Multidisciplinary Approach to Cancer Management
Project Pulse Winnipeg’s first interview and blog post for the 2021/2022 season was dedicated to the Multidisciplinary Approach to Cancer Management. Four professionals, Dr. Shantanu Banerji, Dr. Rick Bhullar, Dr. Pamela Hebbard, and Dr. Sapna Oberoi, were invited to provide insight on their roles in this multidisciplinary process, as well as advice for future health sciences students. The highlights of this event have been summarized below, but the full recording with timestamps for each question can be found in the link below or on Project Pulse Winnipeg’s Youtube channel.
This interview was composed of the following distinguished professionals:
Dr. Shantanu Banerji
Dr. Shantanu Banerji is a clinician-scientist with a practice focused on lung cancer and sarcoma. His laboratory at the CancerCare Manitoba Research Institute is focused on understanding prognostic and predictive biomarkers specific to the treatment of cancer. He is also the director of Precision Medicine and Advanced Therapeutics and an Associate Professor.
Dr. Rick Bhullar
Dr. Rick Bhullar, the Section Head of Musculoskeletal Radiology at HSC Winnipeg, combined his love of sports and medicine. Outside of medicine, Rick enjoys travelling and was a former competitive speed swimmer. He continues to swim regularly with a club at the Pan Am Pool. With a B.Sc. in Life Sciences from Queen's University, Dr. Bhullar completed his medical degree and residency in Radiology at the University of Manitoba. He later obtained a fellowship in Musculoskeletal Imaging at UC San Diego. In 2002 he was awarded the Queen Elizabeth II's Golden Jubilee Medal, presented by the Lt. Governor and Premier of Manitoba to a person who has made “a significant contribution to Canada, to their community, or to their fellow Canadians''.
Dr. Pamela Hebbard
Dr. Pamela Hebbard, a general surgical oncologist with CancerCare Manitoba and Shared Health/Winnipeg Regional Health Authority. She has an appointment as an assistant professor of surgery with the University of Manitoba. She was born in Goose Bay, Labrador and grew up there and in St John’s Newfoundland. Her bachelor’s degree, medical degree and general surgery residency were obtained through the Memorial University of Newfoundland, as was a graduate diploma in clinical epidemiology. She then moved to the University of Calgary for a fellowship in general surgical oncology. Dr. Hebbard has been practicing in Winnipeg since 2012. Her clinical focus is on complex GI malignancy, breast cancer, and melanoma. She has research and administrative interests in optimizing surgical quality in cancer delivery
Dr. Sapna Oberoi
Dr. Sapna Oberoi is a pediatric oncologist with a strong clinical and research background in pediatric hematology-oncology. Her research program focuses on AYA oncology, fatigue in children and adolescents with cancer, supportive care, symptom management and sarcomas. The aim of her research is to improve the outcomes and quality of life of children, adolescents and young adults with cancer.
Despite being in different specialties, all four of them work together in different ways to help with the diagnosis and treatment of cancer. Starting with the radiologist, Dr. Bhullar shares that he is involved in the imaging of patients, which can be done through x-rays, MRIs, ultrasounds, etc. He helps in the process of diagnosing the type of cancer and its relationship to structures in the body, along with treatment planning. As a surgeon, Dr. Hebbard also aids in the process of diagnosing but can also try to remove tumours. She also takes on an administrative role as the lead for cancer surgery in Manitoba, completing paperwork to direct policies for the health system for cancer surgery. Both Dr. Banerji and Dr. Oberoi are oncologists, with Dr. Oberoi specializing in adolescents with cancer. They share that oncologists work with surgeons to acquire tissues important for localized cancers, removing tumours, identifying their size, and finding out if they are involved in lymph nodes. Oncologists will then give systematic therapy, which comes in three forms: chemotherapy, targeted therapy, and the newest form of therapy, immunotherapy.
