“Much of the general public believes oncology is a ‘sad’ field. What do you think about that?” I asked Amol Narang, a radiation oncologist at The Johns Hopkins Hospital.
“I disagree, wholeheartedly,” Narang replied.
When people hear the word “cancer,” their thoughts immediately turn to grotesque images, and many often equate the condition with death. With the way movies have portrayed cancer patients, it is understandable why the public might envisage a cancer patient as hairless, weak and nauseated. Unfortunately, this belief has poured over into the field of oncology, and many medical professionals regard the work as depressing, disheartening and dreary. While the tough experience of a cancer patient should not go unnoticed, the field encapsulates so much more. I had the honor of speaking with Amol Narang, who shined light on this reality.
The field of radiation oncology treats cancer with radiation therapy, which uses targeted high energy X-rays to kill tumors. Even with pancreatic cancer, Narang’s specialty and one of the deadliest cancer diagnoses, the treatments today are highly improved from what they were 10 years ago. Oncology is a rapidly evolving field, and Narang attributes this to oncologists’ passion and excitement about working to improve outcomes for patients. He describes oncology as a field in which that excitement, passion, enthusiasm and hope manifest in the personalities of oncologists and the ways they approach their jobs. In meetings, they don’t bring sadness. They bring eagerness, interest and optimism, and that is highly reflected in the way they interact with their patients. It is overall a hopeful environment for both providers and patients.
Narang acknowledges that there were difficult times in his career. As a pancreatic cancer specialist, the vast majority of his patients don’t survive their cancer. It can be a constant challenge to navigate patients through that process, so “having an incredible team to work with is critical”, he says. Sharing the emotional burden of patients going through a terminal illness with a team of people makes it easier to experience. Team care is an essential part of cancer care.
In dealing with negative outcomes, Narang believes it is critical to be honest and upfront with patients. “Patients come to me with realistic expectations,” he says. “Oftentimes with pancreatic cancer, there is such a stigma associated with it, that there’s nothing we can do for it. These expectations are less than what we can offer them.” Thus, oncologists can actually offer a lot of hope for patients. Narang touched on how being an expert on pancreatic cancer is helpful, since many patients have been diagnosed at a community center and have not been given proper guidance about their care. By the time he sees them, they have had up to several weeks after diagnosis with no direction, and he can be the one to offer patients a high-quality plan and show them confidence that their cancer team is prepared and experienced. That tends to be very reassuring for patients, which is really gratifying to Narang. “Patients realize cancer is a challenging disease to treat,” he says, “and it is important to be upfront and honest as patients go through their treatment, but when a patient has confidence that you’re doing all you can for them, it makes everything a lot easier.”
Narang emphasizes that each of his patients’ stories is inspiring. Many patients come to him after being told there’s nothing that can be done, but with chemotherapy and radiation, his team can greatly improve the chance for survival. He has patients who are four to five years out from treatment and were once told there was no hope. Even when a case is terminal, patients can have specific goals, such as being able to walk their daughter down the aisle. Narang says helping patients achieve goals like this is extremely valuable to him.
He says it is a great privilege to be an oncologist because “patients put their trust in you at their worst time and you get to to work with a community of inspirational people.” He speaks highly about the intimate relationships with patients and their families that he has created as an oncologist, and he says he would choose becoming an oncologist over and over again.
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