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F a l l / W i n t e r 2 0 1 0
Research and Care at Dana-Farber Cancer Institute
Introducing
The New Face
of Cancer Care
Yawkey Center guided by patients and families • Links research, innovative care

Dana-Farber Cancer Institute ...
“Dedicated to discovery ... committed to care” is the
mission of Dana-Farber Cancer Institute (DFCI), described
as one of the world’s premier cancer centers by the National
Cancer Institute. Founded in 1947 by Sidney Farber, MD,
Dana-Farber is renowned for its unique blend of basic and
clinical research and for using its discoveries to improve the
treatment of adults and children with cancer and related
diseases. It is a founding member of the Dana-Farber/
Harvard Cancer Center – one of 40 nationally designated
Comprehensive Cancer Centers. A teaching affiliate of
Harvard Medical School, Dana-Farber is also one of 20
federal Centers for AIDS Research in the United States,
and is consistently ranked one of the top cancer centers in
the country by U.S.News & World Report. In addition, it has
earned “Magnet” status for excellence in nursing.
Dana-Farber partners with Brigham and Women’s Hospital
to deliver care for adults with cancer through Dana-Farber/
Brigham and Women’s Cancer Center. It also has a longstanding
alliance with Children’s Hospital Boston to care
for pediatric cancer patients through Dana-Farber/Children’s
Hospital Cancer Center. By bringing together the strengths of
three world-class institutions, these partnerships provide an
exceptional level of care for cancer patients and their families.
... and the Jimmy Fund
The Jimmy Fund supports the fight against cancer at
Dana-Farber, helping to raise both funds and the chances
of survival for children and adults around the world. Named
to protect the anonymity of one of Dr. Sidney Farber’s
young patients, the Jimmy Fund was established in 1948
by the Variety Children’s Charity of New England in
con junction with the Boston Braves baseball team. Later
adopted as the official cause of the Boston Red Sox, the
Massachusetts Chiefs of Police Association, and the annual
Pan-Massachusetts Challenge bike-a-thon, the Jimmy Fund
is widely regarded as “New England’s favorite charity.”
Individual and corporate gifts, many of them collected
through numerous annual Jimmy Fund events, have helped
the organization g enerate hundreds of millions of dollars for
cancer research and care at Dana-Farber over the decades.
Fall/Winter 2010
Volume 19, Number 2
President and CEO, Dana-Farber Cancer Institute Edward J. Benz Jr., MD
Executive VP and Chief Financial Officer Dorothy E. Puhy, MBA
Executive VP and Chief Operating Officer Janet E. Porter, PhD
Chair, Psychosocial Oncology and Palliative Care Susan D. Block, MD
Chair, Medical Oncology James D. Griffin, MD
Chair, Radiation Oncology Jay R. Harris, MD
Chair, Executive Committee for Research David M. Livingston, MD
Chair, Pediatric Oncology Stuart H. Orkin, MD
Senior VP for Finance Karen S. Bird, MPH
Senior VP, General Counsel, and Chief Governance Officer Richard S. Boskey, Esq.
Senior VP for Research Beverly Ginsburg Cooper, MBA
Senior VP for Experimental Medicine Lee M. Nadler, MD
Senior VP for Development and The Jimmy Fund Susan S. Paresky, MBA
Senior VP for Patient Care Services, Chief Nurse Patricia Reid Ponte, RN, DNSc, FAAN
Senior VP for Communications Steven R. Singer, MPA
(Interim) Senior VP for Human Resources Deloris Tuggle
Chief Clinical Research Officer Philip W. Kantoff, MD
Chief Scientific Officer Barrett J. Rollins, MD, PhD
Chief of Staff Stephen E. Sallan, MD
Chief Medical Officer and Senior VP of Medical Affairs Lawrence N. Shulman, MD
Chief of Radiology Annick D. Van den Abbeele, MD
Director of Editorial and Creative Services Michael Buller
Editor Saul Wisnia
Design John DiGianni
Associate Editor Robert Levy
Managing Editor Eric Schuller
Contributors Christine Cleary, Cindy Hutter, Kara Lacey, Debra Bradley Ruder,
Richard Saltus, Kristie Velarde
Production Assistance Jacqueline Czel, Kimberly Regensburg, Mallory Spector, Lee Whale
Photography John Deputy, Getty Images, Justin Knight, Sam Ogden, Eric Schuller
Paths of Progress is published twice a year by Dana-Farber Cancer Institute. If you have
any comments or would like to be removed from the mailing list, please contact:
Saul Wisnia, Editor, Paths of Progress
Dana-Farber Cancer Institute, Department of Communications
44 Binney Street, OS301
Boston, MA 02115-6084
617-632-4090
saul_wisnia@dfci.harvard.edu
Copyright © 2010 Dana-Farber Cancer Institute. All rights reserved.

CONTENTS
Departments
3 Around the Institute
The search for a universal flu vaccine, seeking cancer’s
“on-off ” switch, a historic campaign comes to a close,
and other news from Dana-Farber
8 Bench to Bedside
Charles Stiles, PhD, and Mark Kieran, MD, PhD, seek
new therapies for a rare childhood brain tumor
10 Tech Preview: Cutting-Edge Microscopes
Peering deep into cancer cells at the Confocal and Light
Microscopy Core Facility
11 Six Questions for ... Deborah Toffler
The head of patient-family services on the Shapiro
Center – a new hub of information at Dana-Farber
31 Legislative Update
A closer look at health care reform and cancer care
Features
12 Building a Place of Healing
Guidance from patients and family members has put the
focus on healing and wellness in the new Yawkey Center
18 Every Beam Tells the Yawkey Center Story
A look back in photos at the Yawkey Center’s growth
since its groundbreaking in June 2007
20 Bridges, Teams, and Dreams
The link between compassionate care and cutting-edge
research at Dana-Farber has never been stronger
26 Genetic Tests, Demystified
A program tailored to one’s genetic profile may help
prevent disease before it materializes
Above photo: Messages and signatures from
Dana-Farber patients, families, and staff grace
one of the structural beams that became part
of the Yawkey Center for Cancer Care.
32 Why I Work Here
Patricia Reid Ponte, RN, DNSc, following in her mother’s
footsteps, touches on teamwork and patient care
33 What I Know
Kathleen Bousquet, grandmother and ovarian cancer
survivor, relates her life lessons

From the President
Dear Readers,
In just a few months, Dana-Farber will open the
14-story Yawkey Center for Cancer Care, the first facility
constructed specifically for clinical use at the Institute
since 1975. It is a structure destined to become the face
of our cancer care, in both a literal and figurative sense.
The building will present a new face to the public,
a handsome glass and terra cotta façade on Brookline
Avenue to replace the current entryway tucked away on
Binney Street. It will also, in many ways, change the
treatment experience for patients and their families. It
will offer an array of amenities with their convenience
in mind, including the ability to more easily check in,
meet with care providers, and receive care; a new patient
and family resource center; an expanded outpatient
pharmacy; a spacious, sunny dining pavilion; centralized
clinical laboratory services; expanded parking areas, and, in the middle of all this activity, a
peaceful oasis – a healing garden.
As one might expect in a new clinical facility, the Yawkey Center’s technology for
diagnosing and treating cancer and related diseases will be state-of-the-art. What makes
it a uniquely Dana-Farber building, however, is the guidance from patients and their
families during its conception and design. As you’ll read in this issue of Paths of Progress,
these key constituents have been involved in literally every aspect of the building – from
the size and shape of exam rooms, to the layout of individual floors, to the artwork on the
walls. The result is a building that advances our model of compassionate care in a setting
of patient safety and respect.
The other element that carries Dana-Farber’s signature is the Yawkey Center’s adjacency
to our research and laboratory facilities. This proximity expresses, in a physical, functional
way, the Institute’s goal of bringing the benefits of scientific research to patients’ bedsides.
I hope you’ll enjoy reading about the Yawkey Center and the other topics covered in this
issue. Together, they offer a panorama of the Institute as it approaches a major milestone in
its clinical history.
Edward J. Benz Jr., MD
President, Dana-Farber Cancer Institute
2 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

