Darrin Godin: Hello and welcome to Talking Hope. I'm your host, Darrin Godin. Today I'm joined by Dr. Krushangi Patel. Dr. Patel is a fellowship-trained hematologist oncologist practicing at City of Hope, Orange County's Long Beach Elm and Long Beach Worsham locations, both key parts of our regional network of advanced cancer care. She joined City of Hope Orange County because of our national reputation for pioneering clinical studies, and she's excited to bring this world-renowned care to the community. When Dr. Patel was a resident, she worked at TGen, a groundbreaking research institute that is part of the City of Hope family of organizations. At TGen, she developed a strong interest in precision medicine that continues today. Welcome Dr. Patel. We're so glad to have you on the show today.
Dr. Krushangi Patel: Thank you, Darren. Thank you for that warm introduction.
Darrin Godin: So tell us what drew you to become a physician and to specialize in cancer care?
Dr. Krushangi Patel: Yeah, so my interest in being a physician started pretty young. My family and I were going through our own medical crisis and we met a physician that was taking care of us and was really knowledgeable and really kind and caring and made what was already a daunting process, much more tangible. And not only was it great to have him and be there for us, but it's something that I've looked back to aspire to become myself. Actually one of the big reasons I actually chose oncology as well is there are a lot of sub-specialties and a lot of specialties in medicine and oncology really gets to work with patients or be with them through their journey. And we get to know family members and sometimes in multiple generations. So we really have strong relationships with our patients and their families and that's really one of the things that drew me to oncology.
The other part of course is that the scientific rigor of it. I did research at the NIH before I completed medical school and my research there was in epigenetics, which is the study of the expression or the change of expression of genes without changing the actual sequence of them. And that actually... Epigenetics really began in oncology care and it began specifically in colon cancer. And we use even now hypomethylating agents and things like that in treatment. And so had a scientific interest starting pretty early as well. And of course now is a very exciting time to be practicing oncology given all of the advancement.
Darrin Godin: Thank you. Well, you're practicing in our Long Beach locations like we talked about at the top of the show. What do you find rewarding about practicing in a community setting?
Dr. Krushangi Patel: Yeah. So being in a community where patients live and work and are, and bringing the most advanced care there is really what I'm passionate about. I think that we have really good centers, whether City of Hope or some of the other national institutes, but patients really aren't necessarily able to get to those centers and be traveling all of the time. And so it's really important that we bring that level of care really where patients live. And so growing this equitable advanced access to care is really what City of Hope is doing very well here in Orange County and I'm very excited to be a part of it. It's really amazing to see what we're able to bring patients close to home and to every type of cancer patient, which is what we do in the community is really see whoever comes in the door, whatever cancer type you have, we can really work through it and figure out what's best for you.
Darrin Godin: And tell us about precision medicine as well and how that your approach to precision medicine.
Dr. Krushangi Patel: Yeah, so precision medicine is really looking at the specific details, specifically genetically, of a patient's tumor. So that can be done through blood, it can be done through the biopsy, the tissue, as well as what we inherited from mom and dad. And so a lot of that testing is done upfront or should be done upfront to understand what that particular tumor in that particular patient is made up of. And then we use that information to help guide our treatment. And so based on what mutations are present and what we think are the drivers of that particular cancer, we can tailor therapies for patients. So it's really the future of how we're treating oncologic patients and cancer patients of all types.
And it's benched to bedside. It's made its way where before we were still just learning and sequencing these things. TGen is a big part of that and we've now began to understood not only what drives, which mutations drive specific cancer types, but also how cancers become resistant to certain treatments. And then test for those as patients progress through different cancer types and then treat the resistance mechanisms as well. So we really brought this bench to bedside from the lab bench all the way to where patients are and to treat them with these therapies.
Darrin Godin: So it's not a one size fits all for everybody. It's personalized, but it's not personalized in the sense of what you want is what you get. It's really what perhaps you need that may be different from the person next to you or somebody else receiving the same types of care. What does that mean for the patient? How does that really make a difference in a patient's care and survival?
Dr. Krushangi Patel: So precision medicine, it got its background in breast cancer. Lung cancers are the leaders in understanding what cancers are driven by, what mutations are really driving these malignancies. And so a really good example I can think of is as I had a patient who came to us having progressed on multiple lines of therapy, but the most recent line really progressing over the last year, two years and really had run out of options before she came to us. And then when I met her, we did her full precision medical workup with all of the genetic testing and found multiple targetable mutations. And so she was started in this case on a pill that she doesn't really cause the side effects that chemotherapy causes. It's something she can take at home. And we watch her closely through lab testing.
