An Institute Original: Dr. Leland J. Foshag’s career is aimed at overcoming the stigma of cancer

December 21, 2015

Besides being a widely admired surgical oncologist, Leland J. Foshag, MD, plays another important role as a professor at the John Wayne Cancer Institute. He provides the institutional memory. Dr. Foshag was one of four physicians who moved the Institute from its origins at the University of California, Los Angeles, to Saint John’s Health Center in 1991.

Dr. Foshag is the only one of the four still working at the Institute. The other three are the late Donald L. Morton, MD, the late Kenneth P. Ramming, MD, and Armando Giuliano, MD. In the 25 years since that move, Dr. Foshag has seen tremendous progress in oncology, but some of the key elements that make the Institute successful have not changed, he says.

“The Institute is not just about clinical practice; it’s about the integration of research and translational medicine.” – Dr. Leland J. Foshag

“The fact that the Institute has been a cohesive unit is clearly a credit to Dr. Morton and all of the other researchers and clinicians,” he says. “I think the most important thing about the Institute has been the commitment to the ongoing fellowship training—looking at the next generation and being able to attract young clinicians.” Dr. Foshag was born in Van Nuys, California, but moved many times as a child due to his father’s work as an aerospace engineer. He considered following in his father’s footsteps by studying engineering in college, but soon found he enjoyed biology and chemistry more than math and physics. He considered being a family practitioner but discovered during his training that surgery “was more exciting and more akin to my personality of solving problems.”

He graduated from the Ohio State University School of Medicine and received his surgical training at Vanderbilt University and West Virginia University. It was serendipity that led him to the Institute. While head of the surgical oncology section at West Virginia University, he attended a lecture given by a guest speaker. The speaker was Dr. Morton, who grew up in West Virginia and had been invited to speak at the school by a colleague.

Dr. Morton’s lecture convinced Dr. Foshag that he should have research experience. He joined Dr. Morton at UCLA to engage in such pioneering work as the sentinel node biopsy and the development of cancer vaccines.

“The Institute is not just about clinical practice; it’s about the integration of research and translational medicine,” he says. “It’s not just taking care of a problem in an immediate sense but looking for answers and improvements for the next patients.”

Today Dr. Foshag’s areas of interest include sarcomas, gastrointestinal cancer, breast cancer and gynecologic oncology. He is an expert in ablative surgery, laparoscopic surgery and endoscopy.

Cancer treatment continues to evolve rapidly, and seeing the success of some of the newer therapies is fulfilling, Dr. Foshag says. But like all good doctors, he isn’t satisfied.

“Oncology has come a long way,” he says. “It’s wonderful to see the level of success and to be able to look forward to what’s coming along. But the sad part is that we know we can be successful in certain situations, but in other situations we are throwing up our hands saying, ‘Why is this different? How is this different?’”

Every day, however, Dr. Foshag tries to reassure patients that cancer is beatable. And greeting longtime patients who come in for checkups is one of the best parts of his job, he says.

“People think cancer is a death sentence,” he says. “It’s nice to have patients who I’ve seen for decades. It overcomes that whole stigma of cancer. We’ve had many patients who have been with us since the beginning of the Institute.”

Between his demanding career and six children, Dr. Foshag is one busy man. His youngest child just left for college, and his first grandchild is due in November. His children are scattered from Boston to Seattle to San Diego to the Midwest.

“My time outside of work is predominantly focused on family,” he says. “If I’m not working, I’m taking someone to college, picking up someone from college or going to graduations.”

His wife, Holly, is adamant about staying in California, he says. “When we moved here we had one child,” he says, with a laugh. “We didn’t necessarily expect to have this many children or stay this long. But it just sort of happened.”