Physicians writing on KevinMD about the diseases they treat and the people who have them: cancer and its screening arguments, pain and the drugs that treat it, diabetes and the obesity argument, mental illness and who gets treated for it, and the decisions at the end of a life. Five maintained records draw on this archive: Cancer: what physicians say, in their own words, Opioids: what physicians and pain patients say, in their own words, End of life: what physicians say, in their own words, Diabetes and obesity: what physicians say, in their own words, and Mental health: what psychiatrists and physicians say, in their own words.
It’s hard to miss the headlines and breaking news feeds on the latest medical studies showing the health benefits of plant-based eating patterns: Vegetarian diets lower the risk or colorectal cancer. Dementia can be delayed through a healthful diet, cognitive training, and physical exercise. Folic acid — a plant-based product of foliage, or leafy greens — boosts heart health. And that’s just in the past few days.
As a primary care specialist …
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Most doctors lack formal training in diet and nutrition
Peanut allergy is a worldwide concern, but especially in Western countries, in which prevalence has doubled in the last ten years, to a rate of 1.4 to 3.0 percent of children. To prevent the development of peanut allergy, national guidelines have attempted to keep pace with this crisis, with recommendations, at first, of delayed exposure to peanut and, more recently, of earlier exposure. But a universally accepted and research-supported approach …
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Preventing peanut allergies. What does the recent data mean?
A drug company recently received FDA approval to peddle its speed-like pill for “binge eating disorder” (the very same pill that is already widely overused for ADHD). And it is sparing no expense pushing the drug — a former world tennis champ is the shill and commercials are everywhere.
Five years ago, I predicted binge eating disorder (BED) would become a new fad diagnosis and a wonderful target for pharma disease …
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Binge eating disorder: Real or disease mongering?
Alarming headlines, based on a recent study, declare that diagnosis with ADHD doubles the risk of early death. Psychiatrist Stephen Faraone, commenting on the original study published in the Lancet, concludes that: “for clinicians early diagnosis and treatment should become the rule rather than the exception.” This conclusion represents a false assumption that the deaths occurred in cases that were not treated.
The large cohort study in Denmark, that looked at records of …
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ADHD and early death: We often miss the story
If it weren’t for the coming together of people from all over the globe, the influenza pandemic of 1918, also known as the Spanish Flu, would not have had the devastating effect that it did. It is estimated that at one point this deadly strain infected one out of every five people on earth and ended up claiming the lives of approximately fifty million people (in comparison, nine million combatants …
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Drinking diarrhea to save lives
The sun rises and the sun sets. It seems like the sun rotates around the Earth. Cancer cells rise and are killed by surgery, radiation and chemotherapy. It seems like cancer is a disease. But the sun does not rotate around the Earth, and cancer is not a disease. The many kinds of cancer cells are the products of the disease neoplasia that can emerge in our bodies’ organs and tissues.
Strange …
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Changing the way we think about cancer
Several years ago, a few colleagues and I performed a systematic evidence review to help update the U.S. Preventive Services Task Force’s recommendations on screening for prostate cancer. One of our key questions asked about the harms associated with prostate cancer screening, other than the overdiagnosis (and resulting unnecessary treatment) of clinically insignificant tumors. Since routine prostate-specific antigen screening had been going on for nearly two decades by then, we expected to …
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Remember the psychological harms of cancer screening
When I was in kindergarten, my school bus used to drop me off at the hospital where my mother worked. My older sister and I would sit quietly in my mom’s office and do our homework while she finished up her work. Most of my friends would get stickers or McDonald’s for their good behavior, but if my sister and I were on our best behavior, my mom would reward …
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Why I started a cuddling program in the NICU
I was a first-year medical student, starting my first afternoon at an outpatient clinic as part of an introductory course in clinical medicine. My white coat was freshly washed; I had a rainbow of pens in one coat pocket, and my shiny name tag dangled from the other. I only hoped that I was as prepared as I looked.
I entered Mrs. Carr’s room. A fifty-five-year-old woman, she sat gingerly at …
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Sometimes, the very best medicine is a listening ear
As a sleep physician, I spend a lot of time educating patients about what sleep is and how it works. Sleep, as I often explain, is not simply the lack of being awake; any more than landing a plane is simply the lack of flying. It’s becoming increasingly understood that sleep is an actively generated state, created by a series of …
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Television ruins your sleep. Here are 5 ways how.
The mortality from colorectal cancer has decreased substantially in the U.S. during the past decade. While some of the improvement is due to better cancer treatment and reduced risk factors, the largest proportion is thought due to screening. The concept that early detection saves lives has now become well recognized. The harms of screening — particularly among individuals with limited life expectancy — are less well appreciated.
Royce et al. recently published a …
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Colorectal cancer screening in the elderly: Can we stop the train?
They say that the path to hell is paved with good intentions. Few things in medicine illustrate that as well as how we’ve approached chronic pain management in the past 10 to 20 years.
The advances that we have made in medicine in the past few decades have been truly remarkable. But, unfortunately, pain is one of the ailments we still do not treat well. One of the difficult aspects of …
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Will the pendulum of pain management swing too far?
From new longer-acting drugs to promising gene therapy trials, much is changing in the treatment of hemophilia, the inherited bleeding disorder in which the blood does not clot. I will mark Hemophilia Awareness Month by discussing research and treatment progress, as well as remaining challenges.
1. Many more treatment products are being introduced, including some that last longer. In people with hemophilia, a “factor” — or blood …
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5 things to know about what’s new in hemophilia
The preferred route for a hysterectomy is vaginal. This means the entire surgery is done through the vagina with no incisions in the abdomen of any kind. The joke among surgeons is that it is a bit like taking a car apart through the muffler. While doing surgery entirely through the vagina may sound highly complex, it’s really just like any surgery. A vaginal hysterectomy done correctly it is an …
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Surprise! When it comes to a vaginal hysterectomy, this insurance company gets it right.
The concept of “personalized medicine” gets thrown around a lot these days. And as an oncologist and a palliative care doctor, who advocates for using data to get information that can provide more personalized cancer care, I believe strongly in it. But what would truly personalized oncology look like?
More than 14 million people are living with cancer in the United States, according to the National Cancer Institute — and some 1.7 …
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What would truly personalized oncology look like?
