Elevating Equity for Women in Cancer Research: A Conversation With Dr. Sandra M. Swain

Mar 12, 2024

When Sandra M. Swain, MD, FACP, FASCO, launched the Women Who Conquer Cancer (WWCC) initiative in 2013, she knew the research impact could be immense. It marks one of the many steps that she has taken to help advance cancer research and treatment for patients around the world. 
“It has been really remarkable to see the progress that has been made by these outstanding early-career investigators in all areas,” said Dr. Swain, who served as the 2012-2013 ASCO president and past member of the ASCO Board of Directors. Today, she sits on the Board of Directors for Conquer Cancer, the ASCO Foundation
Dr. Swain is a professor of medicine, the associate dean for research development at the Georgetown University Medical Center (GUMC), and vice president of genetic medicine at MedStar Health in Washington, DC. She has served as branch chief of the Cancer Therapeutics Branch at the Center for Cancer Research at the National Cancer Institute (NCI), where she was a tenured principal investigator and head of the Breast Cancer Section. Dr. Swain’s research interests include translational research and clinical trials focused on inflammatory and metastatic (HER2-positive) breast cancer, adjuvant therapy for breast cancer, cardiotoxicity, and health care disparities. She has published more than 350 journal articles and is a globally recognized leader in breast cancer research and treatment. 
Dr. Swain discussed her enduring support for Conquer Cancer and why she has dedicated her career to conducting research and improving patient care. 
What initially drew you to a career in oncology and cancer research? 
SS: I loved how oncologists were not just procedure oriented, but rather take care of the whole person. This really requires the humanistic aspect of medicine and understanding patients’ expectations for their care and outcome. Also, at the time, the field was very young with limited effective treatments, and I knew that to make progress we had to focus heavily on research. 
What do you enjoy most about caring for patients? And what do you enjoy most about your research? 
SS: One reason I enjoy working with patients is the connection you share by following them through their life milestones. Many of my patients have been cured, and I continued to see them long-term. I enjoy the relationship that you develop with patients over the course of their care, especially since cancer treatment can be so intense, and health visits are often frequent. You take care of someone in one of their most vulnerable states. You can have a dialogue with the person to understand their needs.  
I especially liked the field of breast cancer since it was so complex, from local to systemic treatment. Research has really changed the trajectory of breast cancer care over the past 40 years in all aspects, including screening, prevention, surgery, reconstruction, chemotherapy, radiation therapy, and supportive and survivorship care. We are now in the phase of trying to optimize treatments in breast cancer by minimizing side effects, instead of maximizing all treatments and potentially causing more toxicity. Additionally, the field of genomics is growing by the day as we learn more about genetic associations with cancer and targets for newer therapies. 
Why is it important to secure long-term research support, such as with endowments?  
SS: The uncertainty of funding causes a lot of stress for early-career investigators, as does taking care of a large volume of patients with complex cases. For investigators who are committed to research and making progress in cancer, receiving a Career Development Award (CDA) from Conquer Cancer allows them to focus on achieving their research goals. A CDA is a 3-year award, so it gives them enough time to develop and implement a project, obtain a considerable amount of data, publish, and then apply for subsequent funding. By endowing Conquer Cancer grants, including CDAs, we ensure that many investigators will get this very important start to their promising careers. 
What role does Conquer Cancer play in advancing research for every type of cancer, including rare and underfunded cancers? 
SS: The NCI definition of a rare cancer is one that affects fewer than 40,000 patients each year. Rare cancers account for about 27% of all cancer cases, including pediatric cancers. For these rare cancers, there are fewer patients and fewer tumor specimens available for research. There may also be fewer pre-clinical models to test new treatments for these cancers. So, it’s very important that we have more investigators working on these rare tumors to ultimately improve patient outcomes. 
How do you envision Conquer Cancer’s WWCC initiative contributing to future research, treatment, and, hopefully, cures for patients? 
SS: I launched the WWCC initiative when I was ASCO president in 2013. More and more women have chosen medicine as a career, with women making up at least half of today’s medical students. I’ve always felt strongly that women needed additional funding support to stimulate their careers in cancer research when they’re starting out. It’s a very high mountain to climb after completing so much training post-fellowship, then taking on a large volume of patients with cancer. When providing care for patients, attention to every detail is vital. At the same time, early-career investigators need protected time to formulate, design, and implement their research projects, whether in the clinic or laboratory. This time is also critical for learning new research techniques, gaining insights about common issues facing patients, and figuring out how to incorporate new ideas into research projects.  
Conquer Cancer’s WWCC initiative has awarded nearly 100 grants in 10 years and raised more than $9 million for these early-career women researchers. I can’t think of funds better spent. These grants help give them the confidence and support they need to push forward for every patient. 
Conquer Cancer is celebrating its 25th anniversary in 2024. What do you see on the horizon for cancer research over the next 25 years? 
SS: I foresee that we’ll continue optimizing and tailoring treatments for individual patients. We are past the era of one-size-fits-all; now, we’re in the era of evaluating specific tumor alterations to maximize patient benefit and improve survival. This includes continuing to build large databases to help determine new targets, which will lead to new treatments. I think soon, many people will have greater access to germline testing so that if there is a cancer risk, we can be assured that preventative measures are put into place. Patient education is also a critical need, as is research into streamlining the return of study results to patients so that they can better understand cancer research and their options for treatment.
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