David Jones is a surgeon who cares for patients with cancers of the chest, including lung and esophageal cancers. As Chief of the Thoracic Surgery Service, he shares his thoughts on the future of treatment for these diseases and offers insight into the strengths of the Memorial Sloan Kettering surgical team. In addition to seeing patients in Manhattan, Dr. Jones will soon be practicing at MSK's new ambulatory cancer care facility opening in West Harrison, NY in October 2014.
What drew you to oncology and how did you end up specializing in thoracic surgery?
I became interested in oncology when I was a medical student performing tumor biology research. The laboratory where I worked was interested in how precancerous cells become cancerous and if there are changes in specific genes or proteins that could predict which patient would ultimately develop a cancer.
Great mentors who were superb surgeons and academic leaders in the field inspired my interest in thoracic surgery. These surgeons were trained at the very best institutions at the time, and their interest and passion was very appealing to me.
What is special or different about being a surgeon at Memorial Sloan Kettering?
MSK surgeons not only are superbly trained, they are also members of a highly select group of some of the most skilled surgeons in the world. In addition to possessing the highest level of surgical expertise, our surgeons exercise superb judgment of when and how to best perform a given procedure.
MSK surgeons have a singular focus on cancer or premalignant conditions, which provides them with a clarity of purpose. Moreover, our surgeons embrace the multidisciplinary aspects of cancer care and understand and appreciate the latest advances in medical and radiation oncology. Lastly, one of the most important missions for MSK surgeons is to innovate, perform patient-centered research, and generate novel therapies and procedures that will improve the care of our patients and that will serve as a model for other programs across the world.
What is the most important thing you tell patients when they come to see you?
At the end of every new patient office visit, I shake the patient’s hand, look him or her in the eye, and make a promise to take good care of that person. I specifically like to use the word “care” in my conversations with patients because we have all had that experience of feeling cared for in one way or another in our lives. It seems like a small thing to do, but there is amazing power in the physical contact that a handshake provides between a surgeon and an often scared and anxious patient who is facing a potentially deadly disease.
Where do you see your field going in the next five to ten years and how will that affect patient care?
In thoracic surgery, tragically we will continue to see an increase in the number of patients diagnosed with lung and esophageal cancers. Many lung cancer patients will be nonsmokers or patients who quit smoking ten to 20 years ago. Most of these patients will be older, and we need to be prepared to offer them operations that can give them the best chance of a cure while preserving their quality of life. These procedures will almost always involve minimally invasive approaches to remove their tumors.
In the next decade I believe we will see a more robust use of intraoperative imaging of tumors to guide our surgeons. There will also be more routine use of genomic and molecular characterization of lung and esophageal cancers that will inform decisions regarding treatment plans. I also believe that there will be continuing efforts to codify and standardize best practices in diagnosing and treating our patients with thoracic malignancies.
These efforts should be designed to provide the most-efficient and cost-effective care without sacrificing quality or superior outcomes. This will be a real challenge, but surgeons must take a leadership role. It is a very exciting time to be a thoracic surgeon — particularly an MSK thoracic surgeon.