Associate Professor Eva Segelov is a Sydney-based medical oncologist with expertise in the diagnosis and management of upper and lower gastrointestinal cancers and breast cancer. She is also an academic and has had a firsthand role in inspiring the next generation of doctors — a role she believes can sometimes teach her more than it teaches her students
I have several hats that I constantly juggle: medical oncologist at St Vincent’s Hospital, Sydney, clinical academic as associate professor of medicine at the University of New South Wales, and principal investigator on a number of oncology clinical trials.
In medical school, despite having an inspirational bedside tutor who was an oncologist, I thought oncology was a futile specialty that consisted of torturing patients with unnecessary and inactive treatments. I diligently avoided an oncology rotation until I was a resident medical officer when that same tutor insisted that I be placed in an oncology term.
From the first day, I knew that it was the specialty for me. I remember being in outpatients and seeing what a difference treatment made to patients, and how much impact you can have on the lives of patients and their families by the way you communicate and interact with them. The fact that it is not a specialty dealing with trivialities, and the multidisciplinary nature of the specialty, all make it rewarding. Holistic care is paramount and constantly throws up new and challenging situations. For example, I have a patient with brain metastases from Ewings sarcoma whose wife could not find a general practitioner in her area who was accepting new patients. I was able to ring the doctor she wanted to see and explain the situation and she kindly took on care of them immediately.
Life as a clinical academic is a hard road, as you are expected to participate in teaching and research as well as maintaining a clinical practice. As a woman (it is still true) it is always harder to be recognised for your achievements and gain senior leadership.
There are many challenges that come with the job. Having patients die is hard but if you have defined for them and their families (as well as yourself) the parameters of what is and isn’t possible, then it becomes bearable. Keeping up with current literature in oncology is a huge task. Finding time for the gym is also a challenge, but, as I am a huge advocate of lifestyle change for patients with cancer, I have to put my money where my mouth is.
I most enjoy my involvement in clinical trials. In the past year, I was fortunate enough to lead (with my Melbourne colleague Jeremy Shapiro) an academic translational research study called the ICECREAM (irinotecan cetuximab evaluation and the cetuximab response evaluation among mutants) trial, for patients with advanced colorectal cancer whose tumours bear a certain molecular profile. We developed the idea, obtained the funding, and were able to commence the trial across Australia and at three European sites, under the banner of our highly active national trials consortium, the Australasian Gastro-Intestinal Trials Group. I have just been in Europe setting up the sites and the buzz of being able to bring from birth through to implementation an academic question to help patients is incredibly exciting. For Australia to be the lead for the internationals shows we are up with the best in oncology translational research.
I have always loved teaching students. There is no greater role as no one person lasts forever. The way to leave a legacy is to impart your knowledge (especially your mistakes) to those coming after you. Medicine has changed enormously. The technological revolution and the era of molecular medicine sometimes mean that students teach me more than I teach them. I am renowned for not really caring about “facts” but concentrating on the process of developing clinical reasoning.
My first mentor, the one who “forced” me into oncology, was Derek Raghavan, now head of oncology at the Cleveland Clinic in Ohio, United States. I share with most oncologists of my generation much nurturing from Alan Coates AO, a doyen of Sydney oncology. Professor Dorothy Keefe from South Australia is an inspiration and her advice on a plane trip has kept me believing that perhaps the glass ceiling can be broken.