Emens has collected some data. She shared a few tidbits at a meeting of cancer doctors in May: Of the first 27 women in the study, 15 were healthy enough to receive all four rounds of vaccine and nine others were able to receive three. Those who couldn't finish them all either had cancer that was progressing or some other medical problem that kept her from completing the treatment. The blood of nine to 14 of the women revealed some level of immune response.
Emens understands. She just can't help. Research science doesn't allow for jumping to conclusions. Emens still needs to write a final paper on the study - and have it reviewed by peers - before anything she has learned can be legitimized. That's a year or two away. The women believe Emens wants to reveal what she knows, but as she told Marangi, "my boss would have my head" if she did.
Doctor as 'rock star'The relationship between doctor and patient, particularly in a trial like this, is complicated. For many, Emens embodies their last hope of survival. Many put her on a pedestal. One patient calls her a "rock star," for her place among a relatively small number of researchers trying to develop vaccines to fight cancer.
Her demeanor isn't warm and bubbly, they say. But if she seems detached to some of them, they're happy that she's working so hard to save lives.
"She's very efficient. We are going to discuss the important facts. We're not going to do the small talk," says Patty Fitzgerald, 44, a former research nurse at Hopkins who joined the trial in April 2007 and showed no signs of cancer in August. "I feel safe in that. I feel I can trust her."
For Emens, the women allow her a chance to put medical theory into practice. They aren't waiting for someone else to take on the risks of being first. They jump in with their eyes open. "Remarkable," she calls them. "There's something about people who are willing to do this."
As cancers go, Marangi figures she has had a pretty good run. She went 11 years cancer-free. Many doctors call that cured. So when the cancer came back two years ago, she was floored. She quickly started to feel as if some doctors give up on women once they are diagnosed as Stage IV.
Marangi's oncologist suggested Emens' trial. Marangi had done this medical pioneer thing once before, participating in a clinical trial for the cancer drug tamoxifen more than a decade earlier. She had just seen a dear friend die as she endured chemotherapy, so Marangi didn't want to head down that road. But neither was she going to sit around and wait to die. She was sold on the trial, despite a lifelong fear of needle sticks, of which there would be too many to count.
Besides, she says, her late father instilled in her a desire to leave things better than she found them.
Marangi was encouraged to learn from a friend at Hopkins about a similar vaccine being developed for pancreatic cancer, a cancer that means quick death for most who get it. The first 14 patients in that Hopkins study got their shots a decade ago. Three are still alive. Marangi says she will be one of the survivors in this trial.
As August rolls around, she still feels pretty good. She does laps in her pool, plays with her three dogs and entertains her 9-year-old grandson, the son of her only child, in town from West Virginia. Sometimes she jokes that her home life is boring. She is pretty happy that it is. She doesn't have a "bucket list"- no cruise to take, no city she must see. She feels as if she has always lived a full and fulfilling life.
But Marangi is nothing if not realistic. She knows breast cancer will kill her, probably not this month or this year but some day. She is getting her affairs in order. She has planned every detail of her funeral - down to burning the CD of disco music to be played. She has picked the spot off Cape Cod where she wants her ashes scattered after her friends toast her at a favorite bar. Her only regret is she will miss the bash.
It is in her will that Marangi inscribes her faith in Emens. Much of her money will be left to the doctor's breast cancer vaccine research.
more on the seriesComing tomorrow: Dr. Leisha Emens must move on with her breast cancer research even as the women in her trials face uncertain futures.
Online at baltimoresun.com/vaccine: Watch a video of Susan Marangi talking about the vaccine and its relationship to her quality of life, and find more photos, videos and previous installments of the series.