In 2003, Nina Kadan-Lottick, MD, MSPH, established the regional Yale HEROS multidisciplinary research and clinical program for long-term survivors of childhood cancer survivors, which is the first of its kind in Connecticut and one of the first in the United States. She intends the HEROS program to serve as a test bed for her pilot studies, which she plans to expand into large, multi-institution studies. Along with her directorship of the HEROS program, Dr. Kadan-Lottick is Associate Professor of Pediatric Hematology/Oncology at Yale School of Medicine, New Haven, Connecticut.
Nina Kadan-Lottick, MD, MSPH
Desire to Give Back to Society
Dr. Kadan-Lottick was born in Chicago to parents who were immigrants from India. “My father moved to the United States to get his master’s degree and PhD here. He was the first of his family to earn a college degree. My parents had an arranged marriage, so my mother, who is a physician, left India to join my father,” said Dr. Kadan-Lottick.
She continued: “One story I grew up hearing had a profound effect on me. When I was born, my mom had eclampsia and almost died. She and I were saved by the anesthesiologist. As I grew up in Chicago, I remember my parents saying how fortunate they were to have been given the opportunity to come to America, a place where being a woman was not an obstacle, as it was back when they were growing up in India.”
When asked if hearing about being saved at birth by a medical professional might have planted a seed to pursue medicine, Dr. Kadan-Lottick replied: “I believe it did. I took it quite personally, so I wanted to find a career where I could give something back to society. I was a history buff in grade school, and, actually, my first thought was to go into politics. I’d follow political stories on the news and had decided I wanted to become a governor. I felt that as governor, I could help things change for the better, with education, health care, and minority challenges. Not mayor or senator, just governor.”
During high school, Dr. Kadan-Lottick marveled at new medical devices that were transforming lives, and she put dreams of a political career aside. “Incredible prosthetics were being developed that were life-changing for people, and there was talk about developing an artificial heart, too. I was so impressed by the new prosthetics that when I went to college, I studied biomedical engineering. I was very excited about new titanium bone implants for joint replacement surgery, so I decided to go to medical school,” she shared.
After receiving her undergraduate degree from Johns Hopkins University, Dr. Kadan-Lottick entered Johns Hopkins University School of Medicine, where she was accepted in an early-decision program that allowed her to spend a year studying abroad. Dr. Kadan-Lottick spent a year in northeastern France, where she lived with a French family. “It was a terrific experience. I worked in a hospital and met other medical students from around the world. I also became fluent in French.”
Switch in Specialties
Although Dr. Kadan-Lottick had entered medical school thinking she’d become an orthopedic specialist, she realized it did not quite satisfy her need to form strong, one-on-one, doctor-patient relationships. “I decided to switch from orthopedics to internal medicine or pediatrics, as I liked to sit and talk with patients, whereas orthopedics is more procedure-oriented. At one point, I had trouble with my schedule, which turned out to be a good thing. By the time I got it straightened out, there were only two electives left to choose from, and one was in pediatric oncology. I’m not sure why I chose it, but it turned out to be a life-changing experience. It was the early days of bone marrow transplants, and I saw how these very sick children were given life-saving treatments. I valued my relationships with children and their families and was humbled by their optimism,” said Dr. Kadan-Lottick.
In fact, the death of a 15-year-old girl with Wilms tumor with whom Dr. Kadan-Lottick had formed a close relationship convinced her to pursue pediatric oncology. “I realized pediatric oncology would offer me the opportunity to care for very sick children and do research to find better ways to treat them. Also, I saw the remarkable advances being made in the field and wanted to be part of it,” said Dr. Kadan-Lottick.
Johns Hopkins offered excellent training programs and, after attaining her medical degree, Dr. Kadan-Lottick stayed on for her internship and residency. She was drawn by Dr. Frank Oski, who was the Chair of Pediatrics and a well-renowned hematologist. Dr. Oski encouraged residents to think critically. “He also encouraged us to find ways to make our own unique contributions to the field of pediatrics and to improve the well-being of children.”
Dr. Kadan-Lottick then pursued her Pediatric Hematology-Oncology Fellowship at the University of Colorado, where she also earned a Masters degree in epidemiology and biostatistics. She becme particularly energized by the advances in childhood acute lymphoblastic leukemia (ALL) as genetic factors were becoming understood as important to guiding therapy.
One of her key mentors was Dr. Linda Stork, who was Chair of the front-line national ALL clinical trial at the time. Dr. Stork taught her a lot about medicine and also how to truly care for the whole patient and family. She recalls that after a patient died, Dr. Stork stayed with the mom and helped her pack up the child’s things and save mementos such as the child’s hospital ID bracelet and a cutting of his hair.
Another important mentor was Dr. Stephen Hunger, a basic scientist who later chaired the Children’s Oncology Group Acute Lymphoblastic Leukemia Committee. Dr. Hunger took great interest in Dr. Kadan-Lottick’s research, although it was clinically based and not lab-based, like his. He helped her prepare her first oral presentation selected at the ASCO meetings. He also helped her connect with Dr. Leslie Robison, the original principal investigator of the Childhood Cancer Survivorship Study, with whom she was fortunate to do a postdoctoral fellowship in cancer epidemiology.
“I realized pediatric oncology would offer me an opportunity to care for very sick children and do research to find better ways to treat them.”— Nina Kadan-Lottick, MD, MSPH
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Working under Dr. Robison and Dr. Joe Neglia at the University of Minnesota, Dr. Kadan-Lottick immersed herself in the running of a large cohort study and learned from senior collaborators from around the world. She learned everything from how to “clean” data to explaining her research ideas coherently to a large room of senior scientists. The Childhood Cancer Survivorship Study investigates how chemotherapy and radiation can cause significant health problems in the years and decades after cancer therapy ends. Strategies are needed for prevention and early management of these late complications so survivors can grow up to live their lives to their full potential. This opportunity cemented Dr. Kadan-Lottick’s commitment to a career that “would weave research with clinical care to continually improve the status quo.”
Dr. Kadan-Lottick currently serves on the Children’s Oncology Group Survivorship Steering Committee, International Harmonization of Long-Term Follow-up Guidelines, and special task forces at the National Cancer Institute (NCI). “As part of my commitment to optimizing cancer outcomes, I serve as the Yale Cancer Center Disease Aligned Research Team Leader for Childhood Cancer. I am also the Yale site primary investigator for the Children’s Oncology Group Clinical Trials consortium,” she noted. This past year, she and Dr. Jason Mendoza at the University of Washington were awarded a $3 million NCI grant associated with the Beau Biden Cancer Moonshot Initiative to investigate a mobile health and social media physical activity intervention to improve cardiopulmonary health in childhood cancer survivors.
Reflecting on the mentors who guided her career, Dr. Kadan-Lottick commented, “I was extremely fortunate to have brilliant mentors who were generous with their time and wisdom. I am striving to pay it forward with the talented young people I work with now. It is personally rewarding and a privilege to be part of their professional journeys.”
What does a busy pediatric oncologist do to decompress? “There are a lot of beautiful trails in Connecticut that are pretty much unexplored. I do a lot of hiking with my husband and with my three kids when they are home from college. I am also an avid reader of medieval history and cozy mysteries,” Dr. Kadan-Lottick said.
DISCLOSURE: Dr. Kadan-Lottick has an immediate family member who has received honoraria from Boston Scientific and Medtronic, has served as a consultant or advisor to Boston Scientific and Medtronic, and has participated in a speakers bureau for Boston Scientific and Medtronic.