Gastrointestinal Oncologist Katherine Van Loon, MD, MPH: A Pioneer in Global Oncology

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Katherine Van Loon, MD, MPH, was raised in Miami, until the age of 12, and then her family relocated to Atlanta, where she spent her junior and high school years. “If you ask my parents about my decision to become a doctor, they will say I first declared it at age 5. Nobody knew how that idea came to me, as there were no medical people in my immediate family. My mother was a stay-at-home mom until I was 13, and then she went back to her profession as a teacher. My dad was a special agent in the FBI. Perhaps the common thread with my decision to become a doctor was that both of my parents were in public service,” she shared.

Dr. Van Loon continued: “My parents would probably describe me as being a challenging kid in that I have always been strong-willed and never readily accepted the status quo. I excelled at school and was a hard worker, and my parents always encouraged that. I grew up in a family setting in which we were always learning, which provided a foundation for academic success. As I got older, my father really pushed me academically. I realize now that a lot of successful professional women have received support from their fathers.” 

Early on, Dr. Van Loon was a math whiz who excelled on her school’s math team. During high school, she remembers driving to the math tournaments in her own car rather than on the bus with the team, which she attributes to the gender bias that causes many girls to move away from STEM-related fields during their middle and high school years. “Although I loved math and had the aptitude for it, I retreated from that identity, because it clearly was not the norm,” explained Dr. Van Loon.

When I see a trainee, junior faculty member, or staff member is not being treated fairly, I feel it’s my responsibility to advocate.
— Katherine Van Loon, MD, MPH

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Tough Undergrad Decision Pays Off

After graduating from high school, Dr. Van Loon went to Duke University for her undergraduate degree in biology. She noted this was a pivotal decision for her family. “I had the opportunity to become a Presidential Scholar at Georgia Institute of Technology. My parents felt this was an ideal situation for me to attend a top engineering school with a very elite full scholarship. But I had my heart set on Duke University, which, of course, was considerably more expensive. Ultimately, they let me chart my own course, but it was a huge financial decision for them. That said, Duke was an incredible experience that opened a lot of opportunities for me,” said Dr. Van Loon.

Although Dr. Van Loon was pre-med during her undergrad years, her road to medicine was not entirely straightforward. “After attaining my undergrad degree, I decided not to directly apply to medical school. Instead, I completed a master’s degree in public health at the Yale School of Public Health. Those 2 years provided an opportunity to consider what I wanted to do with my life. Between my first and second years at Yale, I went to Pietermaritzburg, South Africa, to collect data for my master’s thesis. This was a very impactful summer for me. Before I left for South Africa, I had actually started to prepare applications to PhD programs in public health. But I actually ended up mailing my medical school applications from South Africa.”

According to Dr. Van Loon, the time abroad in South Africa, alone as a single woman, was empowering for her. “My research there was on informed consent in preparation for HIV/AIDS clinical trials. I was there in 2001, when South Africa’s President publicly denounced AIDS and implemented policies that denied antiretroviral agents to patients with AIDS, which ultimately resulted in hundreds of thousands of unnecessary deaths. The general sentiment at that time was that HIV/AIDS was an insurmountable problem for sub-Saharan Africa due to the complexity of the medical, political, infrastructure, and socioeconomic issues. I became enthralled with this incredible historic moment in post-apartheid South Africa.

Meanwhile, my personal research was on the ethics of informed consent. I was interviewing health-care workers who would readily agree to participate in the interview, but at the end, they always asked what I was going to do for them. It was very eye-opening in the sense that I didn’t have a skill to offer; I was simply an academic researcher at that point, and I needed data to write a manuscript. That was really when I decided I needed to have a medical skill to work in an international setting, so it firmed up my decision to pursue a medical degree,” said Dr. Van Loon.

Choosing Oncology

Dr. Van Loon returned home to pursue her medical degree at the Medical College of Georgia, a period she described as a blur, where her sole objective was learning skills to forward her passion for global health. “I excelled during the clinical years in medical school, and I recall having very poignant moments with patients with cancer. This planted the oncology seed in the back of my mind. But, at the same time, I continued to pursue my interests in global health. During medical school, I returned to South Africa to complete a trauma elective at Groote Schuur Hospital in Cape Town. In one of the most violent cities in the world, that elective was an incredible eye-opening experience,” she shared.

