Oncology is one of the most emotionally and mentally challenging careers. Every day, oncologists make excruciating decisions and have difficult conversations with patients who are fighting for their lives.
Yet many oncologists say love their jobs despite — or because of — these challenges. Medscape spoke with four oncology care providers to get an inside look at why they find their careers so fulfilling.
Resiliency After Tragedy
In 2007, medical oncologist Patricia Rich, MD, diagnosed her 23-year-old son, Phill, with leukemia. She cared for him through multiple bone marrow transplants before he died in 2009. Six months later, Rich's partner, Tony, died from an abscess in his brain.
In the face of such devastating loss,how can an oncologist still love their work?
"Loving oncology and feeling the weight of tragedy are not exclusive," said Rich, who specializes in treating lung cancer at City of Hope in Atlanta. "Oncologists often live in the extremes of humanity—triumphs and tragedies. It's why I talk a lot about resilience: bending, bending, bending, but not breaking."
Rich has had a lifetime of experience bending but not breaking. Growing up in Argentina in the 1970s amidst war, she remembers falling asleep to the sounds of shotguns and bombs. When she was 20, her family emigrated to the United States.
As a mother of four at age 34, Rich embarked on medical school at the University of Miami, fulfilling a childhood dream. As a young girl, she got her first taste of what being a doctor might be like while delivering polio vaccines in sugar cubes to children in Buenos Aires' informal settlements. During her medical training, Rich thought pediatrics would be the obvious career choice, but that changed during her oncology rotation when she cared for a young woman with esophageal cancer.
When Rich met the woman, she was struck by how sad and lonely she seemed. Rich gave the woman a hug to provide some comfort, and the patient began to cry. Rich apologized immediately, thinking she had made a mistake. But the patient explained she was happy. Ever since she had been diagnosed with cancer, no one had touched her.
"That was the moment," Rich said, "that I realized how much I loved oncology and that it was my calling."
The instinct for compassion that compelled Rich to hug her patient deepened with her experience of caring for her son. It showed her "how much empathy and connection matter in healthcare," she said. Through oncology, Rich can give her patients the gifts of resiliency, hope, and connection.
"Phill's journey and his presence are foundational to the way I approach patient care," Rich added."He made me a better oncologist."
Advocating for Empathy
Judith Alberto, MHA, RPh, had been a pharmacist for 20 years when a "horrific experience" motivated her to enter oncology.
In 2005, her 58-year-old mother was having cognitive problems, so Alberto's sister took her to the emergency department at a university teaching hospital. After her mother received a CT scan, the tech walked in chuckling and flippantly asked, "So, how long have you had a brain tumor?"
Alberto's mother was diagnosed with glioblastoma and was given 9 months to live.
During her mother's hospital stay following surgery, Alberto recalled how the nurses did not respond to calls for help during her mother's bouts of vomiting and excruciating migraines. The staff kept forgetting to administer steroids to alleviate the brain swelling.
After several incidents of neglect, Alberto took her mother to Jefferson Health's Sidney Kimmel Cancer Center in Philadelphia. There, her mother experienced compassion. Alberto was so moved by how well her mother was treated that when a job became available at Jefferson Health in oncology pharmacy, she applied.
Alberto worked at Jefferson Health for 12 years. In that time, she thought of her mother each day as she built a team of oncology pharmacists dedicated to treating patients with empathy.
"I really have such a heart for cancer patients," said Alberto, who recently became the director of clinical initiatives at the Community Oncology Alliance. "If I can make things better for them, I will."
Alberto encouraged her team to take time to talk with patients, to hold their hand if they needed consoling, and to let them know the pharmacy team would take care of them and do everything to make their journey as smooth as possible.
"I fell in love with [oncology] because of the challenge and because you realize the good you're doing," said Alberto. "We can make such a difference in their lives, and that's really rewarding."
Inspired by Patients
In 2019, hematologist-oncologist Nuruddin Jooma, MD, hiked Mount Kilimanjaro. As he trekked through the bitterly cold, thin air to reach the 19,340-foot summit, he thought of the challenges his patients face.
"I kept thinking, this is nothing compared to what they go through," said Jooma, who works at Florida Cancer Specialists, which has locations throughout the state.
Jooma initially veered away from oncology, thinking it would be depressing. But Jooma had a change of heart after his first day doing a clinical rotation in oncology.
He was surprised that, even in the face of harsh diagnoses and treatments, many patients remained hopeful. He enjoyed his interactions with them so much that, when he peered down at his pager that first day, he was shocked to discover it was after 6:00 PM.
"This was the first time in my training that I wasn't constantly looking at my pager to see when we would finish up. The time flew by," Jooma said.
Jooma recalls an experience in his training that left him feeling inspired. A patient with lung cancer was struggling to breathe and needed a wheelchair. The patient received a pill — erlotinib — that had just been approved to treat lung cancer. Six weeks later, the man walked into the hospital.
These early moments convinced Jooma to become an oncologist.
While Jooma is gratified to know that he can help his patients, he's also grateful for the difference his patients have made in his life.
"I've learned so much from my patients — to keep my priorities together, to not let the little things bother me, and to count my blessings more than I ever used to."
A Mix of Technology and Care
Robert Gin, MD, remembers how a cancer scare at age 17 led him to oncology.
After noticing that lymph nodes in his neck were swollen, Gin went to the doctor. The physician told Gin that he might have cancer. When he got home, Gin was afraid to tell his parents because he didn't want to worry them.
Although blood tests ultimately confirmed Gin was cancer free, the shocking experience opened his eyes.
"Prior to that, I never knew about oncology," Gin said. "This piqued my interest in cancer."
Initially, his interests leaned toward lab-based cancer research. As an undergraduate, he focused on chemistry and cellular biology. But while volunteering in a radiation oncology department, he realized how much he enjoyed interacting with patients. He was impressed with the patients' courage and the clinical staff's compassion.
These traits resonated deeply with Gin. The son of Chinese immigrants, Gin witnessed his parents' thoughtfulness and generosity while working in their grocery store in Chandler, Arizona. His father drove customers home if they didn't have a car and brought meals to hungry neighbors. His mother extended credit to people who couldn't pay.
"These acts of kindness made an impression on me," said Gin, who works at Arizona Oncology in Tucson.
Gin loves radiation oncology, in particular, because it allows him to combine compassion with cutting-edge technology, math, and physics. He is excited about treatments like stereotactic body radiation therapy, which delivers a powerful dose with pinpoint precision that minimizes side effects. The calculations he performs to determine dosage directly translate to his patients' quality of life.
When he builds relationships with patients, he remembers his cancer scare as a teenager.
"I put myself in their shoes," he said. "I can empathize with what they are going through, and I take care of every patient as a person, not just a diagnosis."
Keridwen Cornelius is a freelance journalist and editor based in Berlin, Germany. Follow her on Twitter @keridwen77.
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Lead image: Fizkes/Dreamstime
Image 1: Arizona Oncology
Image 2: Judith Alberto
Image 3: Florida Cancer Specialists
Image r: City of Hope Atlanta
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Cite this: Why I Fell in Love With Oncology: Hope, Compassion, Connection - Medscape - Mar 30, 2023.