Oncology and hematology

2,498 articles · Since 2004

Articles, page 62

Thermography for breast cancer screening: Where is the evidence?

November 1, 2013Nov 1, 2013

Thermography uses heat sensitive infrared cameras to image the body and measure heat emission. Solid tumors, even when they are tiny, have an increased blood flow and inflammation compared with non-cancerous tissue. Theoretically this could lead to a thermal gradient…

Thermography uses heat sensitive infrared cameras to image the body and measure heat emission.

Solid tumors, even when they are tiny, have an increased blood flow and inflammation compared with non-cancerous tissue. Theoretically this could lead to a thermal gradient between a cancer and the surrounding non-cancerous tissues. Some animal studies indicate that thermography might detect heat differences between inflamed and non inflamed tissue and so it was postulated (initially back …

Conditions and diseases

The remarkable resiliency of the human body

David Gelber, MD

November 1, 2013Nov 1, 20133

Kerry was only 28-years-old. He showed up in the ER one night complaining of upper abdominal pain which started suddenly that day. The emergency physician did the usual workup and found two things which led to an urgent call: a…

The large mass was not necessarily an emergency, but free air, that is, air outside its usual place inside the bowel, almost always represents …

Physician voices

How to realize the promise of personalized medicine

J. Leonard Lichtenfeld, MD

October 29, 2013Oct 29, 2013

I attended a meeting recently that got me to thinking about the fact that as we revolutionize cancer research and treatment, we are also going to have to revolutionize cancer care. And that may prove to be an even more…

The meeting was sponsored by a collaboration called ” …

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Patient voices

When a patient teaches you to tango

Roni Zeiger, MD

October 28, 2013Oct 28, 2013

Patients continue to teach me new things about medicine and a woman named Bonnie has been one of my best teachers yet. I met Bonnie last month in an online community where she was sharing with other ovarian cancer patients…

While explaining that this is of course an intensely personal decision, she wanted her community to understand this option, which we physicians are often …

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When a patient teaches you to tango

Physician voices

When treating male patients, watch the wife

James C. Salwitz, MD

October 22, 2013Oct 22, 201310

After you finish medical school classes, the night before graduation, they take you to a dark, quiet room. There, among leather bound tomes 300 years old, diseased skeleton trophies swinging behind glass, as you sip 50-year-old port in ancient crystal,…

This is the wisdom passed not in lectures, rounds or at the operating table; it is the hallowed legacy of thousands of healers over the millennia; …

Physician voices

Climate change and cancer screening: Leave causation to the experts

Peter Ubel, MD

October 9, 2013Oct 9, 2013

In the wake of the horrific floods that struck Colorado recently, many people have debated whether global warming is to blame. The same goes for wildfires that hit that state this summer and for the massive tornado that struck in Oklahoma this spring. In the wake of that tornado, for instance, Senator Sheldon Whitehouse from Rhode Island claimed that Republican opposition to climate change legislation was at fault, for trying …

Physician voices

Life for patients and their families is so much more than data

James C. Salwitz, MD

October 8, 2013Oct 8, 20132

One of the first things I teach medical students is to be aware that they have arrived in a bizarre land. The strange things they see, the disturbed experiences they have, the weird stories they hear, are like noting else in life. I advise students to stay in touch with their feelings, to note what shocks, frightens, or embarrasses them. Remember those emotions now, because as doctors learn their craft …

Physician voices

Communicating with patients with serious or terminal cancers

Michelle Brandt

October 5, 2013Oct 5, 2013

Earlier this month, a candid and powerful personal essay was published by Jessica Rice, a thirtysomething woman with terminal cancer. An emerging theme of Jessica’s piece was the importance of frank conversation between physician and patient, and I was curious what a provider — someone who has difficult conversations on an almost daily basis — would think of this patient’s story and perspective.

Thoracic oncologist Kavitha Jennifer Ramchandran, MD, read the piece …

Conditions and diseases

MKSAP: 56-year-old woman with Sjögren syndrome

mksap

October 5, 2013Oct 5, 2013

A 56-year-old woman is evaluated during a follow-up visit for a 6-year history of Sjögren syndrome treated with low-dose hydroxychloroquine and cyclosporine eyedrops. She has had two episodes of cutaneous vasculitis, which resolved with corticosteroids. On physical examination, temperature is…

On physical examination, temperature is 36.4 °C (97.6 °F), blood pressure is 116/64 mm Hg, pulse rate is 72/min, and respiration rate is 18/min. Oral mucous membranes are dry. There is a new firm, left parotid …

Physician voices

There can be hope at the end of life

Don S. Dizon, MD

October 4, 2013Oct 4, 20139

I remember when Susan*, a close friend of mine with breast cancer (who had been living with metastatic disease for about a year before), was told she was terminal. Beyond the shock and fear, Susan felt grief and anguish that her life would end so much sooner than she (or any of us) had expected. Suddenly, Susan had so many big …

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There can be hope at the end of life

Conditions and diseases

Social support matters in cancer survival

Suzanne Koven, MD

October 2, 2013Oct 2, 2013

A study by researchers at Brigham and Women's Hospital and Dana Farber Cancer Institute published in the Journal of Clinical Oncology confirms what primary care doctors already know: marriage is often, but not always, good for your health. The study…

