Women In Science COE Articles

Articles

  • ASCO GU 2023: Association of Intermittent vs Continuous Androgen Deprivation Therapy with Cardiovascular Disease and Endocrine/metabolic Disorders in Patients with Metastatic Prostate Cancer

    (UroToday.com) On the first day of the American Society for Clinical Oncology (ASCO) Genitourinary Cancer Symposium 2023 focussing on prostate cancer, Dr. Alicia Morgans presented in Poster Session A on the association between intermittent as compared to continuous androgen deprivation therapy (ADT) and cardiovascular disease and endocrine/metabolic disorders in patients with metastatic prostate cancer.

    Published February 16, 2023
  • ASCO GU 2023: Avelumab First-Line Maintenance for Advanced Urothelial Carcinoma: Long-Term Follow-up from the JAVELIN Bladder 100 Trial in Subgroups Defined by 1L Chemotherapy Regimen and Analysis of OS from Start of 1L Chemotherapy

    (UroToday.com) Dr. Sridhar presents long-term follow-up from the JAVELIN Bladder 100 clinical trial in subgroups defined by first line (1L) chemotherapy regimen and an overall survival (OS) analysis from the start of 1L chemotherapy.

    Published February 17, 2023
  • ASCO GU 2023: Efficacy and Safety of Darolutamide in Combination with ADT and Docetaxel by Disease Volume and Disease Risk in the Phase 3 ARASENS Study

    (UroToday.com) The 2023 GU ASCO annual meeting included a session on advanced prostate cancer, specifically new targets, new drugs, and new victories, featuring a presentation by Dr. Maha Hussain discussing efficacy and safety of darolutamide in combination with ADT and docetaxel by disease volume and disease risk in the phase 3 ARASENS study.

    Published February 16, 2023
  • ASCO GU 2023: EVOLUTION: Phase II Study of Radionuclide 177Lu-PSMA-617 Therapy Versus 177Lu-PSMA-617 in Combination with Ipilimumab and Nivolumab for Men with Metastatic Castration-Resistant Prostate Cancer (mCRPC; ANZUP 2001)

    (UroToday.com) The 2023 American Society of Clinical Oncology Genitourinary (ASCO GU) cancers symposium held in San Francisco, CA between February 16th and 18th was host to a prostate cancer trials in progress poster session. Dr. Shahneen Sandhu presented the study design for the EVOLUTION trial, a phase II study of 177Lu-PSMA-617 in combination with ipilimumab and nivolumab versus 177Lu-PSMA-617 alone in patients with metastatic castration-resistant prostate cancer (mCRPC).
    Published February 16, 2023
  • ASCO GU 2023: How to Best Use Current Drugs: Treatment Sequencing and Combinations for Metastatic Castration-Resistant Prostate Cancer

    (UroToday.com) The 2023 GU ASCO annual meeting included a session on advanced prostate cancer, specifically new targets, new drugs, and new victories, featuring a presentation by Dr. Silke Gillessen discussing treatment sequencing and combinations for metastatic castration-resistant prostate cancer (mCRPC). Dr. Gillessen started her presentation by highlighting the current landscape for systemic therapies for mCRPC based on lines of therapy:

    Published February 16, 2023
  • ASCO GU 2023: IMvigor130 and the Future of Immune Checkpoint Inhibitors in the First-Line Treatment of Metastatic Urothelial Carcinoma

    (UroToday.com) The 2023 GU ASCO annual meeting included an oral abstract session on urothelial carcinoma, featuring a discussant presentation by Dr. Andrea Apolo discussing two abstracts: “Atezolizumab + platinum/gemcitabine vs placebo + platinum/gemcitabine for first-line treatment of locally advanced or metastatic urothelial carcinoma: Final OS from the randomized Phase 3 IMvigor130 study” presented by Dr. Enrique Grande and “Final OS analysis of atezolizumab monotherapy vs chemotherapy in untreated locally advanced or metastatic urothelial carcinoma from the Phase 3 IMvigor130 study” presented by Dr. Aristotelis Bamias. Dr. Apolo notes that unfortunately both of these trials were negative, but what have we learned?

    Published February 18, 2023
  • ASCO GU 2023: Niraparib with Abiraterone Acetate and Prednisone in Patients with Metastatic Castration-Resistant Prostate Cancer (mCRPC) and Homologous Recombination Repair Gene Alterations: Second Interim Analysis of MAGNITUDE

    (UroToday.com) The 2023 American Society of Clinical Oncology Genitourinary (ASCO GU) cancers symposium held in San Francisco, CA between February 16th and 18th was host to a Prostate Cancer Rapid Abstract Session. Dr. Eleni Efstathiou presented the second interim analysis of MAGNITUDE, which evaluates the combination of niraparib and abiraterone acetate/prednisone in patients with metastatic castrate-resistant prostate cancer (mCRPC) and homologous recombination repair (HRR) gene alterations.

    Published February 17, 2023
  • ASCO GU 2023: SunRISe-4: TAR-200 plus Cetrelimab or Cetrelimab Alone as Neoadjuvant Therapy in Patients with Muscle-Invasive Bladder Cancer (MIBC) Who Are Ineligible for or Refuse Neoadjuvant Platinum-Based Chemotherapy

    (UroToday.com) On the second day of the American Society for Clinical Oncology (ASCO) Genitourinary Cancer Symposium 2023 focussing on urothelial cancer, the Trials in Progress Poster Session B included a presentation from Dr. Sarah Psutka highlighting the rationale and design of the SunRISe-4 trial, assessing TAR-200 plus cetrelimab or cetrelimab alone as neoadjuvant therapy in patients with muscle-invasive bladder cancer (MIBC) who are unable or unwilling to receive neoadjuvant platinum-based chemotherapy.

    Published February 17, 2023
  • Bringing Women in Science Together, How Mentoring and Community Support Women in Medicine and Research - Tanya Dorff

    Tanya Dorff joins Alicia Morgans to share her journey as a female genitourinary medical oncologist, and the two share ways that organizations can support women as they grow and advance their careers in science. They discuss how organizations such as the Prostate Cancer Foundation (PCF), the Coffey-Holden Prostate Cancer Academy, and initiatives such as the Women in Science PCF scientific retreat play a role in bringing women in science and people in medicine together to meet each other, exchange ideas, and be a part of a community of people who are really dedicated to advancing women in science.

    Biographies:

    Tanya B. Dorff, MD., is an associate clinical professor in the Department of Medical Oncology & Therapeutics Research and serves as head of the genitourinary cancers program at City of Hope. She is an internationally recognized leader in prostate cancer and is renowned for her work in other genitourinary tumor types, including kidney, bladder, and penile cancer. City of Hope Comprehensive Cancer Center, Duarte, CA

    Alicia Morgans, MD, MPH, Genitourinary Medical Oncologist, Medical Director of Survivorship Program at Dana-Farber Cancer Institute, Boston, Massachusetts


    Read the Full Video Transcript

    Alicia Morgans: Hi, my name is Alicia Morgans and I'm a GU Medical Oncologist at Dana-Farber Cancer Institute. I'm so excited to have here with me today, Dr. Tanya Dorff, who's an Associate Professor of Medicine and the GU Section Chief at the City of Hope. Thank you so much for being here with me today, Tanya.

    Tanya Dorff: Thanks for the invitation.

    Alicia Morgans: Great. So I wanted to talk with you a little bit about women in medicine and women in prostate cancer specifically and would love to hear you summarize your story before we get into thinking about ways that organizations can support women as they move through the ranks in science.

    Tanya Dorff: So, I'm sure everyone's journey is different. I started out not really laser-focused. I didn't know I wanted to be a genitourinary medical oncologist, so all along the way, it has really been people who mentored me and even more so, people who believed in me, who saw some potential in me and told me, "This is something you could do," because, without that, certain things didn't even feel like they were on my radar. So, even in internal medicine residency, it was someone saying that this is something that you can be taught.  Because it can feel a little overwhelming when you look at physicians who are not just treating patients, but also doing research and publishing. It can feel like it might take a really special skill set and it does, but it's one that can be developed with appropriate mentorship.  And then in fellowship, really the whole reason I went into prostate cancer is because of the physicians I worked with who were doing prostate cancer, who took me under their wing, had me work in their lab, had me write grants and papers to the point where I felt this was something I could develop expertise in.

    Obviously, it's important for us now that we are on this side of it to be paying it forward and I've really enjoyed being at USC, I mentored medical students, many of them women, but I think it should be a little bit gender blind. I mentor students who are interested and who I work productively with regardless, but medical students, even undergrads, residents, fellows, and now, of course, junior faculty and some postdocs in the Kittles Lab, and it's just really rewarding because you can see potential and you want to help people maximize their impact, so they have ideas, but just by refining those a little bit and by providing opportunities through mentorship, you can really watch someone grow. It's just the greatest feeling.

    Alicia Morgans: I would completely agree with that. And you clearly take a lot of pride and joy in mentoring these junior people, and I know that you have had such accomplishments over time, that your story in itself is quite inspiring. I wonder if you could tell us a little bit about some of the things that were most meaningful to you in terms of grants that you were awarded or opportunities that really helped to define who you are today.

    Tanya Dorff: Prostate Cancer Foundation has certainly played a huge role by bringing together people with similar interests, and also I think one of their big innovations is bringing in people who are doing research in other areas where we would like to utilize some of their ideas and expertise. It could be breast cancer, colon cancer, a researcher, who is studying something that we think could be relevant. Prostate Cancer Foundation has been genius in bringing people together so that we can all meet each other, exchange ideas, and that is often where I got a lot of the ideas for my research, was at the scientific retreat meetings or the Coffey-Holden Academy, and just through the people I met. And now, PCF has done this wonderful step further for women with the women's networking event that occurs in conjunction with the scientific retreat, and it just feels really like a nice safe place for women who might have particular struggles or needs or experiences to get even more mentorship from a broader community and from a group of people who are really dedicated to advancing women in science.

    Alicia Morgans: Wonderful, and if you had to give advice to people who are watching, who are thinking about either following along a path similar to yours or supporting women who are in science, or who are thinking about going into science to achieve as you have, what would your advice be to how to best make that happen?

