Sean McBride, MD | New York

Sean McBride, MD

Radiation oncologist, GU and Head and Neck specialist

Memorial Sloan Kettering Cancer Center – New York, NY

Main site:
Several hundred patients on 10 linacs

Average treatment times:
7:30 a.m. to 7:30 p.m.

80 physicians (40-50 in Manhattan),
40-50 therapists (Manhattan),
1:1 physician:nursing

Special procedures:
All linac-based site, protons off-site (NY consortium), HDR and LDR brachy, intraoperative brachy for GI, GU and Head and Neck, on MR-linac (outpatient)

I have been in practice for almost 12 years now and have been the operational chief for the Manhattan site for about four years. I work closely with our executive vice-chair and our chair to help make sure our operations are running smoothly. I am also president of our medical staff at MSKCC that employs about 1,500 doctors.

Describe your commute.

I take the subway to Manhattan. It’s probably the quietest part of the day, about 45 minutes on a good day and closer to an hour when the trains are running behind, as they often are, with delays that are unexplained and unexpected. For the Brooklyn clinic, it’s a 30-minute walk, and that’s typically the extent of my exercise each week. For Monmouth I drive 45 minutes across the Verona Bridge, through Staten Island, and that’s a good opportunity to listen to podcasts and make work calls.

Describe your home life.

My husband and I have three kids, 9-year-old twins and a 5-year-old. My husband has worked at Google since 2007, with a brief break for business school. The kids are in two different public schools in Brooklyn which makes commuting a little bit of a hassle. They are the main reason why I can only get reading done on the subway.

Where do patients typically receive concurrent chemotherapy?

Every geographic location we have offers medical oncology and surgical oncology clinics so, for the vast majority of patients, the concurrent chemoradiation is delivered in the same building as radiation.

What are some of the challenges that your practice setting presents?

Manhattan is an expensive place to visit and can make for a difficult commute, but some services such as brachytherapy, proton therapy and the MRI-linac are only available in Manhattan. Traffic and parking create challenges to getting patients to treatment in a reasonable time and ensuring costs are not too significant.

What do you personally enjoy most about your practice setting?

I really enjoy my degree of sub-specialization and being able to practice with national experts. I’ve led our Head and Neck tumor board for 11 years now, and that’s one of the things I enjoy the most each week. I derive a lot of satisfaction collaborating with an experienced group of colleagues on the care of a complicated cancer. But easily the thing that I enjoy the most about my job is getting to know my patients at the consult and getting them through their treatment.

What drew you to the field of radiation oncology? And do those reasons still apply in your day job today?

Initially I wanted to go into neurosurgery but realized I didn’t have the attention span for surgery. I really fell in love first with H&N cancer in all honesty, and I really enjoyed brachytherapy with GU. I was particularly drawn to the ability to do definitive management. One thing I really enjoy about GU at MSKCC is we manage the systemic therapies in the localized and biochemically recurrent setting, including the second-generation AR-inhibitors. It’s obviously more work but something I really like.

What has changed the most in your practice, or even in the field, during your tenure?

It is easily the volume of oligometastatic patients: It’s been a sea change in terms of my referral patterns, especially prostate-directed radiation in the oligometastatic setting but also treating primary tumors for oligometastatic H&N cancers. And more broadly, the amount of SBRT across the board.

What worries you the most about the future, either of your practice or the field at large?

I don’t worry. I know there’s some anxiety regarding labor supply and competing therapies, but I have found the field to be incredibly adaptable. The things that we’re using radiation for today would have been difficult to predict 12 years ago. We have such creative people in the field that are constantly investigating expanded indications. Obviously every field of medicine has anxiety surrounding replacement by artificial intelligence, but if anything, AI will augment our ability to see more patients and to treat them more expertly.

What are you most excited about when looking ahead?

The thing that excites me the most is expansion of our field into the polymetastatic setting, and I look forward to some of the trials that are ongoing in that space. I also see a lot of excitement about some of the benign indications, and that’s really being led by our community practitioners. We’ve recently been exploring some opportunities for treatment of osteoarthritis with some of our colleagues up the block at HSS [Hospital for Special Surgery].

What does wellness mean in your life?

In part it means carving out time for you and your family. It grounds you because they’re not concerned about any of the work-related concerns you have. And so it’s a good escape to a certain extent. In the same vein, having a hobby outside of clinical medicine is a good thing. I’m a big history and legal dork and have tried to integrate law into some of the academic research I’ve been doing more recently. There’s a lot of legal issues surrounding telemedicine, for instance, but rad onc more than most specialties is well suited to utilize telemedicine and virtual care provision. But there are regulatory hurdles to implementing that. I enjoy writing on how we can think creatively about regulatory issues: rather than viewing them as barriers, using them as mechanisms to advance efficient clinical care.