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Oncology and hematology

2,498 articles · Since 2004

Articles, page 34

Physician voices

Words are powerful. Use them carefully.

I’ve written in the past about how words are powerful — that they can have multiple meanings, how they can change depending on context. I am often reminded of how true that is in everyday oncology practice, especially when it…

asco-logoI’ve written in the past about how words are powerful — that they can have multiple meanings, how they can change depending on context. I am often reminded of how true that is in everyday oncology practice, especially when it comes to meeting new patients. Some are diagnosed with cancers that carry a relatively good prognosis, …

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Words are powerful. Use them carefully.

Conditions and diseases

Patients can live with metastatic cancer

6

Medicine is an honorable profession. We meet people at a vulnerable point in their lives -- when it comes to cancer, it is often at their most vulnerable. In oncology, care is typically multidisciplinary, and one of the most important…

asco-logoMedicine is an honorable profession. We meet people at a vulnerable point in their lives — when it comes to cancer, it is often at their most vulnerable. In oncology, care is typically multidisciplinary, and one of the most important advances in my own professional career has been this team approach. To see a patient with …

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Patients can live with metastatic cancer

Patient voices

Do not underestimate the power of touch

2

Many months have passed since the spring day when I was hit with the news from my yearly mammogram, but those typewritten words are forever etched in my memory: "The density appears greater in left breast." My doctor comforted me…

Many months have passed since the spring day when I was hit with the news from my yearly mammogram, but those typewritten words are forever etched in my memory: “The density appears greater in left breast.”

My doctor comforted me with statistics showing that mammograms aren’t 100 percent accurate — but she also lost no time in sending me to a surgeon named Dr. Prewitt. Upon meeting him, I immediately felt …

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Do not underestimate the power of touch

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Conditions and diseases

Debunking breast cancer myths: the truth about genes, gender, and destiny

2

An excerpt from Breasts: The Owner's Manual: Every Woman's Guide to Reducing Cancer Risk, Making Treatment Choices, and Optimizing Outcomes. Genetics play a less important role than you probably think. Consider this fact: the identical twin sister of a woman…

An excerpt from Breasts: The Owner’s Manual: Every Woman’s Guide to Reducing Cancer Risk, Making Treatment Choices, and Optimizing Outcomes.

Genetics play a less important role than you probably think. Consider this fact: the identical twin sister of a woman with breast cancer has only a 20 percent chance of getting …

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Debunking breast cancer myths: the truth about genes, gender, and destiny

Health policy

A call for cost transparency

Physicians are the building blocks of value-based care, yet the cumulative human and financial cost of our decisions are mostly hidden from us. Instead, our reality is analogous to being on a diet and a budget at a restaurant that…

Physicians are the building blocks of value-based care, yet the cumulative human and financial cost of our decisions are mostly hidden from us. Instead, our reality is analogous to being on a diet and a budget at a restaurant that doesn’t put prices or calorie counts on the menu.

We need and want cost transparency. A survey from Deloitte University discovered cost is a part of …

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A call for cost transparency

Conditions and diseases

The fall of the digital rectal exam

12

For almost 20 years, the value of the digital rectal exam (DRE), a long time staple of the complete examination of the trauma patient, has been questioned. Performing a rectal examination on all trauma patients is no longer advocated except…

For almost 20 years, the value of the digital rectal exam (DRE), a long time staple of the complete examination of the trauma patient, has been questioned. Performing a rectal examination on all trauma patients is no longer advocated except for a few specific indications.

As recently as two months ago, trauma surgeon Michael McGonigal blogging at the Trauma Pro reinforced the message. Because a rectal examination is so uncomfortable …

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The fall of the digital rectal exam

Conditions and diseases

For those on the margins, access to cancer care is a struggle

2

Sarah* is a new patient, referred to me because she is having difficulty deciding on treatment for breast cancer. I don’t know much else about her, and a quick review of her electronic medical record tells me that she is…

asco-logoSarah* is a new patient, referred to me because she is having difficulty deciding on treatment for breast cancer. I don’t know much else about her, and a quick review of her electronic medical record tells me that she is 48 years old and has hormone-positive disease in her left breast. There are numerous missed appointments, and it appears that her …

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For those on the margins, access to cancer care is a struggle

Conditions and diseases

MKSAP: 57-year-old man with chronic hepatitis C infection

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 57-year-old man is evaluated during a routine examination. His medical history is notable for chronic hepatitis C infection with cirrhosis, which was diagnosed…

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

A 57-year-old man is evaluated during a routine examination. His medical history is notable for chronic hepatitis C infection with cirrhosis, which was diagnosed 3 years ago. He undergoes surveillance ultrasound for hepatocellular carcinoma every 6 months.

