Joey Wahler (Host): He recently joined Regional One Health Cancer Care, so we're getting to know Dr. Alaa Altahan, a Board Certified Hematologist and Medical Oncologist. This is One-On-One with Regional One Health, your inside look at how we're building healthier tomorrows for our patients and our community. Join us as we get to know some of the individuals who help provide lifesaving, life changing care for our community.

Thanks for joining us. I am Joey Wahler. Hi, Doctor. Welcome.

Alaa Altahan, MD: Thank you for having me with you today. It's a pleasure being with you.

Host: Same here. We appreciate the time. So first, Doctor, I know that you're of Middle Eastern descent, and so as a young man, what first draws you to a career in medicine and specifically as a medical oncologist?

Alaa Altahan, MD: I'm actually originally from Syria, which is right next to Lebanon, but I did do my university education in Lebanon. To drive me to be a medical oncologist, I guess I had interest in medicine to start with, from young age and oncology specifically, or cancer world is something for interest for me.

Part of it because of the fascinating science behind it and the challenge that we see. So I got drawn to that at even pre university thinking that I would be a doctor, then I would specialize in oncology. So as I went to university and I got involved in my medical school, in cancer research, that solidified my decision or my feeling that I really want to be an oncologist.

And then when I did my internal medicine residency, I rotated through oncology and that also again reinforced that this is what I want to do in my future.

Host: So what led you to specialize in treating blood conditions and cancers of the blood? Where did that interest come from?

Alaa Altahan, MD: Right. So during our residency as well as fellowship, we rotate and we get to experience the treatment or different cancers, including what we call solid tumors, which include like other cancers, cancer different than blood cancer, like lung and breast, uh urologic cancers and all kind of different cancer, GI cancers.

And then we also rotate through the hematology or malignant hematology part. I did like that malignant hematology part, which includes treating blood cancer and lymphomas and I like it because of a few different things. One of them is, it's a little bit of faster pace compared to the solid tumor, and you can see the changes when you treat the patients kind of sooner, actually, compared to solid tumor, which takes sometimes longer time to see the effect. So these, you can monitor closely within some days or weeks. You can see some changes and see your treatment, which I like. Also, some of those diagnoses can be really devastating and they have really poor prognosis or poor outcomes. So I am interested in working on trying to improve that as well doing research, working with patients as well to try to improve that outcome.

Host: And speaking of which, when you talk about trying to improve outcomes, Doctor, in terms of the options you provide to patients at Regional One Health, can you maybe give us an example of a particular type of blood cancer where the treatment options are improving of late?

Alaa Altahan, MD: So if we look in general cancer, actually, when patients see cancer, especially when it's advanced stage, they see it as unfortunately a terminal diagnosis. And over time we actually have come a long way with cancer treatments. Outcomes have improved significantly, although we still need a lot of work.

Certainly that's true, but there are many cancers that have good chance of cure and hopefully the patient will get treated and be done with it and hopefully it never comes back. For example, lymphomas, we have come through like different development in the addition. It was chemotherapy in the past. For example, CML or CLL, both are chronic conditions. Back in the days, chemotherapy was the treatment and the outcomes were not as good. With advancements for example, in CML, they discovered a specific genetic change, which then they found a drug to target that, and those drugs now altered the course of the disease.

Now, patients can go on treatment for many years, and they continue to be doing well and it's in the form of pills they take at home. For some of these conditions that changed how they, the course of disease. Other examples will include immunotherapy, which came some years now ago, and that also changed the outcomes of cancer in general significantly so

there have been some improvement, but we still have some more to do.

Host: Absolutely. Well, I'm sure that comes as comforting news to some of those joining us. How about this, along with the physical treatment that you offer, you're often a source of support for frightened patients and also their families who are quite frequently a big part of the care picture. So how do you put all of the above at ease?

Alaa Altahan, MD: So it is important, as you said, it's actually not treating the cancer, it's treating the patient. And we work with them to tailor the treatment according to them. But you're right, the, when they receive the news that they have cancer, they're really, really usually worried.

It's a life altering diagnosis. There are a lot of questions, a lot of concerns, a lot of what if and how we're going through this and all of that. So we meet with a patient initially, usually in long meeting, where we try to put everything into perspective. They have questions how that happened or why, and we go through overview of their condition, diagnosis, and

overview of the plan and how we move forward. It is, like I said, this notion that cancer is a terminal diagnosis. There are some conditions where this is not actually the case. Some of these are treatable and curable, although not in a hundred percent of patients, but a good percentage of them. So when the patient knows that, they get some reassurance.

Also, knowing that they have options for treatment, that gives them some reassurance. Involving their families, as you mentioned, which is very important because patients need support during their journey with cancers. Also understanding the values of each patient, and that can be different from one patient to another.

 Understanding what's important to them and tailoring the treatment according to that. Letting the patient know that we are on their side all along from the beginning to the end. In oncology is different that we build really a close relationship with the patients. That we follow them very closely and we try to always be accessible to them.

And that's provide reassurance because when they know that they can reach out to their doctor and get their opinion or advice, or if they have some issues, there's someone that they could reach out to that provides them with reassurance. Of course, in addition to all the social work support and there are support groups that we can provide them with contacts for or community resources that can help them through their journey.

