The concept of “personalized medicine” gets thrown around a lot these days. And as an oncologist and a palliative care doctor, who advocates for using data to get information that can provide more personalized cancer care, I believe strongly in it. But what would truly personalized oncology look like? More than 14 million people are living with cancer in the United States, according to the National ...

Read more...

asco-logoEvery so often I see a patient who views cancer as a constant threat to be handled. The cancer becomes so significant that she feels she can never let her guard down. I always worry about this -- partly because that singular focus on fighting cancer can sometimes detract one from other aspects of life, and those facets that give ...

Read more...

The ink hadn't yet dried on the report of the 2015 Dietary Guidelines Advisory Committee before the assaults began. I guess in this day and age, that's not much of a big, fat surprise. Despite all the over-heated rhetoric I've seen about not trusting this report because the "government" can't be trusted, this report is not from the government. While we may, indeed, need to worry about what the political authorities ...

Read more...

A 75-year-old woman with progressive constipation. An 82-year-old man with unexplained anemia. A 39-year-old mother of two with intermittent blood in her stool. These are three of my patients. And sadly, they are three of nearly 150,000 Americans diagnosed with colorectal cancer every year. March is National Colorectal Cancer Awareness Month for good reason. In the United States, colorectal cancer is the third most commonly diagnosed cancer. It is also the ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 21-year-old male student is evaluated for a murmur heard during an athletic preparticipation physical examination. He is asymptomatic. His medical and family history is unremarkable and he takes no medications. On physical examination, the patient is afebrile, blood pressure is 118/76 mm Hg, pulse rate is 68/min, and respiration rate is 14/min. ...

Read more...

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 60-year-old man is evaluated as a new patient. He was diagnosed with type 2 diabetes mellitus during a health insurance evaluation 6 months ago. At that time, metformin was initiated. Medical history is otherwise unremarkable. On physical examination, blood pressure is 145/94 mm Hg; other vital signs are normal. BMI is 29. ...

Read more...

My last patient, Joyce, a 45-year-old single mother of four with high blood pressure and diabetes, is late. She was in the emergency department last week with dizziness and blurred vision, a blood sugar of 345 and a blood pressure of 190/110. Her last office visit was a month ago, when weighing in at 222, she joked that she wished she could pull those numbers at the casino’s slot machines. She ...

Read more...

The medical condition provocatively called exploding head syndrome, or EHS, brings back the disturbingly graphic images of the 1981 sci-fi horror flick Scanners where the main character blew up people’s heads with the power of telekinesis. Fortunately, as ominous as exploding head syndrome sounds, no skulls have actually exploded, and the condition is reassuringly non-life threatening. For the people who experience the symptoms of EHS, however, the ordeal can be ...

Read more...

I read with interest the recent article written by Dr. Rourke Stay, "What ESPN doesn’t tell you about MRI in professional athletes,” and couldn't agree more.  The bigger issue, however, is what ESPN may leave out of broadcasts about sports injuries.  Prominent figures on the air often espouse their knowledge with enough charisma to convince even the most doubting fan that their opinion is more than just an armchair ...

Read more...

Over 100 million Americans suffer from chronic pain such as spinal disorders (lower back pain, disc disease, pinched nerves and neck pain), complex regional pain syndrome, fibromyalgia and headaches. The cost of chronic pain in human suffering, lost worker productivity and in health care dollars is counted in the billions. Yet despite newer, expensive and invasive treatments like spinal fusions and disc surgery, spinal cord stimulators, steroid and painkiller injections, nerve  "burning" and ...

Read more...