Dr. Horning is internationally acknowledged as one of the most distinguished clinical investigators working in the field of oncology today. A constant advocate for evidence-based oncologic care, Dr. Horning has been the lead investigator for several of the pivotal clinical trials that validated current lymphoma treatment. Sandra has helped establish the standards of care for patients with virtually all classifications of non-Hodgkin’s lymphoma and is the past president of the American Society of Clinical Oncology. She is currently Professor of Medicine at Stanford University and resides in Portola Valley, CA. She is the recipient of the University of Iowa Carver College of Medicine’s Distinguished Alumni Award for Service.
What is your hometown?
How/when did you become interested in science and medicine?
I became interested in science and medicine as a teenager. I was enthralled with the possibility of blending life-long learning and scholarship that would have a direct impact in benefiting people. In my small hometown, physicians were among the most respected individuals. There was just one problem – none were women! An early feminist, I wanted to be in the vanguard of women physicians.
What interested you to pursue a career in medicine and clinical research?
I loved every minute of medical school at the University of Iowa – the biochemistry, pathology, clinical rotations, etc. Internal medicine intrigued me because it was cognitive and seemed endlessly challenging. My interest in clinical research resulted from outstanding role models and mentors throughout my training, and my desire to have a potential impact that was greater than individual patient care.
Please highlight your major career achievements, awards, discoveries, etc.
My major achievements have been in two areas. First, in the clinical investigations of Hodgkin’s and non-Hodgkin’s lymphomas – where I have made seminal observations, developed new treatment regimens that were either more effective or less toxic, and integrated new therapies. Two of my trials led to FDA-approved license expansions. The second area has been in service of international collaborations related to lymphoma and the promotion of oncology and clinical cancer research, where I have served as President of American Society of Clinical Oncology and in a leadership and advisory capacity for academic, government and industry groups.
Is there a teacher, mentor or UI Carver College of Medicine faculty member who has helped shape your education?
There were many individuals at the University of Iowa who encouraged and motivated me to achieve. I am particularly indebted to Drs. Patrick Burns and John Hoag, hematologists who gave me an opportunity to take on an intern’s responsibility on the Hematology Service when I was a fourth year medical student.
How or why did you choose the University of Iowa for your medical education?
I chose the University of Iowa because I had the good fortune to have the opportunity to attend a world class medical school as a state resident. With my father both dying from cancer and being a strong proponent of the University of Iowa it was the right place, the only place, for me at the time.
What kind of professional opportunities or advantages has your University of Iowa medical training provided?
Distinguishing myself as a University of Iowa medical student and with the support of my teachers, I had the opportunity to gain an internal medicine residency at a top institution. More than that, the combination of a rock solid foundation in medical knowledge and the confidence I acquired, allowed me to strive and achieve beyond my dreams.
As a graduate of the UI Carver College of Medicine, what does being the recipient of the Distinguished Alumni Award mean to you?
It is very special to receive the Distinguished Alumni Award because it is a validation of my passion and hard work over nearly four decades and also because it is coming from the institution that I revere and am indebted to.
Please describe your professional interests.
I am interested in applying the most current knowledge about the biology of tumors and their hosts to the optimal management of malignant disease. This requires an understanding of the basic and translational science, careful observations from the bedside back to the bench, innovative clinical investigations including the development and application of biomarkers, and the education and policies necessary to get the clinical science to patients.
How did you become interested in Oncology, and what led you to study Non-Hodgkin’s Lymphomas?
My interest in Oncology is personal. It began before medical school when my father was diagnosed with cancer. His untimely death, and my grandfather before him, gave me a clear understanding of the human burden of cancer and I committed to the challenge of lessening that burden. My interest in Non-Hodgkin’s Lymphomas was opportune as I trained at Stanford University with Henry Kaplan and Saul Rosenberg, international leaders in the study of lymphoma. These disorders were intellectually fascinating and inroads were being made in their successful treatment. I wanted to continue down that path to better understand and treat them.
As one of the most distinguished clinical investigators working in the field of oncology, you’ve helped establish standards of care for patients with lymphoma. What would you say has been your greatest success?
I prefer to look at my accomplishments as a body of work rather than a single greatest success. Further, many of my accomplishments were collaborative in nature, the results of a team working toward a common goal. However, I would like to be remembered as an oncologist who emphasized quality of life issues in the quest for better treatments. My work in follicular lymphoma and Hodgkin’s lymphoma, in particular, has emphasized reduction in toxicity and survivorship issues, while continually striving for improved survivals.
What are some of your outside interests?
The combination of my work and my family has left little time for outside interests! I enjoy reading beyond medicine and my interests are broad. I particularly enjoy U.S. history and classic literature.
Do you have an insight or philosophy that guides you in your professional work?
My philosophy is that the patients and their families are your guides. It can be a major challenge to balance one’s efforts and time in academic medicine. In the end, the new knowledge and the new advances must somehow get to the patients. That is why you give the lecture, present your work, write that paper, and work hard for the necessary policy change.
If you could change one thing about the practice or business of medicine, what would it be?
I would like to see a reduction in the expense and effort devoted to bureaucracy and litigation avoidance.
What is the biggest change you've experienced in medicine since you were a student?
Medicine is far more specialized and there has been a knowledge explosion with regards to understanding the basis of disease and the range and number of interventions. With the technology, there is less reliance on bedside skills and the ability to develop differential diagnoses.
What one piece of advice would you give to today's medical students?
I encourage medical students to retain their humanism and the reason they pursued the medical field, no matter what their career. And, they should do what they are passionate about. If they interact with patients, they must communicate empathy and warmth as well as medical information.
What do you see as "the future" of oncology?
I see interventions that are scientifically directed by a more complete understanding of the tumors and their hosts, “the right treatments for the right patients”. Oncology will become more personalized and increasingly based on understanding the efficacy and toxicity of drugs and other treatments.
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