Oncology/Hematology

How doctors handle fear will determine their ability to give care

Physician

June 1, 2012

There was a night when I was in training that all the decisions, disasters and chaos, which are the practice of medicine, caught up to me. In those dark hours, I felt practically despondent. What I had seen left me in tears and overwhelmed by the tasks in front of me.

At that moment a wise attending physician took a moment to sit with me. Rather than tell me how wonderful …

Where you have your mammogram, and who reads it, matter

Stacey Vitiello, MD

Conditions

May 15, 2012

I’ve received several inquiries from women living in various regions of the country, asking how they should choose where to go for their mammogram, and if it really matters. I cannot emphasize this enough: It matters! Here are a few tips to help your search:

The most basic requirement is whether a facility is accredited under the MQSA (Mammography Quality Standards Act). The accrediting body for most states is the ACR …

Are smokers to blame for the damage they do to their bodies?

James C. Salwitz, MD

Conditions

May 12, 2012

He had yellow nails, leather neck, stained teeth and a deep cough. He wheezed slightly, breathed too quickly and occasionally sprinkled the white handkerchief red. No surprise his ticket to my office was a lung mass to match. We talked about tests, treatment and prognosis. About the future, probably short. Devastated, he was not surprised. He was reaping the reward of 30 smoking years. He sadly admitted, “I knew better, …

No one told me that getting on with life after cancer would be so hard

Merry Jennifer Markham, MD

Physician

May 7, 2012

I met with a young patient recently, a woman who has been done with chemotherapy for lymphoma for close to a year. She was feeling well, and she had no symptoms of cancer, nothing that made her suspicious of a recurrence. After I examined her and reviewed her most recent CT scan and labs, I agreed. No recurrence. I wrote in my note, “NED,” the acronym for no evidence of …

When doctors are incorrect in their prognosis of terminal illness

Manoj Jain, MD, MPH

Physician

April 18, 2012

In January, when my close friend’s lymph node biopsy came back as a rare form of T-cell lymphoma, I scoured the scientific literature. What was his prognosis?He was 56, a little overweight but otherwise healthy. He had helped us move into our home more than a decade ago, and I was like an uncle to his son and daughter.

In the literature I found jagged graphs plunging downward, indicating that my …

End stage colon cancer becomes even more tragic without hospice

Jim deMaine, MD

Physician

April 11, 2012

Mike was a runner, outdoors-man, and fitness nut. This was not so much as for health reasons as for “feeling good”, but he did hope that it would help him avoid illness. It was worrisome when he started with some belly cramping and noticed some blood streaks in his stools. It took about a month until he could be scheduled for a colonoscopy. The news was shocking. “There’s a cancer …

How the CA-125 became a $50,000 blood test

Keith Marton, MD

Conditions

February 3, 2012

What could be so simple as a blood test?

A quick prick with a needle, a wait of a day or two for results and a discussion with the doctor about those results. In the words of our vaunted politicians, it would be an “up or down vote” on whether there was anything to deal with.

That was the thinking of my wife’s physician when she ordered a test called the “CA-125.” …

How Patrick Swayze died: Why we should care

Barron H. Lerner, MD

Conditions

January 26, 2012

When I finished my book on famous patients, the most common question I received was “Are the stories of sick celebrities really relevant to other patients?” My answer was that yes, with some caveats, these experiences are well-worth knowing.

The same can be said for the story of Patrick Swayze’s terminal pancreatic cancer, which has now been told by his widow, actress Lisa Niemi Swayze, in a new book, “Worth Fighting …

Incorporating 12-step program concepts into cancer survivorship

Richard Just, MD

Conditions

January 23, 2012

The fact that the term “cancer survivorship” is now part of our vocabulary is a testimony to advances made in management of these diseases. Most cancer survivors, however, are not unscathed by the experience. As I tell my patients, they won’t be entirely as they were before treatment. How these issues are dealt with varies from person to person. But, awareness that chronic problems may persist long after treatments end …

Did hospital politics lead to physician suicide?

Skeptical Scalpel, MD

Physician

December 17, 2011

What causes a doctor to commit suicide?

