In 2010, I lost my mother to cancer.  She was a fighter and had survived well past her prognosis, but her hospital costs outlived her. Let me go back to late 2004. That was the year the doctors suspected she had cancer. My mother, who was not a smoker, was officially diagnosed with non-small cell lung cancer early on in 2005. When the biopsy confirmed that the small lesion in the ...

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I have been blogging and tweeting about ADHD a lot lately because I believe that change is in the air. This is the worst of times for ADHD diagnosis because statistics show it is wildly overdiagnosed and overtreated. This is possibly the best of times for ADHD diagnosis because I think we have reached the tipping point and feel hopeful that the ADHD fad will soon begin to fade. We humans are ...

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He was a 24-year-old African American man with no history of medical or eye problems.   On an ordinary Thursday evening at 8 p.m., he arrived into the emergency department complaining of a sudden loss of vision in both eyes. “He couldn’t see a thing on our chart.  Vitals are fine, pupils are equal and reactive, and the rest of the neuro exam is unremarkable,” the emergency room attending briefly explained.  “Can ...

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Cardiovascular disease still remains the number one cause of death in women.  Heart attacks account for 24% and strokes 7% of all deaths.  Among minority women, these numbers are even higher.  The challenge remains that doctors traditionally have not identified women at high risk of stroke.  Internists and cardiologists do not routinely think of stroke prevention in women, and neurologists have been busy treating stroke victims and have had no ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 32-year-old woman is evaluated for a 6-month history of nonproductive cough. She has no history of recurrent upper respiratory tract infections and has never smoked cigarettes. She has no fever, dyspnea on exertion, hemoptysis, heartburn, or wheezing. She has worked in the same office for 7 years and has lived in ...

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Address the racial disparity of colorectal cancerAn article published recently in the American Cancer Society journal CA: A Journal for Clinicians received a lot of media attention. The report showed dramatic declines in the rate of people being diagnosed with colorectal cancer, as well as decreases in the rates of colorectal cancer deaths over the past number of years. But the press didn't say much about the fact that not everyone ...

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The headline reads, "Study: Mental illness rate higher in soldiers." The article goes on to offer alarming statistics:

The rate of major depression is five times as high among soldiers as civilians; intermittent explosive disorder, which results in episodes of extreme anger, is six times as high; and post-traumatic stress disorder was nearly 15 times higher than among civilians, the study found.
This would be pretty scary if true -- but ...

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I've had many Twitter conversations with cancer screening advocates who fear that the U.S. Preventive Services Task Force's "D" (don't do it) recommendation against PSA-based screening for prostate cancer will lead to a dramatic spike in prostate cancer deaths as primary care physicians screen more selectively, or perhaps stop screening at all. I seriously doubt these apocalyptic forecasts (for one thing, prostate cancer causes only 3% of deaths in men, and ...

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The incidence of esophageal adenocarcinoma has increased more than five-fold over the past four decades in the U.S. While the rate of rise in incidence of esophageal cancer has slowed somewhat in recent years, this malignancy is still associated with a dismal prognosis. Barrett’s esophagus, the precursor lesion to esophageal cancer, is easily identifiable on routine upper endoscopy and can be monitored for the development of precancerous changes. We generally ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 51-year-old woman is evaluated for a 6-month history of diarrhea and bloating. She reports four to six loose stools per day, with occasional nocturnal stools. She has had a few episodes of incontinence secondary to urgency. She has not had melena or hematochezia but notes an occasional oily appearance to the ...

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