June 6, 2024 • 47 mins
In this episode of Inside Cancer Careers, we are joined by Dr. Elizabeth Jaffee, the current chair of the President's Cancer Panel, and Ms. Daniela Monterroza, an NCI Communications Fellow who supports the panel. They discuss the panel's responsibility in overseeing the National Cancer Program and National Cancer Plan, emphasizing the importance of patient-centric care, community engagement, and addressing social determinants of health in the battle against cancer. Dr. Jaffee and Ms. Monterroza also offer advice to those starting their careers, highlighting the tremendous opportunities in cancer research and public health careers, and stressing the importance of pursuing one's passion.
Show Notes:
- Elizabeth Jaffee, M.D.
- Sidney Kimmel Comprehensive Cancer Center
- Daniela Monterroza
- President's Cancer Panel
- National Cancer Program
- National Cancer Plan
Ad: Interagency Oncology Task Force Fellowship (IOTF)
Your Turn Recommendations:
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Oliver Bogler (00:04):
Hello and welcome to Inside Cancer Careers, a podcast from the National
Cancer Institute where we explore all the different ways people fight cancer and hear
their stories. I'm your host, Oliver Bogler from the NCI Center for Cancer Training.
Today, we're talking about the President's Cancer Panel,
a three-person panel of distinguished scientists and physicians that reports to the President of
(00:25):
the United States on the development and execution of the National Cancer Program.
It was established in 1971 by the National Cancer Act and plays an important role in
setting goals for the nation's plan to end cancer as we know it. Our guests
are the current chair of the panel and a health communications fellow who's been working with it.
Listen through to the end of the show to hear our guests make some interesting
(00:47):
recommendations and where we invite you to take your turn.
It's an honor to welcome Dr. Elizabeth Jaffee, an internationally recognized expert in cancer
immunology and pancreatic cancer. She is deputy director of the Sidney Kimmel
Comprehensive Cancer Center at Johns Hopkins, co -director of the Skip Viragh Pancreatic
Cancer Center and associate director of the Bloomberg-Kimmel Institute for Cancer
(01:09):
Immunotherapy, among many other things. She has served in many distinguished roles in the
world of cancer and is the current chair of the President's Cancer Panel. Welcome.
Elizabeth Jaffee (01:19):
Thank you. I'm delighted to be here.
Oliver Bogler (01:21):
It's also a pleasure to welcome Daniella Monterroza, a health
communications fellow who's been supporting the panel for the past two years. Welcome.
Daniela Monterroza (01:28):
Thank you so much.
Oliver Bogler (01:29):
Dr. Jaffee, the President's Cancer Panel
was created to oversee the National Cancer Program. What is that exactly?
Elizabeth Jaffee (01:37):
Well, as you had said in your introduction, the National Cancer Act of 1971
designated three specific groups. Of course, the first was the National Cancer Institute itself,
which provides research funding to our nation and to researchers throughout our nation. It also
established the National Cancer Advisory Board, which I chaired a few years ago, and the National
(02:02):
Cancer Advisory Board are members who oversee the National Cancer Institute's activities. So mostly
research activities. And that's a Presidential appointment as well to be a member of that board.
And the third is the National Cancer Advisory Panel, which I chair, as you mentioned. And that
oversees all of cancer throughout our nation. It's not just research. It's also all of the
(02:28):
activities associated with cancer throughout the continuum from research to clinical care
and interactions between all groups, including the government, academia, and the private sector.
And so we're able to identify challenges or problems that may be affecting cancer
(02:50):
patients today and do a deep dive into understanding what the problems are,
what the challenges are and try to identify solutions with many of the
experts throughout the cancer community and then advise the president and his team on
how we can overcome some of these important challenges experienced by cancer patients.
Oliver Bogler (03:12):
So that kind of speaks to the multifactorial challenge that cancer is for
our country, right? It's not just research, it's not just understanding the biology of
it. It's not even just developing new diagnostics and therapeutics,
but it's also making sure that people across the country can benefit from them, right?
Elizabeth Jaffee (03:29):
Exactly, and it's all patients. And that's a major issue that
we're trying to tackle, and that is that we really need to be patient-centric. And every
patient is unique. Every community is unique. And we need to appreciate what the challenges are for
different patients from different communities. And so that typically has been a major goal of
(03:52):
the President's Cancer Advisory Panel, not just our panel, but prior panels as well.
Oliver Bogler (03:58):
So the President's Cancer Panel is by its nature quite small,
right? So it cannot by itself move some of these issues. How does it work?
Elizabeth Jaffee (04:08):
Yes, so we are small. I like to think of
us as very nimble. We also have an amazing staff, including Daniela,
who are very experienced in helping us identify problems and in being able to
construct the plan on how we will learn more about those problems and come up with solutions.
So typically, we hold three independent meetings that are public meetings,
(04:34):
but we invite experts around the question we are trying to address. And these meetings have
been very informative because we're able to identify many different experts who bring to
the table their experience with the problem. They bring data to the problem. And so we collect all
(04:55):
of that information. And then our panel meets typically weekly for several hours and we try
to put all of the data we've acquired into a framework that helps us better understand the
problem. And then we think together about what would be solutions that we could recommend to the
(05:15):
President and his team. We write a formal report, we present that to the President and his team, and
then we leave it to the President and his team to determine how best to enact our recommendations.
Oliver Bogler (05:32):
So Daniela, this sounds to me like it's at its heart,
maybe a communications challenge, right? Gathering information,
making sure the right people are connected to the creation or collection of that
information and then disseminating. Tell us about your role in this work.
Daniela Monterroza (05:47):
Yeah, yeah. So as Dr. Liz Jaffee was saying, we're here to help the panel,
right? We're guiding the panel in their process of first identifying an issue,
right? So as she said earlier, you know, they look at the National Cancer Program and that's
where we're there to help them. And we assess what's currently going on in the cancer community,
(06:11):
right? And for that, we need to identify who are the right stakeholders to invite at the table.
And even before that, right, in our effort to identify what issue to tackle,
we're gathering information. We're doing like our own policy analysis research to a certain
extent to identify, okay, you know, what area or what angle we want to approach this by,
(06:34):
and also what area could we possibly come out with actionable recommendations.
And so in that development, we're identifying potential stakeholders,
the scope and goal of our meeting that will ultimately guide the scope of our report.
So in my role, you know, I'm there helping the panel, you know, guiding them with what is this
(06:57):
research paper saying about this particular topic? What are our next steps to make sure
that we're moving the needle forward with not only our meeting series, but with the report.
So we really want to take into consideration different perspectives. And so that is why
we take our time with the whole, you know, report development and meeting series because
(07:19):
we understand that some of these issues, though we're not experts in these areas,
may seem small, but the reality is that when we bring experts together, we see how bigger
the situation is and how important it is for us to have these stakeholders at the table so
that we're coming up with these recommendations that at the end of the day should be actionable.
Oliver Bogler (07:43):
So Daniela, I wonder if you can share with us what would have
been some of the greatest moments in your two years with the panel?
Daniela Monterroza (07:50):
Yeah, I think my one of the biggest moments was last. Well, yeah,
it was last year in the fall. We had our first public meeting and I was also able to partake in
just seeing all the experts at the table was kind of like a ‘pinch me moment’. You know, you know,
I never saw myself in these positions, but it's really rewarding to see everyone come together
(08:13):
and everyone who's really passionate about addressing the burden of cancer in the U.S.
Come together with the goal of like, what can we do to make it better for our cancer community,
right? So that has been very rewarding and just also a learning moment that it's very important
to have different stakeholders at the table when it comes to these, when it comes to coming,
(08:35):
when it comes to creating solutions, we need as many voices as we can have.
Oliver Bogler (08:41):
Dr. Jaffee, so part of the work of the panel is also to help
craft the National Cancer Plan, right, which kind of is an umbrella series of
concepts that sort of lays on top of the National Cancer Program, I guess,
in a way. How does the panel do that, and who are the other participants in that process?
Elizabeth Jaffee (08:59):
Right, so the National Cancer Plan was enacted by Dr. Monica Bertagnolli,
who was NCI director at the time. It was the 50th anniversary of the National Cancer Act,
and she wanted to reconfirm our commitment to taking care of all patients with cancer
(09:21):
and also to identify what are the current problems. It's 50 years since the original Act.
So she utilizes this as an opportunity to identify the current problems that we need
to address and then asked our panel to monitor the National Cancer Plan,
which we are very happy to do. We think it's a very important part of our job.
(09:43):
And so the National Cancer Plan identifies critical issues that cancer patients are
facing today. And our goal is to have a yearly meeting and we've already had one.
And two, learn from the community who are working with cancer patients,
who are cancer patients, who are survivors, who are researchers, who are foundations.
(10:07):
Learn how are they addressing the critical problems that patients face today? How are
they working together on areas where they are passionate about trying to make a difference?
