Dr Rahul P Bhandari On The 5 Things Everyone Needs To Know About Cancer

An Interview With Savio P. Clemente

Find out about your family history of cancer. If any were diagnosed with a cancer, learn more about it. Specifically, educate yourself on how this would increase your risk of cancer, and then what actions you should take in the near future to prevent its manifestation.

Cancer is a horrible and terrifying disease. There is so much great information out there, but sometimes it is very difficult to filter out the noise. What causes cancer? Can it be prevented? How do you detect it? What are the odds of survival today? What are the different forms of cancer? What are the best treatments? And what is the best way to support someone impacted by cancer?

In this interview series called, “5 Things Everyone Needs To Know About Cancer” we are talking to experts about cancer such as oncologists, researchers, and medical directors to address these questions. As a part of this interview series, I had the pleasure of interviewing Dr. Rahul P. Bhandari.

Dr. Rahul Bhandari is a Board-Certified Radiation Oncologist, who specializes in all cancer treatment sites, and practices with a patient-centered group, Tampa Bay Radiation Oncology, in and around the greater Tampa area. For many years now, he has been involved with the fight against cancer in the clinic with patients and behind the scenes through research and academics.

Thank you so much for joining us in this interview series! Before we dive into the main focus of our interview, our readers would love to “get to know you” a bit better. Can you tell us a bit about your childhood backstory?

I was born and raised in Chicago, Illinois by two immigrant parents from India. My father was a medical oncologist, who was just joining residency in Chicago, and was one of about thirty other family members who also were simultaneously pursuing a career in medicine. One could say I was born into a physician’s family, both to the immediate and extended family degree. As such, abundant exposure to the medical world while growing up allowed the field of medicine to become more of a familiarity and source of immense interest. My family never pushed me one way or another to become a physician. Instead, they prioritized maximizing my global education, growing my knowledge base, and developing a multifaceted skillset. To them, knowledge was the ultimate form of currency, and if this bank was large, then life should respectively become easier to navigate through and a build a career upon. As a result, with guidance and support, I took the resulting twists, turns, ups and downs, to end up where I am today as a practicing radiation oncologist. Due to the purity of the journey to this career point, I wake up with a daily fire to get each day going. Having the opportunity to become a part of someone’s life, and to offer help during one of their most vulnerable moments with a cancer diagnosis, is truly a priceless and extremely fulfilling feeling I am lucky to experience daily.

What or who inspired you to pursue your career? We’d love to hear the story.

Around the time of high school, my gut and mind had lined up and started pointing in one direction. The direction was to pursue a career in medicine. I was still not sure which specialty I was most interested in at that point, although, I had the most exposure to oncology due to my father’s own career. Even then, once I knew I was interested in medicine, my goal was to gain exposure to as many specialties as possible to help determine the direction I wanted to take for a career choice. Outside of my interest in medicine, I always had a keen interest in space, anywhere from the marvels to the science behind it all. Cancer reminded me of space a lot. Specifically, with the aspect that we still do not know much about cancer just like space, and how we are in the midst of observing, exploring, and experimenting to hopefully achieve further answers and solutions. The unknowns are immense in cancer as well as with space. Seeing it through this lens, I realized I really wanted to become part of the widely unknown but progressing world of cancer, and do my part within this realm. Outside of both my parents giving me the initial push and assuring I stayed on track; I would have to say that every single person and moment during the process was important to me and to my respective endpoint. I do not take any good or bad past personal experience lightly, as I strongly believe each person and moment that was part of my history, course-corrected me in one way or the other to help me achieve my goals of becoming a radiation oncologist.

This is not easy work. What is your primary motivation and drive behind the work that you do?

