5 Questions with a Medical Oncologist

Why does the interplay of psychosocial and behavioral factors in breast cancer interest you?

I am infinitely interested in the human experience. It’s fascinating when you listen to a patient and realize breast cancer may not be their biggest problem; they may be worried about whether they’re going to feed their children next week, not about something that could come back in ten years. Teasing those things out is important to caring for the individual.

Why medicine, why oncology?

My father is a physician, so I was brought up on medicine. In college, I was kind of a student of life. I tried to explore other avenues, to make sure I wanted to do medicine and not just follow in my dad’s footsteps because he is my hero. I looked into other majors, but I couldn’t not do medicine. I was drawn to both the science of it and the patient care aspect of it. In the end, I felt medicine was too compelling to not do it. I’ve never looked back.

What are some of the unknowns about breast cancer that continue to mystify researchers?

Why do some cancer cells become resistant to our best therapies, how can we prevent this, and how can we develop therapies that overcome it? Continuing to figure out what’s going on at a cellular level as well as globally within the host is critical. How can we better risk-stratify patients so that we can spare patients therapies they don’t need? With good intentions, in breast cancer, we often overtreat the many to help a fraction. We are learning how to better select the patients who will benefit from a therapy, and we’re also working to create therapies that are less toxic and more targeted. Finally, how do we better employ the effective treatments we already have? That’s where you get at the behavioral psychoemotional aspects of cancer care.

What is a hard choice you’ve had to make as a physician-scientist?

There are so many interesting and important things to pursue but I think the hardest thing is choosing to do something risky, recognizing that often scientists and doctors are conservative by nature. But the best scientific work, the best research, is by definition a little risky.

Considering the pain and stress of your work, how do you recharge and prevent burnout?

Doing research helps; it makes you feel that even though you couldn’t fix one person’s problem today, you’re working to fix problems more globally. Another is being a researcher at a place like Dana-Farber: You know in your heart that if you and the studies and the support you have here couldn’t fix a patient’s problem, then probably nobody could have. If I lose a patient, I often say, “I so wish we could have done more, but I am going to continue to work so that we can do more to prevent these tragedies.” Finally, you have to take care of yourself. You’ve got to make sure you’re sleeping, eating, taking time for your family, your friends, your dog—and yourself.

Ekaterina Pesheva is the director of science communications and media relations in the HMS Office of Communications and External Relations.

Image: John Soares