THE NEW YORK TIMES, TUESDAY, OCTOBER 8, 2019 N D3By now you’ve probably heard
that your body is teeming with
bacteria. Some protect against
infections and help you digest
food, while others can make you
ill. Fungi, viruses and protozoa
call your body their home, too,
and researchers are learning that
when their numbers get out of
whack, they can modify your
immune system and even influ-
ence the development of cancer.
A new study published Wednes-
day in the journal Nature found
that fungi can make their way
deep into the pancreas. In mice
and human patients with pancre-
atic cancer, the fungi proliferate
3,000-fold compared with healthy
tissue — and one fungus may
make pancreatic tumors grow
bigger.
One particular fungus was the
most abundant in the pancreas: a
genus of Basidiomycota called
Malassezia, which is typically
found on the skin and scalp of
animals and humans, and can
cause skin irritation and dandruff.
A few studies have also linked the
yeast to inflammatory bowel
diseases, but the new finding is
the first to link it to cancer.
The results show that
Malassezia was not only abun-
dant in mice that got pancreatic
tumors, it was also present in
extremely high numbers in sam-
ples from pancreatic cancer pa-
tients, said Dr. Berk Aykut, a
postdoctoral researcher in the lab
of Dr George Miller, a surgical
oncologist at the New York Uni-
versity School of Medicine.
Administering an antifungal
drug got rid of the fungi in mice
and kept tumors from developing.When the treated mice again
received the yeast, their tumors
resumed growing — an indication,
Dr. Aykut said, that the fungal
cells were driving the tumors’
growth. Infecting a control group
of mice with different fungi did
not accelerate their cancer.
There is increasing scientific
consensus that the factors in a
tumor’s “microenvironment” are
just as important as the genetic
factors driving its growth.
“We have to move from think-
ing about tumor cells alone to
thinking of the whole neighbor-
hood that the tumor lives in,” said
Dr. Brian Wolpin, a gastrointesti-
nal cancer researcher at the
Dana-Farber Cancer Institute in
Boston.
Microbes are one more factor
to consider among the factors
affecting cancer proliferation. The
fungal population in the pancreas
may be a good biomarker for
who’s at risk for developing can-
cer, as well as a potential target
for future treatments.
“This is an enormous opportu-
nity for intervention and preven-
tion, which is something we don’t
really have for pancreatic cancer,”
said Dr. Christine Iacobuzio-
Donahue, a pancreatic cancer
researcher at Memorial Sloan
Kettering in New York.
The new study also sheds light
on how fungi in the pancreas may
drive the growth of tumors. The
fungi activate an immune system
protein called mannose-binding
lectin, which then triggers a
cascade of signals known to cause
inflammation. When the re-
searchers compromised the abil-
ity of the lectin protein to do its
job, the cancer stopped progress-
ing and the mice survived longer.
But the interaction between
microbes and their hosts is very
complex, Dr. Miller said, and
further experiments are needed
before the new findings can be
applied in treating patients.
“This is intriguing and exciting
research,” said Dr. Ami Bhatt,
who studies microbes at Stanford
University. “But it’s probably too
soon to add broad spectrum anti-
fungals, many of which have lots
of side effects, to cancer treat-
ment regimens, even in experi-
mental settings.”Fungi May Have a Role
In Pancreatic Cancer
SCIENCE SOURCE
The yeast Malassezia.By KNVUL SHEIKHThat maybe-comet from another
star really is a comet from an-
other star, and now it has a name
and a date with destiny. On Dec. 7,
the newly named comet 2I/Bori-
sov will make its closest approach
to the sun and then begin a jour-
ney back outward through the
southern sky in December and
January.
This interstellar apparition
announced itself in August, when
Gennady Borisov, a Crimean
astronomer and veteran comet
hunter, noticed a furry dot of light
cruising through the stars of
Cancer on a peculiar path. Astron-
omers around the world fell over
themselves trying to find out
where it came from and where it
was going.
Was it another Oumuamua, the
cigar-shaped rock — later deter-
mined to be the first-known inter-
stellar comet — that streaked
through the solar system in 2017?
Mr. Borisov’s object looked like
a comet from the outset. Astrono-
mers quickly upgraded its name
from BG00234 to C/2019 Q4 (Bori-
sov) as they watched, measured
and tried to confirm that it had
come from outside the solar sys-
tem.
In late September, astronomers
from the International Astronomi-
cal Union’s Minor Planet Center,
which tracks and names solar
system objects, and the Jet
Propulsion Laboratory, operated
by Caltech for NASA, concluded
that the comet had indeed come
from beyond, and agreed on its
orbit. They renamed it 2I/Borisov,
the “I” standing for interstellar
and the “2” indicating that it was
the second such comet found, the
first now officially known as
1I/Oumuamua.
