Cancer patients depend on denial.  Without its protection, we would be overwhelmed by terror.  Denial filters and slows bad news, so we can digest reality in the merciful morsels; thus, we cope.  Without denial, we would shut down, withdraw, and lose hope; healing would not be possible.  However, if we do not move beyond denial, accept the diagnosis and loss, make a plan, we die. Allen, a 43-year-old man, came to ...

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The high cost of health care in the United States in part relates to how clinicians are paid. Performing expensive and often risky procedures simply pays better than engaging patients in a shared decision-making conversation. Shared decision-making (SDM) is a process where clinicians and patients educate each other about treatment options, risks and benefits, and preferences, and then they decide on the best approach together. Patient decision aids can assist ...

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“I had no idea how much cancer sucks.” My patient’s observation seems silly, basic.  Of course, cancer sucks.  It maims, humiliates and kills.  It takes.  What made the statement remarkable was its source.  This is not a medically naïve person, waiting to die. Rather it was spoken by a patient in complete remission, likely cured, who is an expert in cancer care.   To her amazement, it changed life forever. I think that ...

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The president's proposed Precision Medicine Initiative, as mentioned in his recent State of the Union address suggests it's probably time to get ready for some changes in our daily routines as health professionals. I'm not talking about the incredible information that has already been produced by researchers examining the human genome. Nor am I referring to the work that is going on in major cancer centers and elsewhere exploring how to better ...

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asco-logoMom. Dad. Happy. Sad. Friend. Trust. I remember playing this game. A friend would say one thing, and then I would say the first thing that came to my mind. For some reason, it would pass the time. I remember how some words would spark an emotion or a memory. Sometimes happy, sometimes not so happy. But, playing that game was one of ...

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Short-of-breath, weak, in pain.  Cancer -- aggressive, cold, unfair -- ravaged Roger’s body.  But maybe, just perhaps, there was a modern medical miracle.  A drug.  A single daily pill to attack the genetic growth switch in each malignant cell.  Only, there was a problem.  Not a big problem, really, but possibly fatal.  The kind of real life annoyance of living in a modern medical miracle society.  The co-pay cost to ...

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As survival rates for pediatric cancer continue to improve, more and more pediatric practices include children who have been treated for cancer. Some patients are making the transition back to primary care after finishing their cancer treatment. Others are only a few years post-treatment and still being closely monitored for recurrence. Still others have survived five years or more and are considered cured. Whatever their circumstances, these patients can present ...

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medpagetodayFrom MedPage Today:

  1. Predicting Death in Advanced Cancer. Late-occurring signs of declining neurocognitive function proved to be highly specific and highly likely markers of impending death in patients with advanced-stage cancer.
  2. JAK-3 Drug Effective in RA, but Safe? The oral selective JAK-3 inhibitor decernotinib was associated with significant improvements in symptom relief ...

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medpagetodayFrom MedPage Today:

  1. Medicare Lung Ca Screening Gets Down to Business. The final tweaks to Medicare plans to reimburse annual low-dose CT scans for lung cancer screening satisfied many as a good place to start, with an eye toward further refinements.
  2. New Criteria Would Double Fibromyalgia Cases. Applying the proposed 2010 modified ...

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In medicine, the seemingly simple questions become the complex ones. “How’s it going?” It is a question that is frequently asked whenever we encounter friends and acquaintances. In a given day, we ask this question many times out of courtesy and we expect to hear short, affirmative answers, such as “Things are good,” or “It’s OK” as we continue to walk to where we need to go since we are pressed for ...

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