An open letter to my new oncologist: What I want in a doctor

Dear Dr. S,

It was great to finally see you in person this past week. I really, really, REALLY liked my old oncologist, so this feels sort of like rebounding from a personal relationship. Please forgive me if I talk too much about my ex.

Dr. G was my first oncologist. Because she was young, I figured she wasn't likely to retire and leave me in the lurch, like so many doctors have during my long journey with cancer. She didn’t retire, but she did recently leave her post at Oregon's only public academic health center to do research at the VA hospital—leaving me in need of another doctor.

So, Dr. S, I was told you’d be taking her place. Our first "date" was by phone in January. You sounded nice, and we had a good get-acquainted visit, but you confessed you'd recently had COVID-19, so that was worrisome—kind of like hearing your eighth-grade dance partner might have cooties.

Getting to know you

It was clear, from our conversation, that you were smart, and knew a lot about my brand of cancer. Intelligence is one of my top priorities in a physician. I like my doctors to know way more about science and medicine than me.

But listen to me going on. I should tell you more about my medical history.

My name is Mikel Kelly, and I'm a 22-year survivor of prostate cancer. I've seen a lot of doctors since I was diagnosed two decades ago, and I've been in and out of many different medical systems. I believe I'm a very good patient for a 74-year-old, compliant when given medical advice and eager to inform myself.  

A doctor's demeanor matters

I was told I had cancer on June 15, 2000, the same day I learned my dad had died in his small fifth-wheel camping trailer in the Central Oregon boondocks. It was a very bad day.

Five of six samples from my prostate tested positive. For all I knew, I might already have had one foot in the grave. Yet the PA who diagnosed me assured me prostate cancer could be notoriously slow-growing, so I had time to study up and consider available treatments.

It took no time to decide I wanted surgery—the gold standard, they called it. I was a relatively healthy 52-year-old; I just wanted the cancer out of my body. I talked to two or three surgeons in the Kaiser Permanente system and ruled out one unlikeable character right away because he bluntly boasted he'd rid me of my tumor—but I’d be left impotent and incontinent.

I chose a doctor who gave me hope

Instead, I went with a young surgeon, Dr. M. He’d already done plenty of nerve-sparing prostatectomies, and left me feeling hopeful and cared-for.

In all fairness, the grumpy guy I passed on was right: I DID end up incontinent and impotent—but not for some years. I never stopped liking and appreciating Dr. M’s more pleasant bedside manner.

He exuded a strong, can-do attitude, and never failed to look me in the eye and insist we could do this thing together. He was literally the key to my successful cancer fight.

Treatment and my quality of life

The good news about surviving cancer as long as I have is, well, I’m still alive and kicking. The not-so-good news is it can feel like an endless rollercoaster ride of shopping for new doctors, and enduring new treatments and side effects.

Radiation therapy was one of those. While my prostate surgery had been successful, 5 years later my PSA had started climbing, and I was at a gloomy crossroads. So, for 7 weeks, 5 days a week, I went to the basement of the cancer center and lay still as a corpse while they shot a radioactive beam at the parts of my body I held most dear, those responsible for sex, peeing, and pooping. Talk about feeling vulnerable.

This seemed to work, however, and for the next several years, my cancer appeared under control, despite it marking the end of my sex life and beginning of persistent incontinence.

Since then, thanks to two particular medical advancements (and more doctors), I seem to be making headway against this thing.

• Several years ago, when I found myself going through eight to 10 pads a day due to incontinence, I learned about a new, life-changing device, an artificial urinary sphincter. I jumped at the chance to get one, and in January 2018 I had it installed. It worked like a charm and I was suddenly able to be away from the house for more than an hour without pee soaking through my pants.  

• Also, a few years ago, I started aggressive hormone therapy, taking four 250-milligram Abiraterone pills every morning, augmented with a 60-mg Eligard shot in my belly fat every 6 months. I’ve been fighting my body’s manufacture of testosterone for 2 years now, resulting in a 0.05 PSA ever since.

During our recent consultation, Dr. S, I asked you how long I might expect this hormone therapy to work. You said, "Statistically, 3 years." You added that it's been highly successful for me and could go a little longer. I liked your answer. It seemed knowledgeable AND sympathetic.

Welcome to my team

Now that you're my new oncologist—and the Michael Jordan of my team—I expect you to make me forget all about my first oncologist. That's saying a lot, because I liked her so much, and to be honest, it's a little hard starting over with someone new again.

Over the years, I have been asked numerous times who I credit for my almost never-flagging optimism in this ongoing battle for survival. As much as I'd like to brag that I'm just a really cool, unflappable guy, there are a couple people who’ve made me feel bulletproof from the beginning. One was that first surgeon, Dr. M, who imbued me with hope and confidence.

But the real mainstay of my team is my longtime partner, who married me when we were teenagers, and made it clear we were both in it for the long haul. We’re celebrating 55 years this month, and there was never any doubt that she loved me and would support me, whatever waited around the next corner.

I’m extremely grateful for that, because just a few weeks ago, I learned I have a brain tumor that, at this point, is so tiny, it doesn’t seem to be a concern for the doctor who examined me. Time will tell, of course, as with my prostate cancer.

What have I learned through all of this?

In the meantime, I'll be relying on my team—and that includes you, Dr. S—to help get me through.