It's a diagnosis everyone fears, but Tennessee Oncology and Sarah Cannon physician-scientist Erika P. Hamilton, MD said advances in clinical care and research are helping turn the tide on cancer.
A principal investigator and director of the Breast Cancer and Gynecologic Cancer Research Program for Sarah Cannon, Hamilton has seen significant strides occur throughout her career. Without question, she noted, "Cancer is still a scary word." However, Hamilton stressed, "The majority of women who are diagnosed with breast cancer go on to lead happy, full, cancer-free lives."
Hamilton, who is board certified in both internal medicine and medical oncology, grew up with a love of science during her childhood in Charlotte, N.C. "I was kind of one of those annoying children who knew they wanted to be a doctor around fifth grade," she recalled with a grin.
Always fascinated by the 'why,' Hamilton credited her middle school science teacher with encouraging her curiosity. "The dissection of the frog brain wasn't part of the program, but he let me do it ... and I was hooked," she said.
After undergraduate at Washington and Lee University where she was a collegiate tennis player, Hamilton returned home for medical school and residency at the University of North Carolina in Chapel Hill, followed by her fellowship training in hematology and oncology at Duke University.
Originally, Hamilton said she thought she would be a pediatric surgical oncologist, but she soon found she preferred the interactions that come from working with adults. "As I got older, I realized I like the conversations with patients," she said. "I like giving them information and the confidence to make decisions that are right for them."
What's right, she continued, depends on each unique patient and their specific set of circumstances. Hamilton said she and colleagues have come to learn there is no "cookie cutter" approach to cancer. "What I think is exciting about oncology is the development of true personalized medicine," she said. "We've gotten a lot smarter about tailoring treatment to an individual person and her cancer."
Hamilton said molecular profiling and Oncotype testing have been game-changers in the approach to treatment. She added that each year brings new discoveries to refine the science and move it forward to the benefit of patients.
For hormonally driven cancer, she said Oncotype testing could help physicians make decisions about whether or not chemotherapy is necessary. "We've all known that sometimes we were over-treating cancer," she continued. "To spare someone with early stage cancer from chemo is a huge win."
Similarly, molecular profiling allows scientists to look at DNA in an individual's cancer to determine if there is a specific pathway to target. "A lot of times those pathways can be targeted with pills or medicines that are not chemotherapy and are better tolerated," Hamilton said.
With equal passion for research and patient care, Hamilton divides her time pretty evenly between both. It was the seamless melding of the two that drew her to Nashville in 2013.
"I was really drawn to Sarah Cannon for the research opportunity," she said. "We're uniquely poised to bring new clinical trials and therapies to people where they live in their community."
Hamilton said she loves disseminating state-of-the-art cancer care to individuals through the Sarah Cannon network instead of requiring all patients to make the trek to a single academic center. She added, clinical trials are conducted at multiple sites including locations in Texas, Oklahoma, Colorado Missouri, Ohio, Florida and even London, which is part of the Phase I Unit.
"I think the most exciting part of the Phase I Unit is seeing patients have access to new drugs for the first time," Hamilton said. Equally thrilling, she continued, is to look at new schedules and combinations of drugs already in use to increase efficacy.
With more information, however, comes more national discourse over what is exactly the best plan of action. Hamilton said one frustration is the mixed messages healthcare professionals are giving women, particularly when it comes to mammograms. She said the recent public wrangling over the optimal age for mammograms might have had unintended consequences.
"I think women walked away thinking maybe mammograms aren't as important as they really are, which wasn't supposed to be the message at all."
A believer in mammograms starting at age 40, she noted, "We've seen a lot of young women whose lives were saved by early mammogram." However, Hamilton was quick to add there are a number of factors that enter the decision about when to begin the screening. "It's really an individual conversation with a woman based on her risk factors, her family history, and her preferences," she noted.
Making the move from North Carolina to Nashville has turned out to be satisfying both professionally and personally. Hamilton and husband Justin, a pilot with both commercial and U.S. Air Force flight experience, have embraced their new hometown. "It reminds us of the Research Triangle," Hamilton said. "Same I-40 traffic, a little better food scene, and definitely better music scene ... I think we're pretty permanent transplants."
When she isn't tracking down new leads to improve cancer treatment, Hamilton is chasing after a busy toddler at home. "We have a little girl, Patten, who is almost three," she explained.
While time at home is a big priority for the young family, Hamilton said she and Justin are always up for sampling the city's many restaurant options. "We love the Nashville food scene." The hockey fans - Justin played collegiately for the U.S. Air Force Academy - also love cheering on the Nashville Predators.
Their happily hectic life is about to get even busier. "We are expecting our second ... and final ... baby in November," Hamilton said with a laugh.
She doesn't take the gift of family, friends and a fulfilling career for granted. Hamilton knows progress being made labs and clinical trials across the country give the millions of Americans battling the 'C' word a better chance to enjoy those same kinds of priceless, everyday moments.