This is sometimes hard to put into words that will equal the same gravity of feelings and thoughts I do experience at work. For one, I know I am in the right field because I do wake up full of enthusiasm and anticipation for my work day. To try to explain the drive, I would like to give a general example of a cancer patient interaction. During the initial consult, a patient newly diagnosed with cancer usually has a myriad of feelings, thoughts, and questions running through their head, which usually results in confusion and feelings of losing control. During this first visit, my prerogative is to help get their feet back on the ground, to show how they do indeed have control, and to communicate how I am now a part of their team through and through during this journey of fighting a disease that is simply not welcomed. Next is to determine through a multidisciplinary approach the optimal treatment for this specific type and stage of cancer. This process requires researching, educating, critical thinking, problem solving, and an inherent drive to do good by the patient. Agreeing on a plan of action to try an eliminate cancer is motivating enough to come to work every day. Once the patient has completed the recommended treatments, they will be set on a surveillance path. It is during these subsequent follow-up visits, when we have the chance to see patients following treatment completion and can share some recent favorable news about their cancer status, which is the most fulfilling and rewarding aspect of this whole field. To see a patient at one of their lowest moments, be able to help them out of it, and then to share their victories and to achieve the best new version of themselves, is a feeling that is precious and naturally motivating to continue doing my best.

What are some of the most interesting or exciting projects you are working on now? How do you think that might help people?

One of the most common ongoing goals of cancer treatment is to increase the effectiveness of a treatment, reducing the toxicity, while simultaneously preserving a good quality of life. In radiation oncology, those goals are no different. One of the methods that has made great strides in the recent past, and will continue to be refined, is Stereotactic Body Radiotherapy (SBRT). With advancements in machines, software, and within the scope of medicine itself, we are seeing continued improvement in achieving the goals mentioned above. I have personally run research and published papers on SBRT for lung cancers, started an SBRT program at a VA hospital, and continue to refine my own treatment strategies within my practice as new advancements take place. With such innovations, we are generally seeing such aspired increases in overall survival, decreases in toxicities, and escalation in the quality of life.

For the benefit of our readers, can you briefly let us know why you are an authority about the topic of Cancer?

My expertise in cancer started many years before I became a board-certified practicing radiation oncologist. My journey started at the ground level when I was a high school student. I started as a patient transporter, during which time my exposure to cancer patients started building as I would commonly have conversations with each patient as I took them to their next destination. This was compounded with dedicating hours in the lab researching a new cancer drug, for example, or engaging in clinical cancer research. Since then, through my medical career, I have participated in cancer research, education, and clinic work in institutions such as the UPMC Hillman Cancer Center, George Washington University Medical Center, Georgetown Lombardi Comprehensive Cancer Center, Northwestern Comprehensive Cancer Center, and the University of Mississippi Medical Cancer. Also, as an active member of different cancer societies, I work closely with other specialists related to the field so that the most up-to-date and patient centered care can be delivered. When not seeing patients, I enjoy writing for publications, magazines, and participating in interviews all with the goals of spreading awareness and providing education on varying cancer-related topics.

Ok, thank you for all of that. Let’s now shift to the main focus of our interview. Let’s start with some basic definitions so that we are all on the same page. What is exactly cancer?

Cancer, in very simple terms, is a disease where abnormal cells, not native to the body, began to uncontrollably divide. If left unaddressed, it is the potential to invade and spread to other normal body tissues, which can then lead to varying manifestations of symptoms and grave outcomes.

What causes cancer?

Cancer starts at the genetic and cellular level, and there is usually an interaction of many different variables that lead to a cascade of events resulting in a malignancy. There is a myriad of risk factors that can speed up this process, which includes family genetics, lifestyle choices, environmental exposures, amongst many others.

What is the difference between the different forms of cancer?

Cancer usually sprouts from a single organ in the body, commonly as a result of mutations of the normal organ cells to malignant cells. The organ involved usually determines what type of cancer it is, the cells involved, and the behavior of the cancer. Each organ can be a source of many different types of cancers, all which can behave differently from person-to-person. Now with ongoing cancer research advancements, we are discovering that every specific cancer has its own specific blueprint and genetic makeup that makes it unique to that specific person. This means that, for example, two people with blanket diagnoses of non-small cell lung cancer could actually have two completely different cancers at the cellular level. Therefore, these would respond differently to varying treatments.

