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.

What cancer and teatime taught me about burnout

Julia Michie Bruckner, MD, MPH

Physician

March 15, 2018

Chipper in his bow tie, our senior physician approached balancing a tray of milky black tea in his hands. He passed each of us a steaming mug. The scones followed, warm and crumbly, slathered with golden butter and glistening raspberry jam.

We sank into the tweed couches of the hospital lounge eager for a pause. Morning rounds had been a whirlwind of chest pain, strokes, intractable headaches, alcohol withdrawal and diabetes. …

The challenge in oncology: balancing hope and reality

Don S. Dizon, MD

Conditions and Diseases

March 14, 2018

Part of the challenge in oncology is the balance between hope and reality, and that is probably the most important thing to strive for patients living with metastatic disease. Often times, the important conversations relate to treatment options, goals of care, and patient preferences (i.e., how frequent the visits to the doctor and for infusions, …

A patient’s expertise is often undervalued

Adam Hayden

Patient

March 10, 2018

Thanks to a surprising and devastating diagnosis, I know more than most physicians about what it’s like to live with the brain cancer known as glioblastoma, everything from self-titrating my anti-epileptic medications to making sure the right ICD-10 code appears on my MRI referrals. As much as I’d rather not have this expertise, I’ve …

Doctors: Don’t forget to take care of yourselves

Fred N. Pelzman, MD

Physician

March 10, 2018

It’s 10 p.m. on Wednesday night, and I’m finishing up my notes for my patient visits from this morning while I do my bowel prep for my colonoscopy tomorrow.

Now, I know we can argue the biomechanical challenges of doing both of these tasks at the same time, and this certainly may be TMI, but it struck me as I was sitting there trying to do both of these things how …

MKSAP: 50-year-old man with a firm, darkly pigmented papule

mksap

Conditions and Diseases

March 10, 2018

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

A 50-year-old man is evaluated for a firm, darkly pigmented papule on his back that has been growing steadily over a period of several months. His medical history is unremarkable, and he takes no medications.

On physical examination, vital signs are normal. The skin lesion is a 0.5-cm darkly pigmented, raised plaque with irregular …

How cancer transformed this physician

Collin O'Hara, MD

Physician

March 2, 2018

“Wouldn’t it suck if you made it all the way through residency and then got cancer at the end?” my buddy Ron, a fellow medical student, and master of dark comedy, joked. I winced at the thought. God has a funny way of foreshadowing.

Three-quarters of the way through pathology residency I noticed my feet were starting to itch, especially at night. It was a deep itch. I scratched so hard …

Read more…

How cancer transformed this physician

Radical realism: A hospice doctor prepares for death

Shola Vaughn, MD

Physician

February 26, 2018

Bruce Wilson, MD, is a hospice doctor and former cardiologist who was diagnosed with pancreatic cancer in February of 2017. In the months that followed, he publicly discussed events as they unfolded on a CaringBridge blog. The irony of the situation was profound: a hospice doctor being handed what some consider a death sentence. A physician who dedicated his career to changing the conversation about end of life care now …

How an annual physical combined with unnecessary testing doesn’t help

Samuel Harrington, MD

Physician

February 26, 2018

Some would argue that more care for the elderly is …

What’s love got to do with it: lessons from a dying physician

Charles A. Odonkor, MD

Physician

February 14, 2018

They came from all corners of the globe to bid him farewell. He looked cachectic, his frail form interrupted by swelling in his abdomen and legs, a result of end-stage pancreatic cancer. It was Dr. Yeat’s last week in the hospital before being transferred to a nearby hospice. He was now on morphine, and despite severe fatigue and difficulty breathing, he always managed a smile.

Some of his visitors were former …

Is “doing everything we can” at the end of life doing too much?

Jason J. Han, MD

Physician

February 8, 2018

In his soulful book, How We Die: Reflections on Life’s Final Chapter, the late surgeon and author Sherwin Nuland describes one of his patient encounters as a medical student. The patient, a 50-year-old man, presented to the hospital after a heart attack.

A few hours later, the patient suddenly collapsed pulseless and unconscious.

Training in an era when there was no defibrillator or CPR, the author notes:

For reasons I cannot explain to …

Read more…

Is “doing everything we can” at the end of life doing too much?

As a doctor with cancer, I have opinions on opinions

J. Edward Les, MD

Physician

February 6, 2018

The modern news cycle’s obsession with all things Trump has moved light years beyond dispiriting with cacophonous reams of vitriol shoveled endlessly back and forth.

