By Geraldine Carroll, ASCO Publishing

The challenges, inspiration, grief, and resilience that have shaped oncologists around the world illuminate a special edition of the Journal of Clinical Oncology’s (JCO’s) Art of Oncology, which features 36 essays curated from its collection of compelling personal narratives spanning more than 20 years.

About 150 essays are submitted each year. Lidia Schapira, MD, FASCO, of Stanford University, has read 1,200 essays during her 10-year tenure as chief editor of Art of Oncology, and has also interviewed authors on the award-winning Cancer Stories: The Art of Oncology podcast.

In curating the series, Dr. Schapira chose a range of essays that speak to the mission and vocation of the profession, address ethical challenges of practice, honor patients, and provide insightful perspectives about the work and lives of this global community.

As she prepared to complete her editorship at the end of 2023, Dr. Schapira reflected on how her role turned her into a kind of literary confidante, privy to very personal reflections about grief, loss, failure, and hope from essay authors.

“It helped me to expand my thinking about what it is that our colleagues are thinking or worrying about or struggling with,” she said. “Reading every essay felt personally meaningful because authors shared vulnerabilities and related stories of powerful personal connections they were still thinking about, even if those events took place a long time ago.”

Dr. Schapira believes that sharing personal stories can strengthen a sense of community, and help oncologists communicate better and think in different ways about complex moral or ethical problems. Such improvements, she said, can positively impact the care of patients with cancer everywhere.  

Contributors concur. “The Art of Oncology column acknowledges the humanity of the oncology workforce and honors our experiences as individuals who must balance the triumphs of our very rewarding profession with the frustrations of loss or failure,” said Fumiko Chino, MD, of Memorial Sloan Kettering Cancer Center, and a featured Art of Oncology author. “The stories shared through the column strike a chord with many of us because we recognize that push/pull of being the person who brings hope and treatment options, but also gives bad news or is unable to cure.”

The Path to Self-Discovery in Academic Medicine

The essays are poignant and deeply personal. For instance, in “My White Coat Doesn’t Fit,” Venezuelan-born Narjust Florez, MD, of Dana-Farber Cancer Institute, shares her struggle during her medical residency to feel a sense of belonging as a Latina in medicine. A lack of support and hurtful, negative comments from some of her peers ultimately led to a bout of depression. “I felt pigeonholed into a constricting stereotype due to my ethnicity and accent,” Dr. Florez wrote.

Often the only Latina in the room as a resident, Dr. Florez’s route to self-discovery helped her find her calling to support others in similar situations: “I learned how to incorporate and celebrate my ethnicity in the world of academic oncology by teaching others the power of cultural humility, diversity, equity, and inclusion.” She founded the #LatinasinMedicine community on Twitter and the Florez Lab, a research group that focuses on cancer health disparities and discrimination in medical education.

A Catharsis in the Face of Grief

Writing can be a powerful tool in the healing process, providing clarity and comfort. Dr. Chino said it’s healing to know that grief and loss are common in oncology and less isolating to learn that someone else has felt something similar. “I have felt crushed over losing a beloved patient that I couldn’t ‘save’… it can feel like a personal failure when our best treatments just don’t work. Knowing that others who have been through something similar have been able to emerge on the other side and carry a message or a lesson learned forward is empowering,” she said.  

Dr. Chino has also navigated grief following the death of her husband, Andrew; her essay, “Pet Therapy: How the Cat I Never Wanted Saved My Life,” reflects on how her late cat, Franklin, provided an extra layer of support that “allowed a desperate present to turn into a hopeful future.” 

Essays by patients and caregivers have also featured in Art of Oncology.  In the essay “Access Denied,” a bereaved mother, Elizabeth Conrow, whose 5-year-old daughter, Amanda, died of cancer, shares the heartbreaking moment she tried to access her daughter’s patient portal but was denied access. “Just 2 weeks after losing my daughter, I faced yet another heartbreaking and unexpected loss: I no longer had access to Amanda’s medical records. I no longer had a connection to her medical team and the hospital family I had grown to love and care for,” she wrote.

Ms. Conrow has used her experience to advocate for changes to access for medical records, stating that ensuring continuing access after a loss should be considered essential: “As parents grieve the loss of a child, comfort and connection should be readily available without having access denied.”

Cancer Stories: The Art of Oncology Podcast

The award-winning Cancer Stories: The Art of Oncology podcast has illuminated poignant moments in cancer care and the doctor-patient relationship since 2017 and provided oral histories of trailblazers in oncology.  The podcast received the highest honor in the Software and Information Industry Association’s 2023 AM&P Network EXCEL Award—the premier awards program honoring association media. Dr. Schapira was honored to receive the award.

“Pairing the written narrative with a conversation allows us to engage people through their senses and amplify the impact of these stories,” Dr. Schapira said. Writing is a way of processing experiences and stimulating the creative centers in our brains, she noted, and reading is a way of cultivating empathy by appreciating other perspectives. “I hope that listening to the author’s reflections adds another dimension to the experience of storytelling and stimulates reflection, while also connecting us to one another,” she said.

Dr. Schapira is excited for Art of Oncology to continue its important function in JCO in the years ahead. “By selecting pieces that reflect on common challenges we face in our lives and practices, we can influence attitudes and shape the discourse in oncology, and help set the agenda for skills-based, compassionate and ethical practice,” she said.

Read the complete Art of Oncology special edition.