Gina D'AmatoSylvester Comprehensive Cancer Center, Florida, USA

Dr. D’Amato’s passion for her patients guides her on this newest leg of her professional journey in Miami with mentor and GIST expert clinician and researcher, Dr. Jonathan Trent.

This past February, oncologist Gina D’Amato left her practice in Atlanta, GA to join the Sylvester Comprehensive Cancer Center in Miami. A clinician with over 15 years of experience with GIST patients says the Center in Miami is similar to her previous practice with the exception that Sylvester is involved in research such as circulating tumor DNA and currently has three clinical trials in progress.

“It’s encouraging for patients, knowing that they are going to be treated at a state-of-the-art institution that’s on the cutting edge of what’s being developed for GIST,” said D’Amato. D’Amato did her undergrad work and residency at the University of Miami and her fellowship at Moffitt Cancer Center.

D’Amato has specialized in sarcoma and GIST since her fellowship and decided as a youth to be an oncologist after her older sister’s battle with Hodgkin’s lymphoma. Her sister is a survivor of 30 years. “I saw that cancer can be cured. But the cure is tough. And chemotherapy is barbaric and that we have to find better treatment options. I tried to keep an open mind when I went to medical school, about other specialties, but I was always focused on oncology. The need is great for improvements and better treatments with less toxicity.”

Being a general oncologist can be a tough job because you have to know so much about so many types of cancer. D’Amato credits Dr. Trent with her specialization in sarcoma. Her plan had been to be a lymphoma expert, but Moffitt Cancer Center needed a sarcoma specialist and Dr. Trent turned down the opportunity, so D’Amato stepped up.

D’Amato shared that delayed diagnosis in GIST is a continuing challenge. When a patient sees a doctor, a general practitioner, even a ‘general’ specialist, they are not likely to consider a rare sarcoma because it is not the most plausible scenario, particularly with young people. Cancer is not the first diagnosis on their minds.

“You don’t learn about these diseases in medical school. The students aren’t rotating to the clinic or through the oncology floor. They aren’t exposed to it and when patients present with symptoms they are thinking of other diagnosis besides GIST. For example, GIST starts on the outside of the stomach, not the inside. So, when someone has stomach issues, they go to a GI. They’re looking inside because that’s where you can get an ulcer or stomach cancer or something else. They’re not looking on the outside because it’s so rare. Other cancers can have delays too, but other cancers have screening tools; breast cancer has mammograms to detect early; melanoma, skin checks. With GIST, there’s delays in diagnosis, and late stage diagnosis because there’s no screening tool for GIST and if the patient doesn’t get a CT scan or an endoscopic ultrasound that would find the tumor diagnosis is delayed. Often a patient will get diagnosed by either an astute doctor or because they wind up going to the ER with bleeding or abdominal pain.”

Dr. D’Amato says she learns from her patients. Not every patient can be treated the same, the nuances of GIST are different for everyone. For their emotional and physical well-being, she advises them to gather a patient support team and lets them know that they have to take care of themselves.

“I try to tune into my patients when they’re first diagnosed and throughout the course of their care. There’s a certain amount of anxiety with a cancer diagnosis. I feel anger too, for those who haven’t been diagnosed sooner, but I tell myself the same thing I tell the patients, you have to keep moving forward.”

D’Amato says the patients who tend to deal better emotionally with the diagnosis are the ones that were diagnosed right away as opposed to those that had been undiagnosed and ailing for a while. The anger about the delay in treatment can keep patients from moving forward. Other patients can be confused or angry about a cancer diagnosis if they feel they’ve done ‘everything right’. Why did it happen to them when they ate healthy and lived a healthy lifestyle?

“I tell them, yes, you’ve done everything right, and because you were healthy, that means you can tolerate the treatments and fight the cancer better,” said D’Amato. “And I’m optimistic. People survive, against all odds. There are so many new treatments, so much research ongoing.”

Dr. D’Amato is currently seeing patients two and a half days a week, potentially expanding to three, and is hoping to have students rotating with her from the University in the future.