
Education and Credentials
Medical Education: |
---|
Southwestern Medical School, Dallas, TX |
Internship: |
Johns Hopkins Bayview Medical Center, Baltimore, MD |
Residency: |
Johns Hopkins Bayview Medical Center, Baltimore, MD |
Fellowship: |
Johns Hopkins Hospital, Baltimore, MD |
Board Certification: |
Medical Oncology, American Board of Internal Medicine |
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Frequently Asked Questions (FAQs)
Frequently Asked Questions About Clinical Trials
Here are answers to some common questions you may have about clinical trials and what they mean for those diagnosed with cancer.
Clinical trials are research studies designed to improve treatment for those diagnosed with cancer. Some trials investigate new cancer drugs and treatments while others compare standard treatments with new treatments. Before a new treatment is offered to a participant in a clinical trial, it is carefully studied in the laboratory. All our current standard cancer therapies were once experimental research therapies evaluated in clinical trials. Only after clinical trials show one treatment to be superior can that therapy become a new standard treatment. All advances in cancer treatment must be evaluated through clinical trials.
People who participate do so for different reasons. Participation in clinical trials may offer the possibility of new therapies not available to all patients. Some of the research therapies prove to be major advances in treatment, some do not. Research trial protocols are created by the national experts in those particular diseases, so the quality of treatments chosen is high. Some people participate in hopes of helping future patients or future generations.
Our research team will assist you in determining if you are eligible for a clinical trial. Simply ask us if a clinical trial is available for your type and stage of cancer. Most clinical trials enroll individuals who are in reasonably good health other than a cancer diagnosis. A number of “eligibility criteria” exist to make sure the trial is safe for the participants. We will also determine final medical eligibility in accordance with the criteria of the trial protocol. You may qualify for our trials if you are an adult with a confirmed cancer diagnosis, are an active participant in your treatment plan, and are interested in learning more about potential novel treatments.
At Kaiser Permanente, we have a commitment to offer state-of-the-art treatment to our members with a diagnosis of cancer. At any one time, there are more than 30 cancer trials available for Kaiser Permanente patients within the KP Oncology Clinical Trials program (KPOCT). More than 300 Kaiser Permanente patients enter oncology clinical trials in Northern California every year. Interested members may be able to participate in promising new cancer treatments even before they are approved by the Food and Drug Administration (FDA) and available commercially to the general medical community. These new treatments are offered though the KPOCT program. This program consists of a team of oncologists, nurses, and research specialists who review and select clinical trials for our program. The majority (95 percent) of the clinical trials offered through Kaiser Permanente are multi-center trials conducted at university medical school cancer centers and other cancer treatment research centers across the U.S. Kaiser Permanente participates in national trials through national cooperative research groups such as NSABP (National Surgical Adjuvant Breast and Bowel Project), SWOG (Southwest Oncology Group), CTSU (Clinical Trials Support Unit), as well as selected pharmaceutical industry sponsored studies. Most people are not aware that Kaiser Permanente in Northern California is a major participant in these organizations and their trials. You can also find all available clinical trials at www.clinicaltrials.gov.
There are 4 phases to the clinical trials process: Phase 1 - Experimental treatments are evaluated to determine the best dosage and evaluate for side effects. Many treatments do not progress past phase 1. Phase 2 - Once dosage and side effects are known, trials are conducted to get an idea if the new treatment has a beneficial effect (a response rate) in a certain disease. More toxicity information is learned. Phase 3 - The new therapy is compared to the current standard therapy in a randomized trial to see which therapy is better. Phase 4 - After a therapy or drug is approved and felt to be a standard therapy, many more cases are reviewed in order to detect uncommon side effects or outcomes. We participate in mostly Phase 3 trials, and in some Phase 2 trials.
The doctors who conduct a clinical trial follow a carefully designed treatment plan called a protocol. This spells out what will be done and why. Our clinical research study protocols are designed by national experts to safeguard the medical health of patients and answer important research questions. Often a standard therapy is compared to a promising new therapy which we hope will be an improvement. The trial is the test to see which treatment is better. Medications that are not yet approved by the Food and Drug Administration (FDA) for another condition but that show promise for your condition are only given within the context of a clinical trial.
Whether you are in a research study or not, you face many medical appointments, examinations, procedures, and therapies. We will explain in detail the risks and benefits and answer all the questions you might have concerning specific clinical trials. If you join a research study, data on your case will be carefully recorded. Patients in clinical trials are followed very closely according to the research protocol. This close follow-up is often more structured than observation outside of a clinical trial.
If you are thinking about taking part in a clinical trial, some important questions to consider include: What is the purpose of this study? What kinds of tests and treatments are there? How does this compare to standard therapy? What are my alternative choices for treatment? What side effects can I expect? How does this compare to standard therapies? How long will the study last?
