From OncoLog, April 2005, Vol. 50, No. 4
Redefining Success in Cancer Care
Michael Fisch, M.D., M.P.H.
Medical Director,
Community Clinical Oncology Program
Since my first days at M. D. Anderson Cancer Center, I have been inspired by the photographs on the walls of people who have been successfully treated here. These are people of various backgrounds and ages, but the attribute they all share is that they have defeated the cancer that threatened their lives. They appear triumphant, and below their names and ages is the name of their malignancy crossed out in red ink. These photographs cause me to reflect on this question: How do I define success in caring for patients with cancer?
The people in those photos are inspiring success stories, no doubt—after all, Making Cancer History® is M. D. Anderson’s ultimate goal. Yet something seems to be missing; the pictures don’t quite tell the whole story. It reminds me of a baseball player who says his mission is to win the World Series. While true, it doesn’t fully explain the meaning of his efforts each inning of each game throughout the season. Why does he continue to put on his uniform, show up at the ballpark, and sprint for fly balls when the goal of winning the World Series is no longer attainable?
Palliative care physicians often counsel patients about the possibility of finding hope and meaning, even in the face of disappointment or very difficult circumstances. A well-known work in this realm is that of Dr. Viktor Frankl, a psychiatrist and survivor of the Holocaust who wrote Man’s Search for Meaning. One of the statements in his book that I found most striking is this imperative: Live as if you were living for the second time, and had acted as wrongly the first time as you are about to act now. At first it seems confusing, almost like something you might find in a fortune cookie. But with further reflection, I think this statement points toward a more satisfactory definition of success in cancer care.
Success is the act of striving to achieve the very best for our patients, whether it’s the first inning or the ninth. It’s thinking and acting with care and skill so that we achieve the most thorough understanding of a person’s illness, the best possible relationship with the patient and the family, the most ideal delivery of care through teamwork with other health professionals. We help patients maximize both their length of life and quality of life while preserving their dignity each step of the journey.
In the course of striving to give patients our best, sometimes we eradicate their cancer. Sometimes we can’t. Regardless, each patient we treat could be a model of success in our campaign—as long as we are mindful of what it is we are really doing in the practice of cancer medicine. This may sound strange, but it’s true—success is all about us.For more information on this topic or for questions about M. D. Anderson’s treatments, programs, or services, call askMDAnderson at (877) MDA-6789.
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