I know that the next few questions are huge topics, but we’d love to hear your thoughts regardless. How can cancer be prevented?

I believe a more realistic question would be how to increase one’s chances of preventing cancer. There are many resources and movements out there to aid in this, but it all comes to increasing community awareness of the intricacies of cancer and prevention. Some basic active approaches include:

1. Find out about your family history of cancer. If any were diagnosed with a cancer, learn more about it. Specifically, educate yourself on how this would increase your risk of cancer, and then what actions you should take in the near future to prevent its manifestation.
2. Several cancer societies have released valuable information on self-care and the timeline of routine screenings for different cancers. These recommendations also are tailored for persons with other risk factors or family history of cancer. Make sure to stick to these recommendations, as they have been thoroughly studied and have proven to significantly reduce cancer rates and increase prognoses.
3. Listen to your body. The human body generally does a good job of letting one know when something is not right. Whether it be worsening shortness of breath, unplanned weight loss, or relentless fevers and chills. Your body will show red flags, and it is one’s prerogative to take action into further investigating the cause of these.
4. Keep up with annual or recommended checkups with your family physician. This is a great routine self-care habit, which allows the opportunity to check in with your doctor and catch any small problems before they become big.

How can one detect the main forms of cancer?

Every year there are further advancements in how we are detecting cancers. The medical community is only becoming better at accurately determining what is and is not cancer. Each cancer site and type have their own specific ways they can be detected. The goal of cancer diagnoses is to accurately diagnose a cancer while also correctly ruling out a cancer. This can be done through the means of imaging, lab work, physical exams, more invasive procedures, amongst other newer and more promising modalities.

Cancer used to almost be a death sentence, but it seems that it has changed today. What are the odds of surviving cancer today?

The odds generally depend on the type and stage of the specific cancer. There are many other variables that further determine the chances of survival, such as the patient’s performance status, their other comorbidities, or the genetic makeup of the cancer. Some cancers are now becoming chronic diseases, mainly because of the ongoing spread of cancer awareness, advancements in screenings, enhancing treatment modalities, and the all-around increase in knowledge of cancer biology. If a specific cancer is diagnosed early enough, the treatments are effectively delivered, and the patient is compliant with follow-up visits and surveillance tests, the cancer could just become a chronic disease. Of course, this depends on the type of cancer, as some cancers still hold a grave prognosis in today’s time.

Can you share some of the new cutting-edge treatments for cancer that have recently emerged? What new cancer treatment innovations are you most excited to see come to fruition in the near future?

It is an exciting time for cancer research and advancements. With President Biden’s new Cancer Moonshot Initiative, we hope to see even further favorable progression within the field of cancer. One treatment modality that is making great headway with promising results is immunotherapy, which amps up the individual’s own immune to fight the respective cancer. Yet, another showing tremendous outcomes is targeted therapy. Within radiation oncology, we are continuously developing new technologies and strategies to more effectively treat cancers with minimal side effect profiles and improved control and survival rates. The future is exciting, as we are now making movements into dissecting the biological and genetic makeups of each cancer, so that we can better understand them at the smallest level. As a result, cancer treatments will become more personal to the individual and their respective cancer. For example, all Stage I Lung Adenocarcinomas are generally treated the same today. However, in the future, if we are able to determine why Patient A’s lung Adenocarcinoma is molecularly different than Patient B’s lung Adenocarcinoma, then they could receive treatments that are more specific and tailored to the patient’s cancer molecular makeup. This in return should result in better outcomes for each patient.

Healing usually takes place between doctor visits. What have you found to be most beneficial to assist a patient to heal?

