Daniel E Epner, M.D., FACP
Department of Palliative, Rehabilitation and Integrative Medicine, Division of Cancer Medicine
About Dr. Epner
Daniel Epner, M.D. FACP - Professor, Department of Palliative, Rehabilitation & Integrative Medicine
Dr. Epner is a palliative care physician at MD Anderson Cancer Center who practiced medical oncology for several years before moving to the Department of Palliative Care in 2012. He began his faculty career at Baylor College of Medicine as principal investigator of a basic science lab, but he now focuses on psychosocial aspects of oncology. His primary academic interest is communication skills training for medical oncology fellows, palliative care fellows, and a variety of other providers. He uses narrative medicine techniques to teach communication skills. Such techniques include reflective writing; close reading of medically-themed stories; and discussing films relevant to clinical practice. In recent years, Dr. Epner has contributed several reflective pieces about his own experiences as a doctor to the Journal of Clinical Oncology, Annals of Internal Medicine, and other journals to serve as enduring educational resources.
Present Title & Affiliation
Professor, Department of Palliative Care and Rehabilitation Medicine, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
Difficult conversations in clinical oncology, particularly around end of life.
Education & Training
|1986||Baylor College of Medicine, Houston, TX, USA, MD, Medicine|
|1982||Stanford University, Stanford, CA, USA, BA, Human Biology|
|1991-1994||Clinical Fellowship, Medical Oncology, Johns Hopkins School of Medicine, Baltimore, MD|
|1989-1991||Research Fellowship, Molecular Genetics, UCLA School of Medicine, Los Angeles, CA|
|1988-1989||PGY3, Internal Medicine, UCLA School of Medicine, Los Angeles, CA|
|1986-1988||Internship and PGY2, Internal Medicine, The University of Texas Southwestern Medical School, Dallas, TX|
|2012||American Board of Internal Medicine- Hospice and Palliative Medicine|
|1993||American Board of Internal Medicine - Medical Oncology|
|1989||American Board of Internal Medicine|
Experience & Service
Associate Professor, Department of Palliative Care and Rehabilitation Medicine, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 2012 - 2014
Associate Professor, Department of General Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, 2008 - 2012
Chief, Department of Hematology/Oncology, Division of Cancer Medicine, Houston VA Hospital, Houston, TX, 2002 - 2008
Staff Physician, Houston VA Hospital, Houston, TX, 1994 - 2008
Medical Director, International Center of The University of Texas MD Anderson Cancer Center, Houston, TX, 2010 - 2012
Clinical Safety and Effectiveness Program Graduate, The University of Texas MD Anderson Cancer Center, Houston, TX, 2009 - 2010
Institutional Committee Activities
Chair, GME Curriculum Subcommittee, 2015 - Present
Member, GME Committee, 2015 - Present
Member, Goals of Care Committee, 2015 - 2019
Member, Language of Caring Steering and Planning Committees, 2013 - 2014
Member, Intensive Physician Board Review Course in Hospice and Palliative Medicine, 2013 - Present
Member, GME Curriculum Subcommittee, 2012 - Present
Member, Psychosocial Council, 2010 - 2014
Member, Institutional Apology and Disclosure Working Group, 2010 - 2010
Member, Ethics, 2010 - 2016
Member, International Program 8% project, 2009 - 2010
Member, Credentials Subcommittee, 2008 - 2012
- Hui D, De La Rosa A, Wilson A, Nguyen T, Wu J, Delgado-Guay M, Azhar A, Arthur J, Epner D, Haider A, De La Cruz M, Heung Y, Tanco K, Dalal S, Reddy A, Williams J, Amin S, Armstrong TS, Breitbart W, Bruera E. Neuroleptic strategies for terminal agitation in patients with cancer and delirium at an acute palliative care unit: a single-centre, double-blind, parallel-group, randomised trial. Lancet Oncol 21(7):989-998, 2020. e-Pub 2020. PMID: 32479786.
- Andreev-Drakhlin AY, Epner DE. Chemistry of Caring: Timeless Lessons From Oncology Fellowship. J Clin Oncol 38(18):2107-2109, 2020. e-Pub 2020. PMID: 32315277.
