Surgeon Shares Biggest Lesson: ‘Never Underestimate the Power of Hope’
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. Monica Avila
Monica Avila, MD, MPH, received her combined bachelor’s and doctor of medicine degree from the University of New Mexico and her master’s in health care management from The University of Texas School of Public Health. She completed a residency in obstetrics and gynecology at Kaiser Permanente Los Angeles Medical Center. She completed her fellowship in gynecologic oncology at The University of Texas MD Anderson Cancer Center. At Moffitt Cancer Center, her clinical focus is gynecologic malignancies. She specializes in complex surgical approaches, including minimally invasive techniques. She has a special interest in HPV-driven malignancies.
What made you want to go into oncology as a career?
For me personally, it’s the longevity — that long-lasting relationship with patients. Out of all the OB-GYN subspecialties, in oncology, you really get to see a patient and build a strong lifetime bond. You guide them through surgery and then chemotherapy, and even in some cases end of life.
What is the biggest lesson you’ve learned from a patient?
I think the biggest lesson is to never underestimate the power of hope and the power of the patients’ will to live. I’ve had patients literally placed on hospice care who I have taken to the operating room, had successful optimal debulking for ovarian cancer and who are living life right now after chemotherapy. So I never underestimate patients’ ability to keep going and keep living.
What are you working on right now that you’re most excited about?
I have a big passion for health equity, both on the research and clinical side. On the clinical side, each year I do an annual mission to Guatemala through an organization called Faith in Practice. We offer surgical interventions for people who have sometimes never even seen a physician.
From a research standpoint, I’m very interested in HPV-driven diseases like cervical, vulvar, vaginal — the lower genital tract — cancers. I’m interested in forming a consortium of HPV providers across Florida and working toward creating a genomic banking tissue and blood system. The goal is to further different research projects across the state and codify the genetic and genomic profile of populations that have never been fully studied in the literature. For example, all the different Hispanic populations that are in Florida, we’ve never really seen what their genetic or immune profile is and how that relates to how they could be impacted by their treatment.
What is one of the biggest challenges you’ve had in your field and in your career?
I would say figuring out how to best help these diverse populations. We’re up against a lot of socioeconomic barriers, which include financial barriers, transportation barriers, insurance barriers. You realize that it takes a lot to be able to make actionable changes, especially if you’re starting from a place where a lot of these populations haven’t even been studied. That’s been the biggest eye-opener for me.
Who is the person who has encouraged you the most in your career, and how have they impacted you?
My mother has impacted me the most. I’m originally from Havana, Cuba, and she is a foreign medical graduate. She really inspired me because she gave up everything to allow me to pursue my career at the expense of hers. She still works in the medical field now but definitely gave up a lot for us to be able to start anew and grow our own path.
What advice would you give people starting out?
In medicine, no matter how long the journey is, you really have to pick your passion. If you don’t choose what you’re passionate about, you will just kind of flounder and you won’t be doing what’s best for your patients.
How do you continue to grow and develop both professionally and personally?
You need things in medicine that make you feel uncomfortable, situations that make you grow. For me, surgical missions push me to become a better surgeon, to become a better doctor. In Guatemala, you don’t have the equipment that you normally would operate with. You don’t have the personnel. You don’t have the safety net barriers that you usually have — things we take for granted like blood availability.
They say nothing breeds innovation like necessity. When you do those surgical missions, you bring that all back home and apply it and vice versa when you go back. You learn to be creative, to pivot. That’s something that those patients give back to me, and I’m so thankful.
If you had to change careers completely, outside of medicine and research, what would you do?
That’s a tough one. I would probably be a farmer. I like seeing things grow and keeping things growing and going, watching that evolution. I guess it’s similar to oncology in ways.
How do you measure your own success?
I always gauge success by how my patients are doing. That doesn’t necessarily mean physically but also spiritually and emotionally. I like having that connection with them. I like asking patients about how their kids are doing and how their family members are doing. It’s amazing what you can elicit when you show people that you care about them.
What do you wish people knew about cancer treatment and prevention that’s not common knowledge?
Start early. I see so many patients who are so far down the pike and so late stage because they just didn’t want to go in, or they just thought it was nothing. So there is no such thing as a stupid question. There is no such thing as being too early in your cancer journey.
For gynecologic cancers, I would just encourage young women out there to get their HPV vaccine, get their Pap smears or even just go for a general OB-GYN visit. Sometimes you don’t realize it, but one thing leads to another, and we can catch things early. And those things that are caught really early on are highly curable.
