Sanjay Juneja: ‘When There Is a Need and You Can, You Should’

Sanjay K. Juneja, MD

Meet Sanjay K. Juneja, MD, whose passion for education and advancing cancer care has led him to be named Targeted Oncology’s first 2024 Oncology Icon.

A graduate from Louisiana State University (LSU), Juneja had leadership roles and academic pursuits that laid the foundation for his career in oncology. Post-graduation, he began a fellowship at Feist-Weiller Cancer Center, and was guided by mentors like Jay Marion, MD, who emphasized the importance of empathy and patient-centered care.

“He opened up my eyes at a formative time on the empathy and kind of being inside the minds of the patients we treat, the family members, and using a lot of discernment on every word you use, and how you phrase them. I think that was pretty foundational,” Juneja, a hematologist and medical oncologist from Baton Rouge, Louisiana, told Targeted Oncology^TM, in an interview.

As an oncologist, Juneja recognizes the transformative power of utilizing a multidisciplinary approach in the face of rapid advancements in cancer care. His initiatives go beyond clinical practice as he works to break down barriers faced by patients and aims to facilitate knowledge dissemination through both his podcast, "Target Cancer," and his social media presence.

At the forefront of Juneja's vision for oncology is the integration of precision therapy and technological innovation. He is a firm believer in the potential of precision medicine and artificial intelligence (AI) to optimize patient outcomes.

In addition, Juneja cofounded Medfluencers, a platform dedicated to empowering healthcare professionals through social media. The company works to uphold ethical standards while harnessing social media's potential as a tool for patient empowerment and education.

Recognizing Juneja as an Oncology Icon underscores his unwavering dedication to advancing cancer care, fostering collaboration, and empowering patients and healthcare professionals alike.

“It is not only humbling, but it feeds that sense of responsibility that I feel all the time. I think all of us can relate to knowing that more needs to be done and knowing that we have the capacities and ability to do it. Ultimately, our patients deserve it,” added Juneja.

In the interview with Targeted Oncology^TM, Juneja discussed the transformative power of collaboration, technology, and compassionate care in shaping his career, as well as the future of cancer treatment.

Targeted Oncology: Can you start by providing some background on who you are, where you are from, and what drove you to wanting to be an oncologist?

Juneja: I am a practicing hematologist and medical oncologist in Baton Rouge, Louisiana. My wife and I both actually practice heme/onc together, down in Louisiana. The thing that made me want to be an oncologist most was the teaching aspect. I wanted to be a teacher for much of my life until I got into a bad car accident. It is a whole story, but I was able to appreciate that there is every bit of teaching when it comes to medicine; that is where the term doctor originated, in Latin. So, I enjoyed that process and I do believe that with education and learning and understanding, things become less scary. That was the case for me when I lost my eyesight. I would have been pretty terrified in high school if I did not know what the goals were. That experience made me realize that cancer is obviously a scary process, but if we can make anything more tolerable, education might be that.

Tumor microenvironment concept with cancer cells, T-Cells, nanoparticles, cancer associated fibroblast layer of tumor microenvironment normal cells, molecules, and blood vessels 3d rendering: © catalin - stock.adobe.com

Please walk us through some of your schooling, residency, fellowships, etc.

I am actually a full thoroughbred of LSU, Louisiana State University. I went to undergrad at LSU, I was president of the basic sciences college. That kind of opened up the leadership stuff. Then I went to LSU medical school in Shreveport, was the president of the medical school there, and then I went to residency in internal medicine at LSU Health, internal medicine residency in Shreveport, and then I went to fellowship at Feist-Weiller Cancer Center in Shreveport, Louisiana.

Were there any significant figures in your life that mentored you throughout your career?

In respect to oncology, there was a doctor who just passed away, Dr. Jay Marion, MD. He was very compassion driven. He accounted for those elements that may not be in a billing code and kind of the structure of stuff that you learn about in the books, but he had a humanistic approach. He opened up my eyes at a formative time on the empathy and being inside the minds of the patients we treat, the family members, and using a lot of discernment on every word you use, and how you phrase them. I think that was pretty foundational.

You are a strong advocate for collaboration in education and oncology. Can you elaborate on the importance of this approach?

Cancer has evolved a lot in the last 5 to 7 years. Fortunately, or unfortunately, it takes a lot of new collaboration that we did not necessarily have all the time. Now, we are doing chemotherapy, sometimes in a stage II setting, because survival is better. But then if the habit of 30 years is to do upfront surgery and resection, it takes a significant period of time for that to kind of come to fruition across the country. Old habits die hard, so to speak. Also, to be able to kind of know the workflow. We live in a kind of compartmentalized system based on institution and [electronic medical records], and all those things, so I think there needs to be something that kind of democratizes all of it and just dissolves those boundaries, because ultimately, it is challenging to stay on top of everything, and then also coordinate with people that have been doing something differently for a long time. So how does that come forth? In my opinion, it is education. That is why I am very passionate about those kinds of things outside the clinic.

Are there any particular fields or aspects of oncology that interest you the most?

