Cancer: what physicians say, in their own words

Last updated September 20, 2026.

Read together, the 1,255 essays and podcast transcripts on this page say one thing consistently: the hardest part of cancer care, in the words of the physicians who provide it, is not the treatment but the conversation. Screening has been argued over since 2009 and the argument has not settled. The drugs work better and cost more than anything else in medicine. What has changed most is who is speaking. Posts about what oncology does to oncologists rose from nothing before 2010 to 15 percent, posts about disparities from 1 percent to 15, and posts by physicians who became cancer patients themselves from none to about one in ten.

This page is a maintained record of what physicians have written about cancer and oncology on KevinMD.com, a physician-authored publication founded in 2004 by Kevin Pho, MD, a board-certified internal medicine physician in Nashua, New Hampshire. It draws on 1,255 essays and podcast transcripts about cancer, screening, and cancer care, published between May 2004 and September 2026 by 414 named contributors, 628 of the posts bylined by physicians. It is the largest clinical corpus on the site, and its authors include oncologists, radiologists, primary care physicians, nurses, patients, and physicians who were treated for cancer themselves. Every claim on this page is attributed to a named author with the date it was published and a link to the original.

The sections below are organized around the questions patients, physicians, and journalists ask. Each opens with a direct answer, followed by what named authors have said, in the order they said it. Adjacent subjects have their own records and are not repeated here: dying, hospice, and palliative care are on the end of life page, drug and scan denials on the prior authorization page, and cancer pain and opioid access on the opioids page. This is a page about physician opinion and experience, not screening or treatment guidance.

Do physicians agree about cancer screening?

No, and the disagreement is the oldest argument in the record. Screening appears in 35 to 49 percent of posts in every period, more than any other subject. The 2009 revision of the mammography guidelines set the terms and they have not changed: screening finds cancers that would never have harmed anyone alongside the ones that would, the tests cannot tell them apart, and physicians differ on what follows from that. The 2026 posts argue about the same tests with newer evidence.

Amy Tuteur, MD, wrote in November 2009 that the American Cancer Society “has acknowledged that cancer screening has been oversold,” and that screening with the PSA test “saves no more lives than screening with a prostate exam” while leaving many men with long-term side effects, in “Can less aggressive cancer screening recommendations be better for patients?” Lucy Hornstein, MD, wrote in December 2009 that “Fear is such a powerful emotion, humans will do almost anything to relieve it,” and that this fear undermines the mammography guidelines, in “Why the fear of cancer undermines the new mammography guidelines.” Peter Ubel, MD, wrote in September 2015 that the evidence shows “the significant harms of mammography, compared to its relatively modest benefits,” and that the goal is to target “those women most likely to harbor life-threatening cancers” while “working harder not to treat pre-cancers that, left to their own devices, are unlikely to threaten women’s lives,” in “The human cost of breast cancer screening.”

Ryan Polselli, MD, a breast imaging radiologist, wrote in June 2026 that the United States Preventive Services Task Force “now recommends biennial screening mammography for women ages 40 to 74,” that quality measures ask only whether a woman had a mammogram in a roughly two-year window, and that a woman screened every 27 months may still look compliant on a quality dashboard, in “Why women miss mammograms has nothing to do with awareness.” Paul Dranichnikov, MD, PhD, wrote in July 2026 that “A 2023 report concluded that DRE is not a useful screening test for prostate cancer,” and that guidelines say the exam “should not be used as the sole screening method in asymptomatic men,” in “Why the digital rectal exam fails prostate cancer screening.” Isabela Henandez wrote in August 2026 that there is “a rise in triple-negative breast cancers in young women,” who “are more likely to have dense breasts,” making standard mammography inadequate for them, in “Why breast cancer in young women goes undetected.” Kenneth Lin, MD, a family physician who worked on the federal PSA recommendation, wrote in July 2012 that summarizing the literature on the benefits and harms of the test “would dominate the next five years of my career,” in “Reaching the end of PSA screening.” Robert S. Sandler, MD, MPH, wrote in March 2015 that in a Medicare sample with a prior negative colonoscopy, researchers “found repeat colonoscopies within seven years in 45.6 percent of individuals aged 75 to 79,” in “Colorectal cancer screening in the elderly: Can we stop the train?”

