Online Learning Center

My Personal Journey With Cutaneous Lymphoma

Dr. Francine Foss, MD

Yale Cancer Center

Article previously published in the Cutaneous Lymphoma Foundation's Forum Fall 2011 newsletter.

Physicians never stop learning, particularly those of us committed to research as well as patient care. Lifelong discovery is part of what attracted me to medicine, and the advances continue to be very exciting in my specialty – treating lymphomas.

I’ve always been interested in the blood and white blood cells, and was most excited during my internship and residency at Brigham and Women’s Hospital in Boston. While caring for leukemia and lymphoma patients, I was looking down the microscope at bone marrows and blood smears with one of the great hematologists, Dr. William Maloney. I decided to do my oncology fellowship at the National Cancer Institute (NCI) in 1985. The timing proved to be ideal.

A lot of groundbreaking lab work was being done there then and I worked with oncology pioneers such as Dr. Vincent DeVita, who was director, Dr. Paul Bunn and Dr. Edward Sausville. I took over the T-cell lymphoma program, which involved large clinical trials and research into the origins of cutaneous T-cell lymphoma (CTCL).

The disease was not new to me when I joined the NCI, as I lived through the diagnosis and treatment of Sézary syndrome when my best friend’s father developed it while we were in high school. He was cured after many trips to the hospital for chemotherapy and radiation therapy, but at the NCI I saw many patients who weren’t. I recognized the need to pursue new, more effective treatments.

Promising Breakthroughs
Lymphoma is one area in cancer where there has been an explosion of new therapies. We’ve learned a lot about the biology of these diseases, which has led to treatment breakthroughs. With these new treatments, CTCL is treatable and potentially even curable. Many of our patients become long-term survivors.

Over the last 12 years, we’ve seen the emergence of targeted treatments for CTCL as an alternative to chemotherapy. Intravenous infusions such as ONTAK and oral therapies such as Targretin can be combined effectively with each other, as well as with ultraviolet and radiation treatments.

More recently, newer classes of drugs such as HDAC inhibitors have been tremendously valuable for patients. These medications relieve the intense itching many patients with CTCL experience. Patients live longer with a diagnosis that should not be seen as life threatening, a message I share through the Cutaneous Lymphoma Foundation as a medical advisor and seminar speaker.

I’m privileged to be able to practice in an academic center where I can train younger physicians entering this field, as well as interns and residents in primary care so that they can recognize the disease.

It’s especially exciting and rewarding to work in a specialty where I can maintain long-term relationships with large numbers of patients and hear about so many life events – graduations, major trips, weddings, grandchildren, retirement.

Foundation’s Alliance With Doctors
That shared experience is invaluable, and I’ve learned so much from my patients. They really are quite inspiring, as was an outpouring of support from patients when I was ill some years ago. It was an amazing experience.

It’s similarly gratifying to work closely over the years with the Cutaneous Lymphoma Foundation. I became involved in the late 1990s, when Judy Jones, founder and president emeritus, reached out at the beginning to engage oncologists, hematologists, dermatologists and other physicians in a strategic alliance.

From its start, the Foundation has helped to bridge a CTCL information gap. It educates patients and families, as well as community dermatologists and oncologists unfamiliar with the condition. It’s a valuable resource for authoritative background and supportive exchanges through seminars, teleconferences or the CTCL-MF Listserv that it promotes.

This past September, I spoke about maintenance therapies and current clinical trials at the Foundation’s Patient Educational Forum in Kansas City. The people I met and their uplifting spirits reinforce my commitment to continuing the great strides we’ve made.

The vision that motivated me in medical school and at the NCI – to develop new therapies for lymphomas – is upheld by the Cutaneous Lymphoma Foundation as it helps patients and providers work together toward that shared goal.

Dr. Francine Foss, a member of the Foundation’s Medical Advisory Board, is an internationally recognized clinical researcher at the Yale Cancer Center and a professor of hematology at Yale University School of Medicine.

Dr. Francine Foss, MD

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