Know Your Investigator

May, 2020

Dr. Chadi Nabhan recently caught up with Dr. Elisabeth Heath, Professor of Oncology and Associate Center Director for Translational Sciences for the Barbara Ann Karmanos Cancer Institute.

Here are excerpts of the interview:

NABHAN: Thanks for taking the time out of your busy schedule to let the medical community get to know you better. Let’s start by going down memory lane and what led you down the path of medical oncology and more specifically genitourinary (GU) oncology?

HEATH: Oncology is the perfect combination of meaningful patient care along with interesting research questions. The opportunities in oncology and research are just endless. Recognizing this combination potential enticed me to consider oncology as a career. As far as GU oncology, during my fellowship I became very interested in the world of chemoprevention. One of my earlier grants when I was a fellow was looking at COX2 inhibitors as a chemo preventative agent. That led me to interact with prostate cancer researchers at Johns Hopkins where I did my research. Then I was hooked. When I moved to Karmanos Cancer Institute at Wayne State University, it was a natural next step to continue my research in GU oncology.

NABHAN: What does a day in the life of Dr. Heath look like? How do you spend your day?

HEATH: Being an academic investigator, my time is split. Usually half of the week is spent with patient care, with major emphasis on clinical trials. I have a strong interest in drug development and getting my hands on novel agents early in their pathways so that I can help shape and determine next steps. My other half of the week is serving as the Associate Center Director of Translational Science at the Karmanos Cancer Institute. I enjoy meeting with laboratory and epidemiologic scientists to discuss the clinical impact of their research so I can translate their findings to ultimately improve the human condition.

NABHAN: For you as a researcher, as an investigator, when you hear the words “precision oncology”, what comes to mind? What are we talking about?

HEATH: That term (precision oncology) really equates to treatment opportunities. I look at the term as one filled with hope. My job in the clinic is to expand the menu of treatment options for patients as many of them come seeking new treatment options. Expanding clinical trial capabilities is what led us to begin collaborations with Caris. Taking advantage of the molecular platform that Caris offers was a perfect opportunity to move forward and better understand the impact of sequencing on clinical care. This partnership was born out of necessity to increase patient care options. Without innovative partnerships, we wouldn’t be where we are today. So when I hear precision oncology or precision medicine, my patients and I hear hope.

NABHAN: As a researcher, do you see a role for precision oncology or sequencing in determining the sequence of treatments we use? Is there a role to help us decide which treatment to use first or second… or not really?

HEATH: I really think it depends on the disease type. One could say in prostate cancer that knowing whether you have a DNA repair deficiency will influence the way we sequence therapies. In my own practice, clinical trials often determine the treatment sequence, but most of the time it’s directed by standard of care or best practice guidelines. There are many places that will follow NCCN or ASCO or whatever is their disease given guidelines, but most of them typically don’t contradict one another so treatment sequencing remains straightforward.

NABHAN: Let’s look into the future for a moment. Two years from now, you and I are talking about GU cancers and treatment and what’s going on in this area. What do you think that conversation would be like?

HEATH: I think it would go something like, “Hey Chadi, you know what’s so awesome? All of my patients in the clinic get blood tests to determine their genomic profiles. On occasion I still have to biopsy tissue but I get what is needed 80-90% of the time from blood.” Having this new technology will increase access and has the potential to reduce disparity. Improving ease of testing is a real game-changer.

NABHAN: We are living in the COVID pandemic and I’m sure it’s been stressful on you and your patients. Have you changed a lot of the things that you do for your patients during this pandemic as it pertains to cancer? Are there two or three things you’ve done differently than before COVID19?

HEATH: The number one change in my practice is the increase in tele-medicine visits. I suspect that this is probably true globally for most practitioners. The second big thing is witnessing the glaring disparity that exists in our community. COVID-19 has impacted Detroit in a way that will take significant time to recover. The prioritization of which disease is most lethal, COVID-19 or cancer, has become the main discussion with patients. The patients’ fear of COVID is so great that they’re becoming sicker from their cancer because they’re waiting for the “right time” to seek help.

NABHAN: What do you do for fun and to reduce your burnout? Do you have any hobbies?

HEATH: I am fortunate to have my two kids at home so my husband and I are really enjoying spending time with family right now. My second self-care would be to read endless amounts of books. I really enjoy conspiracy mystery books and sometimes I hide in those to escape from what’s going on in the real world. I am also blessed to have a wonderful group of friends outside of medicine who help me stay positive and grateful for each and every day.

Dr. Elisabeth Heath

Professor of Oncology and Associate Center Director for Translational Sciences

Barbara Ann Karmanos Cancer Institute.