LOS ANGELES, March 27, 2013 — Dr. Robert Nagourney, M.D. is author of Outliving Cancer and an oncologist with a unique approach. In 1993, he founded Rational Therapeutics, and pioneered personal cancer therapy using “functional profiling.”
Dr. Nagourney currently heads Rational Therapeutics and continues his treatment of individuals with cancer. He is also an instructor of Pharmacology at the University of California, Irvine School of Medicine. He is board-certified in Internal Medicine, Medical Oncology and Hematology.
According to Dr. Nagourney, two fundamental breakthroughs underlie the success of his approach. The first was the recognition that cancer reflected a deregulation of cell survival, not cell proliferation. The second reflected an understanding of cancer biology as cancer ecology. Researchers must study cancer cells in their native state, not propagated, sub-cultured nor removed from their stroma, inflammatory and vascular environment.
In part one of his interview with the Communities, Dr. Nagourney spoke about his roots as an oncologist.
KW: What made you want to become a doctor and go into oncology?
Dr. Robert Nagourney: Well, actually I got interested in medicine because my family had been in medicine, my grandfather, my uncle. So from my earliest childhood memories, I had wanted to be doctor. My interest in cancer came quite a bit later.
In fact, I was originally not very interested in cancer, but found myself, as a medical student, working in an oncology laboratory. They were doing basic developmental pharmacology and I got involved. The next thing I knew, we published some papers together and I was launched.
KW: How long did it take you to realize that you wanted or needed to find a different way to treat your patients?
RN: Well, as I left my residency and came to Washington D.C. to do my fellowship, which is the specialty training in cancer, I brought with me a kind of sense of accomplishment and a belief that I could eradicate illness and be quite effective as a doctor. I found that my patients were dying and suffering and I wasn’t having very much impact on them. I would say within the first six months of my fellowship, particularly focused on cancer medicine, I had a real hard time continuing because I just couldn’t comfortably continue giving patients such toxic treatments without seeing more benefits.
KW: How did you go about finding a new approach to treating cancer patients?
RN: When I first came to California as a resident, I was very interested in basic research. As I mentioned, as a medical student I had done basic research, I had published in the peer review literature. So I had a sense that I was kind of an up and coming investigator. When I arrived in California at the University of California [Irvine], there was a new faculty member and he and I became kind of friendly.
He was reading much of the same literature that I was reading, in terms of, “how do we a better job with cancer medicine?” He was working on lab tests that would identify good drugs and distinguish them from bad drugs in the test tube as opposed to in the patient, which is the way it was done. In my last year of residency, I took an elective in his laboratory. I learned the techniques he was working on; how to tissue culture and how to study these cells.
When I left California and moved to my fellowship, I brought some of that with me. I took some of that technical expertise and experience with me to my fellowship and by the end of my first year of fellowship, my clinical year of fellowship, I was allowed to start a basic research plan. I applied that technique and those methods in my new Washington D.C. home.
KW: When did you realize that it was important for you to write this book?
RN: The book itself is a narrative about my particular way of thinking and the scientific principles that have guided me toward my current treatments. I use individual patients as a lens on human biology. The questions I pose in the book are, what is cancer? And how does it come about? And, I guess more importantly, how do we treat it?
The book was a vehicle for me to get people to understand the principles of this work, to see real life experiences of patient outcomes and then to use these individual patient experiences as a view into the biological principles. Target therapy, the program of cell death, immune responses, or the process of oncogenesis, all of these principles, even dietary and metabolic issues, are all part of the book because, to me, it’s a very interesting story using cancer as a window on human biology.
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