McCann on the Intersection of Mentorship, Multidisciplinary Care, and Career Aspirations as a Woman in Oncology

From a small town in rural Texas to becoming a breast oncologist at the University of California, Los Angeles (UCLA) Health, the professional journey of Kelly E. McCann, MD, PhD, has been shaped by personal connections to breast cancer, a desire to integrate scientific inquiry with patient care, and an overarching commitment to conducting research through translational oncology.

Through it all, McCann has come to recognize the importance of promoting intersectionality through mentorship within the field of oncology, particularly for women or members of other underrepresented groups, who may benefit from observing how other people with diverse perspectives and experiences achieve balance and build connections throughout their careers.

“Being able to reach out to somebody, talk to them about their story, understand where they’re coming from can go a long way in supporting them,” McCann emphasized during an interview with OncLive® regarding her participation in the Women in Oncology panel during the 41st Annual Miami Breast Cancer Conference. “Ultimately, we all have the same drive here, which is to develop breast cancer treatment strategies. That’s one thing that binds us together.”

In the interview, McCann expanded on her personal career journey and evolving career aspirations as a woman in oncology, discussed her efforts to enact boundaries and build a trusted support system in clinical practice, and underscored how multidisciplinary approaches to breast cancer care can provide more comprehensive support for both patients and practitioners.

McCann is a breast medical oncologist and an assistant clinical professor of medicine at the UCLA Health David Geffen School of Medicine.

OncLive: Could you describe your journey to becoming an oncologist?

McCann: I’m from a small town in rural east Texas, where the high school graduation rate is less than 50%. I got out a long time ago through education. I went to Rice University [in Houston, Texas] for biomedical engineering. Then I went to Stanford University [in California for their] medical scientist training program on a grant from the National Institutes of Health, and there I studied cancer biology. I went to Oregon Health & Science University [in Portland] for internal medicine and then to UCLA for my fellowship in hematology and oncoloogy. Now I’m a breast oncologist and have been doing that for approximately 7 years. I do a lot of clinical trial research, but I’m also interested in translational research because of my background in molecular biology.

Coming from an initial background in biomedical engineering, what drew you to the breast cancer field?

Growing up, my mom had breast cancer twice, her sister had breast cancer in her 40s, and their mother had breast cancer, so it was always a part of my life. It wasn’t always something that was devastating, it was just part of life; you learn from it, you move on from it. That was what interested me in breast cancer in the first place.

When I was at Rice doing biomedical engineering, I was studying to do either a PhD in bioengineering or pharmacology. However, when I discovered the medical scientist training program, [I realized] I could obtain funding for my whole career in both medicine and as a scientist, and in that way, pay for medical school. That’s how I snuck in to do medicine. When I was in medical school, I discovered that I liked to see patients, which was not my original intention. I wanted to be a unicorn until I was 7 years old, and then a chemical engineer. I wasn’t one of those [people] who was born to be a physician—that hit me later. [My career goals have] adapted over time [as I] learned how to be a doctor.

What does work-life balance look like to you? Do you experience difficulties navigating the balance between your professional aspirations and personal obligations?

I don’t have a work-life balance; I have a “work and do more work” type of balance and do research on the weekends and at night, because it is an all-encompassing career. I don’t have a partner or children, so I don’t have to worry about that aspect of my life necessarily.

However, I’m learning to set boundaries with patients, so I can have more of a balance in my life. It’s important to have more of a support staff and build a team around yourself. Maybe you’re not the one doing all the phone calls. You need to have somebody you trust who can help you with those things.

What is the importance of mentorship programs and support networks for women in oncology?

Mentorship is also important. Seeing how other people balance their lives is crucial. As women in oncology, we [can’t] always balance everything without having help. Mentorship is difficult, because to become a good mentor, you have to have had good mentors. There’s not going to be one perfect person who can mentor you in all things, so you must pick up different people who are willing to mentor you, and then carry those things forward.

In medicine, we’re used to having mentors because medicine is a series of apprenticeships so we learn how to become breast oncologists or thoracic oncologists. There are many institutional [efforts] to mentor people of certain subgroups. There are a lot of women in oncology mentorship opportunities, but ultimately, you’ve got to seek out mentorship [yourself].

What initiatives or strategies can be implemented within the oncology community to create a more inclusive and supportive environment in both clinical and academic settings?

Our patients bind us together. I love the doctor-patient relationship, because coming in, you both are there to learn from each other, teach each other, advance someone’s health, and make their life a little better, hopefully. That is such a beautiful, trusting relationship.

For [oncologists] in the LGBTQ+ community, there can be more difficulty connecting with the lives of other people, even at the [most mundane] level. [For example], if I’m doing a tumor board and everybody’s talking about their children, I’m [sometimes] sitting in the corner [feeling like]: ‘that’s not my life, and I can’t connect with you on that.’ Maybe if you’re not out at your institution, you’re the one who shows up alone to graduation or to the holiday party. It can be very isolating. My patients regularly reassure me that it’s not too late for me to get married and have children, and they mean well, so I’ll share something about my cats or a hobby to share a connection.

We should give each other room to have trusting relationships with each other. A lot of times, what gets in the way is being competitive, because we are competing on some level for different trials. [We also need to] be kind to ourselves, our patients, and each other. Whether we’re in the same institution, [regardless of gender], it is important.

How have your own career goals changed over time, and what trajectory do you currently envision for yourself in this field?

I did 19 years of education and training to go toward a translational oncology career. Goals are going to shift over time, but the goal that’s been my guiding light is that I want to be in research. I love seeing patients, and there are many different ways to achieve different goals. For me, being able to define those goals and move forward has been important. It’s important to me that I’d be able to at least give it a shot and be brave and move on if I need to move on. Something that was also mentioned in our Women in Oncology event is that sometimes we have our first job or second job, and moving to the second job might be a great thing, a period of growth that one can’t necessarily get at the place they’re in right now.

What advice would you give your younger self about building a career in breast cancer?

Coming straight out of a fellowship and into an attending position at the same institution, you don’t [always] know what you should be asking for to further your career goals. You might not even know what your career goals are, because you’re still so new. Coming out of fellowship, you’re trained to treat patients with breast cancer, but you don’t know the business aspect of it, for example, or the customer service aspect of it. [Accordingly], your goals can shift over time.

If I could go back, I would change a few things in my breast cancer clinic, because most of our patients with breast cancer are in the curative setting, and we need a lot of help. I would have set up my practice so the patients knew from the beginning that we have a team [behind them]. [I’d let them know] who to reach out to [as] a safety net instead of taking it all on myself. What’s happened over time is that my patients with breast cancer know me and only me. I need to integrate nurse triage, nurse navigators, an advanced practice practitioner, and a whole team of other people [into my practice] so patients feel like I’m not the only person involved in their journey; I’m just one person on a team of people who can get them through the breast cancer diagnosis.

We definitely need multidisciplinary work in breast cancer more than anything. During the first biopsy of breast cancer, [patients are] used to having a surgeon, and may see a radiation oncologist, [as well as a] medical oncologist. Social and psychological care are [also] important. It's a big team of people that can take care of 1 person and hopefully get them through it.

My final thought is on just how far women have come in oncology in a short period of time. I’m in my mid-40s. I’m only one generation removed from medical schools with only a couple of women per class, if any at all. We’re practicing oncology right now with women who were actively discouraged from pursuing careers in science and math. I reflect on this often now that I’m also in the position of mentoring the next generation. My advice to the next generation is that if you’re surrounded with people who can’t see your potential, find people who do.