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Cancer Care Chronicles
July 11, 2019

Not on My Watch

Author Affiliations
  • 1Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, Maryland
JAMA Oncol. 2019;5(10):1395-1396. doi:10.1001/jamaoncol.2019.1904

Ian is a man in his 40s, with a loving family and a fulfilling job. A few weeks of abdominal discomfort and some goading from his wife prompt a visit to his primary care physician. A computed tomographic scan reveals masses in the liver and peritoneum, with a nasty-looking colon tumor. After a colonoscopy, he arrives at the medical oncology clinic with a diagnosis of metastatic colon cancer.

He is the first patient I care for as a July first-year oncology fellow. At my institution, fellows see patients with newly diagnosed cancer in conjunction with a faculty expert. If patients agree, fellows “inherit” the patient, acting as their primary oncologist, with the attending physician following closely. Our meeting lasts an hour and a half. I leave to discuss his case with the attending physician, and we both re-enter the room to finalize recommendations.