day 36 cancer learning

Yesterday I was at the 2012 Learning conference held by Elliot Masie and his team, which celebrates, connects and educates educators, with an emphasis on employee development and learning in the business world. I was there to represent MD Anderson, which had been selected for a Spotlight Award by the Masie Learning Center to acknowledge our breadth and depth in education ( It is a huge honor to be recognized in this way as an institution, and it was a personal honor to represent the many thousands of educators that work every day at MD Anderson who earned this award.


Elliot Masie is a charismatic and interesting man, who has been championing learning for decades. It was very fun to meet him and his team, and be a part if ever so small of the event. Before he invited me on stage in front of the 1,500 or so conference attendees, he asked for a show of hands of people who had been confronted with cancer either personally, or through a loved on, and in a glance around the room it was clear that very few hands were not raised.

We talked for a few minutes about what the education mission at MD Anderson comprises. I am not sure how successful I was in conveying it in the unscripted interview, but it is truly broad, and I want to try here. Education is central to what we do – as I like to say, “Education: the mission starts here”.

We are part of the University of Texas and have two schools: our undergraduate 3rd and 4th year School of Health Professions which educates medical technologists in 8 different disciplines. This is a more traditional learning venue where people earn degrees. We are educating the people who do much of the work in our clinical labs, in imaging and radiation oncology among other areas.

Similarly we educate graduate students in biomedical sciences at our Graduate School of Biomedical Sciences, which we have jointly with the UT Health Sciences Center, also in Hoouston. Then we educate about 600 post-doctoral researchers in our laboratories at any one time. We have nearly twice as many medical residents and fellows who spend time at MD Anderson in over 70 programs, getting highly specialized training in cancer care. These are the next generations of scientists and clinicians who will carry the cancer battle ever forward.

We also train many thousands of nursing students, physician assistants and other non-physician clinical providers, who complete our clinical teams. Then we are also well recognized for educating our employees, with extensive and strong talent development programs.

Very importantly, we also educate our patients, which is critical to effective care.

In our approach to cancer care the patient is a vital member of the care team, and they are involved in care decisions. To be able to make the right decisions, it is important to have a good grasp of the disease, and the implications of the choices you are called on to participate in. Things become more complicated if clinical trials are involved – the patient must give informed consent before being able to participate. Note the word informed. On a more fundamental level it is important for a cancer patient to make the right decisions daily, regarding nutrition,exercise, sleep and monitoring of symptoms and side effects. At several stages in treatment it is common for the patient and their family or friends to be intimately involved in care – I remember the wound drain care I learned when Irene came home after her 24 hour mastectomy, equipped with a how-to-video and handout. Lastly, knowledge is power, and in almost all instances involving the patient will give them some power to be an active, motivated participant, and avoid the risk of being pushed into a passive, role that promotes feeling like a victim.

We meet this patient education mission with several tools and a philosophy. And credit goes to our Public Affairs division, who manage this important area. The tools are fairly self evident. Starting with new patient orientation which helps you navigate the processes and the clinics and centers that are fundamental to your care, to the many well designed and organized handouts. The first thing I received from the Breast Center was a binder with tabs for the major events ahead – chemo, surgery, radiation – and places to file additional documents as they were given to me as I move down my particular road. Very handy was a insert at the front where I could file the business cards of the doctors, physician assistants and nurses I encounter, and may well need to connect with again. I also got a chemo book at my first treatment, which I refer to when I detect/suspect side effects.

A companion to these hard copy materials is an online portal, myMDAnderson, where you can also see this information, and access a much more extensive and rich resource for patient education. You can also see your entire medical record, with a one week delay, allowing you to read your path and radiology reports, operative notes and on and on. Perhaps for some its TMI, but I like to look, from time to time. Just a little at a time. You can send secure email to your doctors – which is great for maintaining privacy. You can see your appointments and even move them if you need to. It is a great tool and makes you feel connected to the process.

We also have patient learning centers in various locations, staffed by professional patient educators and volunteers, and there you can borrow books, pick up handouts and booklets and also access the many how-to videos we have made. These are also available through our on-demand TV system that is everywhere in patient rooms.

Complementing these tools, and central to their usefulness, is our philosophy of involving the patient and using data to make treatment decisions. This manifests itself in the willingness of our doctors to discuss the disease in depth, point to what is known and what is not yet known, allowing for the limits to be seen. They take the time to educate you on the complexities and intricacies of your specific situation, and do so with honesty and compassion. As a scientist I have found these discussions enlightening, and fascinating, and have tried to stay with it even if the subject matter is not my personal area of expertise. At the same time I recognize the desire in me to shift the decision onto the doctor, and I have allowed myself to ask frankly “what would you recommend?”. It is not that I am seeking approval so much as that I want the expert who has spent countless hours integrating the field of, in this case, breast cancer to give me her best opinion. But then we agree on a way forward, and that feels good too. It is in the spirit of being a team member that I am getting educated about breast cancer, and about being a cancer patient.

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