Why I’ve devoted my career to cancer prevention

If you had told me years ago that one day all I’d be doing was preventive medicine — and it would all be related to cancer — I’d have said you were crazy. I am not an oncologist. My board certification is in family medicine.

Still, when I was offered the position of medical director at MD Anderson’s Lyda Hill Cancer Prevention Center in 1996, I accepted. It was such a new field then that I appreciated the challenge. But I thought I’d stay only four or five years. And here I still am, nearly 25 years later.

How I got into preventive medicine

I always knew I wanted to work in health care. My maternal grandmother had hip surgery when I was 10, and I helped nurse her. I’d go get her medications, then take them in to her on a tray. I also changed her bandages and helped her get around. She needed a lot of care.

It was because of that experience that I thought I wanted to become a nurse. So, when I went off to college, my major was nursing. But I rapidly learned that nursing wasn’t my strength. Thankfully, a good advisor steered me toward medical school. I found my niche in family medicine.

Once I entered private practice, I didn’t think I would like doing well-woman exams at first. But then I realized that my interactions with patients during those visits tended to be much calmer and more productive than the ones I had with them when they were sick or injured. And I could really do some things to help people, by educating them and sharing information. So, I started gravitating toward preventive services.

How much cancer prevention has evolved

In my earliest days at MD Anderson, I had more than one faculty member come up to me and say, “I don’t know why you’re here. We don’t need a prevention center.”

But back then, genetic testing for cancer was still in its infancy. And that was before tamoxifen had been shown to reduce the risk of developing breast cancer by 50%. There was also no evidence of weight or fitness being linked to cancer. Now, there is. So, that’s changed the whole paradigm.

We’ve made such huge strides in cancer prevention since those early days that one of the doctors who originally said we didn’t need a prevention program actually asked me to come give a presentation on that very topic. It was really humbling.

The best part of my job: reducing women’s anxiety

Today, interacting with patients is still the highlight of my week. A lot of women who come to see me are very confused. I like unraveling that confusion and replacing it with understanding.

For instance, I’ve had several patients come in with a diagnosis of lobular carcinoma in situ. They’ve been told it was cancer. I reassure them that it’s not, then explain what it is: a condition that predisposes them to possibly developing cancer someday. Sometimes, they’ve also been told that they need surgery right away. I say, “Well, you might or you might not. But we’ll go through a process to determine that.”

I really enjoy educating women on their cancer risk and everything we can do to minimize it. Sometimes, it’s just a matter of framing something differently, so they can better understand it. I might say, “Yes, you’re at higher risk for developing some cancers, but here’s what we can do to catch it early, when it’s more treatable, so you can survive it.” Most of all, I love decreasing patients’ anxiety. That’s the best part of my job.

Therese Bevers, M.D., is medical director of MD Anderson’s Cancer Prevention Center.

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