Husband-and-wife oncology team: Never give up!

You’ll find many husbands and wives who both work at the UT Health Science Center. But you won’t find any like Drs. Monica and Alain Mita.

They share the same specialty – medical oncology – with offices at the Cancer Therapy & Research Center (CTRC) at the UT Health Science Center San Antonio. They traveled the same career path, attending the same schools in Romania and France, earning the same degrees and completing the same fellowships. They hold the same academic appointments and as a result, they tackle the same variety of assignments. They see patients while at the same time teaching residents and fellows at four locations – the CTRC, University Hospital, Audie L. Murphy Division of the South Texas Veterans Health Care System, and CHRISTUS Santa Rosa Medical Center. They manage 30 clinical trials between them, write scientific papers and give lectures at national and international meetings.

Married for 18 years, the Mitas’ personal life revolves around their three children. Stephane, age 7, was born during their fellowship in Toulouse, France. Marianne, 5, arrived the year after they accepted a fellowship at the CTRC Institute for Drug Development (IDD). Adrienne, 2, was born the year they joined the Health Science Center faculty.

Secrets to success

When commenting on the Mitas, a colleague, Christopher Takamoto, M.D., Ph.D., who worked with the Mitas before he moved to private industry, said, “What strikes me as unique is their balanced commitment to their professional careers and to their lovely family. Most working couples end up compromising one spouse’s job in favor of the other’s. For Alain and Monica, this is not the case. Of course this is not an easy thing to do, but they seem to have solved this complex equation exceedingly well.”

One factor that seems to balance the equation is a shared profession. “On days when I’m drained and down, watching kids in their 20s dying, Alain understands exactly what I’m going through,” Monica said. Familiarity not only helps the couple empathize, but advise. “We can be each other’s toughest critic,” Alain said. “It helps to see another person’s perspective. One nurse told us that our marriage lasts because we agree to disagree.”

Monica adds with a smile, “But it’s a sweet victory if we can change the other person’s mind.”

Another factor is friendship. “Monica has told me that the only reason she made it through the rigors of medical school, residency, fellowships and her career is that she and Alain are best friends,” said Jerry Medina, a research nurse supervisor. “They are successful because they are together.”

Friendship produces a willingness to share responsibilities. “If we get a call from the day care that one of the kids is sick, we have to decide who will pick up the child and who will cover the work,” says Monica. They alternate routine pickup from day care, cooking, going to teachers’ meetings and shopping. On weekends, they have fun with their kids. “We ride bikes, visit the zoo, walk around the botanical center and the parks, and go to museums,” Alain says. Once a year, Monica and Alain take a one-week vacation without the children.

Dr. Monica Mita examines 24-year-old cancer patient, Martha Arredondo.

A passion for the cure

At the core, Alain and Monica share a passion for the work of curing cancer.

“They live every patient’s life in their heart,” said CTRC patient referral coordinator, Epp Goodwin. Goodwin schedules patients who are taking Phase I drugs, those shown in the laboratory to be well-tolerated, but still need to be evaluated for safety, effectiveness and side effects. Because the CTRC has one of the largest oncology Phase I clinical drug studies programs in the world, it can offer drugs that are unavailable even in many large cancer centers. Patients come from many states and often arrive with little or no hope, because they have failed conventional treatments.

“I have the utmost respect for these two doctors,” Goodwin said. “They always do what’s right for the patient.” She recalls a patient, a middle-aged woman with lymphoma, who came to the CTRC three years ago. “To qualify for a trial you have to meet certain criteria,” she explained. “When I screened the patient’s records, I knew she didn’t qualify. But Alain didn’t turn her away. He prescribed some things he hoped would make her stronger. Three weeks later, she looked much better and she qualified for a trial. In fact, she ended up taking part in two different studies. We knew we couldn’t cure her cancer, but we could give her time and the best quality of life possible.”

Giving patients hope is what drives the Mitas. “There’s nothing worse than telling a patient there’s nothing we can do,” Alain said. “People with cancer are fighters. They need us to help them.”

The opportunity to work with promising new cancer agents was what lured the Mitas from Paris to San Antonio in 2002. “We knew about San Antonio from reading about clinical trials,” Alain said. “The IDD and CTRC were on the same level as M.D. Anderson and other top cancer centers.”

Seven years later, the Mitas have tested about 50 anti-cancer drugs. At least 17 were deemed worthy of further testing. Because of the Mitas’ rigorous training and experience, they epitomize the latest generation of leaders in developmental therapeutics, according to IDD director Francis Giles, M.D.

“We now look to our IDD investigators to understand the molecular lesions in cancer and to use these lesions as targets for novel approaches,” Dr. Giles said. “We expect them to follow a promising agent from the laboratory to potential regulatory approval – a very complex journey.” He adds that for physician-scientists to be effective across such a broad scientific spectrum, they need to be both experts in early phase drug development and in a specific tumor type. Monica specializes in sarcoma and breast tumors; Alain in tumors of the lung.

Dr. Monica Mita keeps this drawing, given to her by a former patient, in her office as a source of inspiration and encouragement.

A partnership with patients

Monica and Alain insist their partnership in medicine, science and life remains incomplete without patients.

“Without patients willing to participate in clinical trials to test new drugs, we risk being in the same place in 10 years that we are now,” Monica warns. “Ninety percent of cancer patients are never told of the option to enter a clinical trial. Their doctors prescribe conventional treatment, and if it fails, they tell patients there’s nothing else they can do.”

It is precisely these patients who enter CTRC’s Phase I trials. “It’s a great feeling to have the power to help a patient,” Monica says. “It’s great to be able to give them a drug and see a good response. Of course, not all patients will respond. But when it works, it’s worth every effort.”