As a urologic oncologist with a specialty in bladder reconstruction, Dr. John Stein has to tell people one of the hardest things they may ever hear - "You have cancer."

Some can be cured through surgery and aggressive treatment. Many go on to live quality lives with neo-bladders, a prosthetic bladder that performs the same functions as a healthy bladder and does away with an external bag. For others the diagnosis of cancer is a death sentence.

But for all of his patients, the diagnosis is a horrendous wake-up call.

"Being told you have a cancer is a huge life-changing event," reports Dr. Stein, sitting in his cramped seventh-story office in the urology department of the USC/ Norris Comprehensive Cancer Center in Los Angeles. He looks a little weary in his white coat over green-blue surgical scrubs this late Thursday afternoon, some 10 hours through a 13-hour day. "I mean, many patients think they're going to live forever and then they're told they have cancer. A lot of patients will do very well, but still realize: 'Hey, I'm mortal.'"

At such crucial moments, the father of four and parishioner at Assumption of the Blessed Virgin Mary Church in Pasadena, tries to connect with patients. And when he gets to know somebody under his care better, he has no qualms about sharing his beliefs and spiritual outlook on life and death if they ask.

"I've found it to be really important to be able to connect with patients," he says. "I try to be humble and soft-spoken about it. I don't try to bang that drum hard at all. But I have no problem telling someone 'God bless you.' I have no problem offering a prayer with a patient.

"You get to know patients, and I'll tell them I believe that there's something more down the line, and that someone else is watching over everything. We may not have the answers to all of this, but I hope this being - whether you call it God or something else - does.

"I think it's OK to be spiritual and have that sort of an approach and share it with the patients," he adds. "It provides a sense of security for some people. And in the diseases that we deal with, if you're told that you have cancer, it's not uncommon that patients die from their malignancy."

After the diagnosis, the real battle begins, according to Dr. Stein. As a "very competitive guy," who thrived in school sports and volunteers as a coach at a basketball camp, he'll do whatever it takes to win the war against cancer. That same steadfast determination extends to his own research efforts on bladder cancer as well as to teaching University of Southern California medical students and writing for major medical journals.

"This is a fight, and I enjoy that," he says. "I'll do whatever I can to help you."

When asked if the deadly struggle wears him down, he half-shrugs and only notes that some days are longer than others. But there are joys, too, like meeting and helping people - especially the elderly - along their life journey.

He gravitates toward older people because he's curious about who's been important in their lives and what were the keys to their success. Often he finds himself asking senior citizens, "What did you do to make you so happy and to live so long?"

He finds their stories fascinating, believing wisdom comes with age and not necessarily an M.D. or Ph.D. degree. He's had some amazing conversations with patients with number tattoos on their forearms from being in World War II-era Nazi concentration camps.

But Dr. Stein readily admits he often loses the fight against cancer.

He talks about the "nicest man you'd ever meet"- a teacher and coach at a local Catholic high school who was diagnosed with severe prostate cancer. During the two years the educator was his patient, he never once complained or asked "Why me?" But after going through intense therapy, he still died, leaving a "beautiful" family with an incredibly strong mom at the helm.

"I think the hardest thing is especially when there's a young family and they have kids," he says. "That's the most challenging thing - parents who pass away with young children. But, unfortunately, that's part of the job; it's part of what I see.

"You keep on going, and keep on helping as many other people as you can. But you never really get over that. It's very difficult not to become close to some of your patients - especially, unfortunately, if they die.

"It does take a lot out of you," he confides. "I try to stay in touch with these families as much as possible."

John Stein was always around medicine, growing up in Walnut Creek, Calif. His father, an anesthesiologist, would take him to the hospital and operating room where he worked. But he was always more interested in what was going on beyond the curtain, watching the surgeons operate, than he was in paying attention to what his dad was doing.

After attending public school, he went to the University of Notre Dame and then Loyola Medical School in Chicago, with the idea of becoming an orthopedic surgeon. But during a urology rotation he got to know and like the doctors there, and wound up doing a six-year residency and two-years of fellowship training in urologic oncology at USC. In 1997, he joined the faculty.

"I actually thought that being a doctor was a way that I could probably give back more," he recalls. "I think I picked oncology primarily because of the unique challenges as far as trying to take care of patients. I was primarily fascinated with reconstruction and bladder cancer. So that's what kind of pushed me towards this."

The 44-year-old physician, in fact, was instrumental in developing a female version of the neo-bladder in the early 1990s.

That and other challenges have been met with a bedrock faith.

"It helps with patients; it helps with family; and it helps me," Dr. Stein explains. "It provides, hopefully, guidance and balance. This is my ministry. When you help people, you can help them physically, you can help them mentally and maybe there's a spiritual component, too.

"If I can touch them that way, too, maybe I do help them a little bit in terms of global [holistic] healthcare," he adds. "This is how I conduct my ministry."