Interview with Dr. Sarah A.Taylor

On Wednesday, February 17, 2010, we conducted an interview with medical oncologist Dr. Sarah A. Taylor at KU Medical Center. Dr. Taylor has been in practice since 1980. As part of the internal medicine department, she focuses on medical oncology, brain cancer, and breast cancer. The following is a summary of our interview. The answers reported are paraphrased below.

To begin the interview, Caitlin and I introduced ourselves and explained that we were conducting this interview as part of a service-learning project for our evolution class. We mentioned that we were participating in a grid-computing project and gave a brief explanation about what grid-computing entailed.

Q: Are you familiar with grid-computing and how it is affecting research in many medical areas?
A: It's all Greek to me.

(We then proceeded to explain more about our understanding of grid-computing).

Q: What is a typical day like for you? How does your role as a neuro-oncologist play into the team effort to treat brain tumors?
I wear a lot of different hats, so my days differ depending on what hat I am wearing. I am a neuro-oncologist, so three half-days a week I see patients with cancer. The majority of my patients have brain or spinal cord cancers. As an internal medicine person, I take care of all their internal medicine needs. I coordinate the care between their radiation doctor and surgical care doctor. Patient care is an ongoing part of my job. I am also the fellowship director for the Hematology and Oncology program. I have to develop curriculum, write objectives, and supervise the trainees who want to become hematologists/oncologists. Fifty percent of my time is devoted to that. I meet with them individually and review their evaluations by other professors. One half-day a week I visit them at their outpatient clinic and I supervise their care of their patients. I give lectures to them as well as parting of their teaching.
I attend journal club and tumor board, which are also part of teaching. At tumor boards, you have multiple doctors of different specialties. We present cases and discuss them to determine the best care for that patient. At journal club, we review current journal articles. We discuss what is good and bad about them and how they might change our practice.
In general, there is a lot of paper work involved. I work with medical students and residents to teach them internal medicine and oncology. I used to have some grants and do research, but the administrative part to being a fellowship director has changed over the years.


Q: What have been some of your general experiences with the disease?
On the human side, I see incredible strength and love between family members. They're angels. Brain cancer can cause personality changes and significant brain damage, so the person you may have married may not be the same. I have had the privilege to work with the patients and families dealing with pretty horrify things, and see that they're still cared for very carefully. I think cancer in general carries a connotation that is very frightening to anybody, but especially talking about the brain, which controls your life, it can have an even more frightening aspect concerning that loss of control. I get very close to patients because of what they are dealing with.
On the scientific side, I think we have seen some exciting changes with how brain cancer is treated and looked at. I've been in medicine a long time and a lot of doctors used to think oncologist were wasting their time. Now, I've seen a real progress in how aggressive treatment has become. I see people living longer and better, so that is pretty exciting.

Q: Why do you think a physician or researcher of neuro-oncology should be well versed in evolution?
I've never thought about that before. In life, you are best to learn from history. If you forget history, the you can repeat mistakes. I look at evolution as part of history, on the science side. I think if you look at how we get to the basics on the molecular way things work, it goes along those lines too.

Q: Do you feel the general public have a good grasp on the severity of brain cancer and do you feel there is enough emphasis on searching for treatment and cures, like there is for breast cancer?
There are definitely more organizations and publicity now for brain cancer than there were before, like the Brain Cancer Foundation and American Brain Tumor Association. There are certainly some neuro-oncologists that are more verbal than others, who have certainly tried to put it more in the limelight and have helped in that way. I think anytime you have someone famous with a particular cancer, it gets put more in the spotlight. That is what happened with breast cancer years ago. In terms of the severity, I think most people are nervous about it and recognize that it is a very serious problem.
Whether we get enough research funds, we would all like more, but breast cancer is a huge problem. Hundreds of thousands get breast cancer each year, as opposed to about 25,000 that get brain cancer, so by its sheer volume, I don't think brain cancer funding will ever be equal. I'm sure my brain patients wouldn't appreciate me saying this, but I think the money should be allocated to where the great need is.

Q: What can the average person do to improve research and funding for brain cancer?
There are fundraisers and various walks you can participate in. You can make donations to the Brain Tumor Foundation and The Cancer Society. I don't know that there is much else for the average person to do besides fundraising and showing support.

Q: Are there specific walks around the Kansas City area?
There have been several. One in particular is Head For The Cure. The ABTA has had them, but haven't had nearly the amount of participants as say a walk for breast cancer. There are multiple neuro-oncologist in the area; however, a lot of the funds raised go to MD Anderson Cancer Centers. It stared years ago, so some of their fundraising takes place in Kansas City.

Q: What would you suggest to caregivers and friends of persons battling brain cancer?
I try to teach them things while I have them in my clinic. It is always good to keep being educated. Learning more about what you are dealing with is helpful. We have a caregiver class here once a year to learn about brain cancer, physical therapy, and occupational therapy and different resources. the more they understand the easier it is to cope. One of the things that is hard is that people with cancer, in general, want to be the people they were before they got cancer. They want the friend or wife to show them the same amount of respect and treat them the same. No matter how good the outcome can be, its a traumatic thing that impacts all your relationships. It impacts your philosophy of life.
Allowing people to help is an important aspect of care-giving. Sometimes it is very hard for caregivers to take time for themselves.

Q: Just a final question, what is your favorite part of your job or favorite past experience?
That's a hard question. I really enjoy my patients. I love working with medical students. The last three years, I've gone on medical missions with the students to Belize. It's probably one of the best things I've done in my career. It's not neuro-oncology, but general medical care. It's all organized by our medical students. They raise the money, contact the government, get permission, set of the villages, buy the drugs, rent the vans, and arrange the places we stay. We go to 4 different villages in the rain forest and set up villages, churches, and schools. It is so cool! The most fun is people - whether it be patients, families, or students, at all levels. That is what I like the best.

Q: Is that why you went into this profession?
Yep, the people. I love people.... and science :)

(We then concluded the interview and thanked Dr. Taylor for her time and information.)