Taplin’s Key to a Successful GU Career: “Always Finish” What You Start

Mary-Ellen Taplin, MD

Dana-Farber Cancer Institute

With a 30-year career focusing on prostate cancer, Mary-Ellen Taplin, MD, shared how she has seen the field evolve and discussed the importance of having women in the oncology space.

Taplin, chair of the Executive Committee for Clinical Research and an institute physician at Dana-Farber Cancer Institute, and a professor of medicine at Harvard Medical School, spoke with CancerNetwork^® about her career and the research she conducted on androgen receptors.

During the Breaking Barriers: Women in Oncology program, she also touched on what it meant to be a woman in the field and how she overcame any challenges associated with it. Taplin gave a nod to her mentors who pushed her towards success and gave advice to other women entering the field.

“We all need a little push; it’s the advice that sometimes doesn’t feel comfortable. But if you can process it and go to that place, that can lead you to more success,” she said.

CancerNetwork^®: What interested you the most in focusing on genitourinary (GU) oncology?

Taplin: What interested me most when I went into GU oncology was studying the androgen receptor, which is the receptor where testosterone binds, to try to learn mechanisms related to the androgen receptor by which prostate cancer became resistant to our primary therapy, which was and is androgen deprivation therapy.

What are some key research advances that you’re most proud of?

Some of the areas in which I’ve been involved in prostate cancer include studying androgen receptor mutations and showing their functional significance and how they relate to clinical applications of prostate cancer therapy. I’m also proud of the work I’ve done in the area of metastasis biopsy. It was uncommonly done to sample the tumor from metastasis. When I first started working in prostate cancer, I designed studies around getting metastasis biopsies, studied tumor biology, and have developed metastasis tumor banks in prostate cancer. Thirdly, there is my work in neoadjuvant prostate cancer. I’ve done a series of phase 2 trials looking at second-line hormone therapy and giving neoadjuvant [therapy] after surgery, which led to a large phase 3 trial called the PROTEUS trial [NCT03767244], studying that concept in locally advanced, high-risk prostate cancer.

How have you seen the field evolve from a research standpoint throughout your career?

The field of GU oncology has evolved considerably. I’ve been in prostate cancer research for over 30 years. We had a very limited understanding of prostate cancer biology. For instance, the androgen receptor wasn’t even crystallized at the time, and we had one treatment for prostate cancer: basic androgen deprivation therapy. The field in the last 30 years—the knowledge of biology, mechanisms [of action], response, resistance, and the technology that’s now available to us to study—[has evolved considerably]. Prostate cancer is just immense. The whole field of molecular biology and molecular tumor biology has developed over my working years in prostate cancer. This has been thrilling. The number of new prostate cancer therapies that have been developed and translated into improved outcomes for patients has been satisfying. It’s not where we need to be, which keeps us all working hard, but there’s been tremendous progress in the last 30 years.

GU oncology is predominantly a male-dominated field. Did you have any trouble breaking into the space?

GU oncology is a male-dominated field, especially on the urology side. When I started studying prostate cancer around 1992, GU medical oncology was in its infancy. Most of the major cancer centers had very few practicing GU medical oncologists. Being a woman in GU medical oncology, there were very few of us but there were very few GU medical oncologists, especially compared with today. I don’t perceive any significant barriers as a woman, especially on the medical oncology side. There are a lot of opportunities to work collaboratively, with people in different specialties, at least in the Boston area. We have a lot of women at Dana-Farber Cancer Institute—maybe 7 or 8 GU medical oncologists that are women. But in the other specialties around us like urology and radiation oncology, there are very few, if any, women who practice clinical prostate cancer in those areas. [I would say] medical oncology is more diverse.

Do you still see disparities exist today?

The challenges that I’ve experienced were when I was a fellow. It was a long time ago, and medicine was very male-dominated. For instance, of 4 years of fellowship and 12 [participants], only 2 were women. I had 1 child during my fellowship; the other woman had 2 children during the fellowship. It was talked about almost in front of us that [our colleagues] were glad [more] women [didn’t match to] the fellowship. I don’t think that would happen today. Our society has become more inclusive and more welcoming to work-life balances and some specific challenges around childbearing and rearing that women have.

