asco-logo Milly* was 82 years old and had been diagnosed with a recurrent ovarian stromal tumor — one that is typically seen in much younger women. Surgery was ruled out, and a colleague from outside of Boston sent Milly to me for an opinion about medical treatment. I reviewed her case before I met her: no significant medical problems, ...

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asco-logo My background in nursing has given me a perspective that many physicians don’t have. From the beginning of my career, I have valued the information that patients have provided me about the context of their lives, family, work, and beliefs. I have never cared for a knee or a prostate, but rather I have cared for a person whose life experiences ...

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img_1365 When I graduated from medical school, my dad gave me several hundred dollars with instructions to buy something special. It was a kind gesture, but the pressure to self-select a meaningful gift was almost too much. I wanted something to commemorate my transition from student to doctor. Books, stethoscopes, and the like seemed so uninventive. I wanted something for residency that would be ...

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When I was a little, I used to love puzzles. You could find me with pen in hand, sprawled out on my bedroom floor, nose buried deep in word searches or my Highlights magazine. I wanted to know how things worked. I loved building block sets and making up games with my older brother during summer vacations. Over the years, that curiosity eventually morphed into my current profession as a ...

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When it comes to our health and our health care, we love the numbers. Sometimes, we even fall in love with the numbers, assuming that the numbers tell us the whole story when, in fact, that may not be the case. Cholesterol numbers, blood pressure numbers, body mass index, whatever. As patients and consumers, we are frequently defined by our numbers. But what happens when those numbers and other medical tests, ...

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asco-logo She had come to see me in consultation. A professor at a local university, she was well until four years earlier when she developed abdominal bloating and pain — telltale signs of ovarian cancer. Surgery followed, then adjuvant chemotherapy with intraperitoneal treatments. (“Terrible regimen,” she said.) She was fine for two years, until the bloating recurred heralding ...

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Perhaps, doctors struggle more than most with memories that mark sad moments in their careers. For me, one of the most indelible was of a wonderful young man with chronic myeloid leukemia (CML). When I started my oncology career in the early 1970s, CML was almost always fatal. It would start with a chronic phase, which was treated with pretty simple medications. But those medications didn’t cure the disease. The “almost always” ...

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Seven years ago, when I was first diagnosed with Stage 3 breast cancer, I approached it with a determination to win. As a competitive runner, that’s what I’ve always done. Cancer would be another uphill battle, with tough stretches as well as easier ones, just like my races. My oncologist encouraged me to keep running during all my treatments, telling me it would help on many levels. He and I knew it would ...

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A recent study of men with early-stage prostate cancer found no difference in 10-year death rates, regardless of whether their doctors actively monitored the cancers for signs of growth or eradicated the men’s cancers with surgery or radiation. What does this study mean for patients? Based on research we have conducted on prostate cancer decision-making, the implications are clear: Patients need to find physicians who will interact with ...

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A 54-year-old man is evaluated during follow-up consultation regarding laboratory studies completed for a life insurance policy. He reports no symptoms. On physical examination, temperature is 37.2 °C (99.0 °F), blood pressure is 131/76 mm Hg, pulse rate is 88/min, and respiration rate is 15/min. No splenomegaly is noted. Laboratory studies: Hemoglobin 8.9 g/dL (89 g/L) Leukocyte count 3000/µL (3.0 × 109/L) with 30% neutrophils, 10% monocytes, and 60% lymphocytes Mean corpuscular volume 105 fL Platelet count 75,000/µL ...

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