David M Mastrianni MD

Lessons Learned David M Mastrianni MD

"Cancer sucks." These two words are embossed on a small metal pin given to me by a patient. I could never wear it, so it sat on my desk for years, a bleak reminder of a sentiment shared by our patients and their families. Yet even on the worst days in our oncology unit, laughter and life could be heard in the exam rooms and treatment area. As a family member once said, "I used to think heroes were those who do something extraordinary. But now I know that heroes are also those people who keep doing the ordinary without complaint in extraordinarily difficult circumstances." These are the stories of these heroes. Someday, this pin will be wrong. Soon, it may be less true. A transformation in cancer treatment is underway in which traditional chemotherapy is being replaced with molecularly targeted therapies based on our rapidly evolving knowledge. This change is the result of years of investment in basic science to understand the workings of normal tissues and thus cancer. It is the culmination of many events, some obvious and others seemingly small, which have occurred in labs and clinics across the world. It is the work of thousands of scientists, physicians, nurses, technicians, administrators, investors, executives, politicians, families, and patients. For those with cancer, this era is bringing new hope mixed with the enduring struggle to make sense of the human condition. These are also the stories of this transformation. This book follows the patients seen during one typical day in our medical oncology practice in Saratoga Springs, New York. Some patients are undergoing traditional chemotherapy while others receive new targeted treatments. Some have dealt with their cancers for years and are witness to both sides of this transition. All of them have lives outside of their cancers. Contained within these patient stories are short non-fictional essays on the history of cancer and medicine. For many years, I have been privileged to serve on the faculty of Albany Medical College and supervise rotating medical students. These essays grew from the discussions which took place as I worked with these brilliant and dedicated young men and women. I have learned much from these students, most importantly that our medical future is in good hands. I hope patients, families, and others in the world of cancer medicine will find these stories and essays interesting.