Quality of life matters, too: Particularly for cancers with high cure rates, it is essential that long-term quality of life be factored into treatment decisions. When faced with multiple treatment options, it is important to consider the potential long-term changes and side effects of each treatment to make a good decision. Because a cancer diagnosis is always scary, it can be challenging to keep this in mind. As people survive longer after cancer treatment, the permanent impacts of therapies can become increasingly burdensome.
Cancer is a horrible and terrifying disease. There is so much great information out there, but sometimes it is very difficult to filter out the noise. What causes cancer? Can it be prevented? How do you detect it? What are the odds of survival today? What are the different forms of cancer? What are the best treatments? And what is the best way to support someone impacted by cancer?
In this interview series called, “5 Things Everyone Needs To Know About Cancer” we are talking to experts about cancer such as oncologists, researchers, and medical directors to address these questions. As a part of this interview series, I had the pleasure of interviewing Tim Showalter.
Tim Showalter, MD, MPH is the Vice President of Clinical Development at ArteraAI. He is a board-certified radiation oncologist with 14 years of clinical experience and also serves as a professor at the University of Virginia. Tim has contributed greatly to the field of oncology with his direct contribution to over 175 peer-reviewed manuscripts and participation in numerous clinical trials.
Thank you so much for joining us in this interview series! Before we dive into the main focus of our interview, our readers would love to “get to know you” a bit better. Can you tell us a bit about your childhood backstory?
I grew up in South Carolina and Virginia. My mother was an elementary school teacher and my father sold building supplies. My interest in medicine began early, around age 7, when I accompanied my grandfather to his cataract surgery. Witnessing how much it positively changed his life, allowing him to see and read clearly, left a lasting impact on me.
During this procedure, I had the unique opportunity of being brought into the back to watch the doctors work. Witnessing the surgery firsthand was a truly memorable experience and at that moment, I knew I wanted to pursue medicine.
After graduating high school in Richmond, Virginia, I was fortunate to receive a scholarship to Washington and Lee University, where I completed my undergraduate studies. A few months later in 2000, I matriculated at the University of Virginia School of Medicine and proceeded straight through medical school, residency training in radiation oncology, and a career in academic medicine.
What or who inspired you to pursue your career? We’d love to hear the story.
I didn’t have any physicians in the family and no one in my family had ever gone to graduate school. But for me, in addition to seeing the positive impact that medicine had on my grandfather, we had an excellent family medicine doctor who took care of my entire family and served as a role model.
I got to see how a physician could have a positive impact, not only on physical challenges to health but also on mental health and life changes as well. This was an impactful example for me. I think that the desire to make a personal impact on patients is something that really carried me through both medical school and my career, and I attribute a lot of that to watching this doctor care for my family.
This is not easy work. What is your primary motivation and drive behind the work that you do?
My primary motivation is the desire to have an impact. Being able to go to work and feel like you’re doing a good job and having a positive impact on people’s lives, their quality of life, and their length of life is something that is special about medicine. I don’t think you get that in many other careers.
I think about this more now that I’m in my middle-aged, mid-career point. We’re so fortunate as healthcare professionals to be able to do that. I have friends who have been wildly successful in other industries but feel as if something is missing from their careers. The ability to feel like we’re doing a good job and helping people during the workday is really valuable.
Most of my career has been in academic medicine, and I’m still a part-time professor at the University of Virginia. I was really driven by both clinical care and research within academic medicine. The reason why I joined ArteraAI is that it provided an opportunity to make an even bigger impact for cancer globally and to touch more patients’ lives, while also improving their quality of life. It’s about ensuring that people are getting optimal therapies and making good cancer decisions.
For me, stepping back from clinical practice was about trying to have a broader impact than possible seeing one patient at a time. It’s consistent with that initial recognition early in life regarding how medicine could offer this opportunity to be a positive part of people’s lives.
What are some of the most interesting or exciting projects you are working on now? How do you think that might help people?
I think what’s really exciting about ArteraAI is that we are able, through artificial intelligence, to develop precision medicine solutions that are very decision-specific. As a clinician, when a test result comes back, you’re always thinking, “so what do I do now for this exact decision that we’re facing?”
What’s exciting about the ArteraAI Prostate Test is that we’re able to develop predictive algorithms that can be part of a patient’s decision-making process. They help them decide whether they should have treatment A versus treatment B, or if they need a more or less aggressive treatment. Those sorts of decisions are very complex and challenging for clinicians. If we can provide decision-specific insights through the AI tests, then we can help improve the quality of that decision for patients.
For the benefit of our readers, can you briefly let us know why you are an authority about the topic of Cancer?