Unlike Oumuamua, which was
discovered when it was already
leaving the realm of our planets,
Borisov was found while still on
its way in. The latest calculations
have it passing nearest the sun —
about 180 million miles, which isalso about as close as it will get to
Earth — on Dec. 7. Then it returns
outward.
It will be visible in the southern
sky to astronomers, and perhaps
even to civilians, for several
months — “a Christmas comet,”
Michele Bannister, an astronomer
at Queen’s University Belfast and
an expert on small bodies, has
said.
The detecting and inspecting
have already begun. Using tele-
scopes on the island of La Palma
in Spain’s Canary Islands, a team
of astronomers led by Alan
Fitzsimmons of Queen’s Univer-
sity Belfast detected cyanogen in
the gaseous cloud around the
comet. Cyanogen, a toxic gas, is
common in comets.
The discovery by Dr. Fitzsim-
mons’s team was the first time
that astronomers had detected
gas emitted by an interstellar
object. “Over all, we find the gas,
dust and nuclear properties for
the first active Interstellar Object
are similar to normal Solar sys-
tem comets,” Dr. Fitzsimmons
and his co-authors wrote in a
paper submitted to Astrophysical
Journal Letters.
That is to say, nature seems to
work the same out there as it
does here.
Likewise, it seems, for the
origin of these interstellar wan-
derers. Astronomers theorize that
comets are fragments of ice left
over when planets form in the
chilly outer realms of planetary
systems.An Interstellar Comet,
In Time for the Holidays
TRAVIS RECTOR/GEMINI OBSERVATORY/NSF/AURAThe comet 2I/Borisov.By DENNIS OVERBYEwrongdoing. His exams were thorough, he
has said, and performed in accordance with
standard medical practice.
But Ms. Ribaudo and about 50 other for-
mer patients now hope to sue him for mone-
tary damages under a new law in New York
State, the Child Victims Act. The law opened
a one-year window, in August, during which
victims of childhood sex abuse may file civil
lawsuits against abusers even decades af-
ter the crimes occurred.
Kristen Gibbons Feden, a lawyer who
prosecuted Bill Cosby for sexual assault
and is now with the firm Stradley Ronon in
Philadelphia, has agreed to represent the
women. But even if they win in court, they
are unlikely to reap significant compensa-
tion.
Their dilemma highlights a major weak-
ness in the new state law. Though Mr. Cop-
perman is by all indications wealthy, he was
a solo practitioner who ran his practice out
of his basement. He lacks the assets of an
institution like the Boy Scouts or a large
hospital.
Law firms that have eagerly taken on cli-
ents targeting such well-insured and deep-
pocketed institutions — anticipating a
healthy cut of any jury award or settlement
— have shied away from cases against indi-
viduals like Mr. Copperman. Most of the
more than 500 civil suits filed under the new
law so far have targeted the Catholic
Church.
But doctors in particular can be uniquely
positioned to abuse young patients, as some
notorious cases recently have shown.
Lawrence G. Nassar, the team doctor at
U.S.A. Gymnastics, was sentenced to up to
175 years for sexually abusing gymnasts in
his charge.
Earlier this year, Johnnie Barto, a pediat-
rician in Johnston, Pa., was sentenced to up
to 158 years in prison for sexual abuse. Earl
Bradley, a pediatrician in Lewes, Del., was
sentenced to 14 life terms in 2011.
Scores of men are using the new law to
seek damages from Rockefeller University
Hospital over sexual abuse allegedly com-
mitted by Dr. Reginald Archibald, who died
in 2007.
In Ohio, Gov. Mike DeWine has urged leg-
islators to review 25 years of sex abuse
complaints made to the state medical board
after finding it failed to take action against
an Ohio State University physician, Dr.
Richard H. Strauss, despite evidence he had
assaulted male students.
Doctors, and pediatricians in particular,
“are the next wave,” said Marci A. Hamil-
ton, chief executive of Child U.S.A., an advo-
cacy group based at the University of Penn-
sylvania focused on child protection.
“These guys have incredible access, and
prosecutors were disinclined to prosecute
powerful doctors. A lot of these guys got
away with many years of abuse.”
Mr. Copperman’s victims feel they were
failed repeatedly by institutions that should
have protected them. Many see the new law
as their last, best chance for justice.
“Stuart Copperman got away with every-
thing,” said Jeanna Limmer-Salgado, 51, a
teacher in Manhattan, whose complaint
about sexual abuse in the early 1980s was
dismissed by the state medical board. “He’s
living the life, and has been for 20 years.”
