Submitted by Dr.Kattlove’s Cancer Blog

As I write this, Senator Kennedy is undergoing surgery for his brain tumor, not in Boston where he was first diagnosed, but at Duke University in North Carolina. Then he will receive his expected radiation and chemotherapy in Boston. Why this change in venues for his treatment?

The answer is simple. Kennedy was looking for the best surgeon. Yes, there is a difference in surgeons. Several years ago when a family member needed gynecologic surgery, I asked a local surgeon who would be the best to do this. He recommended a local expert not because he was exceptionally smart, or had done great research but because he had “good hands”. Great skill was the most important criterion.

Surgery is like most sports. To be an expert a surgeon needs great hand-eye coordination and experience. Yes, smarts do come into play, since decisions sometimes have to be made at the operating table, but usually, experience helps guide the surgeon’s hands at these times.

Recently, I was asked whether a certain institution would be a good place to treat someone with pancreatic cancer. My answer was that if only radiation or chemotherapy were planned, any first rate academic institution would do. But, if surgery were involved, then I would look for the Kobe Bryant of surgeons. Maybe he or she won’t have the greatest attitude or a warm bedside manner, but who cares? For operating on a complicated cancer, you want skill and experience. Recent studies have found that one of the best training tools for surgeons are video games. Surgeons who spent time at these and were good at them, turned out to be better in the operating room.

After his surgery, the news reports say that Kennedy will return to Boston for the radiation and chemotherapy. Boston is fine because these treatments require brains and experience; traits easy to find in Boston, but not great hand-eye coordination.

The senator’s cancer is fatal and I am sure he has been told this. Indeed all the news articles are full of experts’ dire predictions. One might wonder why he is bothering with all this treatment. I suspect that one major reason is that he is a fighter. In my practice, there were people who would accept all kinds of grueling treatment just because it wasn’t in them to go peacefully into the night. I’m pretty sure that Kennedy is that kind of a guy. Also, it struck me that as a public figure, he may feel a responsibility to set an example, not just in fighting cancer but as a message for life: Don’t give up.

Unless he writes a memoir, we will never know, but I, for one, hope that he beats all our grim expectations.
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