I am a board-certified radiation oncologist with 14 years of clinical practice experience. I completed my training at Thomas Jefferson University and have since been continuously engaged as academic faculty. Throughout my career, I have specialized in genital, urinary, and gynecological cancers. I have taken the lead in numerous clinical trials and secured funding from the NIH for various grant programs. With over 175 peer-reviewed manuscripts, I feel that I have contributed significantly to this field. Additionally, I have served as the scientific lead for clinical trials at a comprehensive cancer center and acted as a principal investigator for multiple research grants. These experiences, coupled with my current role as a professor at the University of Virginia, contribute to my authority on the subject of cancer.
What is exactly cancer?
Cancer is an abnormal pathological process characterized by the rapid growth and reduced death of cells. What sets cancer apart and makes it intriguing is that it originates from our own bodies, as the host. It arises due to a dysregulation in the normal processes of cell growth and death. Distinguishing cancer from normal tissue can be particularly challenging for the immune system.
What causes cancer?
There are numerous environmental and lifestyle exposures that can increase an individual’s risk of developing cancer. However, it’s important to note that cancer has multiple causes, and it’s often not possible to pinpoint the exact cause for an individual’s cancer. Everyone is at risk of developing cancer to some extent, and it’s difficult to completely avoid it. While we can take steps to minimize our risk by adopting a healthy lifestyle, engaging in regular exercise, maintaining a healthy weight and avoiding smoking, cancer is something that affects us all as a society.
What is the difference between the different forms of cancer?
Categorizing cancers can be complex, but there are several important distinctions. As a clinician, one key differentiation is between localized cancers and metastatic cancers. Localized cancers, in general, have a higher cure rate.
Another way to categorize cancers is by distinguishing between solid tumors and liquid tumors. Solid tumors originate in body organs or tissues, while liquid tumors arise from the blood and bone marrow system. Treatment approaches vary depending on the type of cancer, with localized tumors often requiring surgery or radiation, and metastatic cancers requiring systemic therapies like chemotherapy. These are practical distinctions, although there are numerous other ways to subcategorize cancers.
How can cancer be prevented?
Cancer prevention involves managing probabilities, and there are several steps individuals can take. Maintaining a healthy lifestyle, avoiding smoking, consuming a nutritious diet with limited processed foods and engaging in regular exercise are important measures. However, it’s crucial to recognize that even with these efforts, it’s impossible to completely eliminate the risk of cancer. As a clinician, I’ve seen patients who followed all the guidelines and still developed cancer, while others who made poor lifestyle choices remained cancer-free. A cancer diagnosis is not a punishment for life choices, and support is essential for everyone facing this challenge.
How can one detect the main forms of cancer?
We are fortunate to have screening tests for many common cancers. Examples include cervical cancer, breast cancer, and prostate cancer, where screening tests can detect these cancers at an early stage. However, in terms of absolute prevention and risk reduction, certain measures are crucial. For cancers where vaccination is possible, such as cervical cancer and liver cancer, ensuring that individuals receive the appropriate vaccinations is important. Additionally, for colorectal cancer, it is essential to encourage loved ones to undergo regular screening colonoscopies to detect and address precancerous conditions. Similarly, cervical cancer screening is vital for identifying and treating precancerous lesions. Early detection is key as it leads to higher cure rates and better quality of life, while also allowing for less intensive therapies.
Cancer used to almost be a death sentence, but it seems that it has changed today. What are the odds of surviving cancer today?
In general, the odds of surviving cancer today are higher than they used to be, and they continue to improve. However, the likelihood of survival varies depending on the type of cancer. There are still certain cancers, such as pancreatic cancer and glioblastoma, where we have tremendous unmet needs and hope for significant advancements in treatment options. On the other hand, for cancers like prostate cancer and breast cancer, the survival rates have become so high for some stages that we are not only focused on overall survival after treatment but also on improving the quality of life for patients. With the ArteraAI Prostate Test, we strive to personalize treatments by matching the right patient with the right therapy to optimize outcomes based on their individual risk. We also explore opportunities to potentially omit optional therapies if it can significantly improve a patient’s quality of life.
Can you share some of the new cutting-edge treatments for cancer that have recently emerged? What new cancer treatment innovations are you most excited to see come to fruition in the near future?
One exciting trend in cancer treatment is the emergence of precision medicine-based therapies. At ArteraAI, we focus on identifying patients who are more or less likely to benefit from specific treatments, which allows us to optimize the treatment’s effectiveness and ensure it is being used in the right patient population.
