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Interview with Radiation Oncologist Abby Berman

Radiation oncologist Abigail Berman, MD, MSCE

Abigail T. Berman, MD, MSCE is an Assistant Professor in the Department of Radiation Oncology. She specializes in the treatment of patients with lung cancer and other thoracic malignancies with photon and proton radiation therapy. To learn more about her research, practice and experience at Penn, read our interview with Dr. Berman below:

What is the focus of your clinical practice?

I see primarily lung cancer patients, or any patient with cancer that arises within the thorax; for example, I also specialize in thymomas. I am also frequently asked to treat other cancers that have spread to the lung.

How did you become interested in radiation oncology?

I was drawn to cancer patients in medical school. Also, my mom was a cancer patient, and her doctors were really special role models. I specifically chose Radiation Oncology because I was fascinated with looking at the tumor and thinking about how to reach it with radiation, with minimal side effects for the patient. I’ve always been a big puzzle person. Radiation oncologists have a very deep understanding of tumors— their natural behavior and the power of multidisciplinary care with systemic therapy, radiation, and surgery.

What made you decide to stay at Penn after medical school and residency?

Penn is a unique combination of world-class minds and physicians and an extremely friendly and family-like environment, particularly the Department of Radiation Oncology. The people in our department and the whole lung group are brilliant and amazing colleagues. Also, and this is very important to me, the patient always comes first at Penn.

How did you choose to specialize in lung cancer?

When I was coming out of residency, my main mentors were lung cancer doctors and there was an availability to work with them on their team.

What's it like to practice in Philadelphia?

It’s wonderful being able to treat patients in your hometown. It adds a special connection. It’s really a privilege.

What is the focus of your research?

I have three areas of focus. The first is clinical trials combining radiation with immunotherapy or other forms of modulation to make radiation work better. Another area is proton beam therapy for lung cancer. A third area is the use of big data to improve lung cancer clinical workflow.

How does your training in epidemiology inform your work?

In my master’s program, I focused on clinical trial design, an increasingly challenging area. We want clinical trials to move quickly so that we can find answers and make improvements in care available to all patients. The pace of change in lung cancer treatment is so fast that we have to ask and answer these questions at an unprecedented rate. For example, Christine A. Ciunci, MD, MSCE, Assistant Professor, and I lead a trial at Penn that uses proton beam therapy, followed by immunotherapy, for the retreatment of lung cancer. Since the trial opened, the landscape of lung cancer treatment has changed, and many more patients receive immunotherapy up front. We’re thinking about changing the trial to include patients who have had immunotherapy in the past. That’s just one example of how quickly the field is changing.

What do you mean by 'big data' research?

We have a very strong multidisciplinary lung group at Penn. We’re always looking at ways to make care better for our patients, including improving the flow of care at Penn. For example, a lot of our patients end up in the ER. We’d like to prevent that from happening. I have a partnership with Penn Predictive Analytics. We developed an algorithm to predict which lung cancer patients in our care are going to wind up in the emergency room within two weeks. The algorithm assigns a risk prediction score based on information in the patient record. We’re now working on an artificial intelligence/robot text-based model to interface with the algorithm, as we learned that patients prefer text over calling.

What else are you working on that excites you?

I have four clinical trials open. They all involve collaboration with Penn colleagues. One phase 1 trial looks at the microbiome and tries to modulate the microbiome by using antibiotics to change a patient’s immune response to radiation. It should be very interesting.

What sets the lung cancer group at Penn apart?

Penn is very collaborative. We are constantly picking up the phone calling one another in the middle of the day.

How is the use of radiation oncology in lung cancer changing?

Radiation oncology has typically been a black box field. Even a lot of medical students don’t learn what it’s all about it. We were in the basement and not always a full member at the table for cancer care. This has changed. The indications for radiation are rapidly expanding. For example, for patients with metastatic disease, radiation has always had a role in symptom relief. Now we also use radiation in patients with metastatic disease who have cancer in a limited number of sites with the goal of not just symptom relief but eliminating that site of cancer.

How do you talk to patients about radiation oncology trials?

Radiation oncology trials sometimes ask questions about what drugs to add to radiation and there are others that look at technique. For example, we have a study open that is randomizing lung cancer patients to protons and photons.  It can be very challenging to explain esoteric physical principles to patients.  You can’t just scratch the surface.  Most want to understand the differences, the pros and cons. A consult can turn into a mini-physics lesson — in a good way! Patients really want to understand.

What's special about radiation oncology at Penn?

Most notably, the dedicated staff and physicians in the department and the strong and courageous patients. Also, we’re so lucky to have proton therapy here at Penn. Proton therapy holds a lot of promise for lung cancer because it may decrease the risk of side effects.  In a patient population that often is tenuous and doesn’t have room to endure a significant side effect, proton therapy may help by decreasing the amount of radiation that goes to the normal lung and heart.  The Roberts Proton Therapy Center is a tremendous resource for the Greater Delaware Valley, and also as a key proton research center for the world.

You also serve as Associate Director for the Penn Center for Precision Medicine. What does that involve?

It involves working with an amazing leader, David B. Roth, MD, PhD, and a group of energetic and bright individuals across the university. We’re trying to think about how to bring precision medicine to Penn in a uniform, easy way for clinicians. The projects span across all disciplines. We support research at the pilot or implementation phase.

What do you enjoy about Philadelphia?

I love the restaurants, the museums, the walkability. Philadelphia is an accessible city, and it draws everyone into the city.

What do you do when you're not working?

I have a toddler who keeps me busy. I also cook and do yoga. My husband and I love Italy so we try to recreate dishes we’ve had there. We try to get to concerts whenever we can. We recently bought a home so we are enjoying some small projects around the house and meeting the neighbors.

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The Focus on Cancer blog discusses a variety of cancer-related topics, including treatment advances, research efforts and clinical trials, nutrition, support groups, survivorship and patient stories.

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