Oncology/Hematology

How the meat industry is acting like big tobacco

Physician

December 26, 2015

Recently, the World Health Organization (WHO) released its report condemning processed meat as a group 1 human carcinogen — a classification that includes such notorious companions as tobacco smoking, smokeless tobacco, and second-hand smoke. This is not surprising considering that processed meat contains many of the same known or probable carcinogens as cigarette smoke, like heterocyclic amines and N-nitrosamines.

Red meat was labeled in the runner-up category as a …

When an advocate goes too far in the exam room

Anne Katz, RN, PhD

Conditions

December 10, 2015

When is an advocate not an advocate? When should a spouse step back and let the husband make a treatment decision? When should an adult child of a man with prostate cancer let their father decide what is best for him? These are questions that, fortunately, I don’t have to ask all that often. Most men I see for prostate cancer …

It is time for an honest conversation about money and cancer

James C. Salwitz, MD

Physician

September 22, 2015

There are two, old, particularly nasty rumors, about cash and cancer. The first, which seems to be fading, is that scientists cured the disease long ago, but the pharmaceutical industry suppresses the cure so they can get rich selling worthless therapies. This never made sense to me, since the company or person that cures cancer will be rich beyond anyone’s wildest dreams. In addition, I have personally known several thousand …

Treating cancer: Doing nothing is also a choice

James C. Salwitz, MD

Physician

September 14, 2015

Dear doctor:

Attached please find the medical records of Mr. Ron C., who is transferring medical care to your office. Ron is a 63-year-old gentleman with recurrent lung cancer, which has spread to his opposite lung and bones. There are multiple treatment choices for his disease, which we have discussed in detail. However, Ron is leaving my care, because he does not trust me.

As you are well aware, metastatic lung cancer …

The day I saw the humanity in medicine

Robert G. Dorfman

Education

September 13, 2015

At the heart of American medicine is the concept of bedside manner, and with it the concern that doctors are cold and unemotional. Indeed, doctors are exposed to disease and misfortune on a daily basis. A patient who presents with stage IV metastatic stomach cancer is just one of the many hundreds or thousands of such patients that will walk through the hospital doors in the coming years. Quotidian exposure …

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The day I saw the humanity in medicine

Spending time with patients. That’s my job.

Nathan A. Pennell, MD, PhD

Physician

August 18, 2015

I’m sure I am not alone in saying that I am almost obsessively conscious of time. Namely, that there never seems to be enough of it. As busy oncologists, we all have constant demands on our time, from our leadership, colleagues, drug company reps, insurers, and our families, not to mention the time we try to carve out for ourselves. But …

Children with cancer are the real superheroes

Steve Christiansen, MD

Physician

August 6, 2015

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Recently I met a boy, a boy with leukemia, a young boy with comic-book worthy superpowers. This boy, this superhero, is one I will never, never forget.

When I entered the exam room, I was immediately struck by the sight of a young boy who should have been playing football with his friends at the park or jumping off the high-dive at the pool, but instead …

A mother with terminal brain cancer. Her daughter brings her home.

Jessica Vogelsang, DVM

Physician

August 1, 2015

shutterstock_167665019

I found out my mother was dying via text message: YOUR MOM HAS A BRAIN TUMOR IN HOSPITAL — DAD

When the neurosurgery PA wheeled the computer into the exam room to show us the MRI the next morning, I found myself silently uttering an unanswered prayer that the mass would be small, resectable, peripheral. It wasn’t.

“Oh my God,” Mom whispered. “I’m going to …

How motivational interviewing can relieve patients’ suffering

Jeff Kane, MD

Physician

July 27, 2015

The acronym “MI” has traditionally meant myocardial infarct, or heart attack. Recently it’s taken on a new, more salubrious meaning: motivational interviewing.

A growing number of docs are practicing this technique, which amounts to listening to patients to help them recognize their internal sources of behavior. Boston’s NPR affiliate, WBUR, describes typical MI interventions in which doctors, instead of demanding that patients stop smoking or drinking or overeating, gently …

A surgeon who wasn’t God in the OR after all

Hope Amantine, MD

Physician

May 4, 2015

Do you know the difference between a surgeon and God? God doesn’t think he’s a surgeon.

Everyone who goes into the study of surgery has ideas about what they’re going to be. I would imagine that each individual has different expectations of what the future holds, though few find their future at all resembles those expectations.

