Jamie H. Von Roenn, MD, FASCO
When Jamie H. Von Roenn, MD, FASCO, graduated from high school in 1970 and enrolled at the University of Illinois in Champaign, she was determined to seek a career in special education, because she wanted to “help people through difficult situations.” Although Dr. Von Roenn ultimately decided to drop special education as a career and pursue medicine instead, she’s been helping people through difficult situations ever since.
After receiving her medical degree from Rush Medical College, Dr. Von Roenn trained in internal medicine at Presbyterian/St. Luke’s Medical Center in Chicago and later took a position as attending physician at Northwestern University, specializing in lung cancer and melanoma. It was during her first month at Northwestern that Dr. Von Roenn became increasingly aware of how sick cancer therapies made patients, which she had witnessed during her fellowship training as well. She began to think about a career in palliative medicine, which at the time was a discipline on the fringes of mainstream oncology.
Dr. Von Roenn was offered the position of Medical Director of the Northwestern Hospice Program at Northwestern University’s Feinberg School of Medicine. There she trained medical students, residents, and hematology/oncology fellows in palliative medicine and headed efforts to incorporate palliative medicine into the medical school curriculum and internal medicine residency training. She became a co-principal investigator for the Education in Palliative and End-of-Life Care for Oncology (EPEC-O) project, an all-inclusive palliative medicine curriculum for oncologists developed in conjunction with ASCO, the National Cancer Institute, and the Lance Armstrong Foundation.
Today, palliative medicine is an integral component of comprehensive oncology care for patients with cancer. The World Health Organization now refers to palliative care as “a human right to health.”1 In 2016, ASCO published its Clinical Practice Guideline for Palliative Care, which recommends that patients with advanced cancer receive dedicated palliative care services early in the disease course, concurrent with active treatment.2 An updated guideline on palliative medicine is expected this year.
Board-certified in internal medicine, medical oncology, and palliative medicine, Dr. Von Roenn was recognized for her pioneering work in palliative medicine and her contributions to oncology care and cancer pain management with the ASCO–American Cancer Society Award and Lecture in 2011. She was the recipient of ASCO’s Statesman Award in 2009.
Decades of Dedication to ASCO
An ASCO member since 1986, Dr. Von Roenn joined the Society professionally in 2013 as Vice President of Education, Science, and Professional Development. In this role, she helps to plan, implement, and evaluate all formal United States–based education activities (including maintenance of certification and continuing medical education) provided by the Society for oncology professionals and support the training and professional development of oncologists throughout their careers.
Dr. Von Roenn has served on ASCO’s Board of Directors; the Palliative Care Task Force; the Scientific Program, Cancer Education, and Cancer Communications Committees, among others; the Cancer.Net Editorial Board; and the Leadership Development Working Group. She has also served as a leadership coach at the San Diego Palliative Care Institute through the International Fellows Leadership Development Program and has participated in the development of palliative care services worldwide. In addition, Dr. Von Roenn has served as Guest Editor for the Palliative Care in Oncology column in The ASCO Post since the column’s launch in 2014.
After nearly 4 decades in medicine and almost 11 years as ASCO’s Vice President of Education, Science, and Professional Development, Dr. Von Roenn is returning to her passion of early childhood education and childhood literacy. This spring, she announced her retirement from ASCO effective after the 2024 ASCO Annual Meeting. In this interview with The ASCO Post, Dr. Von Roenn discusses her tireless efforts to have palliative medicine recognized as essential to high-quality oncology care and integrated into standard cancer care—and her next act.
Letting Go of an Unsuccessful Program
Why did you decide to leave your clinical practice at Northwestern University and take your position at ASCO?
When I came to ASCO, in 2013, I had had a long-standing interest in education. In fact, my first and last research grants at Northwestern were both education-based, even though education isn’t what I had built my career around. I also felt passionately that the integration of palliative medicine into oncology care was essential for optimal cancer care.
