A Comedic Genius
- Journalist, writer, director, and playwright Nora Ephron lost her life to acute myeloid leukemia at 71 years old; she would have turned 80 years old today.
- Ephron, who co-wrote and directed mega-hit ’90s film Sleepless In Seattle, came up with the famous “faking an orgasm scene,” which the film’s stars Meg Ryan and Billy Crystal also contributed to.
- Acute myeloid leukemia is a type of blood cancer, which starts in the blood-forming cells of the bone marrow, as a leading expert explains to SurvivorNet.
Ephron’s most memorable scene from When Harry Met Sally is often said to be more famous than the film itself; when Meg Ryan’s “Sally” character fakes an orgasm in a crowded restaurant to prove a point to “Harry,” played by Billy Crystal.
Read MoreBorn into Writing
Born in Manhattan to a family of writers (she was one of five sisters who are all writers), Ephron set out to make her own path in Beverly Hills after the family headed west when she was 4. She attended Beverly Hills High School then headed off to Boston’s Wellesley College where she worked for the school paper.
Finally, she wound up back in New York for a journalism career immediately following college, working as a reporter for the New York Post, then she eventually made her way to the New York Times and Esquire magazine.
Ephron also once worked in The White House under John F. Kennedy and famously wrote an essay detailing how she was one of the only interns that JFK didn’t hit on.
Ephron fell into the film business, and while she may have known a thing or two because her parents were screenwriters, her talent and connections were all her own.
Meryl Streep, who starred in Heartburn with Jack Nicholson, Ephron’s first solo screenplay, once called her a “stalwart.”
“You could call on her for anything: doctors, restaurants, recipes, speeches, or just a few jokes, and we all did it, constantly,” Streep said. “She was an expert in all the departments of living well.”
Heartburn was based off of Ephron’s marriage to and divorce from journalist Carl Bernstein, whom she had two children with, Jacob and Max. The writer was also married to two other writers, Dan Greenburn before her marriage to Bernstein, and Nicholas Pileggi, who co-wrote the legendary mob film Goodfellas. Ephron and Pileggi were married up until her time of death.
A Rare Type of Leukemia
Ephron was diagnosed with myelodysplastic syndrome (MDS), a pre-leukemia condition, four years before her death.
Her oncologist, Dr. Gail J. Roboz, director of the leukemia program at Weill Cornell Medical College and NewYork-Presbyterian Hospital at the time, spoke with The New York Times shortly after her death, saying Ephron’s cancer was “not a readily classifiable type.”
“Biologically, the disease is complicated,” Dr. Roboz said, “and we don’t have very accurate ways of predicting for some patients whether this is going to be a condition that they can hang out with for a while.”
Ephron’s MDS developed into acute myeloid leukemia six months before her death. After several months of battling the disease, Dr. Roboz said that Ephron’s body was unfortunately unable to fight off a case of pneumonia.
AML is one of the most common types of leukemia in adults, but is rare overall, accounting for only about 1% of all cancers, according to the American Cancer Society.
What Exactly are Blood Cancers?
Leukemias are cancers that start in the blood-forming cells of the bone marrow. When these cells become leukemic, they stop maturing properly and grow out of control. Eventually, they spill into the bloodstream. Because they are essentially abnormal white blood cells, they prevent your blood from doing normal things like fighting infections, keeping your energy up and preventing excessive bleeding.
Leukemia specialist Dr. Nicole Lamanna, associate professor of medicine at Columbia University Medical Center, tells SurvivorNet how these cancers affect the blood.
Related: Blood Cancer is Different From Other Cancers—Some Treatments Are, Too
“Blood cancers in general affect different parts of the white blood cell count, which we need in a very basic way to help fight this infection,” she explains. “Your blood elements do lots of things. One is to keep energy. One is to fight infection. Two are to help with clotting or to prevent patients from bleeding.”
So leukemias in general “impair your normal blood elements’ ability to do all the things they’re supposed to do.”
Genetics Of Acute Myeloid Leukemia–What Is A Subgroup?
As Efron’s doctor noted, she had an unidentifiable type of AML.
Dr. Roboz spoke explains the genetics of acute myeloid leukemia, and why patients should ask doctors questions about subgroups. “One of the things that’s important for patients to ask doctors is ‘which subgroup of AML am I in?’ Dr. Roboz says.
Studying cytogenetics, which is a branch of genetics that looks at DNA structure, is key in acute myeloid leukemia (AML) research and treatment. In AML diagnoses, patients often have normal chromosomes within AML cells, but according to Dr. Roboz, that isn’t as positive as it sounds.
Related: New Acute Myeloid Leukemia (AML) Maintenance Treatment Extends Patients’ Lives
“In AML, although the majority of patients have normal chromosomes, that is associated with what is termed as an ‘Intermediate prognosis,’ which means that the treatment pathway is going to be different from what we would use for these so-called ‘good prognosis AML subgroups,’” Dr. Roboz says.
Through cytogenetics, physicians will examine the types of chromosomes within patients in order to determine which subgroup of AML they’re in, which is crucial in determining the best treatment they should receive. These prognostic subgroups include cytogenetic information, molecular genetic information and mutations.
“This is something that’s actually becoming very well known to patients because there are initiatives that are trying to have the patient be their own advocate and to say ‘well, what is my subgroup of AML? What kind of AML do I have?’” Dr. Roboz says.
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