Oncology and hematology

2,498 articles · Since 2004

Articles, page 50

The Elizabeth Sedway case: In defense of Alaska Airlines

April 24, 2015Apr 24, 201523

Elizabeth Sedway, a 51-year-old undergoing treatment for multiple myeloma, was outraged to be removed from a Hawaii-San Jose flight due to concerns about her health. Wearing a mask to prevent infection as her immune system was compromised from chemotherapy, she requested handicapped seating and told an airline employee she felt “weak.” The employee consulted with an airline doctor who was concerned …

Conditions and diseases

When the back pain red flags aren’t enough

Davis Liu, MD

April 19, 2015Apr 19, 201514

$28 million was awarded to a patient for a late diagnosis of a pelvic tumor, an osteosarcoma. This rare cancer presented as a case of low back pain and sciatica. The patient claimed that if the osteosarcoma had been caught…

Could doctors have done better in diagnosing more quickly?

These cases strike fear into all primary care doctors. Which patient has a …

Conditions and diseases

We have already changed the way we think about cancer

Leonel Ampie

April 15, 2015Apr 15, 2015

The tenets engendered by cancer have been slowly elucidated throughout the years. The hallmarks of cancer have been well documented by Douglas Hanahan and Robert Weinberg in Hallmarks of Cancer: The Next Generation. Some of these features are well known and are inclusive of sustained proliferative signaling, evading growth suppressions, and others clearly outlined in their review. These cellular processes have been discovered by basic science researchers and subsequently, modern …

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Should we give patients our cell phone numbers?

Anne Katz, RN, PhD

April 13, 2015Apr 13, 201513

I recently attended the David Stroud Adolescent and Young Adult 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…

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 …

Conditions and diseases

MKSAP: 54-year-old woman with shortness of breath

mksap

April 12, 2015Apr 12, 2015

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 54-year-old woman is evaluated for shortness of breath of 3 months' duration and a 4.5-kg (10-lb) weight loss over the preceding 2 months.…

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

A 54-year-old woman is evaluated for shortness of breath of 3 months’ duration and a 4.5-kg (10-lb) weight loss over the preceding 2 months. She has a 35-pack-year smoking history.

On physical examination, temperature is 36.9 °C (98.4 °F), blood pressure is 145/82 mm Hg, and pulse rate is 108/min. Oxygen saturation is …

Physician voices

Angelina Jolie’s story is one of true courage and grit

Miranda Fielding, MD

April 7, 2015Apr 7, 20152

I have always been one of Angelina Jolie’s biggest fans. The Academy of Motion Picture Arts and Sciences saw fit to reward her 1999 performance in Girl Interrupted with an Oscar, but I wasn’t well and truly smitten until the second Lara Croft Tomb Raider movie was released in 2003. In that film, Jolie, who performs her own stunts, is seen …

Medical education

Projection. From an unlikely source.

Ilana Yurkiewicz

April 7, 2015Apr 7, 2015

The patient was hacking sputum into a tissue when the resident and I entered his room. “How long have you had that cough?” “Oh this? As long as I can remember.” “But it’s been worse lately?” “Yeah.” “Worse how?” “More…

The patient was hacking sputum into a tissue when the resident and I entered his room.

“How long have you had that cough?”

“Oh this? As long as I can remember.”

“But it’s been worse lately?”

“Yeah.”

“Worse how?”

“More stuff coming out each time. See?”

He opens the tissue.

“How much sputum is there?”

“Sputum?”

“The stuff you cough up.”

“I don’t look that close.”

“More than two spoonfuls?”

“Oh yes. Definitely.”

“And the color?”

“White-ish.”

“Ever see any streaks of blood?”

“Never.”

“And how long have …

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Projection. From an unlikely source.

Physician voices

Paul Kalanithi: A neurosurgeon leaves his mark on our hearts

Ashley Sumrall, MD

March 29, 2015Mar 29, 2015

At age 37, after a nearly 2-year battle with stage IV lung cancer, a talented neurosurgeon lost his battle. My oncology-related newsfeed is filled with stories this week about this brave and clever man’s recent passing. In a field where the recent tweets tout results of the latest clinical trials (overall survival prolonged from 2 months to 4 months!), it is sobering to be reminded of what truly matters to …

Conditions and diseases

Changing the way we think about cancer

Jack C. Westman, MD

March 26, 2015Mar 26, 20157

The sun rises and the sun sets. It seems like the sun rotates around the Earth. Cancer cells rise and are killed by surgery, radiation and chemotherapy. It seems like cancer is a disease. But the sun does not rotate around the Earth, and cancer is not a disease. The many kinds of cancer cells are the products of the disease neoplasia that can emerge in our bodies’ organs and tissues.

Strange …

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Changing the way we think about cancer

Conditions and diseases

Remember the psychological harms of cancer screening

Kenneth Lin, MD

March 25, 2015Mar 25, 20153

Several years ago, a few colleagues and I performed a systematic evidence review to help update the U.S. Preventive Services Task Force's recommendations on screening for prostate cancer. One of our key questions asked about the harms associated with prostate…

Several years ago, a few colleagues and I performed a systematic evidence review to help update the U.S. Preventive Services Task Force’s recommendations on screening for prostate cancer. One of our key questions asked about the harms associated with prostate cancer screening, other than the overdiagnosis (and resulting unnecessary treatment) of clinically insignificant tumors. Since routine prostate-specific antigen screening had been going on for nearly two decades by then, we expected to …

Physician voices

A thank you to a mother and son in the ER

StorytellERdoc, MD

March 22, 2015Mar 22, 2015

I walked into room 30 to find two eager sets of eyes awaiting me. One set belonged to a young man, late-twenties, muscular and imposing, sitting in a chair in the corner of the room. His eyes were hazel brown, big and inviting, relieved at seeing my entry into their sheltered world. The other set of eyes, darker brown and magnified by her gold-stemmed glasses, belonged to my patient, a …

Conditions and diseases

Colorectal cancer screening in the elderly: Can we stop the train?

