Ask the Experts

4 Questions With an Oncologist



Radhika Rachamalla, MD
More about Dr. Rachamalla

What inspired you to work in the field of medical oncology? Why do you love what you do?

I have been in practice since 2004, and I’m very excited to be a physician in this specialty. I got interested in oncology during my 3rd year of medical school, when my mom was diagnosed with breast cancer in her 40's.

Helping her through her treatments and doctors’ appointments made me understand the multifaceted nature of cancer care; and I found it intellectually and emotionally rewarding. I find the specialty very dynamic with new therapies coming out every month. We are now moving away from a one-size-fits-all chemotherapy approach into a more targeted approach with drugs, including immunotherapy, drugs directed against specific molecular targets, growth receptors, monoclonal antibodies, and beyond. In addition to being very effective, these drugs also are well tolerated, with only a small percentage of patients experiencing serious side effects.

We are in a very exciting era of immunotherapy, which is quickly becoming frontline therapy for various cancers, including lung cancer, kidney cancer, and melanoma. In addition, we’re using various molecular targeted therapies, including tyrosine kinase inhibitors, which have already been approved to treat cancers and leukemias.

 

Can you discuss the basic distinctions among medical, surgical and radiation cancer treatments?

Cancer treatment is multimodal. It includes surgery, radiation and systemic therapy. Surgical treatments remove or debulk the tumors. They serve as a primary curative option as well as a palliative option to help with local complications. Radiation therapy helps to further improve outcomes after surgery. It’s used in combination with chemotherapy to increase tumor kill, to improve disease control rates and to reduce local complications, such as bleeding, pain and obstruction. Systemic therapy consists of drugs, which are given either intravenously or orally. Once in the blood stream, the drugs make their way into various organs and attack cancer cells. Sometimes, we use chemotherapy or radioactive agents instilled directly into the tumor or into the blood vessel supplying the tumor.

 

How do you develop a cancer treatment plan? What’s involved?

We develop a multimodal plan based on the type of cancer, the organ involved, the stage of the cancer, the patient’s general health and age and other factors. For instance, we look for specific markers—like hormone markers and Her-2 receptors for breast cancer. We search for mutations in lung cancer, melanoma, leukemia, and sarcomas.

At our institution, we have a multidisciplinary tumor board, where all surgeons, radiation and medical oncologists meet along with our pathology and radiology colleagues to review and make a treatment plan. We take into account family history to assess genetic risk not only for the patient but also their family members. We are also cognizant of the socioeconomic burdens of cancer, so our social workers are always there to help.

 

What do you wish patients (and their families) knew about cancer treatment—that most people don’t know?

There is a misconception among public that cancer is often related to family history. The truth is that 80-85% of the time, cancers are sporadic, meaning they’re caused by molecular changes that happened during your lifetime. The key to best cancer outcomes for most cancer types is early detection. So I urge patients to undergo age-appropriate screening with mammograms, colonoscopies, pap smears and skin exams. Equally important is to maintain a healthy lifestyle. Avoid smoking, limit alcohol use and red meat consumption, perform regular exercise and avoid obesity.


Vassar Brothers Medical Center
45 Reade Place
Poughkeepsie, NY 12601
845-483-6001
TTY /Accessibility: (800) 421-1220
www.healthquest.org/cancer
 


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