Dr. Nita J. Maihle, a Jackson resident, is a professor of medicine and associate director for basic research for the Cancer Center and Research Institute at the University of Mississippi Medical Center. Throughout her career, she has targeted, in particular, one of the most heartbreaking forms of cancer, ovarian cancer.
In addition to being an experienced cancer biologist, Maihle also has served as a mentor and role model for numerous students, residents, fellows and visiting professors and an advocate for women and other underrepresented individuals in the biomedical sciences. She serves in a leadership capacity for numerous interdisciplinary cancer research organizations throughout the country and for several national research funding organizations.
Maihle earned a bachelor’s degree in biology/botany and a master’s degree in biology from Miami University, a master’s and doctorate in biomedical sciences from Albert Einstein College of Medicine and a master’s degree in medicine from Yale University.
How did you come to focus on cancer research?
“In my undergraduate days at Miami University, I became interested in going to medical school, not to be a physician, but to do something about cancer. I felt being a scientist would lead to a bigger long-term impact.
“I was one of the first students accepted into the program at the new Chanin Cancer Center at Albert Einstein College of Medicine. I spent the first two years completing coursework with the medical students there, and the last two years concentrating on my thesis research.
“I did a post-doctoral fellowship in tumor virology at Cold Spring Harbor Laboratory. Cold Spring Harbor had a strong group of tumor biologists.
“I became interested in studying tumor viruses because of my dad. He was a former World War II soldier and had been stationed in North Africa when he was infected with Epstein-Barr virus, while he was suffering from malaria; this virus eventually led to the development of Burkitt’s lymphoma decades later.
“In many people, the virus hides out and never comes out again. Sometimes it can be decades later when it comes out.
“What happened with him was he got a head cold and a couple of weeks later, he had a fast-growing lump on his face. He went to the doctor, who told him he had a malignant tumor and wouldn’t survive it. We were in disbelief. He lived about 18 months, mostly in a hospital bed in our living room. We got to see this robust, active person melt away from this disease.
“I was a sophomore in high school when he was diagnosed in 1971. In the early 1970s, the president decided to unify the country by declaring a domestic war on cancer. We would use domestic funds to fight a new ‘war on cancer.’ We felt like Richard Nixon was looking into our living room!
“I was interested in science and I was going to cure cancer. I was at an impressionable age. I graduated from Miami University and went on to Albert Einstein. I heard a speaker at Cold Spring Harbor while I was finishing graduate school—a fellow whose boss would later go on to win the Nobel Prize—for his discovery of how tumor viruses are related to the genetics of cancer. It was exhilarating to learn so I decided to go there to continue my training.”
I understand that researchers write grants to fund their work. What was the first grant that you wrote? How successful was it?
“The first grant that I wrote to get research funding was on the virus related to the tumor my dad had. I got scooped by a faculty member at Harvard, who was more experienced. I was encouraged because it meant I was on the right track.”
How did you decide to research ovarian cancer?
“I started thinking about other deserving problems. It seemed that women’s cancers were epidemic. Many of my mother’s friends were dying from breast and ovarian cancer.
“After her best friend died from ovarian cancer, I looked into the literature about what was known about this disease. It was discouraging because so little was known. It was a problem that I thought research would have a high impact on.”
“When I first began my research, women would live for maybe a year or two following their surgery for this disease. The mortality rate was quite high. In the decades I’ve been working on the disease, we’ve more than doubled the time most women with late-stage diagnosis live. We have made progress, but there’s still so much to be done.
“It’s really exciting, having been doing this for over 30 years. Just in the past few years we’ve really turned a corner. Mortality rates in the U.S. from cancer declined by 29 percent from 1991 until 2017.”
How common is ovarian cancer?
“For cancer deaths among women, it ranks fifth, and among cancers of the female reproductive system, it ranks first, according to the American Cancer Society, which forecast that ovarian cancer would kill around 14,000 women this year.
“Ovarian cancer usually strikes older women, often age 63 or older, and does so long before it’s noticed. The mortality rate is high because women typically aren’t diagnosed until late stages of the disease.
“A patient’s survival usually depends on a combination of chemotherapy and surgery. Outcomes using these treatments could be greatly improved if we could just detect this disease in its earlier stages.”
What are the symptoms of ovarian cancer?
“There aren’t common symptoms that will allow a physician to easily diagnose the disease. Often, women go from doctor to doctor, saying, ‘I don’t feel right.’ ‘I feel bloated.’ ‘I have constipation.’ ‘I have diarrhea.’ ‘I feel weird.’ They might initially be diagnosed with some G.I. problem or even an emotional problem.
“The majority of women diagnosed with ovarian cancer are at stage three or stage four. Our treatment options are limited. It’s one we don’t routinely screen for because of lack of approved early detection tests.”
What is significant about the U. S. Department of Defense’s Ovarian Cancer Academy Leadership Award of $2.75 million that UMMC received?
