Oncology and Hematology

Physicians writing on KevinMD about cancer: the screening argument that has run since 2009, how a diagnosis is delivered, what treatment costs patients, life after treatment, and what the work does to oncologists. Four maintained records draw on this archive: Cancer: what physicians say, in their own words, End of life: what physicians say, in their own words, Prior authorization: what physicians say, in their own words, and Opioids: what physicians and pain patients say, in their own words.

Lung cancer screening explained by a pulmonologist

Rizwana Khan, MD

Conditions and Diseases

October 25, 2020

Lung cancer screening is a process that is used to detect the presence of lung cancer in otherwise healthy people at high risk for cancer. In 2020, 229,000 people will be diagnosed with lung cancer, and 136,000 people will die from the disease, making it the leading cause of cancer death in the U.S.

Data show that screening for lung cancer with low-dose computed tomography (LDCT) reduces the risk of dying …

Help the public understand what more can be done to support loved ones affected by a serious illness

Anonymous

Conditions and Diseases

October 13, 2020

“Is there anything more we could have done?”

I am not the first person to ask this question, and I will not be the last.

This past week I learned that an ex-boyfriend from my graduate school years, who had moved overseas in 2016 and disappeared off the grid, was recently diagnosed with lymphoma, developed severe complications, and passed away. He was in his late twenties and a month from moving back …

A medical student’s summer of 2020: Family matters

Rohan Sehgal

Medical Education

October 8, 2020

The summer of 2020 is easily one that I would rather forget but has been one that, I believe, will be etched in my memory for a very long time.

After a brief vacation to visit my maternal relatives in India during last winter break, I welcomed 2020 with some good news: I had been selected for a clinical research internship on an aging population study at the National Institute of …

Death is personal for this physician

Jeff Spiess, MD

Physician

September 26, 2020

In 2017, there were 2,813,503 deaths in the United States. About a quarter of Americans die of heart disease, some 22 …

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Death is personal for this physician

Do COVID restrictions in the office negatively affect patients?

Anne Katz, RN, PhD

Conditions and Diseases

September 21, 2020

Many health care facilities are enacting policies during this time of COVID-19 that restrict the number of people attending appointments in person. Family care providers are asked to wait outside or drop off the patient for their appointment and come back to pick them up later.

There are, of course, exceptions made for those receiving a new diagnosis or when the …

Sunscreens: The balancing act between safety and cancer prevention

J. Leonard Lichtenfeld, MD

Conditions and Diseases

September 12, 2020

That’s the question that will be on the minds of many as the Food and Drug Administration releases a second study on the absorption of sunscreens. The reality is that answering the “safe” question is becoming more complicated—and more important as well, given the fact that so many of us use sunscreens as part of our own sun safety efforts, while others (me included) use sunscreen as part of our daily …

Why this physician created the Cancer and Pregnancy Registry

Elyce Cardonick, MD

Conditions and Diseases

September 7, 2020

Breast cancer is the most common cancer diagnosed during pregnancy. In fact, 5 percent of invasive breast cancers occur in women less than 40 years of age, and 7 to 14 percent of premenopausal breast cancers occur in pregnant women.

Harrington and other surgeons in 1943 felt that the prognosis was so poor for pregnant women with breast cancer that radical mastectomy was not justified. As women delay both marriage and …

The story of how a supportive residency program made a difference

Jason John, MD

Physician

September 6, 2020

An ecosystem of inpatient medicine moved at full speed around me as the news came in. It was the fall of my intern year, and my mother’s glioblastoma was back. Just months earlier, I had begun residency as a liability – a brand new, unproven doctor whose parent in another state was in remission from an almost universally fatal disease, one that was now rearing its ugly head. Someone, a …

Colorectal cancer screening: colonoscopy vs. Cologuard

Hoag Memorial Hospital Presbyterian

Conditions and Diseases

September 2, 2020

When COVID-19 hit, routine cancer screenings nearly came to a halt. Now those postponed appointments and overdue tests will likely result in delayed cancer diagnoses.

Now more than ever it’s an opportune time to educate the community about the importance of regular cancer screenings. While we have powerful treatments for those diagnosed with cancer, nothing is more powerful than prevention or early detection.

Colorectal cancer is the second leading cause of cancer-related …

A letter to my first patient

Lindsay Fleischer

Medical Education

September 1, 2020

It was only my first week in the hospital as a third-year medical student when we met. I entered your room early Tuesday morning. Only knowing your chief concern, I knocked on your door and entered the room. You didn’t complain when I awakened you. You didn’t complain when I asked many questions about a story you had already relayed multiple times to others. You didn’t complain when …

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A letter to my first patient

Where is the line between faith and medicine?

