Samuel L Washington, III, MD
Growing up in Houston, Dr. Sam Washington was the kid with the volcano kits, the chemistry sets, and a circle of family friends who happened to be surgeons. A peek into the operating room at 16 set him on a path that would lead from UC Davis to UCSF, with a focus on community-driven cancer research. Below, Dr. Washington talks about how his work connects the lab, the clinic, and the community to make cancer care more personal and equitable – and why he chose to do it at UCSF.
A. I grew up in in Houston, Texas. I didn't have any immediate family in medicine, but thankfully, we had family friends who were doctors. When I was seven, they started talking to me about medicine. One was a surgical oncologist, another was a plastic surgeon, and then another was a cardiothoracic surgeon. So, they're all trying to recruit me to the surgery side of things, and the idea of cardiothoracic surgery was very interesting after they told me what they did. But again, I was seven,
My family was happy I was interested in science, so they nourished that as much as possible with books, science kits, anything I could get my hands on. My mom made sure that anytime we had to do a career day or talk about heroes, it was always related to medicine.
So, Dr. Charles Richards Drew and his impact on blood transfusions and medicine were often the topic of book reports. Finally, there were a lot of chemistry sets, volcanoes, electrical wiring boards to explore.
Then, we moved to Sugar Land, TX, and there I got my first exposure to medicine in high school.
A. I was around a lot of people who also wanted to be doctors, and none of us knew what that meant. So, all of us were trying to shadow people and understand. One of the family friends, the surgical oncologist, threw scrubs and a white coat on me and brought me into the operating room when I was 16 years old. It was amazing! I was able to see him remove a breast lump, and it kind of cemented what I wanted to do. After high school, I left Texas to go to college at UC Davis.
A. I wanted to do medicine, but I did not want to do the standard pre-med things, so I did genetics. That was a great opportunity for me to understand different aspects of medicine, get more insight and how genetics may impact cancer. That was a way for me to explore something I was interested in that I could potentially use later.
A. Yeah, and I was trying to figure out research fit into that. I wanted to pick something that's interesting and wouldn’t be a chore for me to do in college. I also had to tutor to pay bills, but I had time to volunteer in clinics and do community service around medicine to help me get broader exposure.
A. Yeah. I wasn’t sure how to combine thoracic with cancer because I hadn't seen enough in surgery or medicine to know how those two fit together. Now, thoracic oncology is an entire field, and we have it here at UCSF.
A. In 2007, I was lucky enough to get accepted to UCSF for medical school, and things really opened. I had opportunities after the first year to shadow and do bench research at Stanford, and that's where I realized I don't like bench research. I was much more interested in clinical research and how we approach it.
In the second year of medical school, I met Dr. Peter Carroll, and that set me on the path toward urology and academic medicine. That led to a year of research with him before my third year of medical school.
A. Dedicated and invested! I expected to have to work mostly alone in figuring things out, which was my experience at Stanford.
So, being at UCSF and meeting with him regularly and seeing his interest in what I was doing in and outside of the working work group meant a lot. The fact that there were projects and opportunities to work with the entire team was just so different. I started to see how the questions Dr. Carroll posed in clinic fed into the research, and then how the research fed back into the clinic. A new paradigm for me, I was lucky to benefit from that mentorship… it helped me understand what urology looks like at UCSF and elsewhere.
A. During my residency at UCSF, a fellow encouraged me to investigate that path. During that time, I began to really refine my focus. I transitioned away from other people’s projects and began thinking about my own. Understanding how care varies from place to place in the US led me toward interventional research and care.
Dr. Sam Washington, urologic oncologist at UCSF and member of the Prostate Cancer Action Network (PCAN) of the San Francisco Cancer Initiative (SFCAN) during prostate cancer awareness event at Mission Bay.
A. There were other places that did amazing work, like University of Michigan, UCLA, University of Washington, and Vanderbilt, but it seemed like UCSF was the only place with the right mixture of formal training and interactions with people throughout the university – but in a way where I wasn't directly overlapping with someone else doing the exact same thing.
A. I was lucky enough to work with community groups and organizations from training, but that was largely limited to giving talks at different health fairs. Being on faculty brought a new opportunity to be directly involved with research, and from that, I saw opportunities for me to drive some of that research or guide it different ways. And that's where it really became a question of practical implementation of all we’ve documented about how care differs and how it should be improved.
For me, it became less about just generating observations broadly and more about how we can generate more information to create a path toward intervening and improving. For example, my community partnerships transitioned from just giving talks and health fairs to bi-directional discussions and partnerships. So, how do we work together on funded research? How do we tailor the research towards the needs of that community?