    Tanya Dorff: Yeah, that's a tough question. I think there are so many different approaches. I do think that as a mentee, one needs to be very proactive and make sure mentorship is happening in a way that's productive and to seek out additional mentorship because there might be some projects you're working on with one mentor, but that doesn't mean there isn't advice or guidance or opportunities that could be obtained by connecting with additional mentors. I would stay broad-minded and I would stay really proactive in order to make sure opportunities are achieved. Even now, later in my career, new opportunities arise, like my work with Rick Kittles in our Office of Equity and Diversity and studying how our prostate cancer treatments might work differently in a diverse population and really trying to meet the needs of an underserved or understudied prostate cancer population. There are always new opportunities to grow.

    Alicia Morgans: Wonderful. Well, I sincerely appreciate you for sharing your story and for giving us something to think about as we all seek to support those around us, and certainly, we appreciate hearing about how the Prostate Cancer Foundation has helped you. Thank you.
    Published February 28, 2023
  • ESMO 2022: Additional Insights from the STAMPEDE Trial Platform

    (UroToday.com) The 2022 ESMO annual meeting featured a prostate cancer session, including a discussant presentation by Dr. Elena Castro discussing two key studies from the STAMPEDE trial platform, including “Comparison of abiraterone acetate and prednisolone or combination enzalutamide + abiraterone acetate and prednisolone for mHSPC starting ADT: OS results of 2 randomized Phase III trials from the STAMPEDE protocol” presented by Dr. Gerhardt Attard, and “Clinical qualification of transcriptome signatures for advanced prostate cancer starting ADT with or without abiraterone acetate and prednisolone: an ancillary study of the STAMPEDE AAP trial” presented by Dr. Marina Parry. Dr. Castro started her presentation by highlighting that there are multiple treatment options available for mHSPC:

    Published September 11, 2022
  • ESMO 2022: Biomarkers for Advanced Urothelial Carcinoma: Are We There Yet?

    (UroToday.com) The 2022 ESMO annual meeting featured a urothelial carcinoma session, including a discussant presentation by Dr. Rana McKay discussing biomarkers for advanced urothelial carcinoma. Dr. McKay discussed two abstracts including “Genomic biomarkers in peripheral blood from patients enrolled in the JAVELIN Bladder 100 trial of avelumab first-line maintenance in advanced urothelial carcinoma” presented by Dr. Tom Powles and “PD-L1 expression on immune cells by SP142 co-localizes with dendritic cells and is associated with improved OS with atezolizumab in patients with untreated metastatic urothelial cancer” presented by Dr. Enrique G. Pulido. Dr. McKay started by noting that the treatment landscape of advanced urothelial carcinoma includes expanding treatments with novel mechanisms of action and drug delivery mechanisms:

    Published September 10, 2022
  • ESMO 2022: CYCLONE 3: A Phase 3, Randomized, Double-blind, Placebo-controlled Study of Abemaciclib in Combination With Abiraterone Plus Prednisone in Men With High-risk mHSPC

    (UroToday.com) The 2022 European Society of Medical Oncology (ESMO) annual meeting featured a prostate cancer session, including a presentation by Dr. Rana McKay discussing the trial protocol for CYCLONE 3, a phase 3, randomized, double-blind, placebo-controlled study of abemaciclib in combination with abiraterone + prednisone in men with high-risk metastatic hormone-sensitive prostate cancer (mHSPC).

    Published September 11, 2022
  • ESMO 2022: Disease-Free Survival and Distant Metastasis-Free Survival as Surrogates for Overall Survival in Adjuvant Treatment of Muscle-Invasive Bladder Cancer

    (UroToday.com) The 2022 ESMO annual meeting featured a urothelial cancer session, including a presentation by Dr. Cora Sternberg discussing disease-free survival (DFS) and distant metastasis-free survival (DMFS) as surrogates for overall survival (OS) in adjuvant treatment of muscle-invasive bladder cancer. OS is the gold standard efficacy measure in oncology, and historically a primary endpoint for majority of randomized controlled trials of adjuvant chemotherapy in muscle-invasive bladder cancer. Despite prolonged times to observe mature OS, there is a lack of well-established surrogates that can enable earlier evaluation of efficacy. Using DFS as a primary endpoint as a surrogate of OS may expedite the development of new treatments, increase statistical power, and enable an earlier assessment of randomized trials conducted in earlier treatment of muscle-invasive bladder cancer.
    Published September 12, 2022
  • ESMO 2022: Outcomes of Relapsed Clinical Stage I Versus De Novo Metastatic Testicular Cancer Patients: An Analysis of the IGCCCG Update Database

    (UroToday.com) During the Mini Oral session of the European Society for Medical Oncology (ESMO) Annual Congress focusing on non-prostate genitourinary cancers, Dr. Gillessen presented an analysis of the updated IGCCCG dataset assessing the prognostic effect of relapsed clinical stage I compared to de novo metastatic testicular cancer patients.

    Published September 12, 2022
  • Mentoring Women in Science - David Quinn

    Alicia Morgans and David Quinn discuss the promotion of women through the ranks of medical oncology ensuring they have opportunities within the prostate cancer research and clinical arena. 

    Biographies:

    David Quinn, MBBS, Ph.D., FR, Associate Professor of Medicine, Section Head, GU Oncology, Division of Cancer Medicine and Blood Diseases, Keck School of Medicine USC

    Alicia Morgans, MD, MPH, Genitourinary Medical Oncologist, Medical Director of Survivorship Program at Dana-Farber Cancer Institute, Boston, Massachusetts


    Read the Full Video Transcript

    Alicia Morgans: Hi, my name is Alicia Morgans and I'm a GU Medical Oncologist at Dana-Farber Cancer Institute in Boston. I'm so excited to have here with me today, Dr. David Quinn, who is an Associate Professor of Medicine and a Medical Director of the USC Norris Cancer Hospital in Los Angeles. Thank you so much for being here with me today, Dr. Quinn.

    David Quinn: It's great to be here, Alicia. Welcome to Los Angeles.

    Alicia Morgans: Well, thank you. It's been a long time since I've been anywhere and it is wonderful to be here with you. I wanted to talk with you today about something that is really important to the Prostate Cancer Foundation, and of course in general in medicine, which is really the promotion of women through the ranks of GU Medical Oncology, and ensuring that they have opportunities within the prostate cancer research and clinical arena.

    And I know that this has been a topic that has been very near and dear to your heart, and you've promoted the rise of multiple women throughout our ranks in research and in clinical practice. I'd love to hear your thoughts on how we can do that better, what you have done that has been successful, and why this is so important.

    David Quinn: Well, it's a big topic. It's a really important one. I think my history in mentoring goes back to when I ran the internship program at my hospital, and all of a sudden kind of overnight, we have 50% more women. Which is where we are. In fact, it's higher than that in medicine, so we have had a big change. It was very clear that the needs of those women in their careers were different. Then as time went on, we had a training program for physicians, a specialist program, and during my time there as the senior person running that, we were over 50% women.

    That was good because I think we were, I guess, being permissive of achievement for those women, and it was something they felt comfortable doing. It wasn't easy. From that perspective, when we come to oncology and GU Medical Oncology, it's paying it forward. Who did I first meet in America as formative people outside of my own group? Tia Higano, Maha Hussain, and then there were a host of others, Nancy Dawson.

    They were all extremely good to me, and they were part of what made something very collegiate, but also not overly driven by testosterone, masculinity, whatever you want to call it. People will say, "Well, most of the people that get GU cancers are men. Why would a female oncologist want to get into that when they can do breast cancer or something else where there is a kind of 50/50 split?"

    I think that was a key kind of realization and we would have some insane discussions. Then afterward one of those people or others would come and say, "That was relatively insane. Once we've settled down, we can have a chat about what we think." The balance really helped rationalize that. I think having what were relatively few women involved at that time, we are talking 20 years ago, but where they were not scared and wherein the group we really wanted to hear what they had to say because they look at things completely differently.

    The great strength in training and academic achievement comes through a heterogeneity of thought. We need people that are going to think differently about things. It's not just differences between men and women, it's people of different backgrounds and different perspectives. I think we were talking about the Prostate Cancer Foundation. For as long as I can remember, they've been looking to get people with different aspects on the problem and bring them together. It's important and I've enjoyed it. The other thing is that I have had great people to work with and that's the thing that I'd reflect on.

    Alicia Morgans: Well, you certainly have worked with some of the leaders and do medical oncology, you are one of them yourself playing key roles in SWOG, in the DOD, and in other leadership arenas. The women that you mentioned are some of the women that have shaped what we currently do in prostate cancer care.  But there are two women in particular that I want to hear a little bit more about that you mentored and helped develop. These women, like the other women you mentioned, have been funded by the Prostate Cancer Foundation and do phenomenal work. Can you tell me a little bit about Ana Aparicio? I just learned today that you and Ana worked together many years ago, and still collaborate I'm sure on many levels.

    David Quinn: Oh yeah, so, well, Ana came from a different place. She was educated in Spain, she worked at the VA, and then she came into our fellowship program. Which was great, because she'd have opinions on all sorts of things that were not the standard, which was good. We'd talk about general things, but then as things developed, it was clear that we needed more faculty. She started at USC, she was interested in epigenetics. She worked with Peter Jones who's very eminent in that area, he was our cancer center director at the time.

    She worked mainly on lung cancer actually for about a year, and then we had a position come up. We'd interviewed and we had some good people come, but it just didn't seem to fit. There were always issues about moving people around. I talked to her and I can remember, I kind of was being a bit hedged about how this position might come about and whether she would consider being part of the GU team. She said, "Well, okay, I need to think about it." She said, "Okay, let me think about it." So she said, "Well, GU is what this place at USC is all about. So, what's the problem?" I said, "Okay, well, I just didn't want to push you into it." She said, "I wouldn't let you push me into it." I thought, "Yeah, that's true."

    I think we did very well, and what impressed me about Ana was if we had toxic therapies, dose-dense MVAC, she was not scared. She would get in there and kind of manage that. Also, her interaction with our urologist was key. Then, unfortunately for family reasons, she had to move to Houston. I introduced her to Christopher Logothetis, I think that has seen her lifetime learning extended. I think that has been a great personal interaction also with the rest of the team at MD Anderson. What I think is fantastic is she can translate ideas that are a little bit off-beam, they are not the mainstream. If we look at what aggressive variant prostate cancer is, the rest of us were realizing we were seeing this. She and others, Chris and [inaudible 00:08:20], and the team Paul [inaudible 00:08:24] worked on this.

