The average person often folds under extreme pressure.

That’s part of what drew Dr. Jacob Scott to his practice as a physician-scientist with the Cleveland Clinic. His clinical focus as a radiation oncologist is taking care of patients with sarcoma, a rare type of cancer that begins in the bones or soft tissues in various locations of one’s body.

And in his research lab, he specializes in cancer evolution.

“I picked cancer, because I was really so moved by the strength of patients,” Dr. Scott said. “You know, these are amazing, amazing people. These are people whom you can give a terminal diagnosis to and they choose to get up and live hopefully every day. Most people don’t do that. Most people fold under that kind of pressure. But cancer patients don’t.”

Dr. Jacob Scott grew up playing football and grappling on the mats as a team captain for the wrestling team at Hawken School, before the 1994 graduate went on to attend the U.S. Naval Academy in Annapolis, Maryland, where he majored in physics.

After college, he served in the Submarine Force as an engineer working on nuclear power and engines in the U.S. Navy from 1998 to 2003. Then he decided to go to medical school at Case Western Reserve University.

“I was trying to figure out what to do with the rest of my life,” Dr. Scott said. “So, I didn’t want to boil water as a nuclear engineer anymore, and I chose radiation oncology as a specialty, because I already knew so much about nuclear power. It made sense.”

He then decided to use that expertise to help treat cancer patients, because he was humbled by their fortitude and their fight, he said.

“It felt a lot like the military, where you’ve got somebody, like a combat vet, for example, you tell them, ‘Hey, you’ve got to go over that hill over there, buddy. And you’re probably going to die doing it, but it’s your job,’” Dr. Scott said. “And the people who choose to do that are special people. And I’ve felt that way about cancer patients. I still do feel that way about cancer patients. It really is humbling to get to work with them and learn from their strength.”

But midway through his specialty training in cancer, he felt a little down in the dumps because of his attachment to patients, a lot of whom would die.

So, Dr. Scott decided to go back to grad school to open the door to doing his own research in order to try and make a difference for everyone by taking a crack at some of the fundamental truths about cancer, he said. That’s when he went over to England and earned his Ph.D. in mathematics at the University of Oxford.

“I do a lot of mathematical research now where I really focus on cancer evolution,” he said. “So, I really think about the process by which cancer learns how to beat our drugs. We’ve got all these amazing chemotherapies out there that work, and then patients go into remission and things are good, and then their cancers, a lot of times, come back.

“And when they come back, a lot of times those same drugs don’t work anymore. That’s one of the big questions out there in cancer research in general is, why they stop working.”

Dr. Scott says he takes a similar approach as an evolutionary biologist would in trying to answer that question. For example, maybe a species of bird goes extinct, and then perhaps a similar species of bird that was thought to be extinct comes back and is a slightly newer, stronger and better bird.

That’s the evolutionary process that Dr. Scott considers for cancer, he said.

In terms of sarcoma and other young adult and adolescent cancers, however, there is not a lot of government funding to study those rare cases in comparison to the more common cancers.

Fortunately for Dr. Scott, he is a recipient of funding through the VeloSano Pilot and Impact Awards to help his research and treatments of patients.

And Dr. Scott is also an avid bicyclist who is part of the Cleveland Clinic’s Taussig Cyclotrons team, which participated in this year’s 2020 virtual VeloSano “Bike to Cure” that took place this past weekend.

In its seventh year, the VeloSano initiative has raised more than $21 million for cancer research at the Cleveland Clinic.

“I was not a cyclist before that event,” Dr. Scott said. “I had signed up for the event my first year, because it was what you’re supposed to do and I was helping out the team, and I got really into it. You know, I’m a little older. I’m 44, and there’s not a lot of adult wrestling leagues out there.

“So, it’s something I can do physically that keeps me in shape, and it also allows me to get some PR and to help raise some money and raise awareness, even more importantly.”

In addition to funding from VeloSano, Dr. Scott and some of his physician-scientist peers at the Case Comprehensive Cancer Center receive additional financial support from family foundations. This year, Dr. Scott and Dr. Alex Huang will be the beneficiaries of Russell Township resident Bill Menges’ fundraiser, “Bill Bikes for Bobby.”

Menges, 59, biked from Astoria, Oregon, to Long Island, New York, with a fundraising goal of $44,000 through the “I’m Not Done Yet” foundation, a legacy of his nephew Bobby Menges, who died of sarcoma three years ago.

When Menges was passing through Cleveland on his coast-to-coast journey last month, Dr. Scott and Dr. Peter Scacheri, a member of the Case Comprehensive Cancer Center, joined him on a 45-mile bicycle ride around Cleveland to raise awareness for their cause.

“He was coming off a month of 100-mile days, and he just rocked up and rode with us like it was nothing,” Dr. Scott said of Menges. “And nobody raises money like Bill. I mean, that’s pretty unique.

“Certainly, there’s some other family foundations out there that focus on raising money for pediatric cancer, but I’ve never had somebody do something like that to such an extent where it’s this massive endeavor and massive personal effort.”

Like so many others, Menges’ nephew Bobby had already beaten cancer twice before he died from his third battle with the disease.

Bobby was originally diagnosed with neuroblastoma, a cancer that is commonly found in the small adrenal glands just above the kidneys, when he 5 years old and again when he was 10. He was then diagnosed with cancer a third time, with adolescents and young adults sarcoma, in 2016 and died the next year. He was 19 years old.

His parents, Peter and Liz Menges, of Long Island, now manage the “I’m Not Done Yet” foundation.

“I think that was really why my work resonated with them, because that’s what happened to their boy,” Dr. Scott said. “And that’s powerful stuff, man.”

In 2017, Dr. Scott co-invented the Genomic-Adjusted Radiation Dose, or GARD, a radiation therapy tool that matches radiation dosage with a tumor’s molecular profile. But it’s still considered to be experimental and is maybe a year away from being in the clinic to help patients, he said.

While a lot of his research connecting numbers to cancer is unique, Dr. Scott’s findings are still based on his predecessors, he said.

“Anything I come up with that’s new, the only reason I can see that far is because somebody else came up with the step before,” he said. “I think that’s that quote, that, if I’ve seen as far as I have, it’s because I’m standing on the shoulders of giants.

“So, yeah, we’re definitely trying to take what we know now and go further. When I’m in the lab, I’m not trying to gently tweak something. I’m trying to really rethink stuff entirely and see what we can learn from doing that.”

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