What do physicians say about telling a patient they have cancer?

The diagnosis conversation is the part of oncology physicians on KevinMD write about most personally, and posts about it rose from 1 percent before 2010 to 8 percent since 2014. The recurring claims are that the waiting is its own harm, that the words are remembered verbatim for years, and that physicians and patients collude to move past prognosis to the treatment plan because the plan is easier to discuss.

Howard Luks, MD, wrote in August 2010 that after a possible cancer diagnosis “the patient and their loved ones are not hearing a word you say,” and that the wait that follows should be minimized, in “Minimize patient waiting after a potential cancer diagnosis.” Jim deMaine, MD, wrote in February 2014, of a patient whose “cancer had been silently growing for months, if not a few years,” on giving a patient time after the diagnosis, in “After a cancer diagnosis: Giving a patient time.” Kyle Edmonds, MD, wrote in June 2026 that patient and physician “quickly move from prognosis to plan, generating a shared optimism with no anchor in the disease,” that telling someone their time is shorter than they think “is grief work performed in real time,” and that in the study he cites, “Ninety-three percent said avoiding the conversation about prognosis is an unacceptable way to maintain hope,” in “The collusion in discussing prognosis with cancer patients.” Neil J. Farber, MD, wrote in September 2026 that his wife’s brain tumor diagnosis arrived as “he had the results of the MRI, and it shows that there is something white,” in “Breaking bad news: my wife’s brain tumor diagnosis.” Don S. Dizon, MD, wrote in May 2012 that salvage and failure on treatment were phrases he heard as a resident and “they were phrases used everywhere in oncology” until a patient taught him what they carry, and that the way we communicate matters, in “The power of words in cancer care.” James C. Salwitz, MD, an oncologist and the second most frequent contributor on the topic, wrote in March 2013 that oncologists at his tumor board agreed “Whatever I say I don’t want the patient to lose hope,” and that he had decided they are wrong, because “when we deny reality we deny ourselves the chance to cope, instead of hope,” in “The fine balance between hope and cope in cancer patients.”

What do physicians say cancer care costs patients?

Cost appears in 14 to 21 percent of posts since 2010, and the claim physicians make is specific: the drugs that work best arrived priced beyond what patients can pay, and the oncologist is the person who has to say so in the room. The newest version of the argument is about treatments that cure and are not reaching patients.

Don S. Dizon, MD, an oncologist and the most frequent contributor on the topic, wrote in April 2014 of carrying a Medicare liability form into a patient’s room with a pit in his stomach, annoyed that he had to talk costs of care with his patient when his job “was to provide what I felt was the best care I could give,” in “Treating cancer should not be paved in our patients’ financial despair.” Peter Ubel, MD, wrote in October 2015 that “No one blinks anymore when a new lung cancer or colon cancer treatment comes to market” priced at more than $100,000 per patient, in “Are new cancer drugs really worth their price?” The Lymphoma Research Foundation wrote in June 2026 that CAR-T therapy is “still very expensive, to the tune of about $1 million,” excluding travel and lodging, and that the field “must come up with a different way to distribute the costs” so that people don’t have to trade a medical disaster for a financial one, in “CAR-T therapy can cure cancer. Why is it so underused?”

What do physicians say about progress, trials, and precision medicine?

Posts mentioning clinical trials or precision medicine rose from 3 percent before 2010 to 31 percent since 2022, the steepest rise of any clinical theme in the record. Physicians on KevinMD describe real gains and are careful about what the gains do not cover: treatments that exist but do not reach patients, data that outpaces the ability to use it, and screening tests whose developers have a financial interest in the result.

