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Oncologists should be experts at farewells. I often write a note of condolence if I have not made personal contact with the patient or family close to the time of death.

I was recently consulted concerning a patient in the ICU at my hospital with advanced breast cancer, but I soon realized there were much larger issues at stake. This woman is in her 50s and was diagnosed approximately 1 year ago with metastatic triple-negative breast cancer.

Through its direct mail pieces, print ads, and commercials, my treatment center positions itself as a Shangri-La where all patients bask in the sensitive and professional care of their multidisciplinary team. How very different this picture is from my regular sojourns to the nuclear medicine department in the bowels of the hospital.

Patients with Medicaid coverage or no insurance at all were more likely to present with advanced cancer of a number of types, and were also less likely to receive certain treatments, according to a study using the SEER database.

Each person facing cancer has their own way of coping. They have no obligation to fit a stereotype that others may have conjured up. They are each the poster child of their own unique campaign.