Dr. Dhople was featured in an article by Florida Today.
Oncologist uses image-guided radiation therapy to target tumors
For FLORIDA TODAY
Dr. Anil Dhople loves his specialty of radiation oncology now, but his path to it was not traditional, to say the least.
“I kind of remember my parents always hoping I’d be a doctor but when I went to college, I was going to be a biomedical engineer. In my third year of college, I realized I didn’t want to become an engineer,” he said.
Dhople had an internship with a pharmaceutical company where his job was to mix two chemicals in two different proportions and record the results.
“That was my entire job for the summer, just creating a graph of viscosity. We were making polymers for a drug delivery system that would treat brain tumors. I got exposed to physicians who were treating the brain tumors so that’s how I got a feel that I ought to try medical school,” he said.
Dhople talked about his career path and how returning to his hometown area has helped his practice.
Once you became a medical school student, did you just proceed on to be a doctor?
Dhople: With all my engineering background, medical school was a huge challenge. I hadn’t taken any anatomy or basic physiology classes. In a specialty, you really have to start knowing that in your second year of med school. In your third year, you start doing your clinical rotations, seeing patients. I remember going through medicine, family medicine, surgery and I wasn’t finding anything. All I could think about was that I had spent a lot of money on medical school. I ended up doing a radiology rotation just looking at X-rays and CAT scans. I liked all of the technology with that, but I didn’t like the fact that there was very limited patient interaction. I did a rotation in radiation oncology at UF (University of Florida) and I knew that was it. There’s a lot of physics and engineering involved and, at the same time, it’s a lot of patient interaction. I am not just sitting in a dark room just pushing buttons.
Of the innovations during your career, which has had the biggest impact on patient outcomes?
Dhople: I think the single biggest change has been the advent of image-guided radiation therapy, where we are able to use images that we take, in real time while the patient is getting their treatment, to confirm and verify that we are very precisely hitting the target of the tumor. It allows us to get smaller margins on treatment, to spare healthy tissue from radiation. With that sense of certainty that, we are hitting the tumor we’re able to give higher doses of radiation, which in multiple cancers has been shown to be associated with better outcomes. We can see in real time what’s in the human body. We can see the tumor before the radiation beam goes on and we can verify that the center of the radiation beam is at the center of the target.
What about advances in imaging?
Dhople: Image quality is so good compared to what it was even five years ago. When a person had a brain tumor, or their lung cancer had spread to the brain, we used to always treat the whole brain because we couldn’t see where the tumor was. Now, we’re so accurate that we pinpoint the radiation. It’s gotten so good in the brain that what used to take two weeks takes one day.
How do you develop a rapport with your patients?
Dhople: When I first meet a new patient, I block my schedule from an hour to an hour and a half. I know that if it’s a brand new patient, they deserve at least an hour of my time. Not everybody needs an hour but it’s there for them. One of the benefits of me practicing in my home town is there is an inherent trust that people will have when they’ve heard of me from one of my former teachers. That goes a long way toward establishing rapport. I like to let them explain to me what their understanding is so that gives me a judgment as to how much more information that they need. I just listen to the patient.
How do you break bad news to patients? Do you leave a chance of hope when chances of a positive outcome are unlikely?
Dhople: I may not have been doing this very long but I’ve seen some strange things happen. I’ve seen enough instances where patients by all definition should have been dead in a month and it’s been eight months and I don’t know why. Statistically speaking, they have defied the odds. I do not try to sugar coat too much. If it’s bad news, I think the patient has a right to know. They might need to get their affairs in order. I tell them, if the same situation was posed to 100 people, unfortunately, 95 would have passed away by this time. That doesn’t mean everybody. There are still five people who are plugging along and I don’t know what made those five people so special. I tell them that it may be beyond my control. I don’t try to sell them false hope, I just try to show them that there is room.
What is your favorite part of your job?
Dhople: Often times, radiation is a difficult thing to get through and, toward the end of treatment, when they are feeling down, I know it’s going to get better for them, that the side effects will go away but it may take a few weeks. In the follow-up process, I always like to keep close tabs on them, and I’m able to see them after they recovered and they kind of look at me and say “This was a hard thing to get through, but I knew I could do it.”
What is most difficult?
Dhople: It’s not necessarily giving bad news but telling them I don’t have anything more to offer. That’s one of the worst feelings. Knowing that I can’t do anymore. That’s always hard.