Thursday, November 16, 2017

Mourning and Oncology

I was driving to work one morning (a fresh change after five years relying on the red line to MGH) and as part of my new routine, I listen to The Moth podcast. If you do not know it, it’s a wonderful community of storytellers—compelling stories, told by people from every walk of life. I often find myself drawn in to the program (like a moth to a flame as it were), and before I know it, I’ve reached my destination, whether it be hospital or home.

Friday, October 13, 2017

Goals and Preferences

As an oncologist, I want to provide the best treatment for everyone. That should mean the best chance at a long-lasting remission, if not cure—whatever that might take. Surgery, chemotherapy, radiation therapy—a dark tunnel that I hope patients will enter and then exit, with the sun shining on the other side. But, every now and then, I have a patient who chooses not to pursue the regimen that I think will bring her the best chances. Looking back, I remember such was the case with a woman who sticks out in my own mind. Let’s call her Rachel*.

Wednesday, September 6, 2017


I was reading my emails this morning and came across one from the Foundation for Women’s Cancers, announcing September as Gynecologic Cancer Awareness Month. Their social media campaign centered on the hashtag above, with a focus on clinical trial awareness and participation. It got me thinking again about the enterprise of clinical trials, and just how much goes in to clinical trial enrollment.

Tuesday, July 25, 2017

“At Least”: Helping Our Patients Live Life on Their Terms

I’d known her for almost three years. She had advanced ovarian cancer—clear cell—and was diagnosed with disease already in her chest, stage IV. She had a terrific response to neoadjuvant chemotherapy, which had resolved her extra-abdominal disease sites after three cycles. She had an aggressive interval surgery that achieved complete resection of residual cancer (an R0 resection). She had completed adjuvant chemotherapy and I declared her to be in remission at that time—but it was short-lived; within four months, her disease had returned. Platinum resistance, we call it. We started a new regimen then—not for cure, I told her and her husband. The goal was control.