After attaining her medical degree, Dr. Van Loon did her internship and residency at Beth Israel Deaconess, Harvard Medical School. “I dove into my clinical training and was drawn to the complexity and longitudinal doctor-patient relationships in oncology. But I also returned to South Africa during my final year of residency to work in an HIV clinic in rural KwaZulu-Natal, South Africa. By then, the HIV/AIDS landscape had changed dramatically, and antiretrovirals were widely available in South Africa.”

The Growth of Global Oncology

Dr. Van Loon completed her residency in 2009; at this time, she noted, there was not a clear path to pursue a career in global health as an oncologist, as the agenda in low-resource areas, such as sub-Saharan Africa, was largely driven by infectious diseases such as malaria, tuberculosis, and HIV/AIDS. Dr. Van Loon ultimately decided to put her global health interests aside and pursued an oncology fellowship at the University of California, San Francisco (UCSF), where she was drawn to gastrointestinal cancers. “I had a great research and clinical mentor, Dr. Alan Venook, which is probably why I decided on UCSF for my fellowship and, ultimately, the specialty of gastrointestinal oncology.”

Dr. Van Loon recalled two other key mentors at UCSF during her transition to fellowship. “When I applied to UCSF, I met Dr. Paul Volberding, a trained oncologist who was an attending on the oncology consult service at San Francisco General Hospital in the early 1980s, when the first patients with HIV presented with Kaposi sarcoma. He subsequently spent his career as an oncologist in the HIV world. When I met him, he already had a vision of the need to enhance cancer care in low-resource regions of the world. Then, I met Dr. Bob Hiatt, the former Chair of Epidemiology at UCSF, who also shared a vision for global oncology as an academic field. They both encouraged me to pursue my interests in both oncology and global health at a time when most were highly skeptical of whether it was even feasible to make any meaningful impact on cancer care in low-resource settings. Fortunately, I have always been able to draw on my experiences early in the HIV/AIDS pandemic in South Africa, which provided me with a long-range perspective on tackling problems that seem insurmountable.

Balancing Two Careers in One

Asked how she balances her clinical and research work at UCSF with her global oncology work, Dr. Van Loon responded: “I trained as a gastrointestinal oncologist and maintain a busy clinical practice in the Cancer Center at UCSF. But, early in my fellowship, Bob Hiatt noted that Tanzania needed help building a cancer registry, so I carved out research time to travel to Dar es Salaam.”

Dr. Van Loon commented on a study collaboration on esophageal cancer in Tanzania. “Our early data indicated an usually high incidence of esophageal cancer. So, flash forward to today, and we now have a multidiscipinary portfolio of studies to evaluate the disproportionately high burden of esophageal squamous cell carcinoma in East Africa. We are also building capacity for early detection and clinical care. 

Ultimately, the cancer registry project never panned out, but as a result, I established long-standing partnerships that evolved over time into a multidisciplinary research program between UCSF and Muhimbili University of Health and Allied Sciences and Ocean Road Cancer Institute in Tanzania. Our research program is led by a team of dedicated physicians and research coordinators in Tanzania. Through the COVID-19 pandemic, our research activities have been busier than ever, despite the fact that UCSF faculty and trainees cannot travel. It’s really a testimony to our incredible partners in Tanzania. Now, we have a D43 award to build the first-ever cancer research training program in Tanzania, with a goal to train and mentor a cadre of independent cancer researchers in East Africa.”

Women in Academic Medicine

Gender bias toward women in academic medicine has become another passion for Dr. Van Loon. “The stress over the past year or so that the COVID-19 pandemic has put on health-care workers is tremendous. We were all asked to do more with fewer resources. Although I was previously cognizant of gaps in gender equity in medicine and the sciences, the COVID-19 pandemic brought this issue front and center for me. As a primary caregiver with small kids at home doing distance learning, there have been tremendous threats to my academic career. We have all worked for the past year and a half in crisis mode, and it is apparent now that this pandemic is going to continue. I have tried to focus my energy on mentoring younger female colleagues to help stem the tide of women exiting from academic medicine,” she explained.

Dr. Van Loon continued: “When I see a trainee, junior faculty member, or staff member is not being treated fairly, I feel it’s my responsibility to advocate. Someone needs to be willing to step forward to ensure that every trainee and junior faculty member has access to every opportunity he or she needs to be successful, or the gender gap will only widen. The COVID-19 pandemic has exposed a number of gender inequities we need to address, and I fear we are going to see a regressive impact unless our institutions take a proactive approach. Women must have a seat at the table as these discussions are happening.” 

DISCLOSURE: Dr. Van Loon reported no conflicts of interest.