    Now I'm hoping we are going to see a phase three trial that will test that premise. And I think it's a very important concept to take the elements clinically and test them. Also, looking at those patients in trials, very important, distilling it down. She wrote one of the most difficult papers to write in history. It was in clinical cancer research and it was about this entity defining it. I always try to get my fellows to read that. It is long, and there's a lot of data in there, but it's still relevant.

    Alicia Morgans: She has accomplished so much and I'm happy to hear how that started and how you supported her career within your group, and then also helped her transition when she needed to do that. We will circle back in a minute because I'd love to hear how you generally think about supporting women in their academic development. There is one other person I wanted to hear a little more about, a great friend of yours and a great friend of mine as well, Dr. Tanya Dorff, can you tell me a little bit about your interactions with her?

    David Quinn: Well, I first met Tanya when she was a fellow at USC and I got off on the wrong foot because we had interviewed at least three candidates named Tanya, and I gave her the wrong last name. I said, "look, I'm really sorry" and she said, "yes, the person you're talking about went to City of Hope and she's subsequently done well, as well." But I hadn't met any of these people. I just didn't happen to interview them. That was okay and I thought, "Wow, this could be a long month." It wasn't a long month.

    She dealt with a couple of really difficult patients and she spoke better Spanish at that time than anyone I knew, of course, she spent a significant time growing up in Columbia. Her life journey was interesting to that point. Coming out of fellowship, we really wanted her to come to USC and for a variety of reasons, we did not have a position for her. I can remember several of the urologists being very upset that we did not. For example, the late John Stein was almost in tears when I had to tell him, so anyway, she was beyond well regarded at that time.

    She went off to work in a very, very good private practice and then, ended up the opportunity, came about, we had a position and she came back to us and she was with us for about a decade. During which time she worked extremely hard. She would come and ask me what her strengths and weaknesses were, and I'm thinking, wow, that's a difficult question. We would go through things and she would also talk about making her weaknesses better, which such an immense depth of personality, almost entirely devoid of ego, not entirely, but almost.

    The thing is over time, she grew to be much better than me and she needed to grow. We then had the difficult conversations that all mentors have when she needed to move to another institution to take up a leadership role. That was good because it caused me to reflect and I wasn't ever, there was never a question about her succeeding. It was only an issue of whether the other place was good enough to make sure that she was able to do that. She's gone on to better and greater things. We still interact at least weekly. We have some common projects. And I think from that perspective, it's great to see her move forward, to get PCF grants, to do different things where I may have talked her out of doing something, she's charged forward now at City of Hope. And then she'll often ask whether I want to partner with her on things. I'm thinking, "Wow, am I now good enough?" And she still seems to think that I am, but I have to work at it. So that's a great transition to have as a mentor. And I think also I've seen her grow as a person, and that may be more important for women than it is for men, growing as a person. You never, or very rarely, hear a male junior faculty or fellow say, "I need to become a better person," when in actual fact, we do. So I think from that perspective, that's my lesson from her. And I strive to be a better person because of her.


    Alicia Morgans: Well, that is beautiful. And I love to hear the learning and the mentorship actually going both ways in that situation. And you've clearly both benefited from each other. And if you had to say, what is your, I guess, the number one goal that you have as a mentor for women, for anyone, what would that be?

    David Quinn: That's a good question. So as a person, you need to be on some sort of road to happiness. And if you're not on that road, you need to rethink and not be scared to recalibrate, do something different. And there are some people in their career, and I talk to residents and fellows about this, I don't care what they want to do just as long as it's the right thing and they're comfortable with it. And then the other issue is trying to have that balance. You can call it work-life balance, which is fine. But I also think that the balance is more complicated than that. What's happiness? Will you be happy in your achievements in your career if you get to a point in your career where your family and children don't know you? And the answer is usually no. But some people will close themselves off and do that. But my view is that they don't achieve as well. So if we talk about where people are going in their lives, it's actually important to have that discussion.

    And I think some people that are early in their careers, they don't confront the questions about what they want their life and relationships to be. It can be simple or complicated. And also whether they want to have a family or not. And these are decisions now that I think we discuss more openly. What is the right career choice for them? Will it be stimulating and provide a balance? Some of our trainees are happy to go off and work in a clinical environment for all of their life and then retire with benefits. And hopefully along the way, they will hit that happiness goal. Others are more ambitious and need to achieve things. We've talked about a couple of them. But I think developing the character to deal with problems and solve problems that are clinical and translational and basic, is very important. So, that happiness goal, it's got to be in there. You don't have to be miserable to succeed. You will have to make some sacrifices and work, but most people in our field are very happy to do that.

    Alicia Morgans: They are. It's not the easy road to be a GU medical oncologist. That's for sure.

    David Quinn: Now, on the other side, I don't know whether you're going to interview the people we've talked about, so they may tell you about deep regrets and other things. And so I think that we all have where we missed an opportunity. We weren't quite quick enough. We didn't realize that this was where the field was going to go. And so I think that the environment at PCF in the meetings is very positive towards women. And another colleague that I have not mentored formally at Dana-Farber was pregnant. I don't know how many months, but it was obvious, Rana McKay. And she came into I think one of the last PCF meetings we had. It was at UCLA. And she sat in the front row for the whole thing and needed to get herself organized in the advanced stages of pregnancy. But I think it was interesting the way people just kind of accommodated that and didn't bat an eyelid.

    And what was really interesting was that there were some fellows there from all disciplines. And I usually stand at the back because I can't sit for very long. So they would say, "Who was the lady at the front? And I said, "Well, that is Rana McKay, and it's not her first baby. I don't know what number. But that's what it's all about." And some of them were thinking... The cogs were ticking over, to say, "Okay, I can do this as a career and have a family." So that's an important example. And that's understating Rana's contribution to that and many other meetings where I think the contributions academically and intellectually are kind of key.

    Alicia Morgans: Absolutely. And Rana is a great example of that balance, whatever you want to call it, the happiness balance I think is a good way to think about it. So any final thoughts on how people like you, who are in your position of leadership in so many different ways, can support women within your institution or more broadly to continue to succeed?

    David Quinn: I think that we have lip service and guidelines that says we need to be developing women, people from different backgrounds, etc., etc. That's fine. But there also needs to be some sort of personal touch. So the people we've talked about are easy to like, not difficult to work with, are a blessing on any program. As we work with, most of us work with residents and fellows, we need to connect with them, whether they're male or female, or whether they don't assign. I think it's just kind of important. And their life journey will be a little different no matter what. So for the residents and the fellows at the moment, we've had two years of very, very different situation related to COVID-19. And we've had less contact. We were doing our clinics at the county hospital via telemedicine. So in other words, we were talking to the resident or fellow and we were sitting at home or in our office. And you miss stuff. You also miss stuff because we're all wearing masks. And just how the people are, what their body language is like and how they're traveling.

    And I got a big shock this year, because I normally do July on the Norris inpatient unit, which is where my wife says, "Well, I won't be seeing you much this month." So I'll say, "Okay, I'm sorry. I'll do my best." But where we do have contact with the residents as they come out of internship. And I realized very quickly that having had a break from that for a year, I'd done other service jobs, that this was kind of different. You know, they'd had a year of COVID, and really, they were pretty flat. And educationally, we were doing well. In fact, they said we were doing better than well. But in terms of just their lives doing COVID, it was relatively miserable. And we had to have a kind of debrief on that one.

    And just at that time, it became, I guess, in the media apparent that there were some self harm issues at other places amongst the residents, also more senior doctors. And I felt bad. I hadn't connected for a year. Now, I'd seen the people, but it wasn't like I'd sat there and said, "Hey, what's going on for you? Where are you headed in your life now? What have you decided?" So a number of us realized that we needed to communicate with each other to address that issue.

    Now, I don't know how the GU medical oncologists are traveling because I haven't talked to any of them face to face for quite some time. Actually, that's not true. We had a dinner in July where I think six of us got together in Los Angeles and we got to have a little bit of discussion about how we were doing, but that personal can action is important. There'll be people that will go through difficult times, and you want people that can deal with those things so that they can get strong and deal with other things. And I have two female trainees at the moment in GU medical oncology and I'm watching them be much better than I ever was with difficult situations. But having the challenge of socializing them in the GU medical oncology situation, so can I introduce them to Tia Higano and Maha Hussain, who are still with us, but are on Zoom.

    And there is a realization that stretching right to the early stages as we develop as medical people, that one person's not going to be enough, but also that critical loss of mentors. And we've had a few for the residents, not the past, thank goodness, but went to other places. And when their prime mentor is somewhere else, that's a big adjustment for that person where they've got to work out whether they really wanted to do that or whether they were in "Just in love with a mentor." And these are difficult discussions to have, but they're important.

    So I think we need to spend our time supporting people. I feel guilty that I don't have more time and that I don't use it better. But this is something that PCF has helped encourage. I think it's very collegiate. And I can't remember when we started having the Women's Day. But I remember the first time after we'd had the Women's Day, I said to Howard Soule, we were at a DOD meeting, and I said, "How did it go?" And he said, "Oh, it went very well. And you'll be pleased to know that next year you'll be able to go if you want it." And I thought, "Okay." I said, "Howard, I'm not sure whether there's something you need to tell me." And he said, "Well, yes, there is. We feel like we need to have a comfortable environment where men are not dominating, but you'll be able to sit in a session or tune in. And if you behave real well, they might even ask you what you think."

    So I think that's been good. And the discussion will occur in a very different way to a mixed group, maybe an all male group. Most urologists in various parts of the world are male. And so that discussion is very different for them, plus the culture of where they are. And so we need to keep working on that. And I think that's been a big success initially, because they said, "Okay, we've had our discussion, but we don't have to close the doors." And I think that that's interesting. We're thinking, "Okay, the group is far more self assured." And also the reason for initially maybe not having the male gender there was that women can discuss their challenges, insecurities and will get beyond a lot of that stuff because they realize that there's some common things happening here, and that if they're working with male mentors or male colleagues, they need to be not shy in making that point. And I'm always interested in my section to try and sure that we don't have all men. Now, if I'm outnumbered and it's all women and I retire, I might be okay with that. But I would say, "Look, if a good man applies, you should consider him because I think that he might have contributions and perspectives that are different to yours."

    Alicia Morgans: Well, that's a wonderful perspective. Thank you. And it is just a delight to hear how you think about inclusiveness and different perspectives and all that you do and all that you touch and support and how that leads to of course, supporting phenomenal women in medicine and in prostate cancer specifically. So, thank you so much for taking the time to go through all of it. I sincerely appreciate it.