And so our first meeting brought together experts from some of the leading foundations,
(10:28):
American Cancer Society, American Association for Cancer Research,
ASCO. It brought people from foundations that were representing survivors. And we all met again for a
full day. That was a public meeting. We invite recommendations on a continuous timescale to
send us any information about what different groups are learning, you know, what are some
(10:55):
of the new challenges that they would like us to bring to the national attention. So we receive
emails and other forms of communication from individuals throughout the year.
And we take all this information and again, we put it into a format that can be reported back
to President Biden and his staff, hoping that they will take some of these recommendations
(11:20):
and try to implement solutions that we have suggested. And so we plan to continue to do
this on a yearly basis. The first one was really to get a sense of what everyone was
doing. This coming year, and these are in the fall, we conduct this meeting in the fall,
this coming year we're going to take on the challenges of the health care workforce.
(11:45):
This is a huge problem. It's a problem throughout the continuum of cancer care from the earliest
time of navigating patients into the healthcare system through survivorship. And so we're hoping
to identify experts who are working on this problem to help advise us so that we can again
(12:06):
make recommendations to the President on really modernizing the workforce, the cancer workforce.
Oliver Bogler (12:12):
Very much a topic near and dear to my heart in our work in the Center
for Cancer Training. I wonder with that 50-year perspective that you alerted us to,
what is in the National Cancer Plan today that might not have been in the vision back
in 1971? What are the things that are new and important that we are now working on?
Elizabeth Jaffee (12:32):
Right. I think that some of them, of course, some of the recommendations,
there's eight specific recommendations and some of them are continuous. For instance,
you know, we never receive enough federal funding to really accomplish everything we
want to do. That was true back in 1971 and it's certainly true today. And of course,
(12:53):
you know, our Congress has a lot of issues to address, not just cancer, but cancer is a very
important problem that all Americans at some point experience or know people who experience.
So it is high up, I think on the list and to be able to address particularly today when we have
so many new technologies and we're learning so rapidly, it's really a matter of funding,
(13:18):
being able to translate all this information into the best drugs. We're seeing new
drugs being developed that are really more targeted towards a specific cancer problem.
But we just don't have enough money to really move that needle as quickly
as we'd like to. And of course, that's what President Biden has always wanted us to do.
(13:39):
But then we didn't understand biology at all back in 1971, cancer biology. Now we
understand that cancer biology is very complex. We've learned that it's a genetic disease. We
learned that it's a disease of inflammation but it's also a disease of environment,
of social determinants of health. And so these concerns, particularly social determinants of
(14:04):
health really are critical today because of our better understanding of biology, of understanding
individual patients and how they respond, how they develop cancer, how they respond to cancer.
And the need for understanding ancestry medicine you know, different cultures respond differently.
(14:27):
Even some of our standard chemotherapies, if you test them in one population, you're
going to see one response. If you test them in another population, it's going to be a different
response. Resistance mechanisms are different. So, understanding our patient populations and
the diversity of patients in our country is critical today, which we didn't realize before.
(14:48):
And then, of course, the workforce is another issue that you know,
I think was not the issue back in 1971. At that time, I think, you know,
we really were just establishing really a national cancer workforce.
Oliver Bogler (15:06):
Daniela, as someone who is earlier in their career and is coming into
the world of cancer, and you're getting really this sort of, I don't know, high altitude view,
I guess. What are your thoughts as you consider, for example, the eight goals of the National
Cancer Plan? What are the things that you think are really critical in that concept?
Daniela Monterroza (15:27):
In the position that I currently am in, I do get exposed to different
aspects within the cancer, right? Not only the cancer workforce, but cancer research, I mean,
the practice, the translational work that goes on. So when I think about the National Cancer Plan,
the goals that speak out to me most and that get me excited,
(15:52):
I could say is engage every person and deliver optimal care. I think,
and this is nothing new, right? For our listeners probably learning that clinical trials are not
representative of the US population, right? And so how important it is for all of us to
join forces and finding innovative ways to engage different communities, right?
(16:15):
Because what works with one community, will most likely not work with another
community. So finding ways to tailor our programs,
to tailor our outreach to those communities so that they can participate in this research
that will ultimately lead to better treatments for different populations.
And so deliver optimal care, I think, is also another one that is frequently on my mind,
(16:42):
right? Because we want to make sure that the care that our patients are receiving
is patient centered, right? And what does that mean, right? Does it mean, you know,
creating or fostering or funding more research for that personalized or precision medicine to take
place, right? Allowing people to get better treatment. Or does it also mean, you know,
(17:03):
providing social support? Because we know that the needs of a patient extend beyond just going
to a clinic, what is going on at home? Do they have resources or the financial support that they
need to continue on with their treatment? And so I think working at the President's Cancer Panel or
(17:25):
for the President's Cancer Panel, sorry, I think has exposed me a lot to those factors that may be
naked to the eye, right? You can't see them when you see someone, you can't see the whole story,
right? But it's when we sit down with a patient that we find that, you know, what are their actual
struggles? And we see that everything influences the care, their decisions and things like that.
Oliver Bogler (17:46):
So you said something interesting there, the element of
engaging every person. And I know that's near and dear to Dr. Bertagnolli's heart when she
participated in creating this version. I know Dr. Rathmell, our current director,
is very focused on that. And I know in the report that the panel put out in February, it
talks about this dynamic and sustainable community engagement. To me, that's a huge pivot from, well,
(18:09):
there's these nice doctors and scientists over there doing this really cool cancer
research and they're going to fix it one day, to wait a minute, we're all in this together.
So Daniela, how, from a communications point of view, how do you tell the nation,
the peoples of the nation, you need to come in and get involved in this?
Daniela Monterroza (18:28):
So when it comes to communicating, right,
that concept of that everyone really has a role in ending cancer as we know it,
I think it's taking collaboration with, you know, NCI and other stakeholders to learn, okay, there's
different communication strategies that we can use to reach out to certain populations, right?
(18:51):
And so, the panel has taken the role of, you know, trying to use their channels, either, you know,
through our blogs, X, LinkedIn, our website, to try to communicate to the stakeholders that
are already following us, but also, you know, reaching out to those institutions,
to NCI designated cancer centers to inform their audiences as well of the National Cancer Plan.
(19:17):
So when it comes to communicating, about the National Cancer Plan and encouraging
our communities to get involved in this initiative. It really involves
having different perspectives because we can't assume again that one communication effort
is going to reach them all, right? It's about seeing who do we have at the table,
(19:40):
who are our partners and how can we collaborate with them in order to get the message across.
So, I think we're in the early phases of the National Cancer Plan and it will certainly
take time for more people to get informed or to come to find out about this national
plan that we have in our fight against cancer. But it's connecting with
(20:03):
the current partners that we have that will get that message across.
Oliver Bogler (20:09):
Thank you, Dr. Jaffee. I wonder if you could comment. You're
deputy director of the Kimmel Cancer Center an NCI Designated Cancer Center
at Johns Hopkins. And part of the role of the cancer centers has been community engagement.
So is this also an important element in the strategy that we were just talking about?
Elizabeth Jaffee (20:26):
Yeah, so this is a huge element. And I think what Daniela was pointing out is that,
you know, different cultural groups, different age groups,
there's all different ways of engaging. I was having this discussion with some
of the leaders of our community outreach and engagement actually this past week,
because we met with Dr. Biden to talk about some of these challenges and also potential successes.
(20:55):
And my expert colleagues have utilized a number of different ways in our communities
in Baltimore City versus DC. We have communities in both areas and even
though they're predominantly African-American background, they're different. So you can't
(21:17):
assume just because they're of the same cultural background or the same
race that they're going to deal with issues around cancer communication in the same way.
So there've been a number of interesting ways in which our experts work on this. But traditionally,
(21:39):
going to community groups where they congregate, for instance, barbershops,
the church, those are good for some of the older men. The hair salons for the older women,
but that's not getting the younger individuals and cancer is becoming
unfortunately a disease of even younger individuals. So they've been having specific
(22:03):
events even at these places that will attract younger people, things they may be interested
in around music or around other aspects that an older individual may not be interested in.
Also going to the schools and talking to the middle schoolers or the high
schoolers. They're doing a lot of that because you talk about cancer screening.
(22:29):
You talk about human papillomavirus vaccination. You demystify these things. You remind these
children that their parents are at risk so that they will talk to their parents.
So there's all different ways. And people process differently. I learned that as an
oncologist many years ago in just taking care of different types of patients,
(22:54):
patients from rural areas, patients from religious backgrounds. You know,
sometimes a family doesn't want the patient to know about the disease and you have to
negotiate that. It's a cultural thing. So there's all different aspects that we have
to really train people. We also have to learn how best to communicate based on the individual.
Oliver Bogler (23:16):
So my last question about the panel, Dr. Jaffee,
you've had lots of leadership roles in cancer. You were president of the AACR and many other
things. How does this particular role compare? What are the best parts of it?
