The Doctor Factor: Battling Cancer Together | Newsweek Health for Life

The Doctor Factor

Doctors and patients who battle cancer together can develop a unique bond: corned beef on chemo day.

Cancer Care with a Human Touch

From the magazine issue dated Jun 23, 2008

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They are two women engaged in the universal banter of motherhood. "I brought wedding pictures," says Karen Ulisney, pulling out her photo album. "Kristina got married to a great guy. She's so happy." Claudine Isaacs leans forward and smiles. "How old was she when we met?" Isaacs asks. "Sixteen. And Matt was 6," says Ulisney. Isaacs laughs. Ulisney beams. "He's five-ten now. He's such a handsome young man," says Ulisney, flipping to a photo of mother and son walking arm in arm. "You look just a little bit happy," says Isaacs. "I didn't think I'd make it to the wedding," says Ulisney, tearing up. "That was a milestone."

These are not old friends catching up at a coffee shop. The setting, instead, is an exam room at Georgetown University's Lombardi Comprehensive Cancer Center. Ulisney, 51, is a 10-year breast-cancer survivor in for her annual checkup. Isaacs, her oncologist, is at the cutting edge of compassion. Yes, the doctor performs a physical exam. And she and Ulisney discuss her patient's medications and concerns. (Should she have genetic testing? Does she need a breast MRI?) But their interactions transcend the clinical. The two women are partners in an odyssey that combines medicine with the human spirit.

The science of cancer has made great strides in recent years. Researchers are identifying the unique molecular characteristics of tumors and developing new targeted drugs to attack them. But no technological advance can measure fear or heal the psyche. In the inhumane world of cancer—the terrifying lingo ("malignant neoplasm," "adenocarcinoma"), the burn of radiation, the dread of recurrence—patients want not just excellent care but caring experts. And oncologists are hearing the call. "Part of this humanistic approach is the increasing awareness that there's another person in front of you who's suffering," says Dr. Teresa Gilewski, of Memorial Sloan-Kettering Cancer Center in New York. "The question is, what can you do to help?" Practicing world-class medicine and humane treatment aren't mutually exclusive, says Dr. Lidia Schapira, an oncologist at Massachusetts General Hospital Cancer Center. "They're part of the same definition of a good cancer doctor."

Ulisney had no choice the first time she put on her paper gown. Cancer invaded her breast tissue, but there is more to a patient than her disease. Isaacs, director of Georgetown's Clinical Breast Cancer Program, knows this, and it defines the way she practices medicine. She gently touches patients' arms when she senses they need comfort, she pauses during conversations to allow for a fear that might otherwise be stifled. Isaacs can recite the molecular blueprints of her patients' tumors, but what she remembers after her appointments are over is not the cancer. "It's who they are, what they do, how many kids they have," says Isaacs. "We're afforded an intimacy into people's lives. Hopefully, we can help them through a tough time."

Talk to cancer patients who love their doctors—and, yes, the word "love" comes up frequently—and key themes begin to emerge: hope, trust, respect. Brendan Lohan found all of this in his relationship with Dr. Robert Mayer of Boston's Dana-Farber Cancer Institute. In 1999, Lohan, then 39 and the father of two young children, was diagnosed with advanced colon cancer. Lohan and his wife, Mary Jane McKenna, knew his prognosis was grim. But Mayer made it clear that talking numbers would be unproductive. "He basically said, 'Statistics don't matter when it comes to the individual'," says Lohan, now 48. "That gave me even more desire to fight."

What Mayer did want to focus on, he says, was "developing the very best, most reasonable, rational and tolerable treatment plan." Along the way, he calmed Lohan's anxiety by assessing his disease in real time, rather than fast-forwarding to an unknown future. At first, Lohan was intimidated by Mayer's stature, but they quickly developed a warm rapport marked by simple non-jargony explanations about cancer one minute and chatter about soccer games the next. Over the past decade, Lohan, a carpenter born in Ireland, McKenna, a lawyer, and Mayer, a leading authority on colon cancer, have become fellow warriors. Patients want "somebody who knows them, who they have gone to battle with and come back in one piece," says Mayer. "People whom they trust."

Posted By: Fred R @ 09/27/2008 5:03:31 PM

Back to comment about health Insurance and employer based benefits.
Do you realize that the exact reason we do not have a national plan or universal to access to a universal plan is the employer based system which
1- is discriminatory ( try getting a group plan for small biz with some chronically ill employees)
2 segments the market for the benefit of , well, guess who, the insurance companies
3- reduces wages paid to employees ( everyone knows wages have not risen under bush but did you know that employer costs ( employee comepensation which counts heath insurance) has? This could have been wage increases.
4- keeps out small business and the self employed- work for the man ??? or else!
5- promotes wage slavery those who work in undesirable positions merely to obtain insurance.
6- Watch how fast a national plan or universal access would emerge if the work force was not indentured servants ( see health insurance hostages) .

Posted By: Nins @ 07/07/2008 12:03:22 AM

Did you know that if McCain is elected you will have to pay income tax on the value of the medical insurance that your employer gives you? Worse still, he is offering a tax break for people who pay their own insurance, BUT only $2,500 for individuals and $5,000 for families.

Let's say you have a family of four. Your insurance policy costs would be at least $1,500-2,500 per month under a self-pay plan, which cost more than employer group plans. So, you pay $18,000 -$30,000 per year for insurance, and you get to deduct only $5,000 of that. If you paid $25,000 for you insurance, you would be out of pocket $20,000 per year. This is FAR WORSE than the current system, where if you are self employed you can deduct 100% of you medical insurance costs.