    David Quinn: All right. It's great to see you, Alicia, and I hope you have a good time here in Los Angeles.

    Alicia Morgans: Thank you.

    Published December 14, 2021
  • The Role of Awareness and Support in Elevating Women in Science - Kristen Scarpato & Svetlana Avulova

    Kristen Scarpato and Svetlana Avulova join Alicia Morgans to discuss women in urologic oncology. 11% of practicing urologists are females, which is a number that needs to rise. The trio highlight the Society of Women in Urology, as well as Women in Urologic Oncology, for raising awareness and providing a platform to get women together to network and support each other.

    Biographies:

    Kristen Scarpato, MD, MPH, Associate Professor, Department of Urology, Vanderbilt University, Nashville, Tennessee

    Svetlana Avulova, MD, Associate Professor of Urology, Urologic Oncology, Albany Medical Center, Albany, New York

    Alicia Morgans, MD, MPH, Genitourinary Medical Oncologist, Medical Director of Survivorship Program at Dana-Farber Cancer Institute, Boston, Massachusetts


    Read the Full Video Transcript

    Alicia Morgans: Hi, I'm so excited to be at AUA 2022, where I have the opportunity to talk to Dr. Svetlana Avulova as well as Dr. Kristen Scarpato, both talking with me about women in urologic oncology, women in science in general. Thank you so much for being here today.

    Svetlana Auvlova: Thank you for having us.

    Kristen Scarpato: Thank you for having us.

    Alicia Morgans: Wonderful. I want to highlight before we get started, or as we get started, that the two of you have a really special relationship too, that, Kristen, you were one of the mentors I would assume of Svetlana, and you mentioned this as we were getting started. Just any comments on that just as we start?

    Kristen Scarpato: Well, I first met Svetlana actually when I was a resident and I remember it well, we sat next to each other, eating pizza, and she was a medical student, very interested in urology and Svetlana is a force to be reckoned with. And I distinctly remember meeting her and unfortunately, where I did my residency, we didn't match her, but fortunately, she ended up at Vanderbilt where I did my fellowship and stayed on faculty. And so I had the opportunity to work with her quite extensively as a resident and she continued to be a force to be reckoned with. And I was so happy to see that she chose urologic oncology.

    Alicia Morgans: Absolutely.

    Svetlana Auvlova: And one of the main reasons I chose it is I was lucky enough to see Kristen Scarpato as one of the first female urologic oncologists that was hired on staff at Vanderbilt, by Dr. David Penson. So I think having you as a role model was inspirational and it made me feel like, yeah, I can do it too.

    Alicia Morgans: Yeah. And I think that's so important to have role models. And to that point, there have not been a large number of female urologic oncologists. There actually are relatively low number of female urologists. But when we look specifically in urologic oncology, the numbers are pretty low. And it's something that I think is important to change as we really diversify the group of people, caring for patients with urologic cancers.

    Kristen Scarpato: Yeah, it's true. One of the things that has been highlighted at a couple of sessions this meeting, is that about 11% of practicing urologists are females, so it's a pretty low number and somewhere 3 or 4% of urologists who identify as urologic oncologists, are female. And so the numbers have been really quite low, unfortunately.

    Svetlana Auvlova: And I think to that point, a lot of the women that are in the 3 to 4%, are actually probably within 10 years of practice, or even within five years. We have the greats of Isla Skinner and Char Lee, but really, if you can name a few more in their...

    Kristen Scarpato: Elizabeth Picket was the first and she's always-

    Svetlana Auvlova: Thank you.

    Kristen Scarpato: She's always highlighted. And I think so much now of sort of, I don't know if you can call them mid-career, but Angie Smith, Sima Porten.

    Svetlana Auvlova: Kristen Green.

    Kristen Scarpato: Yep. Kirsten Green, Ann Schuffman. These are pioneer women in urologic oncology who I think-

    Svetlana Auvlova: Stacy Loeb.

    Kristen Scarpato: Stacy Loeb, inspire all of us.

    Alicia Morgans: And you too now, too, as well. Svetlana, how do we change this? How do we support women to go into this field? I think having a diversity of perspectives is always important and there is an emphasis in the field of medicine in general, I think, on making sure that we have a diverse population, not just of our patients, but that we really make sure our workforce is also diversified. So how do we change this?

    Svetlana Auvlova: Well, I think we're doing it right now, we're talking about it. And so I think awareness of it, and then I think also supporting each other, and we've been able to do that through the Society of Women in Urology, as well as through the WUO that's Women in Urologic Oncology, that's been sponsored by SUO and led by Sara Sudka and Sima Porten. So getting women together who are in this field and networking and supporting each other.

    Kristen Scarpato: Yeah, absolutely. I think sponsorship and mentorship are key. And I think, you don't need to have a female mentor to succeed in urologic oncology. I think it helps to have someone who looks like you and shares sort of a common experience to go to and rely on for information about the specialty and to sort of motivate you, but a good mentor, a good sponsor, is really important, whether it's a male or a female.

    Alicia Morgans: I certainly agree with that. I think some of the conversation around the lack of diversity here, has also been, in terms of gender, has also focused a little bit on manels. And I wonder if either of you have comments on that, I know that the AUA has made some effort to highlight women in urology. Sometimes those efforts are exactly what we need. Sometimes we still need to take a few more steps to continue that progress, but would love to hear your thoughts.

    Kristen Scarpato: Yeah. I think we need to get away from manels. I think there are many qualified women and it takes an organization being deliberate, but it also takes the men on the manels speaking up about the lack of gender diversity. And I can think of three examples in the past month of men declining to participate in a program or on a panel or saying that a female needs to be added because they feel uncomfortable with the lack of representation, and that's huge. I feel like that's what we need.

    Alicia Morgans: I would agree. We need those advocates from both genders.

    Svetlana Auvlova: Yeah. And this reminds me of one of my favorite books by Elizabeth Lesser called, Cassandra Speaks, where at the end, kind of the message that she gives is its important for us women to support each other. But what is going to change the needle and change the culture are the men that are going to be supporting the female, so the heforshe in our Twitter hashtag world.

    Alicia Morgans: I agree with that and thanks for bringing Twitter into it because of course, there's a lot of conversation on there and there has been over time and some of it gets a little bit intense. So I think, how do we elevate the dialogue around this? How do we keep it all on the up and up instead of devolving, where we sometimes could? How do we support that conversation, heforshe?

    Kristen Scarpato: I think it's hard sometimes, and you want to offer sort of a knee-jerk reaction and reply. But I think personally, my own hesitation is that whatever you put out there, lives forever. And so you want to be mature and responsible and not engage in some of the dialogue that maybe is not productive.

    Alicia Morgans: Agreed. Other thoughts? Who have heroes of yours been, Svetlana?

    Svetlana Auvlova: Yeah. And this is something that we've discussed earlier, but Madeleine Albright has definitely been a hero of mine, and it's coincidental that she just passed this past month in April. And she always said that women who don't support other women have a special place in hell, so that's sort of been the mantra that I've always stood by. And one of my goals as a young urologic attending at Albany Medical Center is to support our female residents and to have them dream big, because if you don't dream big, then you don't know what you can accomplish.

    Alicia Morgans: I would agree with that. What do you think, Kristen?

    Kristen Scarpato: I think that was an awesome answer and a tough act to follow. And so what I will say is that one of my current day heroes actually is Svetlana. As I said, forced to be reckoned with, great surgeon, brilliant mind, excellent presenter if anyone's looking for a panel participant, but someone who really goes after what she wants and doesn't stop with no. And I think you are inspiring other women to go into your urologic oncology.

    Svetlana Auvlova: Thank you.

    Alicia Morgans: I agree with that. And I also feel inspired just generally by both of you. I think the energy, the passion, and the commitment to supporting the women around you. It's not always easy to keep all of that up. And sometimes, especially in academic medicine, there are forces that push you in directions where you wouldn't necessarily naturally be generous and naturally pull up others, but you both do it and you do it every day. And I encourage you to continue to do it, and I encourage other women to follow your lead. So thank you both for your expertise, your time and your dedication.

    Svetlana Auvlova: Thank you.

    Kristen Scarpato: Thank you.

    Published February 28, 2023
  • The Role of the PCF in Supporting Women in Science - Susan Halabi & Dana Rathkopf

    Susan Halabi and Dana Rathkopf join Alicia Morgans in a conversation on women in prostate cancer research, with a focus on how the Prostate Cancer Foundation (PCF) has supported the development of so many women in this part of science. The pair each share how their careers were impacted by the PCF and its commitment to women in science. The three elaborate on the initiatives the organization is taking to continue to evolve and how the PCF has changed the narrative of this disease.

    Biographies:

    Susan Halabi, Ph.D., Chief of the Division of Biostatistics and Bioinformatics, Duke Cancer Institute, Durham, North Carolina, United States

    Dana E. Rathkopf, MD, Medical Oncologist, Associate Chair, Junior Faculty Development, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY

    Alicia Morgans, MD, MPH, Genitourinary Medical Oncologist, Medical Director of Survivorship Program at Dana-Farber Cancer Institute, Boston, Massachusetts


    Read the Full Video Transcript

    Alicia Morgans: Hi, my name is Alicia Morgans, and I'm a GU Medical Oncologist at Dana-Farber Cancer Institute. I am so excited to have here with me today, Dr. Susan Halabi, who is the Professor and the Co-chief of the Division of Biostatistics at Duke in Durham, North Carolina. And Dr. Dana Rathkopf, who is a Medical Oncologist, and the Chair of the Research Council, as well as being the Associate Vice Chair of Faculty Development in the Department of Medicine at Memorial Sloan Kettering Cancer Center in New York City. Thank you both so much for being here with me today.

    Dana Rathkopf: Thanks Alicia.

    Susan Halabi: Thank you. Thank you, Alicia, for having us.

    Alicia Morgans: I really appreciate both of you talking with me today about women in prostate cancer research, with a focus on how PCF has really supported the development of so many women in this part of science. I'd love to start just by really exploring your journeys in prostate cancer science, and would love to hear from you first, Dr. Halabi.

