Andrea Miyahira: So tell us about your current roles and what path you took to get there.
Neha Vapiwala: So I do wear several hats, I think as many of us do these days. And it's part of the fun for me is having the variety in my career. So as professor of GU radiation oncology, I certainly get to focus on the care of prostate cancer patients first and foremost, really spending time in the clinic and trying to understand what are the needs of our patients today and working with a multidisciplinary team to help them get the best possible outcome for their goals of care. And then along with that, of course, comes the opportunity to teach and mentor the trainees that are there at the University of Pennsylvania, but also that travel from other locations to come visit with us and spend time with us. So having them there, both in the clinic and outside of clinic to try and help them with their careers is an important part of my role. And that is part and parcel of my title as Vice Chair of Education, overseeing multiple different residency and fellowship programs within our department and helping to shape the curriculum and the direction of that education. I also have a role in the medical school as the Dean of Admissions, overseeing undergraduate medical education and selecting the incoming class at the Perelman School of Medicine at University of Pennsylvania. So I have my staff and my team that I get to work with there. And it's switching gears. It's a different mindset of thinking about who is our future workforce and how do we build one that is resilient and that comes to us with various different backgrounds and experiences that will make for a richer learning environment. So those are some of my institutional roles. I was given the honor of serving or being elected as the president of our National Society, the American Society for Radiation Oncology or ASTRO.
And so that's a role that I'm currently in the presidential year, but it's a four-year track and just really an incredible privilege to be able to represent my specialty the best I can, but more importantly, to interface with all of the individuals involved in care of cancer patients across disease sites, across disciplines. And so really it's been perhaps one of my most exciting hats of late, but those are some of the titles that I'm currently managing and enjoying.
Andrea Miyahira: That's wonderful. And what inspired you to come along this path? You could talk about the journey that you took to get here.
Neha Vapiwala: Yeah. So I'd love for the listeners to know that everything in life is not actually planned and strategic and orchestrated. So there are absolutely things that drive you, right? What we refer to colloquially as passion and that passion is important and that will kind of determine what you prioritize and what you don't, and hopefully inform your mentors and your sponsors, "Hey, Neha's really interested in this. Let me think about her for this opportunity." But then there's all the serendipity. There's all the sort of, "I don't really know if I'm eligible for this or if I would even be considered for this, but you know what? Let me explore. Let me just throw my name in the ring and see maybe this will work out." And I have to tell you, the role as a dean in the medical school really came out of me just sort of inquiring and to some degree pushing and applying before I was even technically eligible in terms of professorship. So I was an assistant professor and kind of put my foot in the door and said, "You know what? I'm committed to this. If I do the work, if I demonstrate that I'm going to do the work and care about the larger cause, maybe this will work out." So I wanted folks to know that was not all sort of planned from the get-go. And as far as the ASTRO role, I never in a million years thought that I would be in that role. I believe I am the first female of Asian descent to lead ASTRO in this role. I could be wrong, but I'm pretty sure that's the case. And so even just that, again, not to make it about that alone, but it's a small part of what makes me feel like there aren't barriers except the ones you put on yourself. And so when you ask me about how did I plan for this, it was commitment, the work ethic, the persistence, and then sometimes just going for it.
Andrea Miyahira: Thank you. And so you hold a lot of incredible leadership positions. Congratulations.
Neha Vapiwala: Thank you.
Andrea Miyahira: I guess among those positions, what do you think makes a good leader and how have you used those positions to sort of empower you to make the changes that you have visions for improving?
Neha Vapiwala: That is such an important question. And I think one of the biggest aspects of leadership or my philosophy in leadership is adaptability. And just as you wear many hats and you have different roles and at different times in your career, there's different things that are being asked of you. Adapting to different leadership styles while still staying true to yourself and your personality and your preferences, but knowing, okay, this is a time where I have to be a role model, where I have to guide my team and say to them, "This is why we're doing this. This is our mission. We are mission-driven and this is why your work matters." And whether you are the most junior person on the team or a more senior person with experience, you all play a role and here's why we're here and periodically reminding folks why we are there and what our goals are, and then letting them run with it, delegating. So sometimes that's appropriate. There's other times where you have to be a little more hands-on, not micromanaging, but a little bit more, okay, directive, these are our deliverables, these are our timelines. And that might be a style that you have to adopt either temporarily or for a particular team. Yet other times there might be sort of a servant leadership approach that you take where you sort of say, "I'm here to help my team members shine." My job as a leader is to be behind the scenes, promote them, and all boats will rise, or whatever the expression is, the rising tide will lift us all. And so I think that the key for my leadership has been my willingness to not, I like to think, be rigid with just one approach, and to also let my team know, "Hey, I'm taking this approach and here's why." So they're not confused, how come we're doing this as opposed to that? So communication as a leader and communication that is enough, but not too often and not too prescriptive has been, I think, a part of my approach that's worked.
Andrea Miyahira: That's wonderful and such great advice.
Neha Vapiwala: Thank you.
Andrea Miyahira: And it's also incredible to see you as being the first Asian woman in leadership at ASTRO. So talk about opening doors and how can we continue opening those doors for the next generation?
