There are moments in medicine that never become routine. For me, one of them is sitting across from a patient and telling them they have cancer.
No matter how many years I have practised as an oncologist, those conversations never become easier. Each time I enter that office, I carry not only medical facts and treatment plans, but the knowledge that the words I am about to say may permanently divide someone’s life into “before” and “after”.
Over time, the emotional weight of these moments accumulates.
As oncologists, we repeatedly confront illness, uncertainty and mortality. I often witness fear in its rawest form: a patient’s silence after hearing the diagnosis, a spouse looking at me in disbelief, a daughter asking if her mother will be there for another birthday, or even a mother asking the same about her daughter, as agonising as that may sound.
Breaking bad news is not a rare event in oncology—it is part of the daily rhythm of the job. And while I was trained to do it with compassion and clarity, the reality is that these conversations leave their mark on us as oncologists too.
Admitting that can be surprisingly difficult.
I have always been someone who flourished in structured environments. School, examinations, medical training—those were challenges that rewarded discipline and hard work. My oncology training alone was over six years of facing cancer every day, both in clinical work and academic research.
Medicine, in many ways, felt like a series of hurdles that could be cleared with enough effort and resilience. But emotional exhaustion does not behave like an exam. There is no syllabus for it, no predictable way to prepare. This has been one of the hardest things for me to acknowledge. Not because it is unusual, but because it feels, irrationally, like a kind of failure. When you are accustomed to competence and achievement, it can be unsettling to realise that the emotional demands of your profession can overwhelm even the most resolute.
But I must admit that the sheer guilt that accompanies this feeling is perhaps the most difficult part.
How can a doctor feel burnt out when their patients are the ones living with cancer?
Their suffering—the treatments, the uncertainty, the courage they summon daily—overshadows any emotional fatigue I might experience. It is easy to tell myself over and over that any personal distress I may feel is trivial in comparison.
But that comparison, while understandable, can also be harmful.
Studies consistently show that oncologists have some of the highest rates of burnout in medicine. The reasons are not difficult to understand: repeated exposure to life-threatening illness, the responsibility of guiding patients through complex decisions, and the constant awareness that outcomes are not always within our control.
Research has also shown that burnout does not necessarily affect all doctors equally. In fact, female physicians are at higher risk, about 27 per cent more likely to experience burnout than male physicians, while doctors in high-intensity specialties (such as emergency medicine, critical care, and oncology) often report higher burnout rates.
In many ways, oncologists become deeply invested in their patients’ journeys. That connection is essential to compassionate care, but it also makes stepping away difficult. Even taking a short break can bring an uncomfortable feeling that you are abandoning people who rely on you. I have often found myself thinking about patients long after office hours have ended, replaying conversations or worrying about the next scan result.
Yet, we are taught that doctors cannot care effectively for others if we neglect ourselves. Recently, I have come to appreciate that strategies often dismissed as “wellness buzzwords” are in fact grounded in something much deeper. Exercise, meditation, mindfulness and gratitude may sound simple, but they are powerful tools for maintaining perspective and resilience.
Exercise creates space to release tension while mindfulness encourages us to remain present rather than becoming overwhelmed by future uncertainties. Gratitude reminds us that even in oncology, perhaps especially in oncology, there are moments of extraordinary humanity: a patient finishing treatment or a family expressing thanks.
After all, as a medical student, we learned to examine patients carefully, to analyse symptoms and signs with precision. Yet, we rarely apply the same level of observation to our own emotional state. And acknowledging burnout does not mean we care less about our patients.
The strength required to accompany people through their most frightening diagnoses is not endless. It must be replenished—through reflection, support, and the quiet recognition that even those who aim to help others are still human.