Elizabeth Jaffee (23:30):
Well, for me, you know, as you know,
I continue to grow in my role as a researcher and as a leader in cancer,
you know, therapy and also a leader in thinking about the overall cancer
problem it's provided me with a wonderful opportunity to learn from so many experts.
(23:57):
I've really grown into my positions because I'm able to interact with experts from all types
of environments, all types of work environments, clinical environments, government. And so for me,
it's really interesting to hear different perspectives and to try to put that into some
(24:21):
framework that I can utilize to move particular problems forward that I'm passionate about.
And so the Presidents cancer advisory panel really allows you to think about
what are the big problems with all this knowledge that I've gained,
what are the big problems that I can now take on and really hopefully help cancer patients. I mean,
(24:44):
that's what we're all here for, to help current and future cancer patients.
And as you know, I'm in the latter part of my career,
that's my goal. My goal is to really make an impact. And so it's really given
me the opportunity to work with amazing individuals, to be able to bring people
together who are experts and to be able to become an advisor for big problems.
Oliver Bogler (25:09):
Daniela, what are the key experiences in working with the
panel that you will take with you as you move on through your career?
Daniela Monterroza (25:14):
First and foremost, I think the process that the panel takes to
understand the problem at hand. We may be fast to assume what can be a solution, but the more
time you take to understand what's really going on, that will shape or give way for
the solution to be really effective, I guess, at addressing the problem at hand. So that's one,
(25:43):
right? The second one, I'll say, is always keeping focus on what's the overall objective,
right? My time at the panel, I've seen how important it is to keep the patient at the center.
Like Liz has spoken in this podcast and in previous talks, the emphasis on the cancer
(26:07):
community and the patient itself, right? Our efforts, you know, we need to come together to
be able to overcome these barriers and not work in our, you know, in our silos and try to address
this because more often than not, we will fail, right? If we're trying to address this on our own.
And then third, I would say collaboration which I think has been a theme in this throughout the
(26:35):
conversation today, is just collaborating with one another. A lot of the projects that, you know,
from the President's Cancer Panel that may often go unseen, like the back end, our meetings and
everything like that, it literally involves a group of staff coming together and providing
their expertise. And that ultimately guides us to be able to approach things from a different angle.
Oliver Bogler (27:00):
Thank you. Great. We'll take a quick break and when we come back,
we'll talk to our guests about their career paths and plans.
[music]
Cancer scientists do all kinds of interesting things, and one of them
is to work on the regulation of drugs and medical devices at the US Food and Drug
Administration or FDA. Others shepherd discoveries from the lab to the bedside,
(27:25):
which requires knowledge of regulatory processes. If you are interested in this work,
we have a program at NCI called the Interagency Oncology Task Force Fellowship, or IOTF for short.
The program trains scientists in research and research-related regulatory review,
policies, and regulations.
Fellows learn to build awareness of regulatory requirements into
(27:47):
the early stages of the medical product development process and
to develop strategies to improve planning throughout research and regulatory review.
Many IOTF graduates transition to regulatory work at the FDA or in
industry. Others take what they have learned back to their research work,
which helps them plan for eventual commercialization and regulatory
(28:07):
approval of their discoveries. Check out our website to see comments from several IOTF alums.
Interested? Great… applications are now open!
For more information, see the IOTF website. A link to the website can be found in the show notes.
(28:28):
[music ends]
All right, we're back. Dr. Jaffee, what first sparked your interest
in science and medicine? Was there a moment of awe that got you started?
Elizabeth Jaffee:
There was a moment of awe. My grandmother took me to an American Cancer Society dinner to raise
money after my grandfather's brother died of lung cancer. And I had to be maybe eight years old. And
(28:54):
it really made me realize that there were a lot of people out there who lost people to cancer.
And his name was, his nickname was Happy. So, as an eight year old, I couldn't imagine how someone
whose name was Happy could die of cancer. And then, you know, I started reading more and I read,
(29:15):
you know, I was looking for women who were role models and there weren't a lot of women
role models in science and medicine. But and I know this sounds, you know, kind of common,
probably among women, but Marie Curie's biography was really amazing to me. She identified basically
(29:36):
the whole field of radiation oncology. She was the mother of radiation oncology. And this was
a woman who did basic science, who translated it to something important for patients early
on in her career. And that led me to start thinking this is something I wanted to do.
And then in college, I was in college at a time when we were learning about
(29:56):
the biology of viruses. And it led me to think, you know,
we have these vaccines that are probably the greatest advance medically of the 20th century,
with penicillin antibiotics, that prevented babies from dying in their first year. And
(30:19):
so all of this together made me realize that I wanted to go to go into cancer research.
I wanted it to be about making the patient's own immune system fight
their cancer because as a trainee in oncology, I saw too many people suffer
from chemotherapy. And so I continued to pursue that avenue and I never looked
(30:41):
back. And when I look back on my career now, I'm happy that I took this pathway.
Daniela, what was that moment for you? Was there a moment of awe?
Daniela Monterroza (30:51):
Yeah, so I'll go back to high school. It was during that time,
I think it was junior or senior year that we were all just talking about our majors,
what we were going to study. And so I had grown up saying I'm going to be a doctor, I'm going to
be a doctor. But in high school, I just I didn't feel like medicine was my calling. And so I know
(31:15):
I wanted to be in the health sector, but I just didn't know what exactly that could look like.
And so. And throughout Google searches, I found healthcare administrator. So I said,
okay, that's a, it looks good. So in my first year of college,
we had to take an introductory course to public health. And I was sitting there,
(31:36):
you know, with the idea that I'm going to become a healthcare administrator. But I remember one
class where our professor was talking about the difference between medicine and public health.
And it stuck with me and that's usually what I
use to try to explain my family members what public health is.
Oliver Bogler (31:52):
What is that difference?
Daniela Monterroza (31:53):
Right. So I remember her saying that medicine focuses on the
individual and emphasizes diagnosis and treatment while public health focuses
on population and emphasizes health promotion and the wellbeing of the community as a whole.
And so it clicked that moment, it clicked for me because, when talking about the social
(32:16):
determinants of health, which terms I had never heard of before, I saw that these factors that
were talked about in class, I had lived through, my family had lived through, and my community
had lived through, right? And so that kind of just sparked, you know, that decision,
I'm gonna go full force into public health. And so that guided me throughout my career.
Oliver Bogler (32:39):
So for someone who's listening who might also not have heard
this term social determinant of health, can you give us a couple of examples?
Daniela Monterroza (32:45):
Yeah, yeah, so social determinants of health encompasses those
social factors, right, that influence our health. So it can be, you know, those economic factors,
level of education that an individual has. It could also mean, do you have insurance or not?
(33:06):
What type of environment do you live in? You know, is there access to food? Is there access to safe
places for you to engage in physical activity. Like we see all these factors come into play
and they influence an individual's behavior. They influence an individual's decision. They
influence what the person prioritizes or doesn't, right? And so that affects health as a whole.
(33:31):
And so I saw that in my own family. You know, my parents didn't have insurance,
a lot of cases of diabetes, cancer around me. And so it, goes beyond just health. It's our built
environment. What is in our environment that's influencing all these factors that come into play?
Oliver Bogler (33:51):
Yeah, it's complex. There's lots to study. Dr. Jaffee,
coming back to you, so you were inspired by vaccines. And I think
maybe is that part of why you moved into immunotherapy in your current work?
Elizabeth Jaffee (34:06):
Yes, that's exactly why I did. To me, just looking at what was important
in healthcare in the 20th century, vaccines clearly for infection have changed… it was
a game changer then. And I think we're learning now that immunotherapy is a game changer for even
(34:27):
patients with pretty deadly cancers like lung cancer and colon cancer and melanoma and others.
Of course, we're just at the beginning of the field of immunotherapy,
but I've been in it for 30 years and it was sort of a dream when I got started. And now
it's reality and we just have to figure out how to make it work for everyone.
Oliver Bogler (34:49):
And what drew you to pancreatic cancer? It's the disease you focus on, right?
Elizabeth Jaffee (34:53):
Yes, it is. And it's probably the one that doesn't yet respond as well
to immunotherapy, but we're making good progress. What drew me to that was when I was a medical
resident in 1986, my father called me to tell me that his brother, who was 51 at the time,
had pancreatic cancer. And I just remember that call because I just started internal medicine,
(35:20):
but I started crying, because the one thing I knew is it was a death sentence. And my father was,
he got upset. He thought I was going to tell him about treatments and my uncle would be okay. And
I couldn't tell him that. And my uncle, who was an engineer, was looking for therapies and ended up
going to Mexico for one of these advertisements because there was nothing in the United States.
