Hoosier Cancer Research Network, a nonprofit cancer research organization in Indianapolis, recently welcomed Annette Moore, MD, as a member of its board of directors.

A medical oncologist/hematologist at Community Howard Regional Health in Kokomo, Ind., Moore earned her medical degree from the University of Mississippi and completed her internal medicine residency and fellowship in hematology/oncology at the Indiana University School of Medicine.

Moore’s path to practicing medicine took an indirect route. Raised in Cedar Rapids, Iowa, she inherited a technical aptitude — “a good combination of genes,” she says — from her mother, a dental assistant and homemaker, and father, an engineer. She earned her bachelor’s degree in medical technology from the University of Iowa in 1986.

After a series of moves and job changes, Moore accepted a management position in the pathology and clinical laboratories at the VA Hospital in Salt Lake City. Part of her role at the VA involved teaching pathology fellows about bone marrow biopsies. She would accompany the fellows to conduct the biopsies and return to the lab for analysis and diagnosis. It was her first exposure to patients in a clinical setting.

“You would hear the patient’s story, do the bone marrow, and eventually make a diagnosis,” said Moore. “I thought it was fascinating, putting all the pieces together and actually having a face and a story behind a diagnosis.”

A Move to Medicine

A pathologist with whom Moore worked, Dr. Robert Lynch, noticed her interest in the patients. “He looked at me one day and said, ‘Why didn’t you ever go to medical school?’ And I said, ‘I don’t know.’”

That conversation sparked Moore’s transition to medical school at the University of Mississippi, and later to the Indiana University School of Medicine. She notes the valuable mentorship she received from Dr. Patrick Loehrer, Dr. Larry Einhorn, and others, during her fellowship at IU.

“Dr. Loehrer gave me a lot of opportunities — the opportunity to write a chapter in a textbook, the opportunity to publish, and research opportunities,” she said.

“The biggest thing I learned from Dr. Einhorn,” she continued, “was how to be a good communicator, not only with your patients, but also with your colleagues. He always stressed how important it is when someone refers a patient to you to make a personal connection back to them, to ensure they know what the treatment plan is.”

Moore was involved in research from her first year at IU — a rare opportunity for fellows at many institutions, but not so at IU. “It’s one of the things you’re expected to do,” she said. “You’re expected to rise to the occasion, to buckle down, get the information, understand it, and present. It’s an honor and an expectation.”

Moore participated in two Hoosier Oncology Group studies during her fellowship — GI00-11 (pancreatic cancer) and LUN02-50 (non-small cell lung cancer) — and presented at a poster session for the GI00-11 study during the ASCO 2004 annual meeting.

Finding the Right Track

During her fellowship, Moore spent a year and a half wrestling with the track she would follow in oncology. Ultimately, her interest in working with older patients led her to pursue geriatric oncology in a community setting.

In 2006, Moore began her tenure as a medical oncologist/hematologist at Howard Regional Health System. She also served as the Hospice Medical Director (Howard County) for VNS HealthCare System from 2008-2012.

Moore’s experience with hospice resonated deeply with her desire to provide a continuum of care for her patients. Serving in this dual role allowed her to maintain the relationship with her patients through all stages of care, rather than referring to another provider.

“I always felt I was abandoning them,” she reflects. “And I think patients felt that, ‘You mean this is my last office visit?’ It’s not a natural transition by any means.”

Moore’s focus on a continuum of care is evident from her first consultation with a patient. She still uses a technique she learned from Dr. Larry Cripe during her fellowship: using pencil and paper, she draws an algorithm for her patients, outlining treatment options through all steps of the patient’s care, including end-of-life care.

“I have learned from my role in doing this to set the expectation in people’s minds that hospice is not a negative thing,” she said, “but it’s going to be a part of cancer care for most people. And I think patients appreciate that.”

A Focus on Community

After nearly a decade practicing in Kokomo, Moore notes the changes she has seen: the rise in the number of uninsured or underinsured patients and the increasing prevalence of those who delay treatment for financial or other reasons, missing the opportunity for earlier and more effective intervention.

Change has also brought opportunity. In 2012 Howard Regional Health System joined the Community Health network, which is affiliated with the MD Anderson Cancer Network®, a program of The University of Texas MD Anderson Cancer Center.

“When you have a larger group of oncologists — radiation oncologists, medical oncologists, and surgical oncologists — you can generate a lot more ideas. And we have a lot more support,” she said.

Despite the organizational transitions, the oncology team at Howard Regional has been remarkably stable over the past decade. “It’s like family,” Moore said. “We have the same office staff and the same chemotherapy nurses. I have one partner who also trained at IU. We’re all under the same roof.

“I know all my patients, and I know their family members,” she continued. “It’s a small community, and they know us.”

About Hoosier Cancer Research Network:

Hoosier Cancer Research Network (formerly known as Hoosier Oncology Group) conducts innovative cancer research in collaboration with academic and community physicians and scientists across the United States. The organization provides comprehensive clinical trial management and support, from conception through publication. Created in 1984 as a program of the Walther Cancer Institute, Hoosier Cancer Research Network became an independent nonprofit clinical research organization in 2007. Since its founding, Hoosier Cancer Research Network has initiated more than 150 trials in a variety of cancer types and supportive care, resulting in more than 300 publications. More than 4,600 subjects have participated in Hoosier Cancer Research Network clinical trials.