As a high school freshman, Kurt Weiss, MD, and his classmates took a test that would supposedly predict their future careers.
After answering the many questions, the results said he’d one day become a doctor.
“I thought, ‘What a bunch of nonsense. I watch M*A*S*H with my brother. That’s my only interest in medicine,’” Dr. Weiss recalls.
As it turned out, the test was right — although it surely couldn’t have predicted Dr. Weiss’ exact path to medicine.
Dr. Weiss was diagnosed with osteosarcoma — a type of cancer that begins in the bone — later during that freshman year. He underwent widespread treatment that saved his life.
Today, Dr. Weiss is a sarcoma surgeon and researcher at UPMC Hillman Cancer Center, treating and studying the cancer he once had. He says his own cancer treatment inspired his career choice in every way imaginable.
“Both in my career choice and in the way I think about the universe as a scientist, that experience of being a patient myself has impacted me,” Dr. Weiss says.
A Rare Cancer
Dr. Weiss was participating in spring football practice in 1989 when he noticed he was “losing a step.” He also had a painful mass on his tibia (shinbone).
At his mother’s urging, he visited a sports medicine specialist. After getting x-rays, he was referred to Mark Goodman, MD, an orthopaedic oncologist at UPMC.
“He talked to me, looked at my x-rays, examined me, and said, ‘Well, Kurt, it looks like you have a textbook example of osteogenic sarcoma — that is, bone cancer,’” Dr. Weiss says. “‘If you’re lucky and the disease hasn’t gone to your lungs, you have a 65% chance of being alive in five years, and you should expect to lose your leg above the knee.’
“So, that was a bad day.”
Further tests showed that his cancer had spread to his lungs, dropping his survival chances to about 15%.
He underwent chemotherapy with Michael Wollman, MD, at UPMC Children’s Hospital of Pittsburgh and surgery to remove the tumors from his leg and lungs. He also underwent an osteoarticular allograft, a procedure that used a bone graft to repair the damage to the bone in his leg.
After these procedures, he was finishing another round of chemotherapy when tests showed the lung tumors had returned.
“That moved my life expectancy from about 15% to not calculable,” Dr. Weiss says. “I had another operation to remove those new lung tumors. At that time, Dr. Wollman pulled my parents aside and said: ‘You know, guys, this isn’t going well. Kurt could go downhill pretty fast, and you should be ready for that.’
“So my mom and dad purchased a burial plot for me and started working out the details of my funeral mass.”
The treatment that ultimately saved Dr. Weiss’ life came from an unexpected source.
His older sister, who lived in Allentown, Pa., read in her local paper about an experimental osteosarcoma clinical trial occurring in Houston under the direction of Eugenie Kleinerman, MD. She cut the article out and mailed it to her parents.
“Why in the world they would have had an article about an experimental treatment on an obscure cancer that affects four kids per million that’s taking place in Texas, it can only be described as providence,” Dr. Weiss says.
The trial accepted Dr. Weiss. He underwent three months of treatment in Houston and three months with Dr. Wollman at UPMC Children’s.
He finished treatment in December 1990 and was declared cancer-free, but his medical treatments weren’t over.
Over several years, he had repeated setbacks with the bone graft in his leg that required surgery. During his junior year at the University of Notre Dame, he made the difficult decision to have the leg amputated above his knee. He had the operation after finishing his exams at the end of his junior fall semester.
Pursuing the Path of Medicine
Dr. Weiss jokes that he’s the “black sheep” of his family: a doctor in a family of engineers.
He became interested in medicine very early during his treatment. At 17 years old, he began accompanying Dr. Goodman in his clinic.
“This whole time, I was very interested in the science behind my treatment: the chemotherapy, the experimental treatment, the surgeries I was having,” he says. “All of these things I found fascinating.”
After his leg amputation, Dr. Weiss spent his recovery time studying for the Medical College Admission Test (MCAT) to enter medical school. Through a connection with the Make-A-Wish Foundation, he secured a research job in orthopaedic surgery at the University of Pittsburgh.
“Something happened that I did not expect, which was that I fell in love with research,” Dr. Weiss says. “I found that I had some aptitude for it, and I just thought it was the coolest thing ever.”
After his first year of medical school, he had another “amazing” experience working in Dr. Kleinerman’s lab in Houston for nine weeks.
“That was the first exposure I had to bone cancer research,” he says. “Also, I got to see the magic of what it’s like to look after patients and do research.”
After originally considering pediatric oncology, Dr. Weiss ultimately decided to pursue orthopaedic oncology. He worked alongside Dr. Goodman at UPMC during his residency.
After completing his fellowship at the University of Toronto, Dr. Weiss returned to UPMC full time in 2010. He worked alongside Dr. Goodman for nine years before Dr. Goodman retired.