Host: Absolutely. Now blood cancers are often hereditary. So how important would you say is knowing your family history when it comes to that and getting regular screening if need be as a result?

Alaa Altahan, MD: Right. So there are some cancers that are hereditary. That's correct. So when you have a family history of cancer, the patient should always consult with their physician. Like, I have these cancers in the family. Do I need to get any specific screening and based on different types of cancer, there might be some screenings that can be done in more cases where there are multiple family members, the doctor might refer them to genetic counselor, which can meet with them and they discuss and get a detailed family history and they may consider doing genetic testing, if that is indicated, which can direct their further screening what would be recommended for them in the future to try to catch things early.

Host: Switching gears a little bit, Doctor, your medical residency was at University of Tennessee Health Science Center, where you've since taught as an assistant professor, which I find very cool. So how fulfilling has that been?

Alaa Altahan, MD: It's actually been great. I did my residency here at University of Tennessee and then I did my fellowship actually at the University of Tennessee. And it's been really, great experience and amazing. I worked with the doctors here as the hematology oncology department, has been evolving and it has really developed quite a bit and it continues to improve and expand.

So I recently actually joined them as an assistant professor, which is gratifying to be working alongside with my mentors who I trained with. It has been a great experience with them and I'm happy to be, again, part of the team here.

Host: What would you say is the biggest difference if you've noticed one in, let's say, medical residents in your day and nowadays?

Alaa Altahan, MD: I would say it's mostly the same. I would say, yeah, I mean, I did my residency here, a few years ago. I would say overall it's still the same structure. There has been some changes, in the structure of the training where back in the days, the hours of work and stuff were a little different.

But overall it continues to be the same structure. I would say not a significant change in the training.

Host: Well, that's comforting to know in a world where so many other industries and professors are changing dramatically. Lemme ask you a couple of other things here. How about your life, Doctor, outside of work? What are some of the things you enjoy doing during your free time?

Alaa Altahan, MD: Right? So I guess when we're out of the clinic or the office doing research or the hospital, well, I like to spend time with my family here sometimes exploring nature about around us, going out to the parks and enjoying with my two daughters and my wife the nature outside.

Host: How important in doing that and other things away from work, do you find it to be personally, to be able to detach yourself a little bit from the great work that you do, which is so demanding and challenging, and just kind of take a breather.

Alaa Altahan, MD: Yeah, that is actually very important. I would say in oncology it can be draining. I mean, you work with the patients and it can affect people emotionally as well, you feel with your patients and when you work with them. So it is important to take a little break to be able to rebuild or to refresh and spend some time with your family away from work so you can continue to do the work and provide the care you do.

Host: Because as you pointed out earlier, Doctor, you often follow these patients for quite some time in this line of work, and you do build up a relationship with them as they're going through the ups and downs. Yes?

Alaa Altahan, MD: That is correct.

Host: How about the most challenging aspect of the work you do? What would you say really gets your juices flowing more than anything?

Alaa Altahan, MD: I guess the challenge is really when the options for the patients are limited, and that's really a challenge usually. Sometimes where you don't have much options left for the patients in that unfortunate case it becomes a challenge and difficult to deliver that news to the patient and discuss with them.

Unfortunately, there's not much option or not much options left for them, but on the other side there's always gratifying and great times where you work with the patients and they have really good outcomes or they get cured from the disease. And that's really give you the strength and that you are helping and making some difference in your patient's life.

And that pushes you to do more and continue working with it.

Host: And you led me beautifully there into my final question here, which is in summary, Doctor, I was going to ask what's most rewarding about your job? And when you talk about it being the fact that you can make such a difference in people's lives, in this day and age, when often the focus is on other parts of the healthcare industry, do you think maybe that gets lost in the shuffle sometimes?

That there are people like you that, many of them in fact, that really do make a dramatic difference in people's lives.

Alaa Altahan, MD: Yes, there are a lot of doctors and they're doing great jobs, and they do their best. I mean, they do really do their best to get their patients the best possible care, whether it's in academic university settings or community hospital or small community clinics.

Those doctors are doing their best and they do make significant impact on patient's life, their future, their families, but also there's a whole team behind that. It's not only the doctor. The doctor probably gets in the front where it's more seen, but there's a team of great nurses, great medical assistants, great clinic staff.

Everybody who takes care of the clinic being clean for the patient when they come in, so they feel more comfortable. Everybody, there's a whole team behind it, and those are really, we really need to always appreciate the staff in there that help to make the environment altogether better for the patient and better for the patient care.

Host: Absolutely. Well folks, we trust you're now more familiar with Dr. Alaa Altahan. Doctor, keep up all your great life-changing work. Thanks so much again.

Alaa Altahan, MD: Thank you. Thank you for having me.

Joey Wahler (Host): . And for more information, please visit regionalonehealth.org/cancer-care, or call 901-515-HOPE. That's 901-515-4673. I'm Joey Wahler and thanks so much again for making One-On-One with Regional One Health, part of your journey to better health. Join us next time as we introduce you to another member of the Regional One Health Family.