Seven Questions

John Ruckdeschel

Nevada Cancer Institute boss on modern challenges, old-style miracles and Las Vegas’ medical potential

As the CEO of the Nevada Cancer Institute, John Ruckdeschel is charged with advancing Nevada’s cancer treatment facilities and managing a faculty of 36, including some of the nation’s top researchers and oncologists. Somehow, he still finds time to see patients, too. All of this gets more complicated because the 65-year-old oncologist has to deal with a shoestring budget restricted by one of the worst economic climates in history. Ruckdeschel, however, is well-equipped for such challenges. He successfully led institutions in Tampa and Detroit to becoming National Cancer Institute Designated Cancer Centers, an honor that increases both funding and visibility. Ruckdeschel plans to get NVCI designated, too, putting it on the national stage for cancer research. The center opened on Breakthrough Way and Discovery Street in 2005, and Ruckdeschel took over as CEO in 2009. In that short time, he has spearheaded efforts to ensure steady funding from the state while working to bring credible medical programs to Southern Nevada.

What attracted—if that’s the right word—you to oncology?

No, it was attractive. I chose it in 1967. Everyone at that time was rushing into cardiology and endocrinology and surgery and everything else, and I thought enough of them were jerks that I didn’t want to work my whole life with them. I thought oncology was a wide-open field. No one was doing oncology. And I got into it because it was technically a challenging area, and then my mother was diagnosed and died of [kidney] cancer so that just solidified it.

Do you still see patients regularly?

I’m seeing probably three or four new patients a week. I have probably seen several hundred patients since I’ve been here. Since I first started as a CEO probably 20 years ago, I’ve always seen patients. I think there’s that little physicians CEO guidebook that says, “Don’t see patients; dedicate self to business.” This is ridiculous. I have found over the years that if I’m out and about seeing patients, they’re going to tell me things that I’m not going to get through committee reports.

What is one of the biggest challenges in cancer research today?

We have a tendency to oversimplify very complex systems into very simple systems. We want them to be very simple—that A causes B causes C causes D, and if I interfere with D, that will stop the process. Biological systems that we’re part of have 100 different pathways to get from A to D, and if you take out B, they go via Q. There are all these pluses and minuses operating in the system. [You have to] deal with that complexity because there are very few diseases that have one bad gene that makes the disease. That is so rare in what we do. The idea that this next drug will be the magic bullet that will take care of all cancer—we’re not going to get to that.

Is there a cure for cancer?

The vast majority of folks who have diabetes, heart disease, arthritis are never cured of it. We don’t have cures for any of those diseases, but they’re able to live with it even though it may shorten their life. I’d be ecstatic if we can get to the fact that we can keep people alive for a prolonged period of time. Even though they still have cancer, keeping it under control, something you live with instead of die of. I’m not sure we’ll get there in my practice time; in my daughter’s practice time [she’s a 32-year-old cardiologist] we’ll probably see that type of change.

Is it difficult not to internalize what you see on a daily basis?

It does affect you, no question. There are many patients that, from the very first day I see them, I know their cancer is so extensive they’re not going to be here this time next year. You either find value in helping them get to the end as comfortable as possible and having lived as good a life as they can in that time or not. If you don’t get comfort out of that, I’m not sure why you’re an oncologist in the first place, but I’m not sure who you are as a person, either. It comes from my religious background [as a Roman Catholic] that people would help lepers or people with AIDS. Even though they couldn’t cure it, they would get comfort out of that. I still get great pleasure out of being able to give comfort and help people through what’s obviously the most serious thing they’ve ever faced in their life.

Miracles are often associated with medicine. Do they happen?

I have a patient who came in with widespread lung cancer. I treated her, and she had tremendous side effects from the chemotherapy, so we stopped. Seven or eight years later she was still perking along, and I couldn’t explain that. Is she cured? No. The fact that she’s still perking along like that is relatively miraculous. Do I think someone came down and hit her with a little lightning bolt and said, “You will do well”? No, I don’t see it in that sense, but there are things that I can’t explain.

What are you most excited about for the future?

As a city and a state, we’ve often had this feeling that we’re sort of backwater hicks out here and we can’t do anything right ourselves, so we have to have someone come in and do it. This is where Oscar [Goodman] and I disagree. He’s been all over trying to get the Cleveland Clinic to come here and set up a major presence. It would be nice, but there are things that can grow here. I think the cancer center can grow here. I think there are other areas here that can work. That would be my goal, that those of us who choose to live here actually can replicate here what’s been done in a number of other cities.

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