- Hui D, Abdelghani E, Chen J, Dibaj S, Zhukovsky D, Dev R, Tanco K, Haider A, Azhar A, Reddy A, Epner D, Arthur J, Dalal S, Heung Y, Reddy S, De La Cruz M, Liu D, Bruera E. Chronic Non-Malignant Pain in Patients with Cancer Seen at a Timely Outpatient Palliative Care Clinic. Cancers (Basel) 12(1), 2020. e-Pub 2020. PMID: 31952220.
- Shaw AC, McQuade JL, Reilley MJ, Nixon B, Baile WF, Epner DE. Integrating Storytelling into a Communication Skills Teaching Program for Medical Oncology Fellows. J Cancer Educ 34(6):1198-1203, 2019. e-Pub 2018. PMID: 30219971.
- Weathers SP, Epner DE. Rookie. J Clin Oncol 37(9):JCO1801882, 2019. e-Pub 2019. PMID: 30742562.
- Epner DE. Quinlan Texas. Palliat Support Care 16(5):1-2, 2018. e-Pub 2018. PMID: 29362001.
- Kim SL, Epner DE. Seven Haircuts. J Clin Oncol 36(28):JCO2018788455, 2018. e-Pub 2018. PMID: 30102573.
- Agrawal C, Epner D. Mother Tongue. JAMA Oncol 3(11):1471-1472, 2017. e-Pub 2017. PMID: 28617902.
- Hui D, Frisbee-Hume S, Wilson A, Dibaj SS, Nguyen T, De La Cruz M, Walker P, Zhukovsky DS, Delgado-Guay M, Vidal M, Epner D, Reddy A, Tanco K, Williams J, Hall S, Liu D, Hess K, Amin S, Breitbart W, Bruera E. Effect of Lorazepam With Haloperidol vs Haloperidol Alone on Agitated Delirium in Patients With Advanced Cancer Receiving Palliative Care: A Randomized Clinical Trial. JAMA 318(11):1047-1056, 2017. PMID: 28975307.
- Kinahan H, Maiti A, Hess K, Dempsey J, Beatty L, Baldwin S, Hong DS, Naing A, Fu S, Tsimberidou AM, Piha-Paul S, Janku F, Karp D, Reddy S, Yennu S, Epner D, Bruera E, Meric-Bernstam F, Falchook G, Subbiah V. Post-Discharge Survival Outcomes of Patients with Advanced Cancer from the University of Texas MD Anderson Cancer Center Investigational Cancer Therapeutics (Phase I Trials) Inpatient Unit. Oncology 92(1):14-20, 2017. e-Pub 2016. PMID: 27802448.
- Epner DE. A Perplexing Question. J Clin Oncol 32(23):2503-4, 2014. e-Pub 2014. PMID: 25002712.
- Epner DE, Baile WF. Difficult Conversations: Teaching Medical Oncology Trainees Communication Skills One Hour at a Time. Acad Med 89(4):578-84, 2014. e-Pub 2014. PMID: 24556763.
- Fingeret MC, Teo I, Epner DE. Managing Body Image Difficulties of Adult Cancer Patients: Lessons from Available Research. Cancer 120(5):633-41, 2014. e-Pub 2013. PMID: 24895287.
- Silbermann M, Epner DE, Charalambous H, Baider L, Puchalski CM, Balducci L, Gultekin M, Abdalla RF, Daher M, Al-Tarawneh MR, Smith TJ. Promoting new approaches for cancer care in the Middle East. Ann Oncol 24 Suppl 7:vii5-vii10, 2013. PMID: 24001764.
- Delgado-Guay MO, De La Cruz MG, Epner DE. 'I don't want to burden my family': handling communication challenges in geriatric oncology. Ann Oncol 24 Suppl 7:vii30-vii35, 2013. PMID: 24001760.
- Epner DE. Black and White. Ann Intern Med 159(4):304-5, 2013. PMID: 24026263.
- Epner DE, Baile WF. Patient-centered care: the key to cultural competence. Ann Oncol 23 Suppl 3:33-42, 2012. PMID: 22628414.
- Overman MJ, Epner DE. Lost in Translation: A Fisherman's Tale. J Clin Oncol 29(28):3832-3, 2011. e-Pub 2011. PMID: 21768468.
- Epner DE, Baile WF. Wooden's pyramid: building a hierarchy of skills for successful communication. Med Teach 33(1):39-43, 2011. PMID: 21182381.