(35:44):
And he died three months later. And I grew up with his kids and it was the first time I really
experienced since I went to that American Cancer Society meeting for my great uncle. And it made
me realize when I went into medical oncology that we really had nothing for our patients. And it was
(36:09):
something that I think I was passionate to try to make a difference. And I still feel that passion.
Oliver Bogler (36:15):
Yeah. Well, I hope progress against
pancreatic cancer is swift. It is one of the more difficult diseases.
Daniela, so you got fascinated by public health. And you went to Howard and did a
BA in public health, right? Then University of Maryland for a BA in health admin and policy.
(36:36):
And then you ended up at Johns Hopkins, where Dr. Jaffee is, of course, on faculty. And there you
did a master's in public health as well. So how did that then lead to your current career phase
where you are a health communications fellow? And what is that program? Tell us about it.
Daniela Monterroza (36:54):
Yeah, yeah. So the way I got interested in health communications and public
health came from a previous Pathways position that I got at NIH. So I got to work with a
group called the Health and Science Branch. They were formerly known as the Science Communication
Branch at the Office of the Director. So there they were doing a lot of health communication.
(37:16):
And it was there that I was first exposed to the terms health literacy and plain language.
And so I had never heard of these terms before, and I'm sure it must have been in a course at
UMBC. I must have missed it, but it was here that I got familiarized the important role
that health communication plays and how we're always constantly communicating information
(37:41):
and the channels that our communities use. I saw my parents, you know, use,
you know, social media or, you know, that word to word communication about, you know,
what is going on with a family member, their diagnosis and things like that. And so having
that realization, I wanted to understand more about the relationship of health communication
(38:05):
and public health. And so having that pathways position at NIH is what led me to pursue a
master's of science in public health and going to health education and health communication.
And in my time there, I got to learn about NCI's communication fellowship program. And
that's when I applied. And so basically what this program is, you get to interview different offices
(38:33):
within NCI that are looking for a communications fellow. Whichever office you get placed into,
you get to work on communication related projects. So this could be content management. This could
also range with creating materials for meetings, writing blog posts, which have has been the role
that I've had, my communications role with the panel thus far. And then strategic planning,
(38:57):
you get to be on calls with leadership and deciding, okay, what do we want this
next month to, what do we want to highlight this next month about our work and things like that.
And so I know that right now the communications fellowship program is closed, but they should
be opening in 2025 for new applicants. And it's a great opportunity for you to get a
(39:19):
sense of what communication looks like at a federal level. So I recommend it for anyone
who's curious to learn about that. You get to work with amazing staff. I've gotten to
work with NCI's OCPL team, which they are great and have given me guidance.
Oliver Bogler (39:35):
Okay, acronym alert, you're gonna have to expand that acronym for us.
Daniela Monterroza (39:38):
Yeah. yes. Sorry. Okay. So I've gotten to work with OCPL,
which is the Office of Communications and Public Liaison. And I've learned a lot from them.
Oliver Bogler (39:46):
Fantastic. So Daniela, by its very nature, a fellowship is intended
to be of a limited time. So can I put you on the spot and ask you what's next for you?
Daniela Monterroza (39:55):
Yeah, for sure. I think, you know, one of my priorities is learn as
much as you can, right? So definitely keeping my options like open right now into what direction
I take. You know, whether it looks like, you know, continue working in the federal
space or whether it looks like working more in a community-based organization. You know,
the communication is different from, you know, the Fed level to a community level.
(40:20):
So, right now, my priority is just learn as much as I can and keeping
myself open to those opportunities, not limiting
myself because you can't assume you don't like something if you haven't tried it,
right? So that's my perspective on how I'm taking my next steps forward. Just knocking on every
single opportunity or every single door I can for the next opportunity, but growing in that
(40:43):
health communication space because not only does it entail content development, but it could also
expand to health communication campaigns. What does a health education program look like? So.
Oliver Bogler (40:53):
Yeah, very powerful. Dr. Jaffee, your own
path has been very inspiring and you have occupied many leadership roles. As you talk
to early career researchers and clinicians in your environment, what are you telling
them? How are you encouraging them? What's your advice to our listeners who might be
thinking about joining the cancer research field or trying to find their way in it?
Elizabeth Jaffee (41:17):
Yeah, so what I tell my young trainees is that they are entering this
field at the most remarkable time. I wish I was starting now. The technologies, the knowledge, it
is just unbelievable. It's moving so quickly. The opportunities that you have today to really learn
(41:38):
to develop new approaches to benefit our patients. We just didn't have this when I got started.
So we need the smartest and the most passionate individuals to join us and
to be the next generation to make sure that this amazing science and
these amazing technologies really have impact so that no patient will
(42:00):
suffer the way current patients do today from cancer. That's what I tell them.
Oliver Bogler (42:06):
Daniela, what would you say to someone who was maybe in their undergraduate
years? I mean, you shared with us that you were initially thinking of medicine,
but then you decided public health was a much more
interesting area for you. What would you tell them if they were listening?
Daniela Monterroza (42:23):
Yeah, that it's okay to change plans. I think, you know,
sometimes we may set something for ourselves, right? Our high school self is different from,
you know, our current self, right? And so if your interests change,
pursue what you're passionate about because this is what you'll be waking up to every day to do,
(42:46):
right? So follow your passion and that will give you just a sense of satisfaction in the
work that you do. So don't be afraid to... if switching up is what it takes, then switch up.
It's your career, it's your life at the end of the day and what you're contributing to society.
(43:09):
[music]
Oliver Bogler (43:09):
Now it's time for a segment we call Your Turn, because it's a chance for
our listeners to send in a recommendation that they would like to share. If you're listening,
then you're invited to take your turn. Send us a tip for a book or a video, a podcast,
a talk, anything that you found inspirational or amusing or interesting. You can send those
to us at NCIICC@nih.gov. Record a voice memo and send it along. We may just play it in an upcoming
(43:32):
episode. Now I'd like to invite our guests to take their turn. Let's start with you, Dr. Jaffee.
Elizabeth Jaffee (43:38):
Absolutely. So I have to say most people know me as a cancer researcher,
but I have a number of passions. My favorite passion is hiking,
and I have a bucket list and my daughters who are now 27 will hike with me as well. And so,
for me getting out into the environment, into the mountains clears my mind and allows me to
(44:00):
really enjoy life to appreciate what life is really about. So I recommend
following a passion that you have outside of your work and hiking is a great one.
Oliver Bogler (44:12):
Sounds fantastic. Daniela.
Daniela Monterroza (44:14):
Yeah, so first, an encouragement to volunteer. I think it's
when we connect with our communities, we get to see what they're going through,
what their values are, what their priorities are. And that has influenced a lot of the
direction that I've taken in my career, my lived experiences. So just a call to volunteer
wherever it may be. I've had the opportunity to lead a little group at our local church.
(44:41):
So we do activities with them on Saturdays and it's just really nice to connect with them. So
a call to encouragement and then just a second recommendation for you to check out NIH News and
Health. I think my health communicators might enjoy this one, but it's a monthly newsletter
that provides practical health information and tips based on NIH research findings.
Oliver Bogler (45:02):
That's fantastic. And we're going to put a link in the show notes also for the NCI
Health Communications Fellowship so that our listeners can easily find them. Thank you.
I'd like to make a recommendation as well. Regular listeners will know I've become a
little bit obsessed by AI. So this is for a book that I recently read. It's called Machines Like Me
by Ian McEwan. It was published five years ago, and I only just recently picked it up because
(45:27):
of my obsession and the advances in AI. In this book, McEwan really explores whether a machine
can ever truly understand human emotions and reasoning and does so as always with
a compelling and sophisticated narrative. The characters in the book, human or not,
encounter challenging moral choices and come up with quite different answers to those choices. As
(45:49):
the tech giants develop agents that are more and more like humans or try to appear like humans,
the lessons of this book, from this book were really of note to me. And McEwan,
one of my favorite authors, as always delivers them in his crystal clear prose.
So I want to thank you both for the time you spent with
us and giving us your insights and sharing your experiences.
Elizabeth Jaffee (46:12):
Great, thank you very much for inviting me.
Oliver Bogler (46:15):
That’s all we have time for on today’s episode of Inside Cancer
Careers! Thank you for joining us and thank you to our guests.
We want to hear from you – your stories, your ideas and your feedback are welcome.
And you are invited to take your turn and make a recommendation
to share with our listeners. You can reach us at NCIICC@nih.gov.
(46:36):
Inside Cancer Careers is a collaboration between NCI’s Office of Communications and Public Liaison
and the Center for Cancer Training. It is produced by Angela Jones and Astrid Masfar.
Join us every first and third Thursday of the month wherever
you listen – subscribe so you won’t miss an episode.
If you have questions about cancer or comments about this podcast,
(46:59):
you can email us at NCIinfo@nih.gov or call us at 800-422-6237. And
please be sure to mention Inside Cancer Careers in your query.
