“Everyone creates their own happiness”

Interview with Prof. Dr. Julia Mayerle, expert ­
for pancreas diseases at the university hospital Grosshadern

On November 1, 2016, Prof. Dr. Julia Mayerle succeeded Prof. Dr. Burkhard Göke to take over the professorship for Gastroenterology and Hepatology, in conjunction with heading the Medical Clinic II on the Grosshadern Campus and the city center. Mayerle was awarded the Martin Gülzow Prize, the Sir Hanns Krebs Prize, and the Thannhauser Prize for her scientific work focusing on pancreatic diseases and the most common diseases of the gastrointestinal tract, such as Helicobacter pylori-induced gastritis, Recently, she was nominated for the Innovation Berlin-Brandenburg Award together with a Berlin and Greifswald team of scientists for the development of an early detection test for pancreatic carcinoma. The physician has been involved in the committees of her national and international specialist societies, participated in the development of therapeutic guidelines and coordinated their development for her professional society. Susanne Simon and Rainer Rutz visited her at the Grosshadern Clinic and interviewed her for the category “Women at the Campus”.

Portrait-Prof.-Dr.-Julia-Mayerle

Prof. Dr. Julia Mayerle,
Head of the Medical Clinic II at the university hospital Grosshadern

im Dialog : Prof. Mayerle, what excites you about medicine?
Prof . Mayerle : I wanted to be a doctor as a child. Today, I think it is important to link healthcare and science. I appreciate the freedom to be able to work on basic scientific questions in a translational way. Research and medical care are intrinsically linked for me.

im Dialog : What was your first contact with the Martinsried/Grosshadern Campus?
Prof . Mayerle : I received the topic for my doctoral thesis on pancreatitis and the regulation of cell adhesion proteins by tyrosine phosphatases from Professor Markus Lerch, who at that time worked as a postdoc with Prof. Axel Ullrich, Director of the Department of Molecular Biology at the MPI for Biochemistry in Martinsried. Axel Ullrich is one of the most successful founders on the campus and thus indirectly laid the foundation for my research work on the pancreas.

im Dialog : Pancreatic carcinoma is predicted to be the second most common cause of death due to cancer in 2030. Why are the advances in therapy still so intangible?
Prof . Mayerle : Compared to other cancers, our success in developing and implementing therapy concepts is lower. This is due to several reasons: the disease is symptom-free for a long time and is often diagnosed at an advanced stage. The organ is relatively poorly accessible for obtaining tissue, the tumor is very heterogeneous and surrounded by a connective tissue capsule that prevents the adsorption of chemotherapy. Nevertheless, in recent years we have been able to increase the 5-year survival rate up to 26 percent by adjuvant chemotherapy (after surgery of the tumor) and double median survival even in the palliative situation with combined chemotherapy. The mortality rate of chronic pancreatitis for a benign condition is up to 15%. Previous attempts to cure the disease by causal therapeutic approaches were not successful, so currently therapy is usually symptomoriented. However, our understanding of the disease has developed enormously in recent years. So today we know that mutations in genes coding for digestive enzymes predispose to chronic pancreatitis. We need to arouse the interest of the pharmaceutical industry for this disease, because clinical studies can only be implemented with the help of the industry.

im Dialog : How is a pancreatitis treated today?
Prof . Mayerle : Two percent of the patients in an internal medicine emergency room are suffering from pancreatitis. Today you can intercept the organ failure by fluid administration, then treat the pain, provide an adequate supply of calories if possible by enteral nutrition (via a nasogastric tube), treat infections with antibiotics, remove trapped gallstones endoscopically and thus stabilize the organ function. Endoscopy can also be used as a minimally invasive way to remove tissue. Even for severe pancreatitis mortality has dropped significantly in recent years and we are still learning, albeit at a slower pace than we would like.

im Dialog : You are a native of Munich but worked for a long time in Greifswald. How was your professional career?
Prof . Mayerle : After studying human medicine in Münster, I worked for 13 years at the University of Greifswald, where in 2011, I was appointed to a professorship for internal medicine and molecular gastroenterology. From that time on I took charge of central endoscopy as deputy clinic director of the Department of Internal Medicine A at the Greifswald University Medical Center. In 2016, I returned to my hometown and since then have been in charge of the Medical Clinic II at the Grosshadern Campus.

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Inflamed-pancreas

The pancreatic gland is located in the retroperitoneal space between the stomach, liver and spleen. The pancreas is the main producer of digestive enzymes as well as hormones to control blood sugar levels. Loss of pancreatic function results in malnutrition and maldigestion as well as in diabetes mellitus.

im Dialog: Do you feel that you have had a difficult time as a woman in a leader­ship position?
Prof. Mayerle: I always had the feeling that I was receiving maximum support from male colleagues because there were never any difficulties. But the psychology of women is different from that of men. Women question their own abilities much more. Men are more confident in their abilities and strive very hard to prove this.

im Dialog: Can you give us an example?
Prof. Mayerle: If a man is offered the leading position of a clinic, he is convinced that he is the right person. A woman in the same situation hesitates at first, considering what skills she might possibly lack. The biggest enemy of a woman is the woman herself. Our aspiration is to please everyone. It is not always easy not to lose sight of the work-life balance. It is all the more important that we also see our profession as a hobby, because if you write a manuscript on Sunday and do not relax, but perceive it as stressful, then this limits your performance and well-being into the next week immensely.

im Dialog: What would you recommend to a young colleague who is at the beginning of her career?
Prof. Mayerle: Check once a week to see if you enjoy you work. Because you can only do something extraordinary when working with enjoyment. Appreciation from the outside is often in short supply in our society. Therefore, the motivation for your own actions must come from within. If something is wrong, you have to deal with it. It is important not to waste your life, but to take it into your own hands.

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