Periodically, the Office of Philanthropy invites City of Hope® leaders, faculty and researchers for conversation to learn more about them and their groundbreaking work.
We spoke with Saro Armenian, D.O., M.P.H., who focuses on health outcomes of childhood and adult-onset cancer patients. He is the Barron Hilton Chair in Pediatrics and directs City of Hope’s Childhood, Adolescent and Young Adult Survivorship Program.
Q: What inspired you to pursue a career in oncology?
I was born in Beirut, Lebanon. In 1986, we moved to Baltimore, Maryland, because Beirut became unlivable. Two years after we moved, my younger sister was diagnosed with leukemia. She underwent two bone marrow transplants, and I was her donor for both. Unfortunately, after a five-year battle, she succumbed to the leukemia. So, for years, each time I would think about anything related to medicine or cancer, I would have very strong emotional reactions. But then I started to really think about what I wanted to do with my life, and began reflecting on those relationships that sustained my family through those days. Ultimately, it was the passage and healing of time that drew me to a career in oncology, as well as the need to give back to a medical community that was so integral to my sister’s care. 2023 was the first year I was able to really talk about my sister.
Q: What is your own focus in pediatric oncology?
We have made great advances in the treatment of pediatric cancers, where we can now cure up to 80, 90 — in some cases 99 percent of pediatric cancers. So, as a community of oncologists and pediatric healthcare providers, we began to think about what happens to a pediatric cancer patient later in life as they enter adulthood. There is a high burden of cancer treatment-related late effects that fundamentally changes the lives of patients, the same way that cancer itself changed their lives when they were children. For example, another type of cancer or heart failure or kidney failure or infertility that develops in folks in their 20s, 30s, 40s. My clinical and research focus is on understanding why some people develop these issues and others don’t and how we can develop better strategies to optimize the overall health of the long-term cancer survivor.
Q: What are some of the areas that make City of Hope’s pediatric care unique?
We have such a deep clinical and research bench, and we are providing paradigm-changing care that combines the latest advances in curative treatment with comprehensive support for our patients and families. Moreover, we can tap into advances made by our adult hematology and oncology colleagues in a way that other institutions are not able to. On therapeutic clinical trials, we push the age limit for eligibility down as much as we can; we have enrolled patients who are 12, 14, 16 who have very difficult-to-treat cancers who would have otherwise not had access to lifesaving medications. There is a fluidity between our fantastic pediatric cancer providers, support staff, social workers and child life specialists. It’s hard to imagine, but at most of the large children’s medical institutions, there is an artificial barrier around the age of 21, and after that there’s a disconnect in the communication between healthcare teams. City of Hope does not have those artificial barriers.
Q: How does philanthropy contribute to what you can do at City of Hope?
When I came to City of Hope to do my research, I very quickly recognized that the commitment to a young investigator was unparalleled. It’s a no brainer to say: “Come to our institution, and we’ll protect your time. Ask all the questions you need to ask, develop your research program, and we will support you.” What makes City of Hope so special is that the commitment is real. Every grant and every paper we write at City of Hope is complemented through a partnership with philanthropy and foundation relations. My early years here were fueled by the support that I received from the philanthropy community, and it’s always an honor to be asked to speak about my experiences at City of Hope.
Q: What are some of the unique challenges of the adolescent and young adult (AYA) population?
A study 20 years ago found that, comparing similar cancers, AYA patients (15-39 years old) were doing much worse than their younger pediatric (<15 years) counterparts; their overall survival rate was, in some cases, 50% worse. City of Hope has committed to being the national leader in understanding how to optimize the health of these AYA patients with cancer. Foundations have understood that there’s a real gap that needs to be addressed, and they have put money toward supporting the necessary personnel to build a comprehensive clinical and research AYA cancer program. Now we have a dedicated director, navigator, activities coordinator, and this has all happened within the last 2-3 years. We are building a world class AYA program because these patients deserve the best outcomes we can give them.
Q: The City of Hope survivorship program started almost 20 years ago for patients under the age of 21. How has it evolved?
Our program is remarkable because we see survivors annually for life – unlike other programs, there is no “age-out”. We provide comprehensive clinical care focusing on screening for late effects of therapy, offer multidisciplinary (psychology, nutritional, subspecialty) consultation, and educate our survivors about their cancer history and its associated treatments. We’ve recently expanded this program to young adults (21-39 years) diagnosed with cancer and to people who were not treated at City of Hope. We see anyone diagnosed with a pediatric or young adult cancer who wants to come to us. We also use this remarkable resource as a backbone to build more clinical trials and research studies to understand health outcomes of survivors well into adulthood. Ultimately, the combination of first-class clinical care and research allows us to inform the scientific community about strategies to improve the treatment of cancer patients today and tomorrow.