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    There Is Always Room for Hope

    by Richard Frank, MD

    I am grateful to the staff of WebMD for granting me the opportunity to start and develop this cancer blog. My goal is simple: to help you, whether you are a cancer patient, family member or friend of an individual affected by cancer or just someone interested in learning about this complicated and mysterious disease.

    I am a medical oncologist and it is my job everyday to help those facing cancer understand a multitude of vital issues: what cancer is, why it may have started, how it is staged, how a prognosis is determined, how treatment recommendations are formulated and how those treatments affect the cancer and the person. These and many other issues, including experimental and complementary/alternative ways to treat cancer will be covered in this blog. I look forward to your feedback and to an exchange of ideas. If there are areas you would like me to cover, just ask!

    To inaugurate this blog, I will take you into my office to experience my first patient of the day. As I walked into the examination room, I was greeted warmly with a broad smile and firm handshake by Roger, someone I have cared for three years. Roger is 75 years old, vigorous, and for all appearances, in perfect health. Three years before, however, he was diagnosed with an incurable form of a type of cancer called cholangiocarcinoma (CC).

    Cholangiocarcinomas arise from the bile ducts which funnel bile acids from the liver into the intestines, where they help to digest food. CC can grow in the liver or outside the liver and often cause abdominal pain or jaundice (yellowing of the skin or eyes due to the back flow of bile into the bloodstream); they are typically detected with a CAT scan and surgically removed if feasible. Roger’s tumor, however, was too extensive to be removed and his expected survival was about one year.

    So how is Roger so well now three years later, living with an incurable cancer but not experiencing any symptoms from it? Is it because he has a positive attitude, takes a special herb or found a remarkable new treatment at “the best” cancer center in the world? Unfortunately, I wish I could tell you the reason but it is none of these. Roger was treated in his community, using the conventional cancer therapies of chemotherapy drugs and radiation therapy. They have worked incredibly well. I do believe that Roger would say that his attitude did play a role in his survival and I will admit that it did help see him through some very dark days; he is a natural optimist. However, some individuals function better not being so positive and everyone approaches their situation differently. Certainly, surviving cancer depends on much more than attitude.

    I bring up Roger’s case to illustrate the complexity of the disease we call cancer. For some, the cancer diagnosis means a near certain cure, whereas for others the prognosis is so poor that there is only bewilderment and despair. Yet, there is always room for hope. May I repeat that: there is always room for hope.

    In the posts that follow in this blog, I intend to demystify cancer and help the reader cope with the highs and the lows that necessarily accompany any diagnosis of cancer.


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