Around the Institute
Mapping Mutations
That Matter Most
New Approaches to a Universal Flu Vaccine
A group of researchers at Dana-Farber has been awarded a $6.5 million,
five-year grant from the National Institute of Allergy and Infectious Diseases
(NIAID) to focus on developing a universal vaccine against human influenza
A viruses. The effort is part of a six-center national consortium to study the
workings of the human immune system.
“This grant will enable us to investigate a new approach in an effort to
develop a T-cell-based vaccine against human influenza A viruses,” says
Ellis L. Reinherz, MD, (at left, above) faculty director of the Cancer Vaccine
Center at Dana-Farber and the principal investigator for the NIAID grant.
“Our ultimate goal is a vaccine that targets the conserved viral segments that
cannot vary from one viral strain to another, thereby providing protection
against all seasonal and pandemic flus. Such an advance would eliminate the
need to alter the vaccine when there is a new global threat, as is necessary for
current antibody-inducing approaches.”
Examples of influenza A viruses include the bird flu virus (H5N1), some
seasonal flu viruses, and certain pandemic viruses, such as the 1918 flu that
killed millions of people worldwide.
The grant is part of NIAID’s nationwide research initiative to define
how the human immune system responds to infection or vaccination.
Dana-Farber is one of six Human Immune Phenotyping Centers in the
nation that will receive $100 million collectively over five years to conduct
this research.
The other centers are Baylor Research Institute, Dallas; Emory University,
Atlanta; Mayo Clinic, Rochester, Minn.; Stanford University, Calif.; and Yale
University, New Haven, Conn.
Among the many gene mutations
in cancer cells are the kingpins – the
mutations that a tumor cell literally
can’t live without. To ensure that
these likeliest of suspects receive
scientific attention, a team of
researchers at Dana-Farber and the
Broad Institute of MIT and Harvard
are working to identify critical mutations
in cancers. Dubbed Project
Achilles, their effort seeks to provide
scientists with a guide to cancer’s
essential weaknesses.
“I like to compare our knowledge
of the cancer genome with people’s
picture of the world before we had
satellite-assisted navigation,” says
project leader, William Hahn, MD,
PhD, director of the Center for
Cancer Genome Discovery at
Dana-Farber. “Without good maps,
explorers were always at risk of getting
lost. In cancer, we need to know
where the landmarks are.”
In the project’s first phase, completed
last year, the team screened
25 cell colonies – each representing
a different cancer – for mutations in
about 1,000 genes. That small effort
netted a half-dozen mutated genes
never before identified as cancercausers.
For phase two, researchers
have widened their range to cover all
22,000 genes in human cells, aiming
to screen 300 cancers in two years.
“Our goal is to create a data set
that will be available to researchers
all around the world,” Hahn says. “It
will give scientists the opportunity
to devote their time and resources to
the genes that are the most important
in cancer – and that may hold the
most promise as targets of therapy.”
Fall/Winter 2010 P a t h s o f P r o g r e s s 3

Around the Institute
Historic Campaign Comes to a Close
Dana-Farber recently marked the conclusion of the largest capital campaign
in its history. Mission Possible: The Dana-Farber Campaign to Conquer
Cancer raised $1.18 billion, making the Institute the first hospital in New
England to set and reach a $1 billion goal.
The campaign reached the $1 billion mark in September 2009, one year
early, and continued raising funds until its scheduled completion date in
September 2010 to further support the Institute’s mission to conquer cancer.
Overall, more than two million gifts were received, including 121 gifts of
$1 million or more, 820 gifts of $100,000.
Gifts made during the campaign have helped establish a number of centers
at Dana-Farber critical to the development of personalized cancer care,
including the Center for Cancer Genome Discovery, Blais Proteomics
Center, Lurie Family Imaging Center, Linde Program in Chemical Biology,
Belfer Institute for Applied Cancer Science, and the Center for Novel
Experimental Therapeutics.
A closer look at a few of the
thousands of words associated
with the complex fields of cancer
medicine and research.
astrocytoma: A brain or spinal
cord tumor that originates in small,
star-shaped brain cells called
astrocytes.
BRCA1: A gene that restrains the
growth of cells, which in turn can
help prevent tumors. A person who
inherits a mutated version of the
BRCA1 gene may have a higher
risk for breast, ovarian, and other
types of cancer.
confocal microscopy: A technique
for obtaining high resolution
images of specimens. Confocal
microscopy’s key benefit is its
ability to produce clear images
of thick specimens by excluding
out-of-focus light.
genetic testing: An examination
of a person’s DNA to look for any
genetic alterations that may indicate
the individual is at increased risk
for developing a certain disease
or condition.
germline DNA: The DNA in germ
cells (egg and sperm cells that join
to form an embryo). Germline
DNA is the source of DNA for all
other cells in the body.
infusion: A method of delivering
medications or other fluids
into the body through a needle or
other device inserted into a vein. In
cancer treatment, infusion is most
commonly used to deliver chemotherapy,
which uses anti-cancer
medications to kill cancer cells and
prevent them from multiplying.
C A N C E R D I C T I O N A R Y
4 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

Voices from Dana-Farber
“For more than 20 years, scientists have been
working on harnessing the immune system to
improve survival. Our study provides proof that
such an approach can work.”
Philip Kantoff, MD,
who is leading the first large, controlled clinical
trial to show that a prostate cancer vaccine can
extend the lives of prostate cancer patients
Around the Institute
“It’s critical that physicians recognize that
cancer survivors can have unique health
challenges and that they may need to interpret
symptoms differently in these patients.”
Lisa Diller, MD,
medical director of the David B. Perini, Jr.
Quality of Life Program at Dana-Farber, noting
the importance of ensuring cancer survivors
get a summary of their treatment and a plan
for follow-up care after cancer
“This study adds to a growing body of research
that questions the purported benefit of multivitamin
use, and it underscores the need to investigate
the use of individual vitamins, such as vitamin D,
which may in fact provide real benefit.”
Charles Fuchs, MD,
discussing a recent Dana-Farber study that found
no benefit or detriment for colon cancer patients
who took multivitamins during and after postsurgical
chemotherapy treatment
“I don’t think there is another institution in the
world more committed to patient- and familycentered
care than Dana-Farber, and the Yawkey
Center planning process was just another example.”
Craig Bunnell, MD, MPH,
highlighting the strong involvement of patients
and family members in designing the new
Yawkey Center for Cancer Care (read more on
this topic starting on page 12)
Three Honored for Scientific Expertise
Three Dana-Farber physicians have this year been honored by
their peers with admission into two prestigious scientific academies.
William Kaelin, MD, was elected into the National Academy
of Sciences, considered one of the highest recognitions that can be
awarded to a U.S. scientist or engineer. Kaelin, who is a member of
the Department of Medical Oncology, was one of 72 new members
and 18 foreign associates from 14 countries elected to the academy for
their distinguished and continuing achievements in original research.
Ronald DePinho, MD, and Harvey Cantor, MD, were selected for
the American Academy of Arts and Sciences, a center for independent
policy research that includes more than 250 Nobel Laureates and more
than 60 Pulitzer Prize winners.
DePinho serves as director of the Belfer Institute for Applied
Cancer Science at Dana-Farber. Cantor is Dana-Farber’s Benacerraf
Professor of Pathology and chair of the Department of Cancer
Immunology and AIDS.
In the News
The Boston Business Journal recognized
Dana-Farber with a “Champions
in Health Care” award for an initiative
designed to improve patient safety and
reduce the risk of medical errors through
better communication between providers.
For the tenth straight year, the Institute
ranks as New England’s top cancer
center in U.S.News & World Report’s
2010-11 “Best Hospitals” guide.
Dana-Farber/Children’s Hospital Cancer
Center is the number one pediatric cancer
program in New England and one of the
best in the country, according to the latest
Best Children’s Hospitals rankings from
U.S.News & World Report.
Fall/Winter 2010 P a t h s o f P r o g r e s s 5

Around the Institute
BY THE
NUMBERS
80 percent – Increase since 2001
in the number of clinical trials open to
patients through Dana-Farber/Harvard
Cancer Center.
447 – Number of faculty members
at Dana-Farber who hold one or more
advanced degrees (an MD, a PhD, or
both an MD and a PhD).
New Strategy to Fight Drug Resistance
A research team led by Loren Walensky, MD, PhD, of Dana-Farber and
Children’s Hospital Boston, has found a way to disable a common protein
that often thwarts chemotherapy treatment of several major forms of cancer.
The discovery, published in the journal Nature Chemical Biology, could lead
to drugs that would target this and similar proteins used by cancer cells to
survive chemotherapy.
The researchers found that they could exploit a small portion of the “antideath”
protein, called MCL-1, to make a molecular tool that specifically
blocks the activity of MCL-1 itself. This could allow standard cancer drugs
to kill the tumor cells by apoptosis, or programmed cell death.
“We think this is a very important step toward developing an inhibitor of
MCL-1, which is emerging as a critical factor [that helps cancer cells survive
chemotherapy] in a range of cancers, including leukemia, lymphoma, multiple
myeloma, melanoma, and poor-prognosis breast cancer,” says Walensky.
In lab experiments, the investigators showed that cells resistant to certain
conventional drugs because of MCL-1 activity could be killed when the
MCL-1 inhibitor was added. The MCL-blocking compound is now being
tested in animal models.
The scientists didn’t expect to find that MCL-1’s own compound could
inhibit its pro-survival behavior. “When we uncovered nature’s solution to
selective MCL-1 targeting, we were surprised by the ironic twist,” says
Michelle Stewart, a graduate student in the Walensky lab and an author of
the study. The authors say their findings provide a blueprint for developing
new drugs that block proteins to overcome cancer drug resistance.
275,000 – Square feet of clinical
care space that will be added to Dana-
Farber when the Yawkey Center opens.
256 – Number of registered nurses
who staff Dana-Farber’s outpatient units.
30 percent – Increase in the number
of exam rooms and infusion chairs that
the opening of the Yawkey Center will
bring to Dana-Farber. (The new center
will offer 130 exam rooms and 137
chemotherapy infusion chairs.)
5,100 – Approximate number of
cyclists who participated in this year’s
Pan-Massachusetts Challenge bike-athon,
raising funds for cancer research
and care at Dana-Farber.
12,700 – Size in square feet of the
Yawkey Center’s “green” roof, which
will be landscaped with native plants,
including grasses, sedums, and other
low-lying groundcover, to help cool the
building in summer, improve air quality,
and reduce runoff to nearby waterways.
6 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

