Doctor Spotlight 2014: Julie R. Gralow, MD

Breast cancer oncologist Julie R. Gralow, M.D., photographed at Seattle Cancer Care Alliance on May 2, 2014

Specialty: Breast medical oncology
Hospital affiliation: Seattle Cancer Care Alliance

What has been the biggest change in treating breast cancer in your time practicing?
When I started 20-plus years ago, we pretty much relied on untargeted treatments such as chemotherapy, with lots of toxicity to the whole body. Then we evolved into a more targeted era, separating breast cancer into subsets...resulting in less chemotherapy. Now we’re trying to combine a better understanding of the genetic changes associated with each individual cancer and patient with the pathways and targeted therapies associated with those genetic changes—with a goal of less toxicity and more efficacy.

What’s the one lesson you wish your patients would take to heart?
I think many patients underestimate the impact of lifestyle choices in reducing cancer recurrence and maximizing overall health. Physical activity, maintaining a good body weight and healthy diet play an important role—sometimes much more than a drug.

What inspired you to participate in Team Survivor events?
In 1995, I was asked to nominate some patients who might want to train for a triathlon. The day before, we had a lunch for the Team Survivor triathlon participants. We went around the room and everyone was asked to talk about why they were participating. When it came to my turn, I said I was just there to support the team. A patient sitting next to me—on chemo and quite anemic—asked why I wasn’t going to join them. And I thought about it and realized there was no good answer, so on the spot I said I’d join them the next day. I had to go out and buy swim goggles that night. We’ve been going strong ever since—I still serve as team physician for Team Survivor Northwest—and am even climbing Mount Adams with a group this summer.

What would you say is the public’s biggest misconception about surviving cancer?

Many patients tell me that they get great support from family and friends during surgery, chemo and radiation, but when that’s all done, they are expected to be back to normal again, as if it never happened. It can take months to even years to recuperate from the effects of a cancer diagnosis and treatment, and for many there are long-lasting effects they will face for the rest of their lives.