5 Questions for Emily Tonorezos, MD, MPH

This question-and-answer series explores the motivations, inspirations and accomplishments of investigators at St. Jude. Emily Tonorezos, MD, MPH, Department of Oncology, is a general internist and the incoming Division of Cancer Survivorship director. Before joining St. Jude, she spent five years as the Office of Cancer Survivorship director at the National Cancer Institute.

1. What led you to pursue a career in cancer survivorship care and research?

I’m a general internist, and what I have always loved about internal medicine is caring for chronic conditions of adulthood, such as high blood pressure, diabetes, obesity and heart disease. As we know from research conducted at St. Jude and elsewhere, survivors of childhood cancer can face an increased risk of many of these conditions.

My interest in survivorship began there. A few decades ago, a research initiative for adult survivors of childhood cancer was expanding and hiring junior faculty. I had the opportunity to join the program, and I fell in love with the field and with the patient population.

Since then, working in survivorship has never failed to reward me as both a scientist and a clinician. Survivors are extraordinarily generous with their time. In my experience, they contribute to research in a way that is remarkable among adult patient populations. Of any patient population I have ever interacted with, they are the kindest and most enthusiastic to be involved with research; that generosity has made this work deeply rewarding.

2. What have been the major areas of focus throughout your research career?

I have a broad range of interests, but I was initially drawn to survivorship research through questions about diet and metabolic health. One of my studies, conducted through The Childhood Cancer Survivor Study (CCSS), which St. Jude leads, tested a diet and exercise intervention for adult survivors of pediatric acute lymphoblastic leukemia.

Although the intervention had worked in the general population, it did not produce the same weight-loss results among survivors. That was an important finding because it showed us that this population may need more support to make and sustain behavioral changes. We cannot simply take an intervention developed for the general population and assume it will meet survivors’ needs.

For these types of studies, the science of measuring diet has also advanced tremendously. Instead of relying only on questions about how often someone eats a particular food, we can now use photographs and biological measures from blood or breath, and I have been a part of encouraging the survivorship research field to adopt these approaches.

Beyond the biological portions of diet, I am also interested in its broader effects, including the ways food can promote well-being, social connection, community and culture. We are learning that where you eat, and with whom, can matter just as much as what you eat.

In a similar vein, I have a major interest in how a survivor’s environment shapes their experience, particularly their access to high-quality primary care. I want to understand how we can help survivors find primary care and equip primary care clinicians to care for them well.

Finally, I am interested in quantifying the cancer survivor population: how it has changed, how it is expected to grow, and what services and research will be needed to support it.

3. What attracted you to St. Jude?

When St. Jude offered me the opportunity, it was an absolute no-brainer. CCSS and the St. Jude Lifetime Cohort Study (St. Jude LIFE) are treasured resources for childhood cancer survivorship research. For anyone passionate about survivorship and committed to this population, St. Jude is the place to be.

I had also worked with St. Jude investigators before joining the institution. Through working with the CCSS, I saw firsthand the depth of expertise here and the extraordinary mentorship and support provided by leaders such as Melissa Hudson, MD, the preceding Cancer Survivorship Division director; Greg Armstrong, MD, MSCE, Department of Epidemiology and Cancer Control chair; and Kirsten Ness, PT, PhD, FAPTA, Department of Epidemiology and Cancer Control. My interactions with them were part of the reason I decided to come to St. Jude, and Dr. Hudson has been training me for her former position to ensure a smooth transition.

I am thrilled to be here and could not be happier.

4. What do you hope to accomplish as director of the Cancer Survivorship Division?

I see my role as helping move the Division and its research into the next generation of survivorship science. For me, that includes advancing work related to wellness, diet and quality of life. There is still so much to learn about how we can help survivors not only live longer but also live healthier and more fulfilling lives.

At the same time, I believe it is important to recognize that I am joining a highly successful program. My responsibility is not simply to introduce something new. It is also to sustain and grow the work already happening here and to make sure the Division’s accomplishments are preserved, cultivated and strengthened.

I feel a strong commitment to the people, programs and research that have made this organization so successful. The goal is to build on that foundation while creating opportunities for the future.

5. What message would you like to share with survivors and families who may benefit from survivorship research?

The first thing I would say is thank you. Thank you to survivors for helping us understand what it means to live after a cancer diagnosis. Thank you for participating in research and clinical care and thank you to the families and other people in your lives who make that participation possible.

I also want survivors and families to know that we are doing everything we can to address the challenges faced by children who have been diagnosed with cancer and by those who support them. At the same time, we know we are not done. This work should always be guided by the people we are trying to help — survivors and their families. 

I am incredibly grateful for all the research tools and expertise here at St. Jude, and we want to use them in the ways that will most meaningfully improve survivors’ lives.