Informed consent, and understanding the research program you are agreeing to, is an important part of a clinical trial. It is a requirement in all research. You will be given an oral explanation as well as written information in order to understand what is involved in the trial. This includes possible risks and benefits. You will also be given the opportunity to consider taking part in the trial, ask all necessary questions, and freely choose whether you wish to participate. Those who decline to participate or later withdraw will continue to receive the best medical care. If you enter a trial you will be advised of new developments as the trial goes on. After signing the consent form, you are still free to leave the trial at any time. However, we encourage you to take your participation in the trial seriously and to agree to participate only after thoughtful consideration.
Not every patient chooses to participate in a clinical trial. Participation is completely voluntary. We will discuss clinical trials as an option to consider instead of standard therapy. You will never be enrolled in a trial without your knowledge and informed consent. Your treatment will not be affected in any way if you decline to participate in a clinical trial.
To find out about all of our available trials, call the Kaiser Permanente Oncology Clinical Trials Program at (707) 651-2786. The National Cancer Institute web page for clinical trials across the U.S. can be found at www.cancer.gov/clinicaltrials. The Cancer Information Service is a nationwide telephone service that answers questions from patients and their families. Spanish-speaking staff members are available. Call 1-800-4CANCER.
Frequently Asked Questions about Genetic Testing and Breast Cancer
Here are answers to some common questions you may have about genetic testing and breast cancer.
Genes are the instructions that guide the growth and development of your body. Your genes are located in each cell of your body. You are born with two copies of each gene – one inherited from your mother and the other inherited from your father.
There are genes that are important for controlling growth of cells in the breasts and ovaries. These genes are called breast cancer susceptibility genes. The two most common breast cancer susceptibility genes are called BRCA1 and BRCA2. There are other breast cancer susceptibility genes, but BRCA1 and BRCA2 are responsible for most inherited susceptibility to breast and ovarian cancer.
Everyone has two copies of BRCA1 and BRCA2 – one copy from each parent. In some families, there is a mutation (genetic change) in one of the BRCA genes. The BRCA mutation can come from either side of the family. A woman with a BRCA mutation has a much higher chance, or susceptibility, for developing breast and ovarian cancer. Even men in these families have a higher chance of developing breast cancer. While a BRCA mutation results in a higher chance of developing breast and ovarian cancer, it does not cause cancer. Not everyone who inherits a BRCA mutation will develop breast or ovarian cancer.
Not necessarily. Most breast and ovarian cancers that happen in families are not due to a BRCA mutation, but are caused by other factors. Only about 5 to 10 percent of breast and ovarian cancers are related to inherited mutations in BRCA genes.
BRCA mutations have been identified in families worldwide. There are certain risk factors that help identify who might carry a BRCA mutation. You have a higher chance of carrying a BRCA mutation if you answer “yes” to one or more of the following statements:
- I have had invasive breast cancer and ovarian cancer.
- I have had invasive breast cancer in both breasts.
- I had invasive breast cancer before age 40.
- I had invasive breast cancer before age 50 or ovarian cancer and my ancestry is Central or Eastern European (Ashkenazi) Jewish.
- I have had invasive breast cancer (especially before 50) or ovarian cancer and one or more of my close relatives has also had invasive breast cancer and/or ovarian cancer.
- I am a male who has had invasive breast cancer.
- I have a strong family history of invasive breast cancer (especially before age 50) and/or ovarian cancer.
Testing is most useful for individuals who are at high risk. If your personal or family history of cancer does not show any special risk factors, then you do not need to have genetic counseling or consider testing. However, you should still follow the routine screening recommendations for breast cancer.
Talk with your provider about your concerns. After reviewing your family history and your personal health history, your provider may refer you to a genetic counselor. Genetic counseling is the first step in determining if a BRCA mutation is in your family, and estimating the chance that you may have inherited this mutation. During counseling, the genetic counselor will review your medical records, your health history, and your family history of cancer.
A blood test is available to look for mutations in the BRCA1 and BRCA2 genes, but the test is not for everyone. Testing is most useful when your personal and family history of cancer shows a pattern of an inherited susceptibility to cancer. Your genetics consultation will help determine whether or not testing would be the best option for you.
Deciding about testing for a cancer susceptibility gene is very personal. It can have complex, and sometimes unexpected, emotional effects. One important part of genetic counseling is helping you explore what testing means for you and your family. Your genetic counselor will discuss the pros and cons of genetic testing, including emotional aspects, impact on the family, confidentiality of results, and cancer screening options.
A positive BRCA test means a mutation has been identified in one of the BRCA genes. A woman with a BRCA mutation has a lifetime chance of developing breast cancer that may be as high as 85 percent, with a chance of at least 15 percent that she will never develop breast cancer. It also means that she has a high risk of ovarian cancer. Men with a BRCA mutation may be at higher risk for breast and other cancers.
