A Surgeon Who Thrives on Connecting with Patients
When Kevin Holcomb, M.D. ’92, entered medicine more than 20 years ago, he knew that any specialty he chose would have to satisfy his brain, his hands and his heart. “I really liked internal medicine because it was cerebral. I enjoyed the Sherlock Holmes aspect of figuring out diagnoses,” Dr. Holcomb begins. “But I have the personality type that needs fast answers. I like instant gratification. And I like being able to use my hands.” Plus, theassociate professor of clinical obstetrics and gynecology at Weill Cornell Medical College likes getting to know his patients over time. “Caring for women with gynecologic cancer is all those things,” he notes. “The acuity of illness is high, the complexity is great, the potential for research is huge and I can be involved in people’s lives.”
Growing up in a lower middle class neighborhood in Queens, N.Y., Dr. Holcomb always wanted to be a doctor. And, from his earliest days at NYMC, he gravitated toward oncogenesis. “What stimulated me the most were my first pathology lectures on cancer,” recalls Dr. Holcomb, who directs gynecologic oncology and minimally invasive surgery at New York-Presbyterian Hospital/Weill Cornell Medical Center, where he is also associate director of the gynecologic oncology fellowship program.
NYMC was also where he discovered his passion for hands-on patient care. “As third-year medical students, we were sewing up stab wounds during our general surgery rotation at Lincoln Hospital in the South Bronx,” he recounts. “We were involved in care in the very early stages of our education. It wasn’t just theory. It was hands-on taking care of people.”
He recognized the opportunity for hands-on caretaking during his fourth-year rotationon the gynecological-oncology service at what was then called Columbia-Presbyterian Hospital, which was outside of NYMC’s network of training hospitals. “In patients with tumors that are not easily cured, gynecological-oncologists are the ones doing the chemotherapy and the follow-ups. Even if we’ve cured patients, we’re the ones doing continued surveillance. The patients in our hands see us as primary care doctors for cancer.”
Most of his patients––whom he cures––have early stage cervical or uterine cancers. Ovarian is the most challenging gynecologic cancer because it’s difficult to detect early and carries a significant risk of recurrence following treatment. If diagnosed at Stage 1, it is curable more than 90 percent of the time, Dr. Holcomb says. However, when detected at Stage 3, the cancer’s cure rate drops to 30-40 percent. “Ovarian cancer has vague and nonspecific symptoms, which is why the drive to find an effective screen is more imperative than with other cancers,” he explains.
He and colleagues have been researching such a potential screen, a blood serum biomarker called human epididymis protein 4 or HE4, which has proven sensitivity in identifying malignant ovarian masses, particularly in premenopausal women. “We’re looking for a test so specific and sensitive that you could give it to someone with no symptoms and it would detect ovarian cancer.” His research results are among those that recently influenced Britain’s National Health Service to recommend replacing the standard-bearer CA-125 test for ovarian cancer with HE4 for all premenopausal women who have a mass in or around the ovaries.
Given the terminal nature of some cases, Dr. Holcomb’s penchant to bond with his patients is notable. “I feel their anxiety. I feel their fear. I’ve never been one to turn that off. But it doesn’t paralyze me. I do my job better because of it.”
Yet, women with recurring ovarian cancer often live for years, allowing Dr. Holcomb to partner with them on defining treatment options, goals and expectations. “Your definition of success changes depending on the clinical situation,” he says. “If the disease isn’t curable, then that means offering the best evidence-based treatment you have, and counseling a woman so she can make autonomous decisions so she and her family feel good about her care, because in the end it’s the family who survives,” he continues. “If a woman feels well-informed, has had excellent care, and has a dignified death, that may be the best you can do and that’s success.”
Between his clinical and academic responsibilities, Dr. Holcomb’s plate is full. Still, he writes and publishes prolifically, and serves on at least half a dozen hospital and organizational committees to address issues such as professional education, reimbursement, quality assurance and clinical study evaluation. “I don’t think I’m at capacity,” he says earnestly. “I have a lot to learn. I could do more.”