Faces of Cedars-Sinai: Hematologist-Oncologist Dr. Noah Merin
Sep 28, 2020 Cedars-Sinai Staff
We talked to Dr. Merin to learn more about what drives his passion for treating and curing these types of cancers, the latest advancements in blood and marrow transplants, and why there's a need for healthy people to join the donor registry.
Have you always wanted to become a doctor?
Dr. Noah Merin: I wouldn't say I always knew I wanted to be a doctor. I went to liberal arts college and took classes on every subject. I was interested in the arts and also did some lab work, where I started to get an understanding of how the body works.
After college, I spent two years doing research, and that's when I realized I knew I wanted to do medical research and clinical research. My entry into medicine was through the research side.
What made you decide to focus your medical expertise on blood and bone marrow transplants?
NM: As an intern, I worked with some inspiring physicians in blood and bone marrow transplant and saw they had long relationships with the patients they were treating—and that the patients would put so much trust in their physicians.
In oncology, there's this perception that blood cancers are chronic diseases that are managed. This is true for many diseases in hematology, but some of the worst, most life-threatening hematologic cancers are also some of the most curable.
What's driving the field is the realization that we can try to cure these cancers more safely. One of the contributions I made when I came to Cedars-Sinai was bringing newly developed techniques to help block graft vs. host disease (GVHD) following allogeneic stem cell transplantation. GVHD can occur after a bone marrow or stem cell transplant and can be life-threatening in some cases.
That's been a big change that has resulted in the benefit of our patients, using the newest form of blocking an unwanted immune reaction that can happen after a transplant.
What's the most challenging part of being a hematologist-oncologist?
NM: There's a lot of art in communicating the unknown to patients. I'm sensitive to how stressful this uncertainty is for them. Sometimes ambiguous news is harder to deal with than bad news.
Part of my job is helping people make decisions by weighing their comfort level with different possible outcomes, like the trade-off between a short-term treatment that decreases quality of life in exchange for a longer life, or being cured and having a higher quality of life and taking a greater risk to get that benefit. Conversations like that happen every day in my field.
What is the most rewarding part?
NM: Working in my field is such an incredible gift. With the scientific research and clinical trials we have now, it's amazing what we have to offer our patients. Overall, our ability to safely cure patients is improving.
I like to see my patients go on vacations, just have a good time and go back to doing what they want to do. I don't think treatment should interfere with patients' lives too much.
I tell patients that I work for them. If they communicate their goals, I can help them achieve these goals. If a patient says, "I can't go to my daughter's graduation because it's the same day as my chemo," I say, "Let's adjust your treatment so both goals can be achieved."
What do you think people should know about donating bone marrow or blood stem cells?
NM: I encourage people to come and donate. We have a need for their plasma, their platelets and red blood cells. Our existing blood donation program still depends on healthy donors.
If people are worried about visiting a blood donation center, I would like to dispel the fear that they might contract COVID-19. There is no transmission of coronavirus taking place at any of our hospital facilities. Donors are safe and welcome to come and donate.
If you have had COVID-19 and recovered, we also need people to donate their convalescent plasma to be used in clinical trials.
What do you like to do for fun?
Is that where you're from?
NM: Yes, I'm from Sacramento, which I consider the best city in California. It's a great place to live and visit—close to the mountains, Lake Tahoe, Napa Valley, San Francisco, etc. You can ride your bike everywhere and there's a lot going on culturally.
There's a reputation for Sacramento being boring, but people just don't know how to access its delights. People would be well-advised to spend some time there.