Dr. Nicholas Vogelzang
Before Dr. Vogelzang joined the Comprehensive Cancer Centers of Nevada in 2009, the University of Illinois-Chicago graduate served as the director of both the University of Chicago Research Center and the Nevada Cancer Institute. A noted researcher in the field, he sees about 400 patients a year, 75 percent of whom suffer from prostate cancer. Here are the highlights of his recent interview with Erin Timrawi.
Cancer is something to be fought. Cancer is not really a very frightening word to me because I was diagnosed [with Hodgkin’s lymphoma] when I was a cancer doctor, and I was also trained in the years when cancer no longer was a frightening disease because we finally developed treatments that worked. So to me, it’s just something that needs to be treated.
Surviving cancer gave me a big appreciation for what patients go through—the idea that fear is an everyday accompaniment of your experience, because you always worry that the cancer is going to come back.
I find myself spending more time than I probably should with patients, because you can burn a lot of time talking about Aunt Millie or Cousin Joe. But on the other hand, if you do that, then you understand the person and you help them make decisions. Decision making in cancer medicine is the hardest part. It’s not the technical part of giving chemotherapy, it’s how people make decisions and why they make decisions.
What makes a good doctor is the skill of listening and the trait of curiosity. You have to be truly interested in the other person, and then you have to be curious about their cancer and how it behaves. Remember, every cancer is as unique as the face of the individual.
The genetic information that we’re achieving in cancer research is extremely interesting, and what it gives us is a whole new world as to why certain cancers behave the way they do. It also gives us the idea that we can identify Achilles’ heels on more and more of these patients. That’s very exciting.
My patients come from all over the country. I have research projects that are usually pretty unique or restricted to a few sites in the United States, so at any given time I’ll have … a police sergeant from Tacoma, an orthodontist from Los Angeles, an entrepreneur from Mexico, a shop owner from Lake Havasu, a bunch of folks from Salt Lake City and St. George. Some days I feel I should have a shuttle from St. George.
A growing trend in prostate cancer is less treatment, because for many years we’ve probably over-treated prostate cancer, at least the early stages. On the other hand, it’s still a killer, and you’ve got to know who to treat and who not to treat.
The biggest concern I have with the Affordable Care Act is that there are more government restrictions in place on what you can do and what they will pay for, and medicine has primarily been a self-correcting profession. We’re pretty objective about our results. We look, we correct, we change our practice. Not all doctors do that, but that’s the way it should be. Well, as we see more and more regulations, that ability to correct yourself is no longer present, it’s removed, and the rules are often either mistaken or draconian. [But] the other issue is that I think it will be good if we get more patients with insurance—they can be treated better.
One of my most memorable patients was one of the first patients I treated with testicular cancer. Now, 34 years later, he has developed cancers in the kidney, probably from the drugs I gave him in 1978. So it gives you pause. You say, “Well, I cured his cancer, but now we have to look at the long-term effects.” And so much of my interest has developed into using the human immune system to try to find ways to treat cancer because these chemicals we use can sometimes be quite harsh. They’re very effective, no question, but they can cause collateral damage, so I try to use them judiciously.
I use a lot of phrases, but one is, “I will not give up on you. I hope you will not give up on me.”
My best advice to those who wish to prevent cancer is to exercise more and eat less, and don’t smoke.