An NCI-designated Comprehensive Cancer Center
By Abe Rosenberg | September 25, 2019
Trilokesh Kidambi Trilokesh Kidambi, M.D.
You might say it was inevitable that Trilokesh Kidambi, M.D., a talented young gastroenterologist, would end up at City of Hope. He had plenty of folks pointing the way.
 
“I grew up ‘down the street’ in Claremont,” he said. “My mother’s worked at City of Hope for 14 years as a medical coder. My brother-in-law, Sagus Sampath, M.D., is a radiation oncologist here.”
 
In fact Kidambi, an assistant clinical professor in the Division of Gastroenterology, Department of Medicine, and director of the colon cancer screening program, knew his way around the Duarte, California, campus years before entering medical school. Fascinated by science and math, he spent two of his high school summers in the lab of renowned diabetes researcher Rama Natarajan, Ph.D.
 
“He was one of my best summer students,” recalled Natarajan, the National Business Products Industry Professor in Diabetes Research. “He was truly motivated, really serious about his work and very eager to gain as much research experience as possible during his stay in the lab.”
 
She saw potential in the eager teen.
 
“He had this unique combination of intelligence, curiosity, motivation and hard-working nature, coupled with enormous compassion,” she remembered.
 
Still, it was hardly a slam dunk that Kidambi would one day cycle those qualities into a career in medicine. Why is that? Well … slam dunks!
 
At Claremont High School, Kidambi starred on the basketball court and dreamed about turning pro. A broken ankle changed his mind. But not for the reasons you might think.
 
“I was so impressed by the way the surgeon [treating my ankle] took care of me,” he remembered. “It’s the first time I thought seriously about becoming a doctor.”
 
His medical school mentors at Northwestern University showed Kidambi how gastroenterology would provide the things he craved: immersion in science, leading-edge procedures, the latest technology and, most important, long-term relationships with patients.
 
“Turns out I liked the clinical side — working with patients — even more than the scientific side,” he said.
 
In 2018, Kidambi grabbed the opportunity to “come home” to City of Hope, where he not only works alongside his mom, who he calls his “greatest advocate and supporter,” but where he’s formed a tag team of sorts with gastroenterology chief James Lin, M.D. Together they’re building a robust, multifront effort to stop colorectal cancer before it starts.
 
The need may be greater than ever.
 
Alarming new studies suggest that colorectal cancer, long considered an “older” person’s disease (median age at diagnosis: 68 in men and 72 in women) is increasingly turning up in younger patients. In 1990, only 6% of patients diagnosed with colon cancer were under 50. By 2013, the rate had climbed to 11%, and it may be accelerating, according to the Colorectal Cancer Alliance.
 
“It’s an onslaught,” said Kidambi, adding that no one knows exactly why it’s happening, although higher rates of obesity and lack of exercise among the young likely play a role.
 
Kidambi says he joined City of Hope determined to reverse those worrisome numbers by leveraging the formidable tools now at his disposal.
 
“We need to focus on screening and prevention,” he said. Caught early, colorectal cancer has a survival rate above 90%. Even better, when doctors detect and remove colon polyps, the disease may never take root at all.
 
Colonoscopy remains the most effective method for finding cancer and polyps, but it’s not perfect. It may miss some of the smaller, “flat” polyps (which are more likely to develop into cancer). It’s also the most invasive screening procedure. Patients don’t like it, not to mention the odious prescreening prep that’s required. Less invasive tools like CT or “virtual” colonoscopy and some home-based tests can accurately detect cancerous growths, but they’re less reliable for catching the precancerous polyps.
 
Recent advances may change everything for the better.
 
Chromoendoscopy sends out a dye during the colonoscopy process to “sharpen the picture,” enabling doctors to see and detect more than ever before. Studies suggest this enhancement helps catch more of those troublesome flat polyps, and the dyes don’t appear to negatively affect the patient at all.
 
Researchers are also conducting animal tests on a new system that clears the colon during the actual screening. This could tremendously help patients who have difficulty with the prep ritual. “It’s a game-changer,” said Kidambi.
 
More tools are coming.
 
Kidambi says we’re not far from the day when algorithms, artificial intelligence and big data will examine everything from family history to environment and body mass index in order to more precisely determine which people are most at risk. He’s especially excited to initiate some early studies in this area with TGen, City of Hope’s affiliate specializing in genomic research.
 
And when it comes to bringing all this to more people, Kidambi has another, uniquely personal tool he calls upon frequently.
 
He’s just a really nice guy who puts patients at ease.
 
“He’s so caring and loving. Everyone should have a doctor like him,” gushed Rina Karapetian, a patient who believes Kidambi may have saved her life.
 
She’d had polyps removed in 2014, but wasn’t told they might be malignant. Unsuspecting, she and her husband Digran set off on a multiyear round-the-world trip, visiting dozens of countries.
 
During a stop in Bosnia, Karapetian went for a routine follow-up scan. The doctor found polyps he could not remove.
 
Karapetian called City of Hope and met Kidambi. He did a new screening, which uncovered Stage 3 colon cancer.
 
Karapetian successfully went through surgery and chemo and is doing well. Husband Digran was so impressed, he’s become Kidambi’s patient as well. Best of all, the Karapetians are ready to get back on the road. “Two more years and 18 countries to go!” Rina Karapetian said.
 
Listening to his patients — and to Kidambi himself — one can’t help but think this would-be NBA player was indeed destined to star instead in the medical arena.
 
It may have even been preordained.
 
“My great-grandfather wanted one of his children to be a physician, which is what led my grandfather to enroll in medical school.” he explained.
 
“On the first day, they showed the students the cadavers in anatomy lab. My grandfather took the next train back to his hometown [in India].
 
“He’d hoped one of his nine children would become a doctor. When none did, he hoped one of his grandchildren would.”
 
So it took a few generations. Mission accomplished!

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