“Ultraviolet bad.”
That was the core message that came out of the introduction this morning of the Surgeon General’s Call to Action to Prevent Skin Cancer at a meeting held at the National Press Club in Washington DC.
There were some other messages that now raise skin cancer awareness and prevention high on the public health awareness list, such as …
Today it’s time to say, “Ultraviolet bad”
I knew immediately it was a problem. It was not just that Faith’s cancer had spread with innumerable masses in her liver, golf ball-like tumors in her lungs, punched out holes in her bones. It was not that the chemo, third round and toxic, had failed. Those were awful things. Rather it was her response as I began to tell her. As soon as I said, “I looked at the …
Giving terrible news to those we love
Recent research finds that many internists do not feel comfortable or prepared to care for survivors of childhood cancer. Although the rarity of childhood cancer may explain this, the fact remains that as more and more pediatric cancer patients survive into adulthood busy internists often have some survivors in their practices. These patients would have been treated during the last decades of the 20th century or the beginning of …
5 things internists should know about treating survivors of childhood cancer
In a recent verdict a jury in Massachusetts awarded $16.7 million in damages to the daughter of a Bostonian lady who died from lung cancer at 47, for a missed cancer on a chest x-ray.
The verdict reminds one of the words of John Bradford, the heretic, who was burnt at the stakes. “There but for the grace of God go I.”
Many radiologists will sympathize with both the patient who …
The $16.7 million x-ray: Possible beats probable in court
Recently, I realized that patients coming to my office seeking vasectomies required an additional piece in their counseling. What led to this change? Earlier this month a study out of Harvard University suggested an association between vasectomy and lethal prostate cancer. Published in the Journal of Clinical Oncology, the researchers found that “men with a history of vasectomy had a 10% increased risk of prostate cancer, …
Are vasectomies a risk factor for prostate cancer?
I’m a law abiding blogger. Laws are meant to be obeyed. If an individual opposes a law in a free country, then he should operate within the system to modify it. I recognize that even in free societies, certain laws are so unjust and in violation of natural law that that the citizenry may be justified in relying upon other measures to affect necessary reform.
I’m not suggesting that an unwelcome …
Law and medicine are more intertwined than they should be
I’ve always been good at pattern recognition and my visual-spatial orientation is excellent. Photography is my hobby, so it was only natural that as a medical student and internal medicine resident, I loved my dermatology electives. Each day yielded up a new parade of interesting skin lesions and rashes, and by the end of my rotations I was confident in my diagnoses and recommendations. Contact dermatitis? Steroids! Eczema? Steroids! Psoriasis? …
After retirement, a visit to a dermatology office
This past April, just after the Centers for Medicare & Medicaid Services (CMS) released the highly-anticipated 2012 Medicare provider charge data, the New York Times published an article,”Sliver of Medicare Doctors Get Big Share of Payout.”
Almost everyone agrees that transparency in the Medicare payment system will likely lead to more efficient health care delivery with less waste and less fraud. However, thoughtful analysis must be performed so that undue stigmatization …
Raw Medicare data singles out radiation oncology. That’s misleading.
The first lecture in a radiation oncology residency program is “Radiation Oncology Emergencies,” to educate the new residents how to manage inpatient consultations and emergencies. While preparing my lecture this year, it occurred to me how useful this basic information would be to the physicians calling for the consultation. Sharing our thought process in triaging patient explains why we don’t rush to utilize radiation, even in cases of a cord …
Why we don’t usually give emergent radiation therapy
As many of you picked up from the tone of my last article, I am feeling much, much better. As more time has passed from the disasters of six weeks ago when I lost my relationship and home (making me feel more physically ill than I had felt this entire time), my body has finally had a chance to recover. I also have benefitted from a …
8 ways to better support someone dealing with cancer
I have written many columns urging doctors to be honest with their patients, especially about difficult news. Too often patients are lead on false hope therapy rides, rather than empowered with honest information so that they can cope with their disease and future. Doctors are not the only ones who can keep a painful secret.
I admitted Sarah to the hospital late on Saturday night. For over two years, she had …
Doctors are not the only ones who can keep a painful secret
Kasey sits alone in the examining room, staring at the drug company calendar of a perfect Caribbean beach hanging above the doctor’s desk, but not seeing it at all. She is very frightened. After three years of treatment for cancer, she is in trouble. Kasey feels fine: no shortness of breath, no cough, no pain. Still, she is there to get the report on her CT scan, and she knows …
His reputation precedes him: Meet the bad news doctor
I recently had the privilege of participating in a meeting hosted by the President’s Cancer Panel on the role of social media in improving cancer control and treatment. The goal was to give advice to the Panel on a planned series of meetings they will be convening to discuss the topic. It was the range and quality of the discussion …
The impact of social media on cancer care
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Only in America can we find a way to scare the bejesus out of a woman with normal breasts and a normal mammogram. Because that’s exactly what happened when New York Times reporter Roni Caryn Rabin read her entirely normal mammogram results letter: “A sentence in the fourth paragraph grabbed me by the throat. ‘Your breast tissue is dense.'”
I can’t really blame Rabin for being afraid. The information about breast density in …
Dense breasts on mammogram? Don’t be afraid.
Recently, in front of my family, friends, colleagues, and teachers, I accepted my diploma during the graduation ceremony for the UCLA psychiatry residency program.
While it wasn’t my real diploma — it’s been months since I’ve been able to work, so when I’m better I need to go back and finish some requirements — my residency program coordinator put together an awesome fake diploma so I would have something to pick …
Learning about human nature after a cancer diagnosis
“I just want to know that she’ll be able to travel,” my patient’s husband said.
Stan and Jane Jackson (names changed) sat side-by-side on the mauve loveseat in the exam room. A binder filled with sheaths of paper — copies of Jane’s lab reports, CT scan reports, discharge papers, and chemotherapy information handouts — sat open on his lap. On top …
With advanced cancer, there are no guarantees
Recently, a family physician colleague asked me to explain why the Affordable Care Act requires private health insurers to provide first-dollar coverage for preventive services that the U.S. Preventive Services Task Force assigns an “A” or “B” (recommended) rating, but allows public insurers (Medicare and Medicaid) to determine if and how they will cover these services.
Until recently, the question hadn’t come up, since Medicare has agreed to cover pretty much every …
A rational approach to CT lung cancer screening
The Ellen DeGeneres Show has repeatedly put out a call for viewers to send in their funny sunburn pictures and stories. The following was posted on the website:
Summer is here and everyone is hitting the beach or pool. Just don’t forget the sunscreen! If you did, and you have the bad sunburn to prove it, we want to see the funny photos. Be sure to tell us the story behind …
Social media advocacy matters: The case of the Ellen DeGeneres Show
There’s no good age to die.
Way too many of the patients I’ve seen over the past two years are harrowingly close to my own age. I think it’s less startling to hear that an older person has cancer than when a young person is diagnosed, but I have yet to identify the age when this transition happens.
Maybe it’s an unspoken understanding that older people die and younger people shouldn’t, but …
Chemotherapy: Giving a man one more day of good life
In my line of work, it’s not uncommon for a civil debate about the evidence for a cancer screening test (such as the PSA test for prostate cancer) to rapidly degenerate into the other person questioning my motives or suggesting that the real reason I oppose disseminating or requiring insurers to pay for a test is because I secretly want patients to suffer lingering and painful deaths. (“He obviously doesn’t care about …
What does it take for a cancer researcher to know cancer?
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