This photo shows one of my patients’ children. (I am sharing the photo with the family’s consent.) Can you guess the secret behind this photo? Let me tell you about the background.
The difficult diagnosis of pregnancy-associated breast cancer
Mrs. U was in her first trimester of pregnancy when she discovered a lump in her right breast. Work-up revealed that it was a highly …
The tragic reality of pregnancy-associated breast cancer
On November 22, 2025, Tatiana Schlossberg, a 35-year-old journalist and the daughter of Caroline Kennedy, announced that she was dying from a rare and particularly aggressive form of blood cancer called acute myeloid leukemia (AML). In a heart-wrenching essay in The New Yorker, she described having been diagnosed with the disease just a few hours after delivering a healthy baby girl and when she was seemingly in the prime of …
Can clonal hematopoiesis improve blood cancer screening?
I was in a deep sleep when my phone rang. I looked around; it was still dark. For a moment, I thought it was my alarm, but it was only 5 a.m. It was not the alarm after all. Instead, it was a phone call from an unknown number. I answered it, and to my surprise, it was a patient I had seen in the clinic the previous week. She …
A touching story of patient gratitude and a dozen eggs
Recently, I found myself in a place many physicians know professionally but dread personally: the waiting area outside a procedure room, this time as a mother. My six-year-old underwent what was supposed to be a simple elective procedure under general anesthesia at a day surgery center. He walked in smiling. He was put to sleep by using inhalational anesthesia through a mask. We were debriefed briefly by the ear, nose, …
How implicit bias in health care impacts patient safety
An excerpt from Before and Beyond the Scalpel: Prehabilitation and Pelvic Floor Recovery After Prostate Cancer.
When I heard the word “cancer,” I was not prepared, and I am a physician with more than 35 years of experience.
Intellectually, I knew prostate cancer carries a high cure rate when caught early, as mine was. I understood the staging, the options, and the survival statistics. I had counseled patients through diagnoses far …
The prostate cancer recovery few men are warned about
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What if the moment women stop seeing their gynecologist is exactly when their cervical cancer risk matters most? Nenrot S. Gopep, a physician and public health researcher, joins the …
Why cervical cancer screening drops after menopause, and why that’s dangerous [PODCAST]
May is AANHPI Month. As we celebrate the heritage, resilience, and contributions of Asian American, Native Hawaiian, and Pacific Islander communities, I also think of a poorly recognized health disparity within our community: lung cancer disproportionately affecting women who have never smoked. I was one of these women. Exactly five years ago in May 2021, I underwent major thoracic lung surgery that literally saved my life. The shocking diagnosis made …
Lung cancer in nonsmokers: a hidden health disparity
“Pathology confirms invasive ductal carcinoma.”
I had said those words to patients many times before. This time, they were said to me. For years, I had been the voice on the other end of that call, gently guiding patients through one of the hardest moments of their lives. I knew how to say the words. I knew how to explain the diagnosis. I knew how to help women process what came …
Navigating dense breast tissue and breast cancer screening guidelines
For years, I have heard breast cancer survivors share a common refrain: “I expected to lose my breasts. I did not expect to lose the ability to feel.”
Yet in exam rooms across the country, persistent numbness after mastectomy remains underdiscussed and poorly understood in routine care. It is often framed as an inevitable side effect rather than a life-altering outcome that impacts quality of life after cancer.
We have made tremendous …
Living with numbness after mastectomy: the unseen impact on survivorship
A little boy shuffles down the hallway in his yellow hospital-issued socks, completing yet another lap around the unit. You would never guess that he has leukemia, a blur of dark hair and restless energy. In many ways, he is the healthiest child on the pediatric oncology floor. Today marks his twentieth consecutive day in the hospital. Yet he does not have to be here to receive the drug he …
The pediatric home health system is failing children with cancer
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Pediatric hematology-oncology physician and co-founder of Pink Coat, MD Tammie Chang discusses the article “Unhooking from the ego in medicine.” Tammie shares her personal journey through depression and clinical burnout, explaining how …
Finding peace by unhooking from ego and achieving a loving presence in medicine [PODCAST]
As I approach the 10-year anniversary of hearing the words “I am 99 percent sure you have breast cancer,” I have many emotions: gratitude, fear, anxiety, hope. Having been diagnosed with stage 3 breast cancer in 2016, then learning it had metastasized to my liver, so stage 4, I had so many questions and so much uncertainty.
