Mar 02, 2017
By Hilary Adams, Staff Writer
Three years ago, Richard “Rick” Boulay, MD, chief of gynecologic oncology at Lehigh Valley Health Network, walked onto the stage at TEDx Lehigh River and confronted his audience with something people tend to take for granted.
“We all share a bias against cancer,” he said. “We have a negative stereotype of what cancer does and what it is. It only leads to misery, tragedy, and death.”
He paused. Silence.
“I didn’t hear an ‘ah’ saying that that is unusual.” He continued. “The interesting part is that although that is true in some cases, in most cases it is not.”
Dr. Boulay’s talk, “Cancerism: Confronting the Biases We Share,” questions the attitudes many people have toward cancer: fear, hatred, and, after diagnosis, resignation.
In the talk, he shares the story of a patient at Lehigh Valley who was diagnosed with a form of ovarian cancer with a relatively high cure rate, but refused treatment in lieu of caring for her father, who was dying of cancer at the time. Her mother had already passed away, also from cancer. Three years after their initial meeting, Dr. Boulay was called to the ER, where his patient had been admitted for heavy bleeding, and found her cancer had metastasized to her liver and lungs.
“She said, ‘Doctor, it’s okay. That’s what it’s like in my family,’” Dr. Boulay recounted. “She comforted me during this time.” She died a week later.
“I couldn’t help but feel tremendous tragedy,” he said, “trying to understand how this patient had a curable disease and died of a curable disease—not from the disease itself, but from her understanding of what the disease would do.”
Mind Over Cancer
Dr. Boulay received his medical training at the University of Pittsburgh School of Medicine in 1990, completed his fellowship at Milton S. Hershey Medical Center in Hershey, PA, in 1995, and has been a board-certified gynecologic oncologist since 1998. For the last 18 years, he’s accompanied thousands of patients through their cancer journeys.
When asked about reframing one’s outlook after a cancer diagnosis, Dr. Boulay echoed his sentiments from his TED talk.
“How we manage our hopefulness and how we go through our treatment and survivorship day-to-day really does matter,” he said. “If you’re feeling bad and you can’t get through treatment and you decide to skip a day or two of radiation, that really adversely affects overall cure rate. Having an attitude that allows you to be resilient enough to get through treatment measures is going to improve your overall survival.”
Dr. Boulay is excited by the possibilities of leveraging human connection and a constantly evolving understanding of cancer to improve the lives of cancer survivors. He acknowledges that while there is still much we don’t know about cancer, there a few key things he’s discovered over the course of his career.
“You feel really privileged to work with amazing patients,” he said. “That doctor-patient relationship is a sacred space, and I’ve found it to be a two-way street where I’ve received much more than I’ve given.
“As a practitioner, I’ve learned to understand the breadth of cancer and a person’s response to it, but I never really understood the depth. When my wife and dad were diagnosed, it really came close to home and I understood then the depth of how it feels,” he explained.
“This was still secondhand, but working as a caregiver and managing people’s post-op stuff at home, medication, and the psychosocial stuff that goes with it, was too much for me,” he said. “It was the patients who got me out of the hole every time, in learning to understand how to manage the day-to-day aspects of survivorship through treatment and even after treatment.”
Sharing Lessons in Survivorship Through Music
Cancer is woven through Dr. Boulay’s family like a thread in a tapestry: his grandmother, uncle, father, and wife had all received diagnoses of various types of cancer. Having experienced the roles of both physician and caregiver, Dr. Boulay decided that he had a responsibility to share the lessons he and so many countless individuals have learned from their cancer experiences.
Dr. Boulay and his wife, Julie, cofounded the Catherine Boulay Foundation in 2007 in honor of his grandmother, who died from cancer when he was young. The foundation’s mission is to support the journey through cancer and beyond, emphasizing not only patients but also families and caregivers—everyone who is affected by a cancer diagnosis. When it became clear that they needed to raise funds, Dr. Boulay tapped into one of his lifelong passions: singing.
“I have always sung. I’ve trained in it for a long time. For me, it’s a way to get that emotion out,” he said.
Dr. Boulay has recorded four albums of popular music, with each song accompanied by a reflection or question in the insert. He hosts interactive programs every year for cancer survivors and their caregivers, using his music and these reflections as a sort of guided meditation for those in attendance.
The songs are classics that everyone knows: “Somewhere Over the Rainbow,” “Lean on Me,” and the hit song from Rent, “Seasons of Love,” are all featured on his first album, Hope. He collaborated with the Kutztown University Jazz Ensemble on that album. For an upcoming album, he wrote all original music with the help of composer Dan Foster.
Before his first concert, though, Dr. Boulay was challenged by a cancer diagnosis that struck very close to home. At the age of 44, his wife was diagnosed with leukemia.
“My first CD dropped about 3 weeks before my wife was diagnosed with leukemia, and the only thing I knew about leukemia was that you got it and you died 3 years later, which was what happened to my uncle a few years prior,” he said. “Our kids were young, and I had the first concert set up. So I’m doing this interactive concert about being hopeful, my wife could barely get there because her white blood cell count was so low, and I felt like the biggest fraud because of how unhopeful I felt at the time.
“But what I found, for me at least, was that music spoke to me in a different way. Those nights we couldn’t sleep because life was too much at that point, just listening to an iPod and hearing melody and lyric in ways that I hadn’t heard before was, I found, incredibly powerful.”
According to Dr. Boulay, survivorship begins with the discussion of treatment options and what a patient wants to accomplish after they have received their diagnosis. While the conversation starts with communicating the prognosis and possible courses of treatment, Dr. Boulay advocates continuing beyond those points to the issues that are front of mind for the patient: What do they want to get out of their lives? How will treatment affect them? Do they want treatment at all?
“Giving information in a way that is received intellectually is just the beginning,” he said. “Making sure that you can understand what people want from their lives and try to help them figure out the best way you can go there together? That is medicine.”
“Close to Home: Cancer Survivorship”
Last fall, PBS broadcasted a documentary, in concert with the Catherine Boulay Foundation and Lehigh Valley Health Network, Close to Home: Cancer Survivorship, featuring Dr. Boulay. In it, cancer survivors discuss their experiences—from diagnosis through their remissions and life after cancer—framed within the context of survivorship. You can watch the full documentary on YouTube. Accompanying the documentary is a companion soundtrack, Close to Home: Songs of Survivorship, which explores survivorship issues though song.