Oncology allows room for the humanistic side of medicine. A lady presented today for a follow up on her metastatic uterine carcinosarcoma. She had been feeling very weak from her chemotherapy, and needed another treatment and a CT scan. She wanted to go to Monterey for two weeks over the as holiday to visit her son, but it interfered with her treatment schedule and she would have to come home early. The oncologist told her not to worry, and to come in when she got back for her treatment.
This recommendation was not on the treatment schedule published by the American Cancer Society, but it was on Mary's* treatment schedule. Why? She is 85 years old, with metastic cancer. A visit with her son may be the best medicine for her. Will her cancer progress faster given the treatment delay? Maybe. Will this be her last Christmas, either way? Probably. The oncologist knew this and governed her treatment accordingly.
This is what I love about oncology. You see a patient for a prolonged period of time, in a manner that no other practitioner experiences. You get to know what matters to them and their family. It is one of the few practices that you can stray from published guidelines and still remain in practice. You can make treatment decisions based on the person, not the disease.
Amid a practice of dying patients, success lies not in the prolongation of years, but in the improvement to your patients' health. And even though you know how it ends, there is great satisfaction in contributing to the well-being, both physical and mental, of these patients in their time of sickness.
*name has been changed