I recall when I started my surgery …

MKSAP: 30-year-old woman is evaluated for a 1-year history of fatigue

mksap

Conditions

May 3, 2015

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 30-year-old woman is evaluated for a 1-year history of fatigue, headaches, poor sleep, depression, intermittently blurred vision, and weakness when climbing stairs. She takes no medication. Following a physical exam and lab studies, what diagnostic tests should be performed next?

On physical examination, vital signs are normal. Bilateral ptosis and diplopia are …

When a CT scan misses cancer

Michael Kirsch, MD

Conditions

April 26, 2015

A female patient came to see me with some difficulty swallowing, a very routine issue for a gastroenterologist. I performed an scope examination of her esophagus and confronted a huge cancer occupying the lower portion of her esophagus.

I expected a benign explanation for her swallowing issue. She was relatively young and not particularly ill. She had seen my partner years in the past for a similar complaint, which he …

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When a CT scan misses cancer

Should we give patients our cell phone numbers?

Anne Katz, RN, PhD

Physician

April 13, 2015

I recently attended the David Stroud Adolescent and Young Adult [AYA] Symposium at Keck Medicine of University of Southern California. It was a very interesting symposium with experts in adolescent and young adult cancer presenting on many different topics important for this population. There was also a panel of young adult …

Stuart Scott and his fighting words

Christian Sinclair, MD

Physician

January 15, 2015

ESPN sportscaster Stuart Scott’s recent death has given the American public a chance to reflect on what it means to live with a cancer diagnosis. His speech at the ESPY awards in the summer of 2014 was widely hailed as an inspiration to people with cancer. Obviously, the Jimmy Valvano Award for Perseverance with the ties to cancer research (Jimmy V Foundation) and Scott’s public image as someone being …

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Stuart Scott and his fighting words

What I learned after going through the fellowship match

Anonymous

Education

January 7, 2015

You’ve made it. Four years of college, four years of medical school, and three years (sometimes four or five) of residency, depending on the specialty you chose. You’ve earned a prestigious title.

You are a doctor.

But wait, you are not done yet.

Want to be a cardiologist, oncologist, or gastroenterologist? Add another three years to the eleven spent to become an independent practitioner. Another three years of interest accruing on that six-figure …

The hardest and often worst part of medicine: The waiting

Sarah Mongiello Bernstein, MD

Conditions

January 5, 2015

My brother wears a scar around his neck. It represents his second surgery for papillary thyroid cancer. The first started off the same way. Ugly, red and angry. Curving like an ominous smile around his neck, like a noose. That’s how it felt too — the lump in his throat growing as he sat quietly, alone in a doctor’s office. It’s interesting how physical scars are a visual manifestation of …

Medicine cannot be reduced to just a job. Here’s why.

Kenneth D. Bishop, MD, PhD

Physician

November 9, 2014

A few months ago I was paged by a medical student in the emergency room at ten o’clock. I had just changed my clothes, and before my pager went off my attention had been squarely fixed on the newest Jack Reacher novel.

You can usually tell when someone is going to ask you to come into the hospital from home, because there …

After a prostate cancer diagnosis: The urgency to treat

Anne Katz, RN, PhD

Conditions

November 2, 2014

Hearing the words “you have cancer” changes everything. In my role as clinical nurse specialist in a busy prostate clinic, I see the effects of these three words on men and their families every day. The shock and disbelief, the fear and confusion as most men feel perfectly well with no symptoms at all. Many men want to do something …

The Fault in Our Stars: Should thyroid cancer be renamed?

James Flory, MD

Conditions

October 18, 2014

Josh Green’s novel — and recent film — The Fault In Our Stars (TFIOS) is a new classic of young adult fiction, deservedly famous, and it’s easy to see why. The story is simultaneously deeply sad and really funny, mostly due to the narrator, Hazel. She is an intensely likable 16-year-old, who charms you even while she explains, stoically, that she is dying of thyroid cancer that has spread to …

What’s it like to be an oncologist? This is just one day.

James C. Salwitz, MD

Physician

September 10, 2014

7:00 a.m. Lights on.

Coffee, black and a banana. Paperwork. 27 patient visits, 3 emergencies, 35 phone calls. Lots of computer time. Some laughs and a few tears. Paperwork. Last family meeting. Coffee, black. In between: Thursday.

Was not completely successful in explaining to my frantic patient with the multi-page lab printout, how the problem was not that her tests were bad, but that the computer had used the wrong “normal” range …

Oncology/Hematology

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