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Reshma Mahtani, DO, spotlights the challenges women in oncology may face throughout their careers and gives some advice to those just starting out.
Reflecting on the personal and professional challenges faced throughout her career journey, Reshma Mahtani, DO, shares that the hurdles she overcame helped shape her perspective as a breast oncologist and ultimately fueled her career growth. As a result of these challenges, Mahtani has become a strong advocate for networking and embracing leadership opportunities, remaining open to diverse experiences or perspectives, and prioritizing self-care.
“By experiencing those moments of uncertainty and vulnerability, it taught me lessons about empathy and patient care. I also gained a deeper understanding of the fears and concerns that my future patients may have,” Mahtani explained, as she detailed her experiences with health care from the vantage point of a family member years ago. She was interviewed by OncLive® following her participation as a panelist in the Women in Oncology event held during the 41st Annual Miami Breast Cancer Conference. “This insight has fueled my commitment to providing compassionate and comprehensive care to every individual I treat.”
In the interview, Mahtani, a medical oncologist at the Miami Cancer Institute and chief of breast medical oncology at Baptist Health’s Wellness and Medical complex in Miami, Florida, expanded on the evolution of breast cancer care throughout her career, shed light on the unique challenges women encounter in the oncology field, and emphasized the importance of mentorship, sponsorship, and supportive workplace policies for women early in their careers.
Mahtani: Early on in my education and career, I encountered several challenges that tested my perseverance and adaptability. One significant challenge was that during my college years, my father suffered a major heart attack and had a prolonged hospitalization due to complications. Balancing the rigorous demands of school and my personal and family responsibilities was extremely stressful. My planned career path didn’t go as smoothly as I had hoped, but that struggle allowed me to take a close look at my goals and my true interest in medicine. Ultimately, it was a period of growth and development, which I can appreciate looking back. I also think that my time interacting with the health care team on the other side of where I sit these days was extremely valuable.
I’ve seen progress in many areas in breast cancer and I would broadly group [these developments] into 4 [areas]. The first is early detection and diagnosis. One of the earliest unmet needs [had to do with] reliable early detection. Over time, advances in technology, such as mammography, MRI, and ultrasound evolved to improve early detection rates. Additionally, the availability of genetic testing has enabled personalized screening and early intervention strategies, which have improved outcomes.
The second category where I see a great deal of improvement is personalized medicine. A better understanding of breast cancer biology and genetics has led to the development of targeted therapies. For our patients with metastatic breast cancer, this is extremely important, as advances in this area have expanded treatment options for many patients.
The third area would be survivorship and quality of life. Addressing the long-term physical and psychological effects of breast cancer treatment has become a priority, so survivorship care plans, support groups, and survivorship clinics have been established. Research into fatigue and cognitive dysfunction have led to interventions that have improved support for our survivors.
The last area is access to care and health care disparities based on race, ethnicity, and socioeconomic status. These all remain a significant challenge, but thankfully, we’re starting to talk about these issues more, as well as strategies to address them. Research [efforts focused on] identifying differences in biology based on race and ethnicity, as well as social determinants of health and culturally competent care, aim to address the underlying factors that contribute to these inequities.
[At the Women in Oncology event,] we had some really great conversation surrounding [this topic]. We have unique challenges. Some of these include gender bias and stereotypes that can impact our opportunities for advancement and recognition. This bias may manifest in hiring practices, promotion decisions, and opportunities for leadership.
Balancing professional responsibilities with personal and family obligations can [also] be really challenging and the demanding nature of what we do can make it [difficult] to achieve work-life balance. Additionally, women may experience obstacles related to family responsibility, finding adequate childcare, managing parental leave, and returning to work after taking time off.
Another one would be addressing salary disparities. This can sometimes be a sensitive topic, but we know that there are gaps that persist in salary—especially with women often earning less than their male counterparts for comparable work. This can contribute to a feeling of financial insecurity and, most importantly, to feelings of being undervalued. Hopefully, as more women are appointed to leadership roles, there will be mentors and sponsors for woman who are facing these issues. For those who are in a position to make changes, it is important we speak up and not only provide support and guidance, but also advocate to make meaningful changes in this important area.
Navigating this balance, especially during career transitions, can be particularly challenging. To support women in oncology, there are various resources and policies that may be available. [If these resources are not readily accessible,] they should perhaps be asked about. Depending on your role within an organization and whether it’s appropriate, [oncologists] may be [able to pursue a] flexible work arrangement, [such as] working part of the week remotely or even part time. Organizations that promote a supportive workplace culture, value work-life balance, and recognize the importance of personal obligations can help women feel more supported—especially during periods of career transition.
We also spoke about the importance of mentorship and sponsorship as a resource. I would also say family-friendly policies, such as parental leave, childcare assistance, and flexible schedules can help women balance career aspirations with family responsibilities. The last resource I would highlight is the availability of professional development opportunities. Things like leadership training network events and skills workshops can also help empower women to advance their careers.
Mentorship is extremely important. Although this is something that has been happening organically for years, sort of informally, [requests for mentorship] are much more intentional now. I notice junior faculty and students coming to me and asking me outright, “will you be my mentor?” That’s a great change, because it highlights the importance of making sure that you firmly establish that relationship. It’s also important to differentiate between a mentor and a sponsor. A mentor is someone who offers guidance, advice, and support to another person regarding professional or personal issues, but a sponsor is someone who actively advocates for and supports another person’s career development or advancement. Sponsors use their influence and networks to create opportunities for those that they’re supporting. I’m referring to things like recommending your colleagues for promotion, introducing them to key contacts, or just championing their work within their own institution. As we think of transitions for women in oncology, it’s essential that we recognize the importance of not only having mentors but also sponsors.
Looking back, I would give my younger a few keys pieces of advice. As we start our careers, we often have prescriptive ideas or approaches in our minds of what our paths should look like. I know I had some fixed ideas early on in my career. I would [advise my younger self to be flexible in seeking diverse experiences, and explore various facets of, for example, breast cancer research, as that was my eventual area of interest. Although I explored clinical care in academics as well as community settings, I wish I had been more open to other areas such as work in advocacy and public health for example. Seeking out diverse experiences allows you to explore various facets of your interests. You might find out that you’re passionate about something that you would have never known [about] if you hadn’t been flexible.
I would also emphasize the importance of building a professional network and doing that early on [by] cultivating relationships with mentors, colleagues, and experts in the field. Networking across different sectors, including academics, community, advocacy, and the pharmaceutical industry can be extremely useful. Embrace leadership opportunities; don’t run from those things because you’re scared of being in the spotlight. Those things can be intimidating or scary, but they actually help you grow. Finally, make sure to foster resilience and self-care. Recognize the emotional and physical toll of the work that we do and be very intentional in taking care of yourself. Find ways to disconnect and take care of yourself both physically and emotionally.
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