A Surgeon's Personal Call to Cancer Care

Stefan Holubar, MD, has a unique bond with his patients.

A young man still in medical school at University of Vermont, Stefan Holubar was on a ski vacation in Lake Placid with his brother and some ski buddies when he felt an acute pain in his lower abdomen.

Focus article photo

Stefan Holubar, MD

His brother rushed Stefan to the hospital in New York City, where an obstructing colon cancer was diagnosed by colonos­copy. Emergency surgery for stage III colon cancer on New Year's Eve removed 75 percent of his lower intestine. "I can say without any hesitation at all that a colo­noscopy saved my life," Stefan comments.

"The surgery was a high price to pay, but it's given me both sympathy and empathy for my patients," he contin­ues. "I don't advertise that I'm a cancer survivor, but if I think they will benefit I will share my story with patients, and when I do what often happens is that they breathe a big sigh of relief. ‘Finally, here is someone who understands,' they seem to say. And I do understand."

Relief is an emotion Stefan Holubar, MD, a member of the surgery team at Dartmouth-Hitchcock Medical Center and also a member of the Cancer Center's Gastrointestinal Oncology Program, often hears when he meets with patients to discuss their prognosis and treatment. Patients connect with Holubar, and he connects with them, in the exclusive bond of shared experience. He is, indeed, exactly who his patients aspire to be—a survivor of colorectal cancer.

Holubar had suffered with illness for many years. Pediatricians thought he had Crohn's disease, but the surgeons removing his intestine diagnosed ulcerative colitis; the difference correctly focused attention on Holubar's colon. Most importantly, his condition gave him a unique perspective on colorectal patients. "These tend to be chronic conditions, and a lot of patients with colorectal disease, including cancer, become professional patients," he says. "I'm a doctor who empathizes with his patients because I know just what they're going through. I went through it too."

In addition to the extraordinary con­nection with patients that Holubar's experience has given him, it's also made him an evangelist for colorectal cancer screening and prevention. "It's the fourth most common cancer and the second most lethal," he points out. "Yet it's pre­ventable with screening." What concerns him, he says, is "that we're seeing a lot of advanced colorectal cancer in older patients." Most of those patients prob­ably didn't have a screening when they were younger, and now their cancer has advanced to threatening stages.

It frustrates him, he admits, that current colorectal cancer screening rates are in the 25-30 percent range; he would like to see that increase to 50-60 percent or higher, the sooner the better. "If colorectal cancer is caught early enough, it can be treated and cured, even in older patients. Catching it early is what matters," he says. In his 20s when he was first diagnosed, Holubar has now been cancer-free for 12 years.

When considering specialties as a medical student, there was little question in which direction he would go. "Let's just say I was highly motivated to specialize in colorectal disease," he laughs. Now his training and his experience have merged to bring him full circle, to the other side of the examination table.

"When you're an intern, you know what you've been taught but you don't yet have the experience to fully appre­ciate what many patients are going through," he comments. "I was in the unique position of knowing what it was like for colorectal patients even when I was in med school." He pauses, reflects, and adds, "I feel a calling to this."

April 20, 2011