Best friend inspired cancer doctor to help empower patients
When his best friend was diagnosed with colon cancer three years ago, Dr. David Palma, a radiation oncologist and cancer researcher, tried to help in any way he could.
He soon realized that even with the guidance of a medical insider, it was hard for his friend — a 35-year-old father of three — to make sure he was getting the best possible medical advice and cancer treatment.
So Palma, who specializes in lung, head and neck cancers and who works at London Health Sciences Centre in Ontario, decided to write a book that would empower cancer patients to become their own best advocates.
In Taking Charge of Cancer: What You Need to Know to Get the Best Treatment, Palma explains to patients how to analyze their own medical records, double-check their diagnosis and get a second opinion on treatment options.
“There is a lot of information out there for cancer patients,” says Palma, 38, who is donating author royalties from the book to cancer research.
“But none of it talks about the quality of treatment and how to get top-notch care. Once I realized that information wasn’t out there, when I went through this journey with my friend, I realized that a how-to manual was needed.”
Palma lives in his hometown of London, Ont., with his wife, a family doctor, and their three children, settling there seven years ago after completing a residency in radiation oncology at B.C. Cancer Agency, a master’s degree in epidemiology at the Harvard T.H. Chan School of Public Health and a PhD from VU University in Amsterdam.
He spoke with the Star about why taking charge of cancer is critical when faced with a difficult and scary diagnosis.
What did you learn about cancer while helping your friend?
A lot of doctors have told me — and now I know it’s true — that their practice changes after seeing things from the perspective of a patient. That’s what happened with me. No matter how much you try and empathize with a patient, you only really know what it’s like when you’re on the other side of the examination table as a patient or a friend or a caregiver for a patient.
Your book advocates for patients to get the best cancer treatment. What does good-quality cancer care mean to you?
A patient must truly understand their situation. They have to understand their diagnosis, know the potential treatment options available to them and they must be able to get care that is world class. We know that many patients are not getting one or two or all three of these things.
We hear that patients are more informed than ever. Is this true?
Absolutely. But there are some patients who may feel daunted to get involved in their care because they feel there is too much to learn, that they didn’t go to medical school. But they don’t need to know about all kinds of cancer and all kinds of cancer treatment. They just need to know about one specific kind of cancer — their own.
Can you give an example of the type of question an empowered patient should ask?
Instead of asking: “What is my cancer’s stage?” They should be asking: “How do you really know this is stage 3 cancer? Are there any uncertainties about that?” There are examples of close calls or misses when patients are given the wrong stage and things go down the wrong path and not given the right treatment.
You use clear language and medical fact to empower patients. You also provide them with checklists. Why are they important?
Checklists are a good way to ensure all the critical steps get done. Think of pilots, who use them during flights or if there is an emergency, to make sure steps aren’t missed. In medicine, we use checklists for some things — in radiation treatment, in surgery — and they can have the same benefit. For patients, by using the checklists in the book, it allows them to make sure they have gone through all the right steps to get high-quality care.
Checklists also have a psychological impact. As you check off each box you feel like you are taking one more step toward getting good cancer treatment. Some patients will check off all the boxes, realize their doctors are giving them fantastic care and everything is being done properly. They will sleep better at night. Other patients will check things off and realize maybe they want to change something about their treatment or their treatment team.
You are donating all author royalties received from the book to London Health Sciences Foundation. Why?
First, there are a lot of people who are selling things to cancer patients that aren’t true or aren’t real or don’t work. I have patients, for example, who are paying to get IV doses of Vitamin C, which research shows doesn’t help against cancer. When you go online, it’s hard to know if someone is trying to make money or if it’s in the patient’s best interest. So by donating money (made from the book) to cancer research, people know this is just a volunteer effort by me and I have no fi- nancial motive. The other reason is that I believe so strongly in research. We are doing so much better at cancer treatment now than we were 20 years ago — because of research. Patients know that by buying this book they are helping themselves and also helping future patients down the road. This conversation has been edited for length and clarity.