Specialty: Medical oncology, head, neck and lung cancer
Hospital affiliation: Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center, UW Medicine
As a native of Brazil, what drew you to pursue your career here in Seattle?
In 2004, I was 36, and I was presented with a tremendous professional opportunity here to lead the medical oncology program in lung cancer [at the University of Washington School of Medicine]. This was the best job in academic oncology for lung, head and neck cancers available at the time, and passing it up would have been very challenging. From a personal standpoint, about six months earlier, my wife was a hostage at a bank robbery in Rio. After this episode, she gave me the green light. The move has been good for my daughters and my wife, who is an avid cyclist.
Given the severity and prevalence of lung cancer, why does it lack the same level of media interest and research funding as breast, colon and prostate cancers?
There is a widely held prejudice that lung cancer is a self-inflicted disease. There are many reasons why that is not appropriate, and lung cancer does also occur amongst nonsmokers. But as for the smokers, most of them begin smoking when they’re in their teens, so by the time they are older and therefore fully capable of decision making, they are already addicted. Blaming the patients is really total nonsense.
What does this mean for those afflicted with lung cancer?
They suffer some guilt if they are former smokers, and they do feel bad for what they’re making their families go through. For those that are nonsmokers, they fear that they will be labeled as smokers.
What contributes to the 10 percent of nonsmokers who develop lung cancer?
We still don’t know, and it is an area of intense research. It probably all comes down to genes.
What clinical trials and/or new research do you feel offers the most promise?
A recent study showed for the first time we could feasibly teach an immune system to fight the cancer on its own, without chemotherapy. When our immune cells, or lymphocytes, find cancer cells, the cancer cells have something in the surface of them that locks into something in the surface of the lymphocyte. This sends basically a message of “don’t do anything.” The new strategy puts a kind of patch between the key and the lock, so that the cancer cell cannot turn off the lymphocyte. There are a number of current clinical trials exploring this strategy.
What is rewarding for you about treating patients with lung cancer?
Family and friends will frequently ask me why I chose this as my specialty—frankly, I think they’d prefer if I were a plastic surgeon! The reality is, however, that though it is sad to give bad news, it is very uplifting when you can come into the room and say, “I think you’re gonna be OK, we have your disease under control,” or when the patients start feeling better and are able to return to doing the things they enjoy.