My interest in medicine started at a young age. As a child, I was often sick with infections, and our family doctor would make a house call and put me on antibiotics. I usually felt better very soon and came to respect the healing powers of medicine. In medical school, I did research on childhood leukemia and first learned about radiation as a treatment for cancer. The field is appealing to me because I love math and physics.
Patients arrive in my office with a wide range of knowledge, worries, and expectations about breast cancer. “Is it safe to be around babies or children when I am getting breast radiation?” is one of the questions they most commonly ask. The answer is yes — the external beams that we use turn on and off like a light switch. This means that there is no radiation that lingers in the room after treatment, nor any that leaves with people receiving radiation.
Patients also want to know how we can be sure that radiation worked. Some kinds of cancers have what we call “markers” that tell us how well the treatment (be it surgery, radiation, or a system-wide treatment like chemotherapy) worked. Prostate cancer in men is the best example; a simple blood test for prostate specific antigen (a marker for prostate cancer) provides information on the success of the treatment.
Despite much past and ongoing research, we do not yet have such a marker in breast cancer. However, breast imaging after treatment, like a mammogram, can help us understand if the treatment worked. After patients complete treatment, their doctors will give them more information on the types of imaging that can be used to monitor treatment response based on the type and stage of breast cancer.
I try very hard to communicate in a way that connects with everyone who comes to me for care. I work to reassure my patients about the effectiveness of therapy by sharing the excellent evidence we have from thousands of patients who have taken part in cancer clinical trials. I like to be upbeat and welcoming, as I would be with a visitor to my home. I hope patients leave with a better understanding of their condition and treatment plan.
I am currently researching the effectiveness of radiation versus observation in patients with low-risk ductal carcinoma in situ (DCIS), a type of noninvasive breast cancer. I have also contributed to a novel treatment for certain older women without radiation therapy (RT).
I continue to refine the use of RT in the prone (face-down) position for people with breast cancer. This helps improve long-term cosmetic outcomes and protect vital organs like the heart and lungs. My newest research will explore whether breast radiation after surgery has an impact on patients’ ability to exercise.
In addition to conducting research aimed at improving the ways that we use RT for the treatment of breast cancer, I have advised on best practices for breast cancer treatment and management on a national level. I served for over 20 years on the breast committee for the National Comprehensive Cancer Network (NCCN) guidelines panel. I am a former chair of the Breast Program Committee for the American Society of Clinical Oncology and former Chairman of the Breast Committee for the Radiation Therapy Oncology Group Cooperative Group. I have served on many consensus panels and have written extensively on both breast and eye cancers.
In my spare time, I love needlepoint and knitting, gardening, and traveling with my family.
