OncoDaily Dialogues #7: Aparna Parikh / Hosted by Roupen Odabashian

In our ongoing series called “OncoDaily Dialogues,”we consistently feature prominent individuals in the field of oncology. We showcase their achievements, obstacles they’ve overcome, and significant moments in their journey.

Today, we’re honored to have Aparna Parikh, a renowned GI oncologist, the Director of the Global Cancer Care Program at Mass General, and also an assistant professor at Harvard Medical School. Get ready for an insightful conversation you won’t want to miss!

In this episode of OncoDaily Dialogues, we explore Dr. Parikh’s journey into oncology, her dedication to research and treatment in gastrointestinal cancers, and her insights into advancing patient care. Discover valuable advice for success in oncology, the pivotal role of leadership and mentorship, and the evolving landscape of clinical research and treatment protocols. Don’t miss this engaging discussion with one of the brightest minds shaping the future of oncology.

About Aparna Parikh

Dr. Aparna Parikh is a distinguished GI oncologist, renowned for her expertise in gastrointestinal cancers. As the Director of the Global Cancer Care Program at Mass General and an assistant professor at Harvard Medical School, Dr. Parikh has dedicated her career to advancing cancer care globally. With extensive involvement in global health, she has worked in various African countries, Haiti, and India, focusing on improving access to quality cancer care and education.

She co-founded and co-leads the POETIC fellowship exchange program, which trains clinical oncology fellows from South Africa and Tanzania. Additionally, as a member of the executive board of BOTSOGO, she collaborates with partners to improve access to quality cancer care in Botswana through education, training, and vital clinical research.

Recognized as a leading expert in gastrointestinal cancers, Dr. Parikh’s contributes to the NCCN guidelines for colorectal cancer and directs clinical trials within the GI oncology program at Mass General. Dr. Parikh’s research focuses on introducing innovative treatments for colorectal and pancreatic cancer, advancing the study of these diseases, and improving patient outcomes.

Dr. Parikh’s work extends to liquid biopsy initiatives within the GI Oncology group. She is globally recognized for her expertise in liquid biopsies, which play a crucial role in assessing residual disease post-surgery, evaluating treatment responses, and understanding drug resistance mechanisms. Her research efforts contribute to refining diagnostic tools and improving patient care in oncology.

Dr. Parikh remains deeply committed to addressing disparities in cancer care, particularly in low- and middle-income countries. She champions initiatives focused on enhancing access, equity, and education in these regions, striving to make a meaningful impact on the lives of cancer patients worldwide. Her dedication to advancing research and enhancing patient care has established her as a prominent figure in the field. Dr. Parikh was also recognized in OncoDaily’s 100 Influential Women in Oncology in 2023.

About Roupen Odabashian

Dr. Roupen Odabashian is an accomplished Internal Medicine Physician and Hematology/Oncology Fellow with a profound commitment to advancing healthcare through clinical practice, research, and technology. Currently based at the prestigious Karmanos Cancer Institute, Dr. Odabashian is actively involved in pioneering cancer treatments and conducting clinical research.

In addition to his clinical work, Dr. Odabashian is a multifaceted healthcare professional. He hosts podcast at OncoDaily, engaging with leading experts in oncology to share valuable insights with the medical community. Dr. Odabashian also contributes his expertise as an advisor at Spiraldot Health and Mesh AI, supporting innovative ventures in healthcare technology and collaborative scheduling to combat clinician burnout. With his diverse roles and unwavering dedication, Dr. Odabashian exemplifies a commitment to driving positive change in healthcare.

About OncoDaily 

OncoDaily was founded in 2023. It is a US-based oncology media platform, which features the latest news, insights, and patient stories from the world of oncology. Within a short period of time it became one of the leading oncology media platforms globally.

OncoDaily gathers content from various sources, including social media posts from renowned oncologists from all over the world, news from oncology societies and cancer centers, patient and survivor stories, and career-related information for professionals.

The mission of OncoDaily is to empower patients, survivors, and professionals with the knowledge and inspiration they need to fight cancer. The motto of OncoDaily is “Cancer doesn’t take a day off – neither do we”.

