Kothari is often tasked with delivering the news. He remembers shadowing Arati Desai ’96, a physician and associate professor at the University of Pennsylvania, as she led these conversations with patients. “I think I’ve developed a kind of professional demeanor that is really influenced by the way she practices,” says Kothari, who studied with Desai during his fellowship at Penn until 2021 and credits her with much of what he learned.
“Teaching and mentorship is core to why I’m in academic medicine,” Desai says. “There’s so much that’s learned in medicine by watching and doing.”
Desai joined the faculty there in 2009 as the only brain tumor specialist within oncology. She’s since become a fixture in neuro-oncology; she started leading Penn’s brain tumor clinical trials program in 2016, and continues to mentor and teach.
“Brain tumors are overwhelming to a lot of people including, sometimes, to those of us who practice in this space, because there is this average prognosis that is so difficult,” Desai says. “There have not been major shifts in survival even within our lifetimes.”
The average survival for glioblastoma, the most common primary adult brain cancer, remains one to two years. “Patients who are affected often confront not only a terminal diagnosis, but also life-changing alterations in identity — either functionally in a physical way, or in terms of cognition or speech.”
Brain tumor treatments are also less developed and expansive than they are for other cancers, Kothari says.
“Many areas of cancer are dramatically different than they were just 10 years ago,” he added. “Those types of advances have not been readily translated to the care of brain and spine tumors.”
It was part of the reason Kothari was drawn to the field. After finishing his residency at the University of Chicago, he started a fellowship at Penn to study medical oncology. Kothari expected to focus on blood cancer, but he became more interested in a few clinics that were focused on brain tumors. He spent the last two years training under Desai and working in labs that explored new ways to stimulate the immune system to fight against cancer, a category of treatment known as immunotherapies.
Kothari continues to see patients with brain and spine tumors and provides medical oncology consultations. In July, he was appointed an assistant professor at Emory’s Department of Hematology and Medical Oncology.
“I do think Shawn is making such a courageous decision, as are other people in the space, to take on what is difficult work,” Desai says. “It is sometimes isolating and challenging, and you’re explaining and comforting anticipated hardship and uncertainty to people. He is the right kind of person to do this work.”