From the Duke Cancer Institute archives. Content may be out of date.
Mallori Thompson, administrative director of Cancer Support and Survivorship at Duke, keeps a coin-sized metal angel at her desk. When she feels frustrated, she rubs it.
“It reminds me of why I’m doing what I’m doing,” she says.
The angel was a gift from Liz Menges, whose son Bobby Menges was diagnosed with cancer for the third time in 2016 when he was 19 years old and a freshman at Duke University. Thompson met Bobby only once, in 2017, for an hour. But their conversation shapes what she does to this day.
Bobby Menges (2nd from right) was a freshman at Duke University when he was diagnosed with cancer for the third time.
Duke Teen and Young Adult Oncology Program
While being treated for cancer, Bobby Menges (far left) took a full load of classes to complete his sophomore year while also playing in the Duke jazz band.
After a medical leave at home in New York, Bobby returned to school. He completed his sophomore year, taking a full load of classes and playing in the jazz band, all while receiving treatment at Duke.
In September 2017 he passed away from the disease. But he is still changing the experience of cancer for other young people, through the Duke Teen and Young Adult Oncology Program, a student fundraiser he inspired, and a foundation that his family started in his memory.
You Need to Talk to Bobby
In 2017, Thompson, a medical and family therapist, was forming plans for a support program at Duke for teens and young adults with cancer. The pediatric social workers and physicians all told her, “You need to talk to Bobby.”
Bobby had received cancer care at several different places at different times. He was struck by the lack of any formal support services for teens and young adults.
Kids had clowns and face painting to distract them. Older adults had self-image services and wigs. But none of what was offered seemed appropriate for people his age, who are just beginning to live independently, think about careers, and decide who they are going to be.
Thompson still has her notes from their conversation. “He talked about peer connection being really important, but not through traditional support groups, but by feeling like you’re doing something that a young adult his age would be doing anyway,” she says.
Bobby Menges during treatment at Duke. He became passionate about the need for formal support services for teens and young adults with cancer.
A New Idea
Drawing on those ideas, for their first event the Duke Teen and Young Adult Oncology Program tackled an escape room together. They have also gone rock climbing, done yoga, and tried Krav Maga. Right now, their meetups are virtual because of COVID-19.
After Bobby died, Liz found Thompson’s business card in Bobby’s wallet. She had met Thompson only for a second. But she remembered how excited her son had been about his conversation with her.
“He told me about all the ideas that he had shared with Mallori. As soon as I saw her card, I knew this was something that he would want us to support.”
She called Thompson, and that conversation led to a relationship that has resulted in the family’s foundation making three significant gifts to Duke programs that support teen and young adults with cancer and other chronic health issues. The foundation, called I’m Not Done Yet, is named for Bobby’s desire to always do more.
“Even in the last days of his life when he wasn’t feeling good, he would always get up and do what he needed to do,” Liz says.
The I’m Not Done Yet Foundation gift funds a peer-to-peer support program for teens and young adults with chronic disease and their parents, called “Bobby’s Coaches,” an effort led by Gary Maslow, MD, in the Duke Department of Psychiatry and Behavioral Sciences. Bobby had served as a mentor for teen patients with chronic health issues through the ATLAS program in that department, and Bobby’s Coaches grew out of that.
The foundation’s gifts also provide financial assistance to help young cancer patients pay for fertility preservation services.
“Bobby had so much chemotherapy and radiation for so long at such a young age. But talking about fertility was never on anyone’s radar,” Liz says. “By his third bout with cancer, he was aware of the effects the chemotherapy was having on his body and fertility. It made him so mad that no one had talked to him about this earlier.”
Never Done
Before the gift from I’m Not Done Yet, it was difficult to even mention fertility preservation services to young patients because the services are so expensive, Thompson says. “Now we have an option for people who normally couldn’t afford it.” Because the service is now affordable for more people, a patient navigator discusses it with every teen and young adult cancer patient at Duke. “Mallori and her team figured out a way to take our ideas and make them work in ways that are even better than we intended,” Liz says.
Bobby’s passion for helping others lives on among Duke students, through an annual Shave and Buzz fundraising event that he and other students started during his freshman year. To date, the events have raised almost $450,000 for adolescent and young adult cancer services at Duke.
Students shaved their heads again this year via a virtual event on March 27, 2021, even though those who organized this year’s event never even met Bobby. They exceeded their fundraising goal, raising almost $118,000. “These Duke students are amazing,” Liz says. “Their involvement and engagement have really amplified our efforts.”
Bobby’s love for Duke is one reason why she chose an angel as the symbol that she gives out in his memory. “He can’t be a Blue Devil anymore,” she says, “but he can be a blue angel.”
Teen and Young Adult Oncology
Duke Cancer Institute’s Teen and Young Adult Oncology Program (TYAO) provides patients and their families with support and community during a cancer diagnosis, treatment, and survivorship.
Learn more about the annual Shave and Buzz Fundraiser that benefits the I'm Not Done Yet Foundation and Duke support services for teens and young adults with cancer and other chronic health issues.
