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    Rafael Fonseca, M.D.

    TRANSFORMING TOMORROW. Today.

    EXPANDING INNOVATIVE MYELOMA TREATMENT METHODS TO INCLUDE OTHER BLOOD DISORDERS

    Rafael Fonseca, M.D.

    Hematologist and Chief Innovation Officer

    Scottsdale/Phoenix, Arizona

    I build my hope on seeing the change that has occurred, and my field is oncology, but I think in medicine in general. I'm a strong believer in hard work. I think hard work is essential. I love the responsibility that comes with that. A lot of things that happen around here are built on the idea that, "let's move things forward." We have had to build new things because they have not existed before. I don't think there's any doubt that this is because of that drive that we have from our values. And those values really permeate everything we do. So I think for the future generations, someone else will build the other side of what's happening here.

    I’m a pathological optimist.

    “I’m a pathological optimist. Let’s start with that,” says Dr. Rafael Fonseca. “When I began at Mayo Clinic in 1998, we had two drugs to treat multiple myeloma with a survival rate of about two years. It was thought to be incurable.”

    Now, 25 years later, Dr. Fonseca’s optimism is paying off. As one of the leaders of the Multiple Myeloma team at Mayo Clinic in Arizona, Dr. Fonseca is seeing a growing number of his patients living twenty years post diagnosis. “I firmly believe there is a fraction of patients who are actually being cured because of the treatments we provide,” he says. “And I share this with every new patient. I tell them, I will do my best so you can someday say you had a curable version of multiple myeloma.”

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    Dr. Fonseca is a consultant in the division of Hematology and Medical Oncology, as well as a Professor of Medicine and the Chief Innovation Officer at Mayo Clinic in Arizona. He is also an award-winning physician-scientist identifying prognostic markers and developing new therapies to improve outcomes for patients with blood disorders. “Although,” he adds laughing, “my mother says be wary of anyone with more than two titles.”

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    Growing up in Mexico City, Dr. Fonseca thought he would someday become an actuary. “I was very good at math,” he says. “I could always finish my math exams quickly. I never struggled with homework, and I could see an easy life in my future.” But one day, when he was 17, he had an accident.

    “I fell off a ski boat and became tangled in the rope,” he says. With severe cuts on his arms and legs, he was eventually stabilized after a 12-hour surgery. He doesn’t remember much about his first few days of recovery, except being impressed by the physicians and nurses. “I was truly grateful,” he says. “I thought to myself, maybe someday I could be on the other side of that. And that’s how I decided to become a doctor.”

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    It was during this time in the hospital that Dr. Fonseca felt a connection with his caregivers. “They gave me their full attention in that moment. Because for me, that moment was incredibly unique. To this day it permeates everything I do in the clinic,” he says. And while Dr. Fonseca says he doesn’t necessarily believe in fate, “I vividly remember right before the accident I told myself, you shouldn’t be here. Had I followed that, I’d probably be an actuary somewhere. It may sound bizarre, but I’m almost grateful because it led me to where I am now.”

    And Dr. Fonseca says he loves where he is now, having helped build Mayo Clinic in Arizona into one of the world’s preeminent cancer research centers. “When I Ieft Rochester for Phoenix, I was able to start the program here to treat multiple myeloma,” he says. “I developed the lab and brought along the grants that came with the lab. And shortly after that, I was able to recruit several notable individuals. We were just getting started, but those individuals saw where we were headed. And they, in turn, became inspiration for other individuals in our research efforts. We grew from that small group to a nationally ranked comprehensive cancer center.”

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    As physicians, we’re thrown into the arena and have to innovate every day.

    Mayo Clinic Comprehensive Cancer Center is a world-class leader in research, education, and patient care with an innovative spirit at its core. “I’ll give you an example,” says Dr. Fonseca. “We have patients here that we treat for a condition called amyloidosis, a rare disease where a certain protein builds up in the organs, interfering with their normal function. Those patients are traditionally treated through a bone marrow transplant. And we had a patient who could not go through a bone marrow transplant. At that point, our options were bone marrow transplant or do nothing.”

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    “So we decided, let’s try something in between,” he says. “Something we were using for myeloma. We had no clinical trial, but this person clearly needed treatment. Ultimately, the treatment was successful. As a consequence, clinical trials were developed and now that therapy has become the standard treatment for amyloidosis. Those are some of the challenges in medicine. It’s often difficult to explain because of the nuances of how we practice, and how we have to be very protective of patients’ outcomes. As physicians, we’re thrown into the arena and have to innovate every day.”

    What does Dr. Fonseca see for the future of Mayo Clinic? “I would love a future where other physicians, other academic institutions, the private sector, including biotech and manufacturing companies, think about a partnership with Mayo Clinic,” he says. “And think about it as one of the fastest, most productive, most valuable ways their products can be advanced in a way that ultimately benefits patients. I would like for people to think of Mayo Clinic as a nimble and creative partner, tolerant of the risks that come with innovation. Again, with the core mission of advancing the care for patients.” How does Dr. Fonseca plan to achieve all this? “I can be very persuasive,” he adds with a smile.

    Having authored over 370 medical articles, and cited over 60,000 times, a large part of his career is dedicated to research. “I’ve been fortunate that some of the research I have participated in has changed the course of what we do for the treatment of multiple myeloma,” he says. And when Dr. Fonseca looks ahead to his calendar, his favorite days are the ones where he sees patients.

    I would like for people to think of Mayo Clinic as a nimble and creative partner, tolerant of the risks that come with innovation.
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    “When I’m with a patient discussing treatment options and how we can individualize therapy to maximize the best outcome, that’s when I feel that connection and where I find the most meaning.”

    Rafael Fonseca, M.D.

    Dr. Rafael Fonseca is a hematologist who leads a team of world-class Mayo Clinic researchers working to create a better future for patients with multiple myeloma, a rare form of cancer. His practice focuses on diagnosing and caring for people with plasma cell disorders. He also leads clinical trials that have led to the approval of various drugs for the treatment of myeloma.

    Learn more about Dr. Fonseca
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    Hematology and Oncology

    Mayo Clinic hematologists are experts in treating blood cancers and non-cancerous blood disorders. Oncologists provide care for people with cancer.

    Learn more about hematology and oncology
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    Cutting-edge cancer research

    Mayo Clinic cancer experts are committed to discovering new ways to predict, prevent, diagnose and treat cancer, and to transforming the quality of life for cancer patients today and in the future.

    Learn more about cutting-edge cancer research
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    Understanding multiple myeloma

    Multiple myeloma is a cancer that forms in a type of white blood cell called a plasma cell. Healthy plasma cells help you fight infections by making antibodies that recognize and attack germs.

    Learn more to understand multiple myeloma

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