The Ins and Outs of Oncology Blogging

I entered into the blogosphere a bit late, I know. I straddle a bit of a generation gap; I am too old to be a part of the younger generation that sees no trouble with sharing nearly everything online (yes, that means I don’t do Facebook or other social networking sites), but I am online more than my colleagues (because I do use LinkedIn, the professional networking site, for example). I started reading blogs in earnest when I was on maternity leave with my fi rst child (idle hands do become the devil’s playground). Mostly, I focused on “mommy blogs” and personal (not group) blogs. Eventually, I made my way over to celebrity and gossip blogs, fashion blogs, and cooking blogs—basically hobbies or outside interests (who knew the devil’s playground could be so broad and varied?).

It wasn’t for several years until I started really reading professional development and then medical blogs. And somewhat to my surprise, I found them quite useful professionally—they offered me good tips for my career, and quick summaries of important, recently released articles. Also, I fi nd that lay press articles about cancer are often cited in blogs, and I can at least have some knowledge of the things my patients bring to me in the clinic by that mechanism. Through all of this, I realized that most people who read blogs have a blog of their own (at least it seemed that way to me).

Still, I had no interest in starting my own blog at that time. I wasn’t sure I had a voice, or even if I did, that anyone would want to listen. And I had some concerns about how blogging would aff ect my work life. I knew from making some early online errors that patients have a way of turning up everything you have ever done with your real name via Google and an hour to kill. This is the curse of having an unusual name, and a need to post comments using your real name, I suppose. I wasn’t sure that I would want all of my patients able to read (in essence) my online journal. This says nothing about the intensely personal nature of what I do with patients—the conversations about dying, about chemotherapy, about advanced directives. With so much of what I do covered under HIPAA, what would I have to blog about anyway?

As it turns out, I do have a voice, and I have a lot to say. The way that I started blogging was all quite serendipitous; a physician friend was approached to start a blog as part of an online companion to a print magazine, and I just tagged along. When I saw him doing it, I thought, “Shoot, I can do that.” I come at my blog with an unusual perspective in that I am a geriatric oncologist. I also practice at an academic center and specialize in gastrointestinal oncology. I think that all of these perspectives inform what I consider to be “blog-worthy.” Th e cancer blog world also suff ers from an abundance of young females with breast cancer, and I lend a diff erent perspective to that arena. Most cancer blogs are also written from the patient perspective, and I bring the provider voice to the story. I have mostly a professional blog, and frequently I wish my blog had more of a personal feel to it, but in medicine, I don’t think you can do that with your job title right on the byline. Many of the best blogs are anonymous, and I think that anonymity allows the author to speak absolutely freely.

I’m not sure how others approach their blog, but my process is pretty simple. I am on several list-serves for cancer news organizations and professional groups (like the American Society for Clinical Oncology), which produce daily or weekly e-mails. I scan those regularly and read in depth what seems most interesting to me. I also summarize meetings that I attend, particularly focusing on practice-changing study results. I review the New York Times, MSNBC, and CNN health pages for cancerrelated articles. I pay attention to issues in my clinical practice that elicit some controversy or disagreement among my colleagues. And like most bloggers, I go through others’ blog rolls for possibly interesting sites. I produce an average of two blog entries per week, and with my other job responsibilities, this seems about the maximum I can realistically produce. I really like that I can blog once my kids are in bed, on my own time.

Although I like the process of blogging, I certainly don’t love everything I have ever blogged about. A lot of what I have written about seems a little boring to me now, and some of it seems too superficial. What makes blogs great—the usual short length—can also take away from the complexity of medical literature interpretation. Can you really summarize a phase III randomized trial with important correlative studies in only 300 words? I feel foolish when things I have emphasized end up not being true in larger studies. I feel most foolish when I pour my heart into a posting only to have no one leave a comment, good or bad, about it. But bloggers need to develop a thick skin when putting their opinions out there for all to read. I know that many more are reading than are commenting. Whenever you blog about one particular type of cancer, you always run the risk of other “competing” cancer advocates arguing with you about why their cancer is most important. Usually, I just delete those e-mails, because really, aren’t all cancers important?

Most of my patients like my blog—they do read it, and they click on the links. One of the things about geriatrics is that you are frequently “treating” the family in addition to the patient, and thus I have received nice feedback from concerned children and spouses, as well. I know some of the people I work with have read my blog entries, which has spawned new collaborations for research. It seems funny to me that I can work right down the hall from someone and not realize that they have the same research questions that I do. I think it heads off some of the common questions so that I can focus my consultation with them a bit. I also think it informs potential patients about my usual practice patterns, so they can more carefully choose whether they would like to see me for their cancer care.

I’m not sure how long I will keep on blogging; I am shooting for a year or two. But certainly, oncology is evolving at a quick-enough pace that I should have material to carry on beyond that if I want to. “One day at a time,” I say. If cancer has taught me one thing, that is it.

Dr. LoConte is the author of an ongoing blog for HemOnc Today and an assistant professor of medicine at the University of Wisconsin Comprehensive Cancer Center and the School of Medicine and Public Health in Madison, WI.