Robert S. Sandler, MD, MPH

March 20, 2015Mar 20, 20159

The mortality from colorectal cancer has decreased substantially in the U.S. during the past decade. While some of the improvement is due to better cancer treatment and reduced risk factors, the largest proportion is thought due to screening. The concept that early detection saves lives has now become well recognized. The harms of screening — particularly among individuals with limited life expectancy — are less well appreciated.

Royce et al. recently published a …

Conditions and diseases

What would truly personalized oncology look like?

Amy Abernethy, MD, PhD

March 13, 2015Mar 13, 2015

The concept of “personalized medicine” gets thrown around a lot these days. And as an oncologist and a palliative care doctor, who advocates for using data to get information that can provide more personalized cancer care, I believe strongly in…

More than 14 million people are living with cancer in the United States, according to the National Cancer Institute — and some 1.7 …

Physician voices

I broke my own rule when giving bad news

James C. Salwitz, MD

March 11, 2015Mar 11, 201510

For 25 years, I have taught medical students how to give bad news. Step one: Be prepared. Step two: Find a safe, personal, quiet environment. Step three, and this is most important: Before you speak, ask. What do the patient and family understand? Fail to follow this vital rule and reap the whirlwind. So, therefore, you might ask, if I have such wisdom and experience in this critical area …

Conditions and diseases

When you can’t let your guard down: Cancer as a constant threat

Don S. Dizon, MD

March 11, 2015Mar 11, 20152

Every so often I see a patient who views cancer as a constant threat to be handled. The cancer becomes so significant that she feels she can never let her guard down. I always worry about this — partly because that singular focus on fighting cancer can sometimes detract one from other aspects of life, and those facets that give …

Conditions and diseases

March for colorectal cancer awareness

Steven Naymagon, MD

March 9, 2015Mar 9, 2015

A 75-year-old woman with progressive constipation. An 82-year-old man with unexplained anemia. A 39-year-old mother of two with intermittent blood in her stool. These are three of my patients. And sadly, they are three of nearly 150,000 Americans diagnosed with…

March is National Colorectal Cancer Awareness Month for good reason. In the United States, colorectal cancer is the third most commonly diagnosed cancer. It is also the …

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March for colorectal cancer awareness

Conditions and diseases

3 ways to prevent colorectal cancer

Adewale Ajumobi, MD, MBA

March 2, 2015Mar 2, 20158

March is colon cancer awareness month. We have made tremendous strides in the fight against cancer especially colon cancer. Between 1991 and 2011, U.S. cancer death rate decreased by 22 percent (1.5 million lives saved), and colon cancer death rate…

March is colon cancer awareness month. We have made tremendous strides in the fight against cancer especially colon cancer.

Between 1991 and 2011, U.S. cancer death rate decreased by 22 percent (1.5 million lives saved), and colon cancer death rate decreased by almost 50 percent. This decrease coincides with widespread adoption of colorectal cancer screening particularly colonoscopy.

Despite this progress, colon cancer is still the 2nd leading cause of cancer death in …

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3 ways to prevent colorectal cancer

Conditions and diseases

What cancer denial has to do with global warming

James C. Salwitz, MD

February 27, 2015Feb 27, 20159

Cancer patients depend on denial. Without its protection, we would be overwhelmed by terror. Denial filters and slows bad news, so we can digest reality in the merciful morsels; thus, we cope. Without denial, we would shut down, withdraw, and lose hope; healing would not be possible. However, if we do not move beyond denial, accept the diagnosis and loss, make a plan, we die.

Allen, a 43-year-old man, came to …

Conditions and diseases

Help patients make better decisions about lung cancer screening

Michael J. Barry, MD

February 26, 2015Feb 26, 2015

The high cost of health care in the United States in part relates to how clinicians are paid. Performing expensive and often risky procedures simply pays better than engaging patients in a shared decision-making conversation. Shared decision-making (SDM) is a process where clinicians and patients educate each other about treatment options, risks and benefits, and preferences, and then they decide on the best approach together. Patient decision aids can assist …

Conditions and diseases

The cancer metamorphosis is different for each patient

James C. Salwitz, MD

February 24, 2015Feb 24, 20158

“I had no idea how much cancer sucks.” My patient’s observation seems silly, basic. Of course, cancer sucks. It maims, humiliates and kills. It takes. What made the statement remarkable was its source. This is not a medically naïve person,…

“I had no idea how much cancer sucks.”

My patient’s observation seems silly, basic. Of course, cancer sucks. It maims, humiliates and kills. It takes. What made the statement remarkable was its source. This is not a medically naïve person, waiting to die. Rather it was spoken by a patient in complete remission, likely cured, who is an expert in cancer care. To her amazement, it changed life forever.

I think that …

Oncology and hematology

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