Using History, Humanity to Shape Cancer Care Conversations: Deborah Doroshow, MD, PhD

Deborah Doroshow, MD, PhD, combines clinical oncology with her rare academic background in the history of medicine to guide patients and their families through the cancer journey. She is an assistant professor at the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, where she divides her time between the Early Phase Trials Unit and the Center for Thoracic Oncology.

In her daily practice, Doroshow prioritizes demystifying the health care process by using plain language and gauging each patient's level of understanding before introducing complex information. She is especially mindful that patients at their first oncology visit are often too anxious to absorb much of what is discussed, so she routinely schedules follow-up appointments and, when appropriate, includes family members to ensure everyone is aligned. She views the patient relationship as an evolving, long-term conversation rather than a series of isolated clinical encounters.

“It's obviously not just a 1-time visit; it's a continuing conversation and relationship that, in many cases, lasts a long time and that I really treasure,” Doroshow said.

She also emphasized the importance of understanding patients on a personal level. Rather than beginning with a medical history, Doroshow asks patients about their personal lives, recognizing that this context is essential to guiding them effectively. She also acknowledges that each person's emotional response to a cancer diagnosis is unique, shaped by factors such as personality, faith, and worldview.

Her historical training adds 2 dimensions to her clinical work. First, it tempers her enthusiasm for new treatments. Having studied recurring cycles of overhyped therapies throughout 20th-century medical history, Doroshow helps patients approach emerging drugs with measured expectations, balancing her optimism as a phase 1 trial researcher with critical thinking.

Second, her historical perspective keeps her attuned to systemic inequities in health care access. Doroshow is acutely aware of how racial, economic, and geographic disparities have historically prevented and continue to prevent many patients from receiving optimal care, and she carries that awareness into her daily work.

“This is obviously a huge issue that we have today in terms of ensuring that all patients have access to the newest and most effective treatments,” she said. “So, I do think about that a lot as I work with my patients on a daily basis.”