Oncology and Hematology

Physicians writing on KevinMD about cancer: the screening argument that has run since 2009, how a diagnosis is delivered, what treatment costs patients, life after treatment, and what the work does to oncologists. Four maintained records draw on this archive: Cancer: what physicians say, in their own words, End of life: what physicians say, in their own words, Prior authorization: what physicians say, in their own words, and Opioids: what physicians and pain patients say, in their own words.

How to strengthen the partnership with your medical team

Andrew Griffith

Patient

October 20, 2012

Most of us have find it challenging to make sense of the wave of information when we enter our cancer journey. This is foreign territory, with its own language, culture and routines. It takes time to absorb and understand.

We are not oncologists or hematologists. However, we can learn to improve our discussion with our medical team.

Build your knowledge. By the time you start your treatment, you will likely have searched the …

Why doctors should care about fracking

Deep Ramachandran, MD

Physician

October 20, 2012

Let’s all agree on two things.

First, that energy independence is good for our country. Second that clean drinking water is also good for the country.

The development of America’s huge stores of natural gas, have given us a remarkable opportunity to accomplish the former. In particular, the process of “fracking” has made it possible to increasingly tap those huge natural gas stores. Natural gas sits in rock formations, but releasing it …

Read more…

Why doctors should care about fracking

I’m sorry I was your last memory before dying

Jordan Grumet, MD

Physician

October 18, 2012

I’m sorry.

I really am. No one deserves breast cancer. Especially the kind that spreads to your liver, lungs and brain. The fact that you lived to your eighth decade doesn’t detract from the sadness. You deserve to live. I can’t blame you for not being ready to go.

I apologize that our meeting was so abrupt. I was consulted to see you in the nursing home to address various issues. I …

I’m paying my patients cash to quit smoking

W. Ryan Neuhofel, DO, MPH

Physician

October 16, 2012

I am starting a prize-linked smoking cessation program for my medical practice. Like most family docs, I constantly remind my smokers about the risks of tobacco and my ability to help them quit when ready. And like most physicians I probably have a false belief that pestering “enough” will spur action. As an unofficial student of economics and official student of public health (MPH), I should know better.

Sure, I have …

Plan your return home after a long hospital stay

Andrew Griffith

Patient

October 15, 2012

Just as preparing for a lengthy hospital stay requires planning, so does returning to home after the hospital. While your condition and strength will shape the best approach for you, my experience following my stem cell transplants may be helpful should you find yourself in this situation.

Before you leave get the information you need. Most hospitals are pretty good in providing written information sheets on follow-up care, related instructions, and …

What to expect during your first mammogram

Therese B. Bevers, MD

Conditions and Diseases

October 14, 2012

Getting your first mammogram can be stressful. After all, it’s your first one, so you don’t know exactly what to expect.

Rest assured: even women getting their second or third mammogram may have concerns.

But by learning how to prepare for and what to expect from this important cancer screening exam, you can eliminate some of the guesswork. And, that can make your experience less nerve-wracking.

Here’s what you should know.

Mammograms save lives

Don’t …

Chuck Pagano has leukemia: An oncologist discusses his prognosis

John Salter, MD

Conditions and Diseases

October 10, 2012

I’ve been getting a lot of questions about Indianapolis Colts’ Head Coach Chuck Pagano lately, so I thought I would dedicate a blog entry to discussing his disease and prognosis.

Coach Pagano was recently diagnosed with acute myeloid leukemia (AML), a form of blood cancer that typically carries a rather grim long-term prognosis in adults. While early reports were quite sketchy on the details of Pagano’s presenting symptoms, it seems that …

Why Lance Armstrong will always be a hero

J. Leonard Lichtenfeld, MD

Physician

October 9, 2012

Like many of you, I have been reading the various news stories about Lance Armstrong, especially one recently in a major newspaper, which went into great detail about the allegations surrounding Lance Armstrong’s cycling career.

