Oncology and hematology

2,498 articles · Since 2004

Articles, page 60

Skin cancers are never truly benign

January 27, 2014Jan 27, 2014

I spent 4 hours on New Year's Eve sitting in the surgeon's chair getting a skin cancer taken off my nose. Nothing about the experience fits the "benign" label so many professionals, including yours truly, have used: routine; easy to…

I spent 4 hours on New Year’s Eve sitting in the surgeon’s chair getting a skin cancer taken off my nose. Nothing about the experience fits the “benign” label so many professionals, including yours truly, have used: routine; easy to treat; nothing to worry about. Friends, after this experience, which left me looking like a tall, white-haired Rudolph the …

Read more…

Skin cancers are never truly benign

Conditions and diseases

The FDA and 23andMe puts a libertarian in a dilemma

Dr. Saurabh Jha

January 25, 2014Jan 25, 201430

An advantage astrologers have over genetic testing is that the prediction of astrologers are personally verifiable. An astrologer once emphatically stated that I had no chance of a career in international cricket or Bollywood. So far both claims have turned…

How does one personally verify a “12.5%” increased chance of lung cancer, the sort of number the vendor for genetic testing 23andMe produces? If one develops …

Conditions and diseases

When undergoing chemotherapy, savor the small victories

Elana Miller, MD

January 24, 2014Jan 24, 20144

I was recently readmitted to the hospital for my second round of chemotherapy. I’m doing a regimen called Hyper-CVAD, which involves four rounds of two alternating cycles of treatment, for a total of eight rounds of chemo. For my first…

I was recently readmitted to the hospital for my second round of chemotherapy.

I’m doing a regimen called Hyper-CVAD, which involves four rounds of two alternating cycles of treatment, for a total of eight rounds of chemo.

For my first cycle I got cyclophosphamide, doxyrubicin, and vincristine, along with an intrathecal injection of a drug whose name I’ve since forgotten. This round I’m getting intravenous methotrexate and cytarabine and TWO (insert frowny …

Real physician voices, twice a week

Free, and one click to unsubscribe.

Conditions and diseases

The role of chemotherapy in palliative care

James C. Salwitz, MD

January 24, 2014Jan 24, 2014

When counseling patients and families about end-of-life care, I try to focus on a simple, clear standard. Knowing that events are overwhelming and complex, I say, “Look at each treatment, each action and each moment and ask; How does it improve quality of life?” My goal is to reduce the choices during a chaotic time of life to the simple goal of comfort.

For example, most families are very concerned about …

Physician voices

After a medical mistake: Honesty is the best policy

Jim deMaine, MD

January 23, 2014Jan 23, 20149

Elton John had it right: “It’s sad, so sad. Why can’t we talk it over. Oh, it seems to me that sorry seems to be the hardest word.” Mistakes are all to common in medicine, but can we say the…

Example 1: There’s a diagnosis of recurrent lymphoma in the ICU. The oncologist gives a phone order for cytoxan, prednisone, and vincristine. The recorder, working a double …

Patient voices

Speaking on behalf of patients is not the same as speaking as a patient

Kate Lorig, RN, DrPH

January 18, 2014Jan 18, 20143

Many years ago, Alfred Korzybski wrote that "the map is not the territory." Gregory Bateson went on to argue that the map, which represents reality, is not the reality. This distinction has implications for the role of patient voice in…

Many years ago, Alfred Korzybski wrote that “the map is not the territory.” Gregory Bateson went on to argue that the map, which represents reality, is not the reality. This distinction has implications for the role of patient voice in health care planning and policy.

Today, many organizations are making serious attempts to include the patient voice in policy and decision-making. Unfortunately, more than a …

Physician voices

Doctors often don’t have the time to address social slander

James C. Salwitz, MD

January 17, 2014Jan 17, 20143

Not long ago a woman in my community, who was a patient of an esteemed local oncologist, died. Let us call her “Beverly” and let us say she died of “breast cancer.” I am familiar with the details of the case because one of my partners saw her in consult, but HIPAA and common courtesy forbid me to be any more transparent. Beverly was very popular in our town and …

Conditions and diseases

Thoughts after being diagnosed with cancer

Elana Miller, MD

January 17, 2014Jan 17, 20146

When I was first diagnosed with cancer several weeks ago, I didn’t have much time to think. I was just trying to survive after getting punch to the gut after punch to the gut of bad news. First I went…

When I was first diagnosed with cancer several weeks ago, I didn’t have much time to think. I was just trying to survive after getting punch to the gut after punch to the gut of bad news.

First I went to the ER thinking I had pneumonia, and was told that no, I had cancer. Then I was told instead of it being a more common, more …

Conditions and diseases

Prevention, detection, and treatment of cancer has become more nuanced

Paul Bergl, MD

January 17, 2014Jan 17, 2014

At first glance, no diagnosis seems more terrible than cancer. Although it remains a huge killer in the developed world, cancer has also taken on new meanings in modern medicine. As an ordinary person, I certainly fear the word and would dread the diagnosis. Cancer. It has such a damning and unforgiving ring to it. After 3 years of residency in a tertiary referral center, where I’ve seen …

Conditions and diseases

Radiation therapy is a leap of faith

Matthew Katz, MD

January 12, 2014Jan 12, 20144

Each time I reach the point of recommending radiation treatment for someone with a brain tumor or head and neck cancer, I ask for a higher level of trust from each patient than usual: let us make a mask to…

Radiation therapy is already a leap of faith — who wants invisible rays shooting through them? Fear of unknown …

Read more…

Radiation therapy is a leap of faith

Conditions and diseases

The cost of peace of mind: A case of unneeded bilateral mastectomy

Miranda Fielding, MD

January 10, 2014Jan 10, 201416

I don’t have much in the way of eyebrows. They were victims of too much plucking back in the 1960’s and when you do that, sometimes they don’t grow back. There’s a very nice woman in Solana Beach who shapes and darkens what I have left, infrequently, when I bother to think about it which isn’t very often.