Pursuing Cancer’s
“On-Off” Molecule
The quest to stop the growth and
spread of tumors has seen many
attempts to get cancer genes to
ignore their internal instruction
manual. In a new study, a team led
by Dana-Farber scientists created
the first molecule able to prevent
cancer genes from “hearing” those
instructions, stifling the cancer
process at its root.
The study, published in the
journal Nature, demonstrates that
proteins issuing stop and start
commands to a cancer gene –
known as epigenetic “reader”
proteins – can be targeted for future
cancer therapies.
“In recent years, it has become
clear that being able to control gene
activity in cancer – manipulating
which genes are ‘on’ or ‘off’ – can
be a high-impact approach to the
disease,” says the study’s senior
author, James Bradner, MD. “If
you can switch off a cancer cell’s
growth genes, the cell will die.
Alternatively, switching on a tissue
gene can cause a cancer cell to
become a more normal tissue cell.”
In the study, members of Bradner’s
lab synthesized a molecule
that blocks a specific abnormal
protein in cells from a rare form of
childhood and young adult cancer.
The blockage stops them from
dividing prolifically, and makes
them “forget” they’re cancer cells,
so they appear more like normal
cells. Such laboratory successes
have increased interest in the development
of anti-cancer therapies that
disrupt epigenetic proteins.
Yawkey Opening Spurs Call for Volunteers
With the Yawkey Center for Cancer Care set to open in February 2011, the
need for volunteers at Dana-Farber is growing. When the center opens, the
Institute will need additional volunteers who can help patients navigate the
new facility and assist staff in a variety of areas.
“Many of the new volunteer positions are crucial to our maintaining a
welcoming, patient- and family-centered environment,” says Patricia Stahl,
program manager of Volunteer Services at Dana-Farber. “We try to match each
volunteer with opportunities that fit his or her interests and skills. For example,
some of our volunteers enjoy distributing reading materials from our book cart
to patients receiving infusion therapy, while others excel at providing helpful
answers and information to visitors at our concierge desk.”
Volunteers are a vital resource at Dana-Farber, serving in a diverse range
of roles – from office support to patient assistance. All applicants age 18 and
older are welcome, but volunteers are asked to commit to at least one fourhour
shift per week for six months. Weekday hours are currently available, and
evening and weekend hours may be added.
If you or someone you know is interested in volunteering, please visit
www.dana-farber.org/how/volunteer to fill out an application or learn more.
If you have questions or would like to inquire about specific opportunities,
please call Volunteer Services at 617-632-3307.
Fall/Winter 2010 P a t h s o f P r o g r e s s 7

Bench to Bedside
by Saul Wisnia
Researcher Profile
After nearly 35 years at Dana-Farber, molecular
biologist Charles Stiles, PhD, is still learning –
both about the science of diseases and the ways
he can work with others to stop them.
In 2007, Stiles became co-director, along with Mark
Kieran, MD, PhD, of Dana-Farber’s Pediatric Low-Grade
Astrocytoma (LGA) Program. Infused with the backing
of several donor families whose children had developed
these brain tumors, the colleagues were challenged with
uncovering the genetic abnormalities that cause LGA.
Charles Stiles, PhD
Under ideal conditions, the hunt for cancer-causing
mutations begins with DNA extracted from fresh tumor
samples that have been frozen in liquid nitrogen immediately
after removal in the operating room. For pediatric
LGAs, however, conditions are far from ideal. Unlike
breast, lung, and other common adult cancers that affect
more than 100,000 new individuals each year, only about
1,000 children are diagnosed with LGAs annually. Moreover,
LGAs tend to arise in surgically inaccessible areas
of the brain, and many of the tumors are never removed
at all. For both of these reasons, access to fresh frozen
pediatric LGA tissue for genetic analysis is limited.
To address this scarcity, Stiles and Kieran set up LGA
tissue-banking collaborations with hospitals throughout
North America and in China, Egypt, and Turkey. They
also exploited new technologies developed by collaborators
from the Center for Cancer Genetics at Dana-Farber
and the Broad Institute of MIT and Harvard for conducting
genetic analysis on
LGAs tend to arise in surgically
inaccessible areas of
“archival” (non-fresh)
samples of LGA that
the brain, and many of the
have been fixed in formaldehyde
and embedded
tumors are never removed.
in paraffin (a solid hydrocarbon substance).
As a first step in their research program, Stiles and his
team developed a pair of “paraffin-friendly” tests for two
different mutations in the BRAF gene, which is mutated
in about one-third of all LGAs. Using donor funds, they
hope to soon establish a free national registry for children
whose tumors bear these types of mutations.
Stiles and his team are thinking about the remaining
two-thirds of these tumors for which genetic lesions have
yet to be discovered. They are currently applying their
paraffin-friendly technologies to more than 1,000 archival
samples of LGA, far more than the 50 tumor samples
involved in a typical research study on this tumor type.
“As you examine more samples, you pick up nuances,”
says Stiles. “Instead of waiting for thousands of kids to
be diagnosed here to solve the questions, we’re reaching
out to the rest of the world to solve this together.”
8 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

Bench to Bedside
Clinician Profile
Mark Kieran, MD, PhD, director of Dana-
Farber’s Stop & Shop Family Pediatric Brain
Tumor Clinic, has long dealt with surgical and
biological obstacles in treating his young patients. While
tumors in other organs can often be cleanly removed
during surgery, the intricate nature of brain tissue makes
it difficult to completely excise a tumor there, for fear of
causing cognitive or motor problems in the patient.
“Surgeons can safely remove tissue surrounding liver
or kidney tumors to make sure they don’t leave pockets of
cancer behind, but you don’t want to have to tell a braintumor
patient that we removed the cancer, but now they
can’t breathe or do a common activity on their own,” says
Kieran. “Radiation and chemotherapy can kill tumors left
behind after surgery, but in many patients these treatments
can lead to cognitive problems and other issues.”
Some of the toughest and most common tumors that
Kieran’s team encounters are low-grade astrocytomas
(LGAs), which tend to be
Kids don’t get cancer
relatively slow-growing
nearly as often as adults,
but can still do a lot of
so even though LGAs are
damage because of their
the most common pediatric
brain cancer, there aren’t location in the brain.
many cases to study. “Often, our only option
is to pound them with
chemotherapy and radiation, but then they grow back,”
he says. “For years, I’ve felt that if we just knew more
about their biology, we could come up with a much gentler,
more sophisticated approach to attacking LGAs.”
Now, Kieran and his colleagues may have found what
they need. In 2007, financial backing from parents with
children facing LGAs led to the establishment of Dana-
Farber’s Pediatric Low-Grade Astrocytoma Program.
Because his lab is relatively small, Kieran partnered with
veteran researcher Charles Stiles, PhD, co-chair of the
Department of Cancer Biology, to form the program.
Their first set of experiments resulted in the discovery
that a mutated protein kinase (or enzyme) known as
BRAF is present in nearly 40 percent of LGA cases. The
same altered kinase, it turns out, also often occurs in
cases of malignant melanoma, a common adult cancer.
“Kids don’t get cancer nearly as often as adults, so even
though LGAs are the most common pediatric brain cancer,
there aren’t many cases to study,” says Kieran. “Now,
we’ll soon have the opportunity to use drugs already
tested in adults with melanoma, to see if they’ll also work
in children with LGAs. The possibility of eliminating
toxic radiation and chemotherapy in children by using
biologic agents targeted to the molecular defect in LGAs
would be a tremendous advance.”
Mark Kieran, MD, PhD
Fall/Winter 2010 P a t h s o f P r o g r e s s 9

