The Q&A: Theodora Ross

With each issue, Trib+Health brings you an interview with experts on issues related to health care. Here is this week's subject:

Theodora Ross is both a scientist and physician. She directs the University of Texas Southwestern Medical Center’s Cancer Genetics Program. Ross recently published her first book, “A Cancer in the Family.”

Editor's note: This interview has been edited for length and clarity.

Trib+Health: Why did you enter your field?

Theodora Ross: It wasn’t until four-and-a-half years ago that the opportunity at UT Southwestern came up where I could run a cancer genetics program and get into cancer genetics. It was something that I always wanted to do.

On the other hand, cancer genetics is a relatively new field. Back in the ‘60s, there were two people who thought cancer ran through families. … It wasn’t until the ‘90s when they discovered genes and these clinics started to be formed. … The idea of running a cancer genetics clinic and learning about cancer genetics became really tantalizing and I’m really excited to do it.

So that’s how I got there, and it’s a field that’s still very young.

Trib+Health: Since the field is so young, you’ll be able to make an impact with your research, right?

Ross: That’s what I thought. I have to say that one of the things I thought was I love genetics because genetics is so data driven. You have a family and you can see a type of person and say you have this particular cancer and it happened at this age and they do or don’t have this gene. It seems simple.

When I started, I thought this was going to be good because the science we do in the laboratory, you’re always looking for data and you’re getting the pieces. But you never have all the pieces.

Sometimes you have to make some leaps. Sometimes you have to conclude things before you’re really sure that it’s true.

You really think of genetics as one of those solid areas, but now with the sequencing of these genomes we find that there’s much more variability in the genome than we thought. So you sequence multiple genomes more and more genes seem to be broken in people who don’t have a disease.

You think you can make a lot of discoveries. You think it’s going to be easy. But all of a sudden you have a lot of data so all of a sudden it's like a lot of smoke but no fire. …

The more I got into it the more interesting and more complicated and making an impact is just as hard as any other science.

Trib+Health: You wrote a book called “A Cancer in the Family” and you’re a cancer survivor. Does this make what you do more personal?

Ross: I originally was writing the book in third person to educate people. I did it because I wanted to learn myself. My genetic counselors knew more than I did so I said I better write a book to learn something.

I had this experience and there are things where you’re conflicted. You’re a doctor so you don’t talk about yourself. ... There’s that conflict in writing it.

I had an outline of how I was going to do [the book], but it just didn’t work. It didn’t connect with the patients. So I realized that cancer in the family is a tough topic to discuss; it’s a scary topic for people. Maybe if I use my experience about all the potholes I hit and the mistakes I made … it would connect with the readers more and be more educational.

It worked out really well in the end. It was a fine line of talking about yourself and your own experiences. You want to use it to help other people and connect and that’s about it. ...

Trib+Health: What does it mean if you find a mutation in a person? What should they do?

Ross: It depends on what the gene is, and that’s why we have genetic counselors. They can, depending on what your mutation is. If it’s a mutation in a colon cancer gene, they can tell you to have a colonoscopy at certain intervals. They can tell you, if it’s a really bad gene, to get your colon out. …

If you have a pancreatic cancer family history, we’ll look at the pancreas more often. We still don’t know what to do with that [gene].

There are a lot of different guidelines. In the back of the book, I list all of these different syndromes and what we currently recommend, but things change. One of the things that people can do is realize that things change so when you see a genetic counselor, it's not the last time you’ll see them.

Trib+Health: What’s next for you?

Ross: Always more research. Oh, am I ready for a book? No. Right now, this was my first one, so I’m trying to figure out what you do after you write a book. What you do is take a little bit of a break. I’m not sure what’s next. I have a lot of ideas. 

Writing a book is the funnest thing I’ve ever done in my life. Putting something together like this where you’re learning and you’re learning things that you thought you knew and thought deeper. It’s more educational for the writer than for the reader.

There’s a lot of things that I could write about, but I haven’t made a decision yet.