Alarm bells went off.
Both of Susanne's parents had hoped to become doctors themselves. Mom was stopped by gender discrimination. Dad, one of 8 siblings, was from humble beginnings and was told, “Don't aim too high, son.”
They both went on to happy and successful careers in non-medical fields and would have been perfectly happy to see her go into nursing, but they were not going to see their little girl be dissuaded from a career as a doctor for such an irrelevant reason.
It was time for an attitude adjustment.
“Almost immediately we switched to a female pediatrician, so I'd have a role model,” recalls Warner. “Mom filled the house with every pro-woman empowerment item she could find, and she and Dad made it clear that I needed to learn as much math and science as possible and if I did well, there would be no limits.
“Now, I can't remember a time when I didn't want to be a doctor!”
To this day she's the only doctor in the family, and to hear her mentor describe it, she truly has no limits:
“There are many people we can train to be great technical surgeons, but only some that we can train to be great technical surgeons and great doctors,” says Yuman Fong, M.D., The Sangiacomo Family Chair in Surgical Oncology and professor and chair of the Department of Surgery. “Fewer yet are those capable of innovating a field, and with the courage to do so. These are traits of a great academic surgeon, and I think Susanne can be one of those.”
It was Fong who recruited Warner to City of Hope after mentoring the young research fellow at Memorial Sloan-Kettering Cancer Center in New York several years earlier.
“He said, 'Come work with me and we'll cure cancer together!'” recalls Warner.
“I said, 'Where do I sign?'”
It's always a great day to cure cancer!”
She means it too, which is all the more remarkable considering that Warner specializes in the toughest, most challenging malignancies, like pancreatic cancer with its often grim prognosis.
But that's exactly the point. Warner firmly believes that accentuating the positive makes her a better surgeon and helps her patients.
“We're up against a formidable opponent,” she says. “But attitude and outlook affect outcome. I come to work every day thinking, 'This patient has a shot.' Because if I don't, they'll feel it. And until proven otherwise, I believe our curative intentions will have the desired effect.”
Warner grounds her optimism in scientific reality. She is heartened by advances in the treatment of pancreatic cancer which are significantly improving survival rates.
“We're seeing very promising signs in three critical areas: destruction or removal of the tumors, modulating their microenvironment and training the patient's immune system,” she says.
Warner is determined to make a difference in all three. Ultimately she believes the path to a cure will require a precise combination of strategies — surgery, chemotherapy, targeted therapy, radiation, and immunotherapy — custom-tailored to each tumor's unique molecular composition and clinical situation.
“The crux,” she says, “is to figure out what's right for each patient.”
But right now, except in extraordinary instances, only surgery can cure pancreatic cancer, and only if the disease is caught early enough and hasn't spread. Most cases are detected much later.
As a surgeon, Warner describes herself as “comprehensive and collaborative;” eager to embrace the latest minimally-invasive and robotic advances, yet humble enough to keep those aspirations in proper perspective.
“I need to know I'm better at something than a lot of other surgeons, before I'll offer it to my patient,” she asserts. “I know my limits, and if I come up against them I seek out guidance from my colleagues.”
Equally at home in the operating room and the research lab, Warner is especially excited by the progress in immunotherapy. Among her research projects, Warner is testing specially-modified “oncolytic” viruses that can train the immune system to destroy cancer and also give a patient lasting immunity against their tumor.
With modern chemotherapy and surgery, “We're pushing the limits every day,” she maintains. “We're seeing survival rates extended to several years. And we're just scratching the surface. We're working hard every day to help not only the patient in front of us, but people for years to come. It’s just a matter of finding the right combination for the right patient with the right tumor. I’m confident that during the course of my career we will substantially change the life expectancy for patients with pancreatic cancer."
Warner enjoys exercising both her surgical and research skill sets at City of Hope, where the multi-disciplinary approach is standard procedure. Colleagues say she's a natural fit.
“She is an outstanding surgeon with a sharp clinical acumen,” said Gagandeep Singh, M.D., chief of the Division of Surgical Oncology. “She possesses an inquisitive mind and has a sound research-oriented thought process, making her a perfect translational bridge between the clinic and molecular worlds.”
She's also a bridge to Texas, which is never far away.
“She's a Texan through and through,” says a smiling Fong. “She would routinely end every lecture with a one-slide history lesson about Texas.”
Texas may be home but make no mistake: she loves the City of Hope campus, Deep in the Heart of Duarte.
“The bench to bedside potential in this place is unparalleled,” she says. “I feel it every day, and I'm very grateful to be here.”