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 effective is CA 125 and other biomarkers to screen for ovarian cancer?

Conditions and Diseases
January 7, 2010

Originally published in MedPage Today

by Michael Smith, MedPage Today North American Correspondent

Rising blood levels of several biomarkers show the presence of ovarian cancer — just not early enough.

That’s the conclusion of a retrospective longitudinal case-control study of levels of half a dozen proteins linked to the disease, according to Garnet Anderson, PhD, of the Fred Hutchinson Cancer Research Center in …

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How effective is CA 125 and other biomarkers to screen for ovarian cancer?

How can medical guidelines be immune from politics?

Conditions and Diseases
January 4, 2010

The recent uproar over the new screening mammography recommendations got me thinking about a lot of stuff. One of the lessons cited by some journalists and pundits is on how potentially volatile information should be presented to the public. The USPSTF was excoriated by critics not only for what it said, but how it said it. While the objections over the former can be dismissed as ravings of loud and …

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How can medical guidelines be immune from politics?

Why are women refusing an MRI to screen for breast cancer?

Conditions and Diseases
December 30, 2009

Originally published in MedPage Today

by Crystal Phend, MedPage Today Senior Staff Writer

Many women at elevated breast cancer risk may refuse MRI as part of their screening program, largely because of fear and inconvenience, researchers found.

Among eligible women with dense breasts who were at intermediate to high risk for breast cancer, 42.1% refused additional MRI screening as part of a …

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Why are women refusing an MRI to screen for breast cancer?

How to find the best cancer specialist for you

Conditions and Diseases
December 29, 2009

by Dana Griffen

Receiving a cancer diagnosis is an upsetting experience for the patient, as well as his or her family and friends. Cancer patients are thrust into a new world with new language and new rules. Knowing where to turn and who you can trust is a huge concern.

One of the first things a cancer patient will discover is that he or she will not be treated by only one …

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How to find the best cancer specialist for you

What women should know about the new mammogram guidelines

Conditions and Diseases
December 17, 2009

Whenever I order a mammogram for a woman in her 40’s, I also give her a warning: “Don’t get scared if it’s abnormal.” I tell her this because research shows that a woman who undergoes 10 routine screening mammograms has a 50-50 chance of having something unusual that requires her to go for more tests. The vast majority of these mammographic abnormalities aren’t cancer, but she still needs to get …

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What women should know about the new mammogram guidelines

Explaining basic radiation therapy terms to cancer patients

Conditions and Diseases
December 17, 2009

Originally posted in HCPLive.com

by Colleen O’Leary, RN, MSN, AOCNS

I have always been very intrigued by the various forms of radiation therapy and used to relish the day that I would take my basic oncology class to the radiation oncology department for a tour. I learned something every time. But now, with the advent of new technology and the trend for facilities to advertise that they have the biggest and best …

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Explaining basic radiation therapy terms to cancer patients

Why the fear of cancer undermines the new mammography guidelines

Conditions and Diseases
December 8, 2009

Fear is such a powerful emotion, humans will do almost anything to relieve it. The most effective way to control fear is to manage whatever it is we’re afraid of. Night lights against the monsters under the bed; locks on the doors and a handgun under the pillow to fend off intruders; annual mammograms and PSAs to keep us from dying of cancer. Although all these things may relieve fear …

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Why the fear of cancer undermines the new mammography guidelines

Radiologists don’t agree with the USPSTF breast cancer mammogram screening guidelines

Conditions and Diseases
December 7, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Radiologists have rejected revised mammography guidelines from the U.S. Preventive Services Task Force (USPSTF), arguing that they are not backed by scientific evidence and will lead to unnecessary deaths.

Under the revised guidelines, “screening will begin too late and its effects will be too little,” said Stephen A. Feig, MD, of …

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Radiologists don’t agree with the USPSTF breast cancer mammogram screening guidelines

Do chest x-rays and mammograms increase the risk of breast cancer in young women?

Conditions and Diseases
December 5, 2009

Originally published in MedPage Today

by Kristina Fiore, MedPage Today Staff Writer

Some women already at high risk of breast cancer should be cautious about having mammography or chest x-rays before the age of 30 because the imaging may increase the risk of developing the disease, researchers here said.

Five or more x-rays, or any exposure to ionizing radiation before age 20, …

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Do chest x-rays and mammograms increase the risk of breast cancer in young women?

An oncologist takes on the recent breast and cervical cancer screening controversy

Conditions and Diseases
December 4, 2009

Recently, two groups released new guidelines that may affect breast cancer and cervical screening in women.