We are a production of the U.S. Department of Health and Human Services,
National Institutes of Health, National Cancer Institute. Thanks for listening.
Hello and welcome to Inside Cancer Careers, a podcast from the National
Cancer Institute where we explore all the different ways people fight cancer and hear
their stories. I'm your host, Oliver Bogler from the NCI Center for Cancer Training.
Today, we're talking about the President's Cancer Panel,
a three-person panel of distinguished scientists and physicians that reports to the President of
(00:25):
the United States on the development and execution of the National Cancer Program.
It was established in 1971 by the National Cancer Act and plays an important role in
setting goals for the nation's plan to end cancer as we know it. Our guests
are the current chair of the panel and a health communications fellow who's been working with it.
Listen through to the end of the show to hear our guests make some interesting
(00:47):
recommendations and where we invite you to take your turn.
It's an honor to welcome Dr. Elizabeth Jaffee, an internationally recognized expert in cancer
immunology and pancreatic cancer. She is deputy director of the Sidney Kimmel
Comprehensive Cancer Center at Johns Hopkins, co -director of the Skip Viragh Pancreatic
Cancer Center and associate director of the Bloomberg-Kimmel Institute for Cancer
(01:09):
Immunotherapy, among many other things. She has served in many distinguished roles in the
world of cancer and is the current chair of the President's Cancer Panel. Welcome.
Elizabeth Jaffee (01:19):
Thank you. I'm delighted to be here.
Oliver Bogler (01:21):
It's also a pleasure to welcome Daniella Monterroza, a health
communications fellow who's been supporting the panel for the past two years. Welcome.
Daniela Monterroza (01:28):
Thank you so much.
Oliver Bogler (01:29):
Dr. Jaffee, the President's Cancer Panel
was created to oversee the National Cancer Program. What is that exactly?
Elizabeth Jaffee (01:37):
Well, as you had said in your introduction, the National Cancer Act of 1971
designated three specific groups. Of course, the first was the National Cancer Institute itself,
which provides research funding to our nation and to researchers throughout our nation. It also
established the National Cancer Advisory Board, which I chaired a few years ago, and the National
(02:02):
Cancer Advisory Board are members who oversee the National Cancer Institute's activities. So mostly
research activities. And that's a Presidential appointment as well to be a member of that board.
And the third is the National Cancer Advisory Panel, which I chair, as you mentioned. And that
oversees all of cancer throughout our nation. It's not just research. It's also all of the
(02:28):
activities associated with cancer throughout the continuum from research to clinical care
and interactions between all groups, including the government, academia, and the private sector.
And so we're able to identify challenges or problems that may be affecting cancer
(02:50):
patients today and do a deep dive into understanding what the problems are,
what the challenges are and try to identify solutions with many of the
experts throughout the cancer community and then advise the president and his team on
how we can overcome some of these important challenges experienced by cancer patients.
Oliver Bogler (03:12):
So that kind of speaks to the multifactorial challenge that cancer is for
our country, right? It's not just research, it's not just understanding the biology of
it. It's not even just developing new diagnostics and therapeutics,
but it's also making sure that people across the country can benefit from them, right?
Elizabeth Jaffee (03:29):
Exactly, and it's all patients. And that's a major issue that
we're trying to tackle, and that is that we really need to be patient-centric. And every
patient is unique. Every community is unique. And we need to appreciate what the challenges are for
different patients from different communities. And so that typically has been a major goal of
(03:52):
the President's Cancer Advisory Panel, not just our panel, but prior panels as well.
Oliver Bogler (03:58):
So the President's Cancer Panel is by its nature quite small,
right? So it cannot by itself move some of these issues. How does it work?
Elizabeth Jaffee (04:08):
Yes, so we are small. I like to think of
us as very nimble. We also have an amazing staff, including Daniela,
who are very experienced in helping us identify problems and in being able to
construct the plan on how we will learn more about those problems and come up with solutions.
So typically, we hold three independent meetings that are public meetings,
(04:34):
but we invite experts around the question we are trying to address. And these meetings have
been very informative because we're able to identify many different experts who bring to
the table their experience with the problem. They bring data to the problem. And so we collect all
(04:55):
of that information. And then our panel meets typically weekly for several hours and we try
to put all of the data we've acquired into a framework that helps us better understand the
problem. And then we think together about what would be solutions that we could recommend to the
(05:15):
President and his team. We write a formal report, we present that to the President and his team, and
then we leave it to the President and his team to determine how best to enact our recommendations.
Oliver Bogler (05:32):
So Daniela, this sounds to me like it's at its heart,
maybe a communications challenge, right? Gathering information,
making sure the right people are connected to the creation or collection of that
information and then disseminating. Tell us about your role in this work.
Daniela Monterroza (05:47):
Yeah, yeah. So as Dr. Liz Jaffee was saying, we're here to help the panel,
right? We're guiding the panel in their process of first identifying an issue,
right? So as she said earlier, you know, they look at the National Cancer Program and that's
where we're there to help them. And we assess what's currently going on in the cancer community,
(06:11):
right? And for that, we need to identify who are the right stakeholders to invite at the table.
And even before that, right, in our effort to identify what issue to tackle,
we're gathering information. We're doing like our own policy analysis research to a certain
extent to identify, okay, you know, what area or what angle we want to approach this by,
(06:34):
and also what area could we possibly come out with actionable recommendations.
And so in that development, we're identifying potential stakeholders,
the scope and goal of our meeting that will ultimately guide the scope of our report.
So in my role, you know, I'm there helping the panel, you know, guiding them with what is this
(06:57):
research paper saying about this particular topic? What are our next steps to make sure
that we're moving the needle forward with not only our meeting series, but with the report.
So we really want to take into consideration different perspectives. And so that is why
we take our time with the whole, you know, report development and meeting series because
(07:19):
we understand that some of these issues, though we're not experts in these areas,
may seem small, but the reality is that when we bring experts together, we see how bigger
the situation is and how important it is for us to have these stakeholders at the table so
that we're coming up with these recommendations that at the end of the day should be actionable.
Oliver Bogler (07:43):
So Daniela, I wonder if you can share with us what would have
been some of the greatest moments in your two years with the panel?
Daniela Monterroza (07:50):
Yeah, I think my one of the biggest moments was last. Well, yeah,
it was last year in the fall. We had our first public meeting and I was also able to partake in
just seeing all the experts at the table was kind of like a ‘pinch me moment’. You know, you know,
I never saw myself in these positions, but it's really rewarding to see everyone come together
(08:13):
and everyone who's really passionate about addressing the burden of cancer in the U.S.
Come together with the goal of like, what can we do to make it better for our cancer community,
right? So that has been very rewarding and just also a learning moment that it's very important
to have different stakeholders at the table when it comes to these, when it comes to coming,
(08:35):
when it comes to creating solutions, we need as many voices as we can have.
Oliver Bogler (08:41):
Dr. Jaffee, so part of the work of the panel is also to help
craft the National Cancer Plan, right, which kind of is an umbrella series of
concepts that sort of lays on top of the National Cancer Program, I guess,
in a way. How does the panel do that, and who are the other participants in that process?
Elizabeth Jaffee (08:59):
Right, so the National Cancer Plan was enacted by Dr. Monica Bertagnolli,
who was NCI director at the time. It was the 50th anniversary of the National Cancer Act,
and she wanted to reconfirm our commitment to taking care of all patients with cancer
(09:21):
and also to identify what are the current problems. It's 50 years since the original Act.
So she utilizes this as an opportunity to identify the current problems that we need
to address and then asked our panel to monitor the National Cancer Plan,
which we are very happy to do. We think it's a very important part of our job.
(09:43):
And so the National Cancer Plan identifies critical issues that cancer patients are
facing today. And our goal is to have a yearly meeting and we've already had one.
And two, learn from the community who are working with cancer patients,
who are cancer patients, who are survivors, who are researchers, who are foundations.
(10:07):
Learn how are they addressing the critical problems that patients face today? How are
they working together on areas where they are passionate about trying to make a difference?
And so our first meeting brought together experts from some of the leading foundations,
(10:28):
American Cancer Society, American Association for Cancer Research,
ASCO. It brought people from foundations that were representing survivors. And we all met again for a
full day. That was a public meeting. We invite recommendations on a continuous timescale to
send us any information about what different groups are learning, you know, what are some
(10:55):
of the new challenges that they would like us to bring to the national attention. So we receive
emails and other forms of communication from individuals throughout the year.
And we take all this information and again, we put it into a format that can be reported back
to President Biden and his staff, hoping that they will take some of these recommendations
(11:20):
and try to implement solutions that we have suggested. And so we plan to continue to do
this on a yearly basis. The first one was really to get a sense of what everyone was
doing. This coming year, and these are in the fall, we conduct this meeting in the fall,
this coming year we're going to take on the challenges of the health care workforce.