Tech Preview
Peering Deep into Cancer Cells
by Robert Levy
For close-up views of cells and tissues, few
technologies can compete with confocal
microscopes – unless they’re multi-photon
microscopes or fluorescence lifetime
imaging microscopy (FLIM) systems. A
new piece of equipment at Dana-Farber
gives scientists the benefits of all three
technologies in a single unit.
Standard optical microscopes can magnify
cells more than 1,000 times, but the cells must be
displayed in a single layer, usually between a glass slide
and a thin covering. Confocal microscopes, invented in
the mid-1950s by Harvard scientist Marvin Minsky, can
handle thicker pieces of tissue by excluding light from
outside the instrument’s field of focus. The result is a
crisp image of a thin cross-section of tissue, without the
hazy or unfocused areas produced by conventional microscopes.
Researchers can assemble these slice-like images
into a three-dimensional representation of the specimen.
The new device at Dana-Farber is a “Zeiss 710 laser
scanning confocal/multi-photon/FLIM system” – a complex
description that conveys the range of its capabilities.
The multi-photon system uses a high-powered laser that
delivers long-wavelength light to a single spot in a tissue
specimen. The long wavelengths enable the light to
penetrate deeper into the tissue – as much as half a
millimeter – without damaging surrounding cells. The
result is a “laser sharp” image of a thin swath of tissue,
much as if one made an image of a single page of a book
by shining a piercing light through its cover.
“It gives you the ability to see details that would be
lost in the background fluorescence of conventional
microscope images,” says Lisa Cameron, PhD, director
of Dana-Farber’s Confocal and Light Microscopy Core
Facility, where the new unit is housed. “You can see
deeper into the sample.”
The FLIM system is useful for locating certain proteins
within cells and studying how they interact. It’s based
on the principle of “fluorescent decay”: fluorescent
molecules lose their ability to emit light at different rates,
depending on the type of protein to which they are joined.
By tagging proteins with fluorescent molecules and
measuring how long those molecules continue to give
off light, scientists can see how different proteins
are positioned within cells as well as their proximity
to one another – critical information for understanding
protein interactions.
“The research applications of this instrument are
countless,” Cameron says. “It can help us understand
how cancer cells behave within their tissue environment,
and better perceive the protein activity that underlies
cancer’s growth.”
The LSM 710
combines the
capabilities of
a multi-photon
microscope, a
laser-scanning
microscope, and
a confocal microscope
to give
researchers a
deep view into
the activity of
cancer cells.
10 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

Interview by Eric Schuller
Six Questions for ...
Deborah Toffler
As Director of Volunteer Services and of the Shapiro Center for
Patients and Families, Dana-Farber’s Deborah Toffler, MSW, LCSW,
makes sure that patients and families know how and where to get the
support and resources they need. Here, she gives a preview of a new
patient-family center that will debut on the first floor of the Yawkey
Center for Cancer Care when the building opens in early 2011.
Q:
A:
Q:
A:
Q:
A:
Can you tell us a bit about
the new Ruth and Carl J.
Shapiro Center for Patients
and Families
It will be something we’ve never
had before, a centralized location
for information about all of
our programs and services, where
people can find answers to any
questions they might have.
We can ask any question at
all – really
Absolutely. Say you want to know
when a breast cancer support group
is meeting next, or where to find
the nearest sushi restaurant, or how
you can sign up for a massage. We
want to be the information center
of the Institute, where we can tell
you about anything that’s happening
here or any services that
we offer. If you see or hear about
something that’s going on and you
want to learn more, come to us. If
you have a question, no matter how
complex, our volunteers will find
the answer.
What types of services will
the Shapiro Center offer
It’s going to have a little bit of
everything – maps of the city,
information about our programs,
access to interpreters, all of our
Q:
A:
Q:
A:
brochures and publications, storage
areas for personal belongings, even
a business center where patients and
families can use computers to connect
with friends or the office. We’re
also hoping to help people discover
resources that they may have never
thought to ask about.
What can I expect to see when I
walk in the door
If you’re a first-time visitor, you’ll
find friendly volunteers who can
help you find out what we have to
offer and how to access our services.
If you’ve been there before, you
might head right to the business
center area to check your e-mail or
get online. If you’re more of a selfserve
type, you might use one of our
touchscreen computers, which will
display information on everything
from local hotel accommodations to
daily events at the Institute.
What’s the center’s main purpose
At the core, we want to address the
concern patients sometimes have
about not knowing all that is available
to them. We know that patients
and their families need details about
different things at different times.
The information is out there, but if
you’re not looking for it or you’re
not ready for it, you will miss it. We
want to fix that.
Q:
A:
Why are you excited about this
I’m excited because it’s a space that
is truly patient- and family-centered,
because it was envisioned and
designed by patients and families.
It’s what they’ve asked for, and being
able to directly meet that need is
going to be wonderful. I’m hoping
it will be a place of community – a
place to wait for a loved one, meet a
friend, or just catch up with what’s
happening at Dana-Farber.
Fall/Winter 2010 P a t h s o f P r o g r e s s 11

Patients and
Families Help
Create a
Place of Healing
by Christine Cleary
Hundreds of steel beams
make up the new
Yawkey Center for
Cancer Care at Dana-
Farber. Look closely
at some of them and
you’ll see the names of
patients spray-painted
in bright colors by iron workers
during the building’s construction.
These beams make up the frame
of the building, but since those early
days of the project, patients and families
have lent far more than names
to the facility. Their guidance
underpins almost every aspect
of the Yawkey Center. From
healing gardens to artwork,
from layout of exam rooms
to plans for parking, the
imprint from these key
constituents is felt
throughout the 14-story,
state-of-the-art building and
across the Institute.
“The Yawkey Center is a fine
balance of medical excellence,
beauty, and healing,” says Marlene
Nusbaum, a patient advisor. “I don’t
think of it as a building, but as a
space for us to become the best
we can be.”
This type of input is standard
practice at Dana-Farber, where since
1998 Patient and Family Advisory
Councils (PFACs) have advised
staff on nearly every important
matter concerning patient care. “I
don’t think there is another institution
in the world more committed
to patient- and family-centered care
than Dana-Farber, and the Yawkey
Center planning process was just
another example of that,” says Craig
Bunnell, MD, MPH, associate chief
medical officer and one of the project
leaders for the new center.
The formal involvement of
patients and families began in
2006 when leaders convened a
group called “2020,” with the goal
of designing a facility that would
deliver the best possible cancer care,
now and in the future. Patients and
families attended design meetings
and joined staff members from
Dana-Farber and the architectural
firm ZGF in planning the Yawkey
12 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

Marlene Nusbaum, a patient advisor (left), and
Amy Porter-Tacoronte, MBA, vice president of
Operations and Ambulatory Practice Management,
worked together to plan patient flow
inside the Yawkey Center for Cancer Care.
Fall/Winter 2010 P a t h s o f P r o g r e s s 13

“I don’t think of it as a building, but
as a space for us to become the
Center on site visits to cancer centers
nationwide.
“Despite working with patients
for more than 30 years and considering
myself ‘patient-and-family
focused,’ I am continually reminded
that patients and families may have
a vision that I missed,” says Chief
best we can be.”
— Marlene Nusbaum
Medical Officer Lawrence Shulman,
MD. “Their involvement in planning
for the Yawkey Center plays out this
way: Just when we think a certain
process or facility design will best
meet the needs of patients and families,
they show us why another plan
may be better. This collaborative
work is one of the reasons Dana-
Farber is unique in its approach to
care planning.”
Janet Porter, PhD, chief operating
officer, recalls wrapping up one
planning retreat when a patient, Mary
Dana Gershanoff, raised her hand.
“She said, ‘We’ve spent all this time
talking about making the building
patient-friendly, but what about stafffriendly
We come here because of
the staff, and we want this to also
be a great place for them,’” remembers
Porter. “We went back and
redesigned the floors to make sure
there were enough conference rooms
and workrooms.”
Feeling Welcome
by Debra BRADLEY Ruder
If Maureen Costello could greet every single patient
who will visit the Yawkey Center for Cancer Care, she
probably would. But thanks to the time, effort, and ideas
that she and other patients and families have contributed
during the building’s planning and construction phases,
that won’t be necessary. “My hope is that the environment
itself will be a place of healing from the moment
you walk in the door, and that it will be welcoming at
every turn,” says Costello, a survivor of two cancers who
has received care at Dana-Farber/Brigham and Women’s
Cancer Center (DF/BWCC) for 20 years.
As a volunteer, Costello has served on several Institute
committees focused on making the new building as
comfortable and inviting as possible. She traveled with a
group to Portland, Ore., to visit other health-care centers
designed by ZGF Architects, helped choose sculptures
and other patient-friendly artwork, and co-hosted a “chair
fair” that enabled members of the DF/BWCC community
to voice their preferences for chair styles that will be
used throughout the Yawkey Center.
In addition to an arts background, Costello has a longstanding
interest in diversity issues. Thanks in part to her
efforts, the Yawkey Center’s Thea and James Stoneman
Healing Garden will include a set of large stones displaying
the word “Hope” in languages commonly spoken by
DF/BWCC patients: English, Spanish, Russian, Arabic,
and Portuguese.
Costello had a chance to tour parts of the new building
during its construction. “I felt such a strong sense of
ownership and loved the promise of the decisions we had
made,” she recalls. “I can’t wait until it’s complete.”
To learn more about the Thea and James Stoneman
Healing Garden, visit www.dana-farber.org/yawkey and
click on “News Stories.”
14 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

