Increasing Research on Oral Cancer Survivorship: Dr. Chi Viet

Chi T. Viet, MD, DDS, PhD, FACS, is a surgeon scientist whose research focus is on increasing survivorship and quality of life for patients with oral cancer. Her work has been featured in PBS’ “Life on the Line: Keep Moving Forward.” Read ACOMS’ conversation with her to understand a slice of her perspective and passion.

Could you start by describing your practice and where you currently work?

Dr. Chi Viet (CV): I'm an associate professor at Loma Linda University. I’m also a full-time surgeon. My surgical practice is primarily focused on head and neck malignant and benign pathology, and reconstruction.

Your research focuses on a few areas. Can you elaborate on what those are?

CV: My research is primarily focused on oral cancer, particularly looking at both the symptoms patients experience and the factors that influence their survival. One key area is the burden of cancer symptoms like pain, anxiety, and depression, which significantly impact a patient's ability to not only survive but also maintain a good quality of life. Another area of focus of my research is identifying molecular fingerprints that could predict response to treatment in oral cancer patients.

How are you typically thinking about pain management as compared to many OMS professionals?

CV: Oral and maxillofacial surgeons typically focus on short-term pain management for surgical procedures. My focus is on chronic pain management for cancer patients undergoing treatment. In both scenarios of short- and long-term pain management, opioid dependence is a major concern. With opioid abuse being highlighted as a national crisis, OMS professionals have consciously made efforts to reduce the amount of opioids they prescribe after elective surgeries. Similarly, for cancer patients who survive their treatment but are left with chronic pain, we are devising opioid-alternative strategies to address their pain.

You are currently researching non-opioid alternatives for cancer pain management. Can you tell us more about that?

CV: One of my current grants is specifically focused on finding non-opioid alternatives for cancer patients. We are currently repurposing a cancer drug that also has pain relief potential. Since the drug is already FDA-approved for cancer patients, this approach could be particularly efficient in getting this option to patients — targeting the same gene pathway for both the cancer and pain.

What other areas of research in your field are you excited about?

CV: The majority of my research focuses on identifying molecular predictors of survival in oral cancer patients. This is an area that is currently underfunded, and there is a major disparity in research funding for oral cancer compared to other cancers, despite its poor survival rates. There has been a rise in young patients who do not smoke or drink or have other risk factors, and yet they end up dying of oral cancer. Unlike some other cancers, oral cancer is more complex and likely will not have a single 'magic bullet' cure. An increased research focus and funding are essential to improve survival rates.

You mentioned there aren't many surgeon scientists in oral and maxillofacial surgery. Why is that, and how did you end up on this path?

CV: There are several reasons for the limited number of surgeon scientists in our field. The long training path and the pressure to pay off student loans can make research seem less feasible for some. Additionally, there is a lack of mentorship opportunities for residents interested in becoming surgeon scientists. My path involved a combined DDS/PhD program followed by residency, medical school, and a fellowship in head and neck cancer and microvascular surgery. Witnessing the challenges of oral cancer patients motivated me to pursue research alongside patient care. I realized that with research, I could potentially help not just the patients I treat, but many more in the future.

What advice would you give someone interested in this path?

CV: There is no single defined pathway to becoming a surgeon-scientist in our field, which is exciting because you can carve out your own path. Know yourself, what your purpose is in life, what your talents and shortcomings are, seek collaborators and mentors who can help you hone your skills, and define a focused path for yourself that brings the most fulfillment each day.