The California Cure Challenges of Survival: Dr. Stuart Siegel

When Stuart Siegel was a fresh-faced med student back in the late ’60s, he was searching for a specialty that would offer him a big challenge—and he found it. Childhood cancers back then had a bleak survivor rate of only about 10 percent.

“As a trainee, I spent my time basically preparing the children and their families for the child’s ultimate death,” says Siegel. A twinge of his native New Jersey can still be heard in his voice, even after 37 years in Los Angeles, all but two of those years spent as head of pediatric oncology at USC’s Keck School of Medicine/Children’s Hospital.

In those years, Siegel has been part of a huge paradigm shift: Some 80 percent of kids under the age of 16 with cancer now survive. Yet Siegel’s challenges haven’t gone away—they’ve just gotten more hopeful. “Now what we spend a lot of our time doing, in addition to giving them the therapies we have, is preparing them for life,” he says. So here’s what happens: Survivors are vulnerable to developing secondary cancers later in life, often linked to the radiation they received in treating the primary cancer. That means lifelong yearly follow-ups are a must to ensure something bad isn’t cropping up and, if it is, to intervene as early as possible.

Then there are the psychosocial impacts such as depression, self-esteem issues, anxiety and lack of social skills that linger after the cancer leaves—not to mention the economic effects of costly care—which were issues researchers at first didn’t investigate. Now that’s changed, too. “Children’s Hospital was one of the first to develop a comprehensive psychosocial approach to childhood cancer, which has been the road map for developing these programs elsewhere,” says Siegel.

But with all the successes—and 80 percent is a huge success—Siegel is the first to point out that treatment still isn’t saving 20 percent of the children who get cancer. “Sometimes people ask, How can I do this? Yes, there are difficult days, no question about it, but what better population do you have to make a real difference?

There is nothing bigger than saving a life. Now with the follow-ups, we have patients who continue to see us. They come in married and drop by with their own kids just to say hello. There isn’t a better high than that.” —Samantha Dunn