I think the most interesting thing about oncology is what a lot of people are excited about, and that is precision therapy because we kind of have this older nomenclature. It is where the tissue originated in histopathology under a lens, and we have discovered all kinds of things and properties about the tumor that go far deeper than that. The same thing applies to pharmacogenetics, a fancy term to mean, what is my body doing with the treatments? How does it differ from somebody from Wisconsin? Being able to appreciate all those things, I think, will hopefully change the way that cancer has been able to be treated in the past.

I think the second part that is absolutely necessary, in my opinion, is technology and artificial intelligence, and being able to have the bandwidth and brain power, so to speak, to crunch this litany of data we have because we have discovered all of these things that we have not been studying for 20 or 30 years, like everything else, because they are new. Precision molecular therapy, and all these things, [are new]. Number 2, to have the bandwidth and the intellectual capacity for making pattern recognition with, unfortunately, millions and millions of cases of cancer. That is why I am passionate about artificial intelligence. A lot of my endeavors have kind of focused around that in the last 6 months.

Your podcast, Target Cancer, has gained a lot of recognition. What inspired you to create that platform?

It goes back to this kind of need to team up. Cancer is so challenging that it requires everyone to be obsessively concentrated on whatever their field or specialty is. There are [research and development], PhDs, clinical doctors that are working to meet the needs, and it is easy to get very insulated. But the truth is, it is obviously a very challenging disease process. What that focuses on, and really the podcast in general is, let’s take a moment to kind of get out of our silos and look at the thing as a whole, because otherwise, we are making progress to varying degrees and independent little silos, but because it is such a comprehensive approach with metabolic stuff, drug design, research, and nutrition, there needs to be a place to tie it all together. I was hoping with the podcast to be able to have people of all kinds of different backgrounds and show that it is much like multidisciplinary treatment in the traditional system. It is also multidisciplinary in the understanding of biology and all of those things that I think a lot of patients and people want to hear. It helps empower trust when you talk and consider things that maybe are a little outside of the traditional track of just treatment and rescan.

What are your long-term goals for the podcast?

Hopefully the podcast inspires people to continue to not only think out the box, but desire to learn and know more. If anything, for me personally, it just makes me aware of the amount of work going into different aspects. Like I said, metabolic and nutritional, it is not something we hit too hard in our traditional track and fellowship. There are people that are MDs or PhDs at amazing places that have had things that have not trickled down into everyday community practice, per se. It has also made me appreciate the complexity and important differences in a lot of the tools we use. [For example], molecular testing is not just molecular testing. There are different ways to do that and to stay ahead of it because ultimately, I think everyone experiences, at least as a professional in oncology, some degree of moral injury or guilt for potentially, or conceivably not utilizing every tool and piece of knowledge out there that could best serve their patient. But it is also impossible for one person. So that is the hope of the podcast.

You also cofounded Medfluencers, which focuses on empowering healthcare professionals through social media. Can you discuss some of the challenges and opportunities of that approach?

There are a couple reasons for Medfluencers. Number 1, there is a huge desire from patients, and even people that are noncancer but in the medical field, to know more about it. Number 2, [social media] is unregulated right now, so anyone can say anything. There has been a litany of stories when people are spending tens of thousands of dollars in believing something they have seen because the alternative is not being provided, meaning traditional healthcare or traditional treatments. One may argue we will need to trust it blindly, but we live in a society today where that is a big ask. Why would we trust blindly?

I think there is some kind of emerging sense of responsibility to substantiate why we do the things we do and how. I think there is a need for that on social media. I do not know if it is early enough, or too early, to call it a responsibility just yet. But there are a lot of good people, physicians, nurse practitioners, nurses, pharmacists, that are educating. But the rules are yet to be defined and written as far as regulation, compliance, and liability on licensure and what kind of insurance you need. The cofounder [and I] have spent a lot of time this past year to make sure that that could mean professionals do not end up getting unknowingly into trouble with things. We wanted to do it legally. We have conversations federally just to make sure it is done responsibly. I do think it is something that is reasonable for people to desire as they go through something as scary as cancer.

What does being recognized as an oncology icon for Targeted Oncology^TM mean to you?

It is not only humbling, but it feeds that sense of responsibility that I feel all the time. I think all of us can relate to knowing that more needs to be done and knowing that we have the capacities and ability to do it. Ultimately, our patients deserve it. Targeted Oncology is an example of trying to do just that by making sure that people understand and know everything that is going on in a treatment capacity in hopes that they are best suited to treat their patients. For Targeted Oncology, who is already kind of primarily driven with that purpose, to recognize me as an Oncology Icon, I am extremely flattered.

Secondly, it is also motivating, because I think, again, we get into our silos, we get into our routines, but change only happens in systemic collaboration. I think that starts with talking about it. That is why I think the podcasts and social media, say what you will, they do facilitate collaboration and kind of a reminder of our collaborative purpose. Targeted Oncology saying represents that as well with academicians, clinicians, community professionals, and these are the kinds of things that I think will maximize our impact. There is power in 1 finger, they say, but when you put all 5, you know, you have a fist. It is the same concept. We have to have a way to bring everything together, because that is where the biggest impact is.

