Wednesday, October 17, 2012

OCTOBER 2012: LOST (AND FOUND) IN TRANSLATION

October is Breast Cancer Awareness Month, so you may have seen a lot of pink signs, t-shirts, and calls for participation and contributions in various venues around your community. I became more aware of the disease than ever last month.

I have invasive lobular carcinoma of the breast. I had my annual, routine mammogram on September 4th followed rapidly by digital mammography, ultrasound, and needle biopsy, was diagnosed September 18th, and had a partial mastectomy and sentinel lymph node biopsy on September 28. I will start either chemotherapy or radiation as soon as I get home from the Academy meeting. Either way, radiation and many years of aromatase inhibitor treatment are on the docket for sure.

I am experiencing the full force of translational research, or what we at the Academy have “visioned” as “Today’s Research, Tomorrow’s Practice” for many years, albeit it in oncology instead of optometry. When my surgical oncologist says, “The 20-year results for lumpectomy and radiation are the same as for mastectomy,” all I can see is someone presenting a survival analysis from a randomized clinical trial or case-control study at a national conference and the hundreds of women who were in that study. When I hear, “Your tumor will be sent for genotyping to help us make the chemotherapy decision,” I envision bench scientists toiling late into the night and on weekends to gather results, write papers, receive grants, and translate their results into the very real life preserver and treatment opportunity I am being offered. My medical oncologist is a true clinician-scientist with a basic science laboratory and an active clinical practice; he probably received the equivalent of an Ezell Fellowship from his professional organization way back when.

When breast cancer survivors on Facebook know their tumors’ estrogen, progesterone, and HER2neu receptor status, it means that doctors have spent countless hours educating their patients about the structure and function of cell receptors and the latest therapies to combat those cells’ growth.

It’s the same in optometry. Maybe the stakes are lower for us compared to oncology, or maybe not, at the end of the day. Patients deeply fear blindness.

Next week in Phoenix, you will stroll through the Exhibit Hall, trying out the latest equipment and comparing new devices across manufacturers. You will take notes furiously during a paper or poster or lecture on a topic that directly affects a patient you saw last week and resolve to call her to update her care when you get home from the Academy meeting. You will listen, rapt, while a colleague in the hallway relates his recent clinical experience before providing your own insights on his patient. You will translate today’s research into tomorrow’s practice, in some way, as soon as you get home.

Now that I’m a bit over the initial shock of diagnosis and surgery, I am doing okay and will welcome your words of support in Phoenix, even as I offer my own to Fellows who have been through this themselves. I just got cleared to resume regular activities postoperatively. I took a beginning watercolor class this weekend. I successfully rode a 25-mile breast cancer awareness bicycle ride Saturday, and I am following my doctors’ recommendations (including, “Don’t fall off your bike”) and living my life with my customary cynicism, joy, negative-energy-you-can-feed-off, sleeplessness, and love.

It has been an unparalleled honor to serve these past two years as the President of your Academy. I wish incoming President, and dear friend, Bernie Dolan, all the best.

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