Oncology Fellow Advisor presents our Day in the Life series. In each segment, we interview a prominent thought leader about how he or she got into the field of oncology and his or her typical workday.

In this issue, we interview Brian Lawenda, MD, clinical director of 21st Century Oncology in Las Vegas, Nevada, adjunct assistant professor in the Department of Radiation Oncology at Indiana University School of Medicine in Indianapolis, Indiana, and founder of IntegrativeOncology-Essentials.com. We are thrilled to include an oncologist  who is a social media enthusiast in this series.

If you would like to nominate someone to be interviewed for our Day in the Life series, please send your nomination via email to oncologyfellowadvisor@mcmahonmed.com.

Oncology is a broad field with a variety of subspecialties for oncologists to choose from that best suit their interest and skills. For Brian Lawenda, MD, radiation oncology was where he discovered how he could merge his passion and skill for helping patients. Originally, Dr. Lawenda pursued a medical degree with the expectation of becoming a family practitioner. After attending medical school at Temple University in Philadelphia, Pennsylvania, Dr. Lawenda joined the Navy. He spent one year interning in Hawaii where he oversaw health care for all the ships docked in Pearl Harbor. He also served as the staff doctor for the television show “Baywatch Hawaii.”

However, it was during this time that Dr. Lawenda realized he wanted more from his career and began to look at other medical specialties. “In medical school, we blast through everything so quickly that you don’t have too much time to figure what it is that you want to do.” He was very appreciative of having a couple of years to move around in the general medical world to get to know himself better and figure out what it was that interested him.

“I’ve always been interested in electronics,” said Dr. Lawenda, explaining how he built all sorts of electronic equipment for the Scripps Institute of Oceanography during his college days at the University of California, San Diego’s Revelle College in La Jolla. It was his interest in technology that led him to research areas that melded medicine and technology. During rotations at the Tripler Army Medical Center in Honolulu, Hawaii, he discovered radiation oncology and met a radiation oncologist who inspired him. “I loved what she did every day; she was able to spend lots of time with patients and it just seemed like a really great way to mix technology with patient care, in a way that was very, very personal.”

After informing members of the Navy about his intention to pursue radiation oncology, he met a doctor who continues to be his mentor to this day: Peter Johnstone, MD, FACR. According to Dr. Lawenda, his mentor was the specialty leader for radiation oncology in the Navy. Today, Dr. Johnstone is chairman of radiation oncology in the Department of Radiation Oncology at Indiana University School of Medicine in Indianapolis, Indiana. Dr. Lawenda began to get involved in research and published several articles alongside his mentor. He then was accepted into Harvard Medical School and Massachusetts General Hospital’s radiation oncology residency program, where Dr. Lawenda served as chief resident of the Harvard Combined Radiation Oncology Program. His research included studying the amount of radiation that causes permanent hair loss in patients and examining the effects of antioxidants during radiation treatment.

Today, Dr. Lawenda works as the clinical director for 21st Century Oncology in Las Vegas, Nevada, the largest radiation oncology provider in the world. 21st Century Oncology has 4 offices in Las Vegas alone, as well across the country and even locations in Mexico and South America.

Typically, Dr. Lawenda said, his practice treats about 20 to 40 people per office. His daily routine often involves meeting with patients and his partners in consultation to create a plan for treatment. Usually treatment is some combination of surgery, radiation, and chemotherapy, so Dr. Lawenda and his colleagues work with other specialty providers—surgeons or medical oncologists—to develop a game plan. Once treatment has begun, they keep a close eye on the patient. “Each week, we see all of our patients under treatment and then we see patients in follow-up after treatment is over indefinitely; once we’ve radiated a patient we follow them for years,” explained Dr. Lawenda.

As part of treatment, Dr. Lawenda and his colleagues provide status checks for each patient. “Status checks are what we call visits with patients under treatment to see how the treatment is going for them, see if they have any side effects, ask what we can do for them to make it easier for them to get through treatment.” His week also includes a variety of planning meetings and tumor boards, when he and other specialties meet to discuss treating patients with certain care plans.

A new aspect of Dr. Lawenda’s routine involves his second oncology specialty as an integrative oncologist. IntegrativeOncology-Essentials.com (IOE) is a website that Dr. Lawenda designed and launched to provide information for patients living with a cancer diagnosis.1 “I had been interested in trying to figure out how to get timely information on integrative modalities to my patients,” said Dr. Lawenda. He explained that the information on IntegrativeOncology-Essentials covers a wide variety of topics that are helpful to patients with cancer. Topics include:

·         Discussion of how supplements may interact with treatment in either a positive or negative manner

·         Techniques for patients that can be helpful to reduce side effects and symptoms during treatment, including meditation, acupuncture, and massage.

“[The website] allows me to share this information with my patients in one location. I can refer them to [IntegrativeOncology-Essentials.com] for more details and to obtain the latest updates. Thanks to search engines, IntegrativeOncology-Essentials has grown its audience well beyond my practice. It is now one of the most popular sites on this topic.”

The website’s quality and popularity recently brought it to the attention of members of the board of the Society for Integrated Oncology (SIO). Dr. Lawenda recently demonstrated his site at the SIO national conference. “I am able to get information out to people that is timely and easy to implement. It is working great. Patients are [visiting the site] from all over; it allows me to reach a much greater audience.”

One of the ways he is able to spread this information is through social media. He says Facebook has been the best way of spreading the information to people. Currently the IOE fan page has over 1,200 “Likes.” Dr. Lawenda said that people tend to trust their colleagues, family, and friends, so they are often interested in things that they post online. In a recent article on MedCityNews.com, Dr. Lawenda was tapped as one of 8 “great cancer experts, innovators and advocates to follow on Twitter” as well.2

Dr. Lawenda suggested using social media to follow the news related to a person’s interest. He uses a variety of news feeds and Twitter accounts to keep up to date on newly printed studies published in places like The Red Journal. He said he checks these venues each day, multiple times per day to stay current.

For fellows, Dr. Lawenda offered advice regarding the current state of health care in America. He explained that the health care system is changing and will be managed by an as yet to be defined combination of large physician groups—like the company he belongs to—hospital systems, and insurance companies. He believes small, 1- to 3-doctor practices are slowly fading in the current environment. “There are more regulations and rules as to how patients have access to doctors, and I think that’s going to be more challenging for smaller practices to keep up with—the complex and ever-changing administrative demands mandated in health care.”

For Dr. Lawenda, his career is about his passion and interest in both radiation and integrative oncology. His last piece of advice for fellows is about what is important in finding the right career path. “I wouldn’t focus on the money. Focus on the quality of life you want to live, but most importantly the area of specialty that you’re interested in,” he advised.

References

1.       IntegrativeOncology-Essentials. http://www.integrativeoncology-essentials.com. Accessed November 5, 2012.

2.       Pogoreic D. 8 great cancer experts, innovators and advocates to follow on Twitter. http://medcitynews.com/2012/09/8-great-cancer-experts-innovators-and-advocates-to-follow-on-twitter/. Accessed November 5, 2012.