Lung Cancer Expert Leora Horn, MD, Recalls Her Journey to a Career in Oncology and a Home in Nashville

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The tumultuous history of modern South Africa has numerous stories that lie beneath the surface of the sociopolitical headlines, such as the story of lung cancer expert Leora Horn, MD. “I was born and reared in Johannesburg, South Africa, a second-generation African family. In 1987, because of the increasing violence, my father and mother decided to move to Toronto, Canada. They left their home country with two teenagers and an 8-year-old who had never been out of South Africa before, so it was quite an adventure and culture shock,” she shared.

Leora Horn, MD

Leora Horn, MD

Tough Transition for a Teenager

DR. HORN was 13 years old at the time, and it was a tough transition for a teenager. “I felt like my life was over. I remember going back to South Africa once to visit, and [due to documentation issues] because I’d switched from grade 8 to grade 9, from elementary to high school, I wasn’t allowed back into Canada. We had to go through London, so the Canadian embassy could renew my visa. I remember thinking it was a sign from God and I should stay in South Africa. But that didn’t happen,” said Dr. Horn, adding, “Actually, there were several other South Africans in my high school, some who went to school with me in South Africa. We still keep in touch.”

Career Decisions

ASKED IF there were any influences in her decision to pursue a career in medicine, Dr. Horn said, “There were no doctors in my family, but from grade 9 through my graduation, I worked in a pharmacy. My mother had been a pharmacist in South Africa, and I always felt that it would also be my career path. However, in my junior year of high school, we had an elective course, and I worked in a hospital in the geriatric ward. During that experience, I decided I wanted to become a doctor.”

When it came time to select a college, Dr. Horn decided to stay close to home. At the time, her older brother was attending the University of Toronto, and in 1992 she enrolled there too and received her BS with high distinction. “I applied to medical school but didn’t get in, so I decided to pursue a Master’s degree in pharmacology. I had an amazing tutor, a PhD student named Christine Brezden, who was also my advisor for my Master’s program. She introduced me to the lab at Princess Marguerite Hospital. She’s a medical oncologist now at St. Michael’s Hospital in Toronto.”

Dr. Horn continued: “In 1998, I was accepted to medical school at the University of Toronto. I think my decision to pursue oncology was solidified in my second year, when I met an oncologist named Ian Quirt. I did an oncology elective with him before doing my ward rotations and saw the amazing relationships he had with his patients with melanoma and sarcoma. This was when we did not have as many therapeutic options for our patients. He was absolutely one of the best communicators I’ve ever seen. That’s sort of when I decided on oncology as my specialty.”

Dr. Horn said she thought about going away from Toronto to do her internal medicine training after receiving her medical degree, but that decision was waylaid when she met her future husband during her third year at medical school. “Although we weren’t engaged, I really liked him and decided that I should stay in Toronto. As it was coming up to the time to match, I put Toronto first and luckily matched there. I got engaged during my first year of residency and married in my second year,” she said.

Influential Mentors

DR. HORN remained at the University of Toronto for her internal medicine training, where she met two motivating women, Drs. Sharon Strauss and Katina Tzanetos, with whom she did medical education research, and received her first grant that further defined her career path. “I’d already decided that I was going to do oncology, but I also wanted to become an educator, which was a decision that came directly out of my experience with Drs. Strauss and Tzanetos.”

“What was supposed to be an 18-month fellowship turned into a career move.”
— Leora Horn, MD

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Dr. Horn stayed at the University of Toronto for her medical oncology training. “During my training, I met Natasha Leighl, MD, a thoracic oncologist at Princess Margaret Hospital, who introduced me to Alan Sandler, who was at Vanderbilt in Nashville. Even though I was 6 months pregnant, I went down to Vanderbilt for a 2-month elective, where I also met past ASCO President Dr. David Johnson and Dr. David Carbone. I fell in love with Vanderbilt’s energy and collegial atmosphere,” she commented.

Dr. Horn returned to Toronto to finish her medical oncology fellowship. “Shortly after finishing my fellowship, I had my first child and took almost a year off, something that’s afforded in Canada. At the end of my maternity leave, I moved back down to Vanderbilt, but my husband remained in Toronto. At that time, if you wanted a position in academic medicine in Canada, you had to complete an additional fellowship. So that’s what I wanted to do in lung cancer or sarcoma at Princess Margaret Hospital.”

What was supposed to be an 18-month fellowship turned into a career move, as she worked with Dr. Johnson and Dr. Alan Sandler. “Alan Sandler and Dave Johnson are probably two of the most amazing people anyone can meet. It was a bit challenging because technically I was a single mom working at the cancer center. My husband’s job was also demanding, and he would fly in from Toronto every Friday and leave on Sunday. At the end of my fellowship, Dave offered me a position in thoracic oncology. At that point, I’d also started my Master’s in Health at the University of Illinois. I weighed all the options, but in the end, I accepted the position, largely because of Dave, who is the most incredible mentor I’ve ever met.”

"The future for patients with lung cancer is brighter than ever with the progress we’re making with early detection, targeted therapies, and immunotherapy.”
— Leora Horn, MD

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During the next year, Dr. Horn’s husband moved down to Nashville, and her mentor, Dr. Johnson left Vanderbilt for a position at The University of Texas Southwestern Medical Center. “When Dave left, I think I cried for about 3 months. But I wanted to keep lung cancer relevant at Vanderbilt, so I decided to run the clinical research section of the program. Even though Dave left, I still consider him a valuable mentor, one to whom I can reach out at any time. He’s a special person,” said Dr. Horn, adding, “I love it here at Vanderbilt and in Nashville. It’s a wonderful and vibrant place to work and raise a family.”

Wearer of Two Hats

DR. HORN currently wears two hats at Vanderbilt-Ingram Cancer Center. “I’m Director of the Clinical Research Section of the thoracic oncology program, and this past year, I was awarded an Ingram Assistant Professorship, so I have a chair here at Vanderbilt. And besides running the thoracic oncology program, I am Vice Chairman for Faculty Development at Vanderbilt University Medical Center, where I co-lead the Schaffner Society, which is committed to supporting the careers of clinician educators in the Department of Medicine. In addition, I have clinic twice a week, and I’d say that about half of my patients are on clinical trials,” said Dr. Horn.

Bright Future in Lung Cancer

“THE FUTURE for patients with lung cancer is brighter than ever with the progress we’re making with early detection, targeted therapies, and immunotherapy. The advances in research we’re seeing are far greater than anything we saw even a decade ago, and the U.S. Food and Drug Administration is approving new drugs almost every week, it seems. We had an event this past November that I organized called Lung Cancer Survivor Celebration. Things are changing for the better in lung cancer; we even have support groups at Gilda’s club in Nashville that are for lung cancer survivors and their families,” said Dr. Horn.

Dr. Horn is also a lead investigator on several lung cancer clinical trials and educational projects. She has published more than 100 articles and book chapters and is an active member of ASCO, the International Association for the Study of Lung Cancer, and the Royal College of Physicians and Surgeons of Canada.

Asked how she juggles all of the various career demands, Dr. Horn responded: “It’s a matter of priorities and scheduling, but my most important job is being a mom. It’s important that my children understand how passionate I am about my career, so they can aspire to something they love and that gives them purpose.”

What does a super-busy oncologist do to decompress? “When I was in high school and college, I took tap and modern dancing and still love to dance, so I attend classes. And sometimes we have family dance parties at night.” ■

DISCLOSURE: Dr. Horn reported no conflicts of interest.