It is unconscionable to me that any patient is allowed to linger for days and sometimes weeks in a state of uncertainty, in some cases waiting to learn whether they will live or die.
—David Posner, MD
After six recurrences of colorectal cancer, the chances it will recur again are high. But if I concentrate on that, I couldn’t live my life.
In retrospect, I should have paid attention sooner to the abdominal pain I was experiencing and not dismiss it as a simple case of gas. But at age 47 and with a busy medical practice to run, I couldn’t imagine that something bad was happening to my health. When I finally saw my internist 2 months later, he diagnosed appendicitis and I was rushed into surgery. When the pathology report came back it showed that I had a malignant mass near the cecum, and I was prescribed intraperitoneal chemotherapy. That was 10 years ago.
Since then, I’ve been on a cancer-recurrence whirlwind and it’s hard for me to remember the sequence of events and numerous treatments I’ve had. I know that a year after my diagnosis, the cancer metastasized to my abdominal wall, then to my small bowel, and a year after that to the mesentery, which required significant removal of my small intestine. I’ve also had surgery to remove my gall bladder.
I’ve lost the exact count, but I think in all I’ve had six recurrences—the last, a year ago—and nine surgeries. In addition to the numerous surgeries, I’ve also been treated with radiation and bombarded with a series of high-dose chemotherapeutics—fluorouracil, oxaliplatin, leucovorin, irinotecan, bevacizumab (Avastin), and cetuximab (Erbitux)—so lethal, they nearly killed me.
Medicine Is My Salvation
Through it all, I never missed more than 3 weeks of work. Medicine is my salvation and it has kept me sane. Although I don’t delude myself about the serious situation I am in, I never see myself as someone who is not going to get better. My attitude is, whatever happens, happens, and while I hope I get better, during my remissions I try not to think about my cancer.
Recently, I participated in a project launched by The New York Times that asked cancer survivors to submit their personal stories. The result is the new book Picture Your LifeAfter Cancer (American Cancer Society, 2012). I also participated in a seminar the Times held on cancer survivorship and met a breast cancer survivor whose life revolves so much around having cancer, she’s planned her funeral with the same kind of meticulous detail other people reserve for their wedding.
It was then that I decided to relinquish my role as poster child for cancer survivorship and go back to my life as David Posner, MD. What has helped me get through the past decade is to pretend I don’t have cancer. I know my colorectal cancer has a chance of recurring, but if I spend all my time thinking about that, I wouldn’t be able to live the life I love being a doctor.
Cancer Has Made Me a Better Doctor
While I’ve always considered myself a caring and empathetic physician, having a life-threatening disease has given me new insight into the terror patients with serious diseases often feel, and it has made me a better doctor. Knowing the anguish of waiting for test results that would give me either another 6 months of reprieve from cancer or immediately send me back to the operating table or chemotherapy infusion room, has made me vow to never let my patients finish their day without knowing the results from their PET scan or other tests performed that morning.
Because I have a busy pulmonary practice, if a patient’s test results are negative, my assistant will call to deliver the news, and if the results are positive, I call. It is unconscionable to me that any patient is allowed to linger for days and sometimes weeks in a state of uncertainty, in some cases waiting to learn whether they will live or die.
The fact that I look so healthy despite all my treatment and that I’m a 10-year survivor of colorectal cancer is comforting to my patients with cancer. And because I recognize their look of distress so well, I’m able to offer credible reassurance that what they are feeling is natural.
Most of all, having cancer has given me the ability to alter the way I interact with patients based on their individual circumstance and need. And in return, I get to pretend I don’t have cancer—at least for a while. ■
Disclosure: Dr. Posner reported no potential conflicts of interest.
Dr. Posner is Associate Chief of Pulmonary Medicine at Lenox Hill Hospital in New York.