Years of Consequences
Mr. Copperman lives in Delray Beach, Fla.,
but spends summers in Melville, N.Y., at the
Greens at Half Hollow. It is a luxurious
gated community catering to “active
adults” with tennis courts, swimming pools,
a gym with a sauna and a clubhouse for par-
ties and community activities.
The stone gatehouse, staffed 24 hours a
day, straddles a river and a lush 18-hole golf
course dotted with ponds and fountains. On
a recent summer day, Mr. Copperman told
the guard there not to admit a reporter.
Reached on the phone shortly afterward,
he said he did “not care to revisit” the alle-
gations. “It’s been 20 years,” he said. “I’ve
got a life here.” Mr. Copperman’s lawyer, Jo-
seph Tacopina, also declined to comment.
Moving on has not been so simple for
many of his former patients. In interviews
with about 20 of these women, many said
they still could not bear to be touched in cer-
tain ways, and had difficulties with both
emotional and sexual intimacy.
Others have struggled with mental health
issues, including post-traumatic stress dis-
order, alcoholism, heroin addiction, eating
disorders and agoraphobia.
“I was sick a lot as a kid, and I was so
scared whenever I got a sore throat and
knew I’d have to go to the doctor that I
couldn’t sleep all night,” said Ellen Dom-
browski, now in her 50s, a small-business
owner in Vero Beach, Fla.
She said that during her annual physical,
Mr. Copperman rubbed her genitals so hard
that she almost cried. For years, she was
angry at her mother for not believing her
when she said the doctor hurt her. “That’s
just what doctors do,” she recalled her
mother saying.
One woman said her mother slapped her
when she described her appointment and
accused her of lying to get attention. An-
other said her mother told her she was
crazy and should see a therapist.
Even resilient survivors said they still ex-
perienced flashbacks. Some still avoid male
physicians, are reluctant to leave their chil-
dren with male relatives, and panic when
they take their children to the doctor.
Many said they had married and di-
vorced abusive men and spent thousands of
dollars on therapy.
“A lot of us are fine, but a lot of us are re-
ally badly damaged,” said Dana Marcus, 56,
an administrator of the Victims of Stuart
Copperman Facebook page.
She said the doctor abused her at every
visit, starting when she was about 10. “We
had somebody whom we trusted, who our
mothers and fathers trusted when we were
children, and we were betrayed,” she said.
Ms. Marcus said Mr. Copperman once
molested her in her own bedroom while
making a “house call” to see her brother. Af-
ter leaving Long Island for college, she said,
she could not tolerate visiting her parents in
her old childhood home.
Ms. Ribaudo said the doctor would per-
form a “head-to-toe exam,” rubbing her
genitals and inserting ungloved fingers into
her vagina at every visit. “I could go there
for a paper cut, and he would have touched
my vagina,” she said.
Many former patients felt violated by the
abuse and knew something was wrong, but
were unable to articulate what was happen-
ing or convince an adult to believe them.
Terri Ackerman, 58, who still lives on
Long Island, said that when she was 14, Mr.
Copperman told her she needed a vaginal
“cleaning.” She assumed the procedure was
similar to a dental cleaning.
“I felt very uncomfortable, and I remem-
ber saying, ‘Are you almost done?’ ” she re-
called in a recent interview. “But I just as-sumed that, like when a doctor gives you a
shot, it hurts. They give you a throat culture,
it’s uncomfortable.”
At hearings before the board during the
summer and fall of 2000, six former patients
who lodged complaints during the 1990s de-
scribed Mr. Copperman telling them that
they were “dirty” and needed a “genital
cleaning.” He had them lie on their backs
while he rubbed and scraped their genitals
with his ungloved hands or finger, accord-
ing to the women’s testimony.
One woman identified as Patient G told
the state board she had become sexually
aroused by the doctor’s manipulations, and
two others said they had orgasms.
The three-member panel said Mr. Cop-
perman had displayed “moral unfitness” to
practice medicine. “Rubbing the female
genitalia during a physical examination is
always inappropriate, whether or not
gloves are used,” the panel said.
The state finally revoked Mr. Copper-
man’s license in December 2000. But it
could have acted much earlier. Ms. Limmer-
Salgado lodged a complaint with the state in
1985; she and another patient gave testi-
mony in 1987.
But the three-person panel — consisting
of two physicians and a minister — voted 2
to 1 to dismiss their complaints. The physi-
cians did not believe the women.
Mr. Copperman defended the examina-
tions, citing American Academy of Pediat-
rics guidelines recommending an exam of
the external genitalia as part of a routine
physical. Experts say the exam is supposed
to be extremely brief, but “I’ve always
prided myself on being thorough,” Mr. Cop-
perman said in 2000.
