How I Became a Geriatric Oncologist

Oct 23, 2018

Enrique Soto Pérez de Celis, MD, is a researcher in Medical Sciences at the Department of Geriatrics of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, an academic hospital in Mexico City. Dr. Soto is a member of the ASCO Professional Development Committee, the Cancer.Net Editorial Board, and the Addressing Cancer Health Disparities Among Older Adults Working Group, among other volunteer activities. He is the recipient of a 2014 International Development and Education Award, a 2015 Young Investigator Award in Memory of John R. Durant, MD, and the 2016 Long-term International Fellowship from ASCO’s Conquer Cancer Foundation.

How did you initially choose your current career path? Were there any unexpected detours along the way?

ES: I knew that I wanted to work in geriatric oncology since I was a fellow in internal medicine. I was assigned to the geriatrics ward of the hospital for a rotation and I loved taking care of older adults. Since I was interested in oncology, this seemed like a great career path to follow. Since then I started working to achieve my goal, which was difficult because there were no opportunities for training in geriatric oncology in Mexico. Fortunately, I was able to meet Dr. Arti Hurria, who would go on to become my mentor, at the 2014 ASCO Annual Meeting.

At that meeting, I attended Dr. Hurria’s lecture after she received the BJ Kennedy Geriatric Oncology Award. I had read all her papers and really wanted to work with her, but I had never met her before. After her talk ended, I waited until everybody else had congratulated her and, when only her parents were still in the room, I came up to her, told her who I was, and asked her for an opportunity to go to City of Hope and learn from her. That moment changed my career.

I visited Dr. Hurria as an observer for 3 months during the last year of my medical oncology fellowship. Shadowing her allowed me to improve my clinical skills with older patients, to understand how geriatric oncology research is done, and to learn how to build a successful team, among many other things. That visit changed my life and helped me obtain a Conquer Cancer Foundation Young Investigator Award and a Long-term International Fellowship so I could continue to study geriatric oncology at City of Hope under Dr. Hurria’s mentorship. I was able to spend a whole year with my family in Los Angeles working with Dr. Hurria, and now that I’m back in Mexico we continue to collaborate on multiple projects.

I guess that the message to young physicians is to be daring, follow your dreams, and be brave—things can happen if you go after them!

Describe your typical work day.

ES: In a typical work day, I attend new patient sessions to discuss therapeutic plans with my colleagues. Twice a week I attend the clinic, where I see older patients with colorectal and gastric cancer, as well as older adults who have been deemed vulnerable by other oncologists. The rest of the week is dedicated to research, to teaching geriatrics and oncology fellows, and to visiting hospitalized patients.

If you have to pick one aspect, what part of your job is your favorite? What part is the most challenging or frustrating?

ES: Without a doubt, my favorite part of the job is interacting with patients in clinic. I get to hear their stories and to understand their problems, and this represents an enormous incentive to improve as a clinician. Additionally, listening to patients is the best way to get new ideas for research.

The most challenging or frustrating part of the job is having limited resources to treat our patients. In low- and middle-income countries like Mexico, many patients are uninsured and have to pay for everything out of pocket, which means that some treatments, including supportive care, are out of their reach. However, although this may seem frustrating, it is also an opportunity to develop innovative solutions and to find new ways in which to help patients with collaborations from foundations and other institutions.

What do you wish you had known before you chose your career path?

ES: When I started in oncology I thought that the most important things were new drugs, hazard ratios, and p values. Now I know that taking care of people with cancer goes way beyond that, and that getting to know your patients and what is meaningful to them is the most important thing you need in order to help them achieve their goals.

Why would you recommend this career to someone starting out in oncology?

ES: In an aging world, every oncologist will eventually be a geriatric oncologist, and this is an incredible area of opportunity for clinical practice, academia, and research. On top of that, you get to meet patients with the most incredible stories and experiences that allow you to grow not only as a doctor, but also as a human being. Finally, the geriatric oncology community is full of amazing people who are willing to help out young physicians!

What kind of person thrives in this professional environment?

ES: I think that anybody who truly cares for patients will thrive and be successful in any area of medicine. 

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