Robert Knapp is retired from practice, but still teaches.
Tim Stepien/The Coastal Star
By Lona O’Connor
Robert Knapp’s medical career spans more than five crucial decades of women’s reproductive health. As a young medical resident back in the 1950s, Knapp was an early advocate for safe, legal abortions. The majority of his career has been spent as a researcher into the diagnosis and treatment of ovarian cancer.
Now, at 88, he is retired, but still teaching — between walks along A1A and weightlifting at a gym near his home in Manalapan. And he is looking forward to the possibility that a diagnostic tool he co-discovered will prove to aid early diagnosis for ovarian cancer, which usually is far advanced when discovered.
On Jan. 25, he will attend a fundraising luncheon for PBC H.O.W. (Hearing the Ovarian Cancer Whisper, the organization he founded). PBC H.O.W. offers a three-year, $50,000-per-year research fellowship to gynecologists. It also offers the Robert C. Knapp Medical Student Award and sponsors an “angel fund” to defray expenses for families of ovarian cancer patients.
“Let’s face it, when you realize that one in 70 women will get ovarian cancer, certainly one of those students will be the doctor taking care of them,” said Knapp.
In 2015, 14,000 of the 21,000 women diagnosed with ovarian cancer died, according to the American Cancer Society, a higher mortality rate than for either cervical or uterine cancer.
Early in his career, in emergency rooms, Knapp treated many women who later died from the effects of illegal abortions, often performed at home or under unsafe conditions.
The death rate from infection was “appalling,” he said. “I was terribly upset that these women died.” After treating those cases, he joined the board of Planned Parenthood.
He has spent much of his distinguished medical, teaching and research career at Harvard Medical School, Brigham and Women’s Hospital and the Dana-Farber Cancer Institute.
In the early 1960s, he began working on a way to detect ovarian cancer. He wanted to know why patients who seemed to be in stage 1 cancer died even after their ovaries were removed.
In the 1970s, he and another collaborator, Daniel Friedman, also discovered how ovarian cancer spreads to the lymph nodes.
Then Knapp, the expert on ovarian cancer, joined forces with Robert Bast, an immunological specialist, at the Dana-Farber Cancer Institute in Boston.
“When I became an assistant professor at the DFCI, Bob and I set up our laboratories next to one another and pooled our resources to collaborate on immunotherapy in mice and in women with ovarian cancer,” wrote Bast in an email.
In their studies of ovarian cancer in mice, Knapp and Bast used cancer cells from one of Knapp’s patients. A sign of past times and an indication of his focus on doctor-patient relationships, Knapp made regular Thursday night house calls to his cancer patients.
“Bast sat there with the patience of a saint,” said Knapp of his younger colleague.
Bast tested cancer antigens (CA) one after another, until, his 125th try — CA 125 — provided the basis of a test for signs of ovarian cancer.
Besides the CA 125 test, the two doctors worked on using immunotherapy to form antibodies that would contain the cancer. Bast, now a professor at the University of Texas and researcher at the M. D. Anderson Cancer Center in Houston, is also on the medical advisory board of PBC H.O.W. Bast called their years working together “a wonderful collaboration.” “Bob has been an exceptional mentor for many young physicians and scholars over the years who have made significant contributions to our understanding of ovarian cancer and to the care of women with this disease,” said Bast.
The CA 125 test is used as a follow-up tool, to see whether chemotherapy has been effective. A rising level of CA 125 is considered highly significant in such cases, said Knapp.
In the next few weeks, Knapp hopes to read the results of CA 125 tests expected to be published in the Lancet, the prominent British medical journal.
The study in Britian looked at 200,000 post-menopausal women, who are at greater risk than younger women of contracting ovarian cancer. It should show whether using CA 125 would work as a way of detecting ovarian cancer in the earlier, more treatable stages.
Knapp teaches a session on ovarian cancer at the Weill medical school of Cornell University and another seminar on how patients and doctors interact. He is the author and co-author of numerous publications on obstetric cancers.
If You Go
Sherry Lansing, former chairwoman and CEO of Paramount Pictures, is the guest speaker at the Time is of the Essence luncheon, 11:30 a.m. Jan. 25 at Mar-a-Lago Club Palm Beach, 1100 S. Ocean Blvd., Palm Beach. Pamela Fiori, former editor of Town & Country magazine, is the moderator. For more information, e-mail Jennifer@howflorida.org.
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