Members of the Patient and Family
Advisory Councils (top) have made their
mark on the Yawkey Center, with guidance
that translated into curved architectural
features and open spaces (bottom).
Benefiting from Nature and Art
It’s one of the ironies of life: just
when we most need the restorative
properties of nature – the scent of
pine needles, the feel of soft ground
beneath our feet – we often find
ourselves in synthetic places.
This is generally true when we are
sick, and no one knows it better than
the patients and families who advocated
that the Yawkey Center tap into
the healing power of nature. Lessons
came from a healing environment
committee that began meeting in
2005 under the guidance of consultant
Jeanine Young-Mason, EdD, RN,
a Distinguished Professor Emerita in
the School of Nursing at the University
of Massachusetts Amherst, and a
noted expert on the subject.
“In the past, health care buildings
were generally stark and unpleasant,
but the push today is to make them
as restorative as possible,” she says.
“These spaces must feel physically
and psychologically safe and be aesthetically
pleasing to all the senses.”
Nature generally isn’t square and
lined up neatly, points out Young-
Mason, a sentiment Porter recalls
a researcher echoing when she saw
early architectural renderings of
clinical floors. “Everything is so
pointy!” the researcher exclaimed.
With this in mind, the Yawkey Center’s
reception desks were redesigned
to be curved, its lobby furniture is set
in a circle, and the atrium has been
given rounded features. The building
is also infused with abundant natural
light and calm colors.
One of the most significant
outcomes of the healing environment
discussions is the Thea and
James Stoneman Healing Garden,
a two-story indoor sanctuary in the
new building that features natural
stone walls, seasonal flowers, and a
canopy of greenery. Overlooking the
garden is the Richard P. and Claire
W. Morse Conservatory, which offers
a plant-free environment to protect
patients with allergies or other health
concerns. The garden’s purpose, says
Maureen Costello, a patient advisor,
is to “create an area of quiet respite
in a natural environment for patients,
families, and staff to reflect and
heal amid nature’s beauty.” Patients
pushed for the garden and planned
its design from start to finish.
Fall/Winter 2010 P a t h s o f P r o g r e s s 15

Art can also soothe the soul and
help the body to heal, Young-Mason
points out. Patients and families
helped select more than 300 works
of art for the Yawkey Center, representing
a variety of media and styles,
including sculpture, glass, prints,
textiles, and photographs.
The centerpiece for the atrium
lobby is a “mandala” designed
by Newton, Mass., artist Ralph
Helmick. The circular giant mobile
hangs from the ceiling and features
hand-cut metal images that symbolize
various themes, such as research
and world cultures. Artwork will be
visible in common areas as well as in
exam and infusion rooms, with some
pieces funded by individual gifts and
others by the all-volunteer Friends of
Dana-Farber organization.
Enhancing Patient Experiences
PFAC members also served on
work teams that tackled key operational
issues for the new building,
from pharmacy to scheduling. “We
looked at the patient experience from
the moment the patient walks in the
door or drives into a parking area,”
says Nusbaum, a PFAC member who
co-chairs (with Porter) the Patient
Experience Committee. “How will
they get from parking to their floor
Where will they have their blood
drawn What will the signs say”
During planning for the spaces
where check-ups and chemotherapy
infusions take place, patients and
families asked that the two areas be
on the same floor whenever possible.
“In general, once patients get to their
floor, they can see their doctor and
go across the hall for infusion without
needing to check in and out on
different floors,” says Nusbaum.
Patients also recommended that
infusion spaces have the best views,
because these sessions can be quite
lengthy, but they felt no windows
were needed in exam rooms, where
Patients Find Open Arms
by Debra bradley Ruder
Laura Nakazawa, manager
of Interpreter Services,
talks with a patient
Let’s pretend it
is March 2011, and
Inés, a Spanishspeaking
patient,
arrives for her
first appointment
at Dana-Farber’s
Yawkey Center for Cancer Care. She pulls into the lower
level parking garage and is greeted by an attendant sporting
a button that reads “¿Puedo ayudarle” – Spanish for
“May I help you”
On the second floor, Inés meets her assigned interpreter
and registers as a new patient. After having her blood
drawn and analyzed, she and the interpreter head upstairs
for her treatment. During her visit, Inés passes signs with
international icons, enjoys artwork reflecting cultures
from around the world, and picks up cancer-related
literature in Spanish. She also finds comfort in a Spanish
“hope stone” embedded in the building’s healing garden.
Many of the features described in this hypothetical
visit grew out of very real conversations among patients,
families, and staff members seeking to make it easy for
visitors to navigate the Yawkey Center, including those
who speak languages other than English.
“We’re preparing our interpreters to serve greater numbers
of non-English speaking people, offering materials
in several languages, and making sure patients know
we’re here to help,” says Laura Nakazawa, manager of
Interpreter Services at Dana-Farber.
Her team will train its roughly 50 on-call interpreters –
who speak about 35 languages, from Cantonese to Cape
Verdean – to guide patients and families throughout the
Yawkey Center.
“This building has patient-centered care at its core,
which means striving to serve patients of diverse cultural
backgrounds in their own languages,” says Nakazawa.
“Our goal is to make the experience as smooth as possible
for everyone.”
16 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

Honored to be Involved
by Debra bradley Ruder
Anne Tonachel had been to Dana-Farber many times while working for
Hospitality Homes, which provides lodging for families of individuals
seeking care at Boston-area medical centers. But when she first arrived as a
patient herself – she was diagnosed with stage 3 ovarian cancer in July 2005
– it was a completely different encounter.
“I read ‘Dana-Farber Cancer Institute’ over the entryway, and it was like
somebody hit me in the chest and said, ‘That’s you. You have cancer. That’s
why you’re here,’” she remembers. Although Tonachel – who is now cancerfree
– can’t eliminate that initial shock and fear for others, she has been
working to help patients, families, and even staff members feel more comfortable,
well-supported, and encouraged.
Anne and her husband, Dick, have served on the adult Patient and Family
Advisory Council at Dana-Farber/Brigham and Women’s Cancer Center
since 2007. As the Yawkey Center moved forward, the Tonachels participated
in committees that helped choose wall colors, fabrics, and furniture;
discussed the set-up of exam and waiting rooms; reviewed parking plans;
analyzed patient wait times; and shaped other aspects of the new building.
For the Tonachels, attending myriad meetings is not a burden, but a privilege
– especially given the commitment of Dana-Farber’s leaders to engaging
patients and families in making improvements. Says Dick, “They’re listening,
and, for me, it’s really an honor to be part of the conversation.”
“My hope is that the environment itself
will be a place of healing.”
an outside scene could be distracting
during a patient-clinician meeting.
They also advised on the layout of
exam rooms; instead of seeing an
exam table and clinical equipment
right away, an entrant’s first impression
will be calm colors, a desk,
comfortable chairs, and artwork.
“Who knows better the intricate
— Maureen Costello
workings of a patient’s day than the
patient” asks Bunnell. “As physicians,
we know how we function in
our individual areas, but the patients
know how those areas connect to
the whole experience. Having them
participate in planning from beginning
to end has been critical to our
understanding of how things work
now, and how they can be better.”
In addition to the beams adorned
with patients’ names, another of the
building’s most symbolic features is
a series of etched glass panels between
the handrail and the ramp running
from the atrium to the second
floor. The panels will display illustrations
of relevant chemical compounds,
such as taxol and vincristine,
images of flowers, and meaningful
words suggested by patients and
families. When new patients enter
and are greeted by those words –
“hope,” “inspiration,” “compassion”
– then the chief advisors for the
Yawkey Center will have left their
most important mark.
Fall/Winter 2010 P a t h s o f P r o g r e s s 17

