It’s really no surprise that Dr. Nancy Nixon pursued medicine. She’s always loved the sciences (her undergrad was in biochemistry) and she grew up with two dedicated and passionate physicians as parents. Today, at just 31 years old, she has realized her goal of becoming a medical oncologist and researcher at the Tom Baker Cancer Centre (TBCC) in Calgary. Her practice focuses on breast cancer, a choice she made based on both a rewarding fellowship experience at the TBCC and a tragic, personal loss — Nixon’s mother died of breast cancer 23 years ago.
“[Losing my mom to breast cancer] is one of the reasons I connect so well with my patients,” Nixon says. “I can empathize. I’m sensitive.”
Nixon’s work takes place mostly in clinic settings, where she meets with new patients (four per week) and existing ones, all of whom are dealing with various stages of breast cancer and undergoing systemic therapies like chemotherapy, endocrine therapy, targeted therapy or immune therapy. She and nurse practitioner Camelia Lee spend almost an hour with each new patient they see, discussing the characteristics of the diagnosis, the rationale for the selected treatment, and the treatment and recovery process. They also talk about things like anticipated side effects and the jarring influence the disease may have on a patient’s lifestyle, well-being, employment and plans for the future.
“It is both a privilege and a gift to walk with people during this time,” Nixon says, acknowledging that, in her clinic work, she sees patients who are dealing with some of the scariest and most vulnerable situations of their lives.
In addition to her clinic responsibilities, Nixon consults with other members of her multidisciplinary team (such as surgeons, radiation oncologists, nurses and psychologists) at weekly patient review meetings, teaches second-year medical students about breast cancer and, perhaps most significantly, pursues another area of her practice that is critical to the future of cancer care — research.
A mentor of Nixon’s once highlighted the importance of conducting research (in addition to clinical work) by pointing out that, in a medical practice, a doctor may see thousands of patients over a lifetime, but, with successful research, that same doctor has the potential to reach a wider audience and help hundreds of thousands of patients.
“Research extends beyond the clinic,” Nixon says. “You can have an even more meaningful impact.”
Among Nixon’s many research-related pursuits is the Canadian Metastatic Breast Cancer Priority Setting, a project she spearheaded during her fellowship year in 2016 to solicit feedback from patients and patient representatives about priorities in breast cancer research. “The goal is to give patients and their family members a voice in research,” says Nixon. “I hope this study will address common concerns for the people most affected by the disease.”
As part of the project, Nixon — along with a steering committee composed of patients, physicians, patient advocates and allied health care professionals — constructed a survey and sent it out across the country to French- and English-speaking individuals. Hoping for 500 responses, she received 650 and is in the process of measuring and interpreting the results. Early recommendations by participants include more research into alternative therapies, interest in immune therapy, and best practices associated with early detection of relapses, including re-examining current protocols.
According to Nixon, it’s typical for big pharma, funders and researchers to dictate priorities, but it’s critical that patients also contribute to the discussion. And the global community agrees: she has already had positive feedback from a report she presented on her preliminary findings at a European Society of Medical Oncology meeting last fall in Madrid.
In addition to her work on the Canadian Metastatic Breast Cancer Priority Setting, Nixon has also been a key member of some Alberta investigative studies, including one relating to transitioning breast cancer survivors back to primary care physicians after active treatment and another analyzing “development pathways” of drugs commonly used for breast, colorectal and non-small cell lung cancers.
Both studies highlight the importance of resource utilization, says Nixon. “The first one recognizes the important role of family physicians as part of the cancer management team, and the second one identifies inefficiencies (in drug development) in order to improve the time and cost of getting new, effective therapies to market and to cancer patients.”
Finally, Nixon contributes to work in the Translational Labs at the TBCC. This group examines the roles of biomarkers — such as proteins, nucleic acids and metabolites — in identifying and tracking the spread of cancer. Her current research here looks at bone turnover markers associated with a group of women with metastatic breast cancer who are taking the drug palbociclib. The hypothesis is that the drug will re-introduce healthy bone development and decrease the likelihood of cancer absorption in the bones.
Despite loving both the clinical work and the research, Nixon acknowledges there are difficulties working in the field of cancer. “I wish I had more time for each patient,” she says. “Sometimes I feel like I am being pulled in lots of different directions.”
Nixon handles the stress by talking to colleagues who are dealing with similar issues and can relate to her challenges. She is also buoyed by the unflagging passion and commitment of her team members — such as Dr. Jan-Willem Henning, Dr. Alexander Paterson and Dr. Sunil Verma — to patient care and research. And they, in turn, are honoured to have her as part of the team.
“Dr. Nixon is an amazing and dedicated professional,” says Dr. Henning. “She makes the most of every opportunity to advance as a clinician-researcher, ultimately benefitting her patients.”
Having a diverse, out-of-work life is also critical to tempering job demands. Nixon is married to a software sales director and enjoys running, biking, spin and barre classes, and spending time with family and friends. She also admits to enjoying a bit of television. “If I said I never watched TV, my husband would call me out,” she says with a laugh.
What is on the horizon for Nixon? She’s excited about possibilities for immune therapy in treating breast cancer — “It hasn’t reached prime time in breast cancer yet, but has the potential to” — and will also explore professional options relating to lung cancer.
“It’s an exciting time to be an oncologist,” she says. “We are getting smarter and seeing such impressive changes. I am lucky to be in this field.”
FACT: Dr. Nancy Nixon recognizes the importance of philanthropic support to continue to fund research. She is co-captain of the Tom Baker Cancer Conquerors – a cycling team of more than 200 riders raising funds for the Enbridge Ride to Conquer Cancer, benefiting the Alberta Cancer Foundation. To date, The Tom Baker Cancer Conquerors have raised more than $2 million for clinical trials research at the TBCC.
7 Questions with Dr. Nixon
1. Describe what you do in 10 words or less.
Provide systemic therapies for cancer patients. Participate in cancer research.
2. What’s the biggest misperception about what you do?
The biggest misperception about a career in oncology is that it’s depressing. There are certainly challenging moments, but being able to walk through the cancer journey with patients and their families is a powerful experience with lots of happy moments.
3. Where do you get your best ideas?
Collaborating with colleagues, and listening to patients.
4. If you weren’t a medical oncologist and researcher, what would you be?
Tough one! I recently had a conversation with my husband, who works in the technology field, and even though our jobs are very different, we’re both passionate about what we do because we get to solve problems and help people. Any job where I could do those two things, I think I’d be happy.
5. What is the hardest lesson you’ve learned?
One of the toughest lessons in research is that for every success, there are a dozen roadblocks or failures. I think anyone involved in research knows that persistence pays off.
6. What motivates you?
Having patients put their trust in me during one of the biggest challenges they will face in their lives motivates me to try to know everything, and to do anything I can to earn that trust.
7. Why does your research matter?
I think it’s important to listen to our patients, and my research focuses on that.
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