Inspiring Hope

Winship Magazine: Where does hope live for women with inflammatory breast cancer?

Reshma Jagsi: We have seen tremendous advances over the past few decades. We now recognize the importance of tumor biology and have developed treatments that target the specific drivers of cancer in a specific patient. The very first patient I ever treated as an attending physician was diagnosed with inflammatory breast cancer. We treated her on a clinical trial, and I remember how terrified we all were. I will never forget the look on her face and on her spouse’s face. Thankfully, 15 years later, her cancer has not returned. She is living a full life with her family.

Advances in clinical research require the altruistic participation of patients to make advances that save the lives of future patients with that same condition. So many generations of women have< generously enrolled in trials to test new approaches—and what we have learned from those trials is really saving so many lives. That is where I think hope lives. I hope that by leading such trials, I help to inspire that hope in the patients I’m fortunate to encounter in my clinical practice. They inspire everything I do.

WM: What are some of the innovative radiotherapy approaches you are exploring that are helping treatment for inflammatory breast cancer?

RJ: A particularly exciting approach involves combining radiation therapy with systemic therapies that might be expected to increase the impact on tumor cells but not on normal tissues in the same area—what we call increasing the “therapeutic ratio.” One such approach that I’m actively pursuing is the combination of agents known as PARP inhibitors with radiation therapy for inflammatory breast cancer. My team has identified ways to combine low doses of these agents, which inhibit the repair of DNA (the genetic material in cells), with radiation therapy to pack a powerful punch to any tumor cells the surgeon wasn’t able to see. We’re now leading a national trial to see if this approach can improve outcomes and save the lives of patients who face this dreaded diagnosis.

WM: One of your research interests is focusing on bioethics and gender equity in medicine. Why is this so important for the medical field and for your patients?

RJ: In addition to my medical degree, I have a doctorate in social policy and fellowship training in bioethics. I previously directed a center for bioethics and social sciences in medicine. Making sure that what we are doing in medical research and clinical practice accord with ethical principles and the values of our society is incredibly important.

Although half of our current medical students are women, only 18% of US medical school< department chairs (people in the position I’m currently privileged to hold) are women. Let’s be clear: When I entered Harvard Medical School in 1995, my class was over 50% female. And yet only 18% of people in the rooms where I now sit are women. Think about the loss of access to the full talent pool that that represents. That has motivated me to use my skills as a social scientist to ensure that every talented person in today’s medical school class will have equal opportunity to succeed. It’s not only the right thing to do, but it’s the smart thing to do