Darrin Godin: Hello and welcome to Talking Hope. I'm Darrin Godin and I'm pleased to be speaking with father and son, medical oncologist and hematologist Dr. Simon Tchekmedyian and Dr. Nishan Tchekmedyian, both who practice together at City of Hope, Orange County, Lennar Foundation Cancer Center. Dr. T and Dr. Nishan, it's so great to have you here today.
Dr. Simon Tchekmedyian: Great to be here.
Dr. Nishan Tchekmedyian: Thank you, Darrin.
Darrin Godin: So great to see father and son working together in the same area. Dr. T, I'm sure it has been incredibly rewarding to work with your son. Can you tell us what was your journey to getting into medicine and what has it meant to you to see your son follow in your footsteps?
Dr. Simon Tchekmedyian: Well, I knew I wanted to be in medicine and particularly in cancer care very, very early on in my life. I think my father had an influence on me in that regard. So when I was a kid, cancer was really a very bad disease that had very few options for intervention. And over five, six decades, things fortunately have changed tremendously for the better. And there is a full speed ahead now with the new technologies that allow us to have hope.
Darrin Godin: Awesome. And did you say your father had an influence on you? Was he also a physician or?
Dr. Simon Tchekmedyian: No, he actually had to emigrate from Armenia at the time when he was about to enter medical school. And because of the circumstances, he went to South America, started to work there and was unable to pursue an education in medical school. But he sure made an effort to have his kids do that.
Darrin Godin: Oh, that's awesome. And so you obviously have done the same thing for Nishan. So what has that meant to you to see him follow in your footsteps?
Dr. Simon Tchekmedyian: Well, Nishan joined me for rounds at the hospital when he was a toddler. The nursing team was very familiar with him there. And also twice a year we had events with our patients where we all got together. So my patients saw my children grow, and that was a very good way for them to see what was the relationship really, the human level contact that I had with my patients. I think that played a role in their interests and in their vocation.
Darrin Godin: And Dr. Nishan, what are your memories as a child and what led you to make the decision to pursue medicine and specifically oncology?
Dr. Nishan Tchekmedyian: Well, I certainly remember going on rounds with my dad at the various hospitals, but especially in Long Beach where we were largely based. And I remember playing around the nursing stations, which is something that I don't think would be allowed anymore. But there are the shoots that send medications and other things up and down different floors in the hospitals, which are still used in hospitals today.
And at that time I would just send things up and down to different floors and it was a great time. But in the process, as I got older, I also got to see glimpses of things going on that were very difficult and conversations that were very difficult. And my dad took care of a lot of people who were very close to us and important members of the community. And so I also knew many of them.
And so I got a very close-up intimate view and eventually understanding of what it meant to take care of a patient. And it had to do, of course, with medicine and science and using the latest data and best therapies and also clinical trials, but it also had to do with how one approached the patient and really learning to listen.
And I think that's probably the biggest lesson that I've learned is to learn how to listen first. And it's difficult to do because we live in an environment that is so distracting. In fact, it's often hard to manage our own attention. But listening to our patients is something that we do here and that we strive to do at City of Hope.
Darrin Godin: Great. So it sounds like you learned a lot from your dad and obviously, you've learned a lot in your studies and you bring your own experience to the table as well. I'm wondering, what do you guys have in common in terms of your approach to care delivery?
Dr. Nishan Tchekmedyian: Well, I think we keep-.
Darrin Godin: [Inaudible 00:05:58] Go ahead.
Dr. Nishan Tchekmedyian: Yeah. We keep the patient at the center of what we do. And I think fundamentally, we're constantly working on communication and communicating not only with the patients, their families, their loved ones, their partners, but also communicating with the medical, with the practitioners, the physicians that we're working with, with the primary care doctors who are so important in the infrastructure of our healthcare system and so important to our patients, to keep everybody informed and to collaborate collectively to get a holistic picture of what's going on with the patient. Not only medically, but also in their lives, socially, understanding their motivations and preferences so that we can individualize the care of the patient one by one.
Darrin Godin: And Dr. T, you were going to add?
Dr. Simon Tchekmedyian: Yeah. I think one of the most important aspects and traditions in medicine is to teach. And there's no better way to learn than to teach. And one thing that has happened in the evolution of our relationship with Nishan is that you teach, but at the same time you learn and you, and talk about listening, you start to give very great importance to listen to your son. Because you, as time evolves, you will learn from your children. I think that's a message that I have for any parent, make sure to listen because you will learn.
Darrin Godin: It's beautiful. Beautiful. So let's talk about your actual specialties. Dr. T, what is your specialty and where have you spent the most of your time in the area of research as well?
Dr. Simon Tchekmedyian: Well, research at this point has accelerated. It's a really, the most important factor when you think about hope, because you have to think about not only the importance of the research for an individual patient, which is always front and center in our minds, but the activity at City of Hope with incredible scientists in the lab performing studies now that lead to options for intervention with very specific drugs that can attack weak links in cancer cells, drugs that can influence our own immune systems to harness that power to kill the cancer cells.