So, if you're not self employed, you would stick with your Employer's plan. Employer plans for a family of four have a value of $900-$1,500 per month totaling 10,800-$18,000 per year. Surprise! On April 15th, you owe tax on all of that as INCOME to you. Say your bracket is 25%, and the value of your Employer medical plan is $14,000. You will OWE THE IRS an additional $3,500, and that's ON TOP of whatever monthly premium you already pay to your employer for your insurance.

Many analysts say that McCain's new rules would encourage employers to stop offering health benefits. If that happened, then far fewer Americans would be insured than are insured today, because what family of four can afford $18,000-$30,000 out of pocket per year for self-pay health insurance?

Furthermore, McCain's plan does not require insurance companies to cover pre-existing conditions of people who self-pay their insurance. People under employer group plans have all of their pre-existing conditions covered. This is a hugely unfair aspect of the current system. Insurance companies can afford to cover the pre-existing conditions of the much larger pool of people with group insurance, but they refuse to pay the pre-existing conditions on the smaller pool of self-pay customers. They have been allowed to price gouge the self-pay customers, which is a form of market manipulation that should be illegal.

So let's say one of your kids had diabetes and you have high blood pressure, then your employer stops offering insurance. You now have to buy your own, but you and your child are INELIGIBLE due to pre-existing conditions. Oh, yeah, they will let you buy the insurance, but you can't use it for any pre-existing condition until you have paid on time every month for two years. And you know what happens at one year and 11 months? You get a letter saying your policy has been cancelled. I have many patients this has happened to.

McCain's plan SUCKS.

It does nothing to help middle class working Americans afford or obtain medical insurance. In fact, it makes the current system WORSE.

Member Comments

Posted By: Fred R @ 09/27/2008 5:03:31 PM

Back to comment about health Insurance and employer based benefits.
Do you realize that the exact reason we do not have a national plan or universal to access to a universal plan is the employer based system which
1- is discriminatory ( try getting a group plan for small biz with some chronically ill employees)
2 segments the market for the benefit of , well, guess who, the insurance companies
3- reduces wages paid to employees ( everyone knows wages have not risen under bush but did you know that employer costs ( employee comepensation which counts heath insurance) has? This could have been wage increases.
4- keeps out small business and the self employed- work for the man ??? or else!
5- promotes wage slavery those who work in undesirable positions merely to obtain insurance.
6- Watch how fast a national plan or universal access would emerge if the work force was not indentured servants ( see health insurance hostages) .
Posted By: Bornita @ 07/16/2008 3:35:47 PM

Please refer to the comment i posted on (NOT) Worth Your Time.

There is a study going on on identical twins that prooves or will proove that drinking 8-12 cups of green tea per day, reduces the risk of developing cancer about 80-90 %. Experts will recommend a daily intake of two pills that contain the equivalent extracts. This will be published in a future edition of TIME magazine, online edition.
Posted By: Nins @ 07/07/2008 12:03:22 AM

Did you know that if McCain is elected you will have to pay income tax on the value of the medical insurance that your employer gives you? Worse still, he is offering a tax break for people who pay their own insurance, BUT only $2,500 for individuals and $5,000 for families.

Let's say you have a family of four. Your insurance policy costs would be at least $1,500-2,500 per month under a self-pay plan, which cost more than employer group plans. So, you pay $18,000 -$30,000 per year for insurance, and you get to deduct only $5,000 of that. If you paid $25,000 for you insurance, you would be out of pocket $20,000 per year. This is FAR WORSE than the current system, where if you are self employed you can deduct 100% of you medical insurance costs.

So, if you're not self employed, you would stick with your Employer's plan. Employer plans for a family of four have a value of $900-$1,500 per month totaling 10,800-$18,000 per year. Surprise! On April 15th, you owe tax on all of that as INCOME to you. Say your bracket is 25%, and the value of your Employer medical plan is $14,000. You will OWE THE IRS an additional $3,500, and that's ON TOP of whatever monthly premium you already pay to your employer for your insurance.

Many analysts say that McCain's new rules would encourage employers to stop offering health benefits. If that happened, then far fewer Americans would be insured than are insured today, because what family of four can afford $18,000-$30,000 out of pocket per year for self-pay health insurance?

Furthermore, McCain's plan does not require insurance companies to cover pre-existing conditions of people who self-pay their insurance. People under employer group plans have all of their pre-existing conditions covered. This is a hugely unfair aspect of the current system. Insurance companies can afford to cover the pre-existing conditions of the much larger pool of people with group insurance, but they refuse to pay the pre-existing conditions on the smaller pool of self-pay customers. They have been allowed to price gouge the self-pay customers, which is a form of market manipulation that should be illegal.

So let's say one of your kids had diabetes and you have high blood pressure, then your employer stops offering insurance. You now have to buy your own, but you and your child are INELIGIBLE due to pre-existing conditions. Oh, yeah, they will let you buy the insurance, but you can't use it for any pre-existing condition until you have paid on time every month for two years. And you know what happens at one year and 11 months? You get a letter saying your policy has been cancelled. I have many patients this has happened to.

McCain's plan SUCKS.

It does nothing to help middle class working Americans afford or obtain medical insurance. In fact, it makes the current system WORSE.