Expert Spotlight: Dr. Howard Sandler

Dr. Howard Sandler is the Chair of Radiation Oncology at Cedars-Sinai. He also holds the Ronald H. Bloom Family Chair in Cancer Therapeutics. Prior to joining Cedars-Sinai, Dr. Sandler served as a professor of radiation oncology and urology at the University of Michigan, and Senior Associate Chair at the University of Michigan.

Radiation oncology found Dr. Howard Sandler by fate: "it wasn't a field I had considered at all until a friend suggested I try a clinical rotation in it. And then within a week I had found what I loved." His father was a doctor, but this was at a time when institutional and social rebellion was commonplace and cool. So, Dr. Sandler started his education with a non-medical directed path: he graduated with a physics degree.

The new MD PhD program at his medical school, which offered free tuition, swayed him to study medicine. And it was the engaging clinical care, close connections with patients, and of course helping others that convinced Dr. Sandler that he had made the right decision. Radiation oncology additionally meant working with a lot of physics-related technology, too (a bonus for a science major).

One of Dr. Sandler's most memorable moments in medicine was heading the group of RTOG clinical trials, which focused on prostate cancer research funded by the NCI, for over twenty years: "that research really had such a large impact on patient care today. It's exciting to be a part of something so influential." Dr. Sandler has found the science of clinical trials to be rewarding, as it carries an, "awesome responsibility to do experiments that will help people. The only reason not to do trials is if you think all the questions in medicine have been answered." He admires how much creativity is involved in asking the right questions.

Dr. Sandler's dedication and hard work was ultimately recognized at an annual ASTRO meeting, in which the audience thanked him with a standing ovation. "You don't see that kind of recognition often and it was something I still think back on often."

As for looking forward, Dr. Sandler cites the incredible progress of the human genome project, and how far we still have to go to achieve highly personalized cancer treatment: "we've gotten better and better at reporting the genomic structure of cancers, and it's only a matter of time. There's a lot of data to sort through and it will be an international effort to see even more promising results." Additionally, Dr. Sandler uses theMednet for continuous perspective in oncology: "I check the Mednet email every morning to get a quick infusion of insight from the oncology community."

Coordination and administrative problems, however, cause strain for Dr. Sandler and others: "We have to take things one stride at a time. Prior authorization and administrative tasks have really led to a compression of activity. There is less big thinking and speculation going on in medicine today." He suggests, especially when handling a team working on clinical trials, to recruit physicians who are good at what they do. In turn, Dr. Sandler tries to enrich their experience and make them feel like what they're doing is contributing to the team.

The attitude physicians have at work can be greatly affected by their life outside medicine. "I see a lot of colleagues out of balance between work, family, and their sense of self. It's why I try to do a few things for myself. Tennis, going to the gym; I'm pretty selective about the activities I choose."

Dr. Sandler values stepping back and getting a bigger perspective about medicine, and what physicians can provide to their patients. But, he admits, medical school and the following fellowships and residencies are a long road. "My best advice is to make a decision based on what you're passionate about, and stick with it."