Previous episodes of OncoDaily Dialogues

OncoDaily Dialogues #1 – Harout Semerjian / Hosted by Roupen Odabashian

OncoDaily Dialogues #2 – Piotr Wysocki / Hosted by Roupen Odabashian

OncoDaily Dialogues #3 – Andrés Wiernik / Hosted by Roupen Odabashian

OncoDaily Dialogues #4 – Therese Mulvey / Hosted by Roupen Odabashian

OncoDaily Dialogues #5 – Sarkis Meterissian / Hosted by Roupen Odabashian

OncoDaily Dialogues #6- Navneet Singh / Hosted by Roupen Odabashian

Follow the transcript below

Roupen Odabashian: Welcome to a new episode of OncoDaily. Today, we have the pleasure to interview Dr. Parikh. Dr. Parikh is a renowned specialist in gastrointestinal cancers, emphasizing treatment for young adults with colorectal cancer and pancreatic cancer.

She contributes to the NCCN guidelines for colorectal cancer and plays a pivotal role in directing clinical trials within the GI oncology program, focusing on introducing innovative treatments for both colorectal cancer and pancreatic cancer.

Collaborating closely with research teams at MGH Cancer Center, she advances the study of these cancers. Moreover, Dr. Parikh spearheads the liquid biopsy initiative for the GI oncology group and is recognized globally for her expertise in liquid biopsies.

Her work is instrumental in refining these diagnostic tools for assessing residual disease post-surgery, evaluating treatment responses, and understanding drug resistance mechanisms.

Beyond her clinical and translational research endeavors, Dr. Parikh is deeply committed to improving cancer care in low- and middle-income countries, focusing on enhancing access, equity, and education in these regions. Thank you so much for being here today, Dr. Parikh.

Aparna Parikh: Thanks so much for having me.

Roupen Odabashian: I just want to understand a bit about your background and why did you choose to start your career in GI oncology and focusing on young patients with cancer?

Aparna Parikh: That’s a loaded question. My interest in oncology actually came from a couple of different areas. We’ll talk a little bit about GI specifically, but by way of background, I had a lot of experience and exposure to various low and middle-income countries even prior to medical school and during medical school, and had spent a lot of time in developing countries. At that time, I was thinking I was destined to be an infectious disease doctor and do HIV-related work. I just saw so much cancer and saw the kind of suffering inflicted on patients, the lack of resources in cancer care including palliation in low and middle-income countries, and really started to think a little bit around, I think we needed to move the needle the same way we moved the needle with infectious diseases in low-income countries to taking care of patients in LMICs with cancer.

And I think as I was thinking about that, I had some family members, including a very close uncle of mine in his 40s, that died from stomach cancer. I get screened regularly myself, as I have a risk factor for colorectal cancer and have been since my teens. So I kept sort of thinking about GI cancers as well as I was starting to think a little bit more around which discipline of oncology I was going to go into. And then, you know, I think ultimately where a lot of things lead you in life is who are the people you meet with, who are the people you work with, who are you inspired by, where is the need?

And I was, as I was going through fellowship, once I decided to do oncology, you know, when I started fellowship, I was thinking maybe I’ll do breast cancer. And then when I went through, I liked women’s health, but when I got into fellowship, I just really was drawn to the diversity of GI oncology patients, spanning ages, spanning races, genders, socioeconomic status. I saw the tremendous need to do better with therapies for GI cancers.

And then I really liked the people. I really liked the attendings that were in the space. I liked the feel of being in the clinic. And then I had, you know, when I was a fellow, I had a co-resident also who unfortunately passed away, who died from stomach cancer when we were co-fellows. And so I think all of these things just led me to GI cancers.

And then when I started at MGH, there was a younger faculty member, a newer faculty member who was interested in geriatric oncology, and he was seeing a lot of the older colorectal cancer patients. And I think at that time is when we were starting to see this rise of early-onset colorectal cancers. And not necessarily by design, I just happened to start getting these patients in my clinic. My colleague wanted to see the older ones, so he was getting them.

So by default, all these younger patients, and I was noticing younger and younger kept coming into my clinic. And I started to just see the unique needs that this patient population had, very different than the geriatric needs. Geriatric needs are critically important, but they’re just different from the needs of younger patients. So I would say that the young population sort of just happened. And then I liked seeing that patient population. I think there’s a certain level of, you know, it can be hard.

