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If you had told me years ago that one day all I¡¯d be doing was preventive medicine ¡ª and it would all be related to cancer ¡ª I¡¯d have said you were crazy. I am not an oncologist. My board certification is in family medicine.

Still, when I was offered the position of medical director at MD Anderson¡¯s Lyda Hill Cancer Prevention Center in 1996, I accepted. It was such a new field then that I appreciated the challenge. But I thought I¡¯d stay only four or five years. And here I still am, nearly 25 years later.

How I got into preventive medicine

I always knew I wanted to work in health care. My maternal grandmother had hip surgery when I was 10, and I helped nurse her. I¡¯d go get her medications, then take them in to her on a tray. I also changed her bandages and helped her get around. She needed a lot of care.

It was because of that experience that I thought I wanted to become a nurse. So, when I went off to college, my major was nursing. But I rapidly learned that nursing wasn¡¯t my strength. Thankfully, a good advisor steered me toward medical school. I found my niche in family medicine.

Once I entered private practice, I didn¡¯t think I would like doing well-woman exams at first. But then I realized that my interactions with patients during those visits tended to be much calmer and more productive than the ones I had with them when they were sick or injured. And I could really do some things to help people, by educating them and sharing information. So, I started gravitating toward preventive services.

How much cancer prevention has evolved

In my earliest days at MD Anderson, I had more than one faculty member come up to me and say, ¡°I don¡¯t know why you¡¯re here. We don¡¯t need a prevention center.¡±

But back then, genetic testing for cancer was still in its infancy. And that was before tamoxifen had been shown to reduce the risk of developing breast cancer by 50%. There was also no evidence of weight or fitness being linked to cancer. Now, there is. So, that¡¯s changed the whole paradigm.

We¡¯ve made such huge strides in cancer prevention since those early days that one of the doctors who originally said we didn¡¯t need a prevention program actually asked me to come give a presentation on that very topic. It was really humbling.

The best part of my job: reducing women¡¯s anxiety

Today, interacting with patients is still the highlight of my week. A lot of women who come to see me are very confused. I like unraveling that confusion and replacing it with understanding.

For instance, I¡¯ve had several patients come in with a diagnosis of lobular carcinoma in situ. They¡¯ve been told it was cancer. I reassure them that it¡¯s not, then explain what it is: a condition that predisposes them to possibly developing cancer someday. Sometimes, they¡¯ve also been told that they need surgery right away. I say, ¡°Well, you might or you might not. But we¡¯ll go through a process to determine that.¡±

I really enjoy educating women on their cancer risk and everything we can do to minimize it. Sometimes, it¡¯s just a matter of framing something differently, so they can better understand it. I might say, ¡°Yes, you¡¯re at higher risk for developing some cancers, but here¡¯s what we can do to catch it early, when it¡¯s more treatable, so you can survive it.¡± Most of all, I love decreasing patients¡¯ anxiety. That¡¯s the best part of my job.

, is medical director of MD Anderson¡¯s Cancer Prevention Center.

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