Some people who get a negative test result are relieved. Others who test positive use the results to help plan their medical care and personal decisions. Screening more often and starting at a younger age may help find breast cancer early when it can be successfully treated. You may also want to consider certain surgeries that could help to reduce your risk of developing cancer.
A negative test may give some women a false sense of security, so they may not come in for routine mammograms and breast exams. Testing positive can create stress, especially if no clear plan of action is in place to deal with the results.
After reviewing your medical history and obtaining a detailed family history, we offer testing to our members (female and male) who are found to be at risk for carrying a mutation in a cancer susceptibility gene. We also offer online education, group classes, and individual genetic counseling. Our genetics Web site www.genetics.kaiser.org has additional information.
Health Tools
Office Visit
Office Visit
Table of Contents:
Getting Here
- My office address, maps, and transportation instructions are included in "Offices and Directions".
- Please arrive 15 minutes early to allow time for parking and check-in.
- Please bring your Kaiser Permanente medical card and a photo ID, like your driver’s license, with you.
Before Your Visit
Please bring your medications with you.
- It’s important to know which medicines, and how much of each, you are taking because it influences recommendations for tests or other medicines you might need.
- Our electronic medical record tells us what has been prescribed, but only you can confirm what you take every day. This includes prescription medications as well as over-the-counter drugs, such as aspirin, vitamins, herbs or supplements.
- We can talk about renewing your prescriptions during the visit, or if you already have a prescription, you can pick up a refill at the pharmacy while you are here.
Think about the questions and issues you would like to discuss.
- It is a good idea to write them down and bring them to our visit.
Remember to bring your forms.
- If we sent you a form or questionnaire, please complete as much as you can and bring it with you to our visit.
- If you have a form you need us to complete. Please bring it with you. Remember to tell us when you need it completed and returned.
During Your Visit
Before you see me, you will meet with my Medical Assistant (MA).
- My MA will call you in from the waiting room, will take your vital signs, record your weight and bring you to the exam room.
- You will also be asked whether you smoke and if you exercise. If you do smoke and are ready to try to quit, we will give you information about the many services we provide to help you quit.
You'll receive a Preventive Health Prompt.
- Your Preventive Health Prompt lists all of the preventive tests screenings and immunizations you have had in the past as well as when you are due for your next test or screening. We can discuss and schedule any preventive tests that you need.
We will review your medical information, which is readily available through computers in our exam rooms.
- We can review your lab results and x-rays during your visit. I can order any tests, x-rays or medicines that you’ll need. You will not need a paper prescription or lab order form. After I submit the order, you just go to the laboratory, pharmacy or radiology department and present your card.
You will have a physical examination.
- We will discuss your medical history and any current symptoms you are having.
- Based upon your symptoms I will conduct a thorough ears, nose and throat examination and explore your facial features. I may also use instruments to get a better look inside of your ears, nasal and sinus cavities and throat areas.
Tests in the office.
- We perform certain tests here in the office. These tests include Endoscopy and Fine Needle Aspiration. If you need these tests, I’ll explain them during your visit and then schedule a follow-up appointment.
Please ask questions.
- It is always good to ask questions and voice any concerns you may have about the instructions, medical tests, medications, or treatments. If you don't understand my answers, please ask for more information.
Before you leave, my MA will give you a copy of your After Visit Summary.
- This summary includes my name and the date and time of our visit, your vital signs, my test orders and your medications or immunizations. It usually includes the instructions I’ve given you during our visit and any follow-up information.
- You can refer to your After Visit Summary if you forget what we discussed, or if you want to recheck your vital signs and weight. You can also view your After Visit Summary online.
After Your Visit
Referrals.
- If we talked to another specialist by phone during your visit, we will decide if you should follow up with that specialist or me for additional issues or questions.
- If I referred you to a specialist and scheduled an appointment, you will receive an appointment reminder in the mail.
- If we did not book any other specialty appointment during your visit, you will be contacted by that specialty department to arrange an appointment.
Test results.
- If you had lab work or other tests done, I’ll contact you with your results by letter, email or phone.
- You may view your results online. They are often available online before I contact you, so my comments and recommendations usually follow separately.
Follow-up questions/activities.
- You can contact me by secure email for non-urgent questions. It’s direct communication with me and I am usually able to respond to questions in 24-48 hours. Logon to kp.org with your password.
- You can call my office to schedule an appointment or speak to an advice nurse.
- My surgery scheduler can be a contact person for you if you have any questions related to surgery.
- From my homepage, you can also refill your prescriptions, book future appointments, view your test results and review information about past visits.
