I can confidently tell my DCIS patients if they will benefit from radiation therapy and design a treatment plan that is tailored to them
An experience early on in medical school had a defining impact on the direction of Dr. Arica Hirsch’s career. As a third-year medical student, Dr. Hirsch was doing clinical rotations in Internal Medicine and was assigned to the oncology floor. Her patient was a young woman, in her thirties, who had completed treatment for breast cancer a year earlier. She was admitted with respiratory symptoms and was thought to have pneumonia. “Well, we learned over a number of days, that in fact it wasn’t pneumonia, rather it was metastatic breast cancer that had metastasized to the lungs. This young woman had a husband and a two-year-old daughter. As an impressionable medical student this was a very intense sort of experience. Fortunately, as a medical student I had the time to develop a very close and intimate relationship with her and with her husband. And challenging as it was, it was very moving and revealed to me that was the kind of interactions and relationship that I wanted with all of my patients.”
Today Dr. Hirsch is a radiation oncologist and medical director at Illinois CyberKnife. “Clinically, I was attracted to the field of radiation oncology for a number of reasons. First, it is interesting intellectually. The science continues to expand, and I am always learning. Second, I love the creative analytical aspect of designing the best treatment plan for each of my patients. And of course, it provides the opportunity to develop a close, meaningful relationship with my patients.”
After completing medical school at Northwestern University and residency at Memorial Sloan-Kettering Cancer Center as chief resident, Dr. Hirsch was an Assistant Professor at Memorial Sloan-Kettering Cancer Center where she practiced for 4 years.
Breast cancer is a specialty area for Dr. Hirsch with ductal carcinoma in situ (DCIS) a subspecialty. “I believe the most important aspect of intervention for DCIS is surgical removal and then answer the question of what treatment, if any, should be done next. Many studies have looked at that question and tried to determine, based on various clinical features, which patients should be offered radiation and which ones should omit radiation. I have never felt entirely confident with the results of such studies in making decisions or recommendations for patients.”
Dr. Hirsch has been using DCISionRT®, a biologic signature for breast DCIS to predict radiation therapy (RT) benefit and assess recurrence risk, for about two years. “It took me a while to feel confident in the results of the DCISionRT test. But now, I use it in almost all my cases, and it has significantly impacted my confidence in recommending moving forward with or omitting radiation for my DCIS patients. And my patients love it. They appreciate that with DCISionRT we are getting more sophisticated information that we just don’t have access to otherwise. It is the deciding factor for both me and my patients.”
Dr. Hirsch’s philosophy of care centers around a holistic treatment approach, incorporating evidence-based medicine, utilizing results of studies and believing in care of patients as individuals. She seeks to understand her patients own personal philosophies of their healthcare and priorities in order to achieve the most appropriate treatment plan for each individual patient. “DCISionRT really supports my holistic approach. I can confidently tell a patient if they will benefit from radiation therapy and design a treatment plan that is tailored to them.”