Moses Anthony

Medical Education

August 31, 2020

The long debate about rationality and conformity in both medicine and religion has been intense on many levels. Some people claim science requires certainty, validity, and reliability; others believe faith and optimism are essential for scientific advancement. Some reasons for this argument might include the enormous prosecution of scientists Read more…

Where is the line between faith and medicine?

COVID fallout: A cancer pandemic predicted in the coming years

Hoag Memorial Hospital Presbyterian

Conditions and Diseases

August 28, 2020

Due to the COVID-19 pandemic, the number of cancer screenings performed in the U.S. has plummeted.

After decades of progress in detecting, treating, and preventing many types of cancers, this nation could face a “cancer pandemic” in the next ten years as a result of this delay in routine screenings.

Postponed or canceled appointments for cancer screenings will likely result in delayed cancer diagnoses, recurrence of disease, and increases in cancer deaths.

That …

A doctor’s moment of painful tenderness

StorytellERdoc, MD

Conditions and Diseases

August 27, 2020

I walked into Room 30 to find two eager sets of eyes awaiting me. One set belonged to a young man, late-20s, muscular and imposing, sitting in a chair in the corner of the room. His eyes were hazel brown, big and inviting, relieved at seeing my entry into their sheltered world. The other set of eyes, darker brown and magnified by her gold-stemmed glasses, belonged to my patient, a …

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A doctor’s moment of painful tenderness

The final insult after my husband died alone

Anonymous

Conditions and Diseases

August 27, 2020

This new virus is changing everyday life-hospitals are doing their best to protect their staff and patients. One thing I’ve learned is that they need to do a better job of communicating with families.

My husband was 70 years old when he died of cancer and COVID-related issues. He was diagnosed with stage 4 cancer, lung mets to the brain on December 23, 2019. Because he had only one lesion in …

A discussion about unprofessional behavior: a play in 1 act

Sarah M. Temkin, MD

Physician

August 6, 2020

Setting: An impersonal, windowless conference room within a hospital

Characters: A nurse in charge (NIC), a department chair (DC) and me (ME)

***

NIC: Thank you for joining us to discuss the report you made of unprofessional behavior in the operating room. We’d like to start by letting you know that in this institution, we have a culture of informality. When I first got here, I found it unsettling that doctors were called …

Discussing end of the life care with a pilot

Kashyap Patel, MD

Conditions and Diseases

July 29, 2020

An excerpt from Between Life and Death.

Harry’s request to exclude Susan, from this conversation about cancer diagnosis and options of treatment was quite unusual, especially given how close I knew the couple to be. However, since Susan’s gaze remained on the carpet, I had no choice …

Driving culture change in the pursuit of oncology value

Mark Walshauser, MD

Health Policy

July 26, 2020

Five years ago, if you asked oncologists at my practice to name the list price of a given chemotherapy agent, most wouldn’t have known–unless they were executives, maybe. Pharmaceutical reps rarely talk about costs. The EMRs don’t give list prices. And when we input drug orders back then, no cost analyses were offered.

These days, those same oncologists can quote efficacy and cost data chapter and verse for a variety of …

As an oncologist, this is the hardest role I play

Don S. Dizon, MD

Conditions and Diseases

July 24, 2020

As an oncologist, perhaps the hardest part I play is as witness. I am there to give a diagnosis that, more often than not, will alter someone’s life forever. For some, I see resignation—a sense that they’ve known something was wrong and that it’s what they thought they had. For others, I see an almost …

Don’t become that physician who sees medicine only as a job instead of a calling

Andy Lamb, MD

Physician

July 11, 2020

“Will I ever get better, Andrew?” my mother asked. She laid in bed, too weak to sit up, unable to eat, her myelofibrosis in the final stages of its relentless course. Her question stunned me – did she not know she was dying? How could she not? Was she in complete denial? Was she simply grasping for a final chance at hope when all seemed hopeless? Reality quickly set in, …

What happens when you are not the hero: a story of forgiveness

Anthony Carli

Medical Education

July 4, 2020

In early 2001, my sister was tired, paler than usual. We didn’t think much of it. Then, months passed, and crimson pinpoints appeared on her skin. My brother and I took turns grasping her arm and snickering as our handprints would appear as red dots just a few minutes later. Symptoms amassed silently, but on my ninth birthday in May, something big happened.

I remember hearing words like “low blood count” spoken …