Get to Know... Jeffrey Lancet, MD

Jeffrey Lancet, MD, Chair of the Department of Malignant Hematology at Moffitt Cancer Center in Tampa, Florida, reflects on the mentorship that helped him through a career crossroads.

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When did you know you wanted to be a doctor?

I don’t know that there was any specific epiphany that I had about becoming a doctor. Some people have amazing stories about a life experience that moved me in that direction. During college, I was struggling to choose a future career pathway that I truly wanted to pursue. I knew I wanted to interact closely with people on a regular basis and to have an impact on their lives, and I knew I didn’t want to work behind a desk or at a computer all day. That mindset drove me toward a career in medicine, more than anything else.

Were there any doctors in your family? What did your parents do?

I was the first doctor in my family. Pursuing a professional career like medicine was a new venture for all of us. While my parents encouraged me, it was really my decision, driven by the desire to do something with my life that was meaningful.

My mother worked as a secretary in a medical practice, so I did get to know doctors through her work and had some general exposure to the field.
My father was a civil engineer—sort of a self-made engineer who took a nontraditional path. He never went to college after high school but went back to night school when he was in his 20s and earned his degree over many years. Education was important to him; he wanted me to do well in school and keep my academics up so that I could have a chance to enter a successful professional field.

Walk us down your career path. How did you choose hematology as a specialty, and leukemia specifically?

Until I moved to Tampa to join the Moffitt Cancer Center in 2004, I spent most of my life in Rochester, New York. I completed my undergraduate studies in Rochester, went to SUNY Upstate Medical College for medical school, and returned to Rochester for my residency and fellowship at Rochester School of Medicine & Dentistry.

My first medicine rotation as a third-year student focused on the hematology inpatient service. Back then, in the early 1990s, I was intrigued by acute leukemias. I remember being shocked by the nightmarish state of the disease and the incredibly tough times that patients were suffering through as they were receiving these intensive chemotherapy regimens.

It occurred to me that acute leukemia was a field that was ripe for improvement. I enjoyed the hands-on diagnostic and therapeutic approach. The idea of being able to look at a patient, sample their blood and bone marrow, and make a diagnosis—without having to involve lots of other people—was pretty interesting to me. One could move from the diagnostic to the therapeutic modalities quite seamlessly, within one group or one in individual.

In general, hematologic oncology as a field made sense to me, mostly because the diagnostic tissue and specimens could be easily accessed and viewed under the microscope. Still, it was the clinical experience on that hematology service—watching patients go through so much pain and suffering to achieve generally poor outcomes—that hit home for me. Having the opportunity to take care of some of the sickest patients, and hopefully give them some comfort along the way, was incredibly appealing.

Who helped guide your career path, and what do you think makes a good mentor?

A variety of mentors have helped me through the years. When I was a medical student, I was mentored by a very kind and knowledgeable physician whom I worked with on the hematology service. His warm and gentle bedside manner left an impression on me, along with his approach of looking at the entire patient to understand the disease as fully as possible. He was a passionate guy who cared deeply about doing everything in the patients’ best interests, even at a time when there wasn’t much we could do with the available treatment options.

Later on, my greatest mentor was one of the leaders in the field of hematology and one of the most prominent female oncologists ever to walk this earth: Judith E. Karp, MD. Dr. Karp, who retired about 10 years ago, was at a different institution than me, but we both became interested in a specific type of a clinical research project utilizing a new drug called tipifarnib, that seemed to have some good rationale for use in leukemia. We launched an investigator-initiated trial together in 1999, when I was just finishing my fellowship. A leukemia doctor at heart, Dr. Karp kept me involved and engaged and helped me understand the clinical trial process. She inspired me as someone who was doing her work not because she wanted to become famous and get her name in major journals, but because she was on a mission to improve patients’ outcomes. When I rounded with her, I was in awe of the way she interacted with patients and the trust that they had in her.
Joseph Rosenblatt, MD, was another strong mentor and the division chief at my institution. Dr. Rosenblatt facilitated my involvement in clinical trials as a junior faculty member, giving me a platform to work with various groups and boards and get my name out there.