One could opt out, I suppose, and simply take an elongated holiday from all things media-related. But like moths drawn to a flame, we can’t seem to help ourselves, and your humble scribe is no exception.

And so, I took note last week of Andrew Coyne’s ruminations …

Think twice before tapering opioids in some patients

Casey Grover, MD and Lee Goldman, MD

Conditions and Diseases

February 4, 2018

Bill is a 58-year-old male with a history of head and neck cancer as well as chronic low back pain who presents to his new primary care doctor for a routine checkup and visit for a medication refill. He works in construction and has been on chronic opioid therapy after his cancer — with a stable dose of 15 mg of oxycodone for over five years.

At his new primary care …

I don’t know if this test will save your life

Justin Reno, MD

Physician

February 1, 2018

“So, will this mammogram save my life?” she asked.

I thought for a few seconds …

“I have no idea.”

“What?” she sounded perplexed.

“Well, if you have a cancer that’s aggressive enough to kill you before everything else, but not aggressive enough to have already had cells metastasize, and not so aggressive that it responds appropriately to chemo but it still needs to be rapidly dividing enough to respond to chemo, and we …

At-home genetic testing might revolutionize medicine. And not in the way you think.

Suneel Kamath, MD

Conditions and Diseases

February 1, 2018

Technological advancement often outpaces society’s ability to understand how to use new advances. Direct-to-consumer genetic testing (DTC-GT) is one such technology whose true power far exceeds our collective mental bandwidth to comprehend.

Home testing kits have come into mainstream culture over a short period of time. In 2010, the direct to consumer testing market was valued at $15 million. It grew almost nine times to $130 million in just five years …

What makes a great doctor: a physician reflects

Don S. Dizon, MD

Physician

January 28, 2018

I have been fortunate enough to find a home in academic medicine. Most of that time I’ve spent in oncology — working with residents, fellows, and colleagues on projects, whether they be chart-based or prospectively designed trials. I’ve lectured a ton, and written even more. Yet, my experience in academia has also allowed me to …

When a breast cancer surgeon gets breast cancer: being on the other side of the scalpel

Anne Peled, MD

Physician

January 26, 2018

Six weeks ago, I was diagnosed with invasive breast cancer.

As a breast cancer and breast plastic surgeon, I see women all the time who are in the exact same place I’ve been since receiving the phone call from the pathologist. Shocked and terrified by the news, overwhelmed by what this is going to mean for their life in both the short- and the long-term, waiting for results from what seems like …

My husband was dying. I was being ignored.

Debbie Moore-Black, RN

Conditions and Diseases

January 25, 2018

It was a long December.

A few years ago, my husband of 37 years got his death sentence: recurrence of liver cancer with mets to his lungs and lymph nodes.

He had a “Whipple” — a surgical procedure for pancreatic cancer — on Dec 24, 2015, and the surgeon discovered liver cancer too. So it was a 16-hour surgery. We were told he might die on the table.

His eyes haunted me as …

Obstruction of medical justice: How health care fails patients with cancer

Miriam A. Knoll, MD

Health Policy

January 22, 2018

Isn’t getting cancer bad enough?

That’s the frustrated thought that goes through my mind when I see patients with cancer suffering — not from their cancer, but from the failure of the health care system.

Take Nancy,* a 60-year-old woman with hormone-positive breast cancer. When she came to the emergency room with a fungating breast mass, we knew …

How gauze and tape healed a relationship

Bruce Campbell, MD

Physician

January 18, 2018

“You’ve got to jump off cliffs all the time and build your wings on the way down.”
– Annie Dillard

Months ago, when my patient and his wife were in my office for the very first time, I could already tell that he would resist any display of sympathy from her and she would clearly be uncomfortable with ever being a caregiver for him.

There was tension in the room. He “had not …

Childhood obesity is a grave threat to our nation’s health

Christopher Johnson, MD

Conditions and Diseases

January 16, 2018

We’ve known for some time the prevalence of obesity is growing among Americans — not just adults, but children, too. Obesity is associated with a long list of medical problems, including heart and other vascular diseases, diabetes, and joint problems. It is encouraging that recently the seemingly inexorable growth of pediatric obesity prevalence seems to have reached a plateau. But we still have a future problem looming for population health as …

Oncology and Hematology

Oncology and Hematology

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts