Beyond the Numbers
On Caring for Cancer Patients
Early in my career, I was laser-focused on ensuring that every cancer patient received the treatment with the highest statistical chance of success.
I spent hours analyzing studies, breaking down survival curves, and meticulously explaining treatment options. My discussions with patients often involved handwritten graphs on a whiteboard, mapping out the risks and benefits of each approach in great detail. I believed that if patients had all the data, they would make the best possible decision for their care.
What I’ve learned over the years, however, is that data isn’t always what patients want most. While some appreciate the numbers, many are looking for something more. They want an oncologist who will truly listen—to their goals, their fears, and their values. Not everyone wants to go through aggressive chemotherapy for a small survival advantage. Not everyone wants surgery or radiation if it means compromising their quality of life.
I still provide comprehensive information, but I’ve shifted my approach from a purely technical focus to one that is more patient-centered. Instead of leading with statistics, I focus on guiding patients through decisions based on what matters most to them.
One of the most common questions I hear after discussing treatment options is, “What would you do if this were you or your family member?”
I always keep that question in mind, but I also recognize that my preferences may not align with theirs. My role isn’t to decide for them. It’s to understand what they value, and to help them make choices that reflect those values.
My older brother, Doug, also an oncologist, tried to teach me this lesson early in my career. At the time, I thought I understood, but I didn’t. It wasn’t until years later, after countless conversations with patients, that I truly grasped what he meant.
Oncology isn’t just about statistics or treatment plans. It’s about being present, being compassionate, and ensuring that patients feel heard.
That realization didn’t just make me a better oncologist. It made me a better listener, a better advocate, and, I hope, a better human.
In a world where healthcare can feel cold and overwhelming, maybe what we need most in medicine is someone willing to ask, What matters to you?—and then take the time to truly listen.
Oh my, yes. I have a very smart care team and am grateful for their knowledge. But, for the 4+ years of living with cancer, I’ve asked for two things over and over: (1) I want to be a partner in my care and (2) vitality is very important to me. It has been a steep uphill battle to be heard. I appreciate your words very much. Thank you.
As someone living with metastatic cancer since 2016, I read this and thought “Finally. Someone “gets” it.” Thank you for reflecting and changing your practice. It will make a HUGE difference to your patients.