Tanios S. Bekaii-Saab, MD, FACP: Kelley, we see quite a few patients going through quite a few lines of therapy, sometimes with breaks here and there. We see different biologics, and we continue to build an armamentarium of different types of therapies, whether they are on clinical trials or not. In our practice, at the Mayo Clinic, it is not unusual to see patients going through multiple lines of therapy and continue to do well.
Timothy Willson: Yeah, that is encouraging. That is what keeps you going.
Tanios S. Bekaii-Saab, MD, FACP: Kelley, any thoughts on this?
Kelley Rone, APRN, DNP: You talked about how a lot of times our patients will hear from nononcologists that you have cancer, and you have six months to live, so you should go on vacation. I do not think people who do not work in oncology understand that we have a lot of things to offer people: Especially for colon cancer, there are standard therapies and clinical trials. It is common for patients to have made it through multiple lines of therapy and then enter into the clinical trial arena, which to me is such a brave thing for people to do because a lot of times, we do not necessarily know if something is going to be effective, and people are willing to try it. I have had more than one patient say to me, “If this does not help me, then maybe it will help somebody else.” It seems so brave for people to do it. I have had a lot of patients who have been told, “You have about two years.” Then they are 18 months in, and they think, “I have only six months left.” I say to them, “You are doing great. Why are you limiting yourself? You have all kinds of time to do what you need to do.” A lot of times, people are surprised when they get to us, and we tell them that we have things for them.
Tanios S. Bekaii-Saab, MD, FACP: Reese, I know we will talk a bit about clinical trials later, but I want to touch on this because I find that this, as Kelley mentioned, is not uncommon, unfortunately. When folks reach out to your group, how do you direct them? How do you make sure they understand that a patient is not a statistic and that most patients are doing great and are living beyond expectations? We want many to cross the five-year and 10-year line. Tim is an example of someone who is hopefully going to cross the 10-year line. If he initially went and googled survival, he would have thought that he had less than two years to live.
Reese Garcia: One of the main ways we address this—because I agree, it can be a dangerous road looking up statistics and going off that—is primarily through education. We ensure that not only are our patients being educated by our medical advisory board with the most up-to-date information, but that we are empowering them to have conversations with their providers if they have these types of concerns by saying, “I found this on Google. What does this mean for my care?” It is the education empowerment.
I would also point out, Kelley, one thing that you said earlier stuck out: These patients are extremely brave. Clinical trials are oftentimes seen as a last resort, which you might also find on Google or from discussion boards. In reality, these trials are paving the way for future research, but they are also something that is incredibly important to have on hand early on in the treatment plan. Just because you go in a clinical trial does not mean this is the end of the road. If anything, it is opening up new outlets and avenues for one’s treatment care. A lot of what we do is balancing what people are finding on the internet with the education that we can provide them by putting it into context and ensuring that it is realistic information that will ultimately empower them to make those treatment decisions alongside their doctor.
Tanios S. Bekaii-Saab, MD, FACP: Yeah, you are bringing up a great point about the importance of clinical trials and how we advance care. Patients are volunteers on these trials, so they volunteer their time and their health. They volunteer a lot of things to try to move the field forward, and many times, as Kelley mentioned, they are not even thinking about themselves as much as they are thinking about the next generation and how it can help others. It is incredibly altruistic.
I get asked, “Why did you go into oncology? Why do you take care of patients with cancer?” It is one of the most rewarding jobs on the planet. I get asked multiple times, “Would you do anything else? If you had to go back, would you do anything else? This oncology business sounds somewhat depressing.” I say, “You know what? I would do it 20 times over.” Being able to be around some of the bravest and most heroic patients and be alongside them in their fight is one of the most inspiring and rewarding jobs in medicine and in jobs period.
Transcript Edited for Clarity