128. Alison Wakoff Loren, Bone Marrow Transplant Doctor and Chief of Hematology/Oncology

Show Notes:

Alison Wakoff Loren went to St Louis to medical school at Washington University. She specialized in internal medicine and later completed a subspecialty fellowship in hematology oncology at the University of Pennsylvania. She met her husband in medical school and they have three children all in their early twenties. Alison  is now the chief of the Division of Hematology Oncology at the University of Pennsylvania, specializing in bone marrow transplantation, a curative therapy for blood cancer.

Taking Care of Patients

Alison finds the best part of her job to be taking care of patients, especially those who have just been diagnosed with leukemia. She gets to know people when they are in a vulnerable place and understand their lives, which is a privilege. She also does a lot of administrative work, mentoring trainees and faculty, helping them understand their passions and connecting them with opportunities. Alison is proud of her mentoring success stories. She encourages everyone to show gratitude and warmth, as the world is not always generous, and it is important to show that we can make a difference for each other by showing warmth and gratitude. She also shares a story of mentoring a talented MD and PhD candidate who was unhappy in her research role. 

Helping Patients with Leukemia

Alison discusses the fear and uncertainty people face when discovering they have leukemia. She shares her experiences in delivering sad news to a patient who had been a high school history teacher and had leukemia come back. She mentions that people have incredibly generous spirits and sometimes don't behave their best when they're scared. She also shares examples of people making decisions that matter to their loved ones, such as stopping treatment or continuing treatment when they don't want to. Alison also discusses the range of responses people have when they have to deliver sad news. She explains that most people know they're in for an uphill climb, and it's rare to be surprised. Alison specializes in bone marrow transplants, which are intensive but curative intent therapies, and she emphasizes the importance of laying groundwork ahead of time to make difficult conversations less shocking and offering hope while grounding the conversation. She also stresses the importance of being honest and respectful in her interactions with patients.

Fertility Preservation in  Cancer Treatment

The conversation turns to Alison’s research and the importance of fertility preservation in cancer treatment, which can harm reproductive capacity and lead to infertility. Oncology teams often don't discuss this topic, partly because they are focused on cancer and not reproductive endocrinologists. However, there is a focus on making sure all patients are counseled about the reproductive impact of their treatments and reproductive options to engage in fertility preservation before starting cancer treatments. Alison explains what is recommended for women. She mentions that it is important to discuss these options before starting cancer treatment, as it reduces distress and decision regret for people after treatment. Alison is fortunate to be able to speak and advocate for fertility preservation for people with blood cancers, which represents a special population in oncology care. She has been fortunate to co-chair an effort to develop guidelines for fertility preservation from a large cancer organization. She explains that  colleagues in reproductive science are doing amazing research to extend options for reproductive care before and after cancer treatment, which is exciting to inform oncology clinicians and advocate for insurance coverage for these treatments.

Family Life, Running, and Circadian Rhythms

Alison shares her experiences with her children, including a daughter who works at the Amherst College Library, an older son considering medical school, and a younger son at Bates College in Maine. Her daughter has inspired her to think about women in the workplace, as she was criticized for not valuing women in her division and for hiring women because they are cheaper. Alison also shares her experience with running, which she enjoys but has to get up early to get in before work. She talks about the concept of morning and night people, stating that people have their own internal clocks. She also mentions that research into the biology of the circadian clock is still in its early stages. 

Influential Harvard Courses and Professors

Alison shares her experiences at Harvard, including taking courses with Stephen Jay Gould and Dick Lewontin, who were incredibly intelligent and insightful. She also took Act 10 as a senior, which was an unexpected experience that helped her learn different ways of thinking about the subject. Alison  volunteered at the Mission Hill after-school program, which allowed her to get to know the kids and families there. She tried out for various extracurriculars, such as singing and photography, but found it intimidating. She also mentions the training program for photographers.

Timestamps:

01:51: Alison Wakoff Loren's Medical Journey 

04:12: Motivations and Rewards in Patient Care 

22:20: Mentoring Success Stories 

22:36: Challenges and Insights in Patient Care 

24:17: Balancing Professional and Personal Life 

24:32: Research and Advocacy in Fertility Preservation 

28:54: Influences and Reflections on Harvard Education 

37:25: Extracurricular Activities and Personal Growth 

Links:

Penn Medicine Website: https://www.pennmedicine.org/providers/profile/alison-loren

American Society of Clinical Oncology: https://www.asco.org/

Leukemia and Lymphoma Society: https://www.lls.org/

Featured Non-profit:

The featured non-profit of this episode of The 92 Report is recommended by Ming Chen who reports:

“ One nonprofit that I've been involved in is the Keswick Foundation, which funds pilot programs in Hong Kong and mainland China to help the community serve needs that are not being met by the government. So we work with family and vulnerable populations. We work with the elderly, and we work with things like helping promote social work in China, as well as clinical psychologists in different NGOs around the region. The other nonprofit that I am on the Advisory Council of is the Asian American foundation, TAF for short, T, A, A, F, F. The Asian American foundation, basically, is a platform that gets together different organizations around anti hate, changing the narrative education, helping to advocate for Asian American history taught in public schools, as well as narrative change representation in Hollywood and beyond. And again, it was founded around the 2020, around the growing disturbing rhetoric against Asians with the rise of COVID So yeah, those are two nonprofit organizations that I'm involved with. So again, one nonprofit that's been on the board for for many, many years is called the Keswick Foundation, and it funds pilot programs in Hong Kong as well as Mainland China. And then the Asian American foundation. If you want to learn more about the Asian American foundation, it's www dot T, A, A, f.org, check it out.”

To learn more about their work, visit: 

The Asian American Foundation: https://www.taaf.org/

The Keswick Foundation: https://www.keswickfoundation.org.hk/