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Fighting cancer in the real world
by Kristina Leighton, Wake Weekly Staff Writer
When oncologist Francisco Castillos took his work from the lab to the field, he thought he'd be able to make a more direct impact on the lives of his patients. What he hadn't banked on was the impact his patients would have on him.
"I've learned more from my patients than in all my 20 years of research," he said. "More than anything I've read in any book." Castillos has worked as an oncologist, diagnosing and treating cancer patients, for the past 10 years. As a doctor, he has a unique perspective on the cancer experience -- a disease he deals with every day. Castillos began his career as a cancer researcher in 1982. He hoped, as everyone in the field hopes, to one day find a cure for cancer, saving millions of lives in one fell swoop. But it wasn't that easy. The world of research wasn't as free from political influence as he'd believed. Disillusioned, he searched for a way he could truly impact the lives of those with cancer. He turned to working in what doctors call "the field." Instead of trying to find an all-encompassing cure for cancer, he decided to try to help rid the world of the disease one patient at a time. "I felt I could make a difference with my knowledge of research in the field," he said. " I thought, maybe I can make someone's life better." So he went back to school, and in 1995 received his medical degree from Chicago Medical School in Chicago. He endured the vigorous training doctors must undergo, completing his internship at Yale, his residency at the Virginia Medical College and his fellowship at the University of Alabama in Birmingham. He travelled overseas to treat sick and wounded soldiers as a lieutenant commander in the Navy during the Gulf War, and eventually accepted a position with the Eastern N.C. Medical Group in Rocky Mount. And somewhere along the way, among the dozens of patients he tended to, he discovered just what it means to be an oncologist. The experience, he said, was unlike anything he'd imagined -- and requires a great deal more skill than found in any medical book. Becoming a good oncologist not only requires a good understanding of how cancer cells behave, he said, it also requires compassion and empathy. It requires a true desire to help those in the community who are afflicted with the disease -- through treatment and afterward. It requires the ability to support the family of patients who don't survive. "There is a huge need to know how to do that," Castillos said,"how to be there for the families at the end, to interact with them so that they may find closure." But maintaining objectivity -- knowing when it's best to continue pursuing treatment and when it's not -- is perhaps the most difficult, he said. "You hear about it, you know it's something you're going to have to deal with, but until you are in that situation, you don't realize how hard it is," he said. Some patients simply don't want treatment, he said, and a doctor has to accept that. Others want aggressive treatment right to the very end -- even when it becomes obvious there is no hope of recovery. Somehow, the doctor has to determine when treatments will no longer help a patient, he said, and just figure out how to make them as comfortable as possible. Making those decisions isn't easy, he said. And then there is the almost-godlike status with which some patients assign their doctors. "Patients want to know -- How long do I have to live?" Castillos said. "I say, That's up to God. All I do is provide treatments and hope that they work on that individual. "I can look at what the statistics say, what has happened to others with that particular kind of cancer," he said. "But at the end of the day, I say, 'You are unique, your cancer is unique, and what happens with you will also be unique.'" Castillos said he goes into each encounter with a patient hoping to cure them. In some cases, he succeeds, and is able to send them into remission. In others, he's only able to give them a few more years of life. "But those years can mean everything," he said. "It gives the patient and their family precious time together -- time to come to terms with their illness, time to bring closure to some things in their life." Whenever possible, he tells his patients to hang on while new medications are in the pipeline -- medicine that might be the cure they are looking for. "It gives them hope," he said. "It gives them the energy to fight their disease." Sometimes, too often, though, the disease wins out. "It's hard," he said. "It's disheartening when you have used all your medical knowledge and still the tumor won." It's an emotionally draining job that baffles many. Typical of his profession, Castillos often works 12-16-hour days. He constantly searches for ways to balance his work with time for his wife, cancer researcher Luminita Castillos, and their newborn son. "People ask: How to you do this?" he said. "I see the resilience in the people I treat -- their will to fight, their desire to live -- and I have hope. "The ones who live -- that's what you hold onto. You gather strength from those you helped." Each patient he's treated has taught him something, he said. "I watch them and see how they live life to the fullest every day, cherishing every moment." His patients tell him how they become aware of the smells all around them -- in the kitchen while they're cooking, in the flower bed while they're gardening. They notice all the changing colors of the trees. "They see all the beauty life has to offer," he said. "They've taught me so much about life and how to live. "It's a very humbling experience. I feel honored to be able to take care of them." While Castillos still hopes that through research he or others will soon find the one answer everyone is looking for -- the cure for cancer -- he no longer believes that's the only way he can touch the lives of cancer patients. "I've long since lost the egotism of a new doctor," he said. "I'm here to help other people and make a difference in the lives of my patients and their families. "If I can do that, I feel like I've succeeded in life." Editor's Note: This is the third story in a four-part series on cancer and how it affects members of our community. To make donations to any Relay for Life team including The Wake Weekly's, visit www.acsevents.org/rfl/northraleighwakeforest. Relay for Life is a 24-hour relay event hosted in communities throughout the nation to raise money for cancer research through the American Cancer Society.
Last Updated On: May 5, 2005
Copyright 2005 The Wake Weekly