I value this question, since living with cancer diagnosis is long and difficult journey that could be full of wins and losses. Regardless, for the patient, it is of upmost importance to cater to their physical, mental, and emotional state. It is important to fine tune and strengthen all these aspects. The healthier one is physically, mentally, emotionally, the higher the chance for an enhanced quality of life and overall experience with cancer and its baggage. There also are studies that show self-care, including better nutrition and increased activity levels, result in increased overall survival rates and the quality of life. Healing is a multifaceted and teamwork approach. It is important to surround yourself with supportive people, and to be in a healthy and encouraging environment.

From your experience, what are a few of the best ways to support a loved one, friend, or colleague who is impacted by cancer?

Cancer is sometimes not just a diagnosis for a patient but for their whole family too. I find that patients who have the easiest time dealing with their cancer are those who have unrelentless and commendable support from their friends and family. The best way to support one is to make their diagnoses your own. Be empathetic. Be supportive. Ask the right questions. Listen. Be there even when you are not asked to be there. Go to their appointments with them. Most importantly, help them to continue living their best lives with a positive attitude. If their head is just above water, be aware and do what you need to do to pull them out and show them they are alive and well.

What are a few of the biggest misconceptions and myths out there about fighting cancer that you would like to dispel?

I have to say, I have heard my share of these. A specific one I would like to address is related to radiation therapy. The most common myth I hear during consults is that radiation therapy will burn your skin right off, and the side effects from treatment are not worth going through. I find myself dispelling this a lot, as sure this might have been true in the past, but with ongoing major advancements in technology and symptom control, the side effects with radiation therapy are not nearly as severe as they used to be. Unfortunately, like with any medical treatment, it is sometimes hard to avoid side effects while appropriately addressing the problem at hand, but we are becoming better at decreasing this list and the severity of it.

Thank you so much for all of that. Here is the main question of our interview. Based on your experiences and knowledge, what are your “5 Things Everyone Needs To Know About Cancer? Please share a story or example for each.

1. Cancer is Preventable: Do your own research. Discuss this topic with your family doctor. Cancer societies have published evidence-based screening recommendations, along with risk factors and red flags to look out for. Educate yourself and set up a plan for the foreseeable future. If you are getting your car oil changed, there is no reason you should not be able to meet the recommended checkups so that your own body also is fine-tuned.
2. With President Biden’s new Cancer Moonshot Initiative, we are hoping cancer research, discoveries, and implementation will start moving at an accelerated rate. We also are hoping that cancer awareness is significantly increased, so that patients can take more proactive and calculated approaches to selfcare.
3. Some cancers, if caught early enough, can be curable. This stresses the point of why education and screenings are so important. The path to converting more cancers to chronic or curable diseases will be a collective community effort that will require participation from all parties.
4. Each cancer is a different entity in every person. It will result in your own specific experience. Although, it is beneficial to have a general idea of what your cancer entails, do not get caught up with other peoples’ experiences or outcomes, as yours will be specific to you. As a result, focus on your diagnoses, your mindset, your body, your outlook, and always seek guidance and help when needed.
5. You are not alone in this, so do not try to get through this alone. Confide in your friends and family because their participation will absolutely dictate the experience that you will have as well. Also, reach out to support groups that are specific to your cancer type. Ask your oncologist about other resources that can help you along the way while battling this disease.

You are a person of great influence. If you could start a movement that would bring the most amount of good to the most amount of people, what would that be? You never know what your idea can trigger. :-)

My movement would be to help increase the number of persons attending their annual doctor visits and recommended screenings. This would go along with a movement that brings awareness to the general population about cancer and the few simple things they can do to stay on top of it. Just like a car service light turns on and remains on until the car is treated, it would be amazing to have something simple as a cell phone notification that turns on when one is due for a screening, for example, and will stay on until the self-care has been addressed.

How can our readers further follow your work online?

Readers can follow me on our Tampa Bay Radiation Oncology Website:

https://tbropa.com/physicians/rahul-p-bhandari-m-d/

I am constantly uploading new articles, interviews, and publications related to Cancer.

Thank you so much for these insights! This was very inspirational and we wish you continued success in your great work.