The Oncologist as Author: On Guiding Patients Through Cancer 

A Conversation With Kevin P. Ryan, MD, FACP


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When Tumor Is the Rumor and Cancer Is the Answer is the guidebook to cancer that Kevin P. Ryan, MD, FACP, COL, USAF (ret) wished his patients had during his 30 years of practicing oncology. The book, recently published by AuthorHouse, is an authoritative, inspiring, and even philosophical guide for individuals and families dealing with cancer. It is also the very personal reflection of a man who was not only a clinician—now retired—but who has been a researcher, Air Force colonel, musician, theater reviewer, and Mensa and Intertel member.

Living in Fairfield, California, Dr. Ryan, currently focuses on teaching and writing. In a conversation with The ASCO Post, Dr. Ryan described his experience writing the book, and what he believes it offers to patients.

Patient Heroes

Let’s start with the obvious question: Why did you write this book?

I thought it had to be done. For oncologists, there are always patients who tug at your heart, or your head, or both, and if you admit to that, you want a way to deal with it and to record these experiences.

When I looked around, I didn’t see any books like this. There were books on this tumor and that tumor, this therapy and that therapy—all were about different mouse traps. None seemed to take the patient from the anxiety of thinking it might be cancer, to the diagnosis, through treatment, and afterward, and in a personal way. The book tries to envelop with knowledge the overwhelming sense of loss of control associated with cancer.

I also wanted to pass on stories of patients I consider heroes. The project took me more than 4 years to complete. It required me to be introspective, and it was an affair of the heart.

Large Scope

What does your book offer patients that they cannot get from their oncologist and oncology staff?

There is an awful lot involved from diagnosis through treatment, and oncologists don’t have time to address in full detail the many questions their patients may have. Studies show that patients want time with their doctors, they want more psychosocial involvement, and they do better when they have it. Oncologists cannot possibly reach out and connect on all these levels with their patients—not that they are averse to this, but they don’t have time.

 

Tell us what you included in your book.

The book has a very large scope. It opens by addressing the hit-in-the-gut issues that arise immediately following a cancer diagnosis, and I have tried to give a way of achieving the right mindset for this. I titled the first chapter, “Read the Directions First,” and I include what I call “recipes” for mental and emotional success as patients gird up to weather this storm. I ask patients to “live the good life” and to maintain autonomy, in spite of cancer.

Then I have a big overview of oncology, principles of the various treatment modalities, side effects, alternative and unproven therapies, cutting-edge therapies, medical ethics (which figure into decision-making), and advice to family members on talking with their loved ones about their cancer.  Other chapter titles include “Anxiety Versus Fear,” “When You Suspect the Diagnosis,” “Clinical Trials,” “The Problem of Pain,” “Biological Therapy and the Future,” “Spirituality,” “Medico-Legal Aspects of Oncology,” and “Internet”—which should give you an idea of just how wide-ranging the book is.

I am also speaking to the oncology team, trying to relay what legions of patients have taught me about what works best in terms of respecting their autonomy, keeping them informed, and quenching their anxiety. I hope the book will be useful for speaking to, counseling, and interacting with patients and families.

The Doctor’s Perspective

Your book is not only informative about the biology and treatment of cancer, but it also describes the oncologist’s world to the patient.

Patients ask us all the time, “How can you deal with cancer every day?” Well, whether oncologists are in institutional, academic, or private practices, I see the same traits in many of them: They are all boxing with God on “the Big C.” Oncologists are good at solving mysteries. We like getting to the answer, we are thrilled to get to the core of life, and with the emphasis on genetics, we are seeing these dreams come to fruition.

We want to win the prize, but we may not always be so good at handholding. That’s not our drive. We are driven by a need to beat what might be unbeatable. We also love systematic analysis of data, and so we are masters of clinical trials. Patients have a right to know who their doctors are and why we want to treat them, so I included this.

Personal Touch

You also include stories of cancer survivors who touched your life, and you are a cancer survivor yourself. Obviously, personal stories hold a lot of weight for you.

I had very early–stage melanoma a long time ago (I have dysplastic nevi syndrome). There is nothing quite like looking through a microscope with the head of pathology, “reading” your own cancer. It makes you more empathetic with your patients, for sure. My book concludes with a chapter called “Heroes,” which includes stories that are inspirational to patients and everyone involved in their care. I thought we could all learn from these individuals.

 

You also write in a very personal way, using first-person narration, and you sprinkle the text with a good bit of philosophy. That’s somewhat unorthodox for a medical reference book.

I had a Jesuit education through college. I suppose that is when I learned to speak about philosophical issues. I do like to “rhapsodize” on all aspects of life and, with regard to the book, I think it adds flavor and personality. I write in the first-person because this is an intimate conversation. I don’t want to distance myself from the patient by speaking as if it were a referential textbook. I was taught by my patients, and I am speaking back to them about what they taught me. If I were to detach myself, I would not be doing service to this relationship. I didn’t want this to be a textbook. It’s a dialogue. ■

Disclosure: Kevin P. Ryan, MD, is author of When Tumor Is the Rumor and Cancer Is the Answer.


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