A story about a radiation oncologist from Springfield, IL brought this strange case to my attention. Dr. Thomas G. Shanahan committed suicide by cutting his throat in November of 2011. He was respected in his field, having published many research papers and traveled the world helping to set up brachytherapy clinics in several countries. He also had been an acting alderman in his …

How political correctness interferes with healthcare

Dominic A. Carone, PhD

Physician

December 14, 2011

Political correctness and sensitivity training are interfering with medicine and healthcare. In a recent article published in the journal, Pediatrics, a group of researchers published their findings regarding parental perceptions of the terminology that doctors use to describe childhood obesity (ages 2 to 18). The researchers found that it was undesirable to use the term “fat,” “obese,” or “morbidly obese” because they were stigmatizing, blaming, and the least motivating to …

Saying no to your oncologist is sometimes the right thing to do

Lucy Hornstein, MD

Physician

December 11, 2011

Cancer is a dreadful disease. Just dreadful. Make no mistake: I have tremendous respect for the awesome doctors who treat patients afflicted with it day after day. Still, paradoxically, I can’t help but notice that some of them have just as hard a time as do other doctors with caring for patients at the end of their lives. I believe a large part of their difficulty stems from the ridiculously …

MKSAP: 42-year-old woman with lymphadenopathy, fatigue, and edema

mksap

Conditions

December 10, 2011

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

A 42-year-old woman is evaluated for a 3-month history of progressive cervical lymphadenopathy, fatigue, night sweats, bilateral lower-extremity and abdominal wall edema, and a 4.5-kg (10.0-lb) weight gain. History is significant for three episodes of weight gain and facial and lower-extremity edema lasting 4 weeks in …

How alternative medicine may have killed Steve Jobs

Michele R. Berman, MD

Conditions

October 30, 2011

When they first discovered the tumor in his pancreas in October 2003, his doctors told him an immediate operation was necessary, and could lead to a cure.

As first reported by Peter Elkind in 2008, Jobs decided to think different, declined surgery, and explored alternative medicine treatments for his disease.

Nine months later, in July 2004, the tumor had grown. Only then would he allow his doctors to operate.

Would Steve Jobs be alive today had he consented to surgery when they first discovered …

A doctor’s letter to a patient with newly diagnosed cancer

Dr. Martin Young

Physician

June 9, 2011

Dear “Robin,”

Nothing in my career in medicine has prepared me for being a friend to someone with such a terrible disease. As a doctor I dispense advice on a daily basis, but those interactions remain strangely impersonal. With you, cancer has invaded our inner circle, and we all share your shock and despair.

No one can know exactly what it feels like …

How to create your medical family tree

Karen Lu, MD

Conditions

November 16, 2010

The holidays are a great opportunity to ask family members about their health history.

Learning about your family’s health history can help you answer your doctor’s medical history questions. It can even help your doctor determine if you may be at risk for an inherited cancer like breast, colorectal, ovarian, prostate or endometrial cancer, which sometimes run in the family.

Keep in mind that just a small portion of cancers – about 5 …

Read more…

How to create your medical family tree

Breast cancer and understanding your breast type

Therese B. Bevers, MD

Conditions

October 15, 2010

What does your breast type say about your cancer risk? Quite a bit, actually.

Whether you have large, small or lumpy breasts, self-awareness is very important. Getting to know how your breasts look and feel can help you recognize possible red flags.

Large vs. small breasts

When it comes to cancer risk, size really doesn’t matter. But, size can affect your mammogram and clinical breast exam.

For example, women with large breasts may need …

Watchful waiting is underutilized for most men with prostate cancer

John Schumann, MD

Conditions

October 8, 2010

NPR has a great blog on their website called Shots about current events in health care. Recently, Scott Hensley, the main blogger there, posted a recent article on treatment of prostate cancer from the Archives of Internal Medicine.

If you look at the article, you may notice a very small subheading above the article’s title. It reads “Less is More.”

Very telling.

The thrust of the article and the …

10 cancer signs women shouldn’t ignore

Karen Lu, MD

Conditions

September 22, 2010

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If you’re relatively young and healthy, gynecologic cancers probably aren’t on your radar. But they should be.

This year, more than 80,000 women in the United States will get a gynecologic cancer, such as endometrial (a.k.a. uterine), ovarian or cervical cancer. In general, gynecologic cancers occur more frequently in women after menopause, although they can occur in younger women. While all women …

Read more…

10 cancer signs women shouldn’t ignore

Root beer bonds a chemotherapy patient with his oncologist

Kevin

Conditions

August 30, 2010

by Krupali Tejura, MD

I am treating a patient for head and neck cancer — which can be one of the most harrowing therapies.

To receive chemotherapy and radiation concurrently can be pretty debilitating. Swallowing foods can be next to impossible, and the taste changes and saliva changes are brutal. It’s one of the harshest areas to treat … and I warn the patients beforehand: …

Oncology/Hematology

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