Wednesday, July 13, 2011

Oncology- Today was hard

Today was hard. As much as I love Oncology- and I really do- sometimes it's just hard. Cancer isn't an easy thing. Most patients are not cured. A lot of them can be made to feel better for a while. But, there are some patients who we just really can't do anything for them.

Today was one of those days where it seems like all of the cases we see are those can't-do-anything cases.

My patient, "S", was a 5 year old orange tabby cat. He was so sweet. And his owner loves, loves, loves him. S was dumped by the owner's house as a kitten. One day, while dying of respiratory infection, S jumped up into the owner's lap and declared himself adopted. The receptionist put him in an exam room this morning and told us that she could hear him crying when she left. He cried a couple times while we gathered the history and physical exam. He also cried a little while we talked to him about our diagnostic plan.

The thing is, watching an older man cry just pulls my heart strings. As Kristen (one of my classmates) puts it, I am a co-cryer. His eyes well up and it is just totally reflexive for mine to well up too.

Even starting off in tears, it only got worse from there.

On ultrasound, S had a large mass originating from his pancreas with several other organs involved. On cytology, there was evidence of carcinoma. So, he has a pancreatic carcinoma that has already metastasized.

Even in humans, this is a bad, bad, bad tumor to have. There's no good treatment options.

We broke this news to his owner, who just sobbed. He hung his head, tugged his hair, sobbed and apologized. We told him there was nothing to apologize for.

It was heartbreaking to hear that he hates the month of July because his wife was diagnosed with cancer in July, he was diagnosed with cancer in July, and now his cat was diagnosed with cancer in July. I think we all cried a little.

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