Diagnosis leads surgeon to seek cure
Dr. Kevin Mollen was just 15 years old when he was diagnosed with an incurable disease. Unbeknownst to him at the time, that diagnosis would lead him into a career as a pediatric surgeon at UPMC Children’s Hospital and research aimed at finding a cure.
After dealing with severe abdominal pain for about a year, it was seeing blood in his stool that led Dr. Mollen and his parents to see a gastroenterologist, where he was diagnosed with ulcerative colitis.
“Frankly, I had never heard of the disease before, so I was in shock,” he said. “This was very difficult for me and my parents to accept. I think they — even more than they let on to me — were very upset and very scared.”
Ulcerative colitis and Crohn’s disease fall under the broader category of inflammatory bowel disease. Only a quarter of all IBD patients present symptoms before the age of 20.
Dr. Mollen had been missing school or going in late because of his symptoms for about a year leading up to his diagnosis. It would still be another two years before he discovered a treatment that actually worked for him.
The gap in finding a treatment is common in IBD patients, because not every patient responds to treatments the same. IBD also is characterized by cycles of relapse and remission, making it even more difficult to manage, especially for children.
“Adolescence is difficult for kids at baseline, and then you add something that clearly makes kids different. Symptoms come and go, so out of nowhere you have severe symptoms for days or weeks, and it really interferes with all the things you want to do as a kid,” Dr. Mollen said.
Dr. Mollen and his family combated these issues by educating themselves through the Crohn’s and Colitis Foundation.
The nonprofit organization seeks to find a cure to IBD, as well as provide education to both patients and caregivers. They have contributed over $350 million to biomedical research in efforts to find a cure for IBD.
“At first, that was more of a resource for my parents,” Dr. Mollen said. “I think they began to find a comfort level when they learned more about the disease and met other people and heard about other people struggling with the same thing. As I got older, it was more for me, but it certainly has also driven much of my pathway in life.”
Dr. Mollen serves on the board of directors for the chapter of the foundation that serves Western
Pennsylvania and West Virginia.
“Really early on throughout it all, I came in contact with really outstanding caregivers, doctors and nurses who inspired me and became role models for me,” Dr. Mollen said. “I saw the impact that they could have on people’s lives and along the way I fell in love with medicine.”
Despite having found a treatment that had been working for him, Dr. Mollen still had to have his entire colon removed during his second year of med school.
“That experience really changed my career focus,” he said. “It’s very much why I am a surgeon today and wanted to take care of IBD patients.”
Now the surgical director of the inflammatory bowel program at UPMC Children’s hospital, Dr. Mollen says that it’s “gratifying” to be able to help children through this often difficult and scary period of their lives. About one-third of all patients with IBD will have to undergo some type of surgery in relation to their disease
“As a surgeon, I meet patients at a really critical point in their disease,” he said. “It also means, in general, they’re not doing well. Their symptoms are bad, and now they have to face a scary
operation; my message is always, though, this operation does not change in any way what I want to do with my life.”
One of the biggest challenges in treating IBD, according to Dr. Mollen, is that the disease goes largely undiscussed.
He calls it a “silent disease” for two reasons. One being the nature of the symptoms, which often include abdominal pain and gastrointestinal issues. The other is because, oftentimes, the casual onlooker would not be able to tell a person has IBD just by looking at them.
Because there is no cure, treatments often focus on reducing the inflammation that occurs within the gastrointestinal tract.
Dr. Mollen is working on a research project that is looking for a way to treat inflammation at the cellular level.
In December 2019, he was awarded funding from the National Institute of Diabetes and Digestive and Kidney Diseases to work on an ongoing research project titled, “Mitonuclear Communication
During the Pathogenesis of Inflammatory Bowel Disease.”
The goal of the research is to show how improperly functioning mitochondria in the body’s cells can explain how IBD develops and to see if reversing the dysfunction could lead to improved outcomes in patients.
If Dr. Mollen’s research is successful, it could lead to a more improved way to prevent inflammation in IBD patients and a chance to improve the overall outcome of the disease.
Over half of all patients with IBD develop a decreasing response to therapies, so developing a variety of treatment plans is critical for patient success, according to Dr. Mollen.
“These are newer therapies, and they’ve really revolutionized the way we care for patients,” Dr. Mollen said. “But despite that, care really remains inadequate for many of our patients.
“The causes of IBD are complex and not every patient will respond to the same medication. So, there is much work to be done.”