Dr. Ruben Mesa, director of the UT Health San Antonio Cancer Center, is the subject of an interview in the February edition of San Antonio Magazine.
Interview by Kathleen Petty
This month, the UT Health San Antonio Cancer Center will lead a first-of-its-kind conference focused on cancer among Latinos and officially launch its partnership with MD Anderson Cancer Center, all while continuing its research and care as the region’s National Cancer Institute–designated center. Dr. Ruben Mesa says he wasn’t looking for a career change after 25 years with Mayo Clinic, but becoming director of the center formerly known as the Cancer Therapy & Research Center was an opportunity he couldn’t pass up. “This center is known around the world for its impact,” he says. Between providing care and conducting research that could cure certain cancers, Mesa says the academic institution is poised to continue making an impact.
The UT Health Cancer Center is in the midst of partnering with MD Anderson Cancer Center. What will that mean?
This is really going to be a very exciting time. There are very unique growth opportunities with this relationship with MD Anderson both from the practice side as well as the opportunity to conduct research. Having collaborated frequently with MD Anderson over the years through my roles at the Mayo Clinic, I’ve always had tremendous respect for MD Anderson and their patient-centered model of care. Our close relationship with MD Anderson will allow us to provide care in their model by combining their strengths with ours. Our focus is that individuals who are in San Antonio and South Texas don’t have to leave home or their region to receive world-class cancer care. We anticipate there will be significant growth in patients, though we already serve patients from throughout the region and other places in the world.
Your personal practice and research has specialized on myeloproliferative neoplasms (MPN). What is that?
It’s a group of bone marrow disorders that are a type of chronic leukemia. As we age there are a range of different bone marrow cancers we can develop, some more chronic and some more acute. My focus is on those chronic ones. It’s something new that has not been a key area of focus for the UT Health San Antonio Cancer Center in the past. I’ve brought in some other staff along with me to address this area. I’m already seeing patients in this region, but we have patients who come here from all over the world. The blood diseases and the blood cancers are difficult diseases and they’re becoming more common as our population ages—from myelodysplastic to chronic and acute leukemia. There were very few good treatments when I started my career so it’s been very rewarding to be involved with the science of figuring out why people develop these things and how we can cure or help extend our patients’ lives. My experience, I hope, is helpful not only in terms of these diseases, but also is very relevant across all cancers. We want to best understand why people develop a particular cancer, how we can better diagnose it and how we can better predict how it will behave because cancers don’t affect all individuals in the same way.
Is care moving toward an individualized model?
Individualized cancer care is really the current revolution in cancer care. It starts with understanding the genetics of one’s cancer, but it extends beyond that to utilizing the immune system against cancer and trying to best understand an individual’s background, values, beliefs and support structure so we can have an individualized care plan. This type of care has grown rapidly in the last three to five years, starting with the genetic code and then growing to include other aspects. Two individuals might have the same genetic code for their cancer, but if one is 38 and the other is 76, there are a lot of other factors that need to be considered.
Is integrating cancer care with other health care part of that?
Good cancer care begins with good primary care. The better the overall health of an individual, the more they’re being taken care of through primary care and the more they are involved in taking responsibility for their own health through diet, a healthy lifestyle and appropriate screenings, the better shape they’ll be in if they develop health issues like cancer. Certainly, the vision here at the Cancer Center is development and advancement of the cancer program, but we’re also trying to better the health of the whole community. As modern medicine evolves, it really is the ultimate team sport and cancer care is a real team-based activity. About half of the physicians with UT Health and our clinical partners at affiliate hospitals play a role in cancer care, whether it’s in prevention, diagnosis or screening, active cancer care, survivorship or caring for patients. We want our Cancer Center and community partners to have the same goals and values. Part of our goal is not only how we promote a healthy lifestyle, but also how do we make a healthy lifestyle feasible? There are researchers here who look not just at how you should eat more healthily but how we can make it feasible for you to eat healthier. If you benefit from an anti-inflammatory diet, for example, we want to make it easy to implement when you go home to cook or to shop for food at H-E-B. We don’t want to just put a list of what you should eat up on a website.
How often are patients with cancer dealing with other health issues concurrently?
That’s very common. We’re rarely just one thing. We all have our own health history. We all have the potential for issues with either the heart or the lungs or kidneys or other things. We are developing and rolling out programs that focus on key systems in the body in relation to cancer prevention, treatment and survival. We’ll have cardio-oncology, which will look at the heart in the context of receiving cancer treatment. It will deal both with how you treat cancer in someone with existing heart disease and how your heart is impacted when you are receiving cancer treatment. We are also developing an onco-nephrology clinic that will look at how we protect the kidneys during cancer therapies and how certain cancer treatments affect the kidneys.
Is a cure for cancer on the horizon?
Absolutely. I’m very confident we’re going to find a cure. We’re going to probably find a cure in one cancer at a time—cancer represents many different diseases.
There are many different cancers now where the treatments are dramatically better than when I started my career. It can range from a complete cure where you never see the cancer again, to cancer being controlled so you live out the rest of your days like you do with diabetes or high blood pressure. If we can control it so it’s not a major factor, that too is a huge win. Many of the advances, particularly in the areas of immune-based therapies and more targeted therapies, are making huge impacts. There’s really a revolution going on in the types of treatments that are available.
This interview has been edited for length and clarity.
This article appears in the February 2018 issue of San Antonio Magazine