But what I didn’t see in all of that coverage was much mention of the other side of the man, the side that I …

Doctors are notoriously awful about dealing with death and dying

Miranda Fielding, MD

Physician

October 1, 2012

Some things are just so damned hard to write about. People often ask me, “Why do you have so many animals?” The current count is 4 dogs, two horses and a cat. I used to say, “Because it’s good for my children to learn responsibility. Having a dog, whose life is so much shorter than our own, teaches them about love, and about death. They get to practice parenthood, before …

Policy experts need to lead by storytelling

Kenneth Lin, MD

Physician

September 26, 2012

Public health leaders must often tell people things that they don’t really want to hear. “Stop smoking.” “Eat a healthier diet.” “Exercise for at least 30 minutes each day.” To motivate people to heed these messages, leaders construct simple narratives to communicate the potential harms of undesired health behaviors and the benefits of desired ones. Who wants to spend their golden years tethered to an oxygen tank for every moment …

How colonoscopies are like airline tickets

Michael Kirsch, MD

Physician

September 24, 2012

One would think that a physician who earns his living billing patients would be conversant with the prices of his services. Not this doctor. I am queried periodically by patients asking how much I charge for a colonoscopy.

Of course, every physician recognizes that this question is not phrased properly. It doesn’t matter what we charge; it’s what an insurance company determines we will be paid. I might believe that your …

When patients decide the best is not for them

James C. Salwitz, MD

Physician

September 24, 2012

I have been practicing medicine for 35 years and the great secret is that it just keeps getting better. No day goes by without an important learning moment, a unique observation or just the satisfaction of making a difference. Today I had one of those moments of revelation that will slightly change all days which follow.

Stan is a 57-year-old man with curable colon cancer who requires surgery. Unfortunately, that surgery …

Why do patients often deviate from their advance directives?

Jerome Groopman, MD and Pamela Hartzband, MD

Physician

September 24, 2012

One of the most difficult decisions that patients, families and physicians face involves end-of-life care. The advance directive or “living will” has become an accepted framework for patients to delineate their own preferences about what treatment they would or would not want when faced with a life-threatening disorder. But it was not always this way.

In the past, physicians and families often shielded those with potentially fatal illnesses from candid conversations …

5 ways to help make a cancer diagnosis more manageable

Andrew Griffith

Patient

September 22, 2012

Over the past few years, I have had more than my share of navigating my way through the emotional and practical aspects of my treatment for mantle cell lymphoma. While at the back of my mind the broader questions – why me?, how long will I live? – remain, once I got over the initial anger and depression after the initial diagnosis (and after my relapse), I found these practical …

Despite the best evidence, oncologists cannot dictate treatment

Don S. Dizon, MD

Physician

September 19, 2012

During Multidisciplinary Gynecologic Oncology Tumor Board at Massachusetts General Hospital, a case was presented of an older woman with stage IV ovarian cancer who was deemed inoperable. Following review, we recommended a course of chemotherapy.

I asked our fellow what treatment she would administer, and this sparked a discussion on how patients and providers create a treatment plan. We discussed options, …

CT scans for lung cancer screening: Look closely at the statistics

Kenneth Lin, MD

Conditions and Diseases

September 16, 2012

Enthusiasm for lung cancer screening has never been higher, following last year’s report from the National Lung Screening Trial (NLST) that heavy smokers who underwent 3 rounds of low-dose computed tomography (CT) screening were 20 percent less likely to die from lung cancer compared to a similar group that was screened with chest x-rays (a “placebo” intervention that another study found to be ineffective). My own institution, Georgetown University Hospital, was one of the …

When patients stray from the common sense approach to health care

James C. Salwitz, MD

Physician

September 12, 2012

It turns out that the practice of medicine is just common sense. If someone has fallen and their hip hurts, it is probably related. If someone does not have an infection, do not give an antibiotic. Exercise and good food are, well, good for you. If it is not broken, do not fix it.

Usually, patients understand this basic idea. The best chance of becoming and staying healthy is the simplest …

How to tell your friends and family that you have cancer

Andrew Griffith

Patient

September 11, 2012

One of the hardest things after a cancer diagnosis is telling others: family, friends and colleagues. I preferred to a more open approach for a number of reasons.

Keeping everything inside was harder, talking and writing was a form of release. People close to you need to know to help them support you. Letting people know avoids awkward questions, providing an invitation for support. Previous experience with others who did not share …

Lessons I’ve learned from a colon cancer patient

Allen Perkins, MD

Physician

September 7, 2012

I have been installed as President of the Alabama Academy of Family Physicians. The work should not be too hard and on occasion should be rewarding (or at least ego-boosting). Such was the case the other day when the executive director asked me to recall a patient from “my early days” that had made an impact so he could publish my thoughts, thus officially making me an old geezer. I …

Oncology and Hematology

Oncology and Hematology

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