LUCY SCHULTZE

David McIntosh, MD, can envision the University of Mississippi Medical Center reaching across the state to help doctors and patients improve the realities of life after cancer.

But first and most importantly, patients have to live through it.

"The need is so great, and I'm seeing so many people with advanced cases," said McIntosh, who joined the University of Mississippi Medical Center in October. "It seems critical to focus on diagnosis and treatment first."

While survivorship and quality-of-life issues remain his passion, the past several months have shown him that his efforts here must first be directed to Mississippi patients' most urgent needs.

McIntosh was recruited to UMC by obstetrics and gynecology chair Bryan Cowan, MD, to serve as a professor and director of the Division of Gynecologic Oncology. He comes to Mississippi from Columbus, Ga., where he spent 10 years as director of women's health at the John B. Amos Cancer Center.

"I was at a point in my career where I was looking for another opportunity to help people," he said.

Rural outreach and survivorship efforts have been hallmarks of McIntosh's career in his previous posts. His work in Columbus included helping develop a free-standing cancer center in west central Georgia, and focusing on outreach to disadvantaged and rural populations.

Before moving to Georgia, he worked in the department of obstetrics and gynecology at Rush Medical Center in Chicago and at the University of Nebraska Medical Center. In Nebraska, he developed two rural outreach clinics for patients with gynecologic cancer, and worked with the state health department to establish a cancer screening program.

McIntosh devoted his career to fighting cancer after seeing members of his own family stricken with the disease. He also came of age as part of a generation which, in the 1960s and '70s, strode toward the goal of "curing cancer in your lifetime," he said.

He graduated from the University of Texas Southwestern Medical School, then pursued residency training in obstetrics and gynecology at the University of Oklahoma Teaching Hospitals. He completed a fellowship in gynecologic oncology at the University of California-Los Angeles in 1986.

A relatively young sub-specialty with only a few hundred practitioners nationwide, including three others in Jackson, gynecologic oncology strikes a balance between expertise and versatility.

"We view ourselves as a comprehensive field," McIntosh said. "We are able to give our own chemotherapy, do the surgeries that are necessary and then see our patients long-term in the office."

Although patients who live outside the Jackson area may only see him for a consultation or part of their treatment, the ability to follow patients through the entire cancer journey makes for a special connection between doctor and patient.

While providing a comforting continuum of care for patients, the practice also minimizes the discord that can arise when multiple specialists must be involved in the same case, McIntosh said.

"Years ago, you might have had to include a general surgeon, a urologist, a gynecologist, then after surgery pull in specialists for radiation and chemotherapy," he said. "Right away, you've got five specialists plus the patient's family doctor – and those doctors don't necessarily always agree."

In McIntosh's case, stepping into those various roles at UMC has meant tackling several major surgeries within his first weeks, while also diving into the administrative tasks of establishing a full-time department of gynecologic oncology. He's meanwhile been working to develop the resident teaching program, answering urgent referral calls and simply getting adjusted to his new work environment.

McIntosh sees patients both at the UMC Cancer Institute in the Jackson Medical Mall as well as at the main campus. After several months on the job, he can already tell it's more than a full-time job – so much so that the university is looking to hire another gynecologic oncologist in the coming year.

"I've seen some very, very sick people here, and that makes you think people aren't being diagnosed very early," McIntosh said.

He hopes that the presence of specialists in the field of gynecologic oncology will not only help in treatment but also spur earlier diagnoses.

"If you have this sense that you diagnose something and have no one to send them to, it makes you less aggressive about evaluating problems," he said. "We want to reverse that situation for the doctors and the patients."

As the next step – improving survivorship – comes to the forefront, McIntosh is focused on first gaining an understanding of the different kinds of cancers Mississippi patients are dealing with and the different ways they experience fighting it and living through it.

"A lot of people, once they get past the fear of dying, have to come to grips with living with having had cancer," he said. "There is no road map for that, but we need to develop those road maps for each type of cancer and for different types of people."

For example, he said, people who live in large urban areas are likely to have different ideas and resources than people who live in rural Mississippi. Therefore, different strategies are needed to help them through the cancer experience.

"Ultimately, we'd like the arms of the university to reach out to the state not only for therapy and diagnosis, but also for life after cancer," he said.

Outside of work, McIntosh is active in his church and is buying his first Ole Miss season tickets for football this fall.

He and his wife, Cathie, have three grown children and two grandchildren.