Oncology and hematology

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Articles, page 77

The computer had stopped the doctor from communicating

April 17, 2012Apr 17, 201220

There was no mistake, but a bad thing has happened. Despite the best efforts of the doctors, Bob’s wife is very sick. Due to a rare side effect of treatment, her liver is failing. Bob believes this could have been…

“When we go to see the doctor, he stares at the computer,” says Bob. “He does not look at us. Most of the time, the doctor …

Patient voices

What to say to a newly diagnosed cancer patient

Salli Camphouse

April 15, 2012Apr 15, 20123

“So, the doctor told me I have breast cancer. I just wanted to let you know. I’m doing fine right now, but I have some decisions to make regarding my treatment options. I’ll keep you posted.” This may be a…

“So, the doctor told me I have breast cancer. I just wanted to let you know. I’m doing fine right now, but I have some decisions to make regarding my treatment options. I’ll keep you posted.”

This may be a typical email sent to family and friends after receiving a breast cancer diagnosis. Sending emails seems more practical at this point. With so many friends and family to update, unless a …

Conditions and diseases

Have cancer screening tests been oversold?

Jessie Gruman, PhD

April 14, 2012Apr 14, 20122

Will we – you and me and our parents and neighbors – be a significant force in quelling the tide of over-testing for the early detection of disease? When you have had cancer as many times as I have, you…

Will we – you and me and our parents and neighbors – be a significant force in quelling the tide of over-testing for the early detection of disease?

When you have had cancer as many times as I have, you become suspicious that there are more cancer cells inside you waiting for some obscure signal to make them leap into action and start multiplying out of control. So you develop a …

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Physician voices

End stage colon cancer becomes even more tragic without hospice

Jim deMaine, MD

April 11, 2012Apr 11, 20125

Mike was a runner, outdoors-man, and fitness nut. This was not so much as for health reasons as for "feeling good", but he did hope that it would help him avoid illness. It was worrisome when he started with some…

Mike was a runner, outdoors-man, and fitness nut. This was not so much as for health reasons as for “feeling good”, but he did hope that it would help him avoid illness. It was worrisome when he started with some belly cramping and noticed some blood streaks in his stools. It took about a month until he could be scheduled for a colonoscopy. The news was shocking. “There’s a cancer …

Conditions and diseases

Lower your cancer risk and take a walk

J. Leonard Lichtenfeld, MD

April 8, 2012Apr 8, 20123

I have a confession to make. As soon as I finished reading the Annual Report to the Nation recently, I got up from my desk and took a walk for 20 minutes. What, might you ask, compelled me to do…

I have a confession to make.

As soon as I finished reading the Annual Report to the Nation recently, I got up from my desk and took a walk for 20 minutes.

What, might you ask, compelled me to do this?

The answer is what made me take a walk is the same reason I am writing this follow-up commentary. Sitting …

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Lower your cancer risk and take a walk

Medical education

Why do bad things happen to good people?

Jake McClure

April 4, 2012Apr 4, 20125

In my first week of the 3rd year surgery clerkship, I was introduced to some of the "Rules of Surgery." For example, "All bleeding stops eventually," or, "Everyone doesn't need to die with an incision," and even "The enemy of…

In my first week of the 3rd year surgery clerkship, I was introduced to some of the “Rules of Surgery.” For example, “All bleeding stops eventually,” or, “Everyone doesn’t need to die with an incision,” and even “The enemy of good is better.”

Boarded for this particular afternoon was a pancreaticoduodenectomy (the Whipple procedure), which for students is known to be a must-see operation if given the opportunity. However, the night …

Conditions and diseases

Cancer pain is often undertreated

Jennifer Kelly, MD, PhD

March 20, 2012Mar 20, 20123

Pain is the result of a physiological series of electrical and chemical events that occur in the body. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with actual or potential…

Pain is the result of a physiological series of electrical and chemical events that occur in the body. The International Association for the Study of Pain defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.”

Pain receptors are bare nerve endings that are widely distributed throughout the body in the skin and mucous membranes. When pain receptors are …

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Cancer pain is often undertreated

Conditions and diseases

Cancer screening stories need to report on the uncertainties

Gary Schwitzer

March 16, 2012Mar 16, 2012

A Miami Herald story, heralds “Prostate cancer hits younger men.” You know right away how this one is going to play out. The story begins by profiling a 48-year old man with prostate cancer. It says his “doctor ordered the…

A Miami Herald story, heralds “Prostate cancer hits younger men.” You know right away how this one is going to play out.

The story begins by profiling a 48-year old man with prostate cancer. It says his “doctor ordered the test as a routine practice for his male patients.” There isn’t any discussion about how such ordering as a routine practice doesn’t demonstrate the kind of shared decision-making model that the …

Physician voices

Doctors need to be better trained to deliver bad news

John Salter, MD

March 15, 2012Mar 15, 20125

Last week was tough. I had to refer several patients to hospice, and a few more received bad news regarding their disease. This has always been the toughest part of my job, but it’s also the part patients need me to handle best. I have to remind myself that no matter how hard it is for me to give bad news, the patient and their families are the ones receiving …

Conditions and diseases

A radiologist disagrees with the breast cancer screening guidelines

Stacey Vitiello, MD

March 14, 2012Mar 14, 201216

As a veteran of World War II, my grandfather was a GI Bill success story, the first man to go to college from his impoverished neighborhood in Jersey City thanks to government at its finest. A card-carrying member of the state teachers’ union, and a politically active Democrat for most of his life, it came as something of a shock to me when, after a few decades of observing big …

Conditions and diseases

ACP reminds physicians to assess risk, screen for colorectal cancer

American College of Physicians & Fred Ralston Jr., MD

March 14, 2012Mar 14, 2012

A guest column by the American College of Physicians, exclusive to KevinMD.com. Colorectal cancer is the second leading cause of cancer-related deaths for men and women in the United States. Although the effectiveness of colorectal cancer screening in reducing deaths…

A guest column by the American College of Physicians, exclusive to KevinMD.com.

