Q and A with breast cancer expert Carmen Calfa

As a breast oncologist and researcher, Carmen Calfa, M.D., is driven not only to solve clinical problems and improve treatments, but also to advocate for the emotional needs of her patients and their families.

In her interrelated roles at Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, Dr. Calfa, an associate professor in the Miller School’s Division of Medical Oncology, supports everyone from “previvors” — people with a high risk of developing cancer because of genetic mutations — to people who are decades into survivorship.

She discussed her work in the following interview, which has been edited for length and clarity.

What are your roles at Sylvester?

I’m the Breast Cancer program’s associate director for community outreach. We spread education and we hear the community’s interests and needs. It’s also an opportunity to meet with philanthropic partners, who love to be part of the solution and support our efforts.

Being the medical co-director for Cancer Survivorship and Supportive Care is dear to me. It incorporates everything that an individual needs to achieve, either a potential cure or long remission, or to live with cancer while making life as long and as good as it possibly can be. 

I lead the Genetic Predisposition Syndrome (GPS) Initiative, which is a comprehensive, multidisciplinary “one-stop shop” for patients who have a genetic mutation that puts them at high risk for developing multiple cancers.

As the clinical research lead for the breast program, I work with the clinical and translational leaders to ensure the best portfolio of clinical trials and that every patient has an opportunity to participate in a clinical trial, if they choose to.

I also direct the Biennial Miami Precision Medicine Conference, which is open not only to providers but to patients and advocates, to empower them by providing them a seat at the table.

What led you to become an oncologist?

I’ve always wanted to be a doctor. When I was 3, the only toys I had were stethoscopes and syringes. I was always drawn by connecting with people and trying to make them feel better.

In school, I was good at math and science. I love solving math problems — the hardest ones. As an oncologist, you have to create treatment plans, and I like to find the best answer for the situation.

How does the GPS help people with increased cancer risk?

The GPS allows previvors to take a proactive approach and hopefully prevent the cancer from ever happening or catch it as early as possible. It also helps survivors. You could be a survivor of breast cancer, but now have an increased risk of pancreatic and other cancers because you have a BRCA2 mutation.

The GPS initiative creates a home for these patients and we work collaboratively with other experts at Sylvester.

Understanding the risk factors and the genetics of the cancer as well as of the individual is essential to conquering cancer. I’m a strong advocate for offering germline genetic testing to potentially every person diagnosed with a solid cancer. One in eight will be found to carry a pathogenic mutation that will impact the care of not only that individual, but her/his close relatives. I also strongly encourage people who were diagnosed in the past to inquire about testing or retesting, if only a few genes were initially tested for.

What are your goals for your survivorship work?

Survivorship starts on the day of diagnosis, continues throughout the person’s life and includes the family, caregivers and community. I work with Dr. Frank Penedo and others to develop the best programs for survivors that take into account their physical, emotional and spiritual needs. My dream is that every survivor receives all supportive care services they need to not only survive, but thrive.

Our goal is to allow survivors to reach a cancer-free state or live the longest with the best quality of life, if they have incurable cancer at this time. We want them to have opportunities to join clinical trials looking at new, precision medicine approaches, as well as non-pharmaceutical interventions like exercise, diet or behavioral interventions. We know that, through research, we are going to be able to cure patients that today we think are incurable.

We recognize several unmet needs. For example, there aren’t enough oncologists to take care of all the survivors, and the number of survivors is growing. We need education that will allow care team members to perform these tasks with a level of confidence, experience and expertise. We’ve secured grants to develop training models for primary care physicians. For the new generation of physicians and nurse practitioners, we want to get this training in their educational curriculum as well.

Read more about Sylvester’s research on the InventUM blog and follow us on X at @SylvesterCancer.