Q: What's it like to work with a patient through what may be one of the scariest things they will ever go through?
Every patient I meet is scared. My job is to explain their particular case and recommend an individualized treatment program. Once people see it's not as bad as it seems and we have a plan, they relax and are reassured.
Q: Do you ever use the word "cure"? When? And, why would you pick a field where sometimes after you've gotten patients through treatment you won't know for sure they are cured? And, why did you gravitate to a field where often the best you can do is buy time and make the person's life the best it can be?
At this time cures of cancer are happening everyday in oncology offices across the country. We are now curing many more patients than we don't cure. Take breast cancer as an example: Statistics show that the overall cure rate is approaching 80%. That means that 80 of 100 women diagnosed with breast cancer today will be alive in ten years, and that number will only improve in the future.
Choosing to be an oncologist was an easy choice for me as my father is an oncologist. He encouraged me and taught me how to be the best doctor I can be. Many people ask how I can do this job day after day, losing patients to their illness. I tell them it's because I can help them through their treatment.
Q: Could you pick a specific treatment regimen you rely on often and give (in layperson's terms) a step-by-step of what happens from start to finish?
Curing breast cancer is how oncology got its start and we know more about breast cancer than all the other cancers combined.
In a typical case of breast cancer, the cancer is detected very early on a routine mammogram. The patient has surgery, followed by four rounds of chemotherapy (one dose every three weeks) directed by me to clear up any residual cancer in the body. This is then followed by radiation to the lumpectomy site over several weeks.
Once radiation is done, I will then bring the patient back to discuss lifestyle changes (diet, exercise and vitamins) and initiate an oral anti-estrogen pill for five years which is usually very well tolerated.
Q: How are you relating to the patient & what do you hope for through the process?
This process goes extremely smoothly, which I think surprises many people. The patient must have confidence in the doctor. I try to foster that trust by showing the patient their case is being treated by me the same as in other institutions. Once treatment with chemo starts, the goal is to get through that treatment without complications.
Experience giving chemo and knowing beforehand what someone will "handle" is very important. Customizing doses for each patient's unique circumstances is an example of the experience needed. I assume the role of being the patient's main "doctor" throughout their chemotherapy so they can rely on me. Open communication is the best way to relate to the patient.
Q: What is the tension like when the outcome is uncertain?
Tension is always high when waiting for results, particularly for a scan or lab work. Tension often decreases once results are revealed, regardless of the results because a new plan is set in motion.
Q: What do you feel when there is an immediate crisis, but you have gotten past it and the patient will survive?
Crisis is ever present in medicine. Not a day goes by that life-threatening problems or complications do not develop in the lives of my patients. Remaining calm, acting fast, and relying on experience and training will pull people through their crisis, providing them a sense of relief.
Q: What does it feel like when someone is still here five years later when the odds were against this?
I am constantly amazed as to what is possible today using the newest available treatments for cancer. I have so many patients that if they had been diagnosed 15 years ago with the same diagnosis, they would not have survived long. I'm seeing miracles every single day of long-term survivors of lung cancer, leukemia, breast cancer and other cancers that I cannot keep track of them all.
Q: What does it feel like when you've done all you can but lose the person? How do you talk to this person and what's it like for you?
Dealing with people who are dying is the hardest part of being an oncologist. I promise to relieve suffering to the best of my ability and explain hat I will never abandon them, even though hope for a cure or remission is gone. Once people understand this, they accept the dying process with much more grace.
Q: What have you learned/experienced that has kept you in this field? Have you had any surprises?
Oncology is a tremendous field. You have an opportunity to truly help people every day. I am grateful for this chance and I hear appreciation from patients on a regular basis. This helps me continue in this difficult field with such high stakes.
Q: How have your accomplishments changed your life, both as a doctor and as a person beyond your profession?
Being an oncologist changes your perspective on life because we see there are neither guarantees nor warranties to life. I learned to appreciate every day, knowing each day is a true gift from God. I try to live life to the fullest, enjoy the everyday things and not sweat the small stuff.