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Scripps doctor becomes patient No. 1 in first trial as part of MD Anderson partnership
San Diego Union-Tribune - 3/23/2021
Before she was diagnosed with breast cancer in December, Scripps Health physician Noemi Doohan had a habit of working up to 80 hours a week treating patients, training family medicine residents and doing public health work during the pandemic.
At a time when she most needed, the 58-year-old Solana Beach resident had to figure out how to step back from her hospital work to get the treatment she needed. But thanks to her medical situation and its timing, she became very important to Scripps Health is very different way.
In December, Doohan was the first patient enrolled in the first clinical trial conducted at the Scripps MD Anderson Cancer Center near La Jolla. The center was created in 2018 through a partnership with The University of Texas MD Anderson Cancer Center in Houston, a world leader in cancer treatment and care. The first trial happened to be for newly diagnosed early-stage breast cancer patients like Doohan.
The match was a win-win for her and for Dr. Ray Lin, medical director for radiation oncology at Scripps MD Anderson Cancer Center and principal investigator for the San Diego portion of the Houston-based clinical trial.
Doohan said stepping away from her onsite work with residents and patients during a pandemic was "one of the hardest decisions of my career," but she knew the results of the trial could help many more patients down the road.
"It gave me such a deep sense of purpose, knowing that going through my own treatment, perhaps what I was doing would help other women," Doohan said. "I know we all contribute in different ways, and not all of us are on the front lines. For me, I had to practice what I preached."
And for Lin, having Doohan involved was particularly special, and not just because she was the first local patient in what will likely be about 800 enrollees at MD Anderson-affiliated hospitals nationwide. Besides being a doctor, Doohan has a Ph.D. in molecular biology, which Lin said gives her rare insight.
"It was very easy enrolling her because she has the background in being a physician scientist," Lin said. "She understood it very well. She knows the importance of a clinical trial and what impacts it will have for a lot of people."
The American Cancer Society reports that 1 in 8 women in the U.S. will develop invasive breast cancer in her lifetime, and last month the World Health Organization said that breast cancer has overtaken lung cancer as the most common cancer in the world.
The MD Anderson clinical trial will compare the results of breast cancer patients who undergo three weeks of partial breast radiation therapy following lumpectomy, versus those who receive one week of a higher dose of partial breast radiation after lumpectomy. Past studies conducted in Canada and England have found that breast cancer patients can have similar outcomes with a reduced number of radiation treatments to the whole breast. Also, a recent study in the U.S. examined the side effects of a shorter but intensified course of partial breast radiation (three weeks) and found it to be safe.
"We are hoping that a shorter course of partial breast radiation therapy will allow patients to return to their normal routines sooner and to potentially experience less side effects with a better cosmetic outcome," Lin said.
The clinical trial at Scripps MD Anderson launched a couple months ago and has enrolled five patients so far. All enrollees agree to be randomly sorted, with half getting the three-week radiation protocol and half getting one week. Doohan was assigned the three-week treatment. She said she received exceptional care and was able to continue working via Zoom while she recuperated at home. She went back to work onsite at Scripps hospitals for the first time on Monday.
"I feel great ... almost back to normal," she said on Monday. "It's very hard for a doctor to become a patient and be on the other side. I was put at ease and made to feel comfortable as a patient."
Doohan joined Scripps Health last June from her former job as the public health officer for Mendocino County. Because she didn't want to leave the rural Northern California county without a public health officer during a pandemic, Scripps agreed to let her spend one day a week serving Mendocino County from afar.
Her responsibilities at Scripps include serving as a primary care physician in a specialized clinic for high-frequency emergency room patients at Scripps Mercy Hospital in Hillcrest. She also serves as a hospitalist there overseeing the care for patients who are hospitalized. And she is a faculty member for the 26 physicians in training in the Scripps Chula Vista Family Medicine Residency Program at Scripps Mercy Hospital Chula Vista.
To ensure the safety of the residents in the three-year program during the pandemic, Doohan said she transitioned a lot of her classwork to Zoom meetings and webinar lectures and was proud to have zero infections among the staff. But last fall, she knew the fall COVID surge was going to be unlike anything they had seen before.
"There was no vaccine yet, and we were surging, and I, as a health officer, know exactly what was coming," she said. "It was an 'all hands on deck' kind of thing. We had a meeting with a program director, and we were all just going to take care of each other and run into this fire and do our best for our patients."
That same day, Dec. 9, she found out she had cancer. Doohan had no history with the disease, but because she has dense breast tissue — where lumps can be hard to detect— she always got an annual whole breast ultrasound and mammogram. As a result, her cancer was caught early. She underwent a partial mastectomy and then, in a meeting with Lin about treatment options, she learned about the clinical trial.
"It was an immediate yes for me," she said. "I would like other women to know it was as very positive experience, and if they have the opportunity, they're not only helping themselves but other people who have the same situation. It's a way to pay it forward."
Lin is now enrolling patients in the trial. Enrollees must be newly diagnosed in the early stage of breast cancer with no lymph node involvement. For details, call the Scripps MD Anderson radiation oncology department at (858) 554-4100 to schedule a live or video consultation.
This story originally appeared in San Diego Union-Tribune.
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