On physical examination, temperature is 36.8 °C (98.2 °F), blood pressure is 110/82 mm Hg, pulse rate …

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MKSAP: 57-year-old man with chronic hepatitis C infection

Physician voices

Diagnosing your cancer is my cross to bear

Today, you came to me with a chief complaint: right breast lump. You told me you’ve only been aware of it for the last three weeks. Your eyes told me your terror of not realizing it was there sooner. You…

Today, you came to me with a chief complaint: right breast lump.

You told me you’ve only been aware of it for the last three weeks. Your eyes told me your terror of not realizing it was there sooner.

You told me there wasn’t a history of any breast, endometrial or ovarian cancer in your family. But you held back that you knew there isn’t always a family history.

You told me you …

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Diagnosing your cancer is my cross to bear

Conditions and diseases

How silence can help us learn from our patients

As the patient talked, I found myself nodding my head. In so many ways, she was just like me. Highly educated, a professional, a woman who had worked hard and long to get where she was. And then cancer took…

asco-logo As the patient talked, I found myself nodding my head. In so many ways, she was just like me. Highly educated, a professional, a woman who had worked hard and long to get where she was. And then cancer took it all away, or at least that’s the way she described it. She was diagnosed with metastatic cancer one year …

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How silence can help us learn from our patients

Conditions and diseases

The problem of misunderstanding 23andMe genetic test results

Home delivery for everything from fresh produce to custom-selected clothing has become a way of life for many Americans. While most home-delivery conveniences are generally changing our lives for the better — giving us more time and choices — at-home…

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Home delivery for everything from fresh produce to custom-selected clothing has become a way of life for many Americans. While most home-delivery conveniences are generally changing our lives for the better — giving us more time and choices — at-home genetics kits that reveal information about the risk of developing certain cancers represent a risky step in …

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The problem of misunderstanding 23andMe genetic test results

Conditions and diseases

MKSAP: 62-year-old woman with a left adrenal mass

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 62-year-old woman is evaluated for an incidentally discovered left adrenal mass. Two weeks ago, the patient was evaluated in the emergency department for…

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

A 62-year-old woman is evaluated for an incidentally discovered left adrenal mass. Two weeks ago, the patient was evaluated in the emergency department for diffuse abdominal pain and vomiting. A CT scan was obtained that was normal except for the adrenal mass. Three hours after presentation to the emergency department, the pain resolved …

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MKSAP: 62-year-old woman with a left adrenal mass

Conditions and diseases

What you should know about colon polyps

2

When it comes to colon cancer prevention, the polyp is the key player to know. Colon polyps, called adenomas, are precancerous growths originating from the inner lining of the colon wall. There are other types of polyps in the colon…

When it comes to colon cancer prevention, the polyp is the key player to know. Colon polyps, called adenomas, are precancerous growths originating from the inner lining of the colon wall. There are other types of polyps in the colon which are not considered precancerous, but for our purposes in this article, we will consider the terms colon polyp and adenoma to be …

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What you should know about colon polyps

Conditions and diseases

The FDA approval of 23andMe’s BRCA test: What it means for you

The approval by the Food and Drug Administration of 23andMe’s BRCA test is bound to create a discussion about the merits and pitfalls of direct to consumer genetic testing for cancer risk. It is also going to add fuel to…

The approval by the Food and Drug Administration of 23andMe’s BRCA test is bound to create a discussion about the merits and pitfalls of direct to consumer genetic testing for cancer risk.

It is also going to add fuel to a growing fire about how we as a nation assess genetic risks for cancer, and whether society is prepared for what is inevitably going to become a …

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The FDA approval of 23andMe’s BRCA test: What it means for you

Physician voices

What cancer and teatime taught me about burnout

6

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…

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. …

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What cancer and teatime taught me about burnout

Conditions and diseases

The challenge in oncology: balancing hope and reality

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…

asco-logo 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, …

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The challenge in oncology: balancing hope and reality

Patient voices

A patient’s expertise is often undervalued

2

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…

STAT_Logo 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 …

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A patient’s expertise is often undervalued

Physician voices

Doctors: Don’t forget to take care of yourselves

4

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…

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 …

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Doctors: Don’t forget to take care of yourselves

Conditions and diseases

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

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…

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 …

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

Physician voices

How cancer transformed this physician

9

“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…

“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 …

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How cancer transformed this physician

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