Week 1

This summer I am matched with a medical oncologist, Dr. David Nanus, who specializes mainly in prostate cancer. I spent all day Wednesday with him in the clinic visiting his patients for follow up visits post-chemotherapy. It was interesting to see many patients in a wide range of stages of disease. A few had recently undergone a chemo cycle and were experiencing horrible side effects (nausea, body pains, mouth sores, etc). One man’s results revealed that his prostate cancer had unfortunately metastasized to his liver. Knowing that he might only live six months without treatment, Dr. Nanus created a new chemo regimen for him. Perhaps most interesting, we saw an extremely religious man with prostate cancer refusing chemo, believing that God will heal him. Although some of the cases can have sad outcomes, many other visits produced good news to the patients. MRI and CT scans showed that some tumors were reduced in size for some patients and their prostate-specific antigen (PSA) levels, a protein elevated during cancer, had decreased post-chemo. In particular, one woman’s scans showed that she was still in remission four years later after previously having bladder cancer.

Another highlight this week was attending the gastrointestinal tumor boards, where doctors from all departments gather to discuss individual patient cases and determine the best treatment plan for the patients from many different perspectives. During these meetings they show any scans and biopsy results that the patients have, which I found it extremely useful for me to be able see something in addition to hearing the doctors speak since frankly, most of their medical jargon and abbreviations are way over my head at this time.

I was also able to experience going on rounds in the cardiac ICU when I teamed up with David on Friday. His post describes the visits in more detail, but briefly, the residents are each assigned patients and discuss their status with the cardiologist on duty for the day. Two new patients had just been admitted the night before so their labs and symptoms were discussed in detail. For the other patients a routine was established: briefly discuss any new updates from the previous night and their current status, visit their room to check in and do a quick examination, determine a plan of tests/labs to run that day, and residents are left to implement that plan.

As for a research projects, unfortunately nothing has been decided yet. For now I have observed a post-doc in Dr. Paraskevi Giannakakou’s lab. He is working on isolating circulating tumor cells (CTCs) from patient’s blood samples and staining the cells for biomarkers of the specific cancer type. I will be helping him in some way for this.