“I don’t know what’s going to happen the rest of my career — hopefully I haven’t peaked — but those nine years working with Dr. Goodman, with the guy who operated on me, were the best thing ever,” he says. “I’ve got a great dad, but Dr. Goodman has really been a very special mentor to me.”
The Fight Against Sarcoma
Dr. Weiss has now worked at UPMC for 15 years as an orthopaedic surgical oncologist and researcher. He surgically treats patients with sarcoma and studies the disease in his lab.
His own experiences help him connect with patients when diagnosing and treating them, he says.
He says that when he learned of his diagnosis, all he wanted was to meet a person who had survived sarcoma. Now, he’s that person for other patients.
“One of the things that I’ll say to patients and families is: ‘This is a really terrible day,’” Dr. Weiss says. “‘In fact, this might be your worst day ever. But here’s the thing: I had a pretty bad day, too. And this is not going to be fun, and it’s not going to be easy. But our goal — and, quite frankly, our expectation — is that we’re going to treat this, and we’re going to cure you.’”
Advances in the knowledge and treatment of sarcoma since his diagnosis are a “mixed bag,” Dr. Weiss says.
Research has helped predict which patients with soft-tissue sarcoma will respond to immunotherapy. However, the chemotherapy drugs one takes for osteosarcoma are the same ones Dr. Weiss received 35 years ago, which is “quite disappointing,” he says.
That makes sarcoma research important. There are about 75 types of sarcoma. The disease begins in connective tissues like bones, cartilage, muscles, nerves, and more.
Although sarcoma is a rare cancer, it can have devastating effects, often in young people. Osteosarcoma, in particular, is most common among children, teens, and young adults.
“Doing this research is not only very close to our heart, but it is very, very important for our patients,” says Ines Lohse, PhD, research assistant professor and co-director, Musculoskeletal Oncology Laboratory, University of Pittsburgh Department of Orthopaedic Surgery.
“We are talking (about) children here. No family with a child should be touched by cancer or have to bury their child simply because there isn’t enough research done.”
Though sarcoma is typically curable when localized, the survival rate plummets when the disease metastasizes (spreads).
Dr. Weiss’ research focuses on metastatic disease.
“What we’ve never had a good answer for is what to do when the sarcoma spreads and goes to the lungs,” he says. “Despite the fact that there are about 75 different kinds of sarcoma, they spread to the lung, the lung, and the lung. So they have a pretty limited passport, yet we don’t understand that biology.
“So that is why I’ve decided that my whole scientific life is going to be dedicated to figuring out how sarcoma metastatic biology works and what we can do to interrupt that.”
Inspired by the doctors and researchers who treated and later mentored him, Dr. Weiss has done his part to advance sarcoma research.
Dr. Weiss, Dr. Goodman, and Richard McGough, MD, established a sarcoma tissue bank at UPMC in 2012. They began preserving sarcoma tumors from the operating room for use in scientific research.
The tissue bank now holds about 19,000 specimens from about 700 patients, which Dr. Weiss shares with researchers worldwide.
“Rare disease tumor banking is extremely hard,” Dr. Lohse says. “It has a lot of moving parts, a lot of people that need to come together consistently to make it happen. But having him as that driver, as that force behind it, really brings people together.
“I think that’s his biggest strength. He knows how to bring people together and share that passion about what we do.”
Though Dr. Weiss has done his own sarcoma research, he believes the tissue bank will drive international sarcoma research for years to come.
“When you’re a translational scientist — meaning you’re trying to get something from your laboratory into the patient’s room — these human clinical samples are gold dust,” Dr. Weiss says. “To be able to share them, this incredible resource we’ve built at the University of Pittsburgh, I think at this point, that’s probably the thing I’m proudest of.”
Dr. Weiss also helped to develop Pittsburgh Cure Sarcoma and the Pittsburgh Sarcoma Research Collaborative (PSaRC).
Pittsburgh Cure Sarcoma has raised over $2 million for sarcoma research since 2011. The PSaRC is a team of physicians and scientists at the University of Pittsburgh and UPMC who are striving to advance sarcoma research and bring their findings to patient care.
“If I’ve had any success at all, it’s because I’ve got the supporting cast of people who have come to Pitt to do sarcoma research and who make me look awfully good,” Dr. Weiss says. “I’m just very, very humbled and blessed to be part of the scientific and clinical team we’ve got here. It’s really a wonderful environment.”
The work of Dr. Weiss and other sarcoma researchers has the potential to help the research and treatment of other cancers. For example, a drug called imatinib that first showed promise in treating a type of sarcoma called gastrointestinal stromal tumors (GISTs) is now available to treat other cancers with similar mutations.
“A lot of the very important discoveries that have been made that affect all cancer patients have been made first in rare cancers,” he says. “There’s a lot of power behind discoveries that are made in rare cancers because they can be easily translated to less rare things.”
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