Andrew Kung understands the first-day-of-school excitement that many of his patients went through this month — because he experienced it too, before joining MSK as the new Chair of the Department of Pediatrics in August.
Dr. Kung, who most recently was Chief of Pediatric Hematology, Oncology, and Stem Cell Transplantation at Columbia University Medical Center in New York City, follows in the footsteps of Richard O’Reilly, who led the department for more than 30 years.
We spoke with Dr. Kung to learn a little more about what led him to MSK and what he hopes to do now that he’s here.
Did you always envision a career in medicine?
Actually, in college I was a mathematics and chemistry major. As I was nearing the end of college, I discovered biology and medicine and fell in love with it. So late in my college career, I ended up cramming for the medical tests and got into medical school.
When did you decide on oncology?
The research that I’ve done has always been in cancer. It’s long fascinated me why it is that the basic processes that are important for life can get perturbed and actually cause such a terrible disease. It’s out of that research interest that my interest in treating people with cancer evolved.
I’ve always been interested in research, and that’s why in addition to doing my medical training, I also have a PhD in cancer biology. Having both degrees allows me to care for patients as well as do research that I can make sure is relevant to the patients in the clinic.
What sparked your interest in pediatrics?
I think it was the intersection of a lifelong interest in cancer and a love of children. Now, liking children is not by itself reason enough to become a pediatric oncologist. You have to be sure that you like treating sick children, and that was really cemented during my med school training. When I was given the opportunity to work with kids with cancer, it became a calling. In my mind, there’s no higher moral imperative than to be able to help a sick child — and particularly a child with cancer.
How would you say your research and patient care influence each other?
We’ve entered a time when research and the clinical practice of medicine have started to converge. What we do in the laboratory is helping the child in the clinic almost in real time. And the converse is also true: It is the child in the clinic who teaches us the most important things that we should be working on in the laboratory. So this is a very exciting time for us because we’re finally starting to see the convergence of the last 40 to 50 years of research, as well as seeing the impact that research can have on the patient in the clinic today.
How do you balance both sides of your career?
It is hard to balance, but I think that one of the unique things about working at MSK is that every person here is here for the same purpose, which is to care for people with cancer. The opportunity to collaborate with such an incredible group of people is quite energizing. And every person is willing to go that extra mile, stay that extra hour for the sake of the patient. That to me is very inspiring, and I wanted to be at a place that shared my commitment and my enthusiasm for the care of kids with cancer. To that end, there’s no better place than MSK.
What are some developments in pediatric cancer that you’re really excited about?
I think in pediatric oncology we have the good fortune of having done the research and improved outcomes progressively over the years, so that we now cure 80% of all children who have cancer. But that still is not good enough. So that’s a striking impetus for us to continue to try to do better.
The other issue we grapple with is that in the 80% of patients we cure, almost two-thirds have some sort of long-term side effect. And so we’re trying to decrease the toxicities of the treatments that we use. The ability both to do better in terms of long-term cure as well as to decrease the toxicity of our treatments — those are the most exciting trends in pediatric oncology today.
We hear a lot about precision medicine here. Could you explain what it means to you, and how you’re seeing it help pediatric patients?
The terms “precision medicine” and “personalized medicine” are very commonly used today. There are many of us who actually don’t like the term “personalized medicine” because to us, medicine has always been personalized. Every child that we treat, we make sure that we are not only treating the disease but also caring for the child and caring for the family as a whole.
The goal of precision medicine is to improve the technologies and discoveries that have come out of the laboratory and bring those to the patient in the clinic. Precision medicine as we practice it uses the latest technologies to characterize the child’s cancer, to figure out precisely what went wrong that resulted in the development of the disease. Then we tailor and personalize the treatment plan to be as precise as possible in treating the tumor, being mindful to minimize the toxicities as we treat the child.
How do you cope with the emotionally intense aspects of your job?
Although there are parts of the practice of pediatric oncology that are emotionally a roller coaster, I think you really have to be able to see the silver lining. We can’t measure the success of what we do merely on the basis of whether a child is cured. In many cases, even if a child is not cured, there’s so much we can do in extending his or her life and making sure that life is as comfortable as possible. We have to be able to see that silver lining during those days when the roller coaster is on the downswing.
Being a pediatric oncologist is actually very rewarding. Just walking into the clinic and seeing the kids running around and playing, you would not know that these children had cancer but for the fact that they’ve lost their hair from the chemotherapy. And that sort of resilience and vigor is really very inspiring.
Now that you’re here, what’s one short-term and one long-term goal you have for the department?
My short-term and long-term goals are the same: to take the foundation of excellence that Richard O’Reilly has built in this department and reach even further to find better ways to treat children, and ultimately find ways to return kids back to normal life as quickly and as meaningfully as possible.
Has Dr. O’Reilly given you any advice as you start your new position?
Dr. O’Reilly is one of the fathers of our field. The most important advice that he’s given me is that this place is full of great people, and that I should look around and figure out how to empower the great people who are here to do even bigger and better things.
Collaboration is very important to you. It’s also a big hallmark of Vice President Joe Biden’s national Cancer Moonshot initiative. How do you envision collaboration within the Department of Pediatrics and across the institution?
At MSK, we are surrounded by excellence, not only within the different disease areas but also in basic sciences and translational sciences. I want to make sure that we take advantage of all of the excellence in research and clinical care that surrounds us and learn lessons from our adult oncology and research colleagues. It’s only through collaboration that we can really achieve the type of synergies that allow us to make leaps forward, not only in pediatrics but for all patients with cancer.
Ten years from now, what do you think the biggest change in childhood cancer will be?
I think that the history of childhood cancer has been one of steady improvement. And I believe that with the tools that we have in hand now, we will continue that improvement as we push forward toward the goal of curing one hundred percent of our patients. I don’t know if we’ll reach that in ten years, but I think we will get closer to that goal.
What do you like to do when you’re not working?
I’m a very avid skier. I like vacations where I’m doing something. It fits in with my persona at work, that I don’t like sitting still.
What is one of your favorite children’s books?
I have three kids. My daughter’s favorite children’s book was Pat the Bunny. I still give it as a gift to new parents. For my boys, their favorite book was Go, Dog. Go!
What’s your life motto?
I don’t know about a life motto, but I do have a saying that I use with our fellows. They are trainees that are learning how to be pediatric oncologists, and my saying to them is that as a pediatric oncologist, it’s our obligation to do right for our patients today and do better for our patients tomorrow.