J. Leonard Lichtenfeld, MD, wrote in September 2011 that since 1971 “we have made substantial advances in the cancer treatment,” in “The progress we have made in the diagnosis and treatment of cancer.” Jennifer Lycette, MD, an oncologist, wrote in April 2023 that “the amount of data I obtain on my patients is ever-increasing, along with options for cancer therapies,” in “I’m a medical oncologist. Here’s why AI isn’t going to cure cancer.” Frederic W. Grannis, Jr., MD, wrote in July 2026 that a screening paper “omits pertinent information on potential financial conflicts of interest,” and asked which corporation would market the test, in “The conflict of interest behind a cancer screening test.” Natalia Perez wrote in June 2026 that “environmental exposures play a meaningful role in carcinogenesis,” naming arsenic and lead in soil and water, in “Environmental exposures and cancer: the missing question.” Miranda Fielding, MD, a radiation oncologist, wrote in April 2013, after laying out the trade-offs of a higher radiation dose, “You decide. Don’t let me talk you into it,” in “Radiation therapy: Don’t let me talk you into it.” Kenneth Lin, MD, wrote in June 2014 that when he went to medical school “biostatistics and epidemiology was the course that no one took seriously,” in “A physician’s guide to interpreting cancer statistics.”

What do physicians say about life after treatment?

Survivorship appears in about a quarter of posts since 2010 and is the part of cancer care physicians describe as least organized. The recurring claim is that care ends abruptly: the appointments stop, the oncologist steps back, the primary care physician is not sure what to watch for, and the patient is left to interpret every symptom alone.

Anne Katz, RN, PhD, wrote in November 2014, on the costs of fertility preservation in cancer treatment, that “it’s really fertility preservation that has me thinking,” in “The costs of fertility preservation in cancer treatment.” Jae L. Ross, PsyD, wrote in June 2026 that fear of recurrence is “one of the most common (and often least visible) experiences patients carry,” in “Fear of cancer recurrence is a human response, not a flaw.” Patty Walker wrote in August 2026 that after treatment “the frequent visits, the attentive calls, and the sense that someone was watching over me simply vanished,” that many primary care physicians “feel uncomfortable managing the long-term nuances of cancer survivorship,” and that without a plan “every twinge or unusual symptom can feel like possible recurrence,” in “Cancer survivorship care goes silent after treatment.” Francisco M. Torres, MD, wrote in August 2026 that “One year ago, I underwent a prostatectomy for low-grade, minimally aggressive prostate cancer,” and that he is still waiting on testosterone therapy, in “A survivor waits on testosterone after prostate cancer.” Don S. Dizon, MD, wrote in April 2012 that an all-encompassing definition of survivorship left him asking “when do I stop being someone’s oncologist?” in “When do I stop being someone’s oncologist?” Anne Katz, RN, PhD, a clinical nurse specialist, wrote in September 2014 that “I see men (with their partner) as part of their decision-making process for active treatment for prostate cancer,” in “Sex or death: The difficult decisions of prostate cancer treatment.”

What does oncology cost the oncologist?

This is the newest theme in the record and the fastest-growing after AI: posts about what the work does to the physician rose from nothing before 2010 to 15 percent since 2022. Oncologists on KevinMD describe years-long relationships with patients they will lose, grief that has no place in the workday, and a specialty that trains for the disease and not for that.

