The patient was a young father, diagnosed with a form of lymphoma that was potentially curable. Chemotherapy worked at first, but the cancer returned. A transplant procedure seemed to work, but again the cancer returned.
The patient’s oncologist, Dr. Robert Whorf, wasn’t giving up. He consulted with colleagues at the world-renowned M.D. Anderson Cancer Center in Houston, and learned that a three-drug combination had proved successful in similar cases. But the treatment lacked federal approval for that form of cancer, and the patient’s insurance wouldn’t pay.
Whorf went to bat again, pressuring the insurer to pay, and the company relented. “Five years later” -- he raps on a wooden table -- “he’s doing fantastically.” The man was able to return to work, raise his children, live a normal life. The case seems to encapsulate the career of the Bradenton physician, who started out on a biomedical research track at Harvard, only be drawn into the world of caring for patients.
Whorf, 46, is with the Bradenton West office of Florida Cancer Specialists. It’s a long way from New England, where he was raised, from Harvard and Yale, where he studied and trained, and from Rochester, N.Y., where he attended medical school.
But a close friend who had been a year ahead at Yale had told him to get in touch when he was ready to begin a practice. Whorf called, and his friend told him of an opportunity at Florida Cancer. He came down for a visit.
“I’d never set foot in Florida,” he said. But he and his family had been living in Rochester for seven years -- “like dog years, 49 years of winter” -- and they were easily persuaded.
“You only have to spend one night on the beach on Longboat watching the sun set into the ocean to know this is a special place,” he said.
He, his wife, Patty, and sons, Benjamin and Jacob, settled in northwest Bradenton in 2004 -- just in time for Hurricane Charley and his kin to sweep the state. But Whorf found something else he loved: the people, from all over the country, Rochester natives, even patients from Germany who needed a stateside physician.
He also found a second family, of sorts. Florida Cancer Specialists is a massive practice, with some 100 doctors in 48 locations from Naples to Gainesville. That gives the practice some advantages, such as clout in dealing with insurers and Medicare, and resources like an electronic records system that knits the offices together.
But each office also operates independently, so it feels like a family practice.
“It’s like a big family,” he says. “We’re all very close. But behind it is the infrastructure of a very large practice, which is what you need to survive in this environment.”
That scope also allows Florida Cancer Specialists to be one of very few practices to operate an extensive research arm, giving its patients access to clinical trials of new cancer medications. The division is something Whorf soon will know much better: He was named as director of research operations in late August.
Dr. William Harwin, president of Florida Cancer Specialists, said Whorf is a natural for the job. “He’s a very bright guy. He comes up with creative ideas. He stands above other physicians that way,” he said. “We think he’s the right person to raise research at FCS to a higher level.”
Whorf’s background in biomedical research leads to his strong belief in the need to develop new ways of fighting cancer. Nationwide, Whorf said, only about 3 percent of cancer patients participate in clinical trials. If that figure doesn’t increase, he said, “How are we ever going to have new drugs in 2020?”
Practices such as his can improve participation, he said. In the traditional model, drug trials are conducted at major academic medical centers. But even centers in major areas, like the H. Lee Moffitt Cancer Center in Tampa, face the limit of geography: “They haven’t got the volume of patients,” Whorf said. “If you live in Arcadia, you’re not going to drive to Moffitt.”
With its network of offices, though, Florida Cancer Specialists can get those novel treatments to the patient from Arcadia -- or Clermont, Sebring and dozens of other places. Florida Cancer Specialists is involved in about 55 trials, Whorf said, via partnerships with nationally known organizations such as the Sarah Cannon Research Institute.
Some patients may be put off by misconceptions on the treatment in trials, he said. While clinical trials in some fields involve placebos, or inert substances, in oncology the patient receives either the standard regimen of treatments, or the standard plus the new medication.
“When you offer clinical trials to someone, they’re getting state-of-the-art care,” Whorf said.
Close to home
Biomedical research was going to be his career. While at Harvard, he was in an advanced research program that also offered students some clinical experience. Then two deadly illnesses reached out to his family.
As an undergraduate at the University of New Hampshire, he studied biochemistry. While home on break in 1986, he was repairing a fence with his father, Robert, who fell to the ground with an apparent heart attack. Whorf performed CPR to no avail.
He went on to graduate school at Harvard, studying neuroscience in a special program that afforded the researchers a taste of clinical medicine. Whorf was drawn to the focus on people and left the doctoral program for medical school, choosing the University of Rochester for its patient-centered approach.
While at Rochester in 1996, his mother, Anne, told him she was having trouble sleeping -- a pain so bad she could not lie down. Her doctor told her it was fibromyalgia, but Whorf suspected otherwise and told her to get a chest X-ray immediately. It revealed lung cancer and a massive tumor, far too late. She died six days later.
For some people, the experiences might have caused doubts about medicine, driven them away from the pain seen in hospitals each day. For Whorf, it was the opposite, drawing him away from the detachment of research and immersing him in studying how to fight cancer.
“I’ve never regretted it, not one bit,” he said.
Not even on one particular day this week.
With one of his patients he shares a friendly greeting. They say to each other, “I love you eight-sideways,” referring to the symbol for infinity. That day was her birthday, and that day he helped her arrange a transition to hospice care because treatment had finally failed.
Suprisingly to Whorf, that’s precisely why he does what he does.
“You’ve got people here in the building, right now, who are literally dying, and they have smiles on their faces, they bring cake to the nurses,” the doctor said.
“You see courage, dignity. You see families pull together. You realize how amazing humans can be. I can’t imagine doing another branch of medicine.”
David Gulliver, Herald reporter, can be reached 745-7080, ext. 2630.