(11:45):
This is a huge problem. It's a problem throughout the continuum of cancer care from the earliest
time of navigating patients into the healthcare system through survivorship. And so we're hoping
to identify experts who are working on this problem to help advise us so that we can again
(12:06):
make recommendations to the President on really modernizing the workforce, the cancer workforce.
Oliver Bogler (12:12):
Very much a topic near and dear to my heart in our work in the Center
for Cancer Training. I wonder with that 50-year perspective that you alerted us to,
what is in the National Cancer Plan today that might not have been in the vision back
in 1971? What are the things that are new and important that we are now working on?
Elizabeth Jaffee (12:32):
Right. I think that some of them, of course, some of the recommendations,
there's eight specific recommendations and some of them are continuous. For instance,
you know, we never receive enough federal funding to really accomplish everything we
want to do. That was true back in 1971 and it's certainly true today. And of course,
(12:53):
you know, our Congress has a lot of issues to address, not just cancer, but cancer is a very
important problem that all Americans at some point experience or know people who experience.
So it is high up, I think on the list and to be able to address particularly today when we have
so many new technologies and we're learning so rapidly, it's really a matter of funding,
(13:18):
being able to translate all this information into the best drugs. We're seeing new
drugs being developed that are really more targeted towards a specific cancer problem.
But we just don't have enough money to really move that needle as quickly
as we'd like to. And of course, that's what President Biden has always wanted us to do.
(13:39):
But then we didn't understand biology at all back in 1971, cancer biology. Now we
understand that cancer biology is very complex. We've learned that it's a genetic disease. We
learned that it's a disease of inflammation but it's also a disease of environment,
of social determinants of health. And so these concerns, particularly social determinants of
(14:04):
health really are critical today because of our better understanding of biology, of understanding
individual patients and how they respond, how they develop cancer, how they respond to cancer.
And the need for understanding ancestry medicine you know, different cultures respond differently.
(14:27):
Even some of our standard chemotherapies, if you test them in one population, you're
going to see one response. If you test them in another population, it's going to be a different
response. Resistance mechanisms are different. So, understanding our patient populations and
the diversity of patients in our country is critical today, which we didn't realize before.
(14:48):
And then, of course, the workforce is another issue that you know,
I think was not the issue back in 1971. At that time, I think, you know,
we really were just establishing really a national cancer workforce.
Oliver Bogler (15:06):
Daniela, as someone who is earlier in their career and is coming into
the world of cancer, and you're getting really this sort of, I don't know, high altitude view,
I guess. What are your thoughts as you consider, for example, the eight goals of the National
Cancer Plan? What are the things that you think are really critical in that concept?
Daniela Monterroza (15:27):
In the position that I currently am in, I do get exposed to different
aspects within the cancer, right? Not only the cancer workforce, but cancer research, I mean,
the practice, the translational work that goes on. So when I think about the National Cancer Plan,
the goals that speak out to me most and that get me excited,
(15:52):
I could say is engage every person and deliver optimal care. I think,
and this is nothing new, right? For our listeners probably learning that clinical trials are not
representative of the US population, right? And so how important it is for all of us to
join forces and finding innovative ways to engage different communities, right?
(16:15):
Because what works with one community, will most likely not work with another
community. So finding ways to tailor our programs,
to tailor our outreach to those communities so that they can participate in this research
that will ultimately lead to better treatments for different populations.
And so deliver optimal care, I think, is also another one that is frequently on my mind,
(16:42):
right? Because we want to make sure that the care that our patients are receiving
is patient centered, right? And what does that mean, right? Does it mean, you know,
creating or fostering or funding more research for that personalized or precision medicine to take
place, right? Allowing people to get better treatment. Or does it also mean, you know,
(17:03):
providing social support? Because we know that the needs of a patient extend beyond just going
to a clinic, what is going on at home? Do they have resources or the financial support that they
need to continue on with their treatment? And so I think working at the President's Cancer Panel or
(17:25):
for the President's Cancer Panel, sorry, I think has exposed me a lot to those factors that may be
naked to the eye, right? You can't see them when you see someone, you can't see the whole story,
right? But it's when we sit down with a patient that we find that, you know, what are their actual
struggles? And we see that everything influences the care, their decisions and things like that.
Oliver Bogler (17:46):
So you said something interesting there, the element of
engaging every person. And I know that's near and dear to Dr. Bertagnolli's heart when she
participated in creating this version. I know Dr. Rathmell, our current director,
is very focused on that. And I know in the report that the panel put out in February, it
talks about this dynamic and sustainable community engagement. To me, that's a huge pivot from, well,
(18:09):
there's these nice doctors and scientists over there doing this really cool cancer
research and they're going to fix it one day, to wait a minute, we're all in this together.
So Daniela, how, from a communications point of view, how do you tell the nation,
the peoples of the nation, you need to come in and get involved in this?
Daniela Monterroza (18:28):
So when it comes to communicating, right,
that concept of that everyone really has a role in ending cancer as we know it,
I think it's taking collaboration with, you know, NCI and other stakeholders to learn, okay, there's
different communication strategies that we can use to reach out to certain populations, right?
(18:51):
And so, the panel has taken the role of, you know, trying to use their channels, either, you know,
through our blogs, X, LinkedIn, our website, to try to communicate to the stakeholders that
are already following us, but also, you know, reaching out to those institutions,
to NCI designated cancer centers to inform their audiences as well of the National Cancer Plan.
(19:17):
So when it comes to communicating, about the National Cancer Plan and encouraging
our communities to get involved in this initiative. It really involves
having different perspectives because we can't assume again that one communication effort
is going to reach them all, right? It's about seeing who do we have at the table,
(19:40):
who are our partners and how can we collaborate with them in order to get the message across.
So, I think we're in the early phases of the National Cancer Plan and it will certainly
take time for more people to get informed or to come to find out about this national
plan that we have in our fight against cancer. But it's connecting with
(20:03):
the current partners that we have that will get that message across.
Oliver Bogler (20:09):
Thank you, Dr. Jaffee. I wonder if you could comment. You're
deputy director of the Kimmel Cancer Center an NCI Designated Cancer Center
at Johns Hopkins. And part of the role of the cancer centers has been community engagement.
So is this also an important element in the strategy that we were just talking about?
Elizabeth Jaffee (20:26):
Yeah, so this is a huge element. And I think what Daniela was pointing out is that,
you know, different cultural groups, different age groups,
there's all different ways of engaging. I was having this discussion with some
of the leaders of our community outreach and engagement actually this past week,
because we met with Dr. Biden to talk about some of these challenges and also potential successes.
(20:55):
And my expert colleagues have utilized a number of different ways in our communities
in Baltimore City versus DC. We have communities in both areas and even
though they're predominantly African-American background, they're different. So you can't
(21:17):
assume just because they're of the same cultural background or the same
race that they're going to deal with issues around cancer communication in the same way.
So there've been a number of interesting ways in which our experts work on this. But traditionally,
(21:39):
going to community groups where they congregate, for instance, barbershops,
the church, those are good for some of the older men. The hair salons for the older women,
but that's not getting the younger individuals and cancer is becoming
unfortunately a disease of even younger individuals. So they've been having specific
(22:03):
events even at these places that will attract younger people, things they may be interested
in around music or around other aspects that an older individual may not be interested in.
Also going to the schools and talking to the middle schoolers or the high
schoolers. They're doing a lot of that because you talk about cancer screening.
(22:29):
You talk about human papillomavirus vaccination. You demystify these things. You remind these
children that their parents are at risk so that they will talk to their parents.
So there's all different ways. And people process differently. I learned that as an
oncologist many years ago in just taking care of different types of patients,
(22:54):
patients from rural areas, patients from religious backgrounds. You know,
sometimes a family doesn't want the patient to know about the disease and you have to
negotiate that. It's a cultural thing. So there's all different aspects that we have
to really train people. We also have to learn how best to communicate based on the individual.
Oliver Bogler (23:16):
So my last question about the panel, Dr. Jaffee,
you've had lots of leadership roles in cancer. You were president of the AACR and many other
things. How does this particular role compare? What are the best parts of it?
Elizabeth Jaffee (23:30):
Well, for me, you know, as you know,
I continue to grow in my role as a researcher and as a leader in cancer,
you know, therapy and also a leader in thinking about the overall cancer
problem it's provided me with a wonderful opportunity to learn from so many experts.
(23:57):
I've really grown into my positions because I'm able to interact with experts from all types
of environments, all types of work environments, clinical environments, government. And so for me,
it's really interesting to hear different perspectives and to try to put that into some
(24:21):
framework that I can utilize to move particular problems forward that I'm passionate about.
And so the Presidents cancer advisory panel really allows you to think about
what are the big problems with all this knowledge that I've gained,
what are the big problems that I can now take on and really hopefully help cancer patients. I mean,
(24:44):
that's what we're all here for, to help current and future cancer patients.
