* * Harry McCoy has the world’s toughest, most rewarding job

Harry McCoy can’t make everybody well again, but he sure tries. Harry is a physician, an oncologist and hematologist, and his beat is Blue Ridge Cancer Care’s new Blacksburg Office on Research Drive. I got together with him over a cup of tea recently after he’d offered to help my understanding of how a fictional character in my next novel might deal with that dreaded disease.

First, he explained some concepts and terminology. He said, “When most people think of cancer, they think of tumors. A tumor is medically simply a ‘growth’ and some are cancerous while others are not. But cancer doesn’t necessarily involve forming tumors. What all cancers have in common are cells that have mutated and have uncontrolled growth. Cancer is actually not a single disease, but several hundred or more related diseases.

“We have both solid and liquid forms of cancers. Cancers that develop from organs of the body like the colon, breast or tissue like a muscle are often referred to as “solid” tumors. Cancers that develop from the bone marrow, blood or lymphatic system are referred to as “liquid” tumors. These would be leukemias and lymphomas."

Harry described the lymph system as the sewage treatment plant of the body. “The lymphatic system is comprised of millions of little white cell collected in places called ‘nodes’. These can be so small that they can only be seen with a microscope to as large as a fingertip. There are millions of these in our bodies. If they become cancerous, they grow into a lymphoma. Cancers that start with cells in the bone marrow and circulate in the blood are called leukemias.

“The human body is fascinating, really unbelievable!

“The body is constantly creating new cells. Occasionally, let’s say every 0.001% of the time, the body makes a mistake, a cell makes a detour, and it becomes a genetic accident that can become pre-malignant. The body’s search-and-destroy system will typically weed it out. But occasionally it’ll escape detection and become malignant. Then you have cancer.”

He explained that some people are genetically disposed to cancers. For example, women may have “BRCA,” a hereditary condition that dramatically increases her chance to contract breast or ovarian cancer. There are also a multitude of carcinogenic (cancer-causing) materials in our everyday lives, such as pesticides, radiation, asbestos, and dioxins, some which are natural and others man-made. Lifestyle decisions are a determinant in cancer likelihood and outcomes.

Harry said, “We cannot control our heredity and have only minor control over our environment, but all of us can control our lifestyle. We all need to breathe and to insist on clean air. We need to eat sensibly and consume alcohol in moderation. And of course smoking is extraordinary harmful. The toxins and carcinogens (in tobacco) attack the lips, tongue, throat, esophagus, and lungs.” But, he admitted, “Twenty-five percent of lung cancers we see are in people who don’t smoke. Sometimes we just don’t know the cause.

“The good news these days are that lots of cancers are treatable. Cancer is no longer a death sentence. We have patients that live years and sometimes decades longer, some even to the point where they die from something else.”

Our conversation turned from medical to philosophical and psychological. He admitted that the career he’d chosen was sometimes even hard on him. “I try to take care of myself and my family. I do Tai Chi and I mediate. Practicing medicine is more of a lifestyle than just a career.

“We’re all going to die; we all have an expiration date. We’re all born with the myth of long life, but infants die, children die, and adults die. When people get cancer, they take off their blinders and see the world how it really is.

“I don’t subscribe to the idea of forecasting for my patients their chances of survival. For them it’s not 75/25% or 50/50. It’s either 0 or 100. They either live or die.

“I love my job. I love people, biology, and science. I’m close to people; they let me into places that others don’t go. It never gets more real than what I do. Cancer is a big leveler; it affects young and old, rich and poor. I’ve had homeless destitute people in rooms next to wealthy, accomplished people. They’re all facing the same challenge.

“Some people view cancer as a war. They talk about their ‘heroic battle against cancer.’ Sure, it sets a new course for those affected. I talk about the difference between healing and curing. Curing is about making the body well again, something we cannot always do. Healing is about the soul and making peace in our hearts, something each of us can do.

“To me, cancer is a life experience; it is something we must learn to deal with. While at times it may seem like a war it really is about how to manage this disease and coexist with it.”