Exploring the Multifaceted Role of a Medical Oncologist in Advanced Prostate Cancer Care and Management - Alicia Morgans

November 22, 2023

Alicia Morgans discusses her diverse roles at Dana-Farber, where she primarily treats prostate cancer patients, guiding them through various stages of their disease. Beyond patient care, Dr. Morgans is actively involved in teaching, research, and as the Medical Director of the Survivorship Program, she extends her expertise to a wide range of cancer patients. Reflecting on her career, Dr. Morgans emphasizes the significance of perseverance, mentorship, and embracing opportunities. She credits the Prostate Cancer Foundation grants for pivotal support in her professional growth. Dr. Morgans advises aspiring medical professionals to be curious, collaborative, and resilient in the face of challenges. She concludes by highlighting the profound satisfaction she derives from patient care, reaffirming her commitment to prioritizing patients in her oncological practice.


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

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

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Andrea Miyahira: Hi, I am Andrea Miyahira and I'm the Senior Director of Global Research and Scientific Communications at the Prostate Cancer Foundation. Today I'm interviewing Dr. Alicia Morgans, who's a medical oncologist and a well-known voice of UroToday. Thank you, Alicia, for joining us.

Alicia Morgans: Thank you so much for having me, Andrea.

Andrea Miyahira: So you have a lot of roles at Dana-Farber. Can you tell us about them and what you do on a daily basis?

Alicia Morgans: Sure. So I think the most important one is that I'm a GU medical oncologist and the majority of patients that I see are patients who have prostate cancer. Some of them have localized disease, some of them have recurrent disease and certainly there are a lot with advanced disease too. So I work with a phenomenal team and try to help them make choices throughout their disease journey and live as well as they can and many of them are doing great. So I feel really that that is my primary role. But of course I have other roles. I am a teacher for residents and fellows and medical students who come through, mostly teaching in clinic, but sometimes giving lectures and educational series for our trainees. I work in research and spend a lot of time doing that, writing clinical trials and grants and trying to launch trials off the ground once those grants are funded.

And believe it or not, that can be one of the most challenging parts of the job, but once they're up and running and as that data is coming in, it's also extremely gratifying and so exciting to learn. And then I'm also the Medical Director of the Survivorship Program, which is over all of Dana-Farber. And this actually is something that has been a new role since I've moved to the institute and is really something that has made my mind stretch because I am in that role to support patients who have liquid tumors like leukemias and lymphomas, myeloma, as well as all of our solid tumors. So obviously GU oncology, like prostate cancer, but breast cancer and bladder cancer and all of these patients.

In that program, we have subspecialists who actually treat patients who have cardiac disorders or kidney disorders or endocrine disorders and many others to help them stay well and continue to get their therapies or recover if their therapies have caused complications. And we also have behavioral health folks who help with mental health, sleep, sexual health and many others who help patients as they're trying to wrap up their understanding of where they've been and where they can go as cancer survivors. So that's been a really exciting role since I've moved to Dana-Farber as well.

Andrea Miyahira: So you have a lot of big roles and I think a lot of people look up to you because we knew you from UroToday, you're running this big program at Dana-Farber. You're also engaged in a lot of other outside of your institution, things like Alliance and things like that. So tell us about your career path, how did you get to where you are?

Alicia Morgans: It sounds like a lot when you say it, but obviously it's taken a long time. And I think that's one of the things that's most important to recognize when you're a young person who is interested in medicine, particularly academic medicine, and you look to your teachers and you look to your attendings and you think, "Oh my goodness, I could never do that." But you can, it just takes time and perseverance and a lot of curiosity and interest and willingness to say yes and to try new things. So how did I get here? I started actually as a junior faculty member at Vanderbilt after I finished my fellowship at Dana-Farber and Mass General. I had worked really closely with Matthew Smith, who was my mentor and still remains a mentor from afar and a friend. And he had really helped me explore and understand prostate cancer survivorship and had done a lot of work in bone health. And so that's where I did a lot of my work in fellowship.

But as I took this new role at Vanderbilt, I was able to explore that with a urology mentor, a urologist named David Penson, who helped me have access to large cohorts, studies that were prospective and continue to gather data on patient reported outcomes as well as disease control outcomes from early localized disease. And this was really useful because I hadn't had access to those patient reported outcome type data points before and it was just so helpful to learn. And I think also really useful because urologists and medical oncologists align, but we don't always overlap. And so there were a lot of things that I could ask that David would say, "Here, run with this. I don't need this for my career, but you can do it and I'll support you." And that was really valuable.

I was at Vanderbilt learning and engaging with programs like ECOG and trying to really integrate with the field across the many institutions that we have and did have an opportunity through that role to work on some trials that ultimately were able to be opened within the cooperative group system, which was really exciting. And then ultimately did get recruited to Northwestern where I worked with Maha Hussain, another amazing mentor who helped me really understand clinical trials from a better perspective. I continued to work with ECOG, but then had connections with Alliance and so was able to open trials through them. And throughout this entire process, I was applying for Prostate Cancer Foundation grants and I had my first grant in 2016. This was a creativity award. It completely changed not just my resume and my CV, but my outlook, and it validated my interest and excitement in cognitive dysfunction and patient reported outcomes and complications of survivorship.

