Director of research at Hematology-Oncology Associates: One of the jobs of Hematology-Oncology Associates’ physician is to bring cancer clinical trials to CNY. He talks about this and his career and why he changed his major from computer science to medicine.
Q: Give us an overview of your work with Hematology-Oncology Associates of CNY.
A: I’m a general hematologist and medical oncologist here at the practice. I’ve been here for three years, but I’ve been practicing for more than 10 years. One of the things I do is see patients with a variety of blood disorders and cancers. I’m also the director of our research department, and am working to bring clinical trials to people in this community.
Q: What drew you to your specialty?
A: I originally went to college for computer science and I became interested in medicine while I was studying at Rochester Institute of Technology. I started riding in an ambulance for a while and discovered more and more that I enjoyed medicine. I ultimately decided I would go to medical school. I thought I would be a primary care doctor, but when I was in my training I found I really enjoyed my time training in hematology and oncology with hospitalized patients. And, ultimately, started doing a lot of rotations in clinics. I just really enjoyed it. I liked that I got to deal with a variety of medical problems and organ systems within the body. And I became very interested in the science of cancer medicine.
Q: Have you found there to be any transferable skills from computer science to medicine?
A: Yeah. I think one of the things I enjoyed most about computer science was problem solving. In computer science it’s fixing a broken machine or debugging code. In medicine, your patients come to you with a problem and you try to figure out how everything ties together. Their symptoms, new developments. So it’s also a lot of problem-solving, which is something that attracted me to this field. And also just finding new ways to solve these problems. One of the things that attracted me to research was finding new mechanisms to treat cancer.
Q: Did the pandemic cause issues so far as diagnosing cancer in a timely manner? Have you seen changes in the rates of cancer diagnoses?
A: I think there are a few trends overall. One of those trends is we’re seeing malignancies in younger people. The big example there is colorectal cancer. For the past 20 years we’ve seen a 2% increase each year in people under the age of 50, which is one of the reasons we start screening for colorectal cancer at a younger age. So it feels like we’re seeing more cancer in younger people. In the context of the pandemic, I feel like it’s caused a lot of delays. It’s harder to get things done quickly. So, where something took maybe a week to setup before the pandemic, things are now taking longer due to staffing issues. And, of course, during the pandemic people pushed back a lot of screening. So we’re seeing more people presenting at later stages of disease. If they’d been screened sooner, or presented to get their symptoms looked at sooner, they waited and showed up with more advanced diseases. That was certainly a concern during the pandemic and it seems to be panning out with what we’re seeing in our practice.
Q: When it comes to the increase in colorectal cancers specifically, what do you think is going on there?
A: That’s a great question. In my personal opinion, without being too controversial, is that the standard American diet is a big factor. In certain other countries we don’t see as much of this. It could also be due to other exposures that we’re seeing in society. A lot of people worry it could be diet related, though. Some think it’s due to a decrease in fiber intake, others an increase in animal protein intake. One of the things that we see across the world is that people who eat diets rich in fruits, vegetables, legumes have lower incidences than people who eat diets high in processed foods and processed meats in particular. There are even studies that show if you take people from one part of the world and then move them to a Western society, their incidences increase. When you see this kind of immigrant effect, it strongly implies that it’s exposure-related.
Q: When it comes to fiber, is there a difference between natural fiber and refined fiber so far as colorectal cancer risk goes?
A: I think it’s mainly whole fiber from plant-based foods. You can get fiber in highly processed foods, but I think it’s better to get it from the food itself. We get a bit fixated on getting certain nutrients through pills. “This vitamin is in an apple, so let’s make a pill that isolates the vitamin.” But that vitamin doesn’t always pan out as well as just eating an apple.
Q: Do you find screenings are effective as a mitigation for these increased incidences?
A: Absolutely. These screenings can prevent the cancer. So, for example, doesn’t just grow out of anywhere. Colon cancer starts with an abnormal polyp in the mucous membranes of the colon and that polyp starts to grow more and more mutations over time, and that polyp starts to form more and more mutations and turn into invasive cancer, which can become life-threatening. So if you have a colonoscopy and you find this polyp, and you remove this polyp, then the cancer never had a chance to start. So colorectal screenings are extremely effective. The same goes for mammograms, which detect lesions before they turn into invasive cancer. Even when I see patients for non-cancer related issues, I still harp on them about getting their screenings because it’s just so important. We’re happy to take care of people with cancer, but we’d rather not have to see them in the first place. We’d rather they never develop cancer.
Q: What brought you back to Syracuse?
A: Family. I moved to Syracuse originally in 1989 and it became home. I’ve left a couple times, but it keeps drawing me back. Sometimes moving from Virginia to Syracuse sounds like a counterintuitive move, but I think it’s a great place to raise kids.
Name: Steven Duffy
Position: Hematologist-oncologist and director of research at Hematology-Oncology Associates of CNY
Early Life: Moved with his mom from Dublin, Ireland, to Syracuse at age 11
Education: Medical degree from SUNY Upstate Medical University; residency in internal medicine at SUNY Upstate; fellowship in hematology-oncology, SUNY Upstate
Career: Worked at busy practice in Richmond, Virginia, where he was involved in cancer research, teaching and the development of multidisciplinary cancer care teams
Affiliations: Crouse Hospital; St. Joseph’s Hospital
Family: Wife (Michelle), son (Ian), daughter (Lily)
Organizations: American Society of Clinical Oncology; American Society of Hematology
Hobbies: Hiking, snow activities, exercising