    Susan Halabi: Thank you so much, Dr. Morgan. I could say in one word that the Prostate Cancer Foundation has been phenomenal in supporting me when I was a junior investigator. In 2005, I received my first grant proposal and my proposal was based on secondary data analyses from several clinical trials. So as a biostatistician, everybody told me, well, you don't need to be a PI, but with the support of the prostate cancer foundation, my whole career path changed for the better, like drastically for the better. It opened opportunities and avenues for me to become not only an established statistician, more importantly, to become an independent investigator. And to that, I'm extremely grateful for the Prostate Cancer Foundation in investing in me, because, without that first grant, I would not even have thought to apply to other opportunities.

    Alicia Morgans: I so appreciate you mentioning that. Because it is true, there are a number of biostatisticians who are supportive members of teams, and really so integrally involved. But you are a biostatistician who has led teams, and has led multiple grants and has truly carved out a very clear niche for herself and her work in the prostate cancer space. I think it's wonderful that the Prostate Cancer Foundation had something to do with that. So thank you. Thank you so much. And Dr. Rathkopf, can you tell us, from your perspective, what has your trajectory been like? You've certainly made quite a difference as well, in prostate cancer.

    Dana Rathkopf: Awe, thanks, Alicia, that makes me feel so good. The PCF, also for me, was the first grant that I ever received, and it was sort of like PCF believed in me before I believed in myself. They gave me that confidence. I didn't realize I shouldn't be confident, because they treated me with such respect, even as a young investigator, that it gave me confidence. It gave me the platform to reach out to other investigators to make connections, collaborations, that served me throughout my career. And I didn't stop to think about it. It didn't seem unusual or unnatural, because they created an environment that was just full of science, and full of opportunity, and full of collaboration. And it didn't matter if you were a young investigator, or a senior investigator, or a man, or a woman, it's just an open community where they created that safe space to share ideas, not compete, but to share ideas and build science together.

    And so, PCF really paved the way for me in my career to sort of pay that forward, because learning from them early in my career, how to relate to others, and feel confident around others, and learn and assist others, has sort of given me the blueprint for how I try to treat others in all aspects of my career, and really, my life. So I'm tremendously grateful to PCF for that early training, and all the things they've done beyond that.

    Alicia Morgans: Again, similar to my comments for Dr. Halabi, I just think it's wonderful. The therapeutic advances that you have supported, and worked through in your career, Dr. Rathkoph, have been phenomenally successful. And as you mentioned, really involves collaborations with investigators from many different institutions. Because without those collaborations, we can not complete these clinical trials, or we can not complete the meta-analyses that Dr. Halabi does so well. So I wonder, from both of you, and we can start with you, Dr. Halabi. How do you see PCF continuing to support this collaboration, particularly among the women scientists in the organization, but actually across the entire organization? How do you see that support continuing to evolve?

    Susan Halabi: Thank you. This is an excellent question. As a matter of fact, PCF has really invested in women. We had the women in science retreat now for several years, and it attracted a lot of prostate cancer scientists, whether they are women or men. But through that avenue, I met a lot of women, and it has been really wonderful to network. I feel we are in a very global community, and that everybody works together with their shared data. And I'm grateful for PCF in investing in this retreat and in science. Because by investing in women, we are investing also in them, and then it becomes circular. So I believe the sum is definitely much greater than the parts.

    And what was really striking was in one of the women in science, we have seen high school students, so we are trying to engage people early on. Because as you know, one of the barriers is having scientists early on, like from their school years. So inviting them to their retreat, listening to scientists, seeing other women presenting, building confidence, and playing a role model, is so critical, especially for young women who are still in school. So I think from my perspective, PCF is doing a great job and it will be phenomenal if we continue doing those retreats.

    Alicia Morgans: Thank you for that. And Dr. Rathkopf, what are your thoughts? And maybe you can comment on some of the work that you did just this year at the retreat for women that was hosted by PCF, and you certainly led one of the sessions at that retreat.

    Dana Rathkopf: Yeah. First, I echo, of course, what Susan said, about these women in medicine and science and how PCF promotes them. But it's interesting, I'm glad you asked that question, Alicia, because I was asked to chair a session this year about women in science, and sort of the paths of transition that they are experiencing, which is particularly salient because of COVID. I think we are all in some type of transition now in our lives. And I would say that, because of this open dialogue that PCF gave us the space to have amongst women, I recognized issues that I maybe wouldn't have otherwise recognized, even though I'm a woman myself. And to hear other people bringing up issues that suddenly, I was like, wait, yes, yes.

    I learned so much from just that conference alone. And I made connections with people, not just...I talked earlier about science but on a very personal level. And PCF is, of course, a lot about science, which I appreciate, but there is another side to all of our lives beyond science. And I think it is very difficult to separate them completely. And the fact that they give us the space to consider it all together, and meet people that might be having similar situations, and share those experiences, I think, is really extraordinary and unique in the field.

    Alicia Morgans: I could not agree more. And as we think about moving the field forward, of course, a focus is on our junior colleagues and mentees. And I would love to hear how, in your experience, PCF has engaged with some of your mentees, Dr. Halabi.

    Susan Halabi: Well, as I mentioned, I've been heavily funded by the PCF. So every single grant that's funded, whether it's a Movember challenge or other grant, that is based on collaboration with other PIs, I hire postdoc fellows who are being supported, and now, are very much interested in prostate cancer. So hopefully, I'm developing the next generation of statisticians who will do work in prostate cancer. Because, as you know, data is critical, and it will advance science forward. But taking the time to sit down and mentor those young investigators is really critical. And I wouldn't have been able to do that without those grants that were funded.

    Alicia Morgans: Absolutely. The time that we take to mentor is time that isn't always carved out in our professional lives. And so having funding that allows us to have that time carved out, to work on these projects with our mentees, I think is so, so important.

    And Dr. Rathkopf, I know that you have an interest in faculty development. You have a role there in your department of medicine, which is fantastic. And I know that so many in the field look up to you, and to your accomplishments, and to your, of course, wonderful engagements across our field. I wonder what your thoughts are on how we can best, and how PCF can best support the next generation of researchers.

    Dana Rathkopf: I think PCF is already doing this. As you can hear from Susan, they are providing funds across the spectrum of disease. Not just to senior investigators, but also to junior investigators, team science is so important. I think that it's very important, particularly for young investigators, to have exposure to people that maybe aren't just at their institution. And so these kinds of awards, where they span across multiple centers, I think, create really dynamic interactions that are very unique in many ways to PCF. Because they don't only provide the funding, but they provide the platform for discussion, and ongoing discussion, and sharing the data in real-time, in a way that is very unique, I think, to the field, and so very much appreciated.

    Alicia Morgans: Absolutely. And of course, we know that challenge awards must include a young investigator, that is part of their charm.  But it's also part of the way we lift up those around us too, as you said, Dr. Halabi, to sort of get the next generation ready to participate in prostate cancer research. So as we close today, I'd love to hear just your summary, or your final thoughts on women in prostate cancer research, and how you feel we can move forward, both as a PCF funded organization, but also how we can support our junior faculty and our younger mentees, in continuing to move the field forward.

    Susan Halabi: Yeah. Alicia, as we've been saying, PCF definitely is providing the support. I would say definitely continuing doing that, invest in the young investigator. When I first started my career, there were hardly any women in prostate cancer. And it's so nice now to see more women engage in the disease. You go to the prostate cancer scientific retreats, you see a lot of women presenting. So these are all indicators to me that the Prostate Cancer Foundation has a vested interest in not only the scientists but especially the women scientists. So definitely continue doing that, because we are going to build a stronger community so we can cure the disease. And from my perspective, I feel like the Prostate Cancer Foundation has changed my career, and I'm delighted to talk about my story to others, and encourage them to come to the retreats, and attend, and network, because then, I think, they would realize what a great opportunity it is.

    Alicia Morgans: Well, thank you. And Dr. Rathkopf, you get the final word. What would your message be?

    Dana Rathkopf: I think that PCF is one of the most exciting conferences that we go to, a funding mechanism that we all look forward to applying to, which is different maybe, then some other experiences. And again, it's because they foster a community, taking your word, Susan, thank you, a community of investigators who are sharing data, really raising each other up. And that includes women, absolutely. But really, investigators from all shapes and sizes, from all corners of the globe now, and really brought awareness to prostate cancer research too. As a woman, it's funny, because years ago, I used to get asked all the time, "Oh, you do prostate cancer. Isn't that a man's disease?" And I was always like, well no, it's about the science.

    I'm a wife, I'm a mother, I'm a daughter. I mean, there are a lot of men in my life that I care about. And so, I almost never get asked that question anymore. And I have to credit the Prostate Cancer Foundation to some degree. They are so successful in getting the message out, that prostate cancer affects not just patients, but their families, and all of the potential genomic findings, and what that could mean downstream for family members. It's an extraordinary organization that has that magic combination of science, and just enough competition to keep us on our toes. But so much collaboration, and so much joy involved in the process of really trying to move the field forward, that I feel really fortunate to be part of the PCF family.

    Alicia Morgans: Well, again, I think, I could not agree more. PCF really has changed the narrative of this disease. And I stopped getting asked that question actually, a few years ago, as well, though I was asked a lot when I first got involved. So I do credit them with that. And I credit them, of course, with making a community where we can have these conversations, and as one community, attack this disease to try to make a difference. So thank you so much for your time today.

    Dana Rathkopf: Pleasure. Thank you, Alicia.

    Susan Halabi: It's my pleasure. Thank you, Alicia, for inviting us.
    Published February 28, 2023
  • The Value of a Supportive Community and the Necessity for Women in Positions of Leadership in Medicine - Elisabeth Heath

    Andrea Miyahira interviews Elisabeth Heath, a medical oncologist at the Karmanos Cancer Institute, in this conversation. Dr. Heath is a leader in prostate cancer research and oncology and a mentor to many. In honor of Women's History Month, they discuss Dr. Heath's career journey, the importance of having a supportive community, and the need for women in leadership roles. Dr. Heath advises others to create a board of directors, a group of trusted peers, and mentors who can offer guidance and support. They also discuss the upcoming PCF Women in Science Network Initiative and the importance of work-life balance for women in the field.