Every Beam Tells the Yawkey Center Story
By Saul Wisnia
1
Just as Dana-Farber’s progress was once signalled by the light
shining late at night from the office window of founder Sidney Farber,
MD, the state-of-the-art Yawkey Center for Cancer Care opens this
winter as a beacon of the Institute’s continued commitment to cancer
research and care.
The 275,000-square-foot facility, which will include 130 exam rooms
and 137 chemotherapy infusion chairs, will serve as a model for outpatient
care and clinical research in the 21st century. The environmentally
friendly structure is named in honor of the Yawkey Foundation for its
support of the building’s construction.
February’s opening will be the culmination of a process that began to
take physical shape at a June 18, 2007, groundbreaking ceremony that
featured a passionate speech by the late Massachusetts Sen. Edward M.
Kennedy (photo 1) and ceremonial “first digs” by city, state, and Dana-
Farber/Brigham and Women’s Cancer Center leaders
(2). As work continued at the site (4), the steel
beams which formed the building’s frame
became beams of hope for patients, families,
staff, and supporters – who
wrote messages themselves
or received help from
ironworkers (3, 5).
A SpongeBob-topped crane aided
in the heavy lifting (6), and soon the
building was lighting up the night (7). The
plans were reaching fruition, and thanks to the
input of advocates like Anne Hristov and
Linda Bova (8), the completed Yawkey Center
will feature innovations including the Longwood
Medical Area’s first “green roof ” (9).
For more in-depth coverage of the Yawkey Center,
see the articles starting on pages 12 and 20.
2
18 P a t h s o f P r o g r e s s Fall/Winter 2010

“The need for expert cancer care is growing in our region and nationally, because our society is aging, treatments
are becoming more effective and intensive, and, fortunately, people with cancer are surviving longer. The new Yawkey
Center for Cancer Care is the centerpiece of Dana-Farber’s response to a need for the best 21st-century cancer care
and for new modes of clinical research, designed to bring better treatments to patients more quickly and safely.”
— Dana-Farber President Edward J. Benz Jr., MD
4
3
5 6
7
9
8
Fall/Winter 2010 P a t h s o f P r o g r e s s 19

y Christine Cleary
Bridges, Teams,
Yawkey Center Strengthens Research and Care Ties
and Dreams
20 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

Bridges (center) connect the Yawkey
Center’s patient-care areas (right)
with the Richard A. and Susan F. Smith
Research Laboratories building
next door.
When a moving van pulls up to the curb of
a new home, it often marks the beginning
of a family’s next stage of growth. For the
Dana-Farber family, that moving van arrives this winter,
when many clinical operations move to the new Yawkey
Center for Cancer Care, signaling the next phase in the
Institute’s 63-year battle against cancer.
The Yawkey Center, opening in February 2011, will
create stronger links between patient care and research,
with treatment areas organized by disease type and
focused on the individual needs of adult patients. It will
introduce improvements such as concierges and laboratory
services to make the patient experience smoother.
“Planning the Yawkey Center gives us more opportunities
to rethink and refine how we are doing things,” says
Ellen Frank, PhD, a leukemia survivor and co-chair
of the Adult Patient and Family Advisory Council at
Dana-Farber/Brigham and Women’s Cancer Center
(DF/BWCC). “The essence of Yawkey will be a whole
team, including the researchers across the way, focused
on each patient’s particular type of cancer.”
The majority of patient-care floors in the new center,
where most DF/BWCC patients will receive their treatment,
will connect by bridges to the Richard A. and Susan
Smith Research Laboratories, where much of Dana-
Farber’s laboratory science is done. For the most part,
each bridge will link a particular clinic to research labs
focused on the same type of cancer.
“The Yawkey planners listened to what researchers
and clinicians asked for,” says Barrett Rollins, MD, PhD,
Fall/Winter 2010 P a t h s o f P r o g r e s s 21

Ali Abbas Ali (right), who received care
at DF/BWCC for throat cancer, has a
follow-up visit in the Charles A. Dana
building with Sewanti Limaye, MD. In
the Yawkey Center, spacious exam rooms
will be decorated with soft colors to
convey a feeling of calmness.
22 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

chief scientific officer. “Today in our
cafeteria, hard-core scientists have
lunch with leaders in clinical care.
Scientists concerned with molecular
mechanisms can ask questions about
clinical disease, and vice-versa.”
The design of the Yawkey Center
will further facilitate such collaboration.
Intended to be far more
than passages from one building to
another, the light-filled bridges will
overlook the new center’s rooftop
gardens and serve as a staff lounge –
offering wireless Internet access and
space for conversation.
“The bridges will create a place
where scientists and clinicians can
meet to compare notes on research
and care,” says Wendy Gettleman,
senior director of planning, design,
and construction for the Yawkey
Center project.
Bridge to Discovery
This type of collaboration has long
been a hallmark of Dana-Farber’s
care. For example, Thomas Roberts,
PhD, co-chair of Cancer Biology,
who is studying a family of enzymes
called kinases that prevent abnormal
cells from dying naturally, will be
only a short walk away from Eric
Winer, MD, who, with other investigators,
is leading clinical trials based
on Roberts’ findings. “It should be
very motivating for lab scientists to
know that patients in a connected
building may be benefiting from
their research, and for patients to
know that research related to their
disease is taking place so close by,”
says Winer, director of DF/BWCC’s
Breast Oncology Center.
The two men work together in one
Illustrating a Focus on Individualized Care
The most visible expression of science at work in the Yawkey Center will be a
“Gene Display” symbolizing Dana-Farber’s path to targeted therapies. Built into
the curved walls on both sides of a hallway connecting the Yawkey Center to the
Charles A. Dana building, the display represents microarrays, an innovative
technology used to survey the behavior of many genes in one tumor cell.
Patients and families will vividly see how Dana-Farber science relates to their
care as they walk by colorful four-by-four-inch tiles, and view two video screens
explaining how genetics and cancer care are interconnected.
“The display is meant to be evocative, not literal,” says Todd Golub, MD, a pediatric
oncologist and expert in genomic medicine. “The changing colors viewed up
close convey the excitement of a research field moving quickly, yet the gradation of
color viewed from a distance shows steady progress and perseverance.”
For a gift of $5,000, which can be paid over one to two years, each “gene” can be
personally inscribed with a message to honor a family member, friend, or caregiver. The names
and messages throughout the display will also convey the idea of science and medicine tailored
to each person’s individual type of cancer, in a building that will serve as a model for cancer care.
Lori Palladino named her gene in memory of her daughter, Jill E. Geromini, who died of
neuroblastoma at age 5. “It would be too painful for me to go back as a volunteer and talk with
families,” she says, “so this is a way I can honor my daughter and help Dana-Farber.”
To learn more about naming a gene, please contact Erin Northrop at 617-582-4790 or
e-mail gene_display@dfci.harvard.edu.
The Gene Display will be
located on Level P2 of
the Yawkey Center.
Fall/Winter 2010 P a t h s o f P r o g r e s s 23

“Collaborations between scientists and clinicians will only grow
stronger after the Yawkey Center opens.”
– Thomas Roberts, PhD
of Dana-Farber’s National Cancer
Institute-funded Specialized
Programs of Research Excellence,
which bring together basic and
clinical researchers. Winer had been
observing that, although the drug
trastuzumab (brand name Herceptin)
was very effective (when combined
with chemotherapy) in most women
with HER2-positive breast cancer,
in some cases the cancer became
resistant or relapsed. Roberts and
his colleague Jean Zhao, PhD,
meanwhile, had learned that when
HER2 cancer is shut down by trastuzumab,
abnormal kinases are sometimes
activated in the tumor cells.
“It turned out that the enzymes
we’d been studying are also of interest
to Eric, since they are a primary
way tumors can avoid Herceptin,”
recalls Roberts.
The discovery suggests that some
patients might benefit from drugs
that block these kinases, and a
clinical trial is underway to test the
theory. (The Yawkey Center will
include a significantly expanded
Clinical Research Center for patients
who need close monitoring in complicated
clinical trials.)
“While these types of collaborations
between scientists and clinicians
are certainly going on now,
they will only grow stronger after
the Yawkey Center opens,” Roberts
points out.
Powerful Symbols
Bridges linking the Yawkey Center and Smith building are designed to give
researchers and clinicians an attractive space for conversation and collaboration.
In addition to providing a literal
connection between research and
patient care, the new bridges are
also powerful symbols of the synergy
between the two. Dana-Farber
devotes equal parts of its staff and
resources to each endeavor. It offers
a robust “translational” research
program that brings laboratory findings
to patients quickly and creates
numerous opportunities for scientists
and clinicians to work together.
“Our balanced portfolio of
research and care sets us apart,” says
Rollins. “If you’re a clinician you’re
always hearing about research, and if
you’re a scientist you’re always hearing
about patient care. Both sides
talk to each other to a greater extent
than I’ve ever seen elsewhere.”
Knowing that Dana-Farber is
a place where basic and clinical
research gets done is often meaningful
for patients, as well, who believe
24 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

