Cancer has been a domineering force in my life since childhood. When the grandparents who raised me got diagnosed with rare blood cancers, I had a front-row seat to their losing battle. I was with them in the park when they couldn’t walk any farther. I was with them in the clinic, interpreting in Russian the doctors’ questions. I was with my grandfather in the hospital when he died, and a few years later, I was back there with my grandmother. I had stumbled my way into the world of medicine as their translator and advocate, and after they passed, I found myself wanting to stay.
I started volunteering with cancer patients and working in a translational research lab in high school, and quickly realized medical communication had become my passion. I could offer explanations to families like mine, constrained by language or literacy. I authored newspaper articles sharing my findings from the lab, and that became my foray into public health education. All the while, working with patients, I got to translate not just from Russian or Spanish, but also from science to English. I remember one of my patients kept smoking because all her friends with lung cancer had been diagnosed after they’d stopped. When I took the time to explain latency periods and cancer development, she agreed to try to quit.
My path led me to graduate summa cum laude from an accelerated medical program, graduate top of my class in medical school, and begin internal medicine training at the Hospital of the University of Pennsylvania. But the more I saw how much I could teach patients, the more I realized how much the field of medicine still had to learn.
Over decades of training and practice, doctors often begin to see patients as mere diseases and treatment plans. As a newly minted member of the medical community, I have endeavored to see patients through the life stories and circumstances that lead them to make decisions, scattered with opportunities to intervene and prevent disease. In tandem with doctors across the country, I began publishing a series of epidemiology reviews in medical school, exploring prevention strategies for all the most common cancer types. The more I learned about the risk factors behind cancer for my research, the more I saw them pop up in all my patients’ stories. I only started learning about cancer prevention (of my own accord) after I was taught about oncological management. This education should occur the other way around, with prevention coming first.
With ballooning health care costs and consistently dropping life expectancy, we are missing the forest for the trees. We invest billions in new therapies, which have indeed doubled survival over the past decades, and even made certain cancers curable. But many of these therapies come with life-long risks of immunosuppression, heart disease, or even secondary cancers, and some have side effects that have proven fatal. In oncology, as in most of medicine, prevention is better than cure. And yet, our spending on research, education, and evidence-based public health initiatives for cancer prevention has been virtually non-existent.
