2023 Association of American Physicians Elected Member: Patricia A. Ganz, MD
Patricia A. Ganz, M.D., a medical oncologist, received her B.A. magna cum laude from Harvard University and her M.D. from the University of California at Los Angeles (UCLA) School of Medicine. She completed her training in internal medicine and hematology/oncology at UCLA Medical Center and has been a member of the UCLA School of Medicine faculty since 1978 and the UCLA School of Public Health since 1992. Since 1993, she has been the Associate Director for Population Science at the Jonsson Comprehensive Cancer Center. In 1999 she was awarded an American Cancer Society Clinical Research Professorship for “Enhancing Patient Outcomes across the Cancer Control Continuum.” Dr. Ganz was elected to the Institute of Medicine (IOM) in 2007, now the National Academy of Medicine (NAM). She served on the National Cancer Institute Board of Scientific Advisors from 2002-2007 and on the American Society of Clinical Oncology (ASCO) Board of Directors from 2003-2006. She received the American Cancer Society Medal of Honor in 2010. Dr. Ganz received the Komen Professor of Survivorship Award 1999-2000, and was a Komen Scholar from 2009 to 2019. Her research program has been funded by the Breast Cancer Research Foundation (BCRF) since 2001 and she has been a member of the BCRF Scientific Advisory Board since 2012. In 2005, she received the Jill Rose Award from the BCRF. She has received many other national and international awards recognizing her research on the quality of life outcomes in breast cancer patients and for her pioneering work in cancer survivorship.
Dr. Ganz has served on four NAM consensus committees: From Cancer Patient to Cancer Survivor, 2005; Cancer Care for the Whole Patient, 2008; and Delivering High-quality Cancer Care, 2013, which she chaired, and in 2021 on a Consensus Study Report on Diagnosing and Treating Adult Cancers, a report prepared for the Social Security Administration, 2019-21. Dr. Ganz is a pioneer in the assessment of quality of life in cancer patients, and has focused much of her clinical and research efforts in the areas of breast cancer and its prevention. At the Jonsson Comprehensive Cancer Center, she leads the Cancer Control and Survivorship Program. Her major areas of research include cancer survivorship and the late effects of cancer treatment, measurement of patient reported outcomes in clinical treatment trials, and quality of care for cancer patients. From 2017-2022 she served as the Editor-in-Chief of the Journal of the National Cancer Institute, and she is the current editor of the Survivorship Section of UpToDate.
The Road to the The Association of American Physicians… In Conversation with Dr. Patricia Ganz
Dr. Ganz shares the experiences which have influenced his career in research and medicine, as well advice for the future leaders in medicine.
What events in your life led you to pursue a career and/or research in medicine?
I am a native of Los Angeles. My parents moved to California from Michigan 6 months before I was born. This was post-war Los Angeles, and my mother always told me that being a native was very special, because almost everyone in California had moved here from somewhere else! My father had graduated from the University of Michigan Medical School in the late 1930s and he was the person who always suggested that I should consider a career in medicine. However, he hinted that radiology or ophthalmology would be a good career choice if I wanted to have regular hours (the subtle message that medicine would be a difficult occupation for a woman if she wanted a family). He had general medicine training and ran an urgent care facility in the industrial section of Los Angeles, where he took care of injured workers from meat packing plants and other industrial facilities. Everything was billed through a worker’s compensation fee schedule, and I spent several summers as a young girl doing office work and seeing what went on there. This was just before the advent of the federal legislation that established Medicare, and even at that early age, I was aware about how paying for medical care was a challenge, with most care being delivered in the hospital since people would be hospitalized for routine work-ups as there was no outpatient insurance coverage. It is possible this sensitized me at an early age to the challenges of health care delivery, setting the stage for my future research interests in health services research and health policy.
My father also provided some regular medical care to patients, including some minor surgery (hernia repairs, appendectomies) and sometimes our family would have to wait in the car while he went into Temple Community Hospital in central Los Angeles to check on a patient. He was also very proud of UCLA Medical School, even though he was not affiliated with it, and I remember driving up to the front of the main hospital entrance in the Center for the Health Sciences [CHS] (there was no plaza or parking structure in front of the building; patients were dropped off at the front door) when he wanted to show UCLA to out of town visitors. I also spent several summers during college working as a volunteer in a pediatric cardiology research lab, where in 1968 I met my future husband, Tomas Ganz, when we both had California Cardiology Association summer fellowships. After graduating from Radcliffe College (Harvard University) in 1969, I entered UCLA Medical School as one of only three women in a class of about 125. So you can see, I have had a long association with the medical school and the CHS building, where my current research office is housed.
