‘Not going to stop until every patient has hope for a cure’

Elizabeth Stewart, MD, is a pediatric hematologist-oncologist and Associate Member at St. Jude Children’s Research Hospital in the Solid Tumor Division in the Department of Oncology.

She splits her time between treating children with solid tumors in the clinic and doing research in her lab that focuses on the recurrence of pediatric solid tumors, which tend to be aggressive. Her lab harnesses the power of advanced disease modeling to better understand the cellular and molecular mechanisms that explain why some tumors are hard to treat and return. Here’s what she had to share about the impact and scope of her work and role at St. Jude.

Q: What brought you to St. Jude?

A: For me, being able to work at St. Jude is much more than a job. For me, it's personal. When I was a child, one of my best friends in grade school was a patient at St. Jude. He used to talk about his relationships with his doctors and nurses and how much he loved going to the hospital to interact with them. He just loved his care team so much, and it was his dream to be able to come back to St. Jude and be a doctor.

Unfortunately, when he was in seventh grade, he relapsed from leukemia and never got that chance. While St. Jude gave us more time with him, unfortunately he passed away. And somehow that dream that he had to come to St. Jude sort of morphed into mine. And I thought, “Wouldn’t it be cool if I could come back and sort of live out his dream?”

I got the opportunity to come to St. Jude and be a physician in 2010. I carry my friend’s memory and his hopes and dreams with me every day. When I walk through the doors of St. Jude, he is my motivation. His friends that went through treatment with him are my motivation. The patients that I see every day in clinic are my motivation, and we're not going to stop until every single one of them gets a chance for a cure.

Q: Can you tell us a little bit about the work you do in solid tumor research?

A: I have a unique job at St. Jude where I get to spend part of my time taking care of patients in our solid tumor clinic and then part of my time in a research lab working to come up with new therapies for those very same patients. We're working hard to try to better understand some of these high-risk solid tumors.

We’re really trying to find ways to design new combinations of therapies that are not only going to treat these cancers better, but hopefully also come up with treatments that are going to be less toxic.

Q: What is a solid tumor?

A: Solid tumors are really any sort of solid mass that occurs outside of the brain. When you think of the different types of pediatric cancers, you probably know about liquid cancers like leukemias that are in the bloodstream. You might know about brain tumors, which are masses inside the brain. But solid tumors represent a spectrum of disease which could be muscle tumors, bone tumors or any sort of solid mass that happens outside of the brain.

Q: What specific cancers do you work with, and can you describe the work you’re doing to improve survival rates?

A: My expertise is in sarcomas and particularly patients who have high-risk disease. These are cancers that have either spread to other parts of the body or high-risk cancers in which patients have gone through therapy once and then unfortunately their cancer has returned. Those cancers are harder to treat.

I work with cancers such as rhabdomyosarcoma, Ewing sarcoma, osteosarcoma and a whole spectrum of other solid cancers that happen within the body.

For patients who have relapsed disease — where their cancer has returned — our survival rates are not nearly good enough. We're working diligently in the research lab to better understand the makeup of these tumor cells and to understand why some tumor cells respond to therapy and why others don't. Unfortunately, it's those tumor cells that don't respond to therapy that stay in the body and lead to recurrent disease and end up taking the lives of some of our patients. So, we're digging deep and trying to understand the vulnerabilities of those particular cancer cells that are left behind so that we can come up with new therapies and new combinations of therapies that we think are going to be better for these patients and, ultimately, improve those survival rates.

We're not going to stop until every single patient has got hope for a cure. And it's not just patients that are here at St. Jude. It's every child, everywhere.

Q: Can you think of a St. Jude story or moment that really sticks out in your mind?

A: Within my research lab, we came up with a new therapy for patients with Ewing sarcoma who had relapsed disease that we were able to move forward into clinical trials.

We worked on this, going back and forth from clinic to the lab and back again to constantly perfect the drugs that we're putting together to help improve the cure rates for these patients. And sure enough, we began to see positive responses in patients. When you have something you discovered in a lab that is yielding such positive responses, it’s just a priceless moment.

To have all that hard work by all of the clinical and laboratory teams actually work out is an amazing feeling that you can never recreate. I always said, if I could help just one patient, that it would be enough. Once you've helped one, you want to continue to help more. So, every single day when I'm walking into the research lab, I think of those patients that are on the receiving end of our hard work in the lab. I use that as motivation. It's not enough for us to stop when we've made progress, because our work is not done.

Q: You are known as a physician scientist, so what you do in clinic informs what you do in a lab and then back again. Talk to us a little bit about that and what makes St. Jude unique with that.

A: Being a physician-scientist gives me a unique perspective. Because of my time in clinic, I understand what it's like for these kids that are going through therapy. I understand the side effects that they have. I understand the challenges of taking care of some of these patients and the diseases that are hard to treat. And I take all that information with me back to the research lab and I use it as motivation to develop better, hopefully less toxic therapies.

Q: How long does it take to go from the work you're doing in the lab to taking it to the bedside to work with patients?

A: When working in the research lab, we're searching diligently to come up with new therapies, and it's our goal to cut down on the amount of time it takes to get those therapies to the patients who need them the most. Sometimes, because of the resources that we have from grants and generous donors, we are able to propel these treatments forward faster. As soon as we find something that we think is going to be better or less toxic for these patients, we move that forward as soon as possible, sometimes even within a matter of months.

Q: How do donors and supporters help you do the work you're able to do?

A: The support that we get from our donors to St. Jude means everything. I would not have the tools and resources I need to effectively do my job without the support of every single person that's giving to this institution. I've been a fundraiser myself. I've been a St. Jude supporter. I know what it takes and it's a lot of hard work and it's a lot of dedication.

You make cures happen by your support of St. Jude. You are making it so that the next family that walks through the doors here at our hospital is going to have that hope.