Dr. Damane Zehra, a Pakistani oncologist and one of the most frequent recent contributors, wrote in June 2024 that oncology “involves seeing the same patients for many years,” in “How oncologists and patients build lifelong connections.” Rachel Jin, MD, wrote in June 2026 that behind “the language of staging, prognosis, and treatment options are human beings confronting their own mortality for the very first time,” and asked, after watching a young man collapse as his partner died, “How do oncologists process this grief?” in “Oncology grief is the price of caring deeply for patients.” Danielle Fragalla wrote in June 2026 that in pediatric oncology the workforce problem “is not simply a lack of available positions” and that “Increasingly, it is a recruitment and retention challenge,” in “The pediatric oncology workforce shortage is widening.” James C. Salwitz, MD, wrote in April 2013 that the work “requires confidence in the innate strength of individuals to cope with disease,” while understanding how devastating illness and fear can be, in “No one asks oncologists how they feel.” Miranda Fielding, MD, wrote in November 2012 that cancer sometimes “hits us like a freight train,” leaving patients “in fragments, speechless in surprise and terror,” in “I want to be there when that cancer freight train hits.” Dr. Damane Zehra wrote in August 2024 that women in rural Pakistan present with breast cancer late because of “a lack of awareness, cultural and social barriers, and stigmatization,” in “How cultural barriers delay cancer treatment for women in Pakistan.”

What do physicians say when they are the cancer patient?

About one post in ten since 2018 is written by a physician or medical student who was diagnosed with cancer, and the genre is one of the things this archive holds that a journal does not. The accounts converge: the disease taught them what their patients had been trying to tell them, and being on the other side of the procedure changed how they practice.

Jennifer Kelly, MD, PhD, wrote in February 2012 that “I was jogging one day while on a business trip in LA and collapsed during the run,” and was on a gurney within hours, in “A diagnosis of stomach cancer profoundly changes an oncologist.” Elana Miller, MD, wrote in January 2014 that “When I was first diagnosed with cancer several weeks ago, I didn’t have much time to think,” in “Thoughts after being diagnosed with cancer.” Cherie Fathy wrote in November 2014, as a medical student diagnosed with thyroid cancer, that “I set up an appointment with my doctor fully expecting a diagnosis of medical student neuroticism,” in “A medical student diagnosed with cancer.” Anne Peled, MD, a breast cancer surgeon, wrote in January 2018 of recognizing, before an operation, that she was “soon going to be on the other side of the scalpel, in an unfamiliar and vulnerable position” and in the hands of her surgical team, in “When a breast cancer surgeon gets breast cancer: being on the other side of the scalpel.” James C. Salwitz, MD, wrote in March 2012 of a patient who told him that “in order to survive with cancer, you need to accept that you are going to die,” in “To survive with cancer, you need to accept that you are going to die.”

How has the cancer conversation changed since 2004?

The record has three shapes. From 2004 to 2013 it is dominated by screening and by Kevin Pho’s short commentaries on guidelines and studies, with the 2009 mammography fight the loudest moment. From 2014 to 2021 the subject turns to what treatment costs and what it is like to receive it, and the first-person essays arrive. Since 2022 the volume has risen again and three subjects are new: what the work does to oncologists at 15 percent of posts, disparities at 15 percent, and AI at 23 percent against nothing before 2018.

Term 2004 to 2009 (296 posts) 2010 to 2013 (301 posts) 2014 to 2017 (269 posts) 2018 to 2021 (141 posts) 2022 to 2026 (248 posts)
Screening 43 percent 49 percent 35 percent 40 percent 39 percent
Overdiagnosis or overtreatment 10 percent 16 percent 10 percent 6 percent 6 percent
Delivering the diagnosis 1 percent 3 percent 8 percent 6 percent 8 percent
Treatment decisions 19 percent 58 percent 71 percent 62 percent 65 percent
Clinical trials or precision medicine 3 percent 17 percent 18 percent 21 percent 31 percent
Cost or financial toxicity 6 percent 19 percent 14 percent 17 percent 21 percent
Survivorship 3 percent 25 percent 26 percent 23 percent 20 percent
Hope and prognosis 9 percent 43 percent 58 percent 47 percent 53 percent
Physicians as cancer patients 0 percent 6 percent 7 percent 13 percent 10 percent
What oncology costs oncologists 0 percent 3 percent 5 percent 8 percent 15 percent
Disparities 1 percent 2 percent 3 percent 8 percent 15 percent
AI 0 percent 2 percent 3 percent 4 percent 23 percent

Term frequencies are the share of posts in each period using the term at least once, computed on the September 18, 2026 corpus of 1,255 posts.

