First person profile: Jennifer S. Temel, MD

Abstract

Pioneering work by Jennifer S. Temel, MD, has filled a large gap in cancer care. Although new treatments over the past decades have extended the lives of many patients with cancer and improved the quality of their lives, support for a myriad of physical and psychosocial needs accompanying a cancer diagnosis through treatment and end-of-life care for both patients and caregivers has lagged.

Dr Temel has changed that by developing a model that transformed palliative care from being an exclusive offering for very ill and hospitalized patients near death to an option for all patients with cancer at the time of diagnosis. Moving palliative care upstream in the outpatient setting and delivering it over the course of a patient’s illness have been demonstrated during more than 20 years of research to improve the patient experience as measured by patient-reported outcomes. It also improves a patient’s health care delivery, she says.

Findings from her research have been published in major medical journals. For example, a 2010 randomized study published in The New England Journal of Medicine showed that early palliative care significantly improved the quality of life and mood of patients with metastatic non–small cell lung cancer.¹

Two recent randomized studies published in 2024 in JAMA also demonstrated the efficacy and scalability of early palliative care. One showed the effectiveness and scalability of a stepped palliative care approach in which patients receive palliative care visits at key points in their cancer trajectories; when a decrement in quality of life is noted, more intensive palliative care is administered.² The other demonstrated the effectiveness and feasibility of delivering early palliative care via telehealth.³

“A big piece of palliative care, especially when provided early in the disease in an outpatient setting, is about things like coping, living life to the fullest with a serious illness, and also things like accepting and understanding what the illness and prognosis mean,” says Dr Temel.

Because of her work, early palliative care is now recommended as the standard of care for patients with serious cancers by all national organizations, such as the American Society of Clinical Oncology and the National Comprehensive Cancer Network.

Dr Temel is a professor of medicine at the Harvard Medical School, a thoracic oncologist at the Massachusetts General Hospital (MGH) Cancer Center, and the Barbara McCue Endowed Chair in Oncology and Cancer Outcomes Research at MGH.

Although she wanted to be a physician from a young age, becoming an oncologist was not preordained. A thorny problem presented itself that made her think twice—a huge fear of blood. In college, she chose to work in a laboratory to see if laboratory science might be a better fit than being a physician. As chance would have it, her laboratory was in the cancer center building, where she witnessed patients with cancer and their suffering daily. “It made me realize what I wanted to do and encouraged me to overcome any kind of fear and figure out how to do it,” she says.

That is what drew her to oncology and to care for patients. She earned her medical degree from Washington University, held her first oncology appointment as a faculty member in hematology and medical oncology at MGH, and joined the Harvard Medical School. She is also a Hostetter MGH Research Scholar (2017–2022) and a co-leader of the Dana–Farber/Harvard Cancer Center Outcomes Research Program.

She has continued her more than 20 years of research in palliative care as an investigator in and codirector of the Cancer Outcomes Research and Education (CORE) Program at MGH. She and her team currently are focusing on developing a number of digital tools and apps to increase access to supportive care services because of the lack of sufficient staffing (psychologists, social workers, and other supportive physicians) for palliative and supportive care. “Our team is building digital health apps and digital videos and other types of digital modalities for interventions to increase scalability and dissemination,” she says.

A second focus is caregiver research, which her team has been studying for the past 10 years. “Caregivers of patients with cancer also often have unmet needs that go under-addressed and under-acknowledged,” she says, adding that she and her team are building a caregiver research program.

Areej R. El-Jawahri, MD, associate professor of medicine and associate director of the CORE Program at MGH, met Dr Temel as a third-year medical student. She has worked under Dr Temel’s mentorship throughout her research career and cites Dr Temel’s passion and unwavering commitment to improving the lives of patients living with cancer and their families as her number one strength.

Dr El-Jawahri says that Dr Temel’s other strengths include her immense capacity for bringing people together to address complex problems facing their patients and families as well as building transdisciplinary collaborations with colleagues to study how best to improve the quality of life of people with cancer and care for them.

Dr El-Jawahri also cites Dr Temel’s expert leadership abilities, including the founding of the Supportive Care Research Group (later called the CORE Program) in 2006 as a way to expand research. Composed of clinician researchers from oncology, psychiatry, psychology, nursing, and palliative care, the program has grown from three researchers to more than 30 faculty members. “CORE is unique with respect to its multidisciplinary representation, genuine collegiality, and rich integration of clinical practice informing science and vice versa,” says Dr El-Jawahri.

“Dr Temel’s collaborative approach is noteworthy,” she says. “While most researchers ‘stay in theirs’ or focus their scope of research on their area of expertise, Dr Temel possesses the inquisitiveness, humility, and leadership skills to elicit valuable contributions from senior researchers and trainees outside of medical oncology.”