Elizabeth M. Swisher, MD, Finds Juggling Research Projects and Clinical Care Improves Both
This is the most exciting time ever in the field of oncology. Our knowledge of the biology and genetics of cancer has reached a point in which we can finally save more lives than we thought possible only a decade ago.
—Elizabeth M. Swisher, MD
Elizabeth M. Swisher, MD, Medical Director of the Breast and Ovarian Cancer Prevention Program at the Seattle Cancer Care Alliance, enjoys developing long-term patient relationships and helping patients who are confronted with cancer and terminal issues. She is particularly interested in the genetics of gynecologic cancers and developing ways to assess cancer risk and maximize cancer prevention.
Dr. Swisher was born in Dublin, Ireland. “My family lived in several countries during my early childhood. We lived in Morocco, and my brothers went to a French-speaking school. When I was 4 years old, we moved to the States, settling in the San Francisco Bay area. My dad worked in international finance, and we always had a lot of visitors from around the world. It created an international sort of atmosphere, which in turn helped me develop a sense that the world was barrier-free. I lived there through high school, and in 1987, I left for the East Coast, attending Yale University,” said Dr. Swisher.
Asked why she chose Yale University, Dr. Swisher said: “My parents had met at Stanford, which was right in our backyard. It certainly offered a lot of pluses, but I wanted something more exotic, if you will, and going across the country was exotic at the time. Also, I was a soccer player, an athlete. Yale had a women’s lacrosse program, which was not played on the West Coast. So learning to play a new sport was a nice byproduct of my decision to go to the Yale.”
During college, she spent a summer working in France. In 1988, Dr. Swisher went to the University of California San Diego School of Medicine in La Jolla, California. “While I was in medical school, I went to Guatemala to work and learn Spanish, then I went to Kenya, where I worked at a small rural hospital. I traveled around Africa, arranging things on my own with very little money. It was a great experience, and it taught me that travel and connecting with people from other regions in the world could be done fairly inexpensively,” said Dr. Swisher.
Early Interest in Oncology
In college, Dr. Swisher was interested in math and science; she was drawn to solving puzzles within both disciplines. “I really liked math, but I didn’t fully understand how solving mathematical puzzles would translate into the real world in a way that I could feel good about. I wanted to solve tough puzzles that could potentially change people’s lives for the better,” revealed Dr. Swisher.
Her interest in oncology developed at an early age. “For as long as I can remember,” she explained, “I’d been interested in oncology. As a kid, I remember reading an article when researchers first made the connection between a virus and cancer. I did a report on a viral oncogene that could initiate the carcinogenic process. This was in elementary school, during the days before photocopiers, when you would trace a figure on paper, like a cell. I was fascinated by the concept that your own cells could turn on your body. It was the scientific puzzle that attracted me.”
Dr. Swisher said that when she did her clinical rotations at the University of California San Diego School of Medicine, she was interested in all oncology subspecialties. “Someone once told me that when you go into medicine, you’ll ultimately pick a specialty or field that best describes what you feel being a doctor is. If your preconception of wearing a clean white coat and getting to the golf course at 4, you might gravitate toward dermatology,” she quipped.
“My conception of doctoring was treating people with life-and-death illnesses and even though not always being able to cure them, to be with them during their most difficult times. And given the mortality issues, the doctor-patient relationship in oncology is special. So oncology best described to me what being a doctor was all about,” admitted Dr. Swisher.
Life’s Work in Ovarian Cancer
Asked why she chose ovarian cancer as her life’s work, Dr. Swisher said: “One thing that attracted me to gynecologic cancers was that it’s the one specialty that we do both surgery and chemotherapy. Although I liked the surgical aspect, I wanted to follow my patients after surgery, during their whole journey. And I also love research, and ovarian cancer is the most deadly gynecologic cancer. So if you want to make a difference, it’s natural to be drawn to the most difficult-to-treat disease.”
She continued: “Getting back to my love of scientific puzzles. When I first began working in ovarian cancer, we didn’t even know how the disease started. We have good methods and clear understanding of the etiology of certain cancers, such as cervical, breast, and colon, but not in ovarian; consequently, the disease usually presents at a late stage. So my initial research centered on that clinical mystery, and we learned that most ovarian cancer does not begin in the ovaries but in the fallopian tubes.”
Protected Position in Research
After medical school, Dr. Swisher, who said that she was drawn to the verdant rocky coastline of the Northwest, perhaps by a latent memory of her Irish childhood, went to Seattle to do her obstetrics and gynecology internship in 1992 at the University of Washington School of Medicine. She began her residency in 1993 at the same institution.
“After my residency, I did a fellowship in gynecology and obstetrics at Washington University in St. Louis. It was a great experience,” said Dr. Swisher, “but I really missed the northwest. I’d send Christmas cards to my former colleagues in Seattle, reminding them not to forget me.”
She continued: “When I finished my internship, I was looking for a position that, in addition to clinical work, would also offer a protected position in research. I wanted to have my own lab, but if you’re too busy in the clinic, it’s not possible to be competitive and obtain research grants. As luck would have it, the University of Washington had just received a departmental National Institutes of Health (NIH) grant to help train clinician-scientists. It worked out to be 75% research and 25% clinical work. So I accepted the position.”
Working With Renowned Geneticist
Dr. Swisher returned to the University of Washington in 1999 as a research scholar with a developmental grant in the Women’s Reproductive Health Research Center. “I was fortunate to be assigned a great mentor, the renowned geneticist Mary-Claire King, PhD, and I’ve been working with her ever since,” said Dr. Swisher. She added: “Over the years, Dr. King has become more than a mentor; we’ve become friends, colleagues, and collaborators. It has and continues to be an incredibly rewarding experience.”
Dr. Swisher’s days are very full affairs, as she juggles several research projects and examines data and specimens from clinical trials. “I also spend quite a bit of time calling patients who might be on a clinical trial, giving results, and gathering more information about their family. At the same time, I see patients in the clinic. So, it’s a very busy schedule. I do a lot of genetic work, and as it turns out, my research informs my clinical opinions and vice versa.”
Great Time to Be an Oncologist
Asked about her outlook for the future she said, “This is the most exciting time ever in the field of oncology. Our knowledge of the biology and genetics of cancer has reached a point in which we can finally save more lives than we thought possible only a decade ago. It’s a great time to be an oncologist.” ■