Colorectal cancer is the second leading cause of cancer-related deaths for men and women in the United States. Although the effectiveness of colorectal cancer screening in reducing deaths is supported by the available evidence, only about 60 percent of American adults aged 50 and older get screened.

A new colorectal cancer screening guidance statement from the American College …

Conditions and diseases

MKSAP: 45-year-old man with a mediastinal germ cell tumor

mksap

March 10, 2012Mar 10, 2012

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. Seven years ago, a 45-year-old man was diagnosed with a biopsy-proven mediastinal germ cell tumor. The patient was treated with combination chemotherapy (bleomycin, etoposide,…

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

Seven years ago, a 45-year-old man was diagnosed with a biopsy-proven mediastinal germ cell tumor. The patient was treated with combination chemotherapy (bleomycin, etoposide, and cisplatin) and had a complete radiographic response. He has been disease-free since completing therapy, and follow-up serum tumor marker measurements, chest …

Conditions and diseases

When words are worthless in the cancer clinic

Robin Schoenthaler, MD

March 7, 2012Mar 7, 20126

I met Burt the Monday before Labor Day. As I walked into the room, he stood up--a sturdy, fifty-three-year-old guy with a direct, sky-blue gaze. Although he was a little etched around the eyes, he mostly looked the picture of…

I met Burt the Monday before Labor Day. As I walked into the room, he stood up–a sturdy, fifty-three-year-old guy with a direct, sky-blue gaze. Although he was a little etched around the eyes, he mostly looked the picture of health.

Two years before, he’d had a cancer. It was treated and thought to be gone. But for several weeks now, he’d been having excruciating low-back pain; he rated it a …

Physician voices

When it comes to cancer, do not just focus on survival

Jennifer Kelly, MD, PhD

March 5, 2012Mar 5, 20129

After my recent blog posts, I was inundated with questions regarding how I would change the way I interact with my cancer patients if I return to work. I’ve tried to chronicle my experiences – from diagnosis to death –…

Diagnosis

There was an undeniable shock that disrupted all of the carefully-constructed systems and routines with …

Patient voices

To survive with cancer, you need to accept that you are going to die

James C. Salwitz, MD

March 3, 2012Mar 3, 201220

To have cancer is to change forever. It is a devastating declaration. Each of us copes with the diagnosis differently. How people adjust and move on with their lives are lessons in humanity. I take care of a patient who…

To have cancer is to change forever. It is a devastating declaration. Each of us copes with the diagnosis differently. How people adjust and move on with their lives are lessons in humanity.

I take care of a patient who explained to me how he deals with incurable cancer. Stan is active and able to enjoy grandchildren, friends and hobbies. He describes himself as happy, despite his terminal diagnosis. The key …

Conditions and diseases

How cancer can strengthen your relationship

Jennifer Kelly, MD, PhD

February 29, 2012Feb 29, 20123

When one partner has cancer, both partners are affected, as is their relationship. Although cancer is a health crisis that can wreak havoc on any relationship, many marriages survive, and even flourish, after cancer. Approaching cancer as “our problem” and finding opportunities to continue to connect as a couple can help to minimize both partners’ emotional distress. It is possible to fight the battle against cancer together and to strengthen …

Physician voices

The analogy between baseball hierarchy and medical systems

Michael Fisch, MD, MPH

February 22, 2012Feb 22, 2012

From age six through high school, I played baseball. Playing baseball ended, rather abruptly it seemed, when I went to college, but the lure of the game has always remained. To my colleagues, it must seem that I can hardly understand the world without the comfort of baseball analogies. I was thrilled when my son Ryan, age 12, saw the …

Health policy

Reading between the lines of breast cancer treatment studies

Clayton Christensen & Vineeta Vijayaraghavan

February 20, 2012Feb 20, 20122

Between the Susan G. Komen-Planned Parenthood debate and the study on treatments released by the Journal of the American Medical Association recently, breast cancer has certainly gotten a lot of play in the media as of late. Every major news…

Between the Susan G. Komen-Planned Parenthood debate and the study on treatments released by the Journal of the American Medical Association recently, breast cancer has certainly gotten a lot of play in the media as of late.

Every major news outlet in America covered the breast cancer study released by JAMA which said that nearly half of the women who had second surgeries for breast cancer may not have needed the …

Physician voices

A diagnosis of stomach cancer profoundly changes an oncologist

Jennifer Kelly, MD, PhD

February 19, 2012Feb 19, 201211

I was jogging one day while on a business trip in LA and collapsed during the run. Within hours, I was at the hospital at UCLA Medical Center on a gurney headed for a CT scan of my abdominal cavity. I remember telling the ER physicians that I was a doctor and recommending my own course of action. As my advice to the ER doctors went largely ignored, I realized, …

Patient voices

In love there is a life giving force

James C. Salwitz, MD

February 14, 2012Feb 14, 20126

Here is a toast to the miracle of love. Not to the romantic, chocolate, dance club nightlife type of love. Not warm sandy beach vacation, new bigger home and grand Thanksgiving dinner love. Not even baby’s first words love. I…

Edna and Ken are 90, married and both have active cancer. They have been partners for 62 years. …

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In love there is a life giving force

Oncology and hematology

Articles, page 77

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