How oncologists with cancer choose an oncologist

yellow lock-146536

You might expect that only ordinary people would have trouble getting the best cancer treatment in this country. You’d be wrong. Meet the leading oncologist who struggled to obtain cutting edge cancer treatment from the medical institutions he helped build.

Dr. Vincent DeVita admits he’s had plenty of trouble navigating the US medical system. In fact, he utterly failed to ensure a friend received the best cancer treatment.

The result? His friend died. It’s a sad tale he recounts in the opening of his autobiography, “The Death of Cancer.”

What if I told you that DeVita is the most famous oncologist who ever lived?

I admit, fame is relative; being a famous oncologist means only that other oncologists have heard of you.

To make “famous” fit into a sentence containing “oncologist,” think of someone you know who has been cured of cancer, either with chemotherapy or a combination of chemotherapy and radiation. Then know that Vincent DeVita is personally responsible. He arranged for the design and careful testing of those treatments, and over the years worked to make the successful treatments increasingly milder and safe.

DeVIta also wrote the book on cancer. I’m not exaggerating; his textbook, “Cancer: Principles & Practice of Oncology,” has been the go-to reference for every oncologist in the world for decades.

DeVita’s CV is an almost inhuman chronicle of accomplishment. DeVita was the first Director of the National Cancer Institute. While there, he successfully spearheaded research that produced real cures for many previously fatal cancers.

It boggles my mind to think about it. The FIRST cures for cancer. Ever. In the history of the world. Children cured of leukemia. Young adults cured of Hodgkin’s disease. Testicular cancer. Breast cancer. On and on.

He later became Physician-in-Chief of Sloan Kettering’s famous Manhattan cancer hospital, where he modernized the radiation oncology department. In the later years of his career, he revamped Yale’s then struggling oncology program. Translation: DeVita built our current cancer treatment system.

And yet, even he struggled to obtain the best treatment for a friend with prostate cancer?

What stymied the world’s most well-connected oncologist? Impenetrable bureaucracy? Yes, there was plenty of that. No surprise there.

But what did surprise me, and DeVita, were the attitudes of the oncologists with whom he interacted on behalf of his ill friend. I mean, oncologists are, in a way, DeVita’s children. Why are so many of DeVita’s intellectual offspring stuck in a rut of “therapeutic nihilism,” medicalese for “why bother?”

DeVita’s oncology career began when cancer treatments were brutal and futile. Primitive versions of radiation and surgery were disfiguring, and not only did medications used against cancer cause horrific side effects, they were utter failures. The cancer ward was a waiting room for death.

Not surprisingly, the dim hovel of oncology was left to low-ranking physicians who, for whatever reasons, couldn’t find homes within the more prestigious illnesses. Young DeVita himself went into oncology only because he botched the interview for his dream training slot—in cardiology.

Talk about failing up. During DeVita’s tenure, childhood cancers alone went from being invariably fatal to being curable 80% of the time. That’s thirteen thousand children saved each year in the US alone.

You’d think that DeVita’s decades of work showing that cancer was not only treatable but often curable would have also cured the oncologic establishment of therapeutic nihilism.

Not so, says DeVita, on page 26 of his book. He found that the very doctors charged with healing cancer patients often consider treating advanced cancer an unworthy activity.

“[Many oncologists] will tell you that treating patients with advanced cancer is not worth it. That’s baloney. When a doctor says that, what he usually means is that it would not be worth it for him.” (italics added)

The result?

Despite phone calls, emails, visits and pleading, DeVita failed to obtain permission to use a promising new drug, and his friend eventually perished of metastatic prostate cancer. That’s how the book starts.

The middle of the book recounts DeVita’s career building the National Cancer Institute, the world’s most ambitious, and successful, cancer research and treatment effort. It ends with irony: DeVita facing his own diagnosis of cancer, and struggling yet again, to get the best care from the system he helped build.

So who gets good care?

Per DeVita, the answer is those patients whose oncologists comb through the details of clinical studies of new cancer treatments, looking for clues that could help a minority of patients.

Says DeVita, on page 18 of the hardcover edition,

“Not many people have the time or expertise to search for and find such clues. But I do…It’s the kind of thing a determined oncologist can do on behalf of a patient now if he or she is unwilling to settle for a ho-hum standard of care.”

In summary, unless they insist on better care, most patients, even VIPs like DeVita, are in danger of getting “ho-hum,” off-the-shelf cancer treatment.

DeVita points out, however, that any oncologist determined enough can search the latest medical literature deeply, and find clues that may turn around an otherwise hopeless situation. Such searching takes time and personalized effort; both of these are on the endangered species list in most cancer clinics.

Bottom line: Find an oncologist who will turn the world upside down to find new and better treatments for you. Otherwise, even if you’re the most famous oncologist in history, you’re going to get ho-hum care.

Oregon Integrative Oncology

Leaving no stone unturned.

USA: 541-488-6261

Outside USA: 00 1 541-488-6261