Technological Advancements – The Importance
The topic of technological advancements, such as artificial intelligence and immunotherapy, in medicine, is touched on, along with a bittersweet story from Dr. Banerji highlighting the importance of the continuous evolution of technology and techniques. One of his most memorable cases is a patient who ran out of treatment options and would’ve died if it wasn’t for a new gene test. As a Hail Mary, the tissue was sent for testing and the patient was put on a new drug. Dr. Banerji shares, “This was someone who could barely walk 10 feet to suddenly within the span of 2 weeks of being on the medicine, was able to function normally again. Wound up living another 3 years of really excellent quality of life”. From this story and many other revelations about new medications, the evolution of technology is revealed, as it opens up more possibilities for patients.
Priorities, Passion, and Perseverance
Perhaps the biggest takeaway that students should take from this interview was the repetition of the importance of priorities, passion, and perseverance.
As many know, the learning journey to becoming a doctor occupies lots of time, and Dr. Banerji discusses the importance of picking and choosing priorities. Dr. Bhullar shares that the learning journey that got him to where he is today never ends, as “Medicine is the type of thing where you have to stay on top of it. Everything is changing all the time”. While all four professionals agree that this is a process that requires dedication and time, Dr. Oberoi shares, “Yes, being an oncologist is a lifelong commitment to learning. The field is ever-changing and it does require lots of time. But this being said, I never regret it. It is very satisfying, having the patients go through this journey and supporting them through this cancer journey is very rewarding”. The distinguised professionals all reveal how important the bonds and connections they have made with patients are, to both them and the patient themselves. Dr. Hebbard shares that although it is devastating to tell patients unfortunate news, patients often feel supported because of the relationship formed between the doctor and patient.
Along with the rewards of being a doctor, which the professionals agree is one of the many sources of motivation they have to pursue a path in medicine, all four touch on the importance of passion. Dr. Hebbard talks about how time did not feel like an issue, as “It’s my job, my hobby, my passion. Because of that, it doesn’t feel like a sacrifice. I’m all in”. Dr. Banerji echoes this, informing the audience, “You really have to have a passion for it. It’s not a great field if you don’t have a passion for it. The reality of it is the drive for learning, the drive for knowledge and medicine has to come from within because if you don’t have that passion for learning, the willingness to adapt to the field of medicine can consume you and slowly knock you down over time. So you really have to be passionate”.
When asked how they persevere through challenges and balance their work and personal live, Dr. Bhullar shares how one should always find extracurricular activities and hobbies, discussing how his passion for competitive speed swimming acts as his escape away from work. He also discusses how it is important to learn coping mechanisms to deal with stress. Dr. Hebbard shares how she has had to learn to differentiate her identity at home and work, taking on the role of “mom” at home and becoming “Dr. Hebbard” at work. She says that in order to do this, you really “have to have a lot of passion for both of the roles,” tying in the theme of passion.
Choosing Your Specialty and Major
The uncertainty of what specialty and major high school and post-secondary students would like to pursue is a common concern, which is why this question was asked to our professionals. All four professionals collectively agree that you should not feel pressured to know your path early in high school, with Dr. Oberoi sharing that she only discovered what she wanted to do on the last day of medical school. She provides the advice, “As long as you are sure and passionate about medicine, I would not worry about which field you want to go in”. Dr. Bhullar, Dr. Banerji, and Dr. Hebbard add on to this, advising students to keep an open mind and expand their mindset through their experiences in undergrad, such as by taking opportunities for work experience. Dr. Bhullar shares that the majority of people change their paths once they spend time experiencing different environments. The overall impression that the professionals left is that in the end, one shouldn’t feel pressured to find their calling, as it will be found with experience.
The knowledge and insightful advice provided during this interview have educated and inspired the next generation of health sciences students greatly, and it was truly an honour to have Dr. Banerji, Dr. Bhullar, Dr. Hebbard, and Dr. Oberoi join us in our first interview.