A study by researchers at Brigham and Women’s Hospital and Dana Farber Cancer Institute published in the Journal of Clinical Oncology confirms what primary care doctors already know: marriage is often, but not always, good for your health. The study found that among more than a million people with common cancers such as colon, lung, breast and prostate, those who were married were more likely to be diagnosed early and stick …

Physician voices

Money driven care punishes both the rich and poor

James C. Salwitz, MD

October 1, 2013Oct 1, 20136

Recently I met the husband of a patient with a diagnosis of advanced lung cancer. Even though she was young and had been healthy, the disease spread to her bones. I outlined treatment for this incurable illness: choices, goals and side effects. This was a very tough meeting, because by the end we had to discuss time as measured by dollars.

The particular challenge was that this family had health insurance …

Patient voices

I’ve unintentionally made most of my doctors uncomfortable

Jessica Rice

September 27, 2013Sep 27, 20136

Since becoming ill, I’ve learned that I have the innate ability to make doctors very uncomfortable -- squirmy, even. It’s surprising because I had assumed medical professionals with decades of experience have fielded every possible question a patient might ask.…

Since becoming ill, I’ve learned that I have the innate ability to make doctors very uncomfortable — squirmy, even. It’s surprising because I had assumed medical professionals with decades of experience have fielded every possible question a patient might ask.

But I suppose I’m not a typical patient. In November 2011, I was diagnosed with stage IV lung cancer (bronchioloalveolar carcinoma, a subset of adenocarcinoma) with extensive spread to the mediastinal and …

Conditions and diseases

The catch behind free prostate cancer screening

Janice Boughton, MD

September 25, 2013Sep 25, 2013

I just got an email from a hospital where I sometimes practice with a picture of two aging but clearly active and vital men standing on a beach with the words "free prostate cancer screening" printed below in an attractive…

I just got an email from a hospital where I sometimes practice with a picture of two aging but clearly active and vital men standing on a beach with the words “free prostate cancer screening” printed below in an attractive font. The hospital is sponsoring the screening, along with the urology clinic affiliated with the hospital. The advertisement gives guidelines for who should avail themselves of this service, including men …

Patient voices

The side effects of cancer treatment can become permanent glitches

Jessie Gruman, PhD

September 24, 2013Sep 24, 20137

Sara was treated for multiple myeloma in the mid-90s and had a stem cell transplant seven years ago. When I asked her husband how she was doing, he said, “Pretty well … just the gift of a little edema in…

On one hand you think, “Hey! That’s great! Those little gifts — those side effects — are a small price to pay.”

On the …

Physician voices

Hospice also saves the doctor

James C. Salwitz, MD

September 23, 2013Sep 23, 2013

You are taking care of a patient with metastatic pancreatic cancer. The disease has spread, surgery is not an option and second line chemotherapy has failed. He is in pain, but is poorly compliant with narcotic directions. He keeps falling down the stairs. His wife cries all the time. The family is desperate for help. The patient is in the office with loved ones, looking for guidance.

“What do we do …

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Hospice also saves the doctor

Conditions and diseases

Why is cancer care failing?

Shirie Leng, MD

September 19, 2013Sep 19, 201316

The Institute of Medicine (IOM) recently released a report on the state of cancer care in the United States. The IOM generally knows what it’s talking about. It’s a non-profit, non-governmental advisory group essentially. To get on one of their advisory boards you have to be a national, if not international, expert in whatever field is being studied. According to the cancer advisory board, the state of cancer care in …

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Why is cancer care failing?

Physician voices

When a physician resorts to jargon, educating patients can fail

Peter Ubel, MD

September 18, 2013Sep 18, 201328

The urologist broke the news: "Out of 12 cores, three were positive for cancer, so you have a small amount of cancer." He would soon explain the treatment choices -- surgery, radiation, or active surveillance (watching the cancer closely with…

The urologist broke the news: “Out of 12 cores, three were positive for cancer, so you have a small amount of cancer.”

He would soon explain the treatment choices — surgery, radiation, or active surveillance (watching the cancer closely with blood tests and biopsies). He described each option in elaborate detail, because he knew that the “right choice” would depend on what his 70-year-old patient thought about the pros and cons …

Conditions and diseases

Mammograms in younger women: Is the data there?

Margaret Polaneczky, MD

September 17, 2013Sep 17, 2013

A recent study has concluded that women with breast cancer who failed to get annual mammograms are more likely to die from their disease than those who had annual mammograms, and argues that more frequent mammograms are warranted in women under age 40. Unfortunately, despite all the media attention this study is getting, I don’t think the researcher’s conclusions are supported by the study results.

The researchers did a retrospective medical record …

Physician voices

In the midst health care cynicism, an affirmation of enduring love

Miranda Fielding, MD

September 16, 2013Sep 16, 20139

When I was young, one of my favorite stories was O. Henry’s “The Gift of the Magi.” Originally published in 1905, the short story became standard fare in public school reading classes and I doubt that there are any of you out there who have not read it. But just in case — the story is about a young couple, poor and deeply in love. At Christmas, they have no …

Oncology and hematology

Articles, page 62

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