Seeing the individual behind the diagnosis

My interest in pediatric oncology was a slow burn. I was not one of those kids who grew up saying, “I’m going to be a doctor.” I’m the first physician in my family, so it wasn’t something I saw growing up.

Yet, as I went through my undergraduate program, I found myself drawn to subjects and activities that had an emphasis on interacting with people and caring for others. After shadowing some medical professionals, I thought, “OK. This is what I want to do.” 

Once I determined my career path, figuring out that pediatrics was my realm within medicine was easy. I spent a lot of time around kids growing up. I did a lot of tutoring, and I really enjoyed those one-on-one interactions. Throughout my rotations in residency, I believed my focus would be general pediatric neurology based on the aspects of medicine I found most interesting. However, throughout my training, I found myself drawn to neuro-oncology patients. The cases were complex, and the field was evolving rapidly in how we diagnose and treat their conditions. The overlap between neuro-oncology and neurology — with the long-term complications that those patients can experience and the desire to improve their outcomes — was particularly interesting to me.

My ‘aha’ moment

During residency, I remember getting called down to the emergency department in the middle of the night to see a patient with new neurologic deficits. She ended up needing an MRI, and once we had those results, I was the person to tell her and her family she had a brain tumor. As a neurologist, my role was done at that point because the patient would then see a neuro-oncologist. Her oncologist would guide her care from there.

But I wanted to know more.

I wanted to learn what the next steps would be; I wanted to learn how we would treat her neurologic symptoms; and, most importantly, I wanted to know if she would improve. I found myself following her case and spending more time learning in the neuro-oncology clinic, which was not necessarily part of my normal day-to-day. I had just given that family some devastating news, and I wanted to follow up and explain what the treatment plan would be and provide a reassuring voice. I wanted to be a part of their healing journey with them, to build that connection and help them in a tangible way.

That experience solidified my interest in neuro-oncology, but more than anything, it emphasized how important a physician’s connection is with their patients and their families.  

Care rooted in connection

I didn’t come to these conclusions on my own. I have been fortunate to have multiple mentors over the years who showed me how to approach patient care, especially within pediatric neuro-oncology. They showed me how to have difficult conversations without sacrificing the connection with the patient and their families, even though I was giving hard news. During my neuro-oncology fellowship and now at St. Jude, I have had amazing mentors in both clinical care and research who have taken me under their wing and shown me how to take a question that interests me and use it to make progress.

My research is closely tied to the clinical care I provide. We have a lot more good days than bad days in the clinic; we get to see therapies working, and we get scans back that show no tumors. But there can still be long-term neurologic complications associated with cancer and treatment. My goal — and the goal of so many others here at St. Jude — is to adjust treatment to reduce toxicity and neurologic deficits. We use clinical data to try to predict which patients may have a more strenuous treatment course and develop early interventions to improve their neurological outcomes.

We do our best to treat each patient individually, recognizing that patients are different, even with the same diagnosis. Even in patients with the same type of brain tumor, the patient’s age and tumor’s location can affect them differently and the neurologic complications they might experience. For instance, seizures are a common complication associated with brain tumors that can affect the patient’s quality of life both during and after treatment. But the type of seizure and its effect on the quality of life impacts each patient differently. When addressing patients and their neurologic complexities, I work closely with a variety of specialists to look at the type of brain tumor a patient has, the specific treatment they received and other factors that may help improve outcomes. Almost everything I do from a research standpoint involves connecting with the patients, seeing how they are doing, and modifying their treatment or follow-up care to improve their outcomes.

Propelling the work forward

There are days when our approach doesn’t work the way we hoped it would. Those days are tough. While it doesn’t make it easier exactly, having strong relationships with the patients and their families can make it a little more bearable; more often than not, they are still appreciative of our efforts to provide quality care, even if the outcome wasn’t what we hoped for.

Then, there are the good days. 

Seeing a patient with a brain tumor and then six months later that tumor is gone because of a treatment I helped develop and prescribe is incredibly rewarding. It makes me want to do the next big thing and achieve that for all our patients. While we don’t always have the answers, we won’t stop until the day we do.

Hanzlik was recently named the 2025 St. Jude Outstanding Physician. Learn more about her work.