I was in there about a year ago when she told me, “I …

Physician voices

Inside a home visit: Seeing her as she really was

Jordan Grumet, MD

January 9, 2014Jan 9, 20142

I guess it shouldn't have been a surprise. Her house was exactly as I expected it to be. The door couldn't have been more fitting; red wood with a green holiday wreath attached perfectly in the center. The carpet was…

I guess it shouldn’t have been a surprise.

Her house was exactly as I expected it to be. The door couldn’t have been more fitting; red wood with a green holiday wreath attached perfectly in the center. The carpet was so white that I almost took off my shoes on the front porch before entering through the threshold. The room was warm. The ambient temperature was accentuated by a plethora of …

Physician voices

My cancer shows how our world is ruled by love

Elana Miller, MD

January 6, 2014Jan 6, 20144

I recently wrote about how our world is ruled by love, and circumstances conspired to show me just how true that really is. Love is when I go to the ER at UCLA, where I work, for a cough and…

I recently wrote about how our world is ruled by love, and circumstances conspired to show me just how true that really is.

Love is when I go to the ER at UCLA, where I work, for a cough and feeling that “something isn’t right,” and even though my complaints are mild, I’m brought right in and treated respectfully.

Love is when the chest x-ray comes …

Physician voices

When concierge care is reserved for pets

Deborah Pierce, MD

January 3, 2014Jan 3, 201421

I am a family physician. Like most of my colleagues, though, I must sometimes step out of the comfort of my clinical role to take on the role of patient or family caregiver. Generally, these trips to the other side…

I am a family physician. Like most of my colleagues, though, I must sometimes step out of the comfort of my clinical role to take on the role of patient or family caregiver.

Generally, these trips to the other side of the exam table inspire a fair amount of anxiety.

During visits to the doctor, I find myself noticing many details and comparing the quality of care to that in my own …

Conditions and diseases

The best gift of all: When the sickest patients feel better

Miranda Fielding, MD

January 2, 2014Jan 2, 20142

Ex-marines are some of the toughest patients I ever see, when it comes to dealing with pain from cancer. And career ex-Marines have the market cornered on toughness. Take for example, an elderly friend in Kansas who woke up one…

Ex-marines are some of the toughest patients I ever see, when it comes to dealing with pain from cancer. And career ex-Marines have the market cornered on toughness.

Take for example, an elderly friend in Kansas who woke up one morning with severe upper back pain, feeling faint, and decided as was his Marine Corps habit that a cold shower would be “just the thing.” The cold shower likely saved his …

Physician voices

When does false hope become malpractice?

James C. Salwitz, MD

January 1, 2014Jan 1, 201412

10:11am Tuesday, June 5, 2006: This was the moment Marge was told the mammogram showed a mass, which was probably breast cancer. “But, don’t worry, the tumor is very small and with surgery and radiation, you will be fine.” 1:55pm…

1:55pm Wednesday, March 25, 2009: This was the moment Marge was told that the breast cancer had spread to her ribs. “But, don’t worry, the tumors are small, and with hormones, you …

Physician voices

Why are doctors the worst patients?

Natalie Azar, MD

December 31, 2013Dec 31, 20132

We’ve all been there. You’re in medical school, sitting in a lecture hall -- maybe the course is pathology -- and for the first time since starting your studies, you’re actually learning about real diseases, not just benzene rings and…

We’ve all been there. You’re in medical school, sitting in a lecture hall — maybe the course is pathology — and for the first time since starting your studies, you’re actually learning about real diseases, not just benzene rings and the Krebs cycle. You’re furiously note-taking, and you reach back to work out a kink in your neck. There it is! A palpable, enlarged lymph node. You have lymphoma. You …

Read more…

Why are doctors the worst patients?

Physician voices

The desire to have a baby in the face of metastatic cancer

Don S. Dizon, MD

December 30, 2013Dec 30, 2013

She came to see me, alongside her husband. She was 26-years-old, diagnosed with metastatic myeloma involving her bones, which had presented when she fractured her hip while jogging. Her disease had progressed on treatment and she was to start a clinical trial. Despite being pale, she looked well. I imagined she often heard, “Wow — you look too good to have …

Physician voices

Sometimes we give pain instead of hope

James C. Salwitz, MD

December 25, 2013Dec 25, 20137

One of the most satisfying sports is to make ourselves feel better by degrading another. What better way to make up for our own inadequacy, then to shove someone else’s face in theirs? We see this at work, in our families, in politics and in almost every type of social interaction. Nonetheless, it is particularly painful and tragic when we project our own fear and frailty onto someone that is …

Read more…

Sometimes we give pain instead of hope

Oncology and hematology

Articles, page 60

Real physician voices, twice a week

The Podcast

Latest episodes

Most popular

The Podcast

Latest episodes

Most popular