Patient Guidance and Care Drives McCann’s Passion as a Woman in Oncology

Kelly E. McCann

Although her drive to become a scientist grew in a lab, the patient-centered aspect of medical oncology—specifically, breast cancer care—sparked the drive for Kelly E. McCann, MD, to enter the oncology field.

“When I was doing [PhD] training, I realized that I wanted to go more into the patient care route, because in order to design, you have to be inspired, and you need to know the body,” McCann said.

In an interview with OncLive®, Kelly E. McCann, MD, discussed her path to oncology, highlighting the personal experiences that shaped her career, the role of mentorship in professional growth as a woman in the field, and the patient-centered approach that continues to fuel her desire to help women diagnosed with breast cancer.

McCann is an associate clinical professor of medicine at UCLA Medical School.

OncLive: What drove your passion to enter the oncology field?

McCann: When I was growing up, I always knew I was a scientist by the way I approached the world and my curiosity about everything. Both of my parents were scientists, and when I went to college, I was going to be a biomedical engineer, which is what I majored in. I got into a medical scientist training program at Stanford and [completed] a cancer biology PhD.

The inspiration for treating [patients with] breast cancer patients has always been my mother. She's had breast cancer twice. Her sister has had breast cancer, and their mother—my maternal grandmother—had breast cancer. Therefore, it was always a normal thing for us to have breast cancer in our lives. I wanted to help other people, just like the doctors who treated my mother, her sister, and my grandmother helped them.

Was there a defining moment in your career that solidified this passion to enter the breast cancer field?

When I was at college, I lived close to campus [at Rice University], but I had a surrogate family who was a little bit farther off in Houston, and they became like a family to me. One of them had a gastrointestinal stromal tumor [GIST], and back in the late 1990s, there wasn't much you could do for treatment.

[Her GIST] didn't respond to chemotherapy, and the physicians at MD Anderson would debulked it; ultimately, there wasn't a lot that you could do, and she died in hospice. She was only in hospice for about 24 hours. Then, gleevec (Imatinib) was approved for GIST, and the world just changed overnight; suddenly, there was a medication that we could use to treat [GIST] that made into [more of a] chronic disease instead of [a disease managed with] a series of debulking surgeries that ultimately didn't keep it under control.

That [experience] was a huge inspiration because [I saw that] we can have these overnight successes. At the [2019] San Antonio Breast Cancer Symposium [SABCS] in the HER2-positive symposium, they had [data from] the [phase 3] SOPHIA trial [NCT02492711] with margetuximab [Margenza], the [phase 2] DESTINY-Breast01 trial [NCT03248492] with the first output of fam-trastuzumab deruxtecan-nxki [Enhertu], and the [phase 2] HER2CLIMB study [NCT02614794] for tucatinib [Tukysa]. [These presentations occurred] back-back-to-back. It was just an amazing experience [seeing] how fast our world can change and how quickly we can suddenly have these tools to use on Monday morning [after] a conference that we just experienced over the weekend.

I tell my patients that we've got the ASCO Annual Meeting in June, we've got the ESMO Congress in September, and we've got SABCS in December. After those conferences, [many] drugs start getting approved, and you can have breast cancer treatment patterns change in a very short period of time, which is always very inspiring.

Early in your career, did you have a mentor or a role model who influenced your path?

I grew up in PhD labs, both in undergrad and then in grad school, so my mentors were PhDs. I got a PhD in cancer biology, but my mentor was somebody who was a radiation biologist, so I was used to that model of somebody being a pretty intense mentor.

When you're in a lab, you're doing your experiments, and you can usually run across the hall and talk to your mentor and have somebody right there to discuss data. In medicine, it's a little bit different. It's more hierarchical in a lot of ways, and you have to search out mentors, and there's not usually one mentor to search out.

[Mentors usually come in the form of] a bunch of different people who are [working on] different aspects of things that you want to ultimately make your own niche. In breast cancer, my mentors were Sara A. Hurvitz, MD, FACP, [formerly of UCLA and now of Fred Hutchinson Cancer Center] and Dennis J. Slamon, MD, [of UCLA]. I was in Slamon’s lab, but I was always looking for new mentors, and I am at that point now where I want to mentor other people. I'm right at that transition in my career after being in oncology for 10 years and going from an assistant to associate professor. [I’m on the lookout] for not only people to mentor me, but also people for me to mentor.

As a woman in oncology, what are ways to empower yourself and your patients?

One of the aspects of being an oncologist that I take very seriously is [meeting] a patient in that first appointment, [where you] spend an hour teaching them about breast cancer and trying to put this scaffold together for them to hang pieces of information on.

All [patients with] breast cancer patients come in and have some knowledge about breast cancer because it's so prevalent. They most likely know somebody who has had breast cancer, and they've Googled about it. However, they don't know what information applies to them.

Most of the data and the direct-to-consumer advertising is in the metastatic setting; they don't realize when they're diagnosed. A [majority of] patients in the US are [diagnosed] in the curable setting. Most of the knowledge that they're garnering themselves is not applicable to them.

[In that first appointment], we sit and spend a lot of time trying to put their breast cancer in the context of all of this information that they're getting so that they feel empowered to make decisions together with me, instead of me dictating to them what they should do. [Breast cancer treatment is] very individualized for every patient that comes in, and I appreciate that aspect, particularly in the metastatic setting, when quality of life becomes almost as important, if not more important than the treatments themselves. [In this context], we're choosing [treatments] based on their toxicities and what [patients] want to do.

If a patient wants to go to Europe for 3 months as a bucket list wish, then I'm going to choose a different drug for her [vs 1 we might use if] she was able to come into my clinic every 3 weeks. I like that aspect of shared decision-making most of all in working with patients.

Especially in the metastatic setting, there's a menu of [treatment] options, and if you're going to end up using all of them, then you can pick and choose. It's not always just about the efficacy; it's about what's going to have that patient live her best life for as long as possible.