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Continuing to Learn About Our Chosen Profession: An Oncology Pharmacy Book Group

Karen M. Fancher, PharmD BCOP
Assistant Professor of Pharmacy Practice
Duquesne University School of Pharmacy
Clinical Pharmacy Specialist
UPMC Passavant
Pittsburgh, PA

Christine (Chris) M. Walko, PharmD BCOP
Personalized Medicine Specialist
Chair, Molecular Tumor Board
H. Lee Moffitt Cancer Center and Research Institute
Tampa, FL


Karen’s Perspective
Several years ago, a resident gave me a present at the end of his rotation. It was a copy of The Emperor of All Maladies, the Pulitzer Prize–winning book by Siddhartha Mukherjee about the history of cancer and its treatment. The resident mentioned that he thought I would enjoy it, and I was touched by his thoughtfulness. But despite my good intentions to read it, the book sat on my shelf for a year or two.

After seeing advertisements for the television series of the same name, I decided I should actually buckle down and read the book—and I was immediately amazed at its eloquence. I wanted to give the resident an equally stunning piece of literature, so I went to Amazon and looked at the “Customers who bought this item also bought” section. After I had thrown more than a few items into my virtual cart, a new hobby was born. I started reading oncology-related books in earnest.

Several months later, I ran into Christine Walko, coauthor of this article, at a conference. I had just read a remarkable book about a patient’s experience with metastatic melanoma, and I remembered that Chris was interested in that type of cancer. I casually mentioned the book as something she might enjoy. We met again at the same conference a year later, and she jokingly commented that I should start an oncology book group … and so I did.

Chris’s Perspective
My love of reading is hardly a surprise, given that my mother was a school librarian. A comfy chair, a furry feline foot-warmer, a glass of full-bodied cabernet, and a riveting page-turner became a rare but enjoyable indulgence that helped me unwind as I grew older. Though I enjoy a variety of literature genres, historical fiction and nonfiction became part of the mix after I read The Devil in the White City, by Erik Larson. The Emperor of All Maladies was my choice as I sat in front of a crackling fireplace over the holidays in the snowy South Hills of Pittsburgh in 2011. I remember reading chapters discussing the history of cancer between current studies published in the Journal of Clinical Oncology. The progress we had achieved since those early days of nitrogen mustards was remarkable and made me feel more connected with my profession.

I also was lucky enough to have a patient who told me personal stories about working as a chemist at Cal Tech and training under Linus Pauling. I felt in some ways that I was getting a glimpse of history and meeting someone who had worked with a celebrity (it was then that I fully embraced my hidden science nerd). I began seeking out books that augmented my understanding of aspects of my field through the connection of engaging stories in a similar and personal way. My favorites still include humorous stories—such as The Disappearing Spoon (the author Sam Kean is one of my favorites!)—about the elements in the periodic table.

During her lecture on chronic leukemias for the Board Certified Oncology Pharmacist recertification program, Karen mentioned how she had accidentally found the book The Philadelphia Chromosome, and that had me not only hunting through Amazon for that book but also filling my cart with four more that she had recommended by the end of her lecture. Fortunately, when she was asked to continue to feed my addiction for enriching literature, she obliged and started our online book group.

Our Book Discussion Group
Our Facebook discussion group, the Oncology Pharmacy Book Group, has been open for about a year and currently has 92 members. We post comments about various books related to oncology and other aspects of the medical profession—our thoughts, reviews, and recommendations. As I look back at the books on which our group has posted comments, I see that they can be divided into three broad categories:

Books About Oncology and the Science Behind Its Treatment
Such books are typically heavily focused on the “hows and whys” of cancer—why cancer occurs, how a particular genetic defect was discovered, or how a specific drug was developed.
Examples:
  • The Philadelphia Chromosome: A Genetic Mystery, a Lethal Cancer, and the Improbable Invention of a Lifesaving Treatment, by Jessica Wapner.
  • The Emperor of All Maladies: A Biography of Cancer, by Siddhartha Mukherjee
  • Dark Remedy, by Trent Stephens and Rock Brynner
  • The Serengeti Rules: The Quest to Discover How Life Works and Why It Matters, by Sean B. Carroll

These books often resonate with me in a romantic way, reminding me of my childhood love of science and why I chose pharmacy as a major all those years ago. They also serve as a powerful tribute to the innumerable hours logged by scientists throughout centuries of progress that came before us—and as a truly humbling reminder of how much farther our chosen field has to go.

Books About the Imperfect Nature of Medicine and Health Care
These books provide a perspective on the numerous external factors that continue to disrupt medical progress. Examples:

  • Complications: A Surgeon’s Notes on an Imperfect Science, by Atul Gawande
  • The Immortal Life of Henrietta Lacks, by Rebecca Skloot
  • Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs, by Jerry Avorn
  • Better: A Surgeon’s Notes on Performance, by Atul Gawande

Books in this category often highlight the outside influences that can delay or even entirely derail drug accessibility. From human behavior and finances to the process of informed consent, the course of medical progress has not been a linear one. I find the backstories of these medical detours worthy of reflection. Their authors often offer their perspective on how the process can be improved, which is always worthy of consideration. The personal stories also offer connection between the macro and micro (i.e., human) level of these aspects that are administrative parts of our daily lives.

Books from a Cancer Patient’s Perspective
Although they are not always scientifically accurate, these books are written from the unique perspective of a patient with cancer. The individual’s view of his or her fate, account of coping strategies, and views of the medical profession are always moving. Examples:

  • When Breath Becomes Air, by Paul Kalanithi
  • A Series of Catastrophes and Miracles: A True Story of Love, Science, and Cancer, by Mary Elizabeth Williams
  • Into the Funhouse: An Unpredictable Story of a Relentless Leukemia, by Walter Harp
  • Everybody’s Got Something, by Robin Roberts

I’ll be very honest and admit that after nearly 2 decades as an oncology pharmacist, my empathy occasionally wanes as I get caught up in paperwork, students’ questions, pharmacy inspections, mandatory meetings, and life in general. Books like these make me stop in my tracks and remember exactly why I love my job: I am taking care of patients. The books often make me pause to reflect on how strong, clear, and beautiful these patients remain in dark times. They also remind me of the individual stories that make up every descending Kaplan-Meier curve we see in each published manuscript and the human beings behind the data we use to make our standard treatment recommendations.

Our shared hobby has expanded our minds and hearts in ways that we didn’t expect and continues to renew our energy for working in the field we love. We have thoroughly enjoyed hearing our colleagues’ thoughts and recommendations. We’re already looking forward to the next books on our lists!

Interested in joining our discussion? We’d love to have you—you can find us at Oncology Pharmacy Book Group on Facebook and tell us your favorite oncology reads!

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