It all began with a diagnosis: Merkel cell carcinoma (MCC), a deadly skin cancer. Robert Yolles knew he had to find the best doctor and treatment for his wife, Monica.

“When she was initially diagnosed, the dermatologist was quite surprised; Merkel cell is really so rare,” he says. Yolles immediately set out to gather more information. “One of the first things I did was look online for the 10 most important articles on MCC — and I quickly discovered that Paul Nghiem had written the lion’s share of them,” says Yolles.

Paul Nghiem, M.D., Ph.D., is the head of UW Medicine’s Division of Dermatology and the George F. Odland Chair in Dermatology. Yolles will always remember how quickly Nghiem replied to his call, the call of a stranger — and the doctor’s candor the first time they talked.

“When I spoke with Paul, I shared the advice we’d received about my wife’s treatment plan,” says Yolles. “He said, ‘don’t let them do that.’ He recognized that our well-meaning doctors were applying a treatment protocol that was appropriate for other cancers, but wouldn’t work for us.”

Until very recently, patients with MCC could expect to live just months after their cancer started metastasizing or spreading. Nghiem and his colleagues have been working diligently for years to change those statistics, and they have made significant improvements in management of the disease. The Yolleses were so impressed that they began to travel to Seattle for care, where Nghiem recommended some unusual radiation therapy approaches. The treatment got Monica’s cancer under good control.

“In a lot of ways, my wife was a tough patient, because she’d been through so much, a series of autoimmune diseases over a period of 30 years,” says Yolles. “She was fearful — and Nghiem’s team made it easy for her, which was something extraordinary.”

Tough Conversations
“I remember having tough conversations with patients and families at the beginning,” says Nghiem. “There was really only a 2–5 percent chance that we could provide any kind of lasting benefit to patients whose cancer had metastasized.”

And now: the game-changer. March 2017 saw the first-ever FDA-approved immunotherapy drug for metastatic MCC treatment. The 50 percent of patients who respond to treatment are seeing their cancers shrink or disappear, and in the vast majority of these patients, the responses last many months or years. Increasingly, MCC is a disease that can be survived — even cured for some patients.

“Being able to offer such treatment is super-gratifying,” says Dr. Nghiem. “Half of those treated will do well for a very long time. And that’s more than a ten-fold increase of real, long-term benefits.”

Doing What He Does Best
Monica Yolles died in 2013 of causes unrelated to MCC. However, Robert Yolles stayed connected with Nghiem and became a steadfast supporter of his work. The Yolles family’s gifts have provided funding crucial for Nghiem and his team when they were between grants, supported undergraduate research assistants and created an MCC database of over 1,000 patients — leading to increased screening and identification of patients for clinical trials.

“This is a disease that people don’t even like to talk about. But we found an open and accessible environment, full of people who care. It was a whole different feeling,” Yolles says. “I think part of the power of philanthropy is in supporting these doctors, so they can keep doing what they do best — providing exceptional care to patients and working toward advances in treatments.”

Dr. Nghiem becomes reflective when considering this kind of generosity.

“Sometimes people give because they’re grateful for a positive outcome, and others give because a person didn’t do well, and they don’t want others to have to lose someone,” Nghiem says.

For Nghiem, both of these scenarios are incredibly motivating. “I feel a personal commitment to continue doing the very most I can with these donations,” he says.

ACCELERATE RESEARCH

Through a gift to the Merkel Cell Carcinoma Fund.

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