Since then, it has been a journey of self-reflection, relationship evaluation, insurance negotiations, family …
Surviving stage 4 breast cancer: a 10-year journey of hope
In today’s clinical oncology practice, the saying “no two cancers are alike” is more relevant than ever. I recently treated two patients with very similar advanced non-small cell lung cancer (NSCLC) who were both critically ill. However, molecular profiling revealed distinct genetic drivers for each case, leading to very different, highly customized treatment plans.
Patient presentation and initial assessment
Both patients, in their late 60s and never-smokers, presented with weight loss, worsening …
EGFR vs. ALK: How molecular profiling defines lung cancer treatment
Six months ago, I encountered a challenge I never expected: a robotic-assisted radical prostatectomy. Even now, writing about it feels surreal. Cancer rearranges life without warning, and surgery, regardless of how “minimally invasive” brochures describe it, alters you in ways only understood through experience.
The post-op instructions said that, within hours of surgery, I needed to stay active. That sounded simple enough beforehand. But no one asked about my fitness …
Navigating postoperative complications and post-surgical depression
It is very cold in Islamabad. These days, I feel overwhelmed by joblessness, the constant lack of money, an upcoming medical exam, and the slow progress I am making in life. Apart from studying for my upcoming medical exam, the most consistent part of my routine has become counting money. I check all my bank accounts, calculate every remaining rupee, and make small, anxious plans about how I will manage …
Winter in Islamabad: Finding hope in the daily struggle
“Overdiagnosis is a myth that has been created by a handful of individuals who provide no care for women with breast cancer.”
This quote by Dr. Daniel Kopans encapsulates a long-standing and intense debate in the medical community regarding cancer screening.
In the Dec. 9, 2025, issue of the New York Times, Gina Kolata quoted H. Gilbert Welch, MD, on his perspective that “treatments need to be balanced with the consequences …
The myth of cancer overdiagnosis: Why screening saves lives
After more than 25 years in oncology rehabilitation, clinical education, and survivorship care, I’ve learned to be cautious about “good” numbers from common tools like BMI and bathroom scales that don’t match what is actually happening in the body. A recent study confirms it: When used alone, BMI has been found to misclassify up to 34 percent of the general population as obese.
This year, it became more personal when …
Beyond BMI: Why weight management must look inside the body
Yesterday morning, I learned that one of my teachers had passed away. He was only 63, a devoted, tireless oncologist who spent his life teaching and training many oncologists across Pakistan. Many of his students went on to work abroad as senior oncologists and professors, carrying his legacy far beyond borders.
He was not my direct teacher, but rather the teacher of my supervisor, a teacher of a teacher. Yet distance …
A tribute to an oncologist: the power of mentorship in medicine
She arrived exhausted, a shadow of the lively 31-year-old she once was.
She was diagnosed with leukemia in January 2023, underwent intensive IV chemotherapy, and was now on maintenance oral therapy. When I met her in July 2025, survival was no longer a question. It was about quality of life.
Fatigue consumed her days. Digestive discomfort disrupted her nights. Recurrent infections kept her in constant vigilance. Her laboratory values reflected a body …
Integrative oncology nutrition: a case study in leukemia recovery
At 62, I unwittingly became a cliché: the physician who makes a poor patient.
The hard lump in my right breast, directly inferior to the nipple at the 6 o’clock position, shocked and shook me in the middle of a long August night when it first poked me as I tossed and turned my way through a bout of insomnia.
A screening mammogram for September 12 had been on my calendar for …
When the doctor becomes the patient: a breast cancer journey
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