The US Preventive Services Task Force (USPSTF) recommended against screening women in their 40s and to screen women every other year starting at age 50. The USPSTF left room for individualized screening, particularly in the presence of risk factors such as family history. Still, it is …

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An oncologist takes on the recent breast and cervical cancer screening controversy

ACP: Teasing out science, politics, and emotion about the mammography guidelines

Conditions and Diseases
December 1, 2009

The following is part of a series of original guest columns by the American College of Physicians.

by Steven Weinberger, MD, FACP

It is difficult to find a medical guideline that has garnered so much press and controversy as the recent recommendations about breast cancer screening developed by the U.S. Preventive Services Task Force (USPSTF) and published in Annals …

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ACP: Teasing out science, politics, and emotion about the mammography guidelines

How the mammogram and Pap smear debates ignore the uninsured

Conditions and Diseases
November 24, 2009

by Jeoffry B.Gordon, MD, MPH

The recent recommendation of the US Preventive Services Task Force against routine screening mammograms for healthy, low risk women under the age of fifty has demonstrated our broad consensus about the value of breast cancer screening. The discussions about new guidance from the American Academy of Obstetrics and Gynecology on when to start and how often to do PAP smears illuminate the impact, effectiveness and support …

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How the mammogram and Pap smear debates ignore the uninsured

The health reform politics of mammograms and breast cancer screening

Conditions and Diseases
November 24, 2009

Originally published in MedPage Today

by Emily P. Walker, MedPage Today Washington Correspondent

The emotional debate over a federal panel’s proposal to end routine mammograms for women in their 40s has reignited controversy over a contentious healthcare reform issue: comparative effectiveness research.

Healthcare reform opponents say the new mammogram guidelines by the U.S. Preventive Services Task Force (USPSTF) make their point: If …

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The health reform politics of mammograms and breast cancer screening

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Informed consent is missing from Pap smears and cervical cancer screening

Conditions and Diseases
November 23, 2009

The American College of Obstetrics and Gynecology (ACOG) has just revised their guidelines for Pap smears under some pressure. This resulted from an Annals of Internal Medicine article which documented that only 16.4% of gynecologists followed the College’s prior guidelines. Most did more screenings than indicated, the worst record of the specialties tested. But the ACOG still recommends that nearly all women obtain regular screening at intervals of 1-3 years.

The …

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Informed consent is missing from Pap smears and cervical cancer screening

When women should have their first Pap smear; the new cervical cancer screening guidelines

Conditions and Diseases
November 20, 2009

Originally published in MedPage Today

by Charles Bankhead, MedPage Today Staff Writer

Women can wait longer for their first Pap smear and then repeat the test less frequently, according to recommendations from the American College of Obstetricians and Gynecologists (ACOG).

The organization now says women should begin cervical cancer screening with a Pap test at age 21. Subsequent tests should occur at …

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When women should have their first Pap smear; the new cervical cancer screening guidelines

Can less aggressive cancer screening recommendations be better for patients?

Conditions and Diseases
November 19, 2009

Doctors have understood for some time that it was inevitable. The American Cancer Society has acknowledged that cancer screening has been oversold.

It seems like every day you read in the newspaper that what was standard medical care yesterday is now no longer recommended. Don’t doctors know anything? Well, actually they do. And what seems like paradoxical behavior, no longer recommending aggressive screening for certain cancers, actually represents a more sophisticated …

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Can less aggressive cancer screening recommendations be better for patients?

Why health reformers should be worried about the breast cancer screening backlash

Conditions and Diseases
November 19, 2009

What if a non-partisan, authoritative entity wrote a robust, evidence-based guideline, but nobody followed it?

That is precisely what’s happening with the USPSTF’s recent revision of their breast cancer screening recommendations. The change most find problematic is their recommendation that women younger than 50 not undergo any breast cancer screening, such as with a mammogram.

Here are their reasons explaining why:

The harms resulting from screening for breast cancer include psychological harms, …

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Why health reformers should be worried about the breast cancer screening backlash

Are doctors getting enough skin cancer exam training?

Conditions and Diseases
October 30, 2009

Originally published in MedPage Today

by Nancy Walsh, MedPage Today Contributing Writer

Opportunities to learn how to perform skin cancer examinations during medical training are inadequate, a survey of residents found.

More than half (55.3%) of residents said that they had never observed a skin cancer examination, 75.8% said they’d never been taught to perform one, and 57.4% had never practiced doing …

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Are doctors getting enough skin cancer exam training?

Does robotic surgery for prostate cancer help patients?

Conditions and Diseases
October 19, 2009

Originally published in MedPage Today

by Peggy Peck, MedPage Today Executive Editor

Men who opt for minimally invasive prostate surgery — often with a helping hand from a robot — are twice as likely to have genitourinary complications as men who have a traditional prostatectomy.

That finding is especially troubling because the use of robotic-assisted minimally invasive prostatectomy has increased exponentially in …

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Does robotic surgery for prostate cancer help patients?

Not all doctors discuss the risks and benefits of prostate cancer screening to patients

Conditions and Diseases
October 2, 2009

Originally published in MedPage Today

by Todd Neale, MedPage Today Staff Writer

Men might not be getting the information they need to make an educated decision about prostate cancer screening, two new studies suggest.

medpage-today Among 375 men surveyed by telephone, only 69.9% had discussed a prostate-specific antigen (PSA) test with their physician before making a decision about screening, according to the …

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Not all doctors discuss the risks and benefits of prostate cancer screening to patients

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