No matter what is on her to-do list, patient care is consistently at the forefront of Dr. Borate’s mind. She works with different organizations to expand her understanding of patient care practices, and continuously nurtures inter-field relationships in order to further improve the care she can offer, all while continuing her clinical, research, and university work.
“I think that the focus of all of this work has to be on the patient and their caregivers,” she said. “A diagnosis like myelodysplastic syndrome (MDS) always comes as a shock to patients. There’s a lot of information they need to process so the patient can understand what their disease is, what treatments are available, and how each treatment might impact their quality of life.”
Dr. Borate also believes that leveraging cross-collaboration across numerous professional organizations is the best route to continuously improve patient care.
“We have a huge team at The James Cancer Hospital and Solove Research Institute, even just within our clinical group, and they all require time and training to make this work possible,” she said. “It’s amazing and impressive and even mind boggling to think about how much time, effort, coordination, and teamwork goes into bringing these treatments forward for MDS patients.”
After first developing an interest in blood cancers during the early years of her career, she grew passionate about finding new therapies for rare diseases in the field of hematology. In a lot of ways, the extensive reach of this field is still overlooked.
“Blood is the only organ or tissue that touches every single part of your body internally. It’s the only overarching tissue that flows from your head to your toes,” Dr. Borate said. “If there is something that is not quite right with the blood – whether counts are too low or too high – it really impacts you from head to toe. Because of that, the presentation and treatment of blood cancers are somewhat nonspecific and can be challenging: You’re not really treating a specific part of the body because you’re treating the whole body, but you need to limit the patient’s exposure to excessive toxicities.”
In her decades of experience, Dr. Borate has seen that many blood cancer patients bounce around from specialist to specialist before a diagnosis is made. Many even go to cardiologists before hematologists because their symptoms are often related to being tired and being out of breath. Still, she’s hopeful for the future of blood cancer diagnosis, especially when it comes to MDS.
“I think we’ve already progressed in the way we diagnose MDS,” she said. “Our testing is a lot more sophisticated, to the point that we can go down to the level of each specific gene that affects blood production and we can look for mutations in the genes to figure out what’s going on with the patient. We also have multiple different modalities and drugs to treat patients, on every point of the disease’s spectrum.”
It’s important to keep in mind that none of this would be possible without clinical trials.
“Clinical trials enable the medical community to improve our treatments constantly, rather than be satisfied with the status quo,” Dr. Borate said. “We always have therapies for patients, but these treatments are not always ideal; they may have side effects, they may not work for as long as we would like them to, or as well as we would like them to, and we always want to do better. The only way we can do better is to do clinical trials that offer the standard of care and then add something else to try and make a difference in the life of a patient.”
For patients who may be in the middle of their diagnosis journey, or who may have recently received a blood cancer diagnosis, Dr. Borate still has a message of hope.
“We have good treatments available, and we are here as a community to make sure that we continue to have good treatment options available so that we can help patients live their lives the best that they can, with as much quality as they can,” she said. “Information is power, so read and educate yourself about your disease so you can make decisions that make sense for what works with your life.”
Dr. Uma Borate is a hematologist specializing in the treatment of MDS, AML, and MPN. She earned her M.S. in Pathobiology and Molecular Medicine from the University of Cincinnati, and completed a fellowship in hematology/oncology at the University of Alabama. When she’s not serving on numerous boards, seeing patients, or publishing her work, she serves as an Associate Professor in the Division of Hematology at The Ohio State University and as the disease group leader for the MDS and MPN clinical trial disease group.
