardrop-time #MyDukeCancerStory: On Teardrop Time http://dukecancerinstitute.org/your-gifts-at-work/mydukecancerstory-teardrop-time In 2011 Karin enrolled in community college. At well past 50 years-old, and in a wheelchair following several knee and ankle surgeries, her husband David pushed her around campus. She graduated, with honors, with an associate’s degree in office administration/legal. Now David’s leaning on her. Karin and David say they’re beyond grateful to still be able to enjoy camping weekends with their friends. Karin sometimes brings her knitting, crocheting and sewing projects along and David “plays at his guitar” when he can. Two years ago, a fellow Tear Jerker offered to gut the moldy insides of their Yellowstone camper, completely refurbish it, and make it more accessible to get in and out of as David doesn’t have the range of mobility he used to. Donations from other camping friends poured in for the rebuild that would also accommodate Dave’s mobility limitations.  When it was complete the “sponsors” etched their names on the inside of one of the cabinets. The Drivers were touched. Over the years they’ve learned to lean on family, friends, neighbors, and their pastor for emotional and sometimes logistical help and have recently taken advantage of the patient and caregiver support services at Duke Cancer Institute. “At Duke, they want you to have the fullest life that you can possibly have, in spite of this curve that you've been thrown,” says Karin. “I'm tough, I'm determined.....  and I'm thankful to be alive!” “Life moves a little slower on teardrop time,” is the national motto for the Tear Jerkers. If only time, the Drivers wish, could stand still. CIRCLE PHOTO (TOP): Karin Driver (second from right) with her supportive camping friends. Tue, 05/21/2019 - 16:52 Julie Poucher Harbin /donors/your-gifts-at-work/mydukecancerstory-teardrop-time