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Kala Visvanathan, MBBS, FRACP, MHS
Professor of Epidemiology and Oncology
Johns Hopkins Bloomberg School of Public Health
Sidney Kimmel Comprehensive Cancer Center
Goal: To evaluate prevention strategies and outcomes of second cancers in women who have had breast cancer.
Impact: In spite of that fact that nearly 20 percent of breast cancer patients will be diagnosed with a second cancer within 25 years after breast cancer treatment, little data is available on the prognosis and prevention of second cancers in these patients. Dr. Visvanathan is conducting studies to focus on this question and hopes to provide much needed information which could drive the implementation of a more risk-based approach to screening and prevention of second cancers.
What’s next: Dr. Visvanathan is conducting studies to understand the incidence and outcomes in women diagnosed with a second cancer or breast cancer recurrence. In addition, she will evaluate the impact of the COVID19 pandemic on the health and well-being of women with breast cancer or at increased risk of breast cancer.
Breast cancer deaths have declined dramatically over the last two and a half decades, but the incidence of breast cancer—the number of new diagnoses each year—has remained stable. And even after successful treatment, women can face a breast cancer recurrence or a second cancer, sometimes many years after the initial diagnosis. Dr. Visvanathan is focused on understanding the impact of second cancers in women diagnosed with breast cancer and evaluating strategies to prevent them.
Full Research Summary
Research area: Evaluating new strategies to identify women at risk for developing a second cancer after breast cancer.
Impact: While deaths from breast cancer have decreased significantly, the number of new diagnoses made each year has not. Even if women have been successfully treated for their cancer, their cancer may return or a second (non-breast) cancer may develop, sometimes long after their initial diagnosis. According to a national SEER (Surveillance, Epidemiology, and End Results) database, the cumulative incidence of developing any second cancer among breast cancer patients is between 15-20 percent at 25 years, including a seven percent incidence of developing a new primary breast cancer. Furthermore, the National Cancer institute has identified second cancers as an underexplored area of research. Dr. Visvanathan is focused on understanding the incidence and impact of second cancers in women diagnosed with breast cancer and evaluating strategies to prevent them. Her research will inform clinical practice and address critical gaps in our current knowledge regarding second cancers.
Current investigation: Dr. Visvanathan will leverage multiple resources to examine the incidence of developing a second cancer after hormone therapy and determine the survival rate for a second cancer among those with previous breast cancer. Her team will examine the impact of hormone treatment on reducing second cancers and determine if the incidence of a second cancer puts a woman at greater risk of death from the disease. In addition, her team will evaluate the accuracy of existing prognostic clinical tools to predict 5-year survival for women with a second cancer using the SEER database and/or a Finnish national database. Lastly, they will evaluate the impact of COVID19 on the physical and mental well-being among women with breast cancer or those at risk of breast cancer.
Kala Visvanathan is a Professor in the Department of Epidemiology at Johns Hopkins Bloomberg School of Public Health and the Department of Medical Oncology at Johns Hopkins School of Medicine. Dr. Visvanathan is Director the Clinical Cancer Genetics and Prevention Service and the Cancer Epidemiology Track at Johns Hopkins.
She received her medical degree from the University of Sydney in Australia. She subsequently went on to complete her training in Internal Medicine and Medical Oncology at Royal Prince Alfred Hospital, an academic teaching hospital of the University of Sydney in Australia and at the Sidney Kimmel Comprehensive Cancer Center Johns Hopkins School of Mediine. Dr. Visvanathan also completed training in clinical/cancer epidemiology at the Johns Hopkins Bloomberg School of Public Health.
Her research is focused on primary and secondary prevention of breast and ovarian cancer. Trained as a medical oncologist and cancer epidemiologist, a large part of her research is transdisciplinary and focused on translating results from the laboratory to populations, to identify at risk groups, preventable targets and to evaluate agents that have the potential to impact the natural history of breast and ovarian cancer. She conducts both observational studies and clinical prevention/early detection studies Specific exposures of interest include hormonal exposures, inflammation, genetic and epigenetic changes, DNA damage/repair, obesity and oxidative damage. She has recently co-chaired the American Society of Clinical Oncology national guideline on breast cancer risk reduction.