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		<title>The cancer doctor who braved Harvey to reach his patient</title>

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		<div class="category-title-wrapper"><a class="category-title article-vertical" href="https://www.statnews.com/category/health/" rel="category tag">Health</a></div><span class="post-title"><h1 class="post-title-heading">&#8216;I needed to be next to my patient&#8217;: The cancer doctor who braved Harvey to reach his hospital</h1></span>	</div>
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		<p class="author"><em>By</em> <span class="author-name author-main">Max Blau</span> </p><p class="date slashit">August 31, 2017</p>	</div>
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			<article id="post-276203" class="content-article post-276203 post type-post status-publish format-standard has-post-thumbnail hentry category-health tag-cancer tag-hospitals tag-patients">
				<p class="big-cap-wrap"><span class="big-cap">T</span></p>
<p>iming was everything for this cancer patient. Scientists had already harvested billions of cells in a cutting-edge lab for months. The doctors had performed a handful of rounds of chemotherapy to weaken the tumor. Now came the most crucial part: infusing those cultivated cells back into the patient. If the experimental treatment worked, Dr. Adi Diab felt the patient might have a shot at beating late-stage melanoma.</p>
<p>The Houston oncologist had his patient travel over 100 miles from Louisiana to be admitted at <a href="https://www.statnews.com/2017/08/29/md-anderson-harvey-flood/" rel="noopener">MD Anderson Cancer Center</a> in advance of the infusion. In the midst of chemotherapy, the storm that would become Harvey slowly spun west through the Caribbean Sea, picked up speed, and crashed into the Texas coast as a Category 4 hurricane with winds up to 130 miles an hour. Harvey made landfall Friday night — just days before the high-stakes procedure had to occur.</p>
<p>Over the weekend, as Harvey dumped feet of torrential rain on Houston, a team of providers at MD Anderson debated whether they’d need to postpone the procedure scheduled for Monday. But not moving ahead would essentially mean starting over. So the team made the call Sunday to find a way to get to MD Anderson the following morning. They did so as flooding turned deadly elsewhere in the city, and despite the fact that parts of the <a href="https://www.statnews.com/2017/08/29/md-anderson-harvey-flood/">medical center had flooded</a>.</p>
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					<a href="https://www.statnews.com/2017/08/30/houston-area-hospitals-evacuations/">
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		</aside><p>“We always promise our patients one thing: They’ll never walk alone,” Diab, an oncologist who specializes in melanoma treatment, told STAT. “I didn’t know how long it would take. I had to go. I needed to be next to my patient.”</p>
<figure id="attachment_148827" class="media media-align-center media-third"><img class="media-content size-full wp-image-148827" src="https://www.statnews.com/wp-content/uploads/2016/09/SECTION-BREAK_black.png" alt="" width="205" height="9" data-id="148827"></figure><p>Diab was one of six providers — three lab techs, two doctors, and a nurse — who worked with this melanoma patient. On Monday morning, as Brays Bayou poured out into Houston’s streets, Diab walked roughly three miles, wading through stretches of shin-deep waters, from his home toward his office.</p>
<p>His patient, who has stage 4 melanoma, is one of about 50 adults enrolled in a Phase 2 <a href="https://clinicaltrials.gov/ct2/show/NCT02500576" target="_blank">clinical trial</a> studying a form of adoptive T cell therapy. Tumors typically prevent the immune system’s T cells from tracking down and destroying cancer cells. But Diab said this experimental immunotherapy works by “harvesting” the tumor for any potential T cells. “We like those T cells,” he explained. “They’re in the cancer for a reason, but weren’t able to completely kill the tumor.”</p>
