Perspective

On Cancer: Personal Reflections from a Medical Oncologist

Pictured: Medical oncologist Diane Reidy-Lagunes Medical oncologist Diane Reidy-Lagunes

Diane Reidy-Lagunes is a board-certified medical oncologist in the Division of Gastrointestinal Oncology in the Department of Medicine and Co-Director of the Department of Medicine’s Hematology-Oncology Fellowship Program.

It’s almost July, the time of year when an army of young and energetic physicians storm hospitals across the country and eagerly begin their residency and fellowship training. It’s also my first year as Co-Director of the Memorial Sloan Kettering Department of Medicine Hematology-Oncology Fellowship Program. With that title comes the responsibility to teach the leading young physician-scientists to be outstanding oncology researchers — and equally important is to educate them on being caring and compassionate cancer doctors. I share the following story so that my fellows recognize the challenges that they will likely face. I hope it will also serve to motivate and inspire us all to do better.

Hopes Raised, Then Dashed

After two CT scans showed no sign of cancer, everyone was feeling hopeful about Drew’s future. A 21-year-old college student with an upcoming summer internship, he had three months of adjuvant chemotherapy left, in which we’d attempt to eradicate any microscopic adrenal cancer cells that might still be lingering following his big surgery, which consisted of removing his right adrenal gland and part of his liver. After that, he planned to return to his senior year at a top university, where he would graduate magna cum laude. At least that’s what was supposed to happen.

Then his latest CT scan came back. New tumors were infiltrating his lung, liver, and lymph nodes. The cancer had recurred.

It fell to me, as his treating physician, to break the news — and I found myself struggling with it. How could I explain this to such an extraordinary young man and his supportive family? I retreated to my office to compose myself. When I summoned the courage to face them, it turned out that I didn’t even have to say much; my swollen eyes and the look on my face told the story.

Continuing the Fight

When it comes to cancer, these scenarios are heartbreakingly common — especially in my specialty. I research and treat rare forms of the disease, such as neuroendocrine and adrenal cancers, which don’t get the same funding and resources as more common cancers. I chose my specialty partly because I want to find better treatments for my patients. Developing methods to integrate molecular-based, or “targeted,” therapies and trying to understand how these rare cancers evolve so that we can best target them are two ways we’re attempting to improve our odds. But it begs the question: If we have so many more losses than wins, why do we keep fighting?

We fight because we do have many wins, and those gains are part of what motivate us to keep going. I am fortunate to work with some of the most brilliant and talented physicians and researchers in the world at Memorial Sloan Kettering, and we all fight daily to improve the chances for our patients.

Each one of us is driven by some internal motivation, whether it’s our innate desire to help others, our hope of advancing science to improve treatments, or that we’ve lost a loved one to cancer.

Staying in the Here-and-Now

But we’re not there yet. Although I am also a researcher, I view my primary job as a clinician caring for patients in my clinics right now, the ones waiting for my help and attention. And the truth is that many of them, particularly those with stage IV disease, will die from their cancer. For them, science has not yet achieved victory. We exhaust every option, controlling the cancer for as long as possible and tenaciously continuing our research, but a cure thus far ultimately eludes us. The patients I lose are young adults; they are parents of small children; they are grandparents. Although it is my duty to honestly explain patients’ prognoses, it is hard to escape the pain I feel as I look them in the eyes during that vital discussion. It hurts a lot.

With that painful realization, I also have a responsibility to give them the confidence that I, their treating physician, will be traveling this journey with each and every one of them — and sharing all their emotions along the way. Equally crucial is to provide hope, because the truth is that neither I nor anyone else can predict any one patient’s outcome.

After several more attempts at treatment, Drew passed away from metastatic adrenal cancer on Valentine’s Day of this year. Before he died, he wrote a letter entitled “Saying Good-bye to a Friend,” intending to send it to his friends and family. He never finished it.

I hope that one day I’ll help make those good-byes no longer necessary.

Comments

Congratulations, Dr Reidy!

It was a pleasure to be in your clinics for some afternoons in my Observership in MSKCC. Your knowledge and love for the patients taught me a lot! Being with a complete oncologist help us to construct the kind of doctor we would like to be!

Wish you success, strength e happiness in your new mission!

Best Regards,

Daniella.

