Get Busy Living...

Get Busy Living...

Don S. Dizon, MD, FACP, FASCO

May 01, 2012

One of the hardest jobs in oncology is to deliver bad news—like telling someone that their disease is metastatic and no longer curable. In such a situation, I try to be as direct as possible—not to mince words—yet, at the same time, not to deprive anyone of hope.

Still, I often wonder what happens after they leave my office, after their worst fears about cancer have been realized...after a patient has been told her disease is metastatic and no longer curable.

When I was in New Haven for medical residency, Sam and Barbara, the parents of my friend Michael, took me into their home and became like surrogate parents to me. I always had a place at their dinner table, and I often found myself in their kitchen to escape from medicine. I spent countless hours there and celebrated more than a few holidays with them, Michael, and his wife, Sarah.

When I left New Haven for fellowship in New York City, I would see them rarely, but I always tried to stay in touch. Shortly after I left New Haven, Barbara was diagnosed with breast cancer. I followed her progress from afar as she underwent breast conserving therapy and adjuvant treatment, and celebrated the day it was all done. After several years of calm, her cancer recurred, and this time the news wasn't good. The cancer had spread to her liver and bones, and she was told it was not curable.

In one of my visits to their home, she told me about that experience of being told she had incurable cancer, about how it was hard to hear the term "metastatic" applied to her situation. She told me how she and Sam drove home later that day; how they sat in the kitchen, wondering what would come next, and what they were supposed to do now. She had told me how Sam was driving her crazy being at home with her—knowing there was little he could do. She also told me how waiting around for "the end" was not part of her plan. So, she told Sam to go back to work, because she intended to do the same. She embarked on treatment knowing that every day/month/year was a victory. Ultimately they spent their time together traveling, laughing, and living. Despite metastatic breast cancer, she lived for years and was there to see her daughter marry and her grandchildren enter this world. I can honestly say, she lived. And she lived well.

This thought came to me after a truly enlightening weekend in Philadelphia attending the Living Beyond Breast Cancer annual conference for people living with metastatic breast cancer. It was empowering to see men and women attend this conference, most of whom were living with metastatic breast cancer. The energy of the room brought back memories of Barbara—her spirit, her humor, and her vigor.

During the meeting, I learned what I believe human nature tells us we must do after being told "you have metastatic breast cancer"—and it was what Barbara had taught me so many years ago. We live. We reach out, find support to fight, and in the process, become more than survivors—we become "conquerors." Indeed—as Andy Dufresne said best in The Shawshank Redemption—we decide to "get busy living" not "get busy dying."

I have always found oncology to be an incredible testament to the strength of the human spirit. I think the bravest people I know are those that face each day living with cancer, face each treatment despite any side effects, and approach each test result head on, all the while knowing that there are no guarantees when it comes to the treatment of cancer.

This past weekend I saw firsthand the strength and perseverance that meets "what's next." It was evident in the attendees, the speakers, and the energy that filled the ballroom. But, more than that, I recognized that organizations like Living Beyond Breast Cancer, ASCO, and the American Cancer Society, have helped us to become more than just a group of people sharing an interest and a common cause—we have become a community. I am a member of this community of cancer conquerors...and I could never be more proud to be in their midst.


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