Oncology and hematology

2,498 articles · Since 2004

Articles, page 57

The uncertainty of monitoring prostate cancer post-prostatectomy

May 6, 2014May 6, 20142

Heisenberg uncertainty principle: A principle in quantum mechanics holding that increasing the accuracy of measurement of one observable quantity increases the uncertainty with which another conjugate quantity may be known. Perhaps it is because I just got back from Albuquerque,…

Perhaps it is because I just got back from Albuquerque, a city which has become like a second home to me, that I have Heisenberg on my mind. For the one or two of you out there who are not Breaking …

Conditions and diseases

Responding to cancer as the surgeon or the survivor

Carol Scott-Conner, MD, PhD

May 6, 2014May 6, 20143

“The plastic surgeons tell me that women who like to swim do much better with reconstruction than with prostheses,” says a young breast surgeon at our weekly breast cancer tumor board, the working conference where we discuss every new breast…

There’s a slight note of surprise in her voice; to her, it’s simply another consideration when advising women before mastectomy.

For decades, the only option after a …

Physician voices

A toast to my patients

James C. Salwitz, MD

May 5, 2014May 5, 2014

His wife thinks he looks like Tom Cruise. There is a resemblance, I can see him riding a motorcycle off the side of a burning building, jaw fixed, eyes on fire, ready to save the damsel … only he is not so short. Funny, brilliant and genuine, we have known each other for exactly two decades, sharing the growth of our families, the anxieties of middle age, and the vicissitudes …

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A toast to my patients

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The complex interplay between masculinity and health care

Olutoyin Okanlawon, MD, MPH

May 3, 2014May 3, 201415

About 25km outside of Sao Paulo, Brasil, in a small city called Barueri, lies the grave of my mother’s cousin. Henrique was the Brasilian version of Mr. T -- a larger than life character, he spent his days on the…

About 25km outside of Sao Paulo, Brasil, in a small city called Barueri, lies the grave of my mother’s cousin. Henrique was the Brasilian version of Mr. T — a larger than life character, he spent his days on the pitch as the starting goalie of a local football club. “Senhor Henrique” was well known. He had three major trademarks:

His favorite words to opposing players were “tenho pena de tolo”

…

Conditions and diseases

A patient’s role in ensuring high quality colonoscopy

Douglas K. Rex, MD

April 29, 2014Apr 29, 20145

The American Cancer Society recently released important new data showing that the rate at which people are diagnosed with colon cancer in the U.S. has dropped 30% in the last ten years for those aged 50 and older. Much of this decline was attributed to the widespread uptake of colonoscopy screening. Colonoscopy is the only screening test that examines the entire colon and allows removal of precancerous polyps in the …

Conditions and diseases

No, bras do not cause breast cancer

Jennifer Gunter, MD

April 29, 2014Apr 29, 20144

The myth that bras cause breast cancer is apparently coming ‘round the barn again. The latest scare-you-out-of-your-brassiere “article” claims there are “five research studies” that show a strong correlation between bra wearing and breast cancer. Well, that certainly sounds all…

Why the bra hullabaloo? A couple of anthropologists wrote a whole book about their incorrect theory back in 1995, Dressed to kill: The link between breast cancer and bras. …

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No, bras do not cause breast cancer

Physician voices

Treating cancer should not be paved in our patients’ financial despair

Don S. Dizon, MD

April 24, 2014Apr 24, 201417

Martha (name changed) had recurred yet again -- her third in as many years. Despite our best attempts, remission proved fleeting. Fortunately, she had few (if any) symptoms of the cancer in her abdomen; no bloating, no nausea, no difficulty…

Martha (name changed) had recurred yet again — her third in as many years. Despite our best attempts, remission proved fleeting. Fortunately, she had few (if any) symptoms of the cancer in her abdomen; no bloating, no nausea, no difficulty moving her bowels. Her concerns were more psychological — anxiety and frustration because her cancer refused to go away, and indeed, …

Conditions and diseases

7 steps to eliminating the war analogy in cancer care

Matthew Katz, MD

April 22, 2014Apr 22, 201416

From a philosophical standpoint, one of the things I hate most about cancer is the use of “war” analogies. The “battle” may mobilize patients and families, but it may also interfere with education and informed decision making. And both patients and clinicians often take recurrence or disease progression personally as a failure. Even when everything is done perfectly, the outcomes aren’t. Why …

Physician voices

When free preventive screening tests aren’t really free

Kenneth Lin, MD

April 17, 2014Apr 17, 201412

I recently spoke to a class of undergraduates about the benefits, harms and politics of screening smokers for lung cancer using low-dose CT scans. Afterwards, a student asked how I felt about the Affordable Care Act’s requirement that Medicare and private insurers cover U.S. Preventive Services Task Force “A” and “B” recommended screening tests and other preventive services without co-payments or deductibles, making them free at the point of care.

I admitted that …

Physician voices

To emotionally survive cancer, we must create perspective

James C. Salwitz, MD

April 15, 2014Apr 15, 2014

Hegira: To take flight to escape. To travel from a place of danger to a place of safety. “You have cancer.” You hear the words. Your mind does not understand. “You have cancer.” Shock. Distance. Isolation. Someone else. A mistake.…

Hegira: To take flight to escape. To travel from a place of danger to a place of safety.

“You have cancer.”

You hear the words. Your mind does not understand.

“You have cancer.”

Shock. Distance. Isolation. Someone else. A mistake. A lie. Bizarre, strange, you float above the room. Everyone speaks; nothing is said.

“You have cancer.”