For decades, cancer screening has focused on detecting one cancer at a time through tests such as mammograms, colonoscopies, cervical cancer screenings, and lung cancer screening. While these tests save lives, many cancers still lack recommended screening options and often are not detected until symptoms develop.One of the greatest challenges in cancer care is that many cancers are discovered after they have progressed to more advanced stages. At that point, treatment can be more intensive and outcomes may be less favorable.Multi-cancer early detection (MCED) tests represent a new approach that could change that. MCED tests are blood tests designed to look for signals associated with multiple types of cancer at the same time. Rather than focusing on a single disease, these tests analyze fragments of genetic material and other biomarkers that circulate in the bloodstream. If an abnormal pattern is detected, the test may identify a potential cancer signal and, in some cases, suggest where in the body that signal originated.“MCED testing may help identify certain cancers before symptoms appear, creating opportunities for earlier evaluation and treatment,” said Kevin Oeffinger, MD, director of the Duke Cancer Institute (DCI) Center for Onco-Primary Care and co-director of the Supportive Care and Survivorship Center.Researchers and clinicians are particularly interested in the potential of MCED tests to help detect cancers that currently have no routine screening recommendations. MCED testing may offer another tool for finding some of these cancers earlier.Although MCED testing holds considerable promise, experts emphasize that patients and healthcare providers should understand both its advantages and its current limitations.MCED testing may be most appropriate for adults age 50 and older, as cancer risk increases with age. It may also be considered for younger individuals who have a higher risk of cancer because of factors such as family history, a personal history of cancer, lifestyle factors, or certain medical conditions.Importantly, MCED tests do not diagnose cancer. A positive result signals the need for additional testing to determine whether cancer is present and, if so, what type of cancer it may be.Like all screening tools, MCED tests have limitations. False-positive results can occur, meaning a cancer signal is detected when no cancer is present. False-negative results are also possible, as some cancers may not release detectable signals into the bloodstream.Experts also stress that MCED testing is not a replacement for recommended cancer screenings.“Patients should continue to receive all age- and risk-appropriate screenings, including mammograms, colonoscopies, cervical cancer screening, prostate cancer screening, and lung cancer screening,” Oeffinger said.Currently, MCED tests have not received FDA approval and are available as laboratory-developed tests while additional research continues. While many healthcare organizations can order an MCED test, the Duke Center for Onco-Primary Care offers a dedicated MCED clinic that begins with an individualized discussion about a patient's health history, cancer risk factors, and screening goals.Patients receive education and counseling before testing, assistance with coordinating the test itself, support in understanding results, and guidance through any recommended follow-up evaluations. Rather than leaving patients to interpret complex information on their own, Duke provides coordinated care throughout the testing and diagnostic pathway.As research continues, Duke's experts believe MCED testing has the potential to become an important addition to cancer screening strategies.“Duke's approach ensures patients have access to expert guidance, evidence-based recommendations, and coordinated care every step of the way,” Oeffinger said.To learn more about the MCED Clinic or to make an appointment, visit dukehealth.org/mced-test, or call 919-613-3333.
For decades, cancer screening has focused on detecting one cancer at a time through tests such as mammograms, colonoscopies, cervical cancer screenings, and lung cancer screening. While these tests save lives, many cancers still lack recommended screening options and often are not detected until symptoms develop.One of the greatest challenges in cancer care is that many cancers are discovered after they have progressed to more advanced stages. At that point, treatment can be more intensive and outcomes may be less favorable.Multi-cancer early detection (MCED) tests represent a new approach that could change that. MCED tests are blood tests designed to look for signals associated with multiple types of cancer at the same time. Rather than focusing on a single disease, these tests analyze fragments of genetic material and other biomarkers that circulate in the bloodstream. If an abnormal pattern is detected, the test may identify a potential cancer signal and, in some cases, suggest where in the body that signal originated.“MCED testing may help identify certain cancers before symptoms appear, creating opportunities for earlier evaluation and treatment,” said Kevin Oeffinger, MD, director of the Duke Cancer Institute (DCI) Center for Onco-Primary Care and co-director of the Supportive Care and Survivorship Center.Researchers and clinicians are particularly interested in the potential of MCED tests to help detect cancers that currently have no routine screening recommendations. MCED testing may offer another tool for finding some of these cancers earlier.Although MCED testing holds considerable promise, experts emphasize that patients and healthcare providers should understand both its advantages and its current limitations.MCED testing may be most appropriate for adults age 50 and older, as cancer risk increases with age. It may also be considered for younger individuals who have a higher risk of cancer because of factors such as family history, a personal history of cancer, lifestyle factors, or certain medical conditions.Importantly, MCED tests do not diagnose cancer. A positive result signals the need for additional testing to determine whether cancer is present and, if so, what type of cancer it may be.Like all screening tools, MCED tests have limitations. False-positive results can occur, meaning a cancer signal is detected when no cancer is present. False-negative results are also possible, as some cancers may not release detectable signals into the bloodstream.Experts also stress that MCED testing is not a replacement for recommended cancer screenings.“Patients should continue to receive all age- and risk-appropriate screenings, including mammograms, colonoscopies, cervical cancer screening, prostate cancer screening, and lung cancer screening,” Oeffinger said.Currently, MCED tests have not received FDA approval and are available as laboratory-developed tests while additional research continues. While many healthcare organizations can order an MCED test, the Duke Center for Onco-Primary Care offers a dedicated MCED clinic that begins with an individualized discussion about a patient's health history, cancer risk factors, and screening goals.Patients receive education and counseling before testing, assistance with coordinating the test itself, support in understanding results, and guidance through any recommended follow-up evaluations. Rather than leaving patients to interpret complex information on their own, Duke provides coordinated care throughout the testing and diagnostic pathway.As research continues, Duke's experts believe MCED testing has the potential to become an important addition to cancer screening strategies.“Duke's approach ensures patients have access to expert guidance, evidence-based recommendations, and coordinated care every step of the way,” Oeffinger said.To learn more about the MCED Clinic or to make an appointment, visit dukehealth.org/mced-test, or call 919-613-3333.