And as you know, I'm in the latter part of my career,
that's my goal. My goal is to really make an impact. And so it's really given
me the opportunity to work with amazing individuals, to be able to bring people
together who are experts and to be able to become an advisor for big problems.
Oliver Bogler (25:09):
Daniela, what are the key experiences in working with the
panel that you will take with you as you move on through your career?
Daniela Monterroza (25:14):
First and foremost, I think the process that the panel takes to
understand the problem at hand. We may be fast to assume what can be a solution, but the more
time you take to understand what's really going on, that will shape or give way for
the solution to be really effective, I guess, at addressing the problem at hand. So that's one,
(25:43):
right? The second one, I'll say, is always keeping focus on what's the overall objective,
right? My time at the panel, I've seen how important it is to keep the patient at the center.
Like Liz has spoken in this podcast and in previous talks, the emphasis on the cancer
(26:07):
community and the patient itself, right? Our efforts, you know, we need to come together to
be able to overcome these barriers and not work in our, you know, in our silos and try to address
this because more often than not, we will fail, right? If we're trying to address this on our own.
And then third, I would say collaboration which I think has been a theme in this throughout the
(26:35):
conversation today, is just collaborating with one another. A lot of the projects that, you know,
from the President's Cancer Panel that may often go unseen, like the back end, our meetings and
everything like that, it literally involves a group of staff coming together and providing
their expertise. And that ultimately guides us to be able to approach things from a different angle.
Oliver Bogler (27:00):
Thank you. Great. We'll take a quick break and when we come back,
we'll talk to our guests about their career paths and plans.
[music]
Cancer scientists do all kinds of interesting things, and one of them
is to work on the regulation of drugs and medical devices at the US Food and Drug
Administration or FDA. Others shepherd discoveries from the lab to the bedside,
(27:25):
which requires knowledge of regulatory processes. If you are interested in this work,
we have a program at NCI called the Interagency Oncology Task Force Fellowship, or IOTF for short.
The program trains scientists in research and research-related regulatory review,
policies, and regulations.
Fellows learn to build awareness of regulatory requirements into
(27:47):
the early stages of the medical product development process and
to develop strategies to improve planning throughout research and regulatory review.
Many IOTF graduates transition to regulatory work at the FDA or in
industry. Others take what they have learned back to their research work,
which helps them plan for eventual commercialization and regulatory
(28:07):
approval of their discoveries. Check out our website to see comments from several IOTF alums.
Interested? Great… applications are now open!
For more information, see the IOTF website. A link to the website can be found in the show notes.
(28:28):
[music ends]
All right, we're back. Dr. Jaffee, what first sparked your interest
in science and medicine? Was there a moment of awe that got you started?
Elizabeth Jaffee:
There was a moment of awe. My grandmother took me to an American Cancer Society dinner to raise
money after my grandfather's brother died of lung cancer. And I had to be maybe eight years old. And
(28:54):
it really made me realize that there were a lot of people out there who lost people to cancer.
And his name was, his nickname was Happy. So, as an eight year old, I couldn't imagine how someone
whose name was Happy could die of cancer. And then, you know, I started reading more and I read,
(29:15):
you know, I was looking for women who were role models and there weren't a lot of women
role models in science and medicine. But and I know this sounds, you know, kind of common,
probably among women, but Marie Curie's biography was really amazing to me. She identified basically
(29:36):
the whole field of radiation oncology. She was the mother of radiation oncology. And this was
a woman who did basic science, who translated it to something important for patients early
on in her career. And that led me to start thinking this is something I wanted to do.
And then in college, I was in college at a time when we were learning about
(29:56):
the biology of viruses. And it led me to think, you know,
we have these vaccines that are probably the greatest advance medically of the 20th century,
with penicillin antibiotics, that prevented babies from dying in their first year. And
(30:19):
so all of this together made me realize that I wanted to go to go into cancer research.
I wanted it to be about making the patient's own immune system fight
their cancer because as a trainee in oncology, I saw too many people suffer
from chemotherapy. And so I continued to pursue that avenue and I never looked
(30:41):
back. And when I look back on my career now, I'm happy that I took this pathway.
Daniela, what was that moment for you? Was there a moment of awe?
Daniela Monterroza (30:51):
Yeah, so I'll go back to high school. It was during that time,
I think it was junior or senior year that we were all just talking about our majors,
what we were going to study. And so I had grown up saying I'm going to be a doctor, I'm going to
be a doctor. But in high school, I just I didn't feel like medicine was my calling. And so I know
(31:15):
I wanted to be in the health sector, but I just didn't know what exactly that could look like.
And so. And throughout Google searches, I found healthcare administrator. So I said,
okay, that's a, it looks good. So in my first year of college,
we had to take an introductory course to public health. And I was sitting there,
(31:36):
you know, with the idea that I'm going to become a healthcare administrator. But I remember one
class where our professor was talking about the difference between medicine and public health.
And it stuck with me and that's usually what I
use to try to explain my family members what public health is.
Oliver Bogler (31:52):
What is that difference?
Daniela Monterroza (31:53):
Right. So I remember her saying that medicine focuses on the
individual and emphasizes diagnosis and treatment while public health focuses
on population and emphasizes health promotion and the wellbeing of the community as a whole.
And so it clicked that moment, it clicked for me because, when talking about the social
(32:16):
determinants of health, which terms I had never heard of before, I saw that these factors that
were talked about in class, I had lived through, my family had lived through, and my community
had lived through, right? And so that kind of just sparked, you know, that decision,
I'm gonna go full force into public health. And so that guided me throughout my career.
Oliver Bogler (32:39):
So for someone who's listening who might also not have heard
this term social determinant of health, can you give us a couple of examples?
Daniela Monterroza (32:45):
Yeah, yeah, so social determinants of health encompasses those
social factors, right, that influence our health. So it can be, you know, those economic factors,
level of education that an individual has. It could also mean, do you have insurance or not?
(33:06):
What type of environment do you live in? You know, is there access to food? Is there access to safe
places for you to engage in physical activity. Like we see all these factors come into play
and they influence an individual's behavior. They influence an individual's decision. They
influence what the person prioritizes or doesn't, right? And so that affects health as a whole.
(33:31):
And so I saw that in my own family. You know, my parents didn't have insurance,
a lot of cases of diabetes, cancer around me. And so it, goes beyond just health. It's our built
environment. What is in our environment that's influencing all these factors that come into play?
Oliver Bogler (33:51):
Yeah, it's complex. There's lots to study. Dr. Jaffee,
coming back to you, so you were inspired by vaccines. And I think
maybe is that part of why you moved into immunotherapy in your current work?
Elizabeth Jaffee (34:06):
Yes, that's exactly why I did. To me, just looking at what was important
in healthcare in the 20th century, vaccines clearly for infection have changed… it was
a game changer then. And I think we're learning now that immunotherapy is a game changer for even
(34:27):
patients with pretty deadly cancers like lung cancer and colon cancer and melanoma and others.
Of course, we're just at the beginning of the field of immunotherapy,
but I've been in it for 30 years and it was sort of a dream when I got started. And now
it's reality and we just have to figure out how to make it work for everyone.
Oliver Bogler (34:49):
And what drew you to pancreatic cancer? It's the disease you focus on, right?
Elizabeth Jaffee (34:53):
Yes, it is. And it's probably the one that doesn't yet respond as well
to immunotherapy, but we're making good progress. What drew me to that was when I was a medical
resident in 1986, my father called me to tell me that his brother, who was 51 at the time,
had pancreatic cancer. And I just remember that call because I just started internal medicine,
(35:20):
but I started crying, because the one thing I knew is it was a death sentence. And my father was,
he got upset. He thought I was going to tell him about treatments and my uncle would be okay. And
I couldn't tell him that. And my uncle, who was an engineer, was looking for therapies and ended up
going to Mexico for one of these advertisements because there was nothing in the United States.
(35:44):
And he died three months later. And I grew up with his kids and it was the first time I really
experienced since I went to that American Cancer Society meeting for my great uncle. And it made
me realize when I went into medical oncology that we really had nothing for our patients. And it was
(36:09):
something that I think I was passionate to try to make a difference. And I still feel that passion.
Oliver Bogler (36:15):
Yeah. Well, I hope progress against
pancreatic cancer is swift. It is one of the more difficult diseases.
Daniela, so you got fascinated by public health. And you went to Howard and did a
BA in public health, right? Then University of Maryland for a BA in health admin and policy.
(36:36):
And then you ended up at Johns Hopkins, where Dr. Jaffee is, of course, on faculty. And there you
did a master's in public health as well. So how did that then lead to your current career phase
where you are a health communications fellow? And what is that program? Tell us about it.
Daniela Monterroza (36:54):
Yeah, yeah. So the way I got interested in health communications and public
health came from a previous Pathways position that I got at NIH. So I got to work with a
group called the Health and Science Branch. They were formerly known as the Science Communication
Branch at the Office of the Director. So there they were doing a lot of health communication.