Eric Winer, MD, (at left) will care for patients such as Francine Smith (center) in the Susan F. Smith Center for Women’s Cancers, on
the 9th and 10th floors of the Yawkey Center. Patients like Smith may benefit from the basic research of Thomas Roberts, PhD, (at
right, in his lab) and his colleagues, who will work across the bridge seeking better treatments for women with breast cancer.
the Yawkey Center’s design will
reinforce that message.
Although Dana-Farber has many
clinic-based MDs and lab-based
PhDs, most of its medical staff
fit somewhere on the physicianscientist
continuum. “When it comes
to involvement with lab work, our
clinicians in the Women’s Cancer
Program are a broad mix,” says
Winer. “I am fundamentally a
clinician who used to have little
interest in basic research, but over
time I have become much more
involved in how lab-based science
can help my patients.”
Ease of Access
The Yawkey Center gave Dana-
Farber an opportunity to design a
clinical building from the ground
up. This was a dream come true, say
project leaders, because it allowed
them to more closely focus on the
facility’s key constituents. Patients
with certain illnesses will be concentrated
on the same floor, their
caregivers will be experts in this
type of cancer, and, in general, scientists
working on treatments for it will
be nearby.
“Each floor will have fewer
disease groups and will be more
focused on both the exam and infusion
care for patients with those
diseases,” explains Anne Gross, RN,
PhD, vice president of Adult Nursing
and Clinical Services. She and other
leaders believe this model will help
improve communication between
providers by eliminating barriers and
facilitating flow and flexibility.
“One of the things we always liked
about the first floor of the Dana
building is that patients can see
their provider and receive chemotherapy
all on one level,” says
Gross. “The infusion nurse and care
team in the exam practice have easy
access to one another. We wanted to
base the Yawkey Center clinics on
this concept of co-location and the
experience of patients not having to
travel from floor to floor, checking
in and out each time.”
Patients and families worked
closely with Gross and other
leaders in bringing about these
changes, offering their perspectives
on the value of centralized care
and other improvements. The end
result, says Frank and other patient
advocates, is a building equally
committed to comfort and the
search for cures.
Fall/Winter 2010 P a t h s o f P r o g r e s s 25

26 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

Can science
foresee your
cancer risk
Genetic Tests,
Demystified
by Cindy hutter
If
you could look into
a crystal ball and see
that you had a greater
chance of developing
certain cancers, you
might make some changes today to
lessen those odds.
That is the theory behind the
Friends of Dana-Farber Cancer
Genetics and Prevention (CGP)
clinic. There, under the leadership
of co-directors Judy Garber, MD,
MPH, and Sapna Syngal, MD, MPH,
clinicians and researchers analyze
people’s germline DNA – the genetic
code inscribed in every cell in the
body – searching for specific inherited
gene mutations that are known
to increase the risk of developing
certain cancers. After determining
a person’s likelihood for cancer, the
CGP team helps individuals with an
increased risk take precautionary
measures, such as receiving frequent
screenings, taking certain medications,
and adopting a healthier lifestyle,
to help ward off cancers before
they materialize.
This approach is deeply rooted, as
Dana-Farber researcher Frederick Li,
MD, was among the first to introduce
the concept, in the 1960s, that cancer
risk could be inherited. Considered a
father of cancer genetics, Li discovered
that a germline DNA mutation
of the p53 tumor-suppressor gene,
Fall/Winter 2010 P a t h s o f P r o g r e s s 27

Family medical history plays a key role
in clarifying risks for many diseases,
says Judy Garber, MD, MPH, director
of the Friends of Dana-Farber Cancer
Genetics and Prevention clinic. About
5 percent of cancers result from an
inherited predisposition to the disease.
which normally helps control cell
growth, was linked with increased
cancer risk in families with the
inherited cancer syndrome that bears
his name, Li-Fraumeni syndrome.
His findings sparked other investigators
worldwide to search for inherited
cancer genetic alterations, many
of which have since been identified,
including those that cause certain
breast cancers (such as the BRCA1
and BRCA2 genes), gastrointestinal
tumors (colon, pancreatic, and gastric),
and other cancers.
Today, about 5 percent of cancers
result from an inherited predisposition
to cancer, and CGP leaders say
there are many more cancer genes
still to be discovered. This is one
reason that the CGP clinic will
expand into its own clinical center
when Dana-Farber’s Yawkey Center
for Cancer Care opens in early 2011.
“In addition to identifying people
at higher risk for developing cancers,
we’ll focus on pharmacogenetics,”
says Garber, director of the new
treatment center. “We’re learning
about how people’s genetic endowment
can influence who is more
likely to benefit from certain treatments
and who is likely to experience
particular side effects.”
The CGP clinic currently sees
about 1,200 new people a year,
about 10 percent of whom have
cancer-causing mutations. Some
have had a cancer diagnosis, others
are hoping to avoid cancer for themselves
and their relatives. Garber
says the prime candidates for genetic
testing are people who are diagnosed
with cancer at an early age, or whose
relatives had cancer at a young age
or had multiple or rare tumors.
Claire Cormier was one such
person. “My sister had just undergone
surgery for breast cancer at
Dana-Farber/Brigham and Women’s
Cancer Center (DF/BWCC) when
she read that researchers there were
seeking volunteers to be screened for
pancreatic cancer,” says Cormier, 74.
“Since both our mother and brother
had died of pancreatic cancer, we
enrolled. I found that I carry a
mutation in the BRCA2 gene [which
28 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

Claire Cormier (right) consults with
Sapna Syngal, MD, MPH, of Dana-Farber/
Brigham and Women’s Cancer Center,
about measures that may help lessen
cancer risks caused by a mutated gene.
is associated with breast and other
cancers], but my sister did not.” (Yet,
ironically, it was her sister who had
been diagnosed with breast cancer.)
Cormier, a mother of four and
grandmother of nine, had her ovaries
and fallopian tubes removed to
reduce her risk for ovarian cancer,
which has been linked to BRCA2
mutations. She also has yearly scans
of her pancreas to check for changes
there. So far, the efforts are working.
“It’s exciting to see people with a
strong family history of cancer who
are living cancer-free,” says Katherine
Schneider, a genetic counselor
at DF/BWCC. “They may have had
parents, an aunt, or uncle who died
of the same disease, but with proper
screening, they are surviving.”
One strong benefit of the CGP
clinic is that genetic counselors
meet directly with patients to report
genetic findings and recommend
medical next-steps. For example,
explains Syngal, director of the
Familial Gastrointestinal Cancer
Program at DF/BWCC, if a patient’s
brother had colon cancer and then
the patient developed the disease,
we might recommend surgically
removing more of the patient’s colon
to prevent a future cancer.
“One of the biggest mistakes we
see is when doctors don’t recognize
that someone has an inherited cause
of their cancer, and they don’t recommend
the more intensive monitoring
necessary for people with
genetic risk, who also have a greater
chance of getting more than one cancer,”
says Syngal. “A patient might
say to a doctor, ‘I don’t feel comfortable
coming back in five years,’ and
the doctor says, ‘five years is fine,’
What’s your family history
“It’s surprising to me how many people don’t
know what their relatives died from,” says Katherine
Schneider, a genetic counselor on the Cancer
Genetics and Prevention team at DF/BWCC.
“Because of that, a lot of what we do is detective
work to figure out what organ a family member’s
cancer started in, and what cell type it was.”
As genetic counseling and related techniques
become more prominent, knowing one’s family
history will likely grow more important in
helping health care providers clarify risks for
many diseases.
“What we see all the time is, once you ask
people a question, they go back to family
members and learn that there’s
more of a history [of certain
diseases or conditions] than
they thought,” says Sapna
Syngal, MD, MPH, director of
the Familial Gastrointestinal
Cancer Program.
To stay ahead of the game,
take time to create a record of
your family’s medical history.
The U.S. Surgeon General offers a free,
Web-based tool called “My Family Health
Portrait” to help compile the information. Find
it online at http://familyhistory.hhs.gov.
A family medical
history can help
doctors assess
your disease risk.
Fall/Winter 2010 P a t h s o f P r o g r e s s 29

“This information can help you change a legacy of cancer into a legacy of activism.”
- Judy Garber, MD, MPH
Sisters Barbara Soloman (left) and Claire
Cormier have a family history of breast
and pancreatic cancer. Both underwent
genetic testing to learn if they have gene
mutations that heighten their risk of
developing cancer.
because that is fine for 95 percent of
the population – but it’s not the best
course for someone with a genetic
predisposition to a disease.”
Genetic Counselor Monica Dandapani
adds, “Some people may still
be at increased risk because of family
history, even if they’re not in the
high-risk genetic category – these
people still need additional screening
based on family history. We try to
come up with a screening plan that
makes sense.”
While there are many who find
comfort in knowing whether or not
they are genetically predisposed to
cancer, there are those who prefer
the uncertainty. They don’t want to
be tested because they think it will
change how they think about themselves
or their family. Others would
rather hope that they are negative than
learn that they are positive.
“People are not ‘sick’ just because
they find out they have an altered
cancer gene,” Garber says. “It’s
best when the genetic information
empowers people to take control of
their lives. This information can help
you change a legacy of cancer into a
legacy of activism.”
Even for people with a strong family
history of cancer who do not want
to be tested, there are still screening
and prevention opportunities. CGP
staff encourages such individuals –
and others – to visit the clinic and
learn about their options.
“Risk and prevention is a piece of
cancer that is often left behind,” says
Syngal. “It’s much sexier to find cures
for cancer, but it is at least as important
to try to prevent it.”
30 P a t h s o f P r o g r e s s Fall/Winter 2010 www.dana-farber.org

