Success stories in research, advocacy, and education from low- and middle-income countries deserve international recognition to motivate the next generation of researchers and practitioners and enrich global oncology. I recently had the privilege to speak with Ouissam Al Jarroudi, MD, about her career trajectory as well as an important book project focused on breast cancer. Prof. Al Jarroudi is a medical oncologist at Mohammed VI University Hospital and Professor in the Faculty of Medicine and Pharmacy, Mohammed First University, Oujda, Morocco.
Ouissam Al Jarroudi, MD
Early Career Path
Can you share a bit about your journey into medical oncology? What inspired you to specialize in this field?
To be honest, during the initial stages of my medical studies, I held little enthusiasm for medical oncology as a prospective career path. Like many of my peers, I perceived it as a potentially depressing field of medicine, with cancer often being considered a fatal condition. Furthermore, I harbored doubts regarding the efficacy of contemporary antitumor treatments in combating cancer cells and enhancing patients’ outcomes.
However, my perspective underwent a profound shift during my internship in the Medical Oncology Department of Mohammed VI University Hospital in Oujda, Morocco, in my fifth year of medical school. To my surprise, I found immense satisfaction in this clinical setting, discovering a passion for the complexities of oncology care. This transformative experience ultimately led me to commit to a career in this field, driven by a fresh appreciation for its challenges and rewards.
What fascinates me about this specialty is its position at the intersection of various fields, including biology (encompassing carcinogenesis, oncogenetics, and immunology), comprehensive patient care across multiple organs, and supportive and palliative care. Oncology represents a multidisciplinary and dynamic field, which is very rich in terms of human relations. Collaboration and teamwork with other medical disciplines are integral to the practice of medical oncology.
In clinical practice, medical oncology provides patients with cancer with a holistic and integrated approach to their care, encompassing research, prevention, diagnosis, treatment, rehabilitation, as well as supportive and palliative interventions. It fosters a unique patient-doctor relationship, offering a wide spectrum of clinical scenarios. Moreover, recent years have witnessed remarkable breakthroughs in treatment modalities within this specialty.
The dynamic and extensive nature of medical oncology, particularly its vibrant landscape of clinical and translational research, has greatly inspired my career trajectory. Alongside my aspirations for clinical practice, I harbored a strong interest in pursuing an academic path, dedicated to both teaching and research careers. This ambition led me to successfully compete in the recruitment process for an assistant professorship at the Faculty of Medicine and Pharmacy in Oujda.
Additionally, my passion for translational research came into play during an internship at the Translational Research Department of the Léon Bérard Center in Lyon, France, where I had the privilege of working under the mentorship of Prof. Pierre Saintigny. This experience profoundly influenced my vision of becoming an academic oncologist and reinforced my commitment to bridging the gap between scientific research and clinical practice.
Focus on Breast Cancer
What motivated you to focus on the subspecialty of breast oncology?
My focus on breast cancer stems from its significant prevalence in Morocco. Globally, breast cancer remains the most prevalent cancer and the leading cause of cancer-related deaths among women. The evolution of breast cancer management has undergone remarkable transformations in recent years, primarily driven by advances in the omics sciences, including genomics, transcriptomics, proteomics, and metabolomics.
Breast cancer stands out as one of the most heterogeneous tumor types, influenced by a multitude of factors that drive its initiation and progression. At the end of my medical studies, I was tasked with completing a doctoral thesis on a subject of my choosing to obtain my MD. I opted to explore triple-negative breast cancer for my thesis defense. This opportunity allowed me to deepen my understanding of this specific aggressive subtype and attracted me to specialize in this area.
Book Project
You recently published a specialized book on breast cancer and served as the primary editor. Can you tell us about the establishment of this project?
The genesis of the book, Breast Cancer Research and Treatment: Innovative Concepts,1 arose from the unmet need to enhance outcomes for patients with breast cancer, supported by the aspiration to propose a potential treatment paradigm for this disease. My primary aim was to capture all innovative treatment modalities available for breast cancer, encompassing surgery, radiotherapy, systemic therapy, and immunotherapy. Furthermore, I sought to focus on emerging research in the fields of screening, diagnostics, and management across all subtypes of breast cancer.
Fortuitously, I had the privilege of working with you [Dr. Khalid El Bairi] and Dr. Giuseppe Curigliano as my co-editors throughout every phase of the project, from inception to completion. We also had the privilege of inviting Dr. Sandra Swain, former President of ASCO, to write the preface for our book. Her endorsement was invaluable, given her renowned advocacy for women in oncology through Conquer Cancer, the ASCO Foundation.
African Women in Academia
Notably, you are the first woman from Morocco to edit a book specialized in breast cancer. Talk about some of the challenges women in academia face in Africa.
Women oncologists in Africa face several barriers and challenges to making a career in research, particularly in male-dominated regions. And editing a book is no small feat. It demands time, effort, and coordination with various stakeholders, including the publishing house and multiple authors, in addition to the peer-review process to respect international standards of science publishing. However, some countries in Africa like Morocco are facing a significant shift toward supporting young women scientists to shine in their field. In my case, I received invaluable assistance from my co-editors, and my responsibilities were significantly eased. I therefore extend my gratitude to all individuals who are supporting women in their settings, to make a global shift toward gender equity in academia.