A. I’m in two worlds at times. In the urology space, I still have Peter Carroll, Seema Porten, and Matt Cooperberg and others as mentors. And I’ve built relationships with Nynikka Palmer, Rena Pasick, and Kim Rhoads for a lot of the community work. Also, June Chan, Salma Shariff-Marco, and Scarlett Lin Gomez on the epidemiology side of things. I also work with the men’s health committee under the Cancer Center’s Community Advisory Board and am the formal liaison between our prostate cancer program and our Office of Community Engagement.
A. Thank you. I’m excited for the support from the Prostate Cancer Foundation (PCF). This project represents an ongoing partnership with the Black Men’s Health Committee to improve prostate cancer care and survivorship within the communities of the Greater Bay Area. Since residency, I’ve worked with community members at various events such as health care screenings and fairs, but this was our first opportunity to develop a project together in a more formal way.
In our discussions, there were several goals that guided our planning: 1) creating a project that was responsive to the needs of the local community; 2) providing opportunities for engagement with institutional leadership; and 3) creating a process, rather than a product, that would not be limited or restricted to just UCSF patients.
Prior work has shown that individuals with a cancer diagnosis who are also navigating non-clinical factors, such as food insecurity, transportation barriers, and financial instability, are at greater risk of suboptimal treatment and outcomes for prostate cancer. These factors are related to more commonly reported socioeconomic measures such as income, education, and insurance, but have not been consistently reported. This knowledge gap represents an opportunity to identify ways to personalize cancer care for these patients through their cancer journey.
With support from the Prostate Cancer Foundation, we aim to measure the social needs burden in prostate cancer patients and intervene upon these needs through a community-partnered approach that incorporates feedback from community members and integration of local supportive resources.
A. The Urologic Oncology Fellowship Program at Uganda Cancer Institute will be a two-year program consisting of one year of didactics and clinical experience, and a subsequent year dedicated to research/academic work. The fellowship is designed to provide comprehensive training in urologic oncology, including surgical skills, clinical management, and research expertise that will meet local, regional, and international standards.
Urologic cancers account for over 20% of all cancers diagnosed among men, with prostate cancer being the most common. Uganda has the highest prostate cancer burden in East Africa, with an estimated incidence of about 37.1 percent per 100,000. Despite this high urologic cancer burden in Uganda and the Greater East Africa Region, there is currently no training program in urologic oncology in the country or the region.
The available training programs outside the region are very expensive, and this has hindered training a specialized workforce.
This training program will be in partnership with the UCSF Dept. of Urologic Oncology, Mulago National Specialized and Referral Hospital, College of Health Sciences-Makerere University, and Erenst Cook University. The program includes a didactic component (self-driven reading, physical and online presentations, lectures, and tutorials), clinical teaching faculty from the collaborating institutions/organizations, combined with a four-week observatory at a high-volume urologic oncology center of excellence in the US. It also includes dedicated research time to develop research projects and protocols.
This effort would not have been possible without the dedication of several teams, including Drs. Godfrey Nabunwa and Henry Dabanja at Uganda Cancer Institute; Dr. Kit Yuen at University of Colorado; UCSF faculty, Drs. Sima Porten and David Bayne; partnerships with Drs. Scott Eggener, Michael Large, and Kelvin Moses through International Volunteers in Urology. Furthermore, support from Dr. Benjamin Breyer, chair of the UCSF Dept. of Urology; and the UCI leadership were integral to this program being the first urologic oncology fellowship program in sub-Saharan Africa.
A. My research and clinical practice are becoming increasingly integrated. Our clinical mission to provide the best cancer care drives the research.
My research focus has progressed from identifying observed drivers of regional variations in clinical care to developing interventions to mitigate local drivers impacting cancer care for our patients. I believe this is a natural progression from observational studies towards more prospective interventions grounded in an implementation science framework, informed through community partnerships, and supported by UCSF values and mission. These efforts are also well-aligned with our new Cancer Health Outcomes SPORE grant, titled Interplay of Tumor Genomic and Immune Characteristics and External Drivers to Improve Cancer Health Outcomes SPORE, recently funded by the NCI.
In my role as co-director of the Community Outreach and Engagement Core, with Dr. Scarlett Lin Gomez, we work to ensure that this work remains responsive and relevant to the communities’ lived experiences and will ultimately advance cancer health for our patients. UCSF and our department have been at the forefront of innovation in cancer research and care, and I look forward to contributing to this legacy of building community relationships and bridging the gap between the institution and surrounding communities.