TOP DOCTORS 2024: Oncology Q&A

Dr. William J. Irvin Jr., oncology medical director, director of clinical research and medical director of outpatient infusion centers, Bon Secours Cancer Institute at St. Francis, Midlothian

Education: Bachelor’s degree, University of Virginia; medical degree, internship and residency in internal medicine, Virginia Commonwealth University; fellowship in hematology/oncology, University of North Carolina

Family: Wife, Suzanne; children, Liam, Nora Kate and Carter; two dogs, Pickles and Olive

Career mentor: Dr. Lisa Carey

Book you’d recommend: “Never Split the Difference: Negotiating as if Your Life Depended on It,” by Chris Voss and Tahl Raz

Hobbies: Spending time with family, playing golf, watching my favorite sports teams

Breast cancer has been the subject of high-profile public awareness campaigns for decades. What impact has that had? Over the past 30-plus years, breast cancer mortality rates have decreased by 43%. Half of that decrease is due to improved therapies, and half is due to improved screening, such as mammograms.

What therapies for breast cancer are you most enthused about? The continued development of antibody-drug conjugates — think of a Trojan horse (the antibody) delivering a drug payload (the Greek army) inside a cancer cell (the city of Troy) — is very exciting and is leading to many opportunities for new therapies with improved side-effect risks over standard chemotherapy. With improved systemic therapies, we now have opportunities to give less therapy to achieve a cure, thus avoiding additional toxicity. Overcoming resistance to endocrine or anti-estrogen therapy in estrogen receptor positive breast cancer continues to improve with two new FDA-approved medications in 2023. 

But we still have a long way to go, both in improving options for treatment and options for minimizing side effects and improving quality of life. 

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