Those scientists are working hand in hand with us, with the clinicians at the bedside. So that now that synchrony, that dynamic interaction is leading to clinical trials that not only offer hope to individual patients, they offer hope to all of us as a society to cure cancer, to increase the percentage of patients who can put cancer behind, and also to lead to preventive and early diagnosis interventions that are becoming so, so important as we move forward. And that's certainly the mission of our Irvine Cancer Center, the Lennar Foundation Cancer Center that is now providing these services.
Darrin Godin: Thank you. And what about you, Nishan? Talk about your specialty and areas of research that you've been focused in as well.
Dr. Nishan Tchekmedyian: I'm a general medical oncologist and hematologist. So my clinical practice has patients with a variety of illnesses, but I do have some disease leaning interests and I do clinical trial work in lung cancer and in prostate cancer. In clinical trials, I'm focused on precision medicines. Those are oftentimes pills that target specific genetic mutations that happen in different cancers and also in immunotherapy methods to treat different types of cancers.
We're finding as a general oncologist, that's exciting because we find that some of the genetic mutations apply not only to one type of cancer but to multiple. So you may have, for example, a breast cancer that's driven by an alteration or a mutation in a gene called HER2, but you may have a lung cancer that's also driven by a similar alteration in the same gene.
And you may have a colon cancer that is also driven by a similar genetic mutation. And so it is from a scientific standpoint and also from a clinical standpoint, it's nice to be able to make those connections and see patients and help patients and apply these concepts across multiple cancer types.
Darrin Godin: So this is probably a good time to ask this question, between the two of you, you have so many years and decades of experience, a strange way to ask it, but what excites you about the future of cancer prevention and cancer care?
Dr. Simon Tchekmedyian: Well, it's a very exciting time to be in oncology. And the greatest area of research now is, as Nishan said, precision medicine where we are able to really identify targets in cancer cells that are very specific and avoid the side effects on other tissues.
But also very often in combination now with immunotherapies, drugs that influence the immune system. Cancer killer cells are prompted to identify the cancer that was hiding before, but now is revealed to the immune system so that the cancer cell is attacked. And the combinations of these interventions are leading to really very big advances in the ability to treat cancers. I think that that's what is exciting. We talk about it all the time.
Just in the last day I had a colleague whose brother had a recurrence of a cancer that was being treated somewhere else. And through discussing that with Nishan and then through a couple of communications with our colleagues at City of Hope, we already have a path, an intervention possible in the clinical trial setting that could really offer hope to that patient.
Darrin Godin: That's incredible. That's incredible. Nishan, would you like to add anything to that?
Dr. Nishan Tchekmedyian: Yeah. I agree with all that. You also asked about prevention. I think there's so much work being done in prevention, in understanding the risk factors for cancers, both external risk factors, but also risk factors that we might be born with, which are hereditary or we call them germline mutations in certain genes.
We have a great genetic counseling department that the City of Hope, Orange County, Lennar Foundation Cancer Center. And we work with them very closely because we really do want to prevent cancers in general, but also for our patients and their family members, these types of services are very important. We're getting more and more precise with that technology. We're able to use a saliva swab or even just a fairly simple blood test, draw and test to get that, garner that information. And that's been very helpful and very exciting.
Darrin Godin: That is exciting. And it really demonstrates what we mean by when we say hope is here, that there truly is hope for people who either are already diagnosed or there's hope for people to never have that diagnosis if they're doing the right thing. So thank you both for that. I want to know now, you both have used the word hope several times, so let's start with you, Dr. T. What does the word hope mean to you? What does the concept of hope mean to you?
Dr. Simon Tchekmedyian: Well, it was, I think about four or five weeks ago that one of our colleagues during our Friday research meeting for early interventions presented some information about a patient who really seemed entirely hopeless in terms of achieving any kind of control of a very, very advanced recurrent refractory cancer.
He went through the process that he followed at City of Hope in designing an intervention for her and how that was implemented and all of the barriers that had to be gone over in order to deliver that therapy. And then the patient went into a complete remission. It is truly nearly miraculous, but it's not a miracle. It's hard work by incredibly talented people, doctors who are working to provide hope, when hope seems to have been lost. And we're very proud of that.
Darrin Godin: Thank you. And same question to you, Nishan. What does hope mean to you?
Dr. Nishan Tchekmedyian: Hope to me means the connection that we have with our patients because that's really what provides the hope, is understanding the individual in front of you and understanding all the aspects or as much as you can about their lives is so important. And that connection and that understanding that as their doctor we're going to do whatever it takes, gives hope.
Darrin Godin: Beautiful. Well, Dr. T, Dr. Nishan, both oncologist, both doctors, but at the very core, you're a father and son working together. What a tremendous legacy it is that you've established Dr. T, for your son and for others of bringing hope. And now to see your son continuing in those footsteps and also bringing hope, it just has to be something that your family is so proud of. So we're glad to have you both practicing here at City of Hope, Orange County, and we're glad to have you both as our guest today on the podcast. Thank you for being here today.
Dr. Simon Tchekmedyian: Thank you.
Darrin Godin: All right. And thank you for all the rest of you who have tuned in. We hope that you'll join us next time on Talking Hope. Until then, I'm Darrin Godin. We'll see you next time.