I think you relate to so many of these people sitting in front of you, your age, younger, with, you know, families and kids, and are having their life upended. And so I just felt that if there’s anything that you can do to just provide that compassionate care and try to go a little bit beyond, not, you know, like to think we do everything for all of our patients, but definitely felt a little bit of this, if I can lessen the burden of suffering in these patients that I just really feel for, very uniquely just given the demographic of my own demographic, I realized that I liked that patient population.

And then similarly to what I was mentioning before, I mean, I think saw the need to understand why this is happening. And I think like some of the other areas I work on, it’s one of those things that does keep me up at night, right? Like, what is happening here? And feel very motivated to work along other scientists to understand why this is happening, with eventually, you know, not only being able to potentially risk-stratify better and detect earlier, figure out who are the people we should be screening, but then, you know, can we reverse it ultimately somehow? So I think that’s like a little bit of a long-winded answer, but I think gives you a sense a little bit at least of how I came to that work.

Roupen Odabashian: No, I completely agree with you. I think our personal stories really affect our choices. The same as you, like my best friend recently was diagnosed with colon cancer, and he’s younger than me, which was mind-blowing, stage four, younger than me, right? I can relate, and I’m sorry you’ve been through that. I know how it feels like. It’s very hard.

Aparna Parikh: I’m sorry you went through that as well. Yeah, it’s tough when you see a peer and a loved one.

Roupen Odabashian: Exactly. And you’ve had tons of publications, like more than 200. What’s the secret? If I’m a young oncologist starting my career, I want to be a prolific academic researcher. What are the tips that you would give to your younger self?

Aparna Parikh: To my younger self, and to you and others, I really can’t emphasize how much the support network I had, both from my peers and colleagues but also at home, led to, I think, some of my career successes. And certainly, I’ve had many failures too. But I think it’s so important to find not only the questions that interest you, I think that’s sort of given.

I think it’s really hard to do what we do unless you’re motivated by it. And people ask me, like, you have so many buckets, like, you need to maybe focus. Which one are you going to focus on? And I think, like I mentioned before, if you’re motivated and the different areas you’re working on kind of keep you up at night in terms of what problems you want to dive into and your areas of inquiry, I think the work is no longer work, it’s a passion. And it does feel like a bit of a calling.

And so find the areas you’re passionate about, but you can have the best idea, have the most passion, but if you’re around people that don’t amplify you and lift you up and are collaborative, then it’s really hard, I think, to propel forward. I really truly believe in team science, and I think obviously together we can do better. And I have made decisions around, again, like I mentioned, GI oncology, and I really like that group. I liked the people I worked with.

When I looked at faculty positions, I loved the group at MGH, and I continue to do and continue to love them. And opportunities may come up to leave, and every time I get drawn to the fact that I just really like the people I work with. So even if better packages with more salary and startup packages may come along, I haven’t yet felt propelled to leave because I really like the people I work with. So I would say find the issues you’re passionate about and then find the people you like working with. And I think that at least sets you up for success.

Roupen Odabashian: During our conversation, you mentioned many times about the people who you work with, and I feel like your mentors affected you a lot and where you are today. What are good tips for people who are starting in academic oncology, how to find the right mentor, how to develop that relationship, and how to grow through it?

Aparna Parikh: That’s such a great question, and it’s something that now as a mentor myself, I care very deeply about. And I will say I think first and foremost, I think there has to be a little bit of a connection and a spark. It’s almost like dating a little bit. I think if you can’t see yourself comfortably conversing with someone even in early conversations and it doesn’t feel right, then I don’t even know if it’s worth taking the next step.

I think as you meet people, I think first of all, you want to, you know, there are people that you meet and you’re like, okay, this feels right. And there are others where you’re like, not sure, maybe this is not going to work, and I’m not going to pursue anymore. Or there’s another one, maybe I need another meeting or two to get a sense that this is someone I want to work with. So I think get a sense of who they are, talk to other people they’ve worked with. That’s okay. I think you aren’t, it’s important to be comfortable with who you’re going to have as your primary mentor or mentors.

So get a sense of who else they have mentored, talk to those people. Before if I’m asked to do something else and collaborate on a bigger project even now with someone else, I get a sense from people that they worked with, is it someone you want to collaborate with, or are there any red flags? Tell me what those red flags are.