In spite of doing cardiology research before and after entering medical school, I ultimately made the decision to become a medical oncologist. This occurred after being exposed as a resident to a new hematology/oncology division chief who had been recently recruited to UCLA, rotating through the newly established oncology ward, and seeing the expansion of new cancer therapies as part of the recently signed National Cancer Act of 1971. Cancer treatments seemed to provide much greater potential for cure than what was available for the management of advanced cardiovascular disease (this was before the availability of good hypertension medications and statins), but I had underestimated the future role of prevention in cardiology. In oncology, drugs like cisplatin and doxorubicin had just come on the scene, leading to cures of testicular cancer and some lymphomas. I was also attracted to medical oncology because of the important role of internal medicine in cancer patient care, from diagnosis through management of treatment complications. Focusing on the whole person in cancer care delivery was important to me, and early on I had an interest in the psychosocial aspects of cancer care. This was enhanced by my interactions with a very strong clinical consultation liaison service staffed by psychiatrists and psychologists at UCLA who focused on the behavioral and mental health complications of medical illness. They helped in the day-to-day care of seriously ill patients and exposed many clinicians to the value of collaborative care.
What are some of the challenges you have had to overcome on this journey and what did they teach you?
I will not dwell on my various leadership roles and academic and hospital positions preceding my current position, but I do want to reflect on what it was like almost always being the only woman in the room for many years, and starting a career just as the feminist movement was emerging in the early 1970s. I came from a family of strong and successful women who primarily worked in a family business while also raising their children. When I was applying to medical school, women still were infrequently accepted and young schools like UCLA were reluctant to take a risk filling slots with women who were thought to be at high risk for drop-out or not fulfilling the career that men would have no trouble doing. My interview at UCLA was with a senior gynecologist who had actually taken care of my grandmother and mother. He directly said to me that he was not worried about me being a risk for drop-out, as he knew my family and the work ethic of these women. This interview was mild compared to “stress interviews” that some of my Radcliffe classmates were subjected to.
During medical school, I was always afraid to miss class, because I was sure that someone would notice my absence, when in fact, I don’t think anyone cared. My class notes were in demand (I was smart, reliable and always in class), and in spite of being only one of three women, I made friends and had good relationships with my classmates. Our histology professor was a misogynist who interspersed Playboy pinups in between tissue photomicrographs to keep the guys awake, and he was only finally dismissed from his position several years later when the number of women in the medical school class had grown to about 25. I can say that while these kinds of things were not infrequent, I did not personally suffer very much as a result. I was a top student and was always confident that my performance and merit would overcome most barriers, and to some extent that has always been my strategy.
What inspires you to do the work that you do?
Overall, I have been extremely fortunate to carve out a career as a physician-scientist that has allowed me to combine my passion for clinical care, teaching and research in oncology. From the very beginning, it was my observations about cancer and its treatment that made me focus on the whole person and their experience with the disease. This occurred at a time when only small numbers of patients were expected to survive. From my first academic appointment onward, I focused on the importance of palliative care and rehabilitation as being the cornerstones of high-quality cancer care. Along the way, I benefited from professional engagement with psychologists and psychiatrists who schooled me in the tools of social science research and with whom I did my early research and received my first federal grants. Early on, I recognized the critical need for collaborative team science, and that has continued until the present time. Doing this type of research was my passion, and I was one of the early leaders in field of quality of life research, especially focused on the experience of cancer patients in clinical trials. As I moved forward in my research, it became critical to develop interventions to mitigate persistent symptoms experienced by patients and to develop a better understanding of why some individuals suffered while others did not, even with similar treatments. A focus on host factors—characteristics of the person—has been one of the hallmarks of my research, with an idea that understanding who is most at risk could prevent subsequent morbidity. Along the way, this was translated into a new movement that has focused on cancer survivors—only about 3 million in the US when I started my training, and now over 18 million. I was privileged to be a part of this new movement when in 1986 the National Coalition for Cancer Survivorship (NCCS) was founded by a small group of patients, advocates and physicians.
In 1992, with a mid-career move to the UCLA School of Public Health and the Jonsson Comprehensive Cancer Center, I began to focus on research and policy activities related to the well-being of populations at risk for cancer, as well as people with the disease. I am grateful for having had the Institute of Medicine [IOM] (now National Academy of Medicine) as a platform for some of these activities. I have served on four IOM consensus studies all related to cancer and quality of care, and spent more than a decade (2005-2016) as a member and then Vice Chair of National Cancer Policy Forum. These activities have been among the most important of my career, with key opportunities to translate research into policy.
What would you want others reading this to know?
I want to speak to my love of mentoring and how that has been a central component of my role as the Associate Director for Population Science research in the Jonsson Comprehensive Cancer Center for the past 30 years. This is a research administration role, but it is first and foremost a mentoring and connecting role. Working with senior and junior faculty, medical students and residents, as well as fellows, has been a privilege and one that I take very seriously. Because of the reach of the cancer center across the campus, and engagement with many schools and departments, I have interacted with many young people who are interested in careers focused on cancer. Giving back what I have learned about conducting population science research, helping others to find a problem that they are passionate about studying, and how to pursue high quality collaborative and translational research has been a great privilege for me.