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6 Things to Know When Starting a Career in Oncology


By David D. Tran, MD, PhD
Co-Director, USC Brain Tumor Center
Keck Medicine of USC

I’ve dedicated my career to treating patients with brain and spinal cord tumors and to finding cures for these cancers. Neuro-oncology is one of the most challenging specialties in cancer care, which is why I chose it. The most difficult path is generally where we are most needed.

I have identified six important lessons I wish I had known at the beginning of my nearly 20-year career as a physician-scientist.

#1. Controlling your emotions is a strength. 

Being strong for your patients is one of the most important things you can do for them. A key lesson I have learned is that the ability to regulate your feelings does not make you less human. Rather, it shows the strength of your humanity.

Cancer care is an emotionally taxing profession. I admit there are moments when I cry, especially for younger patients, but I am always calm with my patients and their families. 

You must keep a clear mind to make the best medical decisions possible, and only by remaining mentally steady can you serve as a rock for patients and their families during this exceptionally challenging time. 

#2. Cancer patients don’t always ‘look’ sick.

Before I entered neuro-oncology, I assumed it would be obvious when someone had a brain tumor. I thought, “Their thought processes must be messed up, and they might struggle to communicate or move around.”

However, in the first few months of my fellowship program, it was jarring to see just how “normal” brain cancer patients looked. I had many patients who, from the outside, appeared healthy and no one would guess they had a life-threatening disease – but that might not be the case six months or one year later. 

This realization further inspired me to help patients hang on to their quality of life for as long as possible. 

#3. Caring for family members is part of the job. 

It’s normal for families to feel desperate when their loved one is facing cancer. I’ve lost someone I loved to cancer, and I understand the desire to try anything to help save them. 

I’ve had cases where patients’ families have come to me with remedies they may have read about online. I’ve learned it’s important to step back and analyze the suggestion.

As long as their idea isn’t harmful to the patient and there are few other more-proven options, then I think you can consider proceeding with it. Even if the remedy is unlikely to bring about a cure, it may help the family find closure. When their loved one has passed, they can be comforted that they tried all they could. 

#4. A balance between clinical and research work is achievable.

I love seeing patients and I also enjoy working in the lab. But during my training, the message I often received was that to be successful in a competitive academic environment, I needed to choose one lane or the other. 

I disagree with that advice. For me, transitioning between my research and my responsibilities in the clinic is seamless because I am equally passionate about both. Progress in the lab is even more fulfilling and meaningful because I have patients who I know may benefit from it.

That’s why I always tell medical students and residents who come to work in my lab that it’s possible to pursue both if the enthusiasm is there.

#5. It’s ok to slow down.

Early in my career, I worked day and night to build my reputation in both clinical care and research. I was energized by my passion for the work so I was rarely tired. 

However, that level of commitment often meant significant time spent away from my wife and children. If I could do it again, I’d slow down. Perhaps instead of achieving the success I did within 10 years, I’d have reached the same level after 15 years.

I think it’s important for young people to understand that careers in cancer care and research are highly demanding — sacrifices are made, and finding a balance is not easy.

#6. None of your work is in a vacuum.

A critical lesson to internalize is the importance of teamwork. You need other people — whether that’s other physicians, nurse practitioners, nurses, social workers or support staff — to carry out your work. 

We’re not here to do each other favors, and having an ego isn’t helpful. Be respectful to everyone you work with, and always remember that everything we do is to benefit the patients. It’s all about them, not you.

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David D. Tran, MD, PhD, co-director of the USC Brain Tumor Center, part of Keck Medicine of USC, has dedicated his career as a physician-scientist to finding a cure for brain cancer and other formidable cancers. He specializes in treating patients with tumors of the brain and spinal cord with personalized cancer therapy based on each patient’s unique health, disease profile and genetic makeup.

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The USC Brain Tumor Center offers comprehensive care for adults and children with all types of brain tumors. Our multidisciplinary team focuses exclusively on brain tumors, and we have deep experience from treating a very high number of complex brain tumor cases.