Another physician in my institution, Jane Liesveld, MD, was what I would call my “hands-on” mentor. She worked in the field of leukemia and transplantation and was—and still is—one of the most wonderful physicians I have ever known. Dr. Liesveld is a brilliant physician-scientist and genuine, caring person. I think I began to gravitate toward academic medicine because of people like Dr. Liesveld, who took an interest in the patient rather than in bolstering her own accolades. She got to work, got the job done, and succeeded in a quiet but efficient way.

What do you think makes a good mentor?

The common thread between these three mentors is that they all took an interest in me. That’s what good mentors do: take an interest in people holistically as individuals, not solely as physicians or scientists or workers.
Having mentors who take an interest in you and make you feel good about yourself, who relate to you with their own stories of difficulties, helps you become a stronger physician overall.

I have been blessed and lucky to have three amazing people who guided me during the early stages of my career, when I was at a crossroads: Was I going to go into private practice and become purely a clinician? Was I going to take the academic route, participating in clinical trials and publishing findings? My mentors helped me strike that balance and gave me some of the tools to succeed along the way.

What advice would you give fellows and early-career professionals who may be struggling to find their career focus?

Consider your major interests in the field and focus less on self-centered goals. If you pursue an area just to get your name in lights or on multiple publications, I don’t think you’ll end up satisfied in your career. Be true to yourself and follow your interests. Avoid becoming overly captivated by topics outside of your specific area of interest that you can’t follow through on.

For instance, if you think translational research sounds interesting and cool, but you don’t have a passion for it and can’t imagine yourself being in the lab or under the pressure of having to secure grants all the time, then you don’t need to do translational research. If your true passion is seeing patients on a high-volume scale, then that’s what you should do.

I’d also advise people to focus. Don’t try to do everything and be everything to everybody. Focus on one or two areas that mean a lot to you. Ultimately, you must be true to yourself, know your own strengths and limitations, and follow your passions.

What are the most exciting areas in acute leukemias research now?

I work in the myeloid malignancy field, primarily focusing on acute myeloid leukemia (AML). To me, the most exciting developments right now are in the area of pre-leukemic conditions that we believe predispose patients to developing myeloid cancers such as AML.

We’re learning how preexisting mutations, even prior to a leukemia diagnosis, impact the overall development of the disease and how treatments might influence the development of subsequent leukemias.

It’s a tip-of-the-iceberg scenario, where we focus on what we can see at the present moment. Lurking below the surface, though, there is an entire landscape of molecular abnormalities that are predisposing patients to developing myeloid cancers. We’re just starting to understand what those abnormalities are.

The potential to modulate or mitigate some of those molecular abnormalities before leukemia hits is an intriguing promise for the future. Because many times, once leukemia develops, it’s too late. Even in this day and age, we have so much trouble getting people into remission and cure. Having a way to influence the disease early on will have a huge impact.

Another exciting area is the study of measurable residual disease (MRD), where we can now identify, in real-time, the actual presence or burden of disease after a person has gone through treatment. This information allows us to tailor therapy, intensifying treatment or avoiding unnecessary therapies.

Finally, myeloid leukemias are coming into their own as diseases we can monitor at a very sensitive level in a remission state, so that we can determine what the next steps should be.

How do you spend your time outside of work and whom do you spend it with?

My wife and I have a son and two daughters, so until this point in my career, most of my time away from work has been spent supporting our kids through their various activities and sports. I enjoy the outdoors and am an avid camper, so, when I get the chance, I visit the national parks and do some backcountry hiking. I enjoy roughing it for a few days and seeing sights that most people don’t get to see if they never leave their cars.
Our daughters are grown now, but we were always running between dance recitals and softball practices; my son plays hockey now, so when he graduates high school and I don’t need to shuttle him back and forth to the rink, I’m not going to know what to do with myself. Maybe that’s when I’ll take up forestry and become a park ranger in Yellowstone.

What is one thing most people would be surprised to learn about you?

In my day-to-day work life, I come across as reserved and serious, not very outspoken. People would be surprised to learn that I am a bit of a practical joker. I do have fun with people at work, and I’ll leave it at that.

Also, when I’m not at work, I’m an avid sports fan. Anyone who has watched a football or hockey game with me knows that I can get pretty boisterous and unruly when I’m rooting for a team. People say, “Wow, I was shocked to see you yelling and screaming.”