And then, you know, I do, even for me sometimes, you know, you want to have someone that’s going to make time for you. And how do you know that? I think you get a sense of responsiveness to emails, responsiveness to meetings. But I would start with, and then I also think, you can shift your goals and aspirations over time, but I do think it helps mentors if you have a little bit of a sense of what you want to do.

I’ve had people that have come to me and, you know, just, it’s very different than saying, I think, let’s talk about global oncology, right? I have an interest in global oncology, done, right? Can I work with you? Versus, like, here’s my specific interest in global oncology, or I’ve noticed, or I saw I researched that you have done X, Y, and Z, I’m interested in X, Y, and Z that you’re working on. Or, you know, I, maybe this is not an area you’re working on, but it’s something I am interested in, is this something? So I do think a little bit of focus to bring to your early conversations with people also helps the mentor because it’s harder for someone, it’s harder to know what to do with if someone’s just like, I’m interested in GI cancer, or I’m interested in colon cancer, I’m interested in global oncology. 

Those are good conversation starters, but it’s a little bit tough to figure out what you do as a mentor. And part of it is helping people, it is okay to be undifferentiated, and I think if you’re undifferentiated, then you just come in with flexibility and a willingness to learn and try different things, and then your job is as a mentor is to help that person find the areas that they’re excited working on, but I think that needs to be explicitly stated rather than just I’m interested in this, can you mentor me? That’s a hard, it’s hard to know what to do with that.

Roupen Odabashian: No, I completely agree. I think that’s one of the things I learned the hard way, like you have to be specific because even if you send a general email like, I’m interested in research, okay, so even people who have research, they will not be interested in giving you the project because if you’re not interested in it, you’re not going to put work in it. These things are hard.

Aparna Parikh: Yeah, exactly.

Roupen Odabashian: I want to shift gears a bit about something that we both experienced, cancer in young adults. And I’ve been asked this question many times, but since it’s your specialty and you’ve seen more of it, what do you think is one of the main reasons we are seeing more and more cancer in younger adults?

Aparna Parikh: There’s clearly some, obviously you can take the same host, and that host can have different so there’s the host micro host environment and I think at least for colon cancer we’re realizing microbiome location all of these things matters you know why is it rectum more than colon. Rectum is a reservoir, is that insult causing inflammation, what is driving that inflammation. But I don’t think we entirely know there’s definitely some hypotheses around even as early as in-utero exposures to certain things, antibiotics, sugary drinks, weight changes, not just obesity but actually deltas in weight over time causing hits. I was really interested and a little bit disturbed by the abstract of the New England Journal microplastic in the coronary plaque article yesterday. It was this paper that was looking at the composition of some of the coronary plaques that people have, and within those plaques, they found a lot of these microplastics that are in our environment quite ubiquitously with all the things that we eat.

Roupen Odabashian: I’ve heard about it in the news. It’s crazy. Now I’m so worried about everything I eat.

Aparna Parikh: No, and it’s, I mean, I was a little bit like, well, some of this stuff, like everything in moderation, but then like you see this paper and you’re like, oh wow, they found these microplastics in these plaques. So I don’t think we entirely know. It’s clearly something in our environment that is interacting with the gut that is causing this. As you know, there’s been no clear genomic differences in the non-hereditary patients. So what is that? We don’t know.

I’m really excited, I’m not the lead PI on this, but part of a team that was just announced this week for young-onset colorectal cancer, a Cancer Grand Challenges $25 million grant to try to understand why this is happening. And I’m leading the global parts of the grant in India, looking at two states in India that have very different colorectal cancer incidences in young people, and trying to do some really deep analysis of a large number of patients in two different states that might give us some insight into why is one state like this and why is the other state like this, that might give us some learnings that we might be able to apply to a larger patient population as well.

Roupen Odabashian: Alright, those were my questions. Thank you so much for being here today. I really appreciate it.

Aparna Parikh: Of course, best of luck to you, and such great work that you guys are doing this, and we’ll definitely need to catch some of the other podcasts as well.

Roupen Odabashian: Thank you so much.

Aparna Parikh: Take care. Bye bye.