In selecting doctors to visit, a surgical oncologist just might be the last one you'd want to see. But Dr. Raza Ali Dilawari would like to dispel the notion that cancer surgery is but a grim, desperate attempt to save the hopeless.
"There is a misconception that the general public has," says Dilawari, "that a cancer diagnosis is a kiss of death. Diagnosed early and treated properly, there are long-term rewards for patients."
Born and raised in Pakistan, Dilawari moved with his family to the United States in 1969, when he was 22. After studying at Roswell Park Cancer Institute in Buffalo, New York, Dilawari moved to Memphis in 1975 for a position at the University of Tennessee medical center.
Dilawari chose to focus on cancer surgery at a time when the field was just developing. "It was a new field," he explains, "understanding the biology of cancer. I realized how little I knew. Cancer surgeons did difficult cases, and they did them well. That sparked my interest.
"A surgical oncologist doesn't just know the surgical aspect of a disease, but he or she should also know what there is to offer in a multidisciplinary approach, with chemotherapy, or biological therapy. Traditionally, surgery was the first treatment [after a tumor was found]. Now there are many conditions where surgery comes only after chemo or radiation therapy."
Ask Dilawari about the most rewarding aspect of his work and it's a quick answer. "I have patients I've been working with for 25 or 30 years," he says, "patients who had a very difficult problem, and now they have a useful life."
Dilawari also describes the "evolution" in treatment of breast cancer as a dramatically inspiring part of his career. "I was trained on radical mastectomies," he notes, "and now mastectomies are very infrequent. There are lots and lots of women who have breast preservation without compromising their care."
The biggest challenge a surgical oncologist faces is in patients with recurring cancer, where the initial attempt to control the disease didn't succeed entirely. It's an area where research on the genetic and molecular level may someday help map a cancer patient's treatment even more specifically than it can be today. "We are [discovering] growth factors that promote a tumor," he explains. "Medicines are being developed that target those growth factors, and we're seeing very good response."
Away from work, Dilawari counts tennis and reading about history among his passions, and he's developed an affection for "American football," particularly the college variety. Considering the progress he's seen over more than three decades of fighting cancer, Dilawari has become the face of the one element most appreciated in the heart of a patient, or a college football fan for that matter: hope.