My patient was sitting in a wheelchair. He was in his mid-forties, and before the cancer, had held a physically demanding job that he loved.  Now, the cancer in his spine had ended not only his ability to work, but any ability to use his legs. His wife was devoted to him in a way that seemed as natural and understated and unobtrusive as breathing. In order for me to examine him, she ...

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asco-logoThe couples I see for counseling are not always perfect, not that any couples ever are. But when cancer enters the relationship, for some couples, things get ugly and get ugly fast. I believe that we like to think that cancer makes people “better”; that people rise to the challenge and become the best they can be. I think that we ...

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"I like good strong words that mean something." - Louisa May Alcott My resident and I are removing a large, recurrent cancer from the neck. Dense scar tissue is everywhere from prior surgery and radiation therapy. The going is slow. Each move is arduous, and bleeding obscures the view of the anatomy. “Watch out,” I tell her. “The jugular vein is nearby, probably buried in that scar.” “Yeah,” she responds. “Look at this nerve! ...

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He could not stand Legs weak from the wasting effects of a cruel disease Stripping him of his manhood Denying him his future He could not eat His mouth cracked and dry Saliva having made an untimely exit from his personhood Unable to return again He could no longer dream He would say As I stared at him Longing to do more than hope that his pain patch Would lessen the pain of not just dying but of knowing one is dying. When ...

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I had an upsetting encounter the other day with a 22-year-old woman, who mentioned (secondary to the purpose of the visit) that she was pretty sure she had breast cancer. Why did she think that? She’d found a lump in her breast. (Somewhat unusually for the specific setting, she let me do a breast exam. All I felt was a small area of lumpy breast tissue, possibly a fibroadenoma at worst. Of course, ...

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asco-logo When I was a resident, my colleagues chided me for wanting to be an oncologist. Back then (and it pains me to be old enough to use that phrase, by the way), oncology was thought of as a field of futility. We administered toxic drugs to patients with cancer, and far more often than not, they ...

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For many physicians, the term “compassion fatigue” may imply, as the words describe, that fatigue leads to the loss of ability to feel compassion for others. After all, what physician doesn’t have a day when s/he is too tired, running on too little reserve, and feeling some degree of emotional numbness? Many physicians may not realize, however, that compassion fatigue can go much deeper.  According to the Compassion ...

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After years of declining rates of colorectal cancer (CRC), a study from the American Cancer Society raises the specter that not all is going as well as we would have hoped, especially among younger folks born since 1990. And that raises the question of what the future holds for this frequently preventable form of cancer, ...

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Two years ago, former President Barack Obama announced the Precision Medicine initiative in his State of the Union Address. The initiative aspired to a “new era of medicine” where disease treatments could be specifically tailored to each patient’s genetic code. This resonated soundly in cancer medicine. Patients can already manage their cancer with therapies that target the specific genes that are altered in their particular tumor. For ...

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After Michael Uvanni’s older brother, James, was diagnosed with a deadly form of skin cancer, it seemed as if everyone told the family what they wanted to hear: Have hope. You can beat this, and we are here to help. The brothers met with doctors at a half-dozen of the country’s best hospitals, all with impressive credentials that inspired confidence. Michael Uvanni was in awe when he visited the University of Texas ...

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