Since her first days as a medical oncology fellow at the National Cancer Institute in 1983, Sandra M. Swain, MD, has been based in the Washington, DC area, making for a logistical first for an incoming president-elect of the American Society of Clinical Oncology, headquartered in suburban Alexandria, Virginia. This close proximity will permit Dr. Swain to participate in as many ASCO meetings as she pleases when she officially takes office as President-Elect at the society's Annual Meeting, and begins the first phase of the ASCO leadership three-year plan, which will continue under her presidency from 2012-2013, and then as immediate-past president.
Still, Dr. Swain said that she had jump-started the process and began to increase her ASCO activity as a pre-president-elect as soon as she learned of her election in December.
OT spoke with Dr. Swain days after ASCO's leadership strategic retreat in late-March, which she said she couldn't discuss, though, because it was a confidential working meeting involved in the planning process.
Expert in Inflammatory Breast Cancer
An expert in inflammatory breast cancer treatment, Dr. Swain is Medical Director of Washington Cancer Institute (WCI) at Washington Hospital Center, the largest hospital in the regional MedStar Health system, which also includes Georgetown University Hospital, where Dr. Swain has an appointment as Professor of Medicine.
She joined WCI in 2007 after her second stint at NCI, where she had spent 14 years over a 24-year period.
Her first was as a fellow and staff member working with Marc Lippman's group, until 1988 when Dr. Lippman left for Georgetown and took her and about 50 others with him.
After several years running the breast cancer program at Georgetown's Lombardi Comprehensive Cancer Center, she worked briefly with Bernard Salick, MD, founder and former chief executive of Salick Health Care Inc., a chain of cancer and renal care clinics based in Los Angeles.
"Bernie was brilliant and had great ideas, and I was very attracted to his concept of customer service when taking care of cancer patients, and his holistic approach made sense to me.
"He talked about creating a center in Washington, which I would direct, but that never happened and eventually his company was sold to AstraZeneca."
So for about three years she ran clinical research and was involved in business planning before returning to public service in Bethesda in 1999.
Still, she said she had been able to implement some of Salick's philosophy when she took over as medical director at WCI.
"NCI offered a great opportunity to work with Carmen Allegra, whom I knew from my earlier days there, and it was an exciting time under [then-NCI Director] Rick Klausner, who was so bright, energetic, and visionary."
At NCI she was deputy chief of the medicine branch under Dr. Allegra until he resigned six months later and she was named acting chief.
That lasted until NCI split the entity into various parts and she was named chief of the Cancer Therapeutics Branch until NCI "put it all back together again and I was just a section chief."
Constant Thread: NSABP
The constant thread throughout her career has been the National Surgical Adjuvant Breast and Bowel Project (NSABP).
She first met Bernard Fisher, MD, in 1984 when she was at the NCI, and she ran the Breast Cancer Prevention Trial (P-1) at Georgetown, accruing more than 100 patients.
It was a condition of her rehiring at NCI that she be allowed to continue her work with NSABP. "It was non-negotiable. I had spent my entire career working toward clinical trials for women with breast cancer, and Carmen and the others agreed [I could still participate], although I had to leave NSABP's Board of Directors.
"It may have seemed a little odd, because I was part of NCI's intramural program, but I think the intramural program should be part of high-impact clinical trials, and I ran two trials while I was there."
Asked about the cooperative group mergers now going on (OT, 4/10/11 issue), she said she thought the recently announced NSABP merger with the Radiation Therapy Oncology Group (RTOG) has great synergy-there had always been protocols looking at local therapy issues and now there would be both radiation and surgical input, she said.
Dr. Swain is now back on NSABP's Board of Directors and is Vice Chair of the NSABP Breast Committee as well as a member of NCI's breast cancer steering committee.
Dr. Swain said the areas of interest that she will focus on at ASCO include the society's international community, since one-third of its members are from abroad and about half of its annual meeting attendees are from outside the United States; figuring out ways to increase multidisciplinary involvement in what has been a largely medical oncology dominated organization; and working on both local and global heath care disparities issues.
"Washington Hospital is an inner-city safety-net institution, and we've got an NIH health care disparities challenge grant to increase minority participation in clinical trials."
She also takes great pride in training oncology fellows, she said, considering them "my children," with black-and-white photos of former fellows adorning the walls of her office.
Her camaraderie with other ASCO leaders is also international in scope. She and her husband, Steven Jones, recently returned from a two-and-a-half week photographic safari in South Africa with several other couples.
"We had three former ASCO presidents-Sandra Horning, Marge Tempero, and Gabe Hortobagyi, one president-elect, and others including Edith Perez and Joe Gray," she said, adding that collectively they had thousands of photos.