The minute someone receives a cancer diagnosis, the fight begins.
Beating cancer is a marathon, not a sprint, oncologists say, and this is a fight that requires a team of experts, innovative treatments, and a combination of medical and holistic therapies. Fortunately, Dallas is home to all of this and more when it comes to cancer treatment. Following the initial cancer diagnosis, the next steps are getting organized, assembling a medical team, and creating a plan.
Dr. Steven Paulson, a board-certified hematologist/oncologist with Texas Oncology and president and chairman of the board for Texas Oncology, says when someone receives a cancer diagnosis, they should take time to understand the diagnosis and the prognosis, as cancer types and appropriate treatments differ. What worked for a parent, grandparent, or friend with cancer a few years ago likely won’t be the first line of defense an oncologist will take today. “Look for an oncologist who is an expert in the subject matter with regard to your disease,” Dr. Paulson says. “The oncologist you choose should be board certified in oncology with specific training in your cancer for a narrower focus. I recommend comprehensive, community-based care whenever possible—a center where the care is well coordinated and treatment can be given conveniently, as cancer treatment is a marathon, not a sprint. Understand your options—even get a second opinion—then choose an oncologist you are comfortable with. Your questions should be answered, and when it comes to cancer, all questions are appropriate.”
“Cancer care is light years from where it was, and it continues to improve.”Dr. Raetasha Dabney, Choice Cancer Care
Anyone diagnosed with cancer today has many reasons to hope. Innovative treatments, clinical trials, and new therapies—alone or in combination—are helping people with cancer live longer. “If you were diagnosed even one or two years ago, the number of treatment options since then has expanded significantly,” says Dr. Raetasha Dabney, a board-certified oncologist with Choice Cancer Care. “The one thing about cancer that is certain is that there is so much we know—and so much we still don’t know. We learn every day. Cancer care has changed from the time I began practicing medicine to today. For instance, we can now detect different markers in tumors that help drive treatments. Evidence-based medicine has expanded to include immunotherapy and targeted therapy. We are also doing molecular testing and genetic testing on tumors to pinpoint effective treatments. When we can target the patient’s tumor versus just giving them a standard drug, outcomes are improved. Cancer care is light years from where it was, and it continues to improve.”
Dr. Paulson has been an oncologist for more than four decades and says when he first began practicing medicine, there were usually one or two new drugs per year to treat cancer. Today, there are 20 to 30 new cancer treatment drugs per year. “The pipeline for therapies that are improving outcomes has significantly gone up,” he says. “People are living longer with cancer, even cancers that have a poor prognosis.”
Precision medicine is one of the leading advances in cancer care treatment. Dr. Paulson says there are a variety of treatment names that fall under the precision medicine umbrella, such as targeted therapy. “Precision medicine targets the individual genetic changes in the tumor that led it to becoming cancerous and different than the normal cells in body,” he says. “We are looking for a genetic fingerprint of the cancer and how it differs from normal cells as well as a mutation in the cells that has occurred in the course of a person’s life—a change that took place that led to cancer growing out of that mutation, and the immune system didn’t stop it. What are the changes, and how we can go after those tumors and not hurt normal cells during radiation? Once we have the answers, we can use a more targeted treatment.”
To look at the genetic footprint of cancer cells, oncologists take the cancer that was biopsied or removed and send it to a testing facility, where the genes in that cancer are profiled. “We can look at the tumor tissue removed originally or via a liquid biopsy, which is becoming more available. Blood is taken and sent to the lab to look for specific mutations. This is useful when we don’t have access to tumor tissue, or if it has been depleted. The targeted therapy is administered in a variety of ways—oral therapy or occasionally IV therapy. It will selectively attack and kill those cells. Not every cancer today has a targeted therapy for it, but I believe in the next five to 10 years, most will.”
Clinical trials can also be effective in treating cancer for those who qualify. If a patient has a certain mutation that makes them a candidate for a clinical trial, Dr. Paulson often recommends it. “Texas Oncology now has 1.3 million patient records in its oncologic database,” Dr. Paulson says. “We can take this inclusion or exclusion criteria and enter it into the software that we use, and the AI program can sort through the testing profiles to find the few hundred who may have a particular profile. If a new therapy or promising clinical trial comes along, we know immediately which patients could be a candidate.”
“Cancer treatment is a marathon, not a sprint.”Dr. Steven Paulson, Texas Oncology
Although treatment plans may differ from patient to patient, a common non-medical prescription among oncologists is to encourage patients to become as knowledgeable as possible about their cancer and aware of new treatments that are being developed and offered. The days and weeks following a cancer diagnosis can be a blur of phone calls, consultations, medical tests, and waiting. Dr. Dabney says a patient’s instinct is to research their cancer as much as possible. This is a good first step, she says, because being armed with information is important, but there is also a negative of side to going down the rabbit hole of medical internet searches, she warns.
“The internet has great information, but it also has a lot of incorrect information,” she says. “Become as knowledgeable as you can and partner with an oncologist you trust. Most cancer centers have patient navigators who will assist you in your care plan—everything from insurance coordination and setting appointments to providing you with correct and current information about cancer. We understand cancer patients are anxious, and one way reduce anxiety is to feel empowered with a plan. When I talk to my patients, I am very honest. Most of the time, they have been affected by cancer in some way, so they are concerned. This is not a battle they have to face alone. We are a team. It’s OK to be sad. It’s OK to be upset and have bad days. The best thing to do is set goals and take the process step by step, one day a time. We don’t want cancer to control their life. We want them to control cancer and enjoy life.”