Melissa M. Hudson, MD, director of the Division of Cancer Survivorship at St. Jude Children's Research Hospital, recalls that her interest in science began at a young age. “I remember talking about medicine since I was in junior high school,” she says. She also remembers her delight upon recently finding a paper about becoming a pediatrician that she had written while in the 7th grade. Her family highly valued education, and Dr. Hudson, who currently holds The Charles E. Williams Endowed Chair of Oncology–Cancer Survivorship, was the first among them to enter the field of medicine. Dr. Hudson received her premedical baccalaureate degree in zoology from Texas A&M University and later pursued her medical degree from the University of Texas McGovern Medical School. She says that her exposure to oncology during her general pediatrics residency is how her interest in a career in the specialty of pediatric oncology first began to take shape. An Interest in Pediatric Hematology/Oncology

Dr. Hudson completed a pediatric hematology/oncology fellowship with the University of Texas MD Anderson Cancer Center. “It was very influential in my career,” she says. “It was during a time that when children were diagnosed, they would be admitted into the hospital for months at a time. It was difficult to watch the suffering, and it made me question whether pursuing this specialty was the right decision. However, a trusted mentor recognized my passion for pediatric oncology and encouraged me to stay the course, which ultimately proved to be a good decision for me.”

The exposure at MD Anderson was influential in her decision to pursue a career in pediatric hematology and oncology. “While rotating through the outpatient pediatric oncology clinics at MD Anderson, I witnessed multidisciplinary care that was curing children with cancer. I was attracted to the patient population and specialty; children were surviving cancer, and I wanted to be a part of this effort,” she says.

Dr. Hudson joined the St. Jude faculty in 1989 as a pediatric oncologist and has remained with the institution ever since. As co-chair of the Children's Oncology Group Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancer and the International Late Effects of Childhood Cancer Guideline Harmonization Group, she continues to play a leadership role in developing guidance for health surveillance of childhood cancer survivors. Dr. Hudson is also currently a co-leader of the Cancer Control & Survivorship Program at St. Jude and has coauthored a vast number of journal publications.

Dr. Hudson has received many honors during her career. She was the 2020 recipient of the Northwestern Mutual Award for Excellence in Childhood Cancer Survivorship by the American Society of Pediatric Hematology/Oncology.1 She is particularly proud to have been honored with 2 Team Science Awards from the American Association for Cancer Research: She received one in 2009 as part of the hematologic malignancy investigators at St. Jude, and she received the other in 2019 for the investigators' work in survivorship. “The 2019 award was the culmination of true team science, with so many folks working across disciplines to focus on survivor health,” she says.

She is proud to be a longtime member of St. Jude's faculty. “It's an incredible place to practice medicine,” she says. “Even with families who may not always have happy outcomes, you always have the resources to put patients and families first. It's such a gift that our fundraising efforts not only support research to improve childhood cancer outcomes but also relieve the practical burdens experienced by families affected by childhood cancer.”

Expanding Research Focus

Dr. Hudson's areas of research have expanded significantly over the years. During her first 10 to 15 years as a clinical investigator, Dr. Hudson's clinical efforts and research primarily focused on hematologic malignancies, specifically Hodgkin lymphoma. Today, Dr. Hudson's special research interests include the burden of disease and the quality of life after a cancer diagnosis, the development of survivorship care guidelines, the use of various data sources to direct patient care, and the development of long-term follow-up care goals.

Dr. Hudson believes she has been lucky during her career. “I've had new opportunities and challenges roughly every 10 years that reinvigorated my research and my overall attitude.”

The availability of curative therapy for Hodgkin lymphoma and the risk of late effects in this population led to her increasing involvement as director of the St. Jude After Completion of Therapy (ACT) Clinic. The ACT Clinic provides long-term care for survivors of childhood cancer who have been treated at St. Jude.2 “We educate survivors about their cancer history and associated health risks, health screening recommended for their specific cancer treatments, and ways to reduce health risks,” she says. “We also assist them with identifying health services and resources as they transition from pediatric oncology to primary care.”

In the early years, reports from survivors about health problems during adulthood, such as serious infection after splenectomy and breast cancer after chest radiation, increased Dr. Hudson's awareness of the need to proactively counsel and surveil patients based on their specific treatments. “This understanding informed our first efforts at risk-based health surveillance in childhood cancer survivors.”

The strategy of educating survivors about late effects was not initially accepted on a global scale. While presenting at international conferences years ago, Dr. Hudson recalls speaking with other physicians who felt that discussing potential health risks with patients and families created unnecessary distress. “Over time, perceptions of the importance of survivor education have changed,” she explains. “Now everyone has the same mantra: that survivors need to understand cancer treatment–related health risks to guide their health decisions and behaviors.

“Over time, perceptions of the importance of survivor education have changed. Now everyone has the same mantra: that survivors need to understand cancer treatment–related health risks to guide their health decisions and behaviors.”

—Melissa M. Hudson, MD

“The big challenge for the future will be to integrate new agents into already effective regimens of cytotoxic therapy,” she continues. “Hopefully, these efforts will result in precision treatments that will reduce the risk of late toxicities as well as precision survivorship care that addresses the broad needs of survivors across the lifespan.”