Stories of Impact

Dr. Amy Comander was born into the world of medicine.  Her father was an internist whose dinner table conversations often involved regaling his family with stories from the hospital floor. He would muse on medicine, science and health and enchant his children with the mysteries and magic of how the body works. Looking back, it is clear that Dr. Comander recalls those thoughtful dialogues fondly. “It makes sense,” she says, “that caring for and healing people has always felt like a second nature.”

Dr. Comander pursued her scientific curiosity and was initially drawn to the field of neuroscience. What she learned about neurobiology and psychology informed her decision to become a breast oncologist. She wanted to work directly with patients—to cure them of disease, yes, but more than that: she wanted to help people to improve their lives, health and well-being.

Today Dr. Comander is known for her passionate approach to care. She is always searching for better ways to help her patients as they learn to handle their cancer diagnosis and live a full life. Improved therapies and an increasing interest in overall well-being give her hope for even longer survivorship—now more than ever before.

Q: What led you to specialize in cancer treatment?

A: As an undergraduate at Harvard, I was drawn to the field of neuroscience, and studied under the Mind Brain Behavior Interfaculty Initiative. I now realize that these courses have great relevance to my practice as a breast oncologist. I am passionate about helping breast cancer survivors adopt healthy lifestyle behaviors that will improve their health, well-being and ultimately, the outcome from their cancer.

As a fourth-year medical student at the Yale School of Medicine, I did an elective on the inpatient oncology service at Yale New Haven Hospital. Most of the patients I cared for at that time had blood cancers. It was a great privilege to care for these patients and many of them were very sick. I recall the incredible strength, resilience and courage these patients demonstrated in the face of their challenging chemotherapy treatments and the uncertainty about their future since many of them had limited treatment options.

However, 2001 was a year of great excitement and HOPE in the oncology world! In 2001, a new targeted therapy, called imatinib, was FDA approved as first-line treatment for newly diagnosed chronic myelogenous leukemia. Simply put, imatinib blocks cancer growth, is much better tolerated than standard chemotherapy, and the clinical trials demonstrated amazing results. This breakthrough discovery, as well as the strong relationships I developed with the patients I cared for, inspired me to pursue a career in hematology and oncology.

Q: You mentioned studies at Harvard and Yale, what was your path to your current role?

A: I was among the first students to join the Mind Brain Behavior Interfaculty Initiative in Harvard’s neuroscience department. I knew I wanted to attend medical school, and given my interest in neuroscience, I thought I would pursue a career in psychiatry or neurology. My interest in hematology/oncology grew during my years at the Yale School of Medicine. I did my internship and residency in internal medicine, followed by a fellowship in hematology and oncology at Beth Israel Deaconess Medical Center, an affiliate of Harvard Medical School. During my fellowship, I worked with amazing mentors and I developed an interest in breast cancer. Since that time, I have chosen to focus my career on the care of individuals with a diagnosis of breast cancer. There have been many exciting advances in breast cancer treatment over the past few years.  However, there is an ongoing need to improve survivorship care.

I am currently Director of Breast Oncology and Survivorship at Mass General Cancer Center in Waltham and at Newton-Wellesley Hospital. I am also the Medical Director at Mass General Cancer Center in Waltham. In this role, I focus on program development, operations management, clinical trials implementation, patient access, and patient experience. An important goal of mine is to expand cancer survivorship services to our patients at our community sites.

In 2019, I co-developed the PAVING the Path to Wellness Program, a 12-week lifestyle medicine-based survivorship program for breast cancer survivors. The program was transitioned to a virtual format during the pandemic and has been very successful. I am thrilled to have recently published a PAVING the Path to Wellness workbook, which participants use during the program.

I should also note that I do my best to “practice what I preach” when it comes to lifestyle education for my patients. One of my favorite hobbies is running, and each year I run the Boston Marathon to support charitable causes. I am excited to run my ninth consecutive Boston Marathon in April 2022! This year I am running to support the Ellie Fund, a nonprofit organization based in Massachusetts, with the goal to provide essential support services for breast cancer patients to ease the stresses of everyday life.

Q: How does your work at Mass General Cancer Center serve the cancer community?

A: My clinics are located in Waltham and at Newton-Wellesley Hospital, two network sites closely affiliated with Mass General Cancer Center in Boston. Our patients are grateful to receive care in their community, while also receiving access to clinical trials and other innovative therapies that are available at Mass General Cancer Center. I am fortunate to work with a multidisciplinary team that is dedicated to providing quality survivorship care to patients with cancer. We offer numerous programs, including nutrition services; mind/body programs; an exercise program; and the Lifestyle Medicine Clinic. I look forward to expanding the reach of the PAVING the Path to Wellness Program and training others to run these groups so we can reach more cancer survivors. Finally, during the pandemic, my colleagues and I hosted many educational webinars focused on optimizing health and well-being for cancer survivors.

Q: How did you discover AICR and our resources and research?