And she had a great response and really has almost no measurable disease at this point in time. Those are two of the big benefits is that it can work really effectively if we know what the cancer is being driven by and target that. And it also often is easier to take then some of the other treatment options. And so patients really get to live their lives with some normalcy and that's really what we want for our patients.
Darrin Godin: You mentioned bench to bedside. When I think bench to bedside, I also think about the work City of Hope is doing, the tremendous work that City of Hope is doing around clinical trials and the amount of research that is happening throughout our organization. I think sometimes people, they don't realize the depth and the breadth of how much research is happening across our organization. So when I hear the words bench to bedside, I also think of the things that are being developed or tested or worked on that can be brought to someone's bedside today that may not be the standard of care for many years, but they're able to access that today. So can you talk a little bit more about the importance of that as well in clinical trials?
Dr. Krushangi Patel: Yeah, so while there are some treatments that have been well understood and we're able to order them and provide them for patients, there are a lot of mutations that we don't actually have targets for already. And so bringing clinical trials, understanding them in our labs at City of Hope, both in Orange County and in Duarte, and then really understanding those mutations in the targets, the therapies that can work against them, and bringing that to all of our patients throughout our clinical network here in Orange County. That's one of the robust areas that we really work to advance.
And so we're able to really tailor and bring therapies that, like you said, are not otherwise available. So they're not approved, they're not something you can order or get off the shelf. It's something that patients have to be enrolled in clinical trials. And so we do throughout our network, have clinical trials that make those things available here in Long Beach where we have clinical trials in every cancer type and we really continue to work hard to find out what we think would be most effective against these cancers and really open those trials here so that our patients can have access to those treatments long before they have to go through the rigor of getting approval or being readily available to everyone else. And so we can afford that to our patients before it becomes available anywhere else.
Darrin Godin: And Dr. Patel, are you involved in any certain trials right now that are really exciting you or certain things that you really have an interest in that you're like, "If I can open a trial on this, I really want to be involved in this." What are some of the things that really excites you about the future as you look ahead?
Dr. Krushangi Patel: Yeah, so two of my interests are in sarcoma and pancreatic cancers. And these are areas that are in their infancy in the sense that the targets and the mutations and some of these drivers are still being researched and understood. And so often patients that have these diagnoses will have some very limited treatment options off of clinical trials. And so it's really, really important that we are able to open these trials to understand what drives these cancers and then bring those treatments through the clinical trials here to Long Beach. And so I am actually an investigator, in doing that, I have clinical trials that I'm the primary investigator on as well as many of our other trials that many of our other researchers throughout the City of Hope have open. And so we have access to all of that as well.
And then we work together in City of Hope as a team. I think that's one of the big reasons that I really like working with City of Hope is that we really work as a team. I go to weekly sarcoma tumor boards and we have physicians presenting patients and cases to discuss from Atlanta and from Chicago and from Phoenix. And so we're really able to work as a family and to bring all of that advanced knowledge, all of our experience and expertise to one another and to make decisions together to really bring the best for our patients throughout the nation.
Darrin Godin: Dr. Patel, I have a lot of friends and family members and so forth that unfortunately have needed care here at City of Hope, and thankfully I've been able to connect them in with great physicians and so forth. One of the things I've noticed is this lack of coordination in healthcare. And many people when they know I work at City of Hope and they want to get some help. As they tell their story, what you hear is just this lack of this side talking to this side or this doctor knowing that they're also going to this doctor. And as you talk about that teamwork at City of Hope, talk about what that really looks like and how does that really benefit when there's a team approach and a coordinated approach to a patient's care? What does that mean for a patient?
Dr. Krushangi Patel: Yeah. It really means that we can bring so many treatments to patients. We can create treatment plans that can have different phases where patients can get some complicated treatments, maybe at a specialized center and be there for a day or a week and then come back home and get the rest of their treatment. We have clinical trials that are open at multiple facilities and multiple sites. And so if there is something that needs to be done in the hospital, that component can be done in the hospital and then they can come back here to Long Beach and be treated for the rest of their care.
And so it means that we can bring really advanced therapies to patients. It really means that we talk to the surgeon, that we talk to the pathologist, that we talk to the radiation oncologist and come up with treatment plans together and then address bumps in the roads together. That we address obstacles, if patients aren't tolerating something well or aren't doing well in something, we think about what other opportunities or options we can bring to them. And so it really makes cancer care alive, which is really what it is. It's not you see somebody and you get a treatment and you go on your way.