When I was offered the position at ASCO by Allen S. Lichter, MD [former Chief Executive Officer of ASCO], I made it clear I had an agenda to see palliative medicine integrated into cancer care, and he said, “I know.” As a result, we launched a new symposium in palliative medicine with very clear metrics for success. One of those metrics was to increase the education of palliative medicine broadly to lead to the integration of the field of palliative care into oncology care. What we found was that clinicians who came to the meeting were seriously interested in palliative medicine, and they loved the meeting. But we were preaching to the choir, and attendance by oncologists not already committed to the integration of the two fields was low.
Physicians have time for only a couple of meetings a year. For most oncology clinicians, their second meeting focused on scientific topics or a disease site rather than on palliative medicine. As a result, ASCO chose to sunset the meeting and center efforts instead on innovative approaches to better integrate palliative care principles across the trajectory of the cancer experience.
One approach is ASCO’s Advancing Innovation in Residency Education (AIRE) pilot program called “Combined Oncology and Hospice and Palliative Medicine (HPM) Training. This program allows fellows to complete hematology and medical oncology and hospice and palliative medicine fellowship training in 3 or 4 years with a research year. The program, in partnership with the Accreditation Council for Graduate Medical Education, is for trainees wanting to advance research in symptoms science and further their palliative care skills to deliver high-quality cancer care with palliative/supportive care integrated across the continuum of care. The first cohort of fellows will finish their first year of training in June 2024. The second group has successfully matched, and the number of participating institutions is increasing.
Currently, six medical institutions are involved in this multiple certification program: Icahn School of Medicine at Mount Sinai Medical Center; Fox Chase Cancer Center with Temple Health; The Ohio State University; the University of Pittsburgh Medical Center; Beth Israel Deaconess Medical Center; and Indiana University. All institutions received more than 100 applications for their single position, and we are in talks with other institutions as well. The hope is to continue to grow this program and train more oncologists in palliative medicine.
Another important approach to integrating palliative medicine into standard oncology care is the programming changes at the 2024 ASCO Annual Meeting. Rather than having separate education sessions about palliative medicine, with the support of ASCO’s President Lynn M. Schuchter, MD, FASCO, palliative medicine was integrated into disease-based education sessions. A faculty member in these sessions focused on toxicity prevention and management, quality-of-life concerns, or other symptom management issues, as well as patient communication.
Optimal oncology care requires taking care of the cancer, treatment toxicity, and quality-of-life issues associated with the experience of cancer. ASCO’s goal is for every patient to receive high-quality cancer care, and that will always include symptom support and toxicity prevention and management.
Palliative Medicine and Cancer Care
What is the state of the incorporation of palliative care into oncology medicine globally? Is palliative care more accepted as crucial to patient-centered care?
The integration of palliative medicine into standard oncology care—both in the United States and globally—has improved over the past decade, but it is not where we want it to be. Providing both oncology and palliative care services takes time, and physicians are already so squeezed for time. Effective patient communication is essential in understanding and addressing patients’ concerns, yet it’s getting increasingly difficult to fit the additional time into regular oncology practice.
But progress is being made. Clinicians are paying more attention to patients’ troubling symptoms, especially in managing and preventing toxicities caused by immunotherapy and other targeted treatments. Furthermore, training in palliative care practices has been incorporated into a growing number of hematology/oncology fellowship programs.
Internationally, there are still many barriers to the integration of palliative medicine practices into oncology, including a lack of human resources and access to essential medicines as well as limited financial support. Thus, the degree of integration is highly variable. Palliative care is developing around the world, but progress is slow.
Finding Joy in Medicine
What are the biggest challenges for young oncologists starting their career?
The exponential growth of new knowledge in oncology is the biggest challenge for physicians. The second is the explosion of technology tools, including artificial intelligence, and understanding how to use them effectively without negatively impacting the doctor/patient relationship. I also worry that medicine has become more of a business than a profession, which may lead to more physicians leaving medicine. It’s getting more difficult for many physicians to find joy in the practice of medicine.
What brought me the most joy as a physician was the long-term relationships I had with my patients and their families, which made it possible to understand their goals and needs as they went through therapy. Today, there is less time for physicians to spend with patients. Most of us chose medicine to help patients and to feel like we could make a difference in someone’s life. If you don’t have time to form those relationships, it is so much harder to accomplish that goal.
Celebrating the Successes
As you look over your tenure at ASCO, what accomplishments are you most proud of?