- Epner DE, Ravi V, Baile WF. When patients and families feel abandoned. Support Care Cancer. e-Pub 2010. PMID: 20853170.
- Garcia JM, Li H, Mann D, Epner D, Hayes TG, Marcelli M, Cunningham GR. Hypogonadism in male patients with cancer. Cancer 106(12):2583-91, 2006. PMID: 16688773.
- Lu S, Ren C, Liu Y, Epner DE. PI3K-Akt signaling is involved in the regulation of p21(WAF/CIP) expression and androgen-independent growth in prostate cancer cells. Int J Oncol 28(1):245-51, 2006. PMID: 16328002.
- Garcia JM, Garcia-Touza M, Hijazi RA, Taffet G, Epner D, Mann D, Smith RG, Cunningham GR, Marcelli M. Active ghrelin levels and active to total ghrelin ratio in cancer-induced cachexia. J Clin Endocrinol Metab 90(5):2920-6, 2005. PMID: 15713718.
- Lu S, Chen GL, Ren C, Kwabi-Addo B, Epner DE. Methionine restriction selectively targets thymidylate synthase in prostate cancer cells. Biochem Pharmacol 66(5):791-800, 2003. PMID: 12948860.
- Li M, Ittmann MM, Rowley DR, Knowlton AA, Vaid AK, Epner DE. Glutathione S-transferase pi is upregulated in the stromal compartment of hormone independent prostate cancer. Prostate 56(2):98-105, 2003. PMID: 12746833.
- Lu S, Hoestje SM, Choo E, Epner DE. Induction of caspase-dependent and -independent apoptosis in response to methionine restriction. Int J Oncol 22(2):415-20, 2003. PMID: 12527942.
- Lu S, Hoestje SM, Choo EM, Epner DE. Methionine restriction induces apoptosis of prostate cancer cells via the c-Jun N-terminal kinase-mediated signaling pathway. Cancer Lett 179(1):51-8, 2002. PMID: 11880182.
- Lu S, Gu X, Hoestje S, Epner DE. Identification of an additional hypoxia responsive element in the glyceraldehyde-3-phosphate dehydrogenase gene promoter. Biochim Biophys Acta 1574(2):152-6, 2002. PMID: 11955624.
- Epner DE, Morrow S, Wilcox M, Houghton JL. Nutrient intake and nutritional indexes in adults with metastatic cancer on a phase I clinical trial of dietary methionine restriction. Nutr Cancer 42(2):158-66, 2002. PMID: 12416254.
- Epner DE. Can dietary methionine restriction increase the effectiveness of chemotherapy in treatment of advanced cancer?. J Am Coll Nutr 20(5 Suppl):443S-449S; discussion 473S-475S, 2001. PMID: 11603655.
- Lu S, Jenster G, Epner DE. Androgen induction of cyclin-dependent kinase inhibitor p21 gene: role of androgen receptor and transcription factor Sp1 complex. Mol Endocrinol 14(5):753-60, 2000. PMID: 10809237.
- Lu S, Epner DE. Molecular mechanisms of cell cycle block by methionine restriction in human prostate cancer cells. Nutr Cancer 38(1):123-30, 2000. PMID: 11341037.
- Singh G, Lakkis CL, Laucirica R, Epner DE. Regulation of prostate cancer cell division by glucose. J Cell Physiol 180(3):431-8, 1999. PMID: 10430183.
- Epner DE, Sawa A, Isaacs JT. Glyceraldehyde-3-phosphate dehydrogenase expression during apoptosis and proliferation of rat ventral prostate. Biol Reprod 61(3):687-91, 1999. PMID: 10456846.
- Lu S, Liu M, Epner DE, Tsai SY, Tsai MJ. Androgen regulation of the cyclin-dependent kinase inhibitor p21 gene through an androgen response element in the proximal promoter. Mol Endocrinol 13(3):376-84, 1999. PMID: 10076995.
- Kouvroukoglou S, Lakkis CL, Wallace JD, Zygourakis K, Epner DE. Bioenergetics of rat prostate cancer cell migration. Prostate 34(2):137-44, 1998. PMID: 9465945.
- Rondinelli RH, Epner DE, Tricoli JV. Increased glyceraldehyde-3-phosphate dehydrogenase gene expression in late pathological stage human prostate cancer. Prostate Cancer Prostatic Dis 1(2):66-72, 1997. PMID: 12496918.
