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Fighting the fallout of childhood cancer

Medicine@Yale, 2010 - Jan Feb


A personal encounter with a deadly cancer inspires a $3 million contribution to advance psychosocial care, research for child survivors

Riva Ariella Ritvo, Ph.D., has a favorite quote from Gandhi: “The best way to find yourself is to lose yourself in the service of others.”

For much of her life, Ritvo, known to friends as “Ari,” has aimed to follow that maxim, treating and studying children with autism spectrum disorders at the Los Angeles–area Ritvo Clinic and as a clinical instructor of long standing at the Yale Child Study Center (YCSC). Ritvo’s husband, Alan B. Slifka, M.B.A., a 1951 alumnus of Yale College and founder of New York–based Halcyon Asset Management, is similarly known for his public-spiritedness. In addition to being the major donor to the Joseph Slifka Center for Jewish Life at Yale (named in honor of his father), Slifka has been instrumental in advancing the cause of peaceful coexistence. Through the Alan B. Slifka Foundation, he launched The Abraham Fund, which promotes equality and peace between Arabs and Jews in Israel, and he endowed the Alan B. Slifka Program in Intercommunal Coexistence, a master’s degree program in coexistence and conflict studies at Brandeis University.

“Alan is a visionary,” says Ritvo. “He likes to sponsor things that don’t exist yet. He was founding chairman of the Big Apple Circus. He was the first to release dolphins in captivity into the wild.”

Late last year, the Slifka Foundation built on its tradition of innovative philanthropy with a $3 million gift to the School of Medicine establishing the Riva Ariella Ritvo Professorship in pediatric oncology psychosocial services at the YCSC.

“In providing this gift to Yale, Ariella Ritvo and Alan Slifka are providing essential help for children with cancer,” says Robert J. Alpern, M.D., dean of the medical school and Ensign Professor of Medicine. “The psychosocial challenges faced by young cancer patients are an important problem, and in great need of philanthropic support.”

The new gift has very personal roots. In October 2007, Ritvo and Slifka’s world was turned upside-down when Ritvo’s 16-year-old son, Max, fell ill with mysterious symptoms. Complaining of minor back pain, which he first attributed to a possible sports injury—he is a second-degree black belt in martial arts—Max Ritvo soon developed a fever, which got steadily worse, and he was finally raced to a Santa Monica, Calif., hospital for evaluation.

“Within a week,” recalls Ari Ritvo, “I went from having a boy with a fever and a minor backache to admitting him to the emergency room.”

Max was ultimately diagnosed with Ewing sarcoma, a cancer of the bone and soft tissue that mainly affects teenage boys. It is an insidious disease: like ovarian cancer, Ewing sarcoma generally has no definitive symptoms until after it has metastasized. Because of his advanced illness, Max was flown to Sloan-Kettering.

After several rounds of grueling chemotherapy, Max’s cancer regressed to the point that he was eligible for surgical treatment. Finally, following surgery and a subsequent course of radiotherapy, he was declared to be in remission in June 2008.

Throughout his ordeal, Max and his family relied heavily on the counsel and support of Abraham S. Bartell, M.D., a psychiatrist and psychopharmacologist at Sloan-Kettering specializing in the psychosocial needs of young people with cancer and their families.

In one of Ari Ritvo’s frequent phone calls with Fred R. Volkmar, M.D., the Irving B. Harris Professor of Child Psychiatry and director of the YCSC, Volkmar said that the YCSC had provided seed money for a Yale program providing psychosocial services to pediatric oncology patients. Because of the difference such services had made in her family’s life, Ritvo encouraged Volkmar to submit a pilot program proposal to the Slifka Foundation, which agreed to take over funding for the program. Then, she and Slifka decided to establish the new professorship.

“It’s a wonderful program, and I give Ari Ritvo and Alan Slifka tremendous credit for doing all of this. These are children who have a tremendous range of mental health needs, and so do their families,” says Volkmar. “We want to be there to help address pressing issues, but we can also help to prevent future problems. We want to be involved at all levels, and the vision behind this gift is to do just that.”

With improvements in diagnosis and therapy, more children than ever before survive cancer. But the psychological aftermath, which in addition to emotional distress can include the development of serious learning disabilities in children who undergo chemotherapy, is often overlooked.

“The world needs to accommodate” the ever-increasing number of survivors, says Ritvo. “It’s going to cost some money to do epidemiologic surveys and conduct research to determine who these kids are, and what their specific needs are during and after treatment.”

Max Ritvo, now a Yale freshman in Jonathan Edwards College in the Directed Studies program, continues to do well. He has joined the board of Kids Kicking Cancer, a Detroit-based nonprofit organization that helps pediatric oncology patients manage stress through meditation and the martial arts.

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