A fog-like curse, a venomous reality, a phantom idea. A cold ghost foreign to the soul. I must run. …

Patient voices

Should doctors tell parents of terminal children to quit pursuing quackery?

Suzanne Leigh

April 13, 2014Apr 13, 20146

It was only a matter of time before the name Dr. Stanislaw Burzynski would grab the attention of the family of McKenzie Lowe, a 12-year-old from Hudson, N.H., with that most damning of diagnoses, a diffuse intrinsic pontine glioma, an…

Like McKenzie, my own daughter was 12-years-old with a recurring brain tumor that had started to metastasize and …

Conditions and diseases

A cancer story that defied the odds

James C. Salwitz, MD

April 8, 2014Apr 8, 20144

Sometimes it seems that life is unfair and the odds are stacked incredibly against us. More than 1 in 3 persons will get cancer. The chance of survival if you get lung, pancreatic or brain tumors is pathetically small. The most common cancer in 20 to 30-year-olds is the deadly beast melanoma. We have no easy or effective early detection for most cancers.

However, there are remarkable stories of hope. Here …

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A cancer story that defied the odds

Physician voices

Can narrative medicine inform quality of care?

Don S. Dizon, MD

April 7, 2014Apr 7, 2014

As characterized by Dr. Rita Charon in her JAMA article almost 15 years ago, narrative medicine is “the ability to acknowledge, absorb, interpret, and act on the stories and plights of others.” It is the recognition that scientific knowledge alone…

As characterized by Dr. Rita Charon in her JAMA article almost 15 years ago, narrative medicine is “the ability to acknowledge, absorb, interpret, and act on the stories and plights of others.” It is the recognition that scientific knowledge alone is not enough — not enough for our patients, for ourselves, and for society. It stresses the importance of not only hearing what our …

Conditions and diseases

Don’t forget those where cancer screening didn’t make a difference

J. Leonard Lichtenfeld, MD

April 4, 2014Apr 4, 20145

I had the opportunity recently to participate in a Twitter chat on the topic of colorectal cancer awareness. The chat was intended to bring attention to a nationwide campaign called “80 by 2018” designed to increase colorectal cancer screening rates to 80% of the population over the next 4 years. If it is successful, we should see a decline in both incidence and deaths …

Conditions and diseases

Would you admit this patient into hospice?

James C. Salwitz, MD

April 2, 2014Apr 2, 20144

Allow me to describe a recent case and ask your opinion. Today, you are the intake nurse at hospice and you are asked to evaluate Stan. This gentleman has incurable cancer, but treatment would probably prolong his survival. However, Stan has refused that treatment and been referred to you. It is your job to decide if he is “hospice appropriate.”

Why has Stan refused therapy? It is not that he denies …

Conditions and diseases

Powerless to treat a complicated cancer case in Kenya

Bruce Campbell, MD

April 1, 2014Apr 1, 20144

I was working side-by-side with a Kenyan ENT doctor at his hospital in Eldoret, Kenya. My wife, Kathi, and I were part of a team of head and neck surgeons organized by Indiana University spending two weeks working with Kenyan ENT surgeons to help them build confidence to perform operations independently. In rapid sequence, we were seeing dozens of patients who had signed up to be examined and hoping to …

Physician voices

The dreadful cost of denying how you really feel

Anoop Kumar, MD

March 31, 2014Mar 31, 201412

I was recently sent a link to this article entitled “Smile! You’ve Got Cancer” written by Barbara Ehrenreich. I encourage everyone to read it. The article lives up to its striking title and more. And I couldn’t help but respond with my perspective. So that you know where I’m coming from, my most personal encounter with cancer is that my grandmother died from cancer. I also treat people with acute …

Physician voices

Unexpected lessons from an unexpected patient

Chiduzie Madubata, MD

March 29, 2014Mar 29, 2014

“I’m so sorry, but it looks like the cancer has spread.” As I heard these words come out of my mouth, I knew that in a split second, a new reality was created in the mind of the patient that…

“I’m so sorry, but it looks like the cancer has spread.”

As I heard these words come out of my mouth, I knew that in a split second, a new reality was created in the mind of the patient that I was talking to. I looked at his face and saw that he was trying to remain strong, but in his demeanor, it was apparent that dreams were crushed and that …

Conditions and diseases

Cancer is an international war and peace issue

Tara D. Sonenshine

March 27, 2014Mar 27, 2014

For years internationalists have being trying to make the argument to ordinary Americans that foreign policy matters -- that we must contend with complex issues overseas like countering terrorism while also focusing resources and energies on economic issues at home.…

For years internationalists have being trying to make the argument to ordinary Americans that foreign policy matters — that we must contend with complex issues overseas like countering terrorism while also focusing resources and energies on economic issues at home. We have posed it as a trade-off.

We are making the foreign affairs case the wrong way. Rather than argue the positive merits of trade or the negative repercussions of unchecked …

Physician voices

A struggle against cancer becomes a financial worry

Laura Sander, MD, MPH

March 26, 2014Mar 26, 201429

“I walked in a person, and out a cancer patient,” my dad said as we filed home. Crossing this threshold, we found ourselves on the other side of medicine -- the side on the exam table or gurney, as opposed…

“I walked in a person, and out a cancer patient,” my dad said as we filed home. Crossing this threshold, we found ourselves on the other side of medicine — the side on the exam table or gurney, as opposed to the one standing over it. As a physician I was used to the latter. This is my family’s story in our new position, and how the cost of medical care has impacted …

Oncology and hematology

Articles, page 57

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