Kevin Pearlstein, MD, is a life-long hiker so it’s not surprising that his road to a radiation oncology clinic in Hillsborough, North Carolina, begins in Durham, passes through Medford and Cambridge in Massachusetts, and ends up 10 miles from the North Carolina Cancer Hospital, the clinical home of UNC Lineberger.
Pearlstein’s patients know him well. They bring their pets to appointments … sometimes. They talk, and he listens. He talks, and they listen. Together, they blaze a forward path, building relationships. A long hike, sometimes.
As a teen, he wanted to be an engineer. He focused on making things — like rockets. He graduated magna cum laude in engineering from Tufts University in Massachusetts. He worked in bioengineering — drugs and medical devices. So, medicine began to intrigue him. He went to night school — at Harvard University, no less — catching some prerequisites for medical school. “I think the bar was fairly low. Not like getting into real Harvard,” he laughs.
He chose UNC School of Medicine, not far from Durham, his hometown. So, yes, he bleeds two colors of blue. He can’t help it; his dad still works at Duke University.
‘It’s about the patients’
A year out of residency and an assistant professor in radiation oncology, Pearlstein is clear about his path and why he sits in Hillsborough several times a week. It’s about the patients.
“My interest is focused on quality of life and survivorship. Our patients are living longer. But there may be complications created by our treatments,” he said, meaning things done to target tumors with precision. “Sometimes, we don’t pay enough attention. We need to be asking ‘how does this affect you?’ ”
The N.C. Cancer Hospital clinic in Hillsborough meets a real need. When considering cancer treatment, it’s easy to forget that, during prolonged therapies, transport costs and parking fees are issues for many. You could say the Hillsborough clinic is close to his heart. “I’m passionate about it,” he said. “It’s a lot to go through to access treatment. And we’re meant to serve all people in North Carolina. Having a place like this makes it possible.”
His approach to medicine is holistic and focuses on individualized treatment. He sees people every day for months at a time. “Patients are going through a tough time. You form close bonds. You know them and the family.”
His patients run the gamut of cancers: breast cancer; prostate cancer; gastrointestinal cancer; head and neck; and brain cancer. “We in radiation oncology usually have a role. If not curative, radiation can provide palliative care to relieve symptoms.” A close relationship with patients “helps us tailor our treatments and better describe expectations for them,” Pearlstein said. “For roughly half the patients, we are treating them to get rid of the cancer. Half of them you know will lose the battle, but I can improve their quality of life with radiation.”
And that is why he also is focused on the patient’s downstream experience. In fact, during his residency training, he had a neck injury that sidelined him for months. He’s had to walk this uncertain footing. “Often, they have the same medical problems that other people have, but maybe more because of the cancer treatment that they got. You can’t lose sight of how it impacts them down the road.”
One great team
Of course, he cannot do it alone. He works with physicists and dosimetrists all the time. “Their roles are to help us figure out how to treat a patient. Should we use radiation? How much? These guys put my decision into a plan,” Pearlstein said. “The physicists tell me if our machines can execute that plan. The dosimetrists tell me the right dosage at the right spot, how to bring in the beams without affecting other areas.
“It’s difficult not to always focus on medicine,” he admits. “But you can’t live medicine your entire day. At end of the day, I can look back and know I helped these people.”
And what helps him cope with helping patients and their families deal with cancer? “I have support from all of oncology at UNC Lineberger,” he said. “We talk constantly, and I have social support outside.”
Extended family are close. His father is a neuroscience researcher at Duke, his mother a city planner, one sister is a nurse, and the other an architect.
“My wife, Michelle, is my rock.” Michelle also is a doctor — a dermatologist. Daughter Sophia, 16 months, and Banjo, a sort-of golden retriever rescue but with a curly tail and pointy ears, round out the home life picture.
And how does this family put medicine aside to relax and re-center?
You have to ask? They go on a hike.