    Biographies:

    Elisabeth Heath, MD, FACP, Associate Center Director of Translational Sciences, Leader of the Genitourinary Oncology Multidisciplinary Team, Karmanos Cancer Institute, Detroit, MI

    Andrea K Miyahira, PhD, Director of Global Research & Scientific Communications, The Prostate Cancer Foundation


    Read the Full Video Transcript

    Andrea Miyahira: Hi everyone, I'm Andrea Miyahira and I'm the Senior Director of Global Research and Scientific Communications at the Prostate Cancer Foundation. Today I have the great honor of being joined by Dr. Elisabeth Heath. Dr. Heath is a medical oncologist at the Karmanos Cancer Institute, where she is also Associate Center Director of Translational Sciences, professor of Oncology and Medicine, Chair of Genitourinary Oncology Multidisciplinary Team, and Director of the Prostate Cancer Research Program. Thank you for joining us, Dr. Heath.

    Elisabeth Heath: Thank you for having me. Such a pleasure to be here.

    Andrea Miyahira: Such a pleasure to have you. March is Women's History Month, so we are celebrating women in prostate cancer research and oncology. Dr. Heath, you are a leader in these fields and are certainly someone I have looked up to for a very long time, not just for the impact of your research and patient care, but also as a mentor, as someone who has nurtured the careers of so many at your institution and beyond, even having a program for under-served high school students that are interested in STEM. And you've also helped us organize many of the PCF Women in Science events, including some our new PCF Women in Science Network Initiative, which is having our first forum on work-life balance on March 31st. I do invite anyone who is interested in attending our forums or being on the mailing list to email . So Dr. Heath, would you, I guess, please first tell us about your career journey and what were some of the key moments that propelled you to where you are today?

    Elisabeth Heath: Oh, absolutely. First of all, thank you so much. And it's really a pleasure to be part of a terrific community like this because I think it does make a difference when women have other women to lean on and to share our stories with and to learn from one another. I would say that when I started medical school at Jefferson Medical College in Philadelphia, I honestly didn't have any idea what to expect. There weren't really that many women. I think my class had maybe 25% that graduated 30 years ago, but it was a wonderful time in my life. I met my husband there, we made new friends and those were the days where you were kind of thrown in all together with no social media and nothing but the library books and you just had to focus and get it done. But I learned at that point, you really had to have a team with you.

    I was very fortunate to have several friends and just sort of a community of folks that we can rely on because there was so much material to learn. And then, gosh, that first introduction to patient care, really scary in some respects. I'm sometimes flabbergasted how these patients are so generous to allow medical students to come in and just pop in during a really tough time in their lives. But I think that, in a way, has changed for a lot of students, but not that much. Everyone sort of goes through that same path, whether it's medical school or graduate school or business school or even undergraduate. For me, when I did my residency at Georgetown and my fellowship at Johns Hopkins, it just was an experience that just kept building, it was learning about different topics, but it was just meeting more and more new people.

    And it became quickly evident that women, especially those in leadership, were not that easy to find. They were there on occasion, you obviously could talk to them, but there was really no real set program. So I think what events like what PCF has in terms of the retreat and programs that really support, again, work-life balance, that was almost unheard of 20, 30 years ago. And then when I came to Detroit, now it's 20 years, there was again the same issue of, gosh, where are all the women in leadership? It certainly was a situation where many of us were present, but not sort of in a way that was visible, especially to trainees. So I think that that type of journey is something where we can share to others that are following behind us to show that, well, let's improve that, because it shouldn't be a mystery who we are. So what you're doing here is to really get the folks that have sort of been through the journey out there so people can reach us and ask questions and just kind of share the stories.

    Andrea Miyahira: Yeah, thank you. I guess, are there any stories about women mentors or colleagues who helped you along the way in your career?

    Elisabeth Heath: Oh, there were numerous. And I think in that sense, I was fortunate. One of the best pieces of advice I've received was, "Create your own board of directors." And sometimes those are people that are in medicine. Sometimes those are people that are just folks you really trust their opinion. Some could be friends, some could be even neighbors or folks that go to your church or whatever community you're in. But building that own board of directors was really valuable, because especially when I moved to Detroit, I didn't really know anyone. I was always doing things on the East Coast and I relied heavily on that group. And some were mentors and some were just peers. But without that, I think it would've been harder. So I really encourage those who are starting this journey to come up with their own board of directors to see what that would feel like, and who's going to populate that. And it may change over time, but I think you'll come to rely on that board to help you make big decisions.

    Andrea Miyahira: Yeah, I think that's really great advice. Along the way, were there barriers that you faced and your female colleagues faced that your male colleagues tended not to?

    Elisabeth Heath: Well, I'll tell you this, you can't make it this far, especially as a woman in medicine as a professor, without having some barriers and some challenges. I think the one that pops up, and I'm sure this will come up in our work-life balance discussion and seminars, is we're always unsure of as to what to do with the personal aspect of one's career. And I think there's a little bit of a pause, if you will, in your career to say, "Well, what do I do now? Who's going to do what and where?" And that's a big barrier, because there's no set algorithm. Every person's different. And it's not just having a family. It might be taking care of a parent or a grandparent or an auntie. It just is so varied for all of us. But sometimes these caregiving duties do fall to the women, and that is still sort of a number one question that comes up in a lot of the meetings I have with my own mentees in terms of just where is this?

    So, one of the big barriers was just, there was no set way to do it. And in a career in science, usually there's steps like, well, you finish this, you move on to this, you have a PhD, you get a postdoc, and then you do the next thing. So with this, it's just not so evident. So I'd say that that's probably a more relevant, in a way, barrier current in your face. It's not to say men don't experience it, but I think our maybe thoughts and concerns may be just a little bit different.

    Andrea Miyahira: Yeah, I like to think that we're making progress. I guess what barriers do you think we really come far along in, versus ones that we haven't made any progress in overcoming?

    Elisabeth Heath: Yeah. Well, I think the big one is just there's more women in science. I look at our own medical school at Wayne State University in School of Medicine. It's 50%, as it is, I think in most medical schools. And we have one of the largest classes annually here in the US. So, to see that number of women is just exciting for me. When I was the faculty advisor for the Gold Humanism Society every July at the white coat ceremony, that was my favorite moment. That was my real antidote to burnout. Just look out and see 300 pairs of really eager eyes and proud family members cheering them on.

    And to see half of that audience be women, I think, is wonderful. I think where we still lack some progress is in the leadership roles. And here we may have 50% women in the medical schools, but as you move up and you're now taking deanship roles and director roles and president roles, those numbers fall very, very quickly. And a lot of that is still a work in progress. So until those kinds of statistics change, I think it remains to me too low, and it remains to me still an untackled and unsolved challenge. So we all have to, as a community, work towards improving those numbers.

    Andrea Miyahira: Yeah, I agree completely. I guess for the younger generation of women oncologists, are there any advice that you have? Things they can start doing now to really improve their chances of getting into leadership positions in the future?

    Elisabeth Heath: That's a great question. I think one of the things we don't do very well, I think, as women is setting the expectations. So we're great worker bees and team players and collaborators, and I think those words tend to be part of most people's letters. "Oh, she's great, enthusiastic team player." But then it comes time for sort of academic credit. "Oh, where do I fit into this paper? Or am I presenting? Or is that person presenting?" So, I think we can advocate for ourselves a little bit more, and it could just be done in a more sort of informational ask. Like, "Okay, well if I did this, what are your thoughts on where then this could go? Are you envisioning that in a year there's an opportunity here for me to be on this abstract? And if so, would you like me to take the lead?"

    "Or why don't you share with me what your thoughts are?" And in that sense, I think, again, being very intentional about it helps, because I think what we do a lot is sort of do a lot of the work and then we're, "Well, everyone's going to notice we did the work," and then think the reward will come, and then it doesn't. And you sort of get really upset at that. And then it just spirals. And sometimes in a way, I think being as direct as you can just for expectations, and at that point the person you're doing the project with or whoever could say, "well, actually you're the fifth person that's joining. So at most, you'd be somewhere in the middle if you're okay with that." Then you could say, "Well, gosh, for what I'm envisioning, is there another project that I could help take the lead on?"

    But doing that also takes some homework. So what we don't want is for me to say that and everybody go in and go, "Well, gee, I demanded be first author on this paper I didn't do much." I think there also has to be an understanding that it takes a little bit of time to build that up. So being aware of it, you may not get it right off the bat, but the next opportunity, then at least you've advocated for yourself, and there's that opportunity where that person may say, "Okay, you're up now because you've done the work." A lot of it, I think, is still just setting the expectation and communicating that with everyone around you. I think women also tend to take a lot on. They don't want to say they can't do something. Oh, well there's these five things to do. But then in your mind you're like, "Uh oh, I'm supposed to be somewhere else for two out of these five."

    And then you try to make it work and then you're running around and you realize this is a bad idea, and at the end of the day, you are suffering as the person because you just put yourself in a position to fail. So, don't. If you know two out of the five things you can't achieve, just say it. Just say, "Unfortunately I'll have a conflict with this and this. How would you advise me of these five things? Would you prefer that I tackle these three, or would you like me to do something to rearrange it so I can take on these two, but then someone else could take on the other three?" So being really clear in knowing what you can and can't deliver, I think, helps, because we are everywhere and we are usually expected to do everything for everyone. And at the end of the day, we are burning ourselves out and it's just not worth it.
    Published March 7, 2023
  • Women in Science and The Prostate Cancer Foundation - Amina Zoubeidi

    Amina Zoubeidi joins Alicia Morgans in a conversation on the evolution of her career and how the Prostate Cancer Foundation (The PCF) played a pivotal role in supporting her research initiatives and the collaboration and friendships that result from the Women in Science Program at the PCF Annual Retreat.  PCF  consistently demonstrates a commitment to women scientists by supporting their research. The PCF is committed to fostering a community of innovation and excellence, where hard work and oath to patients are given the absolute greatest opportunity to succeed. Dr. Zoubeidi also shares that earlier this year in 2021, she was awarded the Canada Research Chair 1 in Cancer Therapy Resistance.

    Dr. Zoubeidi’s research program aims to provide mechanistic insight into the molecular (genetic and epigenetic) sources that fuel tumor cell plasticity and emergent resistance phenotypes following targeted therapy. She leverages this knowledge to identify early detection biomarkers and nominate new targets to block the mechanisms utilized by tumor cells to gain access to cell plasticity that can be used alone or in combination to improve the efficacy of existing therapies and patient outcomes. Importantly, as lineage reprogramming is emerging as a conserved mechanism of resistance across tumor types, results from this program may have relevance in other highly prevalent cancers, such as melanoma and lung and breast cancer.