Women in Medicine and Research
Is the setting you work in supportive of women as leading researchers?
Gender imbalance in leadership roles within the field of oncology remains a global concern, reflecting the underrecognition of women’s contributions to research and in health-care systems. In the North African context, collaborative efforts at individual, institutional, and national levels are imperative to address the underrepresentation of women oncologists in academia. Despite some progress, women’s achievements in the field are still not fully acknowledged, largely influenced by the social and cultural dynamics of each region.
Although I was fortunate to receive some support from colleagues for my own advancement, many women oncologists continue to encounter gender inequities. International medical oncology associations like the European Society for Medical Oncology (ESMO) and ASCO have undertaken efforts to raise awareness and implement strategies to bridge this gap, yet substantial work remains to be done, even in my setting in Morocco.
As a woman oncologist in a field that is constantly evolving, how do you see the role of women in medicine and research, particularly in Morocco?
There is a growing role for women in oncology and research, which is essential for gender equity and its impact on improving patient care. Women contribute to enhancing research on cancer prevention, developing innovative therapies based on hypothesis-driven basic/translational/clinical research, and raising a new generation of breast oncology investigators.
A recent study highlighted differences in gender balance among medical oncology subspecialties.2 More women practice breast oncology, whereas more men practice genitourinary oncology. This could be related to patient preference but may also be related to subspecialty culture and the presence of role models within fields. The current literature suggests women oncologists are more interested in breast oncology, including in Morocco.
In my opinion, encouraging and motivating women doctors, as well as providing them with the necessary funding, constitute the main factors contributing to improving research and clinical practice for patients with breast cancer. Promisingly, recent findings from the GEORGiNA study indicated a balanced distribution of senior author positions between women and men in oncology publications in Morocco.3 Furthermore, there has been a notable increase in the number of women serving as lead authors in recent years, underscoring a positive trend toward gender equity in the Moroccan research workforce.
Advice for Young Women
What advice would you give to young women aspiring to enter the medical field?
The key factor is curiosity. Oncology is a rapidly advancing discipline, with great progress in research in both basic and clinical sciences. Consequently, there are abundant new discoveries and opportunities to explore for a better career. I believe that fostering curiosity and maintaining enthusiasm for these advances will enable women in the field to go beyond their traditional roles, particularly in male-dominated environments.
Women have the opportunity to perform research and benefit from the therapeutic revolutions of the past decade. Oncology is a great field that offers a unique and strong relationship between the patient and the caregiver, the possibility of long-term follow-up, and global care with social and psychological dimensions. The multidisciplinary aspect in this specialty is a strength, including the management of complications and adverse events of anticancer therapies, as well as ongoing interactions with other specialists for a holistic management approach.
Perseverance is the key to success! The first steps in the medical domain are and will always be difficult, but confidence comes with time and experience. You can easily fall in love with this specialty.
Work-Life Balance
How do you balance the demands of your profession with personal goals and well-being?
In addition to the emotional challenges of working with patients whose disease threatens their lives, a career in oncology requires a commitment to lifelong learning. In my case, I divide my day over four periods. In addition to my clinical and teaching activities, I devote time to research and free time for my family and myself. Finding a balance between these different activities can be difficult. However, I am fortunate to manage to maintain a certain balance between my work and my personal life most of the time. Recently, I started practicing sports regularly. In addition to helping me stay healthy, physical activity is a stress reliever that helps me to manage my daily worries and enhances my performance and productivity.
Looking Ahead
What are some areas of breast cancer research and treatment that you believe need more attention or innovation?
There is an urgent need for more research in diverse areas of breast cancer, such as identifying novel risk factors, developing prevention strategies, discovering new biomarkers for patient stratification, and finding novel therapies with better clinical benefit/toxicity ratios. Moreover, the integration of artificial intelligence could enhance our treatment selection process, predict treatment responses, and offer solutions for resource-limited settings, particularly in the imaging domain, where there is a shortage of oncology personnel.
Morocco holds great potential in translational research as well as clinical trials but faces numerous challenges as well. There is an urgent need for our patients to be included in international multicenter clinical trials; health-care policy requires development; and more local research needs to be conducted, particularly studies that may impact our daily practice.
Dr. El Bairi is a clinical research fellow at the Faculty of Medical Sciences, Mohammed VI Polytechnic University, Ben Guerir, Morocco.
DISCLOSURE: Dr. El Bairi and Dr. Al Jarroudi are co-editors of the book Breast Cancer Research and Treatment: Innovative Concepts.
REFERENCES
1. Al Jarroudi O, El Bairi K, Curigliano G (eds): Breast Cancer Research and Treatment: Innovative Concepts. Cham, Switzerland, Springer, 2023.
2. Graham LS, Sokolova AO, Khaki AR, et al: Gender differences in faculty rank and subspecialty choice among academic medical oncologists. Cancer Invest 39:21-24, 2021.
3. El Bairi K, on behalf of the GEORGiNA study collaborators: Systematic mapping of gender disparities in oncology publications of North African countries: The GEORGiNA study. JCO Glob Oncol 9(suppl 1):112, 2023.
