Dr Ingo de Muelenaere is a Pretoria-based radiation oncologist and founding member of ICON. In this interview, he shares with readers his typical day and his views on current trends in cancer care.
Q: What is the first thing you do when you get up in the morning?
A: I usually get up at 05:00 and start the day either with coffee or by going to the gym. Exercise is very important to me and always a part of my day.
Q: What time do you get to work and how long is your day?
A: I usually arrive at the office at 07h30. Then I switch on the computer, do email and ward rounds. I try to have lunch but it can happen anywhere between 10:00 and 15:00.
Q: Do you have a special approach when seeing patients?
A: I believe it is important to really connect with patients and not just superficially touch base. I always try to find out how they are feeling and reacting to their treatment. In general, I try to be as light-hearted as possible, but one has to individualise your approach as people are different.
Q: How important is the interaction between doctors and patients in oncology?
A: Very. One of the reasons I like oncology is because of the relationships oncologists build with patients. We meet them when they walk into the office, then we build the relationship when they go undergo treatment. In many other specialities, the patients are diagnosed and you never see them again. As I see patients who have cancer, it is important to be honest and direct and to explain to them what we can achieve with treatment and what the possible side effects and risks might be.
Q: How do patients generally react when confronted with a cancer diagnosis?
A: They are usually shocked. It is important to be patient and honest. So often, they will look at you, expecting that their doctor will tell them what to do. They need to understand the importance of reaching an educated decision about their treatment themselves.
Q: What is your view on the advances made in radiation oncology?
A: There are some very exciting improvements in terms of radiation oncology. This results in shorter and more effective treatment times. More normal tissue is also spared, as the radiation can be targeted more effectively at the cancer. This also means fewer side effects and complications.
Q: What is your opinion on palliative care?
A: We often find that patients don’t understand the concept of palliation, not necessarily because they haven’t been informed properly but because they don’t grasp it. Perhaps they don’t want to grasp it. Too many patients undergo unnecessary treatments, resulting in poor outcomes and a poorer quality of life. The work ICON does is instrumental in driving more patient-centric models of cancer treatment.
Q: What are some of the benefits of radiation therapy?
A: Radiation does not make patients as ill as chemotherapy often does. Radiation technology is moving in leaps and bounds, ensuring shorter and more effective treatment times. Radiation, in certain instances also often offers better outcomes than surgery. For example, in early cancer of the larynx, surgery would result in a patient losing the ability to speak. But with radiation therapy, the patient would see the same outcome – the eradication of the cancer – and will still have the ability to speak.
Q: What do you think is the biggest challenge facing oncology?
A: Cost. There are new treatments and medicines coming onto the market continuously that even healthcare in the US and Europe can’t afford. If they are struggling to afford these, how can we manage it?
Q: How do you deal with the stressful aspects of your job?
A: I like the emotional side of my work, but it can become draining. Every three months or so I need to get away to the bush or somewhere where there is no cellphone reception or the Internet.
Q: Do you have any bad habits?
A: No, but you can ask my wife! I don’t smoke, but I do drink a lot of coffee, about six or seven cups a day!
To find out more about Dr Ingo de Muelenaere and his practice visit www.cancersa.co.za