“I have always tried to live my life in such
a way that if someone said something bad
about me, no one would believe it,” he said.‘A Dream Job’
The cases underscore how difficult it can be
for patients, and especially children, to
identify sexual abuse in a medical setting,
where patients are expected to disrobe and
anticipate that doctors will touch them, oc-
casionally in ways that feel uncomfortable
or invasive.
The current trend in medical practice is to
encourage adolescents to see a doctor with-
out a parent in the room, so that they may
raise issues too embarrassing to discuss
otherwise, like sexual activity or drug use.
According to the Society for Adolescent
Health and Medicine, beginning in adoles-
cence, “routinely spending at least part ofeach visit alone with each patient conveys”
to patients and their parents that this is “a
standard part of adolescent health care.”
In 1997, Mr. Copperman himself pub-
lished a short article in the Archives of Pedi-
atrics & Adolescent Medicine in which he
urged physicians to meet alone with adoles-
cents, and described how he would prepare
parents years in advance, so they were not
taken by surprise when the time came.
“He groomed the parents, as well,” Ms.
Ribaudo said.
The vast majority of pediatricians are
certainly not in the profession to harm chil-
dren, said Dr. Cindy Christian, a pediat-
rician at Children’s Hospital of Philadelphia
who co-wrote a policy statement on protect-
ing children from sexual abuse by health
care providers.
But Dr. Christian acknowledged that pe-
dophiles may be drawn to jobs that provide
access to children. “I’ve always said that if
you’re a pedophile and you can get through
medical school, being a pediatrician is a
dream job,” she said.
In revoking Mr. Copperman’s license, the
state medical conduct office said the action
was necessary to “ensure protection for the
public.” But prosecutors in Nassau County,
where Mr. Copperman had served as presi-
dent of the local pediatric society, did not
press criminal charges, and he never had to
register as a sex offender.
Officials with the Nassau County District
Attorney’s office said there were no crimi-
nal charges because of restrictive state
laws in place at the time.
The women who had testified before the
state medical board were already in their
30s. At that time, state laws gave them only
until their 23rd birthday to press felony
charges, and only until 20 to press misde-
meanor charges.
And because of the way sex crimes were
defined by state law at the time, prosecu-
tors may only have been able to pursue mis-
demeanor charges, according to Silvia
Finkelstein, a lawyer with the Nassau
County District Attorney’s office.
The county’s “special victims bureau
wanted to pursue this investigation and
bring criminal charges,” she said. “But they
needed to find viable charges that were not
outside the statute of limitations.”
A spokesman for the district attorney’s
office said the investigative file on the case
could not be found, and may have been de-
stroyed when a storage facility was flooded.
He said the office was not digitized then.
After Mr. Copperman lost his license, 19
women came forward to file formal com-
plaints of sexual abuse with the state. Ms.
Finkelstein said all the cases were already
past the statute of limitations.
Toby Kurtz, who was the chief of what
was then called the Sex Offense and Domes-
tic Violence Bureau in the Nassau County
D.A.’s office in 2000 and is now retired, said
she had no recollection of the Copperman
case.
The new law is intended to remove some
of the legal barriers to bringing civil and
criminal charges against perpetrators of
child sexual abuse. But critics say it does lit-
tle to help put pedophiles behind bars,
which would protect children most.
Though the law moves the statute of limi-
tations for pressing criminal charges for
child sex abuse by five years, giving child
victims until age 28 to press felony charges
and until 25 to press misdemeanor charges,
it can take decades for adults to come to
terms with abuse they experienced as chil-
dren.
For this reason, many other states have
altogether eliminated statutes of limita-
tions for bringing criminal charges against
perpetrators of child sex abuse, though the
changes are not retroactive and only affect
cases going forward, said Ms. Hamilton of
Child U.S.A.
In that sense, the Child Victims Act “is a
victory for perpetrators,” she said. “They
might be sued and named publicly, so the
world will learn they are perpetrators. But
they won’t be behind bars.”
The women who want to sue Mr. Copper-
man know that he won’t go to jail, and they
say it’s not really money that they seek.
Lynn Barnett Seigerman, 52, a project
manager in San Diego, said she was abused
by Mr. Copperman at her annual physicals
every year when she was a teenager.
“I want my day in court,” she said. “I want
justice to be served, and I don’t think it was.
I want him to pay, not necessarily monetari-
ly — I want him to feel the shame that I felt.”Seeking Justice Deferred
Above, from left, three
patients of Stuart Copperman
as girls, at about the age of
their alleged abuse, in family
photos provided by the
women: from left, Jeanna
Limmer-Salgado, 13; Dina
Ribaudo, 8; and Terri
Ackerman, 14.Prosecutors in Nassau
County did not press
criminal charges, and he
never had to register as a
sex offender.CONTINUED FROM PAGE D1