“In 2009, the Department of Defense through the Ovarian Cancer Research Program funded the Ovarian Cancer Academy. I was selected in 2015 to become dean of that program with Dr. Douglas Levine, a gynecologic oncologist at New York University, as assistant dean. We were selected and able to develop programming for, on average, a dozen trainees a year, physicians and physician scientists, committed to doing something about this disease.
“In 2020, that five-year leadership award ended. We wrote a new grant so that Doug and I would be able to continue the work of the academy from 2020 until 2025. That grant was a $2.75 million award to UMMC, and Doug and I split it.
“The goal is to increase the number of scientists and physicians working on this disease and ground them in the science so they are better able to come up with new ways of screening for, as well as preventing and treating this disease. Each scholar is assigned a senior mentor, an established scientist who can help guide them during their continued career development. Together, we organize professional development programming to help these young scholars. We lead annual workshops and monthly meetings, so that the scholars in this program have every benefit of learning what’s come before in this field—what we’ve already learned about ovarian cancer.
“I’m happy to say this program has become a model nationally for training other scientists in biomedical research. We like to think we’ve helped the field become more collaborative because part of what we stress is a ‘team approach to science,’ the importance of working together.”
What success have you had with your research?
“My research program has been focused on the early detection of ovarian cancer. We’ve discovered molecules in the blood that may one day be helpful in the development of low cost, non-invasive blood tests to identify women in the earliest stages of this disease—stages when it is more responsive to treatment.”
How much have you brought in to support cancer research?
“In my career studying women’s cancers, I’ve brought in about $1 million a year over a period of about 30 years to support cancer research. Together, the trainees in the Ovarian Cancer Academy have already brought in about $50 million to support cancer research in their research laboratories. That is just one indicator of their collective success. Through their efforts, much more research is now focused on ovarian cancer.”
Is there any positive news about ovarian cancer?
“As I mentioned, women diagnosed with ovarian cancer now live longer following their treatment — about twice as long as they did when I was starting my career. More generally, since that time (early 1990s) the survival rate for all of the most common cancers has risen, except those attacking the cervix and the endometrium (the inner lining of the uterus). While we’ve still got a long way to go, especially in the field of ovarian cancer, progress is being made.”
Do patients play a role in your work?
“We like to engage ovarian cancer survivors as ‘advocates’ in the Ovarian Cancer Academy. We have an advisory board that is part of Ovarian Cancer Academy and several patient advocates serve on this board. These women are folks you know in your daily lives. They are the fortunate ones who have survived this disease, and we can learn a great deal through their experience and that of their family members. Many patient advocates will go to the U.S. Capitol every spring and lobby for continued funding to support ovarian cancer research. We invite several advocates each year to attend some of our research meetings. Our scholars learn from their experience, and often engage them as partners in the design of their team science projects.
“The notion that science is something separate is an old-fashioned idea. Doctors don’t know everything. Scientists don’t know everything. Patients know a lot and we all need to learn together and from each other. In solidarity, working together, we can better fight this disease.”
What advice do you have for anyone who wants to become a scientist involved in research?
“Like any profession, science isn’t for everyone. It takes a long time to get through the training that is required, and a certain passion to drive you through the many failures one experiences in any research lab. Most of the things we do don’t work —or at least don’t work the first time —so you’ve really got to be perseverant, and also take a long-term perspective. That said, the Cancer Center and Research Institute at UMMC has several pipeline programs to encourage the entry of young scholars into cancer research. These training programs can be a great way to see if biomedical research is a good ‘fit’ for you.”
What traits are helpful to researchers?
“Optimism. Most scientists are optimists. They have to be because nine out of 10 experiments don’t work.
“Perseverance. You can’t get down when things don’t work. You have to always find what you can learn from whatever the results are and use them in the next study design.
“Delayed gratification. You have to get used to it. You may design an experiment where you don’t understand the results until 10 years down the road.”
What do you enjoy about your work?
“It doesn’t feel like a job. It’s a passion. There’s a book by Rosalynd Pflaum on Marie Curie and her contributions to science, ‘Grand Obsessions: Madame Curie and Her World.’
“Science really is a grand obsession. There aren’t many hours in the day when you’re not thinking about it, even when you’re cooking dinner your mind is often ruminating on some research problem!”
What’s a current success story in research that people should know about?
“One of the greatest success stories that is undercelebrated because of so much going on has been that the development of a COVID-19 vaccine in just under 10 months, actually multiple vaccines that are successful and protective.
“It’s unheard of! It’s nothing short of a miracle. It needs to be understood better and celebrated more. This is a huge success story. Scientists are the heroes, with the government working effectively with academic labs and the private sector. It shows how successful we can be when we all work together. We are so fortunate, as a society, to have folks who have dedicated their lives to be prepared for ‘just this moment’ in our planet’s history.”
“U.S. scientists were particularly well prepared to quickly and efficiently tackle this big problem. The many vaccines rolling out now are the product of a great collaboration and we owe those scientists around the world who have spent their lives preparing for this moment and dedicating their lives during the past year to this successful outcome a huge debt of gratitude.”