Neha Vapiwala: Yeah. So there's doors and there's ceilings, right? It's sort of like a house structure. So on the one hand, you can open doors and maybe it's what that individual wants, that person that's been perhaps not provided this opportunity historically and maybe you're taking a chance on them and you're saying, "You know what? I'm going to offer or suggest this opportunity, sponsor you for this role." But I think it is important as leaders to sometimes check in with that person or those people, make sure that's actually in line with what they're seeking and not just assume. For example, people have long assumed that my aspiration is departmental chair, so an academic departmental chair. Wonderful role for those that want it. I've never espoused that aspiration, and yet many well-meaning and well-intentioned folks have thought, "Oh, you'd be great for this."
Maybe someday, but to date, it has not been a passion of mine or a pursuit. So I think I in turn, when I have my mentees and people I sponsor, I think, "Let me make sure this is in fact something they're seeking, and then I'll help open that door." And similarly, with the ceiling concept, I think that, and unfortunately, stereotypically speaking, I do think there are a lot of women, particularly in specialties like perhaps GU oncology, where there can be underrepresentation in some areas, relatively speaking, prostate cancer, for example, or radiation oncology specifically, growing number, absolutely improving, powerhouse women out there, but historically not always the majority or equal representation in the room. And I say to myself, "Who's putting that ceiling on you in terms of, oh, I couldn't apply for that, or I couldn't be considered for that." Because if it's you putting that ceiling on you, get some advice, create what I call your kitchen cabinet. This is your group of advisors, preferably not your mom or someone who thinks you're amazing and no matter what, but someone who will give you genuine advice, but is also your cheerleader, but is also realistic. Get their counsel and ask them, "Should I put myself out there for this?"
And nine times out of 10, they will probably say yes, even though you might have doubt. And I think that that is an important part of going through that door is sort of not limiting yourself in which doors you're going to pursue. So it's a complex thing, but I think through counseling, through building that kitchen cabinet that helps you through running your ideas and your questions through multiple different lenses and different trusted individuals, I think that really can help a lot of people who want to follow in these footsteps.
Andrea Miyahira: Thank you. And then do you have any initiatives or research projects that you're especially excited about and want to share?
Neha Vapiwala: Yeah. So I think right now there is a lot of excitement. I mean, it's not new, but a lot of excitement in terms of both combination treatments with radiotherapy and new drug agents of all types, whether you're talking about targeted molecular agents, immune therapies, bispecifics, you name it. And there's just so much that's out there that's exciting. And I think the sequencing of local control and the role of focal ablation, for example, of metastatic deposits and how that does or doesn't prime the body for potentially doing better with systemic therapy. There's so much unanswered there. So there's a couple of projects I'm pursuing there, both in the radiopharmaceutical therapy space, which is certainly very hot right now, but also just thinking about external beam and drug therapy in different populations. There's a couple of projects that are in the pipeline that I can't necessarily get into the details of, but I'm hoping to really have those conversations with our industry partners and with our academic partners to say, "How do we push this forward?" And I do believe strongly that the research we do, it can't just be iterative with small little baby steps. We have, as I mentioned yesterday at the Feng Symposium, which was a wonderful event, we can't take advantage of our patient resources and just keep asking the same questions with just very small gains. We need to think a little bigger every time.
And I know that's what my colleagues are doing, so this is not novel advice, but more of that so that every time a patient enrolls, whatever they're contributing, they're contributing their tissue, their time, their effort and their heart into the science. We need to be good stewards of that and we need to be responsible for what they've given us and not just spend it on drug X versus drug Y versus drug Z. If we think at the end of the day, that's not really the key question. So a lot of my research is trying to move towards that. And then also I do have some projects that really are focusing on technological improvements, continued benefits that we can have to improve the therapeutic index of radiotherapy, of radiation oncology in general. So how do we maximize and deliver the dose where we want it? How do we minimize the dose where we don't, continue to reduce our complication rate and use biomarkers to be smart about it, right? Those are like sort of smart tools and the biomarkers are coming at us fast and furious. So which ones make sense, which ones do we need, which ones are affordable and actually likely to be adopted in clinic? So thinking at a high level with that. And so a lot of our work at ASTRO is really also thinking about resource allocation and supporting young researchers in these efforts in addition to my own research.
Andrea Miyahira: Well, that's all exciting and I'm excited for the future for patients and also thank you so much for sharing all of your leadership and career tips with us.
Neha Vapiwala: Yeah. Well, I was so grateful to be asked. And again, many people out there that can give great advice, this is just one perspective. And I would say to folks listening who want to connect and who want to learn more about how do I go down a path of medical school leadership or how do I advance myself within my department? What roles could I be playing at the cancer center, for example? There's a lot of opportunities out there that sometimes go unfilled or unanswered. And sometimes it's unpaid and it's a sacrifice and it's a grind, but I do think in the end, the return on investment can be incredible if you're passionate about it and if you find it fun, as Chuck Ryan said yesterday, having a fun time and loving the people you work with is a key part.