And that grant, I think was the bedrock on which multiple other grants followed, including grants from the Department of Defense, and now more recently places like the National Comprehensive Cancer Network. But multiple PCF grants along the way have just made the whole process exciting, but also supported because without these grants, other grants don't follow and the work doesn't get done. So this has been a huge part of how I've gotten to where I am. I was recruited to join Dana-Farber for the survivorship program role after I was at Northwestern for about four years. And so I made that transition. But I really can't emphasize enough how important the Prostate Cancer Foundation grants were over that time. And some of my colleagues have said it gives you confidence, it gives you validation and I think that that's one of the biggest things, especially as a woman in medicine. We don't always have the innate confidence that some of our male counterparts have and that is something that we can either find within or sometimes we get supported from around us. And PCF has certainly done that.

Andrea Miyahira: Thank you. So I love hearing that. Are there any other inspirations that you've had along the way that have brought you to where you are?

Alicia Morgans: Well, I've mentioned multiple names of people who have inspired me phenomenally. I also should mention that Mary-Ellen Taplin was a very early mentor at Dana-Farber, who continues to inspire me to this day. And sometimes that inspiration is really finding a balance between what we need to do in clinic and what we need to do in research and how our careers evolve and also support our families at home. And she is a wonderful example of that and certainly a success story. So all of these folks plus our community, I think, have been just inspirational along the way.

Even the CEO of Prostate Cancer Foundation, Chuck Ryan and I have worked on research projects and certainly I find inspiration and many laughs from him. And one other person I should mention that's really outside of academic medicine is Gina Carithers, also associated with Prostate Cancer Foundation at this point, she's the president. I knew her way back when. And I think that she's inspired me to just continue to try, to come up with ideas and think about medical education, which is how I initially worked with her, and how we reach people and how we take the learnings that we have in our journals, in our meetings and reach the people who use this information. And she's also just an incredibly vibrant and strong woman leader. And so certainly I would be remiss to not mention her.

Andrea Miyahira: Thank you so much for that. Are there any barriers that you face that you'd want to share, especially as a woman in medical oncology?

Alicia Morgans: Yeah. I think I asked this question of people too and I think that barriers are there. They're around all of us at any given time, but unless we give them the power to stop us, they're really may be just pieces of information that we can learn from and adjust and adapt around and maybe even use to our advantage. I wouldn't say that I've necessarily faced a clear barrier that I felt stopped me from doing something. But I do think not having funding, not having grants, these are barriers that every young person faces, they're not unique to that person, but you have to just keep trying. And as I did and as I got different grants from Prostate Cancer Foundation, doors just continued to open. I do think that a willingness to make new connections outside of the institution has also been really important.

And one could imagine being at a small place like Vanderbilt. My program in medical oncology at least was very small and actually just me and one other physician in the GU group. And I could imagine that that could be a barrier because I didn't have a direct mentor even in medical oncology at that time. But I found mentorship in the urology group and I used that to my advantage to understand and to meet other urologists and to learn from their perspective. And found that over time I've really been embraced by that community and I learned so much from them and hopefully it's bidirectional. So I think there could be lots of things that could be barriers, but if we don't see them that way, hopefully we can work around them and use them to our advantage.

Andrea Miyahira: That's a good way of thinking about things. Are there any tips that you would give to early career women who want to follow in your footsteps?

Alicia Morgans: Wow. That's a big question and I'm actually just honored that you're even asking it, Andrea. I would say to be curious and to meet people, ask questions, be a good partner and offer to collaborate. There are a lot of things that are happening in oncology that are bigger than any one person. They may be clinical trials run by industry sponsors and partners, they may be within the cooperative groups, they may be local things that are going on. And you as a young person may not lead those endeavors, but you can offer to participate and say, "Hey, if there is data on this, within that dataset, can I evaluate it? Can I look at it?"

And asking those questions may be met with a no in nine times out of 10, probably not, but it may be. But there's one time where that's going to be an opportunity and you'll have the chance to learn from those individuals and you'll also be able to add something to science. And none of us, when we're coming into our careers own the data in these large collaborations. But I do think there's a real opportunity to get started, get your feet wet and once you get a name for yourself, then you can ask and people will start saying yes more and more often. So just be a good partner, be curious, ask questions and collaborate.

Andrea Miyahira: Thank you. And my final question is, what are some of the most rewarding aspects of what you do?

Alicia Morgans: As I said when we started, I think the very most rewarding is taking care of patients and being there for them no matter whether things are going well or whether things are going badly. Because that is our role and we are there to support people and bear witness on whatever happens and hopefully make things better in whatever way we can. Even when we can't fix the bigger problem, maybe we can make some little thing better or at least provide some emotional support when things go wrong. I think that if you're in oncology as a physician and patients are not first in everything that you do and the most important driver, then your priorities just need to shift a little. I mean, that's what we do, that's why we went to medical school. And maybe to focus more on research if that's where your passion is, is what is best for you. But for me, it's always patients first.

Andrea Miyahira: Okay. Well, thank you so much Dr. Morgans. It was really a pleasure to hear your journey and thank you.

Alicia Morgans: Thank you so much, Andrea.