A: In my breast oncology clinic visits, my patients often ask me, “How should I resume an exercise regimen?” “What type of diet should I follow?” “How can I get back to my healthy weight?” My patients are often highly motivated to take whatever steps are necessary to improve their recovery from treatment. I will acknowledge that, during my medical training, I did not receive training on how to counsel my patients on these important topics, namely nutrition, weight management and physical activity. A number of years ago I was introduced to the field of lifestyle medicine after attending a Harvard Medical School course. This course was a great introduction to the field of lifestyle medicine, which is defined as the use of evidence-based lifestyle interventions to prevent, treat and often reverse chronic disease. There is a growing body of evidence about the important role that nutrition, body weight and physical activity play for reducing risk for cancer and for optimizing health for cancer survivors. Once I began to explore these areas further, I came across the incredible work being done by AICR.

Q: How do you and your patients utilize AICR’s resources?

A: No one wants to hear the words, “You have cancer.”  This is some of the most difficult news anyone can receive. During and after treatment, many individuals are highly motivated to learn about lifestyle interventions that they can pursue in order to improve their outcome from cancer. Participants in the PAVING program are highly motivated to learn about lifestyle medicine, and I refer them to the AICR website because AICR compiles the latest scientific research from around the world on the role of lifestyle factors in cancer outcomes. My patients have benefited from AICR’s materials on a wide range of topics, including the role of exercise during treatment, and how to manage treatment-related side effects. AICR also provides information about the role of diet, weight management and physical activity for cancer survivors. This information helps individuals make informed lifestyle choices to reduce their risk of cancer recurrence.

Q: How do you know the value of AICR’s resources?

A: The AICR/WCRF Continuous Update Project provides a systematic review of research conducted on diet, weight, physical activity and survival in breast cancer, and this information is extremely relevant to my patients. General guidelines for survivorship care have also been established by other organizations, and they emphasize the role of health promotion and the importance of addressing the role of diet, exercise and weight management.

Q: Can you describe a success story involving a cancer patient or survivor utilizing AICR’s resources?

A: One of the participants in the PAVING program commented on her experience in the program, where I used resources from AICR each week to provide education about diet, weight management and physical activity:

“Learning I had cancer was the worst day of my life. The weeks to follow were bleak. Telling my family and friends, meeting with doctors, taking medical leave, figuring out schedules. I wondered if I’d be around to see my children grow. Thankfully I had an amazing medical team and support system. Over time as the treatment began to work and I met with my therapist, cancer felt less like a scary black hole I’d fallen into and more like a part of me I would learn to accept. During my treatment plan—chemo, surgery, more chemo and finally radiation—I had down times to “recover” before the next regimen. During these down times I began to think about how to live life after active cancer treatment. I spent hours googling. And there was A LOT to take in. What should I eat? How much should I exercise? What types of exercise? How do I reduce stress? It was overwhelming and often I threw my hands in the air feeling exhausted and paralyze

“Enter the Paving the Path to Wellness Program. 12 weeks of meeting once a week with amazing women affected by breast cancer. Some were still in active treatment, like me. Some had been out of treatment for months to years. All were there to learn and support each other. Each week we discussed the science and practical application of healthy lifestyle choices—nutrition, exercise, sleep, social connections, etc. Slowly I felt empowered. One day I was feeling down and decided to write out the daily changes I’ve made since starting the program, and there were 25. Twenty-five healthy changes! When I finished radiation recently and left the cancer center, I had a very different feeling than I’d had in the past. This time I felt ready to handle whatever is thrown at me. I felt empowered with information and support. I will always have a risk of recurrence but instead of focusing on that risk, I will focus on what I can do to live a healthy, happy life, whatever may come.”

Q: Can you comment on the impact of AICR’s resources and how is public awareness around nutrition/lifestyle and cancer risk evolving?

A: Excluding non-melanoma skin cancer, at least 42% of newly diagnosed cancers in the United States are potentially avoidable because they are attributable to lifestyle factors, including smoking, excessive alcohol consumption, excess body weight, poor nutrition and lack of physical activity. AICR data now shows that 12 cancers are linked to obesity. In fact, in the United States, obesity will soon surpass smoking as a leading cause of cancer. There is a need for an increased awareness about the role of obesity and other lifestyle factors and cancer risk, and several organizations are now tackling this mission.

Based largely on the WCRF/AICR systematic reviews and Continuous Update Project reports, organizations are providing guidelines on diet and physical activity for cancer prevention.  Others are developing strategies to address the causes of overweight and obesity as a cancer risk factor, and a key goal is to build awareness among the medical community, policymakers and the public about the connection between cancer and obesity. And resources from AICR are important for helping individuals take charge of their health to reduce rates of obesity and cancer risk.

Q: How does the staff at Mass General Cancer Center benefit from AICR’s resources?

A: To educate our patients, it is important to educate our colleagues first. We also need to “practice what we preach.” I have had the opportunity to give presentations focused on health promotion to my colleagues, and I have shared AICR’s 10 Cancer Prevention Recommendations that are useful and empowering.

Q: How do AICR’s resources help Mass General Cancer Center fulfill its mission?

A: I am fortunate to work at Mass General Cancer Center, one of the world’s leading cancer centers. An important goal of this cancer center’s survivorship program is to promote the health and well-being of patients with cancer following the completion of initial therapy. Use of the evidence-based resources from AICR helps us achieve this important goal of health promotion for our patients.