Spotlight: What I Do As a Cancer Researcher
Some healthcare professionals spend their careers in the laboratory improving the world through their research, while others focus on caring for their patients. Dr. Tina Cascone, MD, does both.
Dr. Cascone is a cancer researcher whose early career is already showing great promise. She is currently studying how immunotherapy can be used to treat lung cancer – or rather, why cancer cells might become resistant to such treatment. Her work shifted towards research after someone close to her got cancer while she was in medical school. However, she still works directly with her patients and considers her clinical responsibilities as part of the foundation of her career. We spoke with Dr. Cascone to learn about her day-to-day work and how she reached where she is now.
First of all, tell us a little about your current job and how long you have been doing it.
I am a trainee oncologist. I am starting the third and final year of study at the Oncological Center . M.D. Anderson University of Texas . Most of my work this year will focus on my research, but I will still have the opportunity to interact with my patients once a week. Since early 2015, I have been working on a research project to better understand how lung cancer becomes resistant to one particular type of treatment, immunotherapy. Immunotherapy works by allowing the patient’s immune system to better recognize and destroy cancer cells. Unfortunately, less than a quarter of lung cancer patients benefit from immunotherapy, so resistance to these treatments is a major problem. My research is supported by the Lung Cancer Alliance through the Young Investigator Prize and the National Institutes of Health T32 Training Grant.
What prompted you to choose your career path? Why oncology and what prompted you to focus on research?
Almost everyone knows or has known a person whose life has been seriously affected by cancer; I’m not an exception. When I was in medical school, a person very close to me developed cancer. This was a catalyst that prompted me to learn as much as possible about the disease. I remember the fascination that sparked what I learned about the genetic changes that occur during the development of cancer. I soon realized that I wanted to pursue oncology as a profession. During my final year in medical school, I became actively involved in research aimed at determining the factors that determine the response of patients with certain types of chest cancer to chemotherapy. It was during this time that I began to realize that the results of research could help in therapy and possibly affect the lives of patients.
What kind of education and experience did it take to get what you are doing now?
After graduating from medical school in Naples, Italy, I entered the school oncology scholarship program. In 2007, I had the unique opportunity to fully immerse myself in the study of non-small cell lung cancer at MD Anderson. At the same time, I managed to get my doctorate, and by 2012 I had a solid research base. As my research experience became more relevant, I also looked for opportunities to directly help patients. It was important for me to see my research in action by working with the people I set out to help. I entered the Internal Medicine Residency at the University of Washington School of Medicine in St. Louis, Missouri, and after completing this training, returned to MD Anderson for a Hematology and Oncology Fellowship in July 2014.
What are you doing besides what most people see? What do you actually spend most of your time on?
In all honesty, it is possible that most of the patients I see are unaware of the time I spend in the lab, and some of my colleagues in the lab may not know how much time I spend caring for patients. Both roles are very important to me and form the basis of what I do every week. During this third year of my internship, most of my time will be spent researching to complete my project, but I will also continue with weekly checks with my lung cancer patients.
What misconceptions do people often have about your job and your job?
Some people might think that you can’t be a caring doctor and a good scientist at the same time, because medicine and science require rigorous training and commitment. Pure scientists may not consider you a true researcher due to clinical responsibility, while experienced doctors may think that your bedside skills are not honed because you are in the laboratory doing experiments. I believe that cancer research and patient care are very complementary and nourishing. The results of my research can have a direct impact on the patients I see every day. It’s a great feeling.
Another potential misconception is that science is a solitary pursuit conducted by people isolated in their laboratories. This is far from the truth. I collaborate with several people on a daily basis and most of our laboratories have an open concept in which you can interact with your colleagues, exchange ideas and work in a team, which is a critical aspect in advancing this area.
What’s your average uptime? Typical 9 to 5 timetable or not?
I don’t know doctors who have a 9 to 5 schedule. My day usually starts very early in the morning by answering emails, preparing for a meeting or presentation, and planning my work day. I’m in the office by 8 am and on the road all day, and in the evening I go home. I try to keep track of the results of tests that I may have ordered for my patients, or I am working on my research a little later, at night, before bed. I try to spend time with my family and dog every day to balance my working hours. Weekends are time for hobbies, family and some research and work in the clinic.
What’s the worst part of a job and how do you deal with it?
The worst part of my job is watching a patient, friend, or family member fight and then lose their battle of illness. I’m not sure if you will ever fully experience this. Despite the professional maturity you gain through your training, it’s hard not to get emotional about what cancer is doing to patients, their families, and their lives. My patients are always on my mind and inspire me to work.
What is the most enjoyable part of the job?
If you are inspired to become a doctor, no matter what kind of doctor you want to become, you must love the feeling of helping others, and I feel it every single day. Helping a patient overcome an illness or being able to provide a new treatment that improves their quality of life is without doubt the most rewarding aspect of my work.
What do people underestimate / overestimate in what you do?
People may underestimate the amount of effort this profession requires to provide excellent patient care and more generally to advance the field of cancer science. Changes in this area are happening quickly, so in order to stay in the know, you need to remain curious and committed to current research without losing your heart, you need to stay in touch with the patients you meet day after day on their paths to cancer.
How much money can you expect at your job?
While in graduate school, the salary definitely doesn’t match the hours and effort put into the job, but that’s okay. I knew what I was signing up for when I decided to go this route. I did not consider money to be a determining factor in my decision to devote my career to patient care and advancement in education.
Is there a way to “advance” in your field?
Each path is different for the explorer, depending on your personal goals. My goal is to become an independent researcher at an academic medical center. Being an outstanding clinician, being productive in your clinical responsibilities, teaching young interns, and receiving grants for your research are just some of the ways you are judged. I think it is also important to fulfill institutional duties and responsibilities, such as teaching, mentoring students, serving on committees, and publishing your research in reputable medical journals in order to move up the career ladder.
What advice would you give to those who want to become your profession?
I believe that medicine is a very noble profession and there is no greater satisfaction than helping others. The doctor-patient relationship that you develop in your practice is very rewarding, and as an oncologist, you accompany your patients on a long journey that requires compassion. Medicine and science are constantly changing, so this field also offers lifelong learning opportunities. I would advise anyone considering going to medical school to take steps to spy on their doctor and read research to better understand what their future careers will be like. This approach will help them make an informed decision. If you like it, go for it.