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.

10 lessons from Hamilton that made me a better oncologist

Ashley Sumrall, MD

Physician

July 26, 2017

Over 30,000 visitors flocked to Chicago in early June to participate in the ASCO annual meeting, the summer mecca for all things oncology. In between plenary sessions and poster presentations, some attendees found their way to one of the Hamilton Chicago performances. Having opened in Chicago about seven months ago, this version of the “hip-hop musical” has packed in audiences, striving to capture some of the success that its New …

Are end-of-life decisions the doctor’s or the patient’s?

Don S. Dizon, MD

Physician

July 24, 2017

I remember meeting this patient the first time. I had just started in a new position, and she was one of my first consults. Tracey* had an aggressive sex-cord tumor of the ovary that had relapsed soon after surgery, grown through primary chemotherapy and grew once more after secondary surgery and “adjuvant” pelvic radiation. I knew …

Should we screen African-American men for prostate cancer?

Kenneth Lin, MD

Conditions and Diseases

July 23, 2017

Regular readers of my blog know that I believe that the harms of prostate-specific antigen (PSA) screening for prostate cancer outweigh the benefits — if benefits exist at all. That isn’t to say that I will not order the test in a man who understands the risks and expresses a clear preference to be screened. In a recent editorial in American Family Physician, I explained my …

Senator McCain has brain cancer. Here’s what that means.

Brian C. Joondeph, MD

Conditions and Diseases

July 20, 2017

By now, most readers already know that Senator John McCain has been diagnosed with a brain tumor — specifically, a glioblastoma. I take no pleasure is suspecting such a diagnosis, as I wrote a few days ago, based on a bit of medical logic and observation rather than what the media reported.

This is a devastating diagnosis for the senator and his family, not the blood clot initially …

Treating the patients we cannot reach

Anne Katz, RN, PhD

Physician

July 17, 2017

I had never met the man, but from a brief reading of the notes in his medical record, I knew that this was not going to be easy. Thirty years old with stage III kidney cancer, the notes showed a long history of missed appointments and late arrivals. I had been asked to talk to him about sperm banking and so …

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Treating the patients we cannot reach

Finding the right words for my patients’ hard questions

Prateek Mendiratta, MD

Physician

July 16, 2017

On a recent visit to DC, I found myself feeling inspired; regardless of your politics, it’s almost impossible not to. At each monument, museum, memorial, and government building, I stood in awe of the boldness, faith, hope, and determination of our founding fathers and their unwavering belief in the future success of their American experiment. So many of these sites are inscribed with famous quotes from leaders who inspired generation …

Artificial intelligence in medicine is still a long ways off

Bruce Campbell, MD

Health Technology

July 10, 2017

“Medicine is a science of uncertainty and an art of probability.”
– Sir William Osler

Two people presented to my clinic on the same day with classic symptoms of head and neck cancer.

Each reported several weeks of unilateral throat discomfort, ear pain, and a neck mass. Each was having some trouble swallowing and had changed his diet to accommodate the soreness. When they opened their mouths, each had a mass with a …

Her patients helped this doctor out of her despair

Jennifer Lycette, MD

Physician

July 8, 2017

Recently I found myself sitting in my car in the parking lot of my clinic, unable to will myself to open the door.

I didn’t want to head into the clinic that morning. Instead, I was filled with despair; overwhelmed with the events of the world.

How can I do it? I thought. How can I walk in there and summon the energy to see my patients?

An even worse thought: Why should …

Scared of clinical trials? 7 reasons to not be.

Stephanie Graff, MD

Physician

July 2, 2017

I see more and more patients decline to participate in clinical trials. Simultaneously, I hear patient advocates on the national stage clamoring for better trial access. Why the disconnect?

Let’s explore 7 reasons why clinical trial participation is right for you:

1. The smartest minds in medicine designed this for you. Clinical trials are not designed by one doctor on the fly. Most oncology drugs have been studied for at least six years …

We must address young patients’ pain and suffering from the start of their cancer journey

Jennifer Mack, MD, MPH

Conditions and Diseases

June 30, 2017

When a child is diagnosed with cancer, overwhelmed parents and patients are often laser-focused on the path to cure. Even though parents do not welcome pain or discomfort for their child, they may feel that symptoms are a necessary cost of curative care. Likewise, it is easy for us, as pediatric oncologists, to accept symptoms and side effects of treatment as normal. Important new research challenges this assumption and challenges …

Where physician and mother meet

Stephanie Graff, MD

Physician

June 30, 2017

In 2017, results of a study were published in JAMA suggesting women are better doctors than men. While I celebrated the acknowledgment for myself and my female physician peers, it prompted me to reflect on how my gender impacts how I practice medicine. Reflection kept bringing me back to a simple truth: my …

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Where physician and mother meet

What a patient taught her doctor about defying death

Linda Girgis, MD

Physician

June 29, 2017

The answer reflected off of her face, and I knew my news would be no surprise.

