A patient who refused chemotherapy offered Dr. Erika Hamilton a lesson in compromise. 


Peggy Zuckerman,

Aug, 07 2018 7:22 PM

As a patient advocate and having the chance to talk to a mix of cancer patients, I would suggest to both patients and physicians that they discuss very openly exactly what the patient understands chemotherapy to be, and how he/she will likely react to it.  I would further ask what experiences have led to that understanding, and also what the patient fears the chemotherapy will do in his/her case.  Too often a patient will remember a relative who had a miserable and futile experienc with chemotherapy, yet upon being asked to expand on that, will realize that that "chemo" happened twenty years ago, with another type of cancer, and with or without surgery.  

It is very easy to latch onto the emotional impact of such an experience, and not realize that times and treatments have trained.  My father died of prostate cancer 30 years ago, and yet it took me at least 15 years not to same a quiet 'goodbye' to the newly diagnosed friend, assuming that they were doomed.  Often a simple, "What makes you think that?" can open a conversation and let the two parties have a more accurate and informed discussion.  And it doesn't hurt for the doctor to remind the patient that they have learned a lot since that chemo, that death, that extreme response.


A precision therapy was indicated and available for my patient, but we lost the window of opportunity to administer it safely.

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Every patient with cancer deserves equal access to the highest quality care and the opportunity to participate in research.


Dorothy Chilambe Lombe, MD

Jul, 24 2018 8:42 PM

Thank you Madam President. We appreciate this inclusion and are already seeing the fruits. LMICs are going through the motions high income countries have gone through already in technological advantages. In a sense it is a priviledged position. We don't need to re-invent the wheel but we need to work closely with colleagues in resource rich environments to make the most of what we have and reverse innovate for the good of our patients.

Dorothy C. Lombe, MD

Clinical Oncologist, IDEA 2016 alumni, LIFE 2018 recipient


Thanks to Conquer Cancer grants, when Dr. Dorothy C. Lombe treats patients with cervical cancer in Zambia, "I will be able to hold more women’s hands and say yes where I had previously said no."

At the most recent Board of Directors meeting, we heard insightful presentations from participants in the Leadership Development Program, pivoted toward the execution of our 5-year strategic plan, and had a...


Raju Kumar Vaddepally, MBBS, MD

Jul, 06 2018 9:55 PM

I am interested in asco leadership development program, how can enroll in to this opportunity? I am early career oncologist.




Michal Tibbits

Jul, 07 2018 9:46 AM

Thank you for your interest in ASCO's Leadership Development Program. The application is open until September 25. Program details and eligibility criteria are available on For specific questions, you can contact email us at or call 571-483-1397.

This was a patient who needed to do cancer her way, and making it about me was not going to work.


Brenda Denzler

Jun, 23 2018 9:42 AM

This is a great article.  I did something similar to/with my doctors when I was going through cancer treatment.  I had inflammatory breast cancer, wherein the customary surgical response is to remove all axillary lymph nodes.  I fought like crazy to preserve them or, failing that, to minimize the damage caused by surgery by not allowing axillary radiation.  In fact, I asked the radiation oncologist to re-do the treatment plan because there was too much scatter to the axilla for my comfort.  I didn't want stray rads to fry the little lymphatic capillaries that were trying to re-grow in that area. 

I realize that my obsession with my axillary nodes didn't make sense to my doctors.  I think I know why, too.  They were focused on the cancer, pure and simple, focusing on "my life" only as an abstract proposition--something they hoped to make sure I had more of.  I was focused on the cancer, but it wasn't a pure and simple mono-focus.  My axillary health was part and parcel of a continuing life that I was envisioning and planning to have.  There was nothing abstract about it. 

In that continuing life that I was taking as a given, I wanted to have as intact an axillary system as possible, both for functional reasons and because I didn't want to be put in the position of having a secondary, lifelong illness as a result of my treatments.  If they were going to give me my life back, I reasoned, then I wanted all of it back, not just a portion of it. 

So I get your patient.  I mean, I think I understand her reasoning.  She was planning on life.  You, on the other hand, were trying to avoid death.  Those two ways of viewing the same problem can result in very different priorities. 

As a pragmatic investigator and physician who has witnessed remarkable progress in the treatments we can now offer individuals with cancer, I believe the FDA’s support of more rapid and nimble testing and...


Robert K. Oldham, MD

Jun, 16 2018 8:34 PM

Not much new in these comments.  ASCO needs to be more supportive of patient access to new drugs rather than supporting the same old positions of the academic centers.

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