The DOCTOR who dispenses HOPE

ONCOLOGIST TRANQUILINO ELICAñO JR. GREETS PEOPLE with a sincere and ready smile and gracious goodwill. He works hard to dispense the most vital medicine a cancer patient needs: Hope.

Elicaño is the son of Tranquilino Elicaño Sr., a respected doctor who became an official of the Department of Health (DOH). It is perhaps because of his father that Elicaño Jr. went on to fulfill his lifelong ambition of healing the sick. Despite initial perceptions that his chosen specialization "would be hard", he went ahead to study in England.

While the common perception is that a diagnosis of cancer is a death sentence, Elicaño says there is hope. "If the cancer is caught early, (patients) survive," he says, adding that the survival rate of his patients is high–"about 75 percent to 80 percent," especially if the cancer is "isolated and non-metastatic."

Metastasis is the medical term that means cancerous cells have spread from their area of origin to other tissues or organs.

With 45 years of work in the field of oncology under his belt, Elicaño laughs heartily when we ask what he does off-duty. He hesitates, as if the concept of being off-duty is a faraway memory.

Finally, Elicaño says he used to enjoy playing basketball and table tennis, but stopped playing "in 1987, when I had to focus more on work."

Now, for leisure, Elicaño likes to watch television and eat out with his family. "I haven’t been to the movies in 30 years," he adds. "It’s a good thing they show movies on television, otherwise I’d miss them all."

He is also the proud father of 15-year-old Tranquilino Rene III, whose photographs cover most of the wall space in the Elicaño clinic.

"I had TJ late in life, probably because I enjoyed my bachelorhood and because I worked hard at being an oncologist," Elicaño says, waggling his eyebrows with a smile.

One framed collage of TJ’s photos has a small cross-stitched piece that reads: "A father’s love is measured by the smile on a child’s face."

Like most doctors, Elicaño is skeptical about "food supplements" claiming to "prevent and treat cancer"–claims that have yet to be proven–but he is not overly concerned about these "nutraceuticals". He shrugs and says "supplements are okay. They don’t do any harm, but they seldom do any good."

Most of the patients who seek treatment at Elicaño’s clinic along E. Rodriguez Ave. in Quezon City have cancer of the breast, cervix, lungs and nasopharynx.

Of these cancers, he says breast cancer patients have the highest survival rate–"except if the patient suffering from breast cancer is male. In men, breast cancer is fatal because it spreads fast."

He explains that female breasts are larger and contain more tissue into which the cancer cells may spread first before reaching vital organs like the heart and lungs. In men, minimal breast tissue means that cancer in this area can spread to nearby organs faster.

According to him, the most difficult cancer to treat is the kind that originates in the pancreas "because it is diffuclt to detect and, more often than not, patients diagnosed with pancreatic cancer already have the disease at an advanced stage; the cancer is often terminal when it is diagnosed."

Dealing with terminally ill cancer patients "is really hard", he admits, his smile fading. "You have to get used to it when a patient is terminal" –a circumstance in which most doctors, whose prime motivation is to save lives, often feel powerless and depressed.

Instead of being depressed or distant when confronted with his patients’ conditions, Elicaño takes a more personal and cheerful approach: "I jam with (my patients). I let them eat what they want to eat rather than restrict their diets. Cancer is not a death sentence or a reason to live a depressed or deprived life."

Part of the rationale behind his bedside manner is that a cancer patient does not need any more stress than he or she is already under, being sick and all. Instead, Elicaño prefers to keep his patients as relaxed, comfortable and happy as he can–"after all, the cancer treatments are already hard on the patient’s body."

His view of oncology is that the battle against cancer can be won if the disease is diagnosed early and the four basics of cancer treatment– surgery, chemotherapy, radiation therapy and hormone therapy–are applied properly.

Cancer does not discriminate between the rich and the poor," Elicaño says, though he admits that the ability to afford often costly treatment regimens does help improve cancer patients’ chances of survival.

He also notes with concern the fact that the incidence of cancer is increasing–among the poor as well as the rich.

Seeing that poverty affects cancer patients’ survival in the Philippines, Elicaño is preparing to set up a radiation therapy center that will charge only half the rates being charged by similar existing facilities.

He is also flexible when dealing with patients, since "some patients want to know the diagnosis, some do not want to know and I respect their wishes. Women often come to me after detecting a breast mass, and I ask them either way, if it is cancer or not, if they want to know the truth." In cases where a patient does not want to know if the cancer diagnosis is confirmed, Elicaño speaks to the next of kin and advises them about the best mode of treatment for the patient.

Elicaño cites the United Kingdom’s socialized health system, under which cancer patients "get the same treatment" regardless of social or financial status.

Under the UK system doctors are not distracted from their prime focus of healing the sick because physicians who make "inter-referrals" to other medical specialists or practitioners "don’t lose money."

"When I came from abroad, I had this thing about making singil (charging fees) ," he explains. "Under the socialized (health) system, you get paid the same fees."

This doctor’s distinctions are many, though his casual manner belies the impressive resumé: he approaches people easily, with a genial smile and a firm handshake.

Elicaño was the youngest physician from any country to be awarded the Diploma in Medical Radiation Therapy by the Royal College of Physicians of London and the Royal College of England in 1962. In 1965, Elicaño was the youngest doctor to receive the Ten Outstanding Young Men (TOYM) award in Medicine.

In 1977, Elicaño, then working with the DOH, received the Outstanding Performance Civil Service Commission Award after he initiated and led nationwide cancer control and radiation protection programs. He was also instrumental in the implementation of the National Health Program upgrades of medical manpower development and the formulation of guidelines for charging hospital fees and physicians’ professional fees.

Elicaño has served as the director of the National Cancer Control Center, among various posts he held at the DOH, Department of Education (DepEd), Department of the Interior and Local Government (DILG), Philippine College of Oncology, the Professional Regulation Commission and the Philippine Federation of Private Medical Practitioners.

It was through Elicaño’s pioneering efforts that the first satellite cancer radiation therapy centers attached to the DOH were established in the key cities of Baguio, Cebu and Davao.

He was the first to determine and publish the toxic tar and nicotine contents of cigarettes sold in the Philippines–data which eventually became the basis for the DOH "Yosi Kadiri" anti-smoking campaign launched in 1994 by then Health Secretary Juan Flavier.

Taking his fight against cancer to another level, Elicaño has worked to increase cancer awareness through his regular articles in The Philippine STAR, his Sunday column "What’s Up Doc?" in Pilipino Star Ngayon, his Health Talk program on RPN-9 and his regular spot on Radyo ng Bayan. His active media advocacy for cancer awareness dates back to 1964, when he began writing about cancer for various newspapers.

He now serves as the senior medical adviser of Manila Mayor Lito Atienza, is president of the Ramon Magsaysay Memorial Foundation Inc., chairman of the Cancer Foundation of the Philippines and director of the Elicaño Cancer Clinic.

And in the midst of all these responsibilities, he keeps his focus on his primary mission: To heal the sick and give them hope.