In the context of prostate cancer treatments, I am particularly excited about radio-ligand therapy. This therapy involves attaching liquid radioactivity to an antibody, which can selectively target cancer cells in the body. Radio-ligand therapy has shown promising results in metastatic prostate cancer and has the potential to impact localized disease as well. It’s an exciting field that utilizes biochemistry to deliver targeted therapy to the right location within a patient’s body, ultimately improving outcomes. Ongoing research and advancements in this area offer great opportunities to use radiation therapy as a systemic approach to cancer treatment.
Healing usually takes place between doctor visits. What have you found to be most beneficial to assist a patient to heal?
I have found two things to be highly beneficial in assisting patients who are healing from cancer.
First, providing patients with information and setting clear expectations about the healing process is crucial. When patients have a good understanding of what to expect, including potential side effects and the normal recovery process, they are better equipped to handle the challenges. By discussing these details and clarifying what is considered normal or abnormal, patients can approach their healing journey with greater confidence. I encourage open communication and always make myself available for any questions or concerns.
Second, I have seen the magical impact of exercise and maintaining a sense of purpose and activity in patients’ lives. While rest is important when needed, I advise patients to engage in activities they love and to incorporate regular exercise into their routine. Exercise not only helps with physical recovery but also plays a significant role in combating post-treatment fatigue and managing the emotional aspects of going through treatment. Staying active and engaged can contribute to a better overall healing experience.
From your experience, what are a few of the best ways to support a loved one, friend, or colleague who is impacted by cancer?
From my experience, one of the best ways to support someone impacted by cancer is to help them with logistical challenges. Cancer has a way of disrupting various aspects of a person’s life, including family dynamics, transportation, and everyday tasks. By offering assistance and following through on practical matters, such as preparing a meal, making calls on their behalf (e.g., contacting their insurance company), or helping them with scheduling family events, you can greatly alleviate some of the burdens they face. These seemingly small gestures can make a significant difference for your friend or family member during their cancer journey.
What are a few of the biggest misconceptions and myths out there about fighting cancer that you would like to dispel?
As an oncologist, one of the biggest misconceptions I often hear is that it must be a depressing profession. I would like to address this myth and emphasize that being an oncologist can be quite inspirational. Being present with patients as they face a challenging diagnosis and navigate their treatment journey allows me to have a positive impact on their lives. Being a source of support, providing information, and helping patients feel better during their cancer journey is incredibly rewarding. So, contrary to the misconception, being an oncologist can be a very positive and fulfilling experience.
Thank you so much for all of that. Here is the main question of our interview. Based on your experiences and knowledge, what are your “5 Things Everyone Needs To Know About Cancer?
Here are the five things everyone needs to know about cancer:
- Cancer impacts all of us: Whether it’s a personal experience, a family member, or someone in the community, cancer is a common group of diseases that can affect anyone. It’s important for all of us to have some level of awareness regarding cancer risk mitigation and how to support loved ones who have cancer.
- Catching cancer early is crucial: Early detection and successful treatment play a significant role in cancer management. When cancer is diagnosed at an early stage, the treatment options and their impact on quality of life are generally more positive compared to advanced stages of cancer. Prevention and regular screening efforts are vital in increasing cure rates and improving overall health.
- Every cancer is different: Each cancer patient is unique, and every cancer diagnosis is different. Tumor characteristics, personal preferences, and individual views on cancer can vary from one person to another. It’s essential for patients to receive individualized information and engage in shared decision-making processes to determine the best treatment options for their specific situation.
- There are often multiple options: In many situations, there are multiple different treatment approaches to consider. For example, patients with low-risk prostate cancer can be safely managed with active surveillance, surgical removal of the prostate, or prostate radiation therapy. To make an informed decision, patients should take time to read high-quality educational materials from reputable sources (for example, from the American Cancer Society), ask questions from health care providers, and potentially seek consultations with multiple physicians.
- Quality of life matters, too: Particularly for cancers with high cure rates, it is essential that long-term quality of life be factored into treatment decisions. When faced with multiple treatment options, it is important to consider the potential long-term changes and side effects of each treatment to make a good decision. Because a cancer diagnosis is always scary, it can be challenging to keep this in mind. As people survive longer after cancer treatment, the permanent impacts of therapies can become increasingly burdensome.
You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger.
If I could start a movement that would bring the greatest good to the most people, it would be making health data more widely shareable and accessible to patients and researchers. Currently, there are limitations, such as siloed data, restrictions, interoperability challenges, and privacy concerns that hinder the progress of research and the fight against cancer. By finding ways to overcome these obstacles and enabling researchers to learn more efficiently from the healthcare system, we could accelerate advancements in improving cancer cure rates and overall healthcare outcomes. This movement would have far-reaching benefits, impacting not only cancer patients but also individuals with various health conditions. It would promote collaboration, knowledge sharing, and ultimately lead to better healthcare for everyone.
Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.