- Epner DE, White P, Krasnoff M, Khanduja S, Kimball KT, Knaus WA. Outcome of mechanical ventilation for adults with hematologic malignancy. J Investig Med 44(5):254-60, 1996. PMID: 8763976.
- Epner DE, Coffey DS. There are multiple forms of glyceraldehyde-3-phosphate dehydrogenase in prostate cancer cells and normal prostate tissue. Prostate 28(6):372-8, 1996. PMID: 8650074.
- Epner DE, Partin AW, Schalken JA, Isaacs JT, Coffey DS. Association of glyceraldehyde-3-phosphate dehydrogenase expression with cell motility and metastatic potential of rat prostatic adenocarcinoma. Cancer Res 53(9):1995-7, 1993. PMID: 8481901.
- Epner DE, Herschman HR. Heavy metals induce expression of the TPA-inducible sequence (TIS) genes. J Cell Physiol 148(1):68-74, 1991. PMID: 1907289.
- Epner DE, Koeffler HP. Molecular genetic advances in chronic myelogenous leukemia. Ann Intern Med 113(1):3-6, 1990. PMID: 2073245.
- Epner DE. Allowing Awe in Life. Am J Clin Exp Urol 6(2):32-36, 2018. e-Pub 2018. PMID: 29666829.
Manuals, Teaching Aids, Other Teaching Publications
- Wendy Leebov. Language of Caring Skill Building Video.
- Epner, DE; Brown, R; Baile, WF. Discussing Prognosis. American Society of Clinical Oncology: ASCO University webpage (http://university.asco.org/).
- Neumann JL, Gallagher C, Epner D, Susan G, Buitrago J, Richard C. Advanced Care Planning (ACP) Before Stem Cell Transplantation (SCT) Treatment Begins. Biology of Blood and Marrow Transplantation 17(2):S359, 2011.
- Epner DE, Baile WF. Pyramid of Relational Excellence. Medical Encounter 24(1):112, 2010.
- Epner D. Using Stories to Teach Cancer Providers Cultural Competence. European Association of Cancer Education.
- Epner DE, Schmeler KM. University of Texas MD Anderson Cancer Center Experience caring for patients from countries undergoing political-social conflict. In: Cancer Care in Countries/ Societies in Transition – Individualized Care in Focus. Springer: Switzerland, 409-416, 2016.
- Epner DE. Communication Between Patients and Health Care Providers. In: Advances in Cancer Survivorship Management. Springer, 421-432, 2014.
- Epner DE. Anemia. In: lnternal Medicine Issues in Palliative Cancer Care. Oxford University Press: New York, 127-130, 2014.
- Epner, DE. Thrombocytopenia. In: Internal Medicine Issues in Palliative Cancer. Oxford University Press: New York, 135-138, 2014.
- Epner, DE. The hypercoagulable state of cancer. In: Molecular Mechanisms of Hypercoagulable States. RG Landes Co: Austin, 1997.
- Epner, DE. Cancer Chemotherapy. In: Encyclopedia of Human Biology. Academic Press, Inc, 1997.
Books (edited and written)
- D Epner. Empathy: Real Stories to Inspire and Enlighten Busy Clinicians. McGraw Hill: New York, 2022.
Grant & Contract Support
|Title:||“Role of glycolysis in prostate cancer cell motility/metastasis”|
|Funding Source:||American Cancer Society (ACS)|
|Funding Source:||Baylor College of Medicine|
|Title:||“Role of GAPDH in prostate cancer metastasis”|
|Funding Source:||Baylor SPORE in prostate cancer pilot project|
|Title:||“Role of multifunctional GAPDH in prostate cancer”|
|Funding Source:||Veterans Administration|
|Title:||Caroline Wiess Law Award for Research in Molecular Medicine|
|Funding Source:||Baylor College of Medicine|
|Title:||“GAPDH: Novel Regulator of Cell Structure and Migration”|
|Title:||“Dietary Methionine Restriction- Novel Cancer Treatment: Mechanistic Studies”|
|Funding Source:||Ross Products Division, Abbott Laboratories|
|Title:||“Dietary Methionine Restriction: Novel Treatment for Hormone Independent Prostate Cancer”|
|Funding Source:||Department of Defense (DOD)|