At Tufts Medical Center, Dr. J. Scott Nystrom created and led the Cancer of Unknown Primary Program, an oncology specialty that uses gene-based testing to study, diagnose, and treat metastatic cancer of undetermined origin.
He began exploring the field in the 1970s, when most oncologists believed cancer could not be diagnosed and treated if its origin wasn’t known, said his colleague Dr. Jack Erban, clinical director of Tufts Medical Center’s Cancer Center.
“It turns out that it’s less important to know where the cancer came from than how to treat it,” Erban said. “Scott had the insight to say, ‘Maybe it doesn’t matter where it came from. Maybe we can see its path through molecular profiling.’ That’s what he believed, and he was right.”
Dr. Nystrom died of a heart attack Jan. 29 in his Palm Beach Gardens, Fla., home, where he had just moved after retiring. He was 67 and “one of the most vigorously energetic people you could meet,” Erban said. “It was such a tragic thing. He was less than a month into his new life.”
Though he died so soon after beginning his much-anticipated retirement, “he enjoyed every day, every minute” of those few short weeks, said his wife, Gail.
The Nystroms, who formerly lived in the Back Bay, had settled into their Palm Beach Gardens home after a Dec. 31 retirement dinner with his colleagues at Tufts Medical Center.
In Florida, Dr. Nystrom would “exercise for an hour every day, read his medical journals, and then we’d eat lunch in the sun,” she said.
Part of the new life Dr. Nystrom had planned included continuing hisresearch into cancers of unknown origin.
“He loved the sunshine and the warm weather,” his wife said. “He also loved having so much time to devote to his research.”
At the time of his death, Dr. Nystrom was working on a paper and on a website for the Tufts program with Dr. Pamela Smith, an oncologist who now heads the program.
“We were working together until the day before he died,” said Smith, who added that Dr. Nystrom was “such a strong and helpful mentor for me and for so many other people.”
Many doctors, she said, still “very strongly reject the idea that we can analyze cancer with a computer-generated algorithm,” but Dr. Nystrom “could stand up to any criticism, and was always moving forward with confidence.”
Smith recalled that Dr. Nystrom had a gift for asking the right questions, listening to a variety of opinions, and taking care of people.
“His mind was always going a hundred miles an hour,” she said. “And he inspired so much confidence in people.”
He retired from clinical practice to continue his research, she said, and spend more time with his family.
“He was such a strong family man,” she said. “He talked about his wife and kids all the time.”
John Scott Nystrom was born in Chicago. He was 19 and attending Northwestern University in Evanston, Ill., when he took a job at a Marshall Field department store and met Gail Benzel, a fashion coordinator.
They married in 1969 and moved to Milwaukee, where Dr. Nystrom graduated from the Medical College of Wisconsin in 1970.
He completed his internship and residency at the School of Medicine at the University of Southern California in Los Angeles, the city where the couple’s two daughters, Jennifer and Wendy, were born.
Dr. Nystrom also had taught at the University of Connecticut School of Medicine.
In 1979, the family moved to Grosse Pointe, Mich., where he worked in private practice and taught at Wayne State University School of Medicine in Detroit.
After Dr. Nystrom died, the family received notes of condolence from people he had cared for decades earlier, said his daughter Jennifer L’Estrange of Bokarina, Australia.
“He chose a specialty in medicine that was really hard, harder than most. And it was an active choice,” she wrote in an e-mail. “He wanted to help people who really needed help.”
While working in her father’s office during her summer vacations, she saw his work ethic firsthand.
“The hours were harder and longer, and success was won the hard way,” she said. “But the problems he solved every day were challenging and complex, and the solutions had an impact on the lives of his patients that few doctors see.”
Despite those challenges, she said, her father “carried a lightness of spirit and sense of fun with him throughout his life.”
Her sister, Wendy, of Los Angeles, recalled that Dr. Nystrom liked to take his daughters trick-or-treating, then he would tease them by filching from the candy they collected.
Dr. Nystrom also was a sports fan who especially liked hockey, which he played until he was in his 40s, his wife said.
“Everything he did, he did well,” she said.
“He was a gentle, sweet man, just a wonderful person,” she added. “He always had a twinkle in his eye, and a sense of humor that really balanced the more serious part of his life and work.”
A service has been held for Dr. Nystrom, who in addition to his wife and daughters leaves two grandchildren.
At Tufts Medical Center, Dr. Nystrom treated patients “very conscientiously and carefully,” Erban said. “He was remarkably comfortable caring for patients with a number of different types of cancer.’’
Dr. Nystrom also was always willing to take on extra work, said Erban, who recalled that when a hospital in Metheun approached Tufts Medical Center for help in its oncology department, Dr. Nystrom did not hesitate.
“He was tapped on the shoulder and asked whether he’d mind driving out to Methuen once a week,” Erban said of Dr. Nystrom, who rented a car for the weekly trips. “He jumped right into it.”