Patient’s Letter About ‘One Sip of Water’ Serves as Reminder for Gastrointestinal Oncologist

SPECIAL SERIES: WOMEN IN ONCOLOGY

Women faculty at Moffitt Cancer Center come from different backgrounds and cultures around the globe. Their areas of research and clinical care span the entire cancer continuum, including clinical science and trials, basic science, epidemiology, health outcomes, medical physics and more. Community involvement, mentorship and inclusion among faculty are foundational, and we celebrate the essential roles women play in making a difference at the cancer center and in society.

An Interview with Dr. Rutika Mehta

Rutika Mehta, MD, MPH, has been a gastrointestinal oncologist at Moffitt Cancer Center for six years. She received her medical degree from Topiwala National Medical College in Mumbai, India. She earned a Master of Public Health in epidemiology at Indiana University School of Medicine in Indianapolis. Mehta also completed a one-year research fellowship in pathology at Indiana University School of Medicine, Translational Genomics Core. She completed her internal medicine residency at Johns Hopkins University/Sinai Hospital of Baltimore, Maryland. Mehta completed a hematology/oncology fellowship at the University of Buffalo, Roswell Park Cancer Institute, in New York. Her clinical and research interests focus primarily on esophageal and gastric cancers and cancer genomics.

What made you want to go into medicine as a career?

Honestly speaking, I wanted to be an aeronautical engineer. But I was an only child, and my father wanted to keep me far away from anything that involved flying. So after college, I tried to do something unconventional and started with dental school. I soon realized it was not meant for me. I was fortunate enough to transfer to the medical school at the same institution. Soon enough, the workings of the human body were very fascinating, and I still feel that transition to be the best decision I made.

I was exposed to the field of oncology when I began working in the lab of a breast pathologist while doing my master’s in public health. Learning about breast cancer and genomics developed that passion in me to look more into oncology as a career.

What are you working on right now that you are most excited about?

My focus has been upper gastrointestinal (GI) cancers, including esophageal and gastric cancers. What’s most important is improving survival in these patients. We see a higher proportion of older patients in Florida. How can we optimize treatment for them, especially if they are early stage? Not all of our patients are eligible for surgery. Are there treatment options beyond chemotherapy and radiation that we could offer? So that’s one aspect I’m working on.

The next aspect is that a majority of patients diagnosed with GI cancers are in stage 4. For years, we have been using the same chemotherapy backbone to treat patients, yet we cannot identify which patients will have a long, durable response while others will not. With the help of some philanthropic funds, we are now embarking on a project where we collect tissue specimens from patients before and after starting chemotherapy to identify any changes in the tumor that can predict response to treatment.

As you have grown your career both in clinical care and research, what is a surprising lesson you’ve learned?

At Moffitt, I have been fortunate to serve many patients with aggressive cancers. One of the challenges that comes with this is that most of them have complex medical problems and symptoms. It is hard to see them not be able to swallow and yearning for a gulp of water. Over time, we develop a connection with our patients and family members, know about their vacations, important life events, etc. While I feel like I am always prepared for a challenge, losing a patient is very hard emotionally.

Another surprising thing is that we’ve seen an influx of younger patients, and we just don’t know why. The average age that gastroesophageal cancers are diagnosed is 65. But I’m seeing patients who are in their 30s and 40s who are not expected to have this type of cancer.

What is one of the biggest challenges in your field?

The biggest challenge is to have a balance, as a mother, as a wife, as the only child of my parent, as a physician, as a researcher and as a friend. I was recently listening to a podcast that said to imagine yourself in a four-seater car and you are one of the passengers. You can have only three other priorities to fill the seats. But most women have more than three priorities. So it’s challenging to cut down the number of priorities.

Who is the person who encouraged you the most in your career, and how did they impact you?

There are many people who have impacted my career. I wouldn’t have been here without my mother. She taught me the principles of how to balance being a career woman and having a family.

I have to thank my mentor at Indiana University who encouraged me toward oncology. My mentor during fellowship who is a GI oncologist gave me advice to consider GI oncology as a career. And had I not been here at Moffitt with all my great colleagues, I would not have been as successful at what I do. Everybody has contributed a lot.

My husband, who I have known for 22 years and is also an oncologist, knows what I go through each day. His support has been paramount.

What are some of the big lessons you have taken from mentors?

“Everything happens for a reason. If it is meant to be, it will happen.” When I started working in the breast cancer lab, I thought I wanted to be a breast oncologist. During the end of my fellowship, I was interviewing for breast oncologist jobs, but I just didn’t feel like I fit anywhere. My mentor, the GI oncologist, asked why I was so focused on breast oncology and suggested I look into GI instead. He recommended Moffitt, so I interviewed here, and I haven’t looked back.

What is one important lesson you’ve learned from a patient?

A lot of times we are so focused on what’s the next treatment that we forget how the patient is actually feeling. One thing I learned early on is that a lot of patients with esophageal cancer are not able to swallow, even saliva. The wife of one of my patients wrote me a letter after he passed away. She explained how, toward end of life, his quality of life was significantly affected by increased secretions, and she suggested that I should pay more attention to this and address this as a symptom. She was right. From that point on, discussion about quality of life due to symptoms from the cancer has been a major part of my conversations with patients. I try to do my best to address them.

Another patient who touched my heart wrote a letter to me and my team, saying he yearned to have one sip of water. I haven’t forgotten that sentence.

These things have made me deeply understand what our patients go through on a daily basis. I do a better job now to walk patients through what their expectations can be from the start of the journey.

How do you maintain a good work/life balance?

For me, my family is very important. I was the only child, and my mom quit her full-time job to raise me. But she also told me: “You need to be an independent woman. Never quit your job.” So I’m trying to follow her legacy but do things differently. I actively try not to keep my work laptop open in front of my son after 6 p.m. It is a routine in our home to ask our son about his day at school, read a book, browse through old photos or just talk about friends. My son has been learning to play the piano, so it is fun listening to him play now. On the weekends, I make it a point that if he is awake, I won’t turn on my work computer.

If you had to change careers completely, outside of medicine, what would you be?

I would probably be a chef. I love to cook. Cooking is my stress buster. I love to cook any type of cuisine, for family or for large groups of people, and I love to experiment with new recipes.

What support positions or unsung heroes do you most appreciate at Moffitt?

Usually I am the last person to leave the clinic, and I see the environmental services staff cleaning the patient rooms. We don’t usually get to see them during the day, but I would say a thank you to them. Patients feel like they’re in a safe environment with a clean room.

There are a lot of people working behind the scenes. As a large cancer center, we tell patients to get their bloodwork before their appointments and results will be ready in 45 minutes in time for their clinic appointment. That happens because someone is working behind the scenes to ensure the blood from phlebotomy gets to the lab and the person in the lab is running the machines and reporting results. It’s frustrating when labs are delayed, but we never tell them thank you for the majority of the times that labs are on time.

What do you wish people knew about cancer prevention that’s not common knowledge?

When we talk about living a healthy lifestyle, we’re not just talking about eating a salad every day. That’s not enough. You need to also be mindful of whether you’re having three good meals a day. A lot of people skip breakfast or snack at midnight or have dinner late and go straight to bed. We may lose track of how much coffee we’ve had, and caffeine can cause a lot of changes in normal tissue that might be unfavorable in the long run. Physical activity is also very important. We fail to realize how little we actually exercise or walk if we don’t make a conscious effort. These are all little things we could change to improve our overall health and contribute to cancer prevention.