Gastrointestinal oncologist Emily K. Bergsland, MD, was born and spent her formative years in La Crosse, Wisconsin, situated on the banks of the Mississippi River. “No one in my family was in the medical field; however, both my parents valued higher education. In fact, when I was in high school, my mother went back to school to earn a master’s degree in special education. I’m the third of four children and, like my siblings, attended the University of Wisconsin in Madison,” she shared.
Dr. Bergsland continued: “My oldest sister attained a PhD in microbiology, and that was really the first time I thought about pursuing a graduate degree. During college, I also gravitated toward the biologic sciences and double-majored in biochemistry and molecular biology.”
My choice of oncology was based on the complexity of care and the very personal longitudinal relationships with patients with cancer.— Emily K. Bergsland, MD
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When asked about early role models, Dr. Bergsland commented: “Ann Burgess, who had a PhD in biochemistry and molecular biology, stands out. She directed the undergraduate biology core curriculum at the University of Wisconsin and was one of the few female faculty members I encountered in the sciences.”
Dr. Bergsland highlighted two pivotal research experiences she had during her undergraduate work. “As a freshman, I worked for Robert Auerbach, PhD, a developmental biologist who studied angiogenesis. I started out washing glassware and making chemical solutions, but I eventually worked up to helping one of the postdocs with her research. Later, I completed an honors thesis on vitamin D while working in the laboratory of Hector DeLuca, PhD. Both experiences solidified my interest in a career in research. I considered pursuing a PhD, but after volunteering at University Hospital, I decided medical school was a better fit. I really liked the idea of advancing the care of patients,” she related.
Academic Medicine Calls
After attaining her BS, Dr. Bergsland entered the University of Minnesota to pursue her medical degree. “I chose the University of Minnesota after receiving a scholarship. I recall the first couple of years were very dry, consisting mostly of lectures. Then, we began the clinical rotations, which I really loved. While I enjoyed all of my rotations, I gravitated toward internal medicine, in part because of the flexibility it offered in terms of subspecialization.”
Asked about influential people during medical school, Dr. Bergsland said: “While completing the required introductory courses, I worked as a lab technician for an endocrinologist. The summer before my 4th year, I did a lab-based research rotation with a hematologist named Charles Moldow, MD. He was a terrific role model, as he balanced a challenging career in academic medicine with a full life outside of work,” she noted.
“However, the most important person in my career-forming period was my future husband, Robert Warren, MD. We met while we were both trainees at the University of Minnesota, and he was very supportive of my career interests from the start. As a resident, he moved to New York to do 3 years of clinical and research training in surgical oncology at Memorial Sloan Kettering Cancer Center. His perspective was very different from mine, and I’m not sure I would have left the Midwest, let alone pursued a career in academic medicine, if not for him.”
In 1989, Dr. Bergsland began her internal medicine residency at the University of California, San Francisco (UCSF). “I was interested in hematology/oncology from the start, probably because we had a lot of exposure to it on our inpatient rotations. But, I also considered going into infectious disease. I trained in San Francisco during the AIDS epidemic, which was a very impactful experience. I had the privilege of meeting extraordinary patients and caregivers, while developing an appreciation for the value of a multidisciplinary team. The concept of medicine as an ever-changing science was on full display, as providers worked to integrate rapidly evolving information about disease-related complications and therapies. Looking back, this was the impetus for my desire to go into a subspecialty and become an academic physician,” said Dr. Bergsland.
“In the end, I chose oncology because I was drawn to the complexity of care and the longitudinal relationships with patients,” she explained. “Equally important, in the 1990s, the field held great promise, as laboratory advances were being translated to the clinic in the form of targeted cancer therapies. In short, it was a time of hope, and this was a big draw.”
Asked about mentors along her oncologic journey, Dr. Bergsland replied: “I rotated in Alan Venook’s clinic as a resident and was assigned to his continuity clinic as a fellow in medical oncology. His mentorship was the driving force behind my decision to become a GI oncologist. In addition, for the research phase of my training, I spent several years working in Douglas Hanahan’s laboratory studying multistep carcinogenesis and tumor-associated angiogenesis in mouse models.”
Dr. Bergsland continued: “Working with Doug was a great opportunity, given his given his prominent role in the cancer research community and because so much of the work in his lab was linked to the antiangiogenic agents that were entering the clinic. I ultimately made a full transition from the lab to the clinical setting, but my previous training formed the foundation for a clinical–translational research career in GI oncology.”
Finally, Dr. Bergsland singled out Margaret Tempero as an important role model. “Not only is Dr. Tempero an extremely successful woman in oncology, she also was the first mentor I met with a specific disease focus within GI oncology. She encouraged me to specialize in neuroendocrine tumors, and began referring patients to me early in my career, facilitating the acquisition of disease-specific expertise. Ironically, I had studied a mouse model of pancreatic neuroendocrine tumor in Doug Hanahan’s laboratory, so it felt like a natural fit.”
Disease-Specific Focus Through Multiple Avenues
For the past 2 decades, Dr. Bergsland has focused her research and clinical efforts on neuroendocrine tumors. “I’ve had the great opportunity to work with a number of outstanding collaborators at UCSF, including Drs. Eric Nakakura (Surgical Oncology), Tom Hope (Nuclear Medicine) and Nicholas Fidelman (Interventional Radiology), as we established the UCSF Center for Neuroendocrine Tumors. In addition to the multidisciplinary clinic, we host a bimonthly tumor board, as well as a support group for patients and caregivers (in collaboration with the NorCal CarciNET Community). Interestingly, one of the most gratifying accomplishments on the clinical side has been seeing our team members become experts, advocates, and teachers, sharing their knowledge with others. Our patients are often very complex and face very special challenges as a result. Navigating the spectrum of multidisciplinary care can be extremely daunting, as can living with a cancer that is compounded by hormone-mediated symptoms. Our team members understand this, and it has been rewarding to see our trainees, nurse practitioners, nurses, and other team members become experts in their respective disciplines, while working to advance the care of our patients.”
Dr. Bergsland wears many professional hats and has been a longstanding member of the Alliance for Clinical Trials and ASCO. “Nationally, I am past Chair of the Neuroendocrine Tumor Task Force of the National Cancer Institute’s Gastrointestinal Steering Committee, a member of the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology Neuroendocrine Tumors Guidelines Panel, and current President of the North American Neuroendocrine Tumor Society (NANETS),” she stated.
Looking forward, Dr. Bergsland stressed the importance of working with patient advocates to integrate the patient perspective, as well as interinstitutional partnering across the country, which she points out is vital for rare diseases such as neuroendocrine tumors. “There’s still a lot of work ahead to make our collaborations more seamless and efficient. As my career continues, I hope to continue to work on this challenge. In addition, I have an ongoing focus on education and mentoring. I directed our fellowship program for over a decade and now serve as Associate Director for Education for the Comprehensive Cancer Center at UCSF. In this capacity, our team is looking for creative ways to ensure the success of our trainees and to expand educational opportunities for the next generation of cancer researchers and care providers.”
How does a busy oncology leader decompress? “Exercise and being with my family and friends,” Dr. Bergsland said. “For many years, I’ve met up with a close friend and colleague, Pamela Munster, MD, at least weekly to road bike or run, which has been a big source of support. My children are grown (boy-girl twins), but I connect with them whenever I can, and my husband and I make an effort to keep social activities on the books. In the end, I love what I do, but think it is really important to pay attention to self-care and to take time to decompress."
DISCLOSURE: Dr. Bergsland has received honoraria from UpToDate. She has consulted for Hutchison MediPharma, Merck, AAA, and Novartis (all uncompensated).