Heme/Onc: First Week Overview

So I finished my first week of heme/onc, and so far it seems like a pretty good rotation. I'll definitely learn a lot for sure b/c I'm working with an excellent doctor, Dr. P. He splits his time between the cancer clinics in Weatherford and Fort Worth, and so will I. On Tuesdays we have Tumor Board, where all the hematologists and oncologists in the practice (along with PAs, NPs, and nurses) get together and discuss difficult cases they've seen. I've seen three patients so far that'll be presented at next week's tumor board, and there was one patient with mesothelioma that was presented at the tumor board at Plaza (yes, I attend those as well). I was really sad for the mesothelioma patient; he's not even 50 yet and has a wife and daughter just slightly younger than me, and though he remained calm throughout our discussion, he ended up having to comfort his wife when she started crying. *sigh* Cancer really does destroy lives.

There are all kinds of cancer patients, but a few stand out more than others. One is a 59 year old woman with Stage IV lung cancer with bony mets who was recently told that her cancer was spreading despite aggressive chemo treatment. Another woman, despite being 63, was in complete denial of her diagnosis (renal cell carcinoma) and regressed to a childlike state whenever she answered questions. Her speech would become high-pitched and extremely pressured as she insisted that she was fine, and beside her, her husband couldn't stop smacking his lips. Tardive dyskinesia, anyone? We all agreed she had some serious unresolved psych issues. Yet another patient with pancreatic cancer was insistent on trying an alternative medication called Anvirzel that's derived from the oleander (a poisonous plant) instead of chemo, and despite our telling him that oleander isn't FDA approved and that he shouldn't take it without a physician to monitor his progress, he feels it's his only shot at buying himself more time (he's 75). He then asked why Dr. RP wouldn't monitor his progress, but Dr. RP, being a PhD as well, wouldn't do it b/c there's not enough publications or proof that Anvirzel is truly safe, just a few patient testimonies scattered throughout the internet claiming it works. We'll have to talk to him again next week; I doubt his mind will have changed. And on the other spectrum, I've met some really sweet patients with positive attitudes about staying in remission. And if I could choose the type of cancer to have, I'd definitely choose breast.