We really want to hold the hands of our patients and go through every step with them, make sure they're feeling well on treatment, make sure we can bring as much normalcy to the lives of patients who are fighting cancer and now really living with cancer. We're really long times to home because that's where they're going to be for a majority of their time, and we want that to be high quality time. We want their cancer to be in control during that time, and we want to be able to bring the absolute best to our patients.
Darrin Godin: That's good news. I live close to Long Beach. I'm not in Long Beach, but I'm very Long Beach adjacent. And so I'm so happy that City of Hope, Orange County embraces the Long Beach community and the importance of the Long Beach community. I think of you being able to coordinate care for a patient and have access to the depth and breadth of all that City of Hope is such a benefit to a patient without having to drive far, whether it's to Duarte or other places.
You mentioned something that made me think about just the team approach, and I'm in marketing, so we have our marketing phrases that we use, but I really believe this one where we talked about, when cancer chooses your battles, you need to choose your warriors. And I just think of City of Hope as you don't just get one doctor. When someone comes to see you, they're getting you and all your background and all your experience and all your care and concern, but that team, again, that you mentioned, that surrounds you, you have access to 600 plus other physicians who specialize in everything under the sun and have in most cases, maybe hopefully seen most of it, and have answers and research and information to provide. So how does that make you feel being part of a system like City of Hope where you're not alone in that and you are surrounded by so many experts?
Dr. Krushangi Patel: Yeah, I think that's one of the big reasons that I really like being with City of Hope is that we have so many experts with so much knowledge and all of our experts are up-to-date. They know what's cutting edge, we're keeping up with the new therapies, the new diagnostic tests that really help us understand what happens with each person's cancer. And so it's really great conversations when I have them with other physicians. They have really great ideas to bring to the table, and they're always changing. They're never the same conversation twice. And that's really makes it exciting to work here, but it also makes it so that we really can bring the best. And you never feel like you're treating them alone and patients never feel like they're battling it alone. And that's really important.
Darrin Godin: You said a phrase earlier too that we take your hand, and you've probably heard our president, Annette Walker say, and others across the organization say this, "When we take a patient's hand, we don't let go." And I feel like we don't just take their hand, we take their family's hands as well. And thank you for what you're doing on that front. What else do you want our viewers and our listeners to know?
Dr. Krushangi Patel: Yeah. I mean, I think that's a big part of it is that when you're faced with a diagnosis like this, it can be very daunting, it can feel overwhelming. There's a lot of information and misinformation that exists out there, but you aren't alone. You aren't parsing through this information alone. We can provide support, we can provide information, we can help you understand what your cancer is made up of and what would work for you now and for you throughout your journey. And so we can continue to assess what's going on with your cancer and make sure that we're doing what's right for you throughout the entire journey.
And so I really want patients to understand that we're here really to support you and understand what you're going through, understand what it is that your goals are and help bring that to you. Whatever that takes, whether it's a clinical trial with new therapies, whether it's something very specific that's targeted to your specific cancer type, whether it's just some advice that you take with you when you leave with us. Whatever it is, we're here to provide the best for you. And that's really what City of Hope prides itself on and why I love working with this group of people and with this organization.
Darrin Godin: Well, last question for you. We ask every one of our guests this question, what does hope or the concept of hope mean to you?
Dr. Krushangi Patel: So hope to me really means having something to look forward to. And I think for our patients, that's really what we're fighting hard to do. I feel like I work every minute of every day to understand each of my patients' cancer and how I can not only treat it, but bring them the best life moving forward. Give them something to really look forward to and to enjoy. And so you'll hear me in my visits asking patients, "What are your hobbies and what do you enjoy doing? And can we make sure that you're doing more of that?" And sometimes you get a side eye, but I think at the end of the day, that reminds patients and it really helps us to center us in what we're doing here, which is really helping you to get your life back. And that's really what we're all hoping to achieve. And it's really nice to get a front row seat to see patients be able to get that.
Darrin Godin: That's awesome. A front row seat too, like we say, this is a place where we try to make sure that cancer loses and life wins. Those moments that are important to you in life will win and continue to be available to you. So Dr. Patel, thank you so much for joining us today. City of Hope is recognized as top five in the nation for cancer care by US News and World Report. And we are here for you in Orange County. We're here for you in Long Beach and across Southern California.
We are first in research, first in treatment, first in survival. When it comes to cancer, it's hope first. Visit us at cityofhope.org/oc to learn more. You can make an appointment at any of our City of Hope, Orange County locations by calling 888-333-HOPE. That's 888-333-4673. Again, I'm Darrin Godin. Thank you so much for joining us on Talking Hope and we hope to see you next time.