As Manager of the Tumor Registry at MSKCC - even though I knew better - I was hoping for a miracle at the end of your story. You are a wonderful person to help people the way you do. I am so proud to be part of the MSKCC team as it is a great place to work and I believe every patient is given hope and an opportunity to believe they will "get better".

As a RN for 30 years and as a family member of cancer patients, I have learned the true caring of a health care professional is invaluable to the patients and families. While your medical knowledge is sought after, sometimes a kind thought is what is remembered and cherished. Keep caring. I applaud the work you do.

From the first day we met you in your office with Cheryl, we could see the concern and care that you have for each patient. You have always been the kind of physician that truly cares for your patients and we cannot imagine going through this journey without you caring for Cheryl. Thank you for all you do for the patients under your care.

Michael and Sara, thank you so much for your kind words. We have shared your message with Dr. Reidy.

God Bless You!!! I've been a patient at MSKCC since 2007 for thyroid, bladder and prostate cancers. Your the kind of doctor I appreciate.

You're (Correction)

I have been in the field of Oncology since the late 80's (on the commercial side) and this is really sad to me. I have not seen the advances except in experimental therapies like personalized Cell Therapy (Gene modified T-cell, Dendritic cells or genetic testing ) until only recently and not many know about these therapies.

What is worse is that only in our nation can a regulatory agency like the FDA give in to large lobbyists and companies to allow what we put in our mouth to actually be the same as unregulated drugs. Today as a nation we still modify our food (GMO) and pour pesticides into and on everything before proving they are safe by similar standards as we do in the pharma and biologics industry. It makes no sense. Most of the developed world does it the right way.

So all we do is try to solve problems after they have happened which is likely in the case of Drew and many other kids I see in my job every week. It seems silly to waste billions in research and eventual clinical trials when the FDA could really solve this up front. I don't get it. If you'd like the documentation to back up what I'm saying, just let me know. Kudos to the MSKCC staff for all they do. Great organization.

Dr. Reidy - you bring hope and compassion to many who come to you for your expertise. Although many call the treatment a "fight" or a "battle" against the disease, I believe this struggle is more of a journey that you wholeheartedly choose to travel along with your patients. Hopefully one day, this "journey" will take the patients; and you to higher heights in achieving a cure.

Dr. Reidy - you are truly an amazing young medical oncologist. I have seen you several times at your office and hope to visit you again. Please keep up the good work. You give use all a chance for a longer future. We want every cancer patient to have many more birthdays.

I am most great full that Dr. Reidy is with me on this journey of living with cancer. Her optimism and thoughtfulness makes the struggle that much easier. Thank you, Dr. Reidy.

Dr Reidy if it weren't for you and the staff of Sloan we wouldn't have my mom around. You have touched our lives not only for the efforts you make and your knowledge, but your kind words. You are one of a kind. My heartfelt thanks for all you have done for us.

Dr. Reidy: I am honored to run on Fred's Team with you. My wife and both parents are cancer survivors, although I have many friends that are not. I run to raise money so cures increase, and to help make a difference. Keep up the great work and hope to see you at the dinner before the race.

Dr. Reidy:

I read this article when it first came out, but am now going back and re-reading it. You treated my best friend, Nan Purvis Lanier for years until she passed away this past March 27.

I feel like it's my duty to tell you how much my dear friend thought of you. She would come back from her trips to Sloan Kettering saying "I got to see my gal, Dr. Diane Reidy! She is so beautiful and smart!" She honestly was so proud of you.

I am so grateful to you for how well she was treated at Sloan. It seemed the approach factored in her daily quality of life, as well as trying to treat the tumors. That was so important because in those last years she could actually enjoy her life with her young son, Greyson, grow her hair back out, and not feel so terrible all the time. I know she was so grateful for each second she had with him.

I just wanted to say thank you for all that you do. I know Nan appreciated you so much and I wanted to pass that along.

Thanks again,
Sarah Young, Raleigh NC

Sarah, thank you so much for your comment. We've forwarded it to Dr. Reidy. We're very sorry for the loss of your friend.

Add a Comment

We welcome your questions and comments. Because this is a public forum, please do not include contact information or other personal details. Also, keep in mind that while we can provide general information and resources, we cannot offer personal medical advice. To make an appointment with one of our experts, contact our Physician Referral Service at 800-525-2225 or online.
Your e-mail address is kept private and will not be shown publicly.

More information about formatting options