Jens Hillengass [JH]: I love to go to work in the morning and see my patients and work with them. Patients with myeloma live so long, that I have time to build a relationship. I had patients over decades — it’s difficult to say it’s a friend, but it’s a very close relationship because they trust you. I admire a lot of my patients who are not grumpy, who are not yelling at me. Those who are grumpy and yelling at me, they have every right to do so. They have a horrible disease and I can understand it, to a certain degree.
Philip McCarthy [PM]: I’m old enough so that when — back in 1985, when you were a little boy, the survival wasn’t very good back then. One hundred patients, 50 would be dead within three years.1 We didn’t have a lot back then to treat with.
I met a physician from Oman. He told me, “Treating myeloma used to be like waiting for a cab and none would come, and now, all of a sudden, five come at once. So which do you take?” And so now, we have all these great options of how to treat, and now figuring out how to do that is very exciting. So it’s been quite interesting in terms of both drug development cellular therapy development and developing ways so that we can cure patients of their disease.
JH: The treatment was good but not as good as it is today. I love to give them, even if it’s avery short list of options, and it’s such a great experience to see how their whole appearance changes when you tell them, “OK, it’s not the end yet.”
PM: I keep telling people, “We don’t know if five years from now, what bad feature your disease may have. It may be gone.” You can’t be Pollyanna and say, “Oh, everything will be just great, and you’re going to live for the next 30 years.” I always say, “I would love to tell you that, but I’d be lying. And I have to give you some reality check. But I also want to say that we have things that we can do for you.” And that’s the thing that I find is the best in terms of trying to be as honest as possible but without being doom and gloom.
And so the big issue is how can we best attempt to either control your disease long-term, because we really can’t cure myeloma yet.2 A lot is personality driven — how they approach it, how I approach them, because I have to tailor what I say a lot based on what the patient thinks and how they are composed. And also their caregivers - how their families react.
JH: To see patients being thankful, being happy, it’s very rewarding.
PM: I just love what I do. My only regret is someday, I’ll have to retire.
JH: That’s also my regret, that you have to retire someday. (laughs)
PM: I know it sounds perverse to say it’s so much fun. But it is fun to watch people get better. That is the thing that really brings me joy and allows me to keep getting up in the morning and come in and help people out and fight difficult problems.
1. National Cancer Institute. Myeloma SEER Relative Survival (Percent) By Year of Diagnosis. Available at: https://seer.cancer.gov/csr/1975_2016/browse_csr.php?sectionSEL=18&pageSEL=sect_18_table.09. Accessed on: June 25, 2019.
2. Jakubowiak A. Management strategies for relapsed/refractory multiple myeloma: current clinical perspectives. Semin in Hematol. 2012, 49 (Suppl 1):S16-S32