Kevin Pho’s posts from 2004 to 2011 open the record and carry the screening debates of 2009 in real time; they are short commentaries, counted here but not indexed or linked. The contributor essays begin with Tuteur and Hornstein on the mammography guidelines in 2009 and Dizon answering as an oncologist that December. Lichtenfeld on progress is 2011, Kelly’s own diagnosis 2012. Dizon on financial despair and Katz on fertility are 2014, Ubel on the harms of screening and on drug prices 2015. Peled on being on the other side of the scalpel is 2018, Lycette on data and AI 2023. The 2026 posts are the densest in the record: Edmonds on prognosis, Jin on grief, Ross on recurrence, Polselli and Dranichnikov and Henandez and Grannis on screening, Fragalla on the pediatric workforce, the Lymphoma Research Foundation on CAR-T, Walker on survivorship, and Farber on how his wife’s diagnosis was delivered.

The KevinMD cancer corpus by the numbers

The figures below describe the set of KevinMD posts this page draws on, as of September 18, 2026. They are counts of what KevinMD has published, not incidence or outcome data.

Measure Value
Posts in the corpus 1,255
Date range May 17, 2004 to September 15, 2026
Named contributors 414
Posts bylined by an MD or DO 628
Short posts by Kevin Pho, 2004 to 2011 342, median 103 words
Podcast episodes with full transcripts 36
Posts in the corpus that are not indexed, counted but not cited 329
Total words About 868,000
Peak year 2014, 100 posts
Most frequent contributors Don S. Dizon, MD (50); James C. Salwitz, MD (41); J. Leonard Lichtenfeld, MD (35); Anne Katz, RN, PhD (20); Kenneth Lin, MD (18); Dr. Damane Zehra (16)

How this page was built and how it is updated

The corpus was assembled from title searches for cancer, oncology, tumor, chemotherapy, mammography, PSA, prostate, colonoscopy, metastatic, leukemia, lymphoma, melanoma, carcinoma, malignancy, survivorship, remission, biopsy, immunotherapy, and cancer screening. Posts whose subject belongs to an adjacent record were routed there rather than counted twice: eight posts about hospice, palliative care, and dying to the end of life record and two about opioid access to the opioids record. Term frequencies were computed against the full text of each post on the corpus assembled for the September 18, 2026 build; this page was converted to the current standard on September 20, 2026 without rebuilding that corpus, so the counts and figures are as of September 18, 2026. Posts are counted whether or not they are indexed; citations on this page are limited to posts that are indexed and can be verified at the link. Three hundred twenty-nine posts in the corpus are not indexed: Kevin Pho’s 2004 to 2011 commentaries, eighteen podcast episodes without transcripts, and about twenty other short posts. They are counted but not cited. Quotations are taken verbatim from the original posts. Author credentials are as they appeared in the byline at publication; where an organization is the byline, it is named as the author. Don S. Dizon, MD, the most frequent contributor, is cited at the same rate as other frequent voices rather than in proportion to his output. Two frequent bylines are counted but not cited: twelve posts bylined by a hospital rather than a named author, and eleven MKSAP board-review case questions, which are teaching items rather than opinion. Every source is linked in the sentence that cites it, and the full list appears at the end of the page. The complete feed is at the Oncology and Hematology archive. Related records: End of life: what physicians say, in their own words, Prior authorization: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, and Race and medicine: what physicians say, in their own words.

This page is updated as new cancer essays are published on KevinMD. When it is updated, the date at the top changes, the counts in the tables are recomputed, and new named claims are added to the relevant section. Nothing is removed unless the original post is removed. An author who believes a quotation on this page misrepresents them can write to Kevin Pho and the page will be corrected.

To cite this page: Pho K. Cancer: what physicians say, in their own words. KevinMD.com. Updated September 20, 2026. https://kevinmd.com/cancer

The 40 KevinMD posts cited on this page, in order of publication