Offices and Directions
Gaithersburg
Gaithersburg, MD 20879
Profile
Welcome to my Web page. You’ve taken a positive step in improving our communication, which is so vital to your health care. First, you should know that you’ll be treated by top hematology/oncology physicians, as well as the most caring nurses and staff. You’ll be offered a wide range of options for possible treatment, including chemotherapy (intravenous or oral), biologic therapy, targeted therapy, and opportunities to participate in research trials. All of your specialists, from your surgeon to your oncologist to your pharmacist will have access to your labs, records, radiology films, and care plans. We’ll supplement your care with the power of the internet, so you can email your physician and fill prescriptions from home. Please see the links on this page to contact me and for additional resources.
My advice to patients:
Call us with any concerns. Cancer care can be complicated; we can give you answers and reassurance.
Please bring a family member or a good friend to your first visit and to other important meetings with your physician. Having the support of a person you trust can be vital to making our meetings fruitful.
My goal is to give you the longest and best quality of life possible. Please communicate your goals and priorities to me so that I can help you fulfill your goals.
Stay positive. The therapies are so much easier and more effective than they used to be.
Awards & Recognition
- Top Doctor, Washingtonian Magazine, 2010, 2012, 2014, 2015, 2016, 2017
- Super Doctor, Washington Post, 2012, 2013
- Top Doctor, Washington Consumers' Checkbook, 2011, 2017
- American Cancer Society Health Care Hero Award, 2010
- Daily Record Physician Finalist Health Care Heroes, 2010
- America’s Best Doctors – Consumer Research Council, 2005-present
- Cancer Research Institute Postdoctoral Fellowship Research Award, 1996-1998
- Cum Laude, Yale University, 1987
About Me: Outside the Office
Family and Friends
Wife: Evelyn Tang, attorney at the Department of Justice
Children: Aaron and Natalie
Hobbies and Interests
Running, member of Montgomery County Road Runners
Ran in the National Marathon, spring 2010
Swimming, previously a member of Montgomery County Ancient Mariners
Recent adventures
Winter camping with my son’s Boy Scout Troop
Visited China with my family
Roles and Responsibilities
- Oncology Service Chief
- Member, Mid-Atlantic and Ohio Institutional Review Boards
- Member, Mid-Atlantic Ethics Committee
- Principle Investigator, Cooperative Trials Study Unit
My Colleagues
Dr. Matilda So, Largo, Permanente oncologist and hospitalist for 20 yrs
Dr. Mahrukh Hussain, Largo and Shady Grove, Permanente oncologist for 7 yrs, from NCI
Dr. Elizabeth Pfaffenroth, Largo, Permanente oncologist for 2 yrs, from NCI
Dr. Piyapong Vongkovit, Shady Grove and Capital Hill, Permanente oncologist for 1 year, joined from private practice in North Carolina
Dr. Pamela Seam, Largo and Capital Hill, just joined our medical group, specializes in oncology and hematologic disorders
Dr. Nitin Verma, Shady Grove, just joined our medical group
My Staff
We have great staff supporting the oncology department. Our staff at Largo received an award for their service excellence Largo in 2009. Our staff at Shady Grove are consistent a top performer in patient satisfaction surveys.
What My Patients Say
Dr. Hwang was terrific: encouraging, positive, and caring. He's the best. Also, the nurses in the oncology ward at Gaithersburg are exceptional. They treat you like you're family. What incredibly fine people! - JR
I received exceptional, all-encompassing care with Dr. Hwang as the lead. Dr. Hwang restored my health and prolonged my life with his knowledge, honesty, encouragement, and compassion. Communicating with him is easy. He’s so thoughtful that when I emailed him on important matters regarding treatment, he takes time to telephone me, usually the same day, to discuss whatever I’m going through. Dr. Hwang consistently gives thorough options, as well as the research behind the options. - MB
I have been seeing Dr. Hwang and his staff for years now and overall received excellent care and concern from both Dr. Hwang and his staff. I appreciate greatly Dr. Hwang's willingness to coordinate my care with my oncologists at NIH from whom I have also been receiving care and treatment since 2000. I admire Dr. Hwang's commitment to supporting drug trials and other treatment trials in an effort to provide the best and most appropriate care for his patients. - SR
I had a very pleasant experience with Dr. Hwang from day one when we met him for consultation. He was straightforward and very knowledgeable on the discussions we had with him. When I went back for my visit after the surgery, he was very patient and explained about the medications I needed to take and the required follow-up with him. He made both my husband and I feel comfortable and we felt confident on follow-up treatment with his guidance. Thank you Dr. Hwang; I look forward to seeing you for my future appointments. - GS
Dr. Hwang is my cancer doctor. He has been very responsible and very helpful in fighting my cancer. Thank you very much Dr. Hwang for your excellent work and care for me! - DF