Dr. Maie St. John: Stopping the Spread of Head and Neck Cancer


As a head and neck cancer surgeon, Dr. Maie St. John is no stranger to making tough decisions. But what if there was a device that could improve the detection of these surgical margins? Watch and learn more.

Dr. Maie St. John vividly recalls her childhood visits to Egypt—annual trips that shaped her calling as a doctor and scientist. Each summer she would travel halfway around the world from her home in Texas, and later Altadena, California, to visit her mother’s family. Her grandfather, the chief doctor in Zagazig, would take his bright and inquisitive granddaughter on house calls through the dusty streets of the bustling town.

“The village was quite undeveloped when I was young. We saw anything and everything,” said St. John, now a head and neck surgeon and a researcher at UCLA’s Jonsson Comprehensive Cancer Center. “We saw lots of people in the later stages of cancer.”

Dr. Maie St. John

She can still picture one patient in particular, a new mother who called complaining of tooth pain. When the doctor and his granddaughter arrived, the gravity of the situation was painfully apparent, even to young Maie. A tumor had overtaken a majority of the woman’s face. Infection had set in.

“I can still see this young woman with a baby in her arms, dying of this disease. It was a very moving experience for me,” said St. John, who also is an assistant professor of surgery. “Cancer became my calling. I never really considered anything else.”

Head and neck cancer is the sixth most common cancer in the world. Nearly 70,000 new cases of head and neck cancer will be diagnosed this year alone, and about 85 percent of these cases are directly linked to tobacco use.

Despite new and more effective therapies, the survival rate for patients with advanced stages of disease remains poor. The major cause of death in these patients is the spread of the cancer, known as metastasis.

The process of metastasis has emerged as St. John’s primary research interest. Working in the lab of Dr. Steven Dubinett, director of the UCLA Lung Cancer Research Program and the Specialized Program of Research Excellence in lung cancer, St. John and her colleagues are working to better understand a molecule called E-cadherin.

The “glue” that keeps cells stuck together, when E-cadherin in tumor cells is lost, the cells can break apart and are free to spread throughout the body. Tumor cells that lose E-cadherin become very dangerous, and patients with these tumors frequently die of metastatic cancer. Additionally, when E-cadherin is present, the cells are more sensitive to cancer therapies.

“We are focusing our work on understanding what controls the presence of E-cadherin, so we can come up with ways to prevent tumors from breaking apart and spreading,” St. John said. “Studying E-cadherin will allow us to gain a better understanding of how cancer spreads. This will then enable us to increase the survival of patients with head and neck cancer.”

St. John received her doctorate in cell biology and her medical degree from Yale University in 1999. During her surgical residency at UCLA, she was recognized for both her surgical and research prowess. After finishing her residency in 2005, she was invited to join the UCLA faculty.

Finding joy and fulfillment in both patient care and research, she pursues a vertically integrated approach to medicine. Her clinic and surgical workload cover the full range of head and neck disease, including cancer, endocrine disorders, pediatrics and trauma. At the same time, St. John spends long, productive hours in the lab in pursuit of discoveries that will improve diagnosis, treatment and prognosis for her patients.

“My husband, Rick, says I’m in the business of putting myself out of business. If that happens in my lifetime, I would be thrilled,” she said.

Taking a cue from her grandfather, the mother of two young boys has already introduced the oldest, Zane, 3-years-old, to her lab and the hospital.

“He knows Mom’s a doctor and feels that hospitals are a place where good things happen,” St. John said. “My boys can pursue whatever career path they choose, but I do want them to learn compassion. I want both my boys to have a desire to help people.”

By Dan Page, 2007