What are some of the biggest challenges you face in treating people with lung cancer?
We’ve seen great advances for treatment of lung cancer – targeted therapy, immunotherapy, and multimodality therapy, meaning we can treat patients with surgery, chemotherapy, and these other agents all together. The biggest challenge is getting patients diagnosed earlier. I’d love to see more people screened for lung cancer, when appropriate. I also want to make sure more patients get their tumors profiled so we can treat them in more personalized ways. It’s education, awareness, and access. It’s treating patients from all over Connecticut and the country, regardless of their socio-economic status or ethnicity, and making them aware of the new treatments for lung cancer.
What inspires you to work as an oncologist?
I’ve been working in this field for almost 30 years. When I was looking for my career, I knew I loved working for and caring for patients. I enjoyed working with the surgeons and the radiation oncologists, and there were some new chemotherapies back then, but, frankly, there was not the same excitement there is now. Not as many people were rushing to work in the field.
I was inspired by a Yale graduate, Dr. Emil (Tom) Frei III. Toward the end of his career, he would spend time with me and tell me how he would cure people with acute lymphoblastic leukemia, and he said, ‘Let’s see if we can do the same thing for lung cancer.’ He said, ‘This is a field where you can have a great impact. There isn’t much new to offer. But if you work and bring science to bear, you can make a difference.’
Over the past 25 to 30 years, I have personally seen the progress we have made. I have seen people who would not be alive (years ago) have many quality years. I just saw a patient with my colleague Dr. (Scott) Gettinger (MD) who has been on immunotherapy for 13 years; one of the first patients with lung cancer treated with it. This was an advanced disease where there would have been no hope of survival 20 years ago and she was here with her husband, and they had just gone for a walk on a beautiful fall day. This is what makes it exciting: New therapies and helping patients. I have built a wonderful team here at Yale and I love it every day.
There have been some exciting developments from clinical trials for certain types of lung cancer therapies in recent months. Should patients talk to their doctors about enrolling in clinical trials?
Absolutely. Clinical trials push the standard of care. Clinical trials also mean that if you are going to think about a clinical trial, you at least must consider what is the best standard of care at the time. You may not choose the clinical trial because it is looking at something new, but at least it raises the bar. If you are dealing with a disease where the therapy, unfortunately, might not be guaranteed to be a cure, why not look for something new? The things we now offer routinely emerged from clinical trials years ago.
The patient I mentioned surviving with lung cancer for 13 years was on a clinical trial. We are trying to do more clinical trials here at Yale and make them available to everyone, regardless of race or socio-economic status. Patients should be talking to their doctor and patient advocates about clinical trials. I think clinical trials are the best way to get new drugs to patients quicker to improve their lives, improve outcomes, and improve their quality of life.
With screening events happening this month, how can we best emphasize the importance of screenings to people who may be at risk?
With grassroots and community efforts. Only 5 to 6 percent of people who are eligible for lung cancer screening are getting screened. If lung cancer is found early, multi-modality therapies can be used and people can be cured, no doubt. We need to get that word out and we need to build trust. We need people (who are longtime smokers) to get a CT scan. If something is found, you have got to get it biopsied. It is a bit of a process, but people need to know it is available. We need to go to where people are. We must go to churches and community events and bring the message out. I would love for Yale to have mobile CT scan that we could bring to community events and screen people.