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Learning Your ABC

December 30, 2021

In September's Editor's Corner, Keith Stewart, MBChB, MBA, argued that cytotoxic chemotherapy should be declared a thing of the past and imagined a future where hematologists embrace the rallying cry of "anything but chemotherapy."

In response to Dr. Stewart's column, Francis A. Forte, MD, recounted his early experiences treating patients with cytotoxic chemotherapy and his hope for the future.

Dear Dr. Stewart,

I was the first intern to begin an infusion of anthracycline to a patient on protocol.

Soon, anthracycline was being called "The Red Death" and I was considered the odd man out among my fellow interns. They probably wondered how I could be interested in hematology-oncology. Other fields were so much more promising.

I sensed then, and for a long time afterward, that there was much truth in this. I have waited for the days of oral medications, less alopecia, and good nausea control.

So, more than 56 years later – thanks to the researcher into the molecular structure and pathways of the errant cells – we are beginning to see those beacons. There is hope. "ABC" will not be an acronym for a blockbuster chemotherapy regimen, but a triumphant cry of joy: "Anything but chemotherapy!"

Well, after many coffee spills and 12-hour Saturdays, I am still enthusiastic about my oddball specialty choice, I have always cherished the doctor-patient relationship, and I strive to offer hope for the hopeless and their families.

With each new attack on the inner workings of the cells and harmful side effects, my excitement grows. We are all grateful for the boundaries we have crossed in pain control and survivorship. With fewer and fewer of my patients older than me these days, I have set my sights on developing treatment schedules that work and that my patients can tolerate.

Francis A. Forte, MD
Hematology & Oncology Associates of Englewood
Englewood, New Jersey

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