There are lots of unknowns in the field of medicine—unresolved pains, unexplained symptoms, sometimes even miraculous cures. Carolyn Presley, MD, assistant professor in the Division of Medical Oncology in the College of Medicine, knows one thing to be true of the patients with lung cancer she treats.
“A lung cancer diagnosis will be one of the hardest life events my patients face,” she says. “Lung cancer is a tough disease to treat and cure, but our dedicated team is there for them regardless of the outcome.” That dose of reality doesn’t deter Dr. Presley from her important work as a physician-scientist. She performs clinical and outcomes research on patients with thoracic cancers, such as lung cancer, who are older in age, working to help them retain their functional status and do the everyday things they’ve done all their lives.
Maximizing the functional status of older adults who are going through lung cancer can mean many things. It could be helping them remain independent by continuing to work, managing their finances or medications, or even just getting dressed. “Older adults are considered a cancer disparities group because they’re older and understudied,” Dr. Presley says. “I’m passionate about it because I want older adults to live well even though they have a cancer diagnosis.”
An ambitious researcher
Dr. Presley is one of the up-and-coming junior faculty members making a difference at Ohio State's Comprehensive Cancer Center. She completed her residency in internal medicine through the primary care program at Yale University before discovering she loved working with older patients, prompting her to create her own fellowship in geriatric oncology. She was recruited to Ohio State by Ashley Rosko, MD, a geriatric oncology researcher at the Ohio State Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute.
Presley is a health services outcomes researcher. She is also incorporating behavioral research and behavioral interventions to improve function and resiliency in older adults. What she has found through her research is that a lot of her patients suffer from comorbid mental health issues such as anxiety and depression, but also there’s a lot of physical deconditioning that happens as well that affects their mobility that’s really important for maintaining function.
Seventy-five percent of Dr. Presley’s time is dedicated to protected research. She sees patients with lung cancer one day a week. The Cancer and Aging Resiliency Clinic that she started meets one Friday a month at The James.
She has also collaborated with her palliative care colleagues to start the Onco-Pall Clinic in Thoracic Oncology. The clinic has received 85 referrals in the first six months, up from fewer than 40 the year prior to the clinic opening.
With immunotherapy and targeted treatments, people with advanced lung cancer are living longer than ever, but still the majority don’t make it past five years. Dr. Presley’s research is focused on treating the patients while maximizing quality of life. That begs the question, how can you improve that quality of life? Dr. Presley says that a lot of it is aggressive symptom management. She is starting a new study using relaxation techniques and physical therapy intervention. She is also removing burdens on patients who have to travel to various locations for different treatments by arranging to have providers located in one place.
A dedicated physician
Three months after starting at Ohio State in 2017, Dr. Presley had a baby. She had not yet accrued paid maternity leave under university policy, which required an employee to work at Ohio State for 12 months before being eligible. Seeing that as a flaw in the system, Dr. Presley worked to change it. She considers her efforts as a big accomplishment that required getting a lot of people to talk to one another. Like most physicians, she has an active plan to not get burned out. She sees a psychologist monthly and invests in academic coaching, as burnout is common among physicians. Dr. Presley believes you need someone who isn’t your spouse, friend or boss to check in with, and a burnout prevention plan in your toolbox for success. Along with academic coaching, Dr. Presley seeks coaching through the Ohio State’s Center for Faculty Advancement, Mentoring and Engagement, and she participates in Women in Medicine and Science to network with other women.
Dr. Presley encourages people to celebrate the wins in their life, and to keep a happy file. For every bad thing, many people don’t remember the five good things they did that day as well. One needs to remind themselves of the good things they did so that they can go home and be present with their family, friends and whatever they do to relax. One can’t simply focus on the mistakes or what they did not accomplish that day.
Married for 10 years now to Dan Spakowicz, they have two daughters: 5 years and 15 months. Dan is a microbiome researcher in medical oncology at Ohio State.