Nonetheless, the lump in my throat grew as I hesitated to tell her the latest we found on her recent scans. The fact that this was a recurrence of a previous cancer and she dealt with this inhumanity in the past also did not make it any easier.

It was then that Mrs. B spoke up, …

There is no place for blame in cancer

Jennifer Lycette, MD

Conditions and Diseases

June 26, 2017

I recently read a post by oncologist Dr. Stephanie Graff on the experience of blame, from self and others, that people with cancer are subjected to:

The talk about risk factors and early detection makes us think we can achieve perfection, and that cancer is somehow a personal fault … let us stop making accusations and blaming persons diagnosed with cancer. They are blameless.

Her post, “Read more…

There is no place for blame in cancer

Is the future of cancer screening at your local shopping mall?

J. Leonard Lichtenfeld, MD

Conditions and Diseases

June 10, 2017

That’s the question sticking in my mind after reading a recent report about a local radiology practice opening a large mammography center in an upscale shopping mall in Long Island, New York.

Let’s face it: Medical care is changing. And with changes come new ideas. Some will work, some won’t. The thought of getting a mammogram while on a shopping trip may just be what the doctor ordered …

Let’s stop calling cancer a war

Don S. Dizon, MD

Physician

June 8, 2017

I remember, when I was a kid, that my grandmother would spend time at our breakfast table reading the newspaper. Not cover to cover, mind you — she seemed to always focus her attention on the obituaries. Sometimes she would look up and tell anyone sitting around her about the death of someone near her age …

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Let’s stop calling cancer a war

The only perfect cancer statistic is an imperfect one

Stephanie Graff, MD

Conditions and Diseases

May 30, 2017

As an oncologist, I spend my days with women and men diagnosed with cancer. My patients, particularly my advanced-stage or Stage 4 (metastatic) patients, often ask what they did wrong. How did they end up with metastatic cancer? They share with me the subtle accusations made by friends, family and acquaintances that somehow they brought this on themselves. “If only Susan had done her screening mammograms faithfully, she never would …

Bearing witness: An oncologist’s role at the end of life

Jennifer Lycette, MD

Physician

May 27, 2017

My patient was sitting in a wheelchair. He was in his mid-forties, and before the cancer, had held a physically demanding job that he loved. Now, the cancer in his spine had ended not only his ability to work, but any ability to use his legs.

His wife was devoted to him in a way that seemed as natural and understated and unobtrusive as breathing.

In order for me to examine him, she …

The unhappy couples after a cancer diagnosis

Anne Katz, RN, PhD

Conditions and Diseases

May 26, 2017

The couples I see for counseling are not always perfect, not that any couples ever are. But when cancer enters the relationship, for some couples, things get ugly and get ugly fast. I believe that we like to think that cancer makes people “better”; that people rise to the challenge and become the best they can be. I think that we …

What surgeons do is a violent act

Bruce Campbell, MD

Physician

May 18, 2017

“I like good strong words that mean something.”
– Louisa May Alcott

My resident and I are removing a large, recurrent cancer from the neck. Dense scar tissue is everywhere from prior surgery and radiation therapy. The going is slow. Each move is arduous, and bleeding obscures the view of the anatomy.

“Watch out,” I tell her. “The jugular vein is nearby, probably buried in that scar.”

“Yeah,” she responds. “Look at this nerve! …

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What surgeons do is a violent act

To be an oncologist today is to be a part of a revolution in medicine

Don S. Dizon, MD

Physician

May 8, 2017

When I was a resident, my colleagues chided me for wanting to be an oncologist. Back then (and it pains me to be old enough to use that phrase, by the way), oncology was thought of as a field of futility. We administered toxic drugs to patients with cancer, and far more often than not, they …

Oncology and Hematology

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