Radiation Oncologist Targets Cancer Inequities

Mar 14, 2019 at 03:16 pm by admin

David Schwartz, MD

Dr. David Schwartz Attempting 'Something Remarkable'

When David Schwartz, MD, was finishing college at Stanford, he wasn't sure what was next.

There was possibly law school, a career in literature or a few other options, but medical school didn't top the list.

"I had worked as a camp counselor every summer, and then I got an opportunity to be a counselor at Camp Ronald McDonald in Los Angeles, one of the first camps in the U.S. specifically created for kids with cancer," Dr. Schwartz recalled. "It was a life-changing experience. It was so formative, so emotionally resonant that it placed me on a new path. I wanted to be a cancer doctor."

After medical school at UCLA, Dr. Schwartz trained and worked at some of the leading cancer research centers in the country, including Fred Hutchinson Cancer Center in Seattle, MD Anderson Cancer Center in Houston, and UT Southwestern in Dallas.

In 2016, with a curriculum vitae the size of a phone book, Dr. Schwartz was recruited to Memphis as Vice-Chair in the Department of Radiation Oncology at the University of Tennessee Health Science Center-West Cancer Center. He currently serves as interim chair of the Department of Radiation Oncology at the UTHSC College of Medicine and is also Professor in the Department of Preventive Medicine.

As founder and director of the Center for Health Equity, which is part of the Center for Innovation in Health Equity Research at UTHSC, Dr. Schwartz has found Memphis to be a perfect fit.

"Coming to Memphis gave me the opportunity to do something remarkable, to a cancer disparities program in direct partnership with its home community," he said. "I came with the purposeful intent to create a health disparities and outcomes research center in radiation oncology. It's the first of its kind in the United States."

Dr. Schwartz is now helping to lead the creation of a new academic cancer center spearheaded by Methodist Le Bonheur Healthcare and UTHSC. "We are building a 21st century cancer center from the ground up. My partners are the best of the best; they're national experts from big-time places. We've faced up to the fact that Memphis has never had a nationally recognized academic referral center for adult cancer like St. Jude Children's Research Hospital, and, simply put, it deserves one.

"But this center has to fit Memphis, not the other way around. We are framing the center as being not just a partner with the community, but as a true part of the community. We are picking what is the best of Memphis - the authenticity, the soul, the culture - and mixing it with what's best from outside Memphis. We will bring the best technology and talent from across the country and place it into the hands of our neighbors and our clinical colleagues practicing in the region."

There may not be a better place or greater need for such an ambitious project than Memphis, with its large medically underserved populations and high poverty levels. Rates of cervical cancer, head & neck cancer, breast cancer and lung cancer are among the highest in the nation. Much of that, he said, is preventable.

"If you look at the instances and risks for hypertension, diabetes, obesity, chronic renal failure, stroke or heart attack, it walks hand in hand with cancer risk," Dr. Schwartz said. "I really harp on my patients to get primary care and focus on their overall health, for themselves and their families, because cancer is the stalking horse for just about every chronic illness you can think of."

He envisions a more proactive approach to healthcare that not only helps current patients, but also reaches out to their families and neighbors to prevent cancer through healthy living.

"What we as Americans think of as healthcare focuses mostly on restoring health after it has been lost, which is the wrong time to jump into the fight," Dr. Schwartz continued. "We need sustainable, affordable, authentic ways to nurture health, to keep it intact in the first place. How can we engage with our neighbors to ensure we can all flourish in a more healthful city without expensive medications or procedures? We are focusing many of our current research projects on this question.

"Nobody knows what one individual's cancer comes from, but we all know instinctively that the way you live your life, the things you're exposed to, your family background, and maybe even your emotional and psychological state - all of these things weave together into a tapestry that determines whether you thrive or don't."

Dr. Schwartz says he, wife Katherine and their two daughters, ages 10 and 12, have been taken by the friendliness and soulful charm of Memphis, but he also sees "an underdog mentality" about the city that is unwarranted, given the medical resources and level of expertise that is here.

"We need to raise our expectations of what we have to offer to the city and what we can help our city attain on a more global level," he said. "Here in Memphis there's a lot of cancer, and we have to be realistic about the profound social realities and disparities impacting our city. But I believe it's ironic and happily fixable, that the most under-utilized community-based cancer fighting resource is our own medical community here in Memphis. We purposefully will never create a specialty center 'black hole' for doctors to refer patients to, never to hear from again. We're partners.

"We plan to work with our colleagues entrusting us with their patients. We will study and establish holistic healthcare pathways which provide not only durable cures but also durable health, for everyone. This is my personal mission at the medical school. It is also shared as a mission, I believe, by everybody I'm blessed to work with."

Since Dr. Schwartz is seeking to bring cancer care directly into the worlds of patients to make them active partners in the quest for good health, why not start early?

The radiation oncologist's work recently got the attention of TEDx Memphis, local independent producers of videos featuring expert speakers on science, business, technology and other disciplines.

The project that got their attention was a National Institutes of Health grant submission that he helps to lead that would allow 6th and 9th graders to apply for cancer research grants in their communities.

He is partnering with Michelle Martin, PhD, at UTHSC College of Medicine, and Idia Thurston, PhD, University of Memphis, on the project. Martin is head of the UTHSC Center for Innovation in Health Equity Research. Thurston is an assistant professor in the Department of Psychology and is an adjunct assistant professor in the Department of Pediatrics, UTHSC/Le Bonheur Pediatric Obesity Program.

The young students would take a fundamentals of science research course and then, working with their teachers, scientists and doctors, formulate their own research questions and research plans to answer those questions.

"We envision the projects being focused on real world issues that the kids see as directly relevant to their own neighborhoods and their own lives," Dr. Schwartz explained. "This could be something as straightforward as hypertension control and its relationship to cancer risk, or as profound as trust and trauma issues impacting their neighbors' relationships with cancer providers.

"They will apply for grants, get resources, literally own their projects, and then present their results in a local scientific forum to their community. They may even get the chance to present at real medical meetings and publish in real medical journals. We want to train the new energetic experts who will replace us, and who will excite younger students to follow them. There's never been a program like this in the country. I think it's pretty cool."

RELATED LINKS:

Methodist Le Bonheur Healthcare

University of Tennessee Health Science Center

National Institutes of Health

University of Memphis

Sections: Feature Profiles