<figure id="attachment_276309" class="media media-align-right media-third"><img class="media-content size-medium wp-image-276309" src="https://www.statnews.com/wp-content/uploads/2017/08/DrDiab-328x492.jpg" alt="Dr. Adi Diab" width="328" height="492" data-id="276309" srcset="https://www.statnews.com/wp-content/uploads/2017/08/DrDiab-328x492.jpg 328w, https://www.statnews.com/wp-content/uploads/2017/08/DrDiab-768x1152.jpg 768w, https://www.statnews.com/wp-content/uploads/2017/08/DrDiab-1024x1536.jpg 1024w, https://www.statnews.com/wp-content/uploads/2017/08/DrDiab-500x750.jpg 500w, https://www.statnews.com/wp-content/uploads/2017/08/DrDiab-640x960.jpg 640w, https://www.statnews.com/wp-content/uploads/2017/08/DrDiab-384x576.jpg 384w, https://www.statnews.com/wp-content/uploads/2017/08/DrDiab.jpg 1200w" sizes="(max-width: 328px) 100vw, 328px"><figcaption class="media-label"><span class="media-caption">Dr. Adi Diab</span> <cite class="media-credit">MD Anderson Cancer Center</cite></figcaption></figure><p>By the time he arrived at MD Anderson around 10 a.m., Marie-Andrée Forget, a senior research scientist, was already in the <a href="https://www.mdanderson.org/research/departments-labs-institutes/labs/til-laboratory/research.html" target="_blank">laboratory</a> preparing the harvested T cells for the infusion. Her trek had been less perilous — but she’d left behind a water stain in her ceiling that had grown about 2 feet wide. She didn’t know if she’d return to a flooded apartment.</p>
<p>But being there early was important: She had to test 14.5 billion T cells harvested from the patient to make sure it was safe to proceed with the infusion.</p>
<p>“All weekend I’d been super nervous,” Forget said. “It was not because of Harvey, or the water stain getting bigger, but the life of the patient. The minute I started processing cells, I was not nervous anymore.”</p>
<p>Two months earlier, scientists in Forget’s lab took a tumor removed from the patient and cut it into small fragments, placing them onto culture plates. Over the course of several weeks, the T cells grew by the millions until the point where scientist froze the plates until the patient could come in. Two weeks before the infusion, Forget’s team transferred the samples into five 1-liter flasks that sat at room temperature to allow the T cells to keep growing. Finally, on the morning of the infusion, the cells were run through a centrifuge, washed clean of culture media, and tested to make sure they were sterile.</p>
<p>“Our therapy is like the army,” Forget said. “The [T cells] were outnumbered. In the lab, they go through boot camp, so when we re-inject them into the patient, they [become] soldiers ready to attack the tumor.”</p>
<figure id="attachment_148827" class="media media-align-center media-third"><img class="media-content size-full wp-image-148827" src="https://www.statnews.com/wp-content/uploads/2016/09/SECTION-BREAK_black.png" alt="" width="205" height="9" data-id="148827"></figure><p>With Diab and other team members in place on Monday, Forget concentrated the cells into a single infusion bag — a process that took most of the day to finish. The bag was then transported from the lab to the procedure room. Around 5 p.m., the infusion got underway.</p>
<p>One of Dr. Diab’s fellow doctors, who was already on call, ended up handling the infusion. The process works similarly to a blood transfusion, except slower. It usually takes no more than an hour to complete — medical personnel move slowly to monitor vitals and reduce the chances of side effects including fever, chills, or low blood pressure. As the patient receives the harvested T cells, the team also administers a dose of Interleukin-2, a group of proteins designed to boost the immune system during cancer treatment. The goal of it all is simple: give T cells a better shot at defeating cancer.</p>
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		</aside><p>Diab stuck around to make sure his patient felt all right. The patient did, despite all the uncertainty in Houston and back at home in Louisiana, where his family faced an incoming storm.</p>
<p>“The patient was grateful,” Forget said. “It was emotional for us.”</p>
<p>Days after the procedure, Diab said his patient ultimately tolerated the treatment well. For the next portion of the clinical trial, the patient will likely undergo a therapy regimen that includes more doses of Interleukin-2 followed by the drug Keytruda, which enables the immune system to assault tumor cells.</p>
<p>The patient’s road back to health, like Houston’s after Harvey, remains a long one. But Diab and Forget said their team is willing to keep walking with the patient for however long it takes.</p>
<p>“I know this might sound like a heroic story, but this is a regular story that happens in many different flavors for many patients at many other care providers,” Diab said. “I’m not trying to be humble. [But] I was not the only one.”</p>				<div class="clear"></div>
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												<b class="fn">Tom</b> <span class="says">says:</span>					</div><!-- .comment-author -->

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								September 3, 2017 at 9:28 am							</time>
