For Doctors Day, we asked four amazing Knight Cancer Institute doctors to share their answers to two important questions. Gary Takahashi, M.D., F.A.C.P., specializes in blood disorders, brain and spinal cord cancer, gastrointestinal cancer and hematology.
What drives you to want to take down cancer?
My interest in oncology was kindled during my residency at OHSU. My preconceptions of what it was going to be like were shattered when I saw first-hand how it was possible in many cases to make a positive and significant impact into this very frightening disease. But what really spurred me was that the people I met in clinic were the most upbeat, optimistic, and courageous patients I had ever cared for. I developed a special appreciation for what they go through in the battle against cancer. I saw that battle could use more foot soldiers, and decided that this would be my calling.
How has the overall outlook for your patients changed over the course of your career?
Cancer has improved in so many ways since the time I was in training. Although medicine has been practiced in some form for hundreds of years, medical oncology didn’t really get started until the 1950s, when scientists were seeing some responses in cancer to toxins developed during the second World War. Because of the discoveries in molecular biology and cell biology, the revolution in electronics and technology, and the internet allowing scientists to collaborate and disseminate information, the world of medical oncology has advanced incredibly far from the mustard gas days.
As a practitioner, I can offer more treatments to patients than I could when I first started practice, and as the treatments become more targeted to the disease, they often become less toxic and more suitable to long-term administration. We are beginning to see cancer evolve from being an imminently fatal condition to something more like a chronic illness. Dr. Brian Druker has already demonstrated how this has revolutionized the treatment of chronic myelogenous leukemia, with safer and more effective drugs. Similar technological advances have revolutionized the treatment of lung cancer, melanoma, kidney cancer, leukemias and lymphomas. I have had patients who were bedridden or wheelchair-bound improve to where they could walk again, enjoy more Christmases, renew marriage vows, see someone graduate, take a trip they never thought they’d be able to do. I have seen widely metastatic cancer vanish after treatment with immunotherapy or targeted therapy.
We still have a long way to go, as these victories are still not as frequent as we’d like them to be, but when they happen, there’s nothing like that feeling of satisfaction. I am fortunate to practice in an environment such as OHSU, where access to new technology allows us to develop a familiarity with new treatments that aren’t immediately available elsewhere. OHSU was one of the first to offer gene expression profiling to our patients, in order to identify those who might benefit from targeted therapy. That gave us a wonderful advantage for our patients that became part of the mainstream only later. Now, evaluation of the genetic expression of a malignancy is a key component in the selection of appropriate therapy, as well as eligibility for clinical trials. At OHSU, we now have or will soon have access to cutting-edge therapies such as CAR-T cell therapy, radioimmunotherapy and the latest in diagnostic imaging, to name a few.
I feel fortunate to work with a lot of very smart, hard-working and highly-motivated individuals. Everyone strives to provide the best experience we can for our patients.