(37:16):
And it was there that I was first exposed to the terms health literacy and plain language.
And so I had never heard of these terms before, and I'm sure it must have been in a course at
UMBC. I must have missed it, but it was here that I got familiarized the important role
that health communication plays and how we're always constantly communicating information
(37:41):
and the channels that our communities use. I saw my parents, you know, use,
you know, social media or, you know, that word to word communication about, you know,
what is going on with a family member, their diagnosis and things like that. And so having
that realization, I wanted to understand more about the relationship of health communication
(38:05):
and public health. And so having that pathways position at NIH is what led me to pursue a
master's of science in public health and going to health education and health communication.
And in my time there, I got to learn about NCI's communication fellowship program. And
that's when I applied. And so basically what this program is, you get to interview different offices
(38:33):
within NCI that are looking for a communications fellow. Whichever office you get placed into,
you get to work on communication related projects. So this could be content management. This could
also range with creating materials for meetings, writing blog posts, which have has been the role
that I've had, my communications role with the panel thus far. And then strategic planning,
(38:57):
you get to be on calls with leadership and deciding, okay, what do we want this
next month to, what do we want to highlight this next month about our work and things like that.
And so I know that right now the communications fellowship program is closed, but they should
be opening in 2025 for new applicants. And it's a great opportunity for you to get a
(39:19):
sense of what communication looks like at a federal level. So I recommend it for anyone
who's curious to learn about that. You get to work with amazing staff. I've gotten to
work with NCI's OCPL team, which they are great and have given me guidance.
Oliver Bogler (39:35):
Okay, acronym alert, you're gonna have to expand that acronym for us.
Daniela Monterroza (39:38):
Yeah. yes. Sorry. Okay. So I've gotten to work with OCPL,
which is the Office of Communications and Public Liaison. And I've learned a lot from them.
Oliver Bogler (39:46):
Fantastic. So Daniela, by its very nature, a fellowship is intended
to be of a limited time. So can I put you on the spot and ask you what's next for you?
Daniela Monterroza (39:55):
Yeah, for sure. I think, you know, one of my priorities is learn as
much as you can, right? So definitely keeping my options like open right now into what direction
I take. You know, whether it looks like, you know, continue working in the federal
space or whether it looks like working more in a community-based organization. You know,
the communication is different from, you know, the Fed level to a community level.
(40:20):
So, right now, my priority is just learn as much as I can and keeping
myself open to those opportunities, not limiting
myself because you can't assume you don't like something if you haven't tried it,
right? So that's my perspective on how I'm taking my next steps forward. Just knocking on every
single opportunity or every single door I can for the next opportunity, but growing in that
(40:43):
health communication space because not only does it entail content development, but it could also
expand to health communication campaigns. What does a health education program look like? So.
Oliver Bogler (40:53):
Yeah, very powerful. Dr. Jaffee, your own
path has been very inspiring and you have occupied many leadership roles. As you talk
to early career researchers and clinicians in your environment, what are you telling
them? How are you encouraging them? What's your advice to our listeners who might be
thinking about joining the cancer research field or trying to find their way in it?
Elizabeth Jaffee (41:17):
Yeah, so what I tell my young trainees is that they are entering this
field at the most remarkable time. I wish I was starting now. The technologies, the knowledge, it
is just unbelievable. It's moving so quickly. The opportunities that you have today to really learn
(41:38):
to develop new approaches to benefit our patients. We just didn't have this when I got started.
So we need the smartest and the most passionate individuals to join us and
to be the next generation to make sure that this amazing science and
these amazing technologies really have impact so that no patient will
(42:00):
suffer the way current patients do today from cancer. That's what I tell them.
Oliver Bogler (42:06):
Daniela, what would you say to someone who was maybe in their undergraduate
years? I mean, you shared with us that you were initially thinking of medicine,
but then you decided public health was a much more
interesting area for you. What would you tell them if they were listening?
Daniela Monterroza (42:23):
Yeah, that it's okay to change plans. I think, you know,
sometimes we may set something for ourselves, right? Our high school self is different from,
you know, our current self, right? And so if your interests change,
pursue what you're passionate about because this is what you'll be waking up to every day to do,
(42:46):
right? So follow your passion and that will give you just a sense of satisfaction in the
work that you do. So don't be afraid to... if switching up is what it takes, then switch up.
It's your career, it's your life at the end of the day and what you're contributing to society.
(43:09):
[music]
Oliver Bogler (43:09):
Now it's time for a segment we call Your Turn, because it's a chance for
our listeners to send in a recommendation that they would like to share. If you're listening,
then you're invited to take your turn. Send us a tip for a book or a video, a podcast,
a talk, anything that you found inspirational or amusing or interesting. You can send those
to us at NCIICC@nih.gov. Record a voice memo and send it along. We may just play it in an upcoming
(43:32):
episode. Now I'd like to invite our guests to take their turn. Let's start with you, Dr. Jaffee.
Elizabeth Jaffee (43:38):
Absolutely. So I have to say most people know me as a cancer researcher,
but I have a number of passions. My favorite passion is hiking,
and I have a bucket list and my daughters who are now 27 will hike with me as well. And so,
for me getting out into the environment, into the mountains clears my mind and allows me to
(44:00):
really enjoy life to appreciate what life is really about. So I recommend
following a passion that you have outside of your work and hiking is a great one.
Oliver Bogler (44:12):
Sounds fantastic. Daniela.
Daniela Monterroza (44:14):
Yeah, so first, an encouragement to volunteer. I think it's
when we connect with our communities, we get to see what they're going through,
what their values are, what their priorities are. And that has influenced a lot of the
direction that I've taken in my career, my lived experiences. So just a call to volunteer
wherever it may be. I've had the opportunity to lead a little group at our local church.
(44:41):
So we do activities with them on Saturdays and it's just really nice to connect with them. So
a call to encouragement and then just a second recommendation for you to check out NIH News and
Health. I think my health communicators might enjoy this one, but it's a monthly newsletter
that provides practical health information and tips based on NIH research findings.
Oliver Bogler (45:02):
That's fantastic. And we're going to put a link in the show notes also for the NCI
Health Communications Fellowship so that our listeners can easily find them. Thank you.
I'd like to make a recommendation as well. Regular listeners will know I've become a
little bit obsessed by AI. So this is for a book that I recently read. It's called Machines Like Me
by Ian McEwan. It was published five years ago, and I only just recently picked it up because
(45:27):
of my obsession and the advances in AI. In this book, McEwan really explores whether a machine
can ever truly understand human emotions and reasoning and does so as always with
a compelling and sophisticated narrative. The characters in the book, human or not,
encounter challenging moral choices and come up with quite different answers to those choices. As
(45:49):
the tech giants develop agents that are more and more like humans or try to appear like humans,
the lessons of this book, from this book were really of note to me. And McEwan,
one of my favorite authors, as always delivers them in his crystal clear prose.
So I want to thank you both for the time you spent with
us and giving us your insights and sharing your experiences.
Elizabeth Jaffee (46:12):
Great, thank you very much for inviting me.
Oliver Bogler (46:15):
That’s all we have time for on today’s episode of Inside Cancer
Careers! Thank you for joining us and thank you to our guests.
We want to hear from you – your stories, your ideas and your feedback are welcome.
And you are invited to take your turn and make a recommendation
to share with our listeners. You can reach us at NCIICC@nih.gov.
(46:36):
Inside Cancer Careers is a collaboration between NCI’s Office of Communications and Public Liaison
and the Center for Cancer Training. It is produced by Angela Jones and Astrid Masfar.
Join us every first and third Thursday of the month wherever
you listen – subscribe so you won’t miss an episode.
If you have questions about cancer or comments about this podcast,
(46:59):
you can email us at NCIinfo@nih.gov or call us at 800-422-6237. And
please be sure to mention Inside Cancer Careers in your query.
We are a production of the U.S. Department of Health and Human Services,
National Institutes of Health, National Cancer Institute. Thanks for listening.
Popular Podcasts
Crime Junkie
Does hearing about a true crime case always leave you scouring the internet for the truth behind the story? Dive into your next mystery with Crime Junkie. Every Monday, join your host Ashley Flowers as she unravels all the details of infamous and underreported true crime cases with her best friend Brit Prawat. From cold cases to missing persons and heroes in our community who seek justice, Crime Junkie is your destination for theories and stories you won’t hear anywhere else. Whether you're a seasoned true crime enthusiast or new to the genre, you'll find yourself on the edge of your seat awaiting a new episode every Monday. If you can never get enough true crime... Congratulations, you’ve found your people. Follow to join a community of Crime Junkies! Crime Junkie is presented by audiochuck Media Company.
24/7 News: The Latest
The latest news in 4 minutes updated every hour, every day.
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.