procedural medicine specialties - hem/onc in future?

[aashkab]

Hi,

I am an MS II interested in hem/onc.

One concern I have is that my naive impression leads me to believe that it is mostly drug administration and reading labs/scans, etc. It is very intellectually rewarding I feel and can keep my brain stimulated. However, I think I would also appreciate the art of a "well placed stent" or the "efficiency" of a surgery. My question to you is, are there any procedures in hem/onc that are rewarding? Will there be any to come you think?

Cardio has been redefined with the advent of interventional medicine. Do you think hem/onc's could one day be performing interventional drug delivery/tumor removal (this may already be going on)? I would like to partake in research but the thought of drug trials over and over again sounds boring after 10 or 20 years.

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[gutonc]

As an onc fellow I've done the following procedures:
Bone Marrow Biopsies - a hojillion of them
Paracenteses
Thoracenteses
LPs
Skin Biopsies
FNAs
Central line placement for chemotherapy, stem cell transplant (nothing like losing central access @ 11pm just before the cells arrive) and pheresis

If I never have to do another one of them again, I'll be OK with that. They're cool the first couple of times, after that, it's just one more thing slowing you down and keeping you from seeing your family. And I'm in no way an expert at any of those procedures. I know how to do them and can do them if needed, but there are other people who do way more of them than I do and will do a better job. So why not let them?

If you want to cut out the tumor, be a surgeon. Want to do direct drug delivery to a tumor? Go into IR. Want to biopsy it? Radiology, GI or Pulm - in addition to surgery of course.

There's more to research than "drug trials." And even those aren't boring if you're the PI.

 

[aashkab]

thanks for the response. that does help a lot. i suppose that you are also exposed to much of the surgical/interventional techniques given the "team approach."

What other kinds of research is there for a hem/onc PI?

If not drug trials, is it drug development? From basic to translational to clinical?

I have been reading about stem cell transplants being performed without being matches.

I'd also guess that a hem/onc could participate in genetic/cytongenetics research in recruiting patients and families for testing.

What else is out there? Thanks for the reply. I really appreciate it.

I suppose I need to experience a drug trial to really appreciate it.

 

[gutonc]

thanks for the response. that does help a lot. i suppose that you are also exposed to much of the surgical/interventional techniques given the "team approach."

What other kinds of research is there for a hem/onc PI?

If not drug trials, is it drug development? From basic to translational to clinical?

I'm a fellow, not an attending. But I currently have 5 different projects in various stages. One basic science mouse project, two translational (but more on the basic side) human projects, one LOI in progress for a Phase I/II drug trial and an epidemiology project.

Your research options are essentially unlimited. I have a colleague doing an imaging trial and another one working on infectious complications in acute leukemia.