    Biographies:

    Amina Zoubeidi, BSc, MSc, Ph.D., is a Professor at the Department of Urologic Sciences and Senior Scientist at the Vancouver Prostate Centre. She is Michael Smith Scholar, who received multiple awards including PCF Challenge Award, UBC Faculty of Medicine Distinguished Achievement Awards for Overall Excellence-Early Career (2014) and for Excellence in Basic Science (2018), and three Teaching Awards for Excellence in Basic Science, Department of Urologic Sciences, Faculty of Medicine, University of British Columbia (2014, 2017 & 2018).

    Dr. Zoubeidi has been awarded a number of prestigious grants, including a Prostate Cancer Canada Translation Acceleration Grant, US Prostate Cancer Foundation Challenge Award, and numerous Canadian Institute of Health Research awards and Terry Fox Research Institute awards. 

    Alicia Morgans, MD, MPH, Genitourinary Medical Oncologist, Medical Director of Survivorship Program at Dana-Farber Cancer Institute, Boston, Massachusetts


    Read the Full Video Transcript

    Alicia Morgans: Hi, my name is Alicia Morgans and I'm a GU Medical Oncologist at Dana-Farber Cancer Institute in Boston in the US. I'm so excited to have here with me today Dr. Amina Zoubeidi, who is a Senior Research Scientist at the Vancouver Prostate Center, as well as being a Professor in the Department of Urologic Sciences at the University of British Columbia. She is also the Canada Research Chair in Cancer Therapy Resistance. Thank you so much for being here with me today Dr. Zoubeidi.

    Amina Zoubeidi: Thank you so much Alicia for having me, and welcome to my home. I'm talking to you today from my house, and I hope we can see each other and you can come to Vancouver and I can see you here.

    Alicia Morgans: I would love that and you have a beautiful home, and you also have a beautiful history of research in prostate cancer, and I would just love to hear your take on the evolution of your career and how you got to where you are.

    Amina Zoubeidi: Well you know my journey started a long time ago as a grad student, and I was fortunate to start my Ph.D. with amazing women in prostate cancer.  I was working on kinases and their role in prostate cancer progression. I think that having this role model in front of me, this woman who was a Professor [inaudible 00:01:13] Miguel, drives me to see that I can do it. And I think that it is more about the mentor and the mentee, and my research started earlier. I think this, this one.... I remember when I started research in prostate cancer with just a few women, I'm just talking about the case in Canada, but today it is so interesting to see these amazing scientists and amazing clinician-scientists in the field. It is just fantastic and making us all being, as being in the world of men or men's disease, because there is no world of men, but the men's disease and how we can make a difference today.

    Alicia Morgans: I think that's a great point, and it is interesting that when you started there were, there were fewer women, of course, and that has evolved over time. I know that your work has been funded by so many places, and you've done so many exciting and innovative projects. I'd love to hear your thoughts on those awards that have come specifically from PCF and, what your thoughts are there in terms of their commitment to women scientists, which I think has only grown over the last number of years.

    Amina Zoubeidi: Well, I have to say that PCF was the first award that I got as an independent scientist. I have this...I do believe personally if I didn't get this PCF young investigator award in 2010, I do not think that I could have achieved what I achieved today because the Prostate Cancer Foundation does not only offer salary support or a grant, it supports a whole network.  I believe that PCF in which we call the village that can raise a kid, and that is what the Prostate Cancer Foundation is. I think every time that I was going to PCF and watching those people giving those talks, I was looking at them, and I said, "I wish one day I can give a talk at the PCF," it was this driving thing going every, every time to the PCF retreats and hoping I can be there, and that makes a huge difference in my career.

    It is this external validation coming, just being a part of this PCF makes a difference for me because they pushed me to be better and better and better. Not only that, you know, I've been very fortunate to receive also a Challenge Award from PCF, which allowed me to grow at a really specific time of my career and to show that I can do it and that I didn't stop there.  I didn't stop there because of all the support that PCF is giving to women in science. I started being involved in PCF Women in Science, which just consolidates everything for me.  It consolidates not only my career but also my self-confidence as a woman in the field. That support impacts me and I believe impacted so many other people, so many other women. I do believe it's not very specific only to women in science, or in prostate cancer, but I think it's general for anybody who is an early investigator when they have so many hurdles somehow rather than challenges.  We can do it because PCF offers this well-organized platform to support you and facilitate your research through collaborations.

    Alicia Morgans: I think it's so interesting that that was your first grant. That was my first grant as well. And it is something that I think as a young investigator, to know that your colleagues, the people that you look up to, the people giving those talks at the meetings are the ones reviewing your grant, that you know that they're picking that apart, but still they have found that your grant is worth funding is incredible, as you said, just confidence-building and does bring you into the fold, so I love that. I also love as I've watched you for the last number of years participating in the PCF Women in Science day, and that whole celebration and education of how we can work together as women and continue to lift each other up. I'd love to hear your thoughts on that particular day and the importance of recognizing women in science through that forum.

    Amina Zoubeidi: I think that this is very important to celebrate each other. I think that we forget to celebrate and now we have one day that we can look at each other and we can say "we did it, we're good." It's just positive, it's a simple thing, but it is extremely positive, but also celebrating others that they are young or well established or at the verge of retirement and celebrate those things. It just highlights the achievements, it is very important. And I think sometimes we are in the shadow of others, and today I think that we are doing very well. I think that the future is bright for us.  We hear a lot that there is not a lot of women in leadership positions, not necessarily because they don't want to be in leadership but because of the culture, but we are changing and we are moving forward.

    And what PCF is doing, is just giving us this opportunity.  PCF is giving women in science a chance to be proud of themselves, to say I can do it, I can organize a day, I can mentor, and I can make a difference. That is what women in science are about, all that celebration, mentoring, supporting in every aspect, such a positive day, such a positive environment, that we all, as women, we know, even when we were teenagers, we know, we know that we need this friendship, we know that we need be part of a group.  That is who we are as women and I think the PCF Women in Science offers that, it brings us together and it is incredible.

    Alicia Morgans: It is incredible. And I think it's a unique opportunity through the PCF to have that. And, you know the other thing that I wanted to comment on and to hear your thoughts on that is incredible is your elevation, your competition, and then subsequently your naming as the Canada Research Chair in Cancer Therapy Resistance, that came from somewhere and brought you to such an amazing position. I would love to hear a little bit more about that important role that you play.

    Amina Zoubeidi: I'm going to start again, that it is about PCF, it was the first thing. Yeah, and you know, building on that PCF, the confidence that PCF gave me with this young investigator, award, going to PCF and the person next to me and that I will not name, I could name certain names, telling me what is new in your research that is driving me. And I know that people's expectations are high. And from there you go from one to the other, to the other, and you're performing and performing with this beautiful network of collaboration that PCF offered to us, really with the click, if somebody doesn't respond to you, just contact Howard Soule and the collaboration would be there. You know what Canada did, Canada figured out that women in science, women are not yet at... Is not because they are not there yet, but they are not having these leadership positions.

    And they pushed the universities to put women forward, they didn't say that you are not going to be having men, but to have men, but also, where are the women? You know, for example, for this Canada Research Chair, it was like a very low number of women. And the government decides that society is 50/50, and we should recognize women in Science, in Literature, in History. And that is what happened, and I think that initiated from the government is helping so much.  PCF is doing it at a certain scale, but in Canada, they are trying to do it at a larger scale as in, it is very extremely competitive, not only in your department or your faculty or the university, but when you go, your file goes through all this, then it goes to the governments, you are competing with History, you're competing with Engineering, you're competing with everything.  And we are all in a pool.

    I was fortunate to be awarded this Canada Research Chair. And it is how this chair is also about how you can retain talent and specifically talented people in science, in my case as a woman was important, that for them how we can retain that coming from, you know, you have an obligation, you have salary support from the government, you have a [inaudible 00:10:15] government, but not it's not really, but that is kind of a word that we have to acknowledge every time we have it.

    Alicia Morgans: Well, congratulations. This is a huge honor that you clearly have been awarded for what you do and the impact and the influence that you have, and those that you have helped to elevate with you and your mentees and your collaborators. So I sincerely congratulate you of course, but also appreciate your time and sharing your experiences with me.

    Amina Zoubeidi: Thank you very much Alicia for having me.
    Published December 6, 2021
  • Women in Urologic Oncology - Anne K. Schuckman

    Anne Schuckman and Alicia Morgans discuss the unique challenges and opportunities for women in urologic oncology. The two explore their own journeys in the field and provide suggestions on how young women seeking a career in urologic oncology can build their careers with confidence.

    Biographies:

    Anne K. Schuckman, MD, Director, LAC+USC Urologic Oncology, Keck Hospital of USC, USC Norris Cancer Hospital, Los Angeles, California 

    Alicia Morgans, MD, MPH, Genitourinary Medical Oncologist, Medical Director of Survivorship Program at Dana-Farber Cancer Institute, Boston, Massachusetts


    Read the Full Video Transcript

    Alicia Morgans: Hi, I'm so excited to be at AUA 2022, where I have the opportunity of speaking with Dr. Anne Schuckman about women in urologic oncology, the unique ways that we can lift women in this profession, as well as some of the challenges that we face, even among our patients and their perceptions of urologic oncologists. It's so wonderful to talk with you today.

    Anne Schuckman: Thank you so much for having me.

    Alicia Morgans: Wonderful. Well, I know that you have had many roles over time where you have had the opportunity to influence the field of urologic oncology, urology in general, by not only elevating the women around you in your ranks, in urology and in medical oncology and in other spaces, but also in helping us to fill our ranks with newcomers, with young students, and medical trainees. I'd love to hear your thoughts on how you made that most effective and how you supported young women in that way.

    Anne Schuckman: I had the opportunity at USC to be the medical student advisor for the Department of Urology for many years. Through that process of really making a one-on-one connection with first and second-year medical students, we encourage them to do the rotation and then do the sub-I. I think that without a female mentor, it's pretty intimidating to go into the field of urology. With the female mentor, I think, you can really see how you can fit in, what the different opportunities are, and encourage those women to think of it as something that is inclusive of women.

    Alicia Morgans: I think that's so important, and not necessarily when we use our academic brains and we're thinking about getting all the scores that we need to get, to get to each level through medical training, it's so daunting, it's so hard. I'm so impressed with the young people who are still doing that. I don't know that I could do it again if I had to, but there's so much that you think about that drives you, and it's not necessarily conscious that you think, "Someone has to look like me in order for me to go into that field." But I think there is a subconscious something about it, where first, if you don't see the field, because you don't see anyone like you that you kind of latch onto, or if you just don't see someone that you aspire to potentially be like this person, it can make a real difference in how you're choosing a specialty.