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					<p>Thank you for sharing such a lovely story. Its things like this that dont get enough press. &#8220;you will never walk alone&#8221; means allot more to me now than any football chant.</p>
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				<div class="reply"><a rel='nofollow' class='comment-reply-link' href='https://www.statnews.com/2017/08/31/cancer-patient-houston-harvey/?replytocom=758881#respond' onclick='return addComment.moveForm( "div-comment-758881", "758881", "respond", "276203" )' aria-label='Reply to Tom'>Reply</a></div>			</article><!-- .comment-body -->
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								September 1, 2017 at 11:52 am							</time>
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					<p>I have been a patient of MD Anderson since 2005. Finest group of health care providers anywhere. Excellent hospital and staff.<br />
My prayers are with all of you at MD Anderson and all of Texas! God Bless!!</p>
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								September 1, 2017 at 12:33 am							</time>
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					<p>I&#8217;m inspired by all of you.  Many thanks.</p>
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					<p>tzadik!</p>
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					<p>Pretty impressive !</p>
<p>My wife is at MSK w/ Brain Cancer in Remission&#8212;1.79% survival rate !</p>
<p>Good Luck and my Prayers  to MDA and their patient !</p>
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					<p>I too would expect nothing less from the Angels that work there. My daughter is battling Leukemia and they have saved her life more than once.<br />
We both cried when we read this, because it is such a wonderful place and you are treated so great there&#8230;&#8230;God Bless all of you.</p>
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					<p>I&#8217;ve Heard Nothing But Good Reports About MD Anderson&#8217;s Doctors &amp; Staff And The Great Care That&#8217;s Given To Patients Coming From Near &amp; Far&#8230;Dr Diab Showed Just What God Wants Us To Do In Such Crisis &#8221; If We Do The Possible He Will Do The Impossible&#8221;.</p>
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					<p>I expect nothing less at MDAnderson. This just exemplifies the attitude of the entire staff.</p>
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TrendMD.register({journal_id: '54188', element: '#trendmd-suggestions', authors: 'Max Blau', url: window.location.href, title: 'u2018I needed to be next to my patient\u2019: The cancer doctor who braved Harvey to reach his hospital', abstract: 'Timing was everything for this cancer patient. Scientists had already harvested billions of cells in a cutting-edge lab for months. The doctors had performed a handful of rounds of chemotherapy to weaken the tumor. Now came the most crucial part: infusing those cultivated cells back into the patient. If the experimental treatment worked, Dr. Adi Diab felt the patient might have a shot at beating late-stage melanoma.\r\n\r\nThe Houston oncologist had his patient travel over 100 miles from Louisiana to be admitted at MD Anderson Cancer Center in advance of the infusion. In the midst of chemotherapy, the storm that would become Harvey slowly spun west through the Caribbean Sea, picked up speed, and crashed into the Texas coast as a Category 4 hurricane with winds up to 130 miles an hour. Harvey made landfall Friday night \u2014 just days before the high-stakes procedure had to occur.\r\n\r\nOver the weekend, as Harvey dumped feet of torrential rain on Houston, a team of providers at MD Anderson debated whether they\u2019d need to postpone the procedure scheduled for Monday. But not moving ahead would essentially mean starting over. So the team made the call Sunday to find a way to get to MD Anderson the following morning. They did so as flooding turned deadly elsewhere in the city, and despite\u00a0the fact that parts of the medical center had flooded.\r\n\r\n[stat_readmore type=\"standard\" post=\"275873\" \/]\r\n\r\n\u201cWe always promise our patients one thing: They\u2019ll never walk alone,\u201d Diab, an oncologist who specializes in melanoma treatment, told STAT. \u201cI didn\u2019t know how long it would take. I had to go. I needed to be next to my patient.\u201d\r\n\r\n[caption id=\"attachment_148827\" align=\"aligncenter\" width=\"205\"] __[\/caption]\r\n\r\nDiab was one of six providers \u2014 three lab techs, two doctors, and a nurse \u2014 who worked with this melanoma patient. On Monday morning, as Brays Bayou poured out into Houston\u2019s streets, Diab walked roughly three miles, wading through stretches of shin-deep waters, from his home toward his office.