I’m most proud of my openness and willingness to try new things, to evaluate the results objectively, and make decisions based on data. That approach was exemplified by our decision to sunset the Palliative and Supportive Care Symposium when the program didn’t meet its goals. We learned from that experience and have since integrated palliative care education and science into the ASCO Quality Care Symposium and better incorporated it into the Annual Meeting, as noted previously.
The willingness to try new things, accept that not every idea will be successful, end programs before a lot of time and money are spent, and think about alternative approaches to reach our goals serves an organization like ASCO well, and it frees us to be creative and innovative. Lisa Greaves, ASCO’s Chief of Educational Meetings and Department Operations Officer, is fond of reminding us that the Annual Meeting should reflect the interests of all our members and meeting attendees.
To meet that goal, in 2022, ASCO launched the Communities of Practice, a volunteer-led, -ASCO-facilitated, opportunity for individuals to come together and build a network based on their area of special interest. Since then, the program has grown from 3 specialty areas—palliative care, geriatric oncology, and survivorship—to 12 specialty areas at the 2024 Annual Meeting. Seeing the growth in and success of this program is very gratifying.
I am also proud of the changes we have made in the delivery of education at our meetings. Learning sciences, put simply, focuses on the processes of learning and the factors that shape successful learning. We have incorporated the principles of learning sciences into the delivery of content presented at our educational sessions. This change could not have happened without the support of leadership and the commitment of ASCO’s Education, Science, and Professional Development staff. Our staff is committed to learning evidence-based education strategies, teaching them to faculty, and brainstorming ways to better integrate those practices into all of ASCO’s education programs.
For example, during this past year’s plenary session at the Annual Meeting, every abstract presented began and ended with the key points from the study instead of waiting for the big finale on the last slide. This change is based on the science of memory. We retain more of what we have heard first and last during a presentation. When you hear a study conclusion first, as you listen to the data presented, you engage with the content to evaluate whether it supports the study’s conclusion. Engaging with new knowledge in this manner integrates into your memory more firmly than listening alone.
For the 2024 ASCO Annual Meeting, we instructed abstract presenters to start and end their presentation with the study’s conclusions. We asked all discussants to start their presentation with a case history, when appropriate, to demonstrate how the clinical abstract’s findings would or would not apply to individual patients. Learning is more effective when it is built on prior knowledge and the learner is motivated to expand that knowledge.
Clinicians attend the Annual Meeting with their patients in mind and the desire to bring new knowledge to their practice. Abstract discussions focused on the practical application of new data reinforce the clinical utility of the new knowledge.
I am also extremely proud of ASCO’s Education Scholars Program. This highly competitive, application-based program for oncology medical educators is focused on creating a cadre of volunteers who will advance medical education within ASCO and their institutions and serve as change agents for ASCO’s education programs. We now have 60 graduates, and they are increasingly being integrated into ASCO’s education programs.
The many successes of the Education, Science, and Professional Development Department are primarily the result of the creativity, hard work, and commitment of the staff; to Clifford A. Hudis, MD, FACP, FASCO, Chief Executive Officer of ASCO, who is an incredibly thoughtful leader; to partnerships across the organization; and to ASCO leadership.
I have been so fortunate to work with such highly motivated, creative, and goal-focused people. I will miss my ASCO family, but I’m also excited about starting this next stage of my life. I am still putting my future plans in place, but I know one focus will center around childhood literacy.
Thanks, Thanks, and Ever Thanks
I want to say what an honor and pleasure it has been to work with you on the Palliative Care in Oncology column. All of us at The ASCO Post are grateful for your contribution and support of the publication over the past decade and wish you well in your next pursuit.
Thank you. I’ve loved working on the column. It covered one of the aspects of oncology care I care deeply about, including making a difference in the life of people impacted by cancer.
DISCLOSURE: Dr. Von Roenn reported no conflicts of interest.
REFERENCES
1. World Health Organization: Palliative care. Available at www.who.int/news-room. Accessed May 16, 2024.
2. Ferrell BR, Temel JS, Temin S, et al: Integration of palliative care into standard oncology care. J Clin Oncol 35:96-112, 2017.
