Nina Sanford, MD, is assistant professor and chief of the gastrointestinal radiation oncology service at UT Southwestern Medical Center. Dr. Sanford’s illustrious career began with her medical degree from Harvard Medical School, followed by an internship in internal medicine at Brigham and Women’s Hospital, and a residency in radiation oncology at Harvard/Brigham and Women’s Hospital/Massachusetts General Hospital. Currently, she treats patients with various gastrointestinal cancers and is actively involved in several clinical trials, focusing on the combination of high-dose radiation therapy with immunotherapy and addressing disparities in health care access.
In this interview with GI Oncology Now, Dr. Sanford shares her unique experiences and insights, from her specialization in radiation oncology to the challenges and rewards of balancing her clinical, research, and teaching responsibilities. She offers a personal glimpse into her life outside the hospital and provides valuable advice to those aspiring to enter the field, underscoring the importance of pursuing one’s true passions and embracing the multifaceted roles that define a fulfilling career in oncology.
Was there a pivotal moment in your life or career that significantly influenced your decision to specialize in radiation oncology?
Dr. Sanford: Not really. There was no aha! moment. I think it was more a gradual narrowing of specialty choices, based on my experience as a medical student and my personal growth.
For instance, I knew that as incredible as surgery is, it’s not something I could have seen myself doing for many decades. What I mean by that is I have such respect for surgeons (I think if I had to choose 1 doctor to care for my family for the rest of my life, it would be a general surgeon), but the lifestyle would have been tough for me to sustain in the long run. So that left me with the non-surgical specialties. So many things in life depend on chance and the people you encounter, and I think between Dana Farber and MGH, where I did my clinical rotations, there’s no shortage of oncology legends. One of them happened to be my society master in medical school Dr. Anthony D’Amico, a radiation oncologist, and he encouraged me to sign up for a radiation oncology elective my fourth year. I enjoyed the specialty and the people, and just decided to give it a go!
Your involvement in GI oncology clinical trials has been a significant part of your career. Can you share more about your experiences with these trials, the specific goals you aim to achieve, and why this area of research holds particular importance for you?
Dr. Sanford: I’ve always liked thinking about clinical trials, and I’m now enjoying getting to work on them firsthand. Obviously, from an impact standpoint, randomized studies generate practice-changing evidence. But they’re also quite interesting from an operational perspective. There’s the science and statistics part, which I enjoy, but also a very human aspect as well, because you have to design a trial that actually enrolls in your health ecosystem and is feasible. Otherwise, all you’ve really done is a thought experiment. So, it’s a balance of a lot of factors, which is the challenging and fun part for me. I am involved in the NRG Oncology cooperative group, so here I have to give a shoutout to my mentors Ted Hong and Bill Hall, who’ve given me every opportunity in NRG and beyond. Thank you!
But regarding your question about my goals, I think broadly, through clinical trials, my aims are number one, to rigorously assess the value of radiotherapy across GI cancers, thinking about when and who and how radiation can help. And then related to that, two, to innovate in the ways radiotherapy can benefit patients.
Radiation oncology presents unique challenges distinct from those in medical oncology. Could you elaborate on some of these specific challenges, both from a clinical and a research perspective?
Dr. Sanford: I think most would agree there’s both over- and under-treatment across oncology in the US and globally. What I mean by that is some patients receive unnecessary care, meaning treatment adding toxicity with no benefit, but others have limited access to cancer therapies that can meaningfully lengthen life or improve symptoms. An example of the latter is radiotherapy for painful or bleeding metastases. I see that contrast even in my own patient population in Dallas, which is very diverse, because about half are from the county hospital, which provides care to uninsured patients in Dallas. So honestly, I think in 2024 that is the biggest challenge in radiation oncology. But that issue isn’t specific to radiation oncology; it affects all cancer specialties.
I think a challenge unique to radiation oncology is that in terms of research funding, we are working with much smaller budgets because most trials are government sponsored, not industry sponsored. And then also from a policy standpoint, there’s a lot less representation from radiation oncology on decision-making committees across the board, (from guidelines to grant funding), so we need to be smart in designing trials that show the unique added value of our modality. We also need to advocate for our specialty in an honest way.
Your role as an assistant professor at UT Southwestern involves both teaching and research. What aspects of teaching do you find most rewarding, and how do you balance these responsibilities with your clinical work?
Dr. Sanford: My teaching is mostly through having residents on my service, so it goes hand-in-hand with clinical work. The aspect I like most about teaching is building confidence in our trainees to pursue a career path that best fits with their own interests and life goals: academic or private practice, translational or clinical research, whether you get an MPH, an MBA, or you’re “just” an MD, I think there are many ways to be impactful in oncology. Looking back at my own career trajectory, it really hasn’t been linear, and some of my current academic endeavors don’t quite fit the mold. And I think that’s OK.
Outside of your professional responsibilities, what hobbies or interests do you pursue that help you unwind and maintain a healthy work-life balance?
Dr. Sanford: Most of my time outside work is spent with my family. As for myself, my hobbies aren’t too earth-shattering, but I’d first say reading; I love to read everything, and people who know me can attest that I never go anywhere without my Kindle. Second would be exercise. I used to roll my eyes when people talked about exercise endorphins. But of course, I was wrong. Regular exercise helped get me through a pretty difficult time in my life a couple of years ago, and I’ve kept it up since. I also love grocery shopping. I like to tell people that Dallas might have zero historical architecture or natural beauty, but we totally have the best grocery stores, between Costco and Central Market. Central Market totally puts Whole Foods to shame. We don’t have many farmers’ markets here, but I think those are overrated anyway.
And then, lastly, I will add in fashion, because probably my biggest time-suck is scrolling through outfit recommendations on social media (the algorithms know me too well!). I wish I could say cooking, but I honestly would not even subject my worst enemy to anything I make.
Looking back on your career so far, what is one piece of advice you would give to young women aspiring to enter the field of radiation oncology?
Dr Sanford: Two things come to mind. The first isn’t specific to women, but I think it’s important to be honest with yourself about what you actually like and don’t like to do, particularly in terms of research. Just as an example, I tried some translational research earlier in my career. But then I realized I didn’t really enjoy doing it, and perhaps as a result of that, wasn’t very good at it. So I stopped. There aren’t enough hours in the day to do research you don’t enjoy (better to spend that time fashion scrolling!)
Then, for women/parents, I think it is helpful to accept that you can’t be the best parent and researcher all the time, on top of the other roles you have (clinician, spouse, friend, etc). When I’m shuttling around my kids to weekend sports or to birthday parties, someone else may be writing the paper I have in mind. And that’s OK. It’s not unfair, it’s just my life choice, and it’s better to accept that sooner than later (or never). Enjoy your times with your family, because many people don’t have that luxury, and it does really go by fast.
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