\r\n\r\nHis patient, who has stage 4 melanoma, is one of about 50 adults enrolled in a Phase 2 clinical trial studying a form of adoptive T cell therapy. Tumors typically prevent the immune system\u2019s T cells from tracking down and destroying cancer cells. But Diab said this experimental immunotherapy works by \u201charvesting\u201d the tumor for any potential T cells. \u201cWe like those T cells,\u201d he explained. \u201cThey\u2019re in the cancer for a reason, but weren\u2019t able to completely kill the tumor.\u201d\r\n\r\n[caption id=\"attachment_276309\" align=\"alignright\" width=\"328\"] Dr. Adi Diab[\/caption]\r\n\r\nBy the time he arrived at MD Anderson around 10 a.m., Marie-Andr\u00e9e Forget, a senior research scientist, was already in the laboratory preparing the harvested T cells for the infusion. Her trek had been less perilous \u2014 but she\u2019d left behind a water stain in her ceiling that had grown about 2 feet wide. She didn\u0027t know if she\u2019d return to a flooded apartment.\r\n\r\nBut being there early was important: She had to test 14.5 billion T cells harvested from the patient to make sure it was safe to proceed with the infusion.\r\n\r\n\u201cAll weekend I\u2019d been super nervous,\u201d Forget said. \u201cIt was not because of Harvey, or the water stain getting bigger, but the life of the patient. The minute I started processing cells, I was not nervous anymore.\u201d\r\n\r\nTwo months earlier, scientists in Forget\u2019s lab took a tumor removed from the patient and cut it into small fragments, placing them onto culture plates. Over the course of several weeks, the T cells grew by the millions until the point where scientist froze the plates until the patient could come in. Two weeks before the infusion, Forget\u2019s team transferred the samples into five 1-liter flasks that sat at room temperature to allow the T cells to keep growing. Finally, on the morning of the infusion, the cells were run through a centrifuge, washed clean of culture media, and tested to make sure they were sterile.\r\n\r\n\u201cOur therapy is like the army,\u201d Forget said. \u201cThe [T cells] were outnumbered. In the lab, they go through boot camp, so when we re-inject them into the patient, they [become] soldiers ready to attack the tumor.\u201d\r\n\r\n[caption id=\"attachment_148827\" align=\"aligncenter\" width=\"205\"] __[\/caption]\r\n\r\nWith Diab and other team members in place on Monday, Forget concentrated the cells into a single infusion bag \u2014 a process that took most of the day to finish. The bag was then transported from the lab to the procedure room. Around 5 p.m., the infusion got underway.\r\n\r\nOne of Dr. Diab\u2019s fellow doctors, who was already on call, ended up handling the infusion. The process works\u00a0similarly to a blood transfusion, except slower. It usually takes\u00a0no more than an hour to complete \u2014 medical personnel move slowly to monitor vitals and reduce the chances of side effects including fever, chills, or low blood pressure. As the patient receives the harvested T cells, the team also administers a dose of Interleukin-2, a group of proteins designed to boost the immune system during cancer treatment. The goal of it all is simple: give T cells a better shot at defeating cancer.\r\n\r\n[stat_readmore type=\"standard\" post=\"275317\" \/]\r\n\r\nDiab stuck around to make sure his patient felt all right. The patient did, despite all the uncertainty in Houston and back at home in Louisiana, where his family faced an incoming storm.\r\n\r\n\"The patient was grateful,\" Forget said. \"It was emotional for us.\"\r\n\r\nDays after the procedure, Diab said his patient ultimately tolerated the treatment well. For the next portion of the clinical trial, the patient will likely undergo a therapy regimen that includes more doses of Interleukin-2 followed by the drug Keytruda, which enables the immune system to assault tumor cells.\r\n\r\nThe patient\u2019s road back to health, like Houston\u2019s after Harvey, remains a long one. But Diab and Forget said their team is willing to keep walking with the patient for however long it takes.\r\n\r\n\u201cI know this might sound like a heroic story, but this is a regular story that happens in many different flavors for many patients at many other care providers,\u201d Diab said. \u201cI\u2019m not trying to be humble. [But] I was not the only one.\u201d', publication_year: '2017', publication_month: '8' });
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