    Anne Schuckman: Absolutely. I mean, I was very lucky, as a medical student, to have a female mentor at USC, but she was the only female really in the department at that time. Not even just urology, even in Los Angeles, in a big urban area on the West Coast, which I think is pretty liberal. There are real paucity of senior female surgeons, not just urology, sort of across the board, and seeing how people can fit together goals such as getting married, having a family, and still have a successful career looks very different for female students than it does for male students. There's no question about that.

    Alicia Morgans: Absolutely.

    Anne Schuckman: The other thought I have on that is I think that many times women in general sort of suffer more from imposter syndrome than men do or than male students do. I think that even just opening up the conversation to how they feel about where they fit into this, can really open their eyes.

    Alicia Morgans: Well, I think that's a great take on that and I'm sure your years being there really helped to improve people's, at least, mindset around who is a urologic oncologist? Who is a urologist? You've continued that over time and I wonder, are there organizations that listeners should be aware of, that trainees should be aware of, that really do support women in urology?

    Anne Schuckman: Absolutely, and we've been really lucky with this over the years. I mean, there's always been a society of women in urology, but over the course of the last five years or so, there's so many more young women going into urologic oncology that we've actually managed to form a society of women in urologic oncology. And this year at the SUO meeting, we had this fabulous event that wasn't at like six in the morning, which was unbelievable, and the number of trainees who attended, whether they were students or fellows or international fellows, was so encouraging. As this matures, we'll have more opportunities to actually sponsor women-centered research, or just sponsor specifically women who are going into academic careers in a scientific way and not just a mentoring way.

    Alicia Morgans: That's also so important because I think women sometimes realize that to reach all of these metrics, to be in the scientific community, in the academic community, there are also challenges, there are hurdles. And to your point about the imposter syndrome, one could say, "It's just too overwhelming. It's enough for me to maybe be a fantastic urologist, but I'm going to do that in private practice because I want to have a family." I think it's so important that these societies help support people as they proceed through an academic pathway, if that's what they want as well.

    Anne Schuckman: Well, I think some of it is even understanding that an academic pathway may even be friendlier, actually, to having a family and to having some control over your life and your schedule. I think that, that's maybe a misperception amongst trainees in terms of what your life looks like and just seeing people do it, obviously, is what matters.

    Alicia Morgans: I would agree. I think in medical oncology as well, the academic schedule actually gives you a lot more flexibility.

    Anne Schuckman: Absolutely.

    Alicia Morgans: I'm not in the OR ever, but I'm not in clinic as much as my colleagues who are in private practice. It is definitely more of my making in terms of the schedule.

    Anne Schuckman: It's been fun, too. One of the things that's interesting is, again, even in a big city like LA, I've really connected with most of the other female urologists in Los Angeles and there's not that many. I feel like we've been very lucky to create a little referral network. Most of these women I've honestly never met in person, but we talk on the phone all the time and have formed these relationships. I've started asking them if my residents can go out and shadow in their private practices, just so they can kind of see what that even looks like, because they don't get any exposure to private practice during training.

    Alicia Morgans: That's fantastic, too. All of these wonderful things that we're doing and that you're doing to really elevate women in the field and show them that this is a possible opportunity, a really phenomenal opportunity for them, it's great. But one thing that I think is still interesting is that our patients are going through this journey with us and patients don't always perceive women as their urologic oncologist, as their surgeon, because of the history of urology or urologic oncology. I wonder if you have any comments about that?

    Anne Schuckman: It's funny. When I talk to a new patient about bladder cancer, I'll spend easily an hour to an hour and a half going through the nuts and bolts of the diagnosis and the surgery and exactly how it's going to happen in the recovery. And almost every time, at the end of about an hour long conversation, they say, "Well, who's going to do the surgery?" And I asked my male colleagues if they've ever had this experience to a person, they said, "No, that's absolutely never happened to me." And then they're very excited about it, which is funny, they say, "We're so happy you're doing it. We're so glad that you spent all this time with us," but it's just this sort of idea that, "Well, that's not what a surgeon looks like."

    Alicia Morgans: Now, well you are very clearly what a surgeon looks like and I really appreciate your time. Do you have any closing thoughts for those who are listening and who are thinking about this as a field or, in general, women who are watching?

    Anne Schuckman: I would say just spend some time and take the risk of spending time in clinic or spending time with a female urologist and learn about the field. Certainly, it's a long journey, but at the end of the road, it's a fantastic field for women to be in. It's a great ability to control your life and you'll have a fantastic career ahead of you.

    Alicia Morgans: I think it's more than just a career; it's a passion. It's a life's work, and I so appreciate that you are sharing that life's work with us and helping to elevate those women around you who want to do the same. Thank you.

    Anne Schuckman: Thank you so much.

    Published October 17, 2022
  • Women in Urologic Oncology: Past, Present, and Future - Alicia Morgans & Sam Chang

    Alicia Morgans is joined by Sam Chang in a conversation on supporting women in urology and the allyship of the AUA and The Society of Women in Urology. They discuss the Society of Women in Urology's efforts to support women and elevate this topic.

    Biographies:

    Sam S. Chang, M.D., M.B.A. Patricia and Rodes Hart Endowed Chair of Urologic Surgery Professor Department of Urology at Vanderbilt University Medical Center

    Alicia Morgans, MD, MPH, Genitourinary Medical Oncologist, Medical Director of Survivorship Program at Dana-Farber Cancer Institute, Boston, Massachusetts


    Read the Full Video Transcript

    Alicia Morgans: Hi, I'm so excited to be at AUA 2022, where I have the opportunity to speak with Dr. Sam Chang. Thank you for being here.

    Sam Chang: Alicia, it is really my honor and pleasure.

    Alicia Morgans: Well, it is my honor and pleasure, and I'm really excited also to talk to you about allyship and supporting women in urologic oncology and in urology in general, and I'd love to hear how you and different allies at the AUA and The Society of Women in Urology have been working to really elevate this topic.

    Sam Chang: Alicia, this is a topic that for individuals who know about it, they're the ones who really don't need to know about it. It's for the huge majority of individuals, many of them men, who really don't understand the current situation, the situation in the past, and the situation in the future. So, actually thanks to the AUA and Dr. Raman and The Society of Women in Urology, the AUA helped support a course and a course was put on specifically for allyship in terms of the gender disparities in the issues that we've had. And, part of that was an evaluation of kind of what is the issues, what are the problems, and then action steps. And so, understanding that this starts early on in terms of individuals in medical school, not having mentors, not having any idea of what is going on in urology, then understanding that once women are in urology residency, still less than 10% of urology residents are women.

    And if you look at the practicing workforce, it's even a lower percentage, and so the numbers are improving, but unfortunately, as women finish their residencies and they look at positions, they're paid on average almost $100,000 less per year. It takes them on average almost one and a half years longer to get promoted from assistant to associate professor. When they come to publications, they're in fact less likely to be cited, less likely to be cited as having actually noble and innovative work just because they're not getting the support, and the mechanisms aren't in place. And so, a part of this course was education regarding just that there's just a few of the examples of disparities, and then action items in terms of what individuals, like men in the workforce, who have already started these kinds of networks and connections that women have always been excluded for. So, I think it was very important to start off with the recognition, start off with their action items that can be done,, and then hopefully we can start making inroads.

    Alicia Morgans: I think that's a great approach, and really, as you said, raising awareness first, and then to think about the publications, we echo the people around us. We echo our teammates, we echo our colleagues, and if women aren't in the room, are not the colleagues that we're around on a regular basis, we're not going to be echoing them as much, or citing them as much. So, what did the AUA say? How can we help with that particular problem?

    Sam Chang: So, repeatedly the understanding of starting that process of recognition, so how? Well, you have the understanding of, and the AUA has made active inroads in, we're going to have more women in panels, we're going to have more women as moderators, we're going to have more women invited to speak. And then within the editorial process of The Journal of Urology, there's been a big emphasis on the assistant and the associate editors and the lead editors to actually model and mentor other women, so they can become more involved. And so, I think understanding the problem, then starting those processes, and also understanding within the SWIU, that actually at different levels mentorship can occur. And so, they actually have a group of young women urologists actually starting to mentor residents within the program, and young female urology residents are looking at medical students as well. So, they're starting processes to begin the education, but more than anything, it's actually starting to put those women in positions to succeed.

    Alicia Morgans: Well, and you are in a position, and have been for years at your institution where you do elevate and support those around you. Do you have advice for others about how to put women in those positions?

    Sam Chang: Well, I think men... It's a two-way street obviously. The men need to understand, men being people that are my age and multiple times as this panel has been put together, I've been deemed the senior, seasoned person on this panel, and part of it is understanding that it's been an old boys network in reality, and that's starting to change, but what we need to do as men is recognize there's an issue and problem, like I said, but then make an active stance of, okay, if we have this individual, we need another individual that is a woman.

    Oh, we don't have this, we need... And, just by recognizing that and putting women in those positions, we make a difference, but a point that we really try to emphasize is that that's not enough. We need to make sure that those women have all the resources then to succeed, and I think too often early on women been put out as [inaudible], okay, we've put them in this position, but we've not given them resources to succeed, and they've been on an island. That's starting to change, and so it's a combination of recognizing, supporting, and then making sure they succeed.

    Alicia Morgans: Well, I am so pleased that you are working on this topic. You are a good friend and colleague, and I know you're a such a [inaudible]-

    Sam Chang: We've tried.

    Alicia Morgans: We have always tried, and you have tried in particular and you're such a supporter of women in any stage of their career, and of course, you have daughters, which also means you're supporting young women even from the ground up.

    Sam Chang: Absolutely, and I've been fortunate because I've learned from my mentors who've always made that, and so it's not been as big a step for me. For others, it's really a big step, and so I applaud those who are really starting to make those efforts and I think a groundswell has started, so hopefully, that'll continue.

    Alicia Morgans: I hope so too, and I applaud you for your efforts and I appreciate your ongoing support with AUA and SWIU.

    Sam Chang: Thanks very much, Alicia. I appreciate it.

    Alicia Morgans: Thank you.

    Sam Chang: Thanks.

    Published February 28, 2023