When the Oncologist Becomes the PCP: Emily K. Curran, MD

Who is your patient’s primary care doctor when they’re in the hospital twice a week for chemo? Ask them, and there’s a decent chance they’ll give you the name of their oncologist, not their internist.

This is the reality Emily K. Curran, MD, has come to embrace in her work as an associate professor of internal medicine at the University of Cincinnati College of Medicine, where her focus is on caring for patients with leukemia. For patients navigating active treatment, the lines between cancer care and everyday medical management blur fast, and Curran has learned to live in that overlap rather than resist it.

It’s a role she’s leaned into. As she puts it, patients often introduce her as their primary care doctor, even though, for example, “I’m probably not as up to date on the management of diabetes as I should be.” Still, she manages it, because during leukemia treatment the calculus changes entirely. Blood pressure medications get chosen based on what won’t interact with chemo, not necessarily what’s textbook-ideal. Insulin becomes the default for diabetes management, simply because it’s easier to control in patients undergoing treatment. Once a patient reaches remission and their visits start to space out, Curran is the one telling them it’s time to go find their primary care doctor again.

But her most interesting work may be in what happens after that point. Curran has helped build a dedicated oncology primary care clinic, staffed by physicians who specialize in exactly this in-between space: patients with a cancer history who need both general medical care and someone who understands the unique, lingering toxicities of chemo. It’s part of a broader survivorship movement she says is gaining real traction nationally, and it’s a far cry from where the field stood not long ago. As she puts it, survivorship for older adults with acute lymphoblastic leukemia (ALL) simply “wasn’t a thing” before.

In this conversation, she gets into how oncologists end up wearing the primary care hat, what makes survivorship care for patients with ALL different from other cancers, and why she believes dedicated oncology-primary care partnerships might be the future of long-term cancer care.