For Dr. Arti Hurria, practicing medicine was in her blood. Both her parents were doctors – and from the age of four she was instilled with the belief she would follow in their footsteps.
Today Dr. Hurria is a geriatric oncologist. Her practice focuses on caring for older patients with breast cancer. In addition to seeing patients, she is the Director of the Center for Cancer and Aging Research and Professor of Medical Oncology at City of Hope in Duarte, California. She also serves on several medical and clinical trial panels.
In recognition of National Doctors’ Day, BCRF spoke with Dr. Hurria about her work serving an older patient population, her inspiration and her hopes for the future of breast cancer.
BCRF: What made you go into oncology?
Dr. Hurria: Both my parents were doctors and I think it was always assumed I would become a doctor, too. I was inspired by my mother’s bedside manner and the care and compassion she felt towards her patients. I may have also been influenced by my father, who started telling people I was going to be a doctor from the time I was four years old.
I had always been interested in women’s health and enjoyed talking to them about issues that affect women, so going into breast cancer was just a natural fit. I like the relationships that develop over the course of cancer care. I’ve gotten very close to my patients. My clinics are social as much as they are about medicine.
BCRF: What made you pursue a specialty in geriatric oncology?
Dr. Hurria: Geriatric oncology wasn’t actually a specialty when I was in residency, but I was inspired by an experience treating an older patient. She suffered from dementia and other comorbidities. In caring for her, I became close to her daughters as they learned to care for an aging parent. We’ve stayed in touch over the years.
The experience made me realize the need to incorporate principles of geriatrics into oncology and a mentor made the suggestion of combining the two. I just feel in my element when I’m taking care of older patients.
BCRF: How has the clinical management of breast cancer care changed how you care for your patients?
Dr. Hurria: We’ve made amazing progress in the last 40 years. We’re finding breast cancers earlier and earlier and that has a positive impact on outcomes. Technology has changed how we do geriatric assessment in ways that minimize provider time, so emphasis can be on selecting the most appropriate care, maintaining function and reducing or at least not adding to morbidity.
We’re also beginning to understand how cancer therapy accelerates the aging process in healthy younger adults. This research can help us identify biomarkers of aging that can be applied to understanding the effects of cancer and cancer therapy on the aging process and used for the clinical assessment of aging.
BCRF funding has allowed our group to pursue exciting research we would not be able to do, including analyzing data from 700 patients to identify clinical and biological (including genetic) predictors of chemotherapy effects. This work will allow us to personalize care for older patients. By knowing in advance what drugs could worsen functional decline or quality of life for an individual patient, we can tailor therapy to reduce the likelihood of adverse side effects.
BCRF: What new trends do you see that would make caring for your patients better?
Dr. Hurria: We’re seeing a trend where doctors are not just focusing on curing on the disease but also on maintaining function, thinking of patients as healthy survivors not just survivors.
There has been a dramatic shift towards personalized care, such as de-escalating therapies–meaning giving less when appropriate. This can reduce exposures to expensive drugs that may not add benefit but may have side effects that affect the health of older or frail patients.
There’s still a lot to do to before we can know definitively who can receive less treatment, but several clinical trials have shown that it is not always beneficial to add therapy.
BCRF: How close are we to curing breast cancer?
Dr. Hurria: We’re making great strides, and we are curing many breast cancers. The vast number of patients are going to be long-term survivors, which means we have to manage long-term side effects of cancer diagnosis and treatment.
Thinking of breast cancer as a chronic disease is so important. Our success will be in helping people live through chronic disease. I would love to be out of the cancer business, but not the medicine business.
Read more about Dr Hurria’s research on our Meet the Researchers page and read more about breast cancer in older adults on our blog.
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