Terry Burke — a decorated Marine captain and successful businessman — was taking a chance on 30-year-old Curt Thorne and offering him a senior-level position at Cigna.
“On paper, I was not the most qualified for the job,” Thorne remembers. “But Terry very much listened to his own drummer and followed his own beliefs. He had seen something in me, and he thought I could be successful.”
Thorne took the job in 1989 and over the next three decades, what started as a business relationship grew into a deep friendship. After Thorne moved on to run a series of different companies, he relied on Burke’s business acumen and advice, with Burke serving on the company boards.
“He was quite a mentor to me,” Thorne said.
When Burke died from bladder cancer in 2017, Thorne wanted to honor his mentor. He and his wife, Heather, joined by Burke’s wife, Sherry, launched the Terry Burke Fund for Bladder Cancer Research at Vanderbilt-Ingram Cancer Center. The Burke Fund is supporting a range of discovery research aimed at improving outcomes for bladder cancer patients, and it is helping train the next generation of bladder cancer physician-scientists.
“This fund is designed with Terry’s passions in mind,” Thorne said. “He loved being a mentor; he loved creating opportunities for people to get ahead. Supporting young doctors at the beginning of their careers would be right up his alley.
“And, as it relates to philanthropy, Terry advocated support of less popular causes where an outsized impact can be realized. Bladder cancer is just such a cause: when compared to the death rate caused by bladder cancer among all cancers, it has not attracted its share of funding and research. The Burke Fund could have a big impact for patients, which is humbling.”
Bladder cancer is the sixth most common cancer in the United States and the fourth most common in men. The National Cancer Institute estimated there would be about 81,000 new cases of bladder cancer in 2018, with three times as many men as women affected by the disease.
About 90 percent of patients with bladder cancer are older than 55; the average age at diagnosis is 73. Smoking is a primary risk factor.
Although bladder cancer is among the top 10 most common cancers, it remains underappreciated, said Kimryn Rathmell, MD, PhD, Cornelius Abernathy Craig Professor of Medicine and director of the Division of Hematology and Oncology.
“It’s not uncommon to have a patient say, ‘I didn’t even know that bladder cancer was a thing,’” Rathmell said. “It’s as common as kidney cancer and more common than pancreatic cancer.”
One of the challenges for bladder cancer is in diagnosing the disease, which currently requires a cystoscopy. In this procedure, a urologist inserts a thin tube with a light and camera through the urethra into the bladder (like a urinary catheter) and examines the inner lining, taking tissue samples for testing.
Initial symptoms of bladder cancer, however, may look like those for a urinary tract infection (UTI).
“A primary care physician might think a patient has a UTI and prescribe antibiotics, then the symptoms come back months later,” said David Penson, MD, Paul V. Hamilton, MD and Virginia E. Howd Professor of Urologic Oncology and chair of the Department of Urology.
This was the case for Burke. He was 74 when he noticed occasional blood in his urine. His physician said he had an infection and prescribed antibiotics. Six months elapsed before he was examined by cystoscopy.
“They saw lots of tumors inside the bladder,” said his wife of 47 years, Sherry Burke. “The diagnosis came out of nowhere. I think if we’d had some knowledge about bladder cancer, we would have known what questions to be asking.”
Terry Burke had several months of chemotherapy, followed by removal of the entire bladder (cystectomy). The cancer had already metastasized, and he died about three months later.
“Early detection would have made such a difference to him,” Sherry Burke said.
With support from the Burke Fund, the Vanderbilt team is searching for urinary markers to diagnose and follow bladder cancer.
The group is collecting urine samples from patients undergoing cystoscopies for diagnosis, tumor removal and surveillance. They are examining a panel of five different potential biomarkers in the samples and then combining the information with the clinical findings to develop a predictive model.
“We would love it — as would all investigators looking for biomarkers — if you could give us a urine sample, and we could say yes or no, you have bladder cancer or you don’t,” said Sam Chang, MD, MBA, Patricia and Rodes Hart Professor of Urologic Surgery and the primary mentor for Amy Luckenbaugh, MD, the first Terry Burke Fellow.
The recent approval of five immunotherapies — medications designed to harness the patient’s own immune system to fight cancer — for locally advanced or metastatic bladder cancer has prompted new research questions.
The Burke Fund is supporting efforts to use immunotherapies to treat cancers that are still localized to the bladder and to characterize and test the immune cells that are present in freshly isolated bladder cancer tissue samples.
The team is also testing an unconventional immune therapy: reovirus, an “oncolytic virus” that causes little or no human disease and preferentially kills cancer cells.
“We know it kills bladder cancer cells in culture, and now we’re moving into our animal models,” Chang said. “The Burke Fund has been used to launch multiple projects that could not have been started without this funding.”
Thorne thinks that Terry Burke would be proud of what Vanderbilt physician scientists are doing in his name.
“Vanderbilt-Ingram has a deep commitment to the mission above the other things that get in the way, and Terry was very mission-driven,” said Thorne, who serves on the Cancer Center’s Board of Overseers. “It would be wonderful if the Burke Fund contributes to advances that give a lot more bladder cancer patients a fighting chance.”