Legislative Update
How Will Health Care Reform Affect Cancer Care
New federal rules may benefit cancer patients and research
by Eric Schuller
The Patient Protection and Affordable Care Act – known more commonly as the federal
health care reform law – will extend health insurance coverage to every American by the
year 2014. While many details of the new law have yet to be sorted out, its basic framework
indicates how it may impact the millions of Americans who have cancer or will one
day be diagnosed with the disease.
“From a patient standpoint, we’re optimistic that national
health care reform is going to help improve access
to care and the quality of insurance coverage,” says Anne
Levine, vice president for external affairs at Dana-Farber.
“For example,” she explains, “one of the bill’s provisions
that went into effect immediately was the removal
of caps on the amount an insurance company will pay
for care over a patient’s lifetime.” While lifetime caps
are typically set in the millions of dollars for each person,
such limits can be devastating for someone facing a
catastrophic or chronic illness, because coverage stops
when the cap is reached. The elimination of lifetime
caps allows patients to receive the treatment they need,
while curbing out-of-pocket costs that can lead to financial
hardships.
Another provision that has already gone into effect will
no longer allow insurance companies to deny coverage to
children up to age 19 with a pre-existing condition, a provision
that will apply to all Americans starting in 2014.
This most immediately benefits patients and survivors of
pediatric cancers, in cases when an employer switches
insurance providers or when a parent changes jobs.
Patients facing cancer will be further protected by a
requirement that all insurance plans cover routine costs
for patients enrolled in clinical trials, expanding on a
Massachusetts clinical trial coverage law that has been
in place for more than a decade. The requirement, which
will take effect in 2014, may particularly benefit patients
at Dana-Farber, which hosts hundreds of active clinical
trials at any given time.
Prevention is another key focus of the new law, which
guarantees coverage and eliminates out-of-pocket costs
for many routine exams and screenings, such as mammography,
colorectal cancer screens, and Pap tests for
cervical cancer. It also provides funds for an expanded
national prevention and public health program to be
administered through the Department of Heath and
Human Services.
“I think we have a lot to look forward to in the new
federal law, but we’re continuing to work with members
of Congress and policymakers to ensure that the reforms
will give people ongoing support,” Levine says. “We want
the new law to help individuals throughout their cancer
journey, which means providing preventive services,
ensuring access to high-quality treatment and research,
and helping survivors get the ongoing help they need.”
Learn more about Dana-Farber’s legislative efforts at
www.dana-farber.org/legislative-action-network.
Fall/Winter 2010 P a t h s o f P r o g r e s s 31

Why I Work Here
FOCUSED ON PATIENTS AND FAMILIES
by KARA LACEY
When she first arrived at Dana-Farber 10 years
ago, Patricia Reid Ponte, RN, DNSc, was
pleasantly surprised to learn that a patient
would be conducting part of her interview. Immediately,
she knew she had landed in the right place.
Today, as Dana-Farber’s chief nurse and senior vice
president for Patient Care Services, and executive director
of Oncology Nursing and Clinical Services at partnering
Brigham and Women’s
Hospital, Reid Ponte places an
emphasis on the importance of
patient- and family-centered
care. It wasn’t until she
started working here, however,
that she fully understood
what that meant.
“Without patients and
families at your side, offering
their perspective, you’re
not as good a clinician,
researcher,
or administrator,”
says Reid
Ponte. “Our
leadership and
staff realize
that whether
you’re
developing
a care plan
or building
a new
facility, it
is impossible
to get it
right without
patients and
families – as well as frontline staff – being involved in
planning and decision-making, Understanding this and
prioritizing it has helped Dana-Farber be excellent.”
Growing up in Somerville, Mass., Reid Ponte knew
early that she wanted to follow in the footsteps of her
mother, a registered nurse at Massachusetts General
Hospital (MGH) for more than 30 years. As a high school
and college summer student, Reid Ponte worked on the
patient care floors at MGH in a
“Dana-Farber’s
variety of jobs including kitchen
aide, unit secretary, and unit aide. focus and priorities
align with
She learned a lot about diversity,
teamwork, and patient care.
my own core
Now, decades later, Reid Ponte
leads a large team of nurses, pharmacists,
social workers, chaplains, think of work-
values, so I can’t
nutritionists, and support staff ing in a place
within Dana-Farber/Brigham and
that would be a
Women’s Cancer Center, Dana-
Farber/Children’s Hospital Cancer better fit.”
Center, and a growing network of
satellite centers – all of whom, she says, will play
a critical role as health care reform takes shape
and progresses.
“Strengthening the education of clinicians will be
important as we start caring for people in different,
more holistic ways,” she says. “As advances give patients
more treatment options, nurses will play a pivotal role
in helping them and their families make decisions
about care.” Reid Ponte also takes great pride in Dana-
Farber’s designation as a Magnet hospital, the highest
inter national honor for nursing excellence.
“Dana-Farber’s focus and priorities align with my own
core values, so I can’t think of working in a place that
would be a better fit,” says Reid Ponte. “I know that we’re
making an impact, both on the lives of patients and families
and in our understanding of the science of cancers.”
Patricia Reid Ponte, RN, DNSc

What I Know
KATHLEEN BOUSQUET
As Told to KRISTIE VELARDE
Kathleen Bousquet and her daughter Stacey
Holmes share many things: a love of Maine,
the beach, and the same warm smile. Recently,
the women learned about one more bond – a mutation
in BRCA1, a gene buried in their DNA that can trigger
breast or ovarian cancer.
Bousquet, 61, was diagnosed with ovarian cancer in
1995. Holmes found out she had breast cancer last year,
at age 38. But while
“I feel like anyone
else with a to traditional treatments,
Holmes responded well
chronic disease. Bousquet’s path was
Like those with
riddled with challenges
and setbacks.
arthritis or diabetes,
I am manag-
Bousquet received five
Over the past 14 years,
ing an illness.” rounds of chemotherapy,
paced between a series of
brief remissions. She knew she needed a different
approach, and, in 2008, agreed to genetic testing.
It brought good news. Bousquet learned that she qualified
for a trial of two drugs, cediranib and olaparib, a
combination found to be most successful in treating patients
with BRCA1 mutations. Working in tandem, these
medications stop blood flow to the tumor and damage its
DNA so that cancer cells cannot multiply. In Bousquet’s
case, the treatment has kept her cancer in check, and her
body free of harsh side effects.
Here, Bousquet, a mother of two and grandmother of
three, shares what she has learned from her experience.
Standard chemo isn’t always the answer. The targeted
drugs I’ve been on let me live a normal life.
I feel like anyone else with a chronic disease. Like
those with arthritis or diabetes, I am managing an illness.
The best part about being a grandparent is enjoying
your grandchildren without the worries.
Annual gynecological check-ups are critical for every
woman. It saved my life.
Road rage is a complete waste of time. Cancer taught
me not to sweat the small stuff.
Everyone should have a good rapport with their doctor.
When I was first referred to Dana-Farber/Brigham
and Women’s Cancer Center, someone told me I was “in
the best hands.” Immediately, I felt huge relief, and, four
years later, I know every word was true.
People can be so giving.
When my daughter was
diagnosed with breast
cancer and I was still in
treatment, her friends
and neighbors made sure
her three young boys
had a home-cooked meal
every night.
A cure for cancer may be
a long way off, but I think
targeted drugs are what
the future holds for
many people.
It’s important
to have options.
Dana-Farber
has given me
several treatment
options
– not to
mention
boatloads
of hope.
Kathleen Bousquet

Non-profit Org.
U.S. Postage
P A I D
Dana-Farber
Dana-Farber Cancer Institute
44 Binney Street
Boston, MA 02115-6084
617-632-4090
www.dana-farber.org
A teaching affiliate of
Harvard Medical School
Two “stars” from the ninth annual WEEI/NESN Jimmy Fund Radio-Telethon, Jimmy Fund Clinic Activities Coordinator
Lisa Scherber and 16-month-old Aejay Jensen, bond during the August event broadcast from Boston’s Fenway Park.
Jensen is a clinic patient.