An Open Letter to Dr. Gary D. Hammer

Three years after my daughter’s death, I had the great privilege of speaking with world-renowned Dr. Gary Hammer on dying with adrenal cancer.  Dr. Hammer referred to Megan’s last days as ‘death present,’ which can be the scariest of places until you find peace with your own mortality.  For close to 90 minutes, the physician and research scientist who is on the cutting edge of treatment for adrenal cancer, pulled up a metaphorical chair to help this grieving mom re-evaluate the balance of reality and hope and begin to understand hope as more than a cure;  “Hope is the bolster to fight and the permission to surrender.”  Full of hope, Megan found peace in the surrender.

Widow Tanja Santiago’s open letter to Dr. Hammer strikes a deep chord in my heart, and she has asked me to post it.  May its simple truth echo around the world.


Dear Dr. Hammer,

Here is something I meant to share with you (and maybe a couple other oncologists)… every year my kids and I attend the ACC (Adrenal Cortical Cancer) CURE walk, I have flash backs to when my husband Ken and I first met you in your clinic. I remember the emotions and the wish to have a fighting chance to battle this cancer. And I remember the harder we fought, the less likely his chances of survival were. Looking back, chemo was not worth the time we put into it, but he got his fighting chance.

When we arrived at UPenn, every time we sat with Dr. Keefe, he ended the conversation with suggesting Hospice Care as an alternative. Not a week went by that he did not offer it;  even when Ken was on chemo TORISEL, fighting for his life. And every week we declined because it was absurd to consider dying. Then came a point about a month before he died, where I thought that Ken continuing to live in pain and agony would be the cruelest thing that could happen to him.

However, I continued to support his wish for treatments, and he received it until a week before he died. Then finally, three days before he passed, he requested Hospice Care. I had heard of patients fighting to live until they passed away. Thankfully, he finally realized that certain things were inevitable, and that death was not the worst thing that could happen to him. We had time to make peace…it was only for a couple of days, but the fighting that cancer brought into our lives made ‘peace’ impossible….and parting in peace was the most valuable lesson I have learned so far.

Certain areas in my life do not have peace but the peace and the grace I felt then is unlike any other. Even today, when I visit patients on Hospice Care, it is the overwhelming amount of peace and grace that are almost always present. I know no one wants to hear that sometimes death is here for us….and the challenge to have peace within those last x amount of days/ months or years is enormous….but if that can be achieved, the time after ‘losing’ someone will not be as difficult as most people perceive it to be.

Anyway, I know this is a chunk here, and I don’t know how you feel about loosing 99% of your patients to adrenal cancer, but I wanted you to know that even though it was a horrible and challenging time, it was the best of our ten years together. It was not a waste. It brought us closer together and we had peace in the end. I will have this until the day I die. Therefore, I must say thank you to Adrenal Cancer, as odd as that might sound. And thank you, Dr. Hammer, for all you do for your patients and what you did for us.

Tanja Santiago

Key Notes:

  • Tanja Santiago is the widow of Ken Santiago, who lost his courageous battle to Adrenal Cancer on May 16, 2012.  He was diagnosed on June 19, 2011, his 40th birthday, and fought with great valor for 11 months.  She is the mother of Tea and Max, and devotes her life as a volunteer with Hospice Care.
  • Gary D. Hammer, M.D., Ph.D. serves as the director of the Endocrine Oncology Program in the Comprehensive Cancer Center. The program is uniquely recognized as an international center of excellence for the treatment of adrenal cancer. Research conducted in Dr. Hammer’s laboratory has led to the development of new national and international therapeutic trials with biological-based therapies for adrenal cancer that target the molecular defects in cancer stem cells while sparing normal tissue.


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Article by: Valerie Bourdain

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