Winning this award comes kind of at a time in oncology where there have been a lot of significant advancements. How do you see your work contributing to this progress?

The work that I am trying to do is hopefully just a Band-Aid. It is kind of a low lift, immediate solution to a problem that requires a longer term, systemic reboot, because it is hard to keep up with the material. There is a lot of dissociation of sorts as this evolves in so many different ways. I am hoping that we have the grace, as medical oncologists and professionals, to be okay with patients knowing and learning about their cancers and asking questions that say, should I get retested on my molecular sequencing or my receptor status? Or, it has been a couple of years and I read that neoadjuvant makes more sense. I think that takes a degree of humility, but is necessary, just given what has happened in the last 5 to 8 years compared with the 30 years before. It has been all compacted, so I am hoping that that can help facilitate it until there is a solution.

On the other side, being on the editorial board for AI and precision oncology and speaking on artificial intelligence from a medical and healthcare perspective, number 1, debunking a lot of the misunderstanding of AI. I think that is a very quick way to make up or at least help the spilling, that I think everyone agrees is happening when it comes to updates and making sense of all of the variation and how people respond and how outcomes are and not being able to explain it to patients. I think we wish we could explain it better. I think that is where technology and AI can accelerate in colossal ways the things we have yet to be able to explain ourselves.

How do you balance your roles as physician, educator, media personality, etc?

When people ask, isn't it hard or depressing to be an oncologist, 1, that question always kind of hurts me a little bit, but 2, the truth is extremely humbling. We know how finite life is and we see how long guaranteed life is. [This] “hat wearing” is because we have a finite amount of time to make good on all of the stuff that people have invested in us. The person that admitted you to med school, to fellowship, etc. I take it all as a support and investment that you were positioned on the shoulders of many before you to be where you are today. We want to accomplish as much as we can. I think to balance not being burned out is just finding fulfillment and purpose and revisiting what we are doing and asking, is it fulfilling?

We can do a lot of things that seem taxing, but I call it sometimes like a rewarding exhaustion because there is good exhaustion and bad exhaustion, but at the end of the day, if we have reward and feel purpose, and we follow that calling, the universe wills you to push in that direction. That is something that I think is very important to revisit. Enjoy every moment, even what seems like a stressor is a blessing, right? I have 3 kids, and sometimes something seems stressful but I am like, I have 3 kids. And same in the clinic. I get to take care of this person. It is a true honor, This family is trusting you and their entire life with your management. When you take a step back, I think the stuff that seems exhausting really is more humbling than anything else.

Looking back at your career trajectory, what are some key moments that shaped your passion for improving cancer care?

Very quickly going into practice, there were some things that seemed unfair or unjust. I got involved pretty early with Louisiana Oncology Society and the Cancer Advocacy Group of Louisiana, where I was able to see that one can have an influence with policy and just do right or make right for something that may be lagging for patients. That kind of inspired this uptick on saying there is a way to change the things that you observe. I have been working the last couple of years with the Alliance for Patient Access outside of DC, because I was able to appreciate that when we change things on a state level, and a lot of states do it, we can change it at a federal level. That was encouraging to know that we can influence decisions. That was formative for me, that happened about 2 years ago.

When I posted my first social media completely by serendipity, it was not with any intention or active pursuit of anything. When the comments started to trickle in about what changed in their life or their family members life there have been, or that immunotherapy was not offered, it felt good at first, but then it very quickly became a little more concerning, because we are like, whoa, how is this happening? That is kind of a responsibility, like there are everyday Americans in 2022, 2021, etc., that may not be seeing the same care in one place compared with another. That was by far the biggest catalyst in recognizing that we have a long way to go for all of us as part of the healthcare system. Not turning away from it, and then finding immediate solutions. When we see that difference happening, again, it is the universe just telling you that this is what you have to do, whether you want to or not. When there is a need and you can, you should.

What advice would you give to aspiring oncologists interested in innovative approaches, patient education, and outreach?

I think by far the most important thing, if you are going into oncology, is that you are always practicing. When I say that, I don't mean just with what you are prescribing or how you are working a patient up, but even like learning people, understanding people, and adapting emotionally, showing empathy. Also, to yourself, I think that stuff continues to have to be built upon, because it is challenging for several reasons. Just recognize that if it is not perfect today, or if it is depressing, or if it is stressful, that is why it is practice. Those elements are just as important as the medical memorizing stuff.

Secondly, I think it is important, and again, I may be a little biased, but we cannot get behind on technology, because we know technology helps things. It is immensely challenging to stay on top of oncology in itself as a general oncologist, but as tools become available, tools are only as valuable as they are known to us. We could use a screwdriver all day manually, and that is hard, but if a drill was invented and we do not know that a drill is there, our projects are going to take a lot longer, and it gets physically taxing. There are tools out there that can completely revolutionize the way we do things already that are causing this fatigue and burnout. I am just discovering them, but I do think that to not have them would make something already challenging as a field even more challenging in practice and in labor. Seek it out, sign up for Targeted Oncology, learn this stuff, have diversified sources and categories, because if you pigeonhole yourself, it is very easy to lose sight of those things.