How do you try to achieve work-life balance?

The question of work-life balance needs to be [considered]. Different strategies need to be used at different points in your life; it changes over time. When I was younger, and my children were young, a strategy that my husband and I had was that he was an [emergency department] doctor who worked nights, and I worked days. We needed less childcare, and we were involved with our children in ways that we wanted to be. Other people would do it differently by hiring help and different things. As the kids get older, your situation changes, and your challenges with work-life balance need different attention.

I would say that thing that was part of my life that was the biggest challenge to my happiness and my stress was having a long commute. I had to have it for personal reasons. For anyone starting out, I would think carefully about how long your commute is because work is busy, family is busy, and just devoting 2 to 3 hours a day to driving or commuting in whatever fashion you do takes a bite out of your peace over time.

I’ve always been active. Exercise has been a part of my life, and just stepping away and taking that time to stay healthy [is important]. Exercise has helped me with my work like that. The big thing is women need to say “no.” One of the things that I never hear talked about is we make our stress by not carefully thinking about what we’re saying “yes” and “no” to. We say “yes” oftentimes to a lot of projects. But when you dig deep down, are you going to get satisfaction out of that project yourself? Are you doing it for somebody else? Are you doing it because you don’t want to say “no?” The big lesson in work-life balance is just thinking carefully about what you say “yes” to on the work side and maybe on the home side, too. Do you need to have a huge party or dinner? You could, but if you also have a grant due at that time, it may be best not to say “yes” to both. A lot of times we make our own challenges with work-life balance, at least in my case.

Have you had any mentors that impacted your career trajectory?

I have had 2 main mentors, but I didn’t have the opportunity to have any female mentors, at least in medical school and beyond. I went to an all-women’s college, so I had a lot of positive mentoring with professors in college. My principal investigator Steven P. Balk, MD, PhD, whom I worked with as a fellow and continue to work with to this day, was very instrumental to my success early in the laboratory and in prostate cancer. One of the things he taught me, which I took to heart, was to always finish what you say you’ll do. We all collaborate with a lot of big groups and a lot of different types of experts and colleagues. Just being a finisher is the key to your success, or to anyone’s success.

My other mentor was Philip Kantoff, MD, who was a medical oncologist at Dana-Farber and recruited me to go to Dana-Farber. He pushed me to be more aggressive than I naturally am, per my personality, to succeed in academic medicine. He gave me a push to reach outside of my comfort zone, and to be a little bit more aggressive than I think I would have been if left to my own devices. I’m thankful to both of my mentors for many years of collaboration and friendship.

What advice would you give to a woman starting in the field?

I could probably think of lots of free advice. I ran a meeting yesterday, and I had a young investigator present at Dana-Farber. She’s incredibly accomplished, and she was so self-deprecating that I wanted to take her aside and tell her to stop apologizing for various things. Young women need to embrace their accomplishments, not in an arrogant or conceited way, but just to be confident that what they’re doing is important and as good or better, probably, than the next guy and to stop apologizing. Embrace it and feel good about yourself. All our careers have ups and downs. It’s not an even trajectory up, and there are going to be periods where things are more challenging, projects don’t work out, or you have medical challenges or family challenges. It’s a marathon. I would advise when you’re having a more challenging period to be kind to yourself. It’s going to be better at some point in the future.

Reference

Kibel As, Gleave M, Brookman-ay SD, et al. PROTEUS: A randomized, double-blind, placebo (PBO)-controlled, phase 3 trial of apalutamide (APA) plus androgen deprivation therapy (ADT) versus PBO plus ADT prior to radical prostatectomy (RP) in patients (pts) with localized or locally advanced high-risk prostate cancer (PC). J Clin Oncol. 2022;40(suppl 6). doi:10.1200/JCO.2022.40.6_suppl.TPS28