Oncology and hematology

2,498 articles · Since 2004

Articles, page 55

After retirement, a visit to a dermatology office

July 31, 2014Jul 31, 20147

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? …

Physician voices

Raw Medicare data singles out radiation oncology. That’s misleading.

Sea Chen, MD, PhD

July 30, 2014Jul 30, 2014

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…

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 …

Conditions and diseases

Why we don’t usually give emergent radiation therapy

Miriam A. Knoll, MD

July 29, 2014Jul 29, 2014

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 …

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Physician voices

8 ways to better support someone dealing with cancer

Elana Miller, MD

July 22, 2014Jul 22, 2014

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 …

Physician voices

Doctors are not the only ones who can keep a painful secret

James C. Salwitz, MD

July 22, 2014Jul 22, 20143

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…

I admitted Sarah to the hospital late on Saturday night. For over two years, she had …

Physician voices

His reputation precedes him: Meet the bad news doctor

James C. Salwitz, MD

July 15, 2014Jul 15, 20144

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 …

Conditions and diseases

Dense breasts on mammogram? Don’t be afraid.

Margaret Polaneczky, MD

July 10, 2014Jul 10, 20144

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…

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 …

Conditions and diseases

Learning about human nature after a cancer diagnosis

Elana Miller, MD

July 10, 2014Jul 10, 2014

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,…

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 …

Conditions and diseases

With advanced cancer, there are no guarantees

Merry Jennifer Markham, MD

July 9, 2014Jul 9, 20143

"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…

“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 …

Conditions and diseases

A rational approach to CT lung cancer screening

Kenneth Lin, MD

July 7, 2014Jul 7, 2014

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…

Until recently, the question hadn’t come up, since Medicare has agreed to cover pretty much every …

Conditions and diseases

Social media advocacy matters: The case of the Ellen DeGeneres Show

Sherry Pagoto, PhD

July 4, 2014Jul 4, 20143

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…

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

…

Physician voices

Chemotherapy: Giving a man one more day of good life

Kenneth D. Bishop, MD, PhD

July 3, 2014Jul 3, 20142

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…

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 …

Physician voices

What does it take for a cancer researcher to know cancer?

Kenneth Lin, MD

June 27, 2014Jun 27, 2014

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…

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 …

Physician voices

A perfect thank you note to an oncologist

James C. Salwitz, MD

June 26, 2014Jun 26, 2014

I got a letter the other day from a local urologist requesting clearance for a patient of mine to have surgery. The doctor wanted to know whether there were any contraindications, from the standpoint of the patient’s cancer, such as bleeding, infection or poor wound healing, which would preclude local anesthesia, bilateral incisions, sharp separation, ligation, and electrocauterization of the vasa …

Physician voices

Has abolishing medical paternalism gone too far?

James C. Salwitz, MD

June 19, 2014Jun 19, 20147

Carrie is a 72-year-old retired real estate agent with a high school education. She raised three kids, but they do not talk to her anymore. Since her husband died, Carrie has lived alone. A melanoma was removed from her right…

“What does that mean?”

“Well, we wouldn’t know for sure until …

Conditions and diseases

Cancer screening in those with metastatic disease

Don S. Dizon, MD

June 18, 2014Jun 18, 2014

“Your cancer has come back.” These are words no one treated for cancer wants to hear, yet they are words I have said far too often in my own career. In this case, I had said this to a patient…

“Your cancer has come back.”

These are words no one treated for cancer wants to hear, yet they are words I have said far too often in my own career. In this case, I had said this to a patient I had cared for ever since her initial diagnosis. At that time, she had stage III breast cancer. After her surgery, …

Medical education

The importance of professional evolution in medicine

The Red Humor, MD

June 18, 2014Jun 18, 20144

I've been a practicing oncologist for all of seven months, and so was surprised when my chief asked that I take part in our quality review panel. The quality review panel is an internal group that is tasked with the…

I’ve been a practicing oncologist for all of seven months, and so was surprised when my chief asked that I take part in our quality review panel. The quality review panel is an internal group that is tasked with the responsibility of looking into allegations that a patient’s care was not in keeping with best practice or what is generally considered the standard of care. Cases (often in the form …

Conditions and diseases

Hospital bills should not outlive our loved ones

Nadi Nina Kaonga

June 18, 2014Jun 18, 201417

In 2010, I lost my mother to cancer. She was a fighter and had survived well past her prognosis, but her hospital costs outlived her. Let me go back to late 2004. That was the year the doctors suspected she…

In 2010, I lost my mother to cancer. She was a fighter and had survived well past her prognosis, but her hospital costs outlived her.

Let me go back to late 2004. That was the year the doctors suspected she had cancer. My mother, who was not a smoker, was officially diagnosed with non-small cell lung cancer early on in 2005. When the biopsy confirmed that the small lesion in the …

Drugs and prescribing

A prostate cancer breakthrough: The good and not-so-good news

J. Leonard Lichtenfeld, MD

June 18, 2014Jun 18, 2014

The annual meeting of the American Society of Clinical Oncology is a place where many commercial interests jostle for attention to make their latest promising therapy the star of the show. But a standard widely available generic drug stole the show by producing incredible results in improving survival for men with advanced prostate cancer. And that has some of us …

Oncology and hematology

Articles, page 55

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