An Interview With Anupam Rishi, MD, Moffitt Cancer Center

Anupam Rishi, MD, is an Assistant Member in the Department of Radiation Oncology at Moffitt Cancer Center, with a focus on genitourinary and gynecologic malignancies and advanced expertise in image-guided brachytherapy. Dr Rishi completed a General Surgery internship and Radiation Oncology residency at Moffitt Cancer Center/University of South Florida and pursued a dedicated Brachytherapy Fellowship at Moffitt Cancer Center. Dr Rishi’s clinical practice spans the full spectrum of modern radiation oncology. As one of the few fellowship-trained brachytherapy specialists in the country, Dr Rishi offers specialized expertise in advanced image-guided brachytherapy, which involves internal radiation therapy delivering high-dose radiation precisely to tumors while minimizing radiation to surrounding normal tissues.

Monday:

○ 8 am-9 am: Resident Didactics (when scheduled).

○ 8 am-4 pm: Clinic, simulations, machine image checks for IGRT.

○ 4 pm-5:30 pm: GU Multidisciplinary Tumor Board and Radiation Oncology Case Review Conference.

Tuesday and Wednesday:

○ 7:45 am-5 pm: Operating room, typically 2 prostate or GYN brachytherapy cases/day, multiple HDR treatments.

Thursday:

○ 8 am-5 pm: Clinic, simulations, machine image checks for IGRT, and minor procedures (e.g., prostate fiducial marker placement and perirectal hydrogel spacer insertion).

Friday:

○ 8 am-9 am: GYN Multidisciplinary Tumor Board/Resident Didactics.

○ After 9 am: Administrative duties, research, contouring.

I have always been interested in oncology and knew I wanted to work closely with patients navigating cancer care. I was also drawn to the technology and innovation in medicine, and radiation oncology uniquely integrates imaging, physics, and precision treatment delivery in a way that continuously evolves and innovates. Moreover, I also wanted a specialty that involved procedural work, and radiation oncology offers that through brachytherapy. The field also offers meaningful opportunities to engage in global education and knowledge sharing, which aligned with my interests. Ultimately, radiation oncology was the specialty that brought together my interests in oncology, technology, education, and procedural care within a single specialty.

As a student, you learn the broad, established indications for radiation therapy. However, once I began practicing, I was struck by how rapidly emerging data expanded those indications. A significant portion of my practice now focuses on treating oligometastatic disease, which is when cancer spreads out of the primary site of disease to other, usually ≤5, sites. Conditions previously classified as stage 4 and treated primarily with palliative intent can now, in selected patients, be approached more definitively, improving outcomes and quality of life. For example, modern precision SBRT techniques can achieve local control rates exceeding 90% for small-volume metastatic diseases. In appropriately selected patients, this approach can improve progression-free survival and delay the start of alternative systemic or targeted therapies. The advent of immunotherapy has further expanded this paradigm, opening an entirely new spectrum of indications for radiation oncology in ways I had not fully anticipated during training.

I’m excited by how rapidly technology is reshaping the precision and personalization of radiation oncology, as well as expanding tools for impactful global education. Advances such as MRI-guided adaptive radiation therapy, SBRT, proton therapy, and sophisticated image-guided brachytherapy are allowing us to treat tumors more accurately while minimizing dose to normal tissues. In parallel, I’ve been deeply involved in educational innovation. Brachytherapy is a procedural skill that requires dedicated training, and not all centers have the infrastructure, case volume, or experienced educators needed to teach it. In collaboration with the International Atomic Energy Agency (IAEA), I am involved in developing virtual-reality-based training for gynecological and prostate brachytherapy. It’s very exciting to be able to pave the way for more accessible and immersive learning opportunities.

I had a personal interest in virtual reality even before incorporating it into my professional work, and I own a VR headset, so I know its potential. At Moffitt, we also have a team that is enthusiastic about both global health and VR innovation, so it truly became a matter of being in the right place at the right time.

Most residency programs provide foundational brachytherapy training. However, for residents interested in more advanced applications, such as prostate brachytherapy or complex interstitial techniques, additional exposure at high-volume centers can be very beneficial. A dedicated brachytherapy fellowship, like the one I pursued, is not necessarily required. For trainees whose home institutions may not offer robust exposure, there are ways to supplement that experience, including elective rotations at other programs and opportunities through the American Brachytherapy Society (ABS). One such opportunity is the “300 in 10” initiative for PGY4 or PGY5 to complete a 2-month focused brachytherapy experience at participating high-volume centers, including Moffitt.

If someone has any interest in radiation oncology or is even undecided, I strongly encourage you to spend time shadowing and to see firsthand what we do and how we do it. It’s a specialty that isn’t widely discussed during medical school, so even a few days of exposure can be very illuminating. Most radiation oncologists would be more than happy to welcome students and share their experiences.