Dr. Mack Ruffin: A career dedicated to research

August 23, 2017 at 3:37 pm Leave a comment

Ruffin_Chair_Portrait_03-02-2017_15

By Heidi Lynn Russell

Most people may not consider their family doctor to be a cancer prevention researcher. But Dr. Mack Ruffin IV balances one-on-one patient care with scientific sleuthing. When he’s not attending to patients and instructing medical residents at Penn State Health Milton S. Hershey Medical Center, Ruffin is pursuing mysteries about how people’s daily habits and decisions can lead to deadly consequences.

Recently, he received a lifetime achievement award from the Society of Teachers in Family Medicine – the Curtis G. Hames Research Award. It honors those whose careers over the years exemplify dedication to research in family medicine. Ruffin, professor and chair of the Department of Family and Community Medicine, came to Penn State College of Medicine last year from the University of Michigan Medical School in Ann Arbor. He has 27 years of experience as a physician-scientist.

A Lifetime Battle against Colorectal Cancer

One of Ruffin’s goals is for his department to be in the top 10 in National Institutes of Health research funding.

His driving motivation throughout the years has been the prevention of colorectal cancer, the third-most commonly diagnosed cancer in men and women in the United States. Although death from this type of cancer can be avoided with regular screening, most adults age 50 and older are not current with theirs, Ruffin says.

“I have tried to reduce the burden of colorectal cancer with multiple studies,” he says. “We want 80 percent of adults to be current with colorectal cancer screening by 2020.”

Early in his career, Ruffin researched better ways that primary care doctors could encourage screenings. As a result, the Department of Family Medicine at the University of Michigan created and implemented software that helped doctors remind their patients to be tested.

“These practices have, for the last five years, had 80 percent of adults age 50-74 years current with their screening for colorectal cancer,” he says.

But at the time of his study, use of electronic records was not widespread. His recommendations were too overwhelming for smaller practices to implement.

Nevertheless, Ruffin was determined to find ways to make patients want to follow through with cancer screenings. His next target: The dreaded colonoscopy.

“One of the barriers to colorectal cancer screening is many patients and physicians focusing only on colonoscopy for screening. This invasive, expensive and time consuming procedure is not well accepted by patients. The existing non-invasive stool tests are proven effective, but not reaching enough patients,” Ruffin says.

So he worked with a team of investigators to create and fund the Great Lakes-New England Clinical, Epidemiological and Validation Center, which is now part of the Early Detection Research Network at the National Cancer Institute. Rather than go through the expense and discomfort of a colonoscopy, patients could receive pre-cancer colon screenings with serum, plasma and urine samples. A stool test, which is another alternative to colonoscopy, “is not perfect but is out there. There is no perfect test,” Ruffin says.

“We are currently running a large study to validate the performance of these new tests. One my milestones for Penn State Health this year is to open a site for this study in Hershey. In the next three to five years, we will be able to provide new simple screening tests for colorectal cancer that don’t require colonoscopy,” Ruffin says.

The Ripple Effects of Collaboration

When you oversee 40 junior researchers, the ripple effects of their work to prevent cancer multiply, Ruffin says. That’s why a mid-career study was so meaningful. In 2005, he received a 10-year grant award from the National Institutes of Health to mentor clinical researchers in the study of cancer chemoprevention. Chemoprevention is not chemotherapy. It involves taking an agent to reduce the risk of cancer. A good example is aspirin. Some of Ruffin’s early work showed that aspirin, as low as 81 mg a day and taken under advisement of a doctor, can reduce one’s risk for colorectal cancer.

The knowledge that researchers took from this award spread across the country, Ruffin says.

“All of these junior researchers are now well into their medical careers in academic medical centers across the country. My impact on advancing the science through these investigators is greater than any one study that I completed,” he says.

Preventing Cancer for Pennsylvania’s Youngest Residents

Since coming to Pennsylvania, one of Ruffin’s new focus areas is preventing the HPV virus, which leads to cervical cancer later in life. The Hepatitis B and HPV vaccine are primarily a cancer prevention vaccine. It’s important for parents to vaccinate their children as early as age 9 – before they become sexually active – so that they will be protected later. But Ruffin has found a unique challenge in central Pennsylvania. Ruffin is working with a number of teams to examine how to make significant changes in the rates of HPV vaccination.

“Central PA remains far behind the rest of the country in getting 11-to-13-year-olds to complete this series,” he says. “The problem is the vaccine is to prevent  a sexually transmitted virus. You have all of those overtones, which stigmatize the vaccine. Parents should focus on it as a vaccine to prevent cancer.”

The Joy of Patient Care

Although he spends a lot of time as a researcher, Ruffin immensely enjoys family medicine and helping his patients stay healthy.

“I was not sure I fully understand the joy I have received from care for patients over many years until I left my practice at the University of Michigan. I had been in the same office for 27 years. I had cared for hundreds of families. I had been with them from birth, the ‘terrible twos,’ adolescence, teens, college and starting all over again. I delivered children of patients who I delivered. I have been there with families for losses of children, parents, spouses and grandparents. I have helped families deal with bad news of cancer, dementia, stroke, diabetes and symptoms that defy diagnosis,” he recalls.

Scientific breakthroughs are important in the battle against cancer, but so is a good bedside manner, he says. A physician’s personal interactions with patients go a long way in encouraging cancer-preventing lifestyle changes.

“I see a lot of physicians of all natures who can’t lower their language down. They have a hard time not interrupting patients. It’s hard for them to deal with patients’ emotions. And it’s hard for them to say, ‘I don’t know,’” he says. “We need to think differently. The next generation hopefully will take us to that place. Penn State Health medical student and resident education is one institution focusing on this aspect of health, communication.”

 

 

 

 

Entry filed under: Features.

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