Curiosity and apprehension. I experience this tension as a young man ushers me through large daunting doors with “Authorized Personnel Only” posted in bold red letters. Inside, a massive machine dominates the room, and yet my focus turns to the patient lying on the table, face covered in a white mask holding his head still while the technician targets the malignant brain tumor. “All right in there?” the specialist asks, and ...

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I was confused. Perhaps, I needed another cup of coffee. The chart did not make sense. Ellen, who I was about to see because she was transferring her care, was receiving medication for cancer that was a simple pill; inexpensive, with few side effects. What confused me is that it was obvious the therapy would not work. Baffled, I called the oncologist who had been treating Ellen for two years. A ...

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I’m writing to you from the future -- approximately ten years from where you are now. You’re a few months into your medical oncology residency, just beginning to assimilate to the flow of your daily responsibilities as a doctor committed to the diagnosis and treatment of cancer. You hate living in upstate New York, and are dreading the upcoming winter and the associated endless piles of snow and sub-zero temperature nights ...

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I enjoyed Agatha Christie’s Hercule Poirot. Not only did the ingenious Belgian solve the murder so artfully. But someone identifiable is killed, and someone identifiable is the killer. Epidemiological studies are whodunits, too. Except you don’t know who has been killed, what the murder weapon is, or who the killer is. You only know that a murder may have happened. A study found a higher incidence of breast cancer with ...

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asco-logo She had been a patient for several years, and I still remember meeting her that first time: Her breast cancer was stage IV at diagnosis, already established in her bones; she was scared; she was in pain. Surgery was taken off the table, and she was referred for medical therapy. We had discussed prognosis, the incurableness of her cancer, ...

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There are times, as a healer, I feel helpless. These are not just the moments when cancer consumes. I understand that the dread disease has yet been conquered, and there is still terrible loss.   This not when I refer a patient elsewhere; I know my limits. Rather, these are the times when I am trapped, ignored, and the result is needless suffering. In his classic, often quoted, 1942 short story, Runaround, ...

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“Don’t forget to bring that stool card back in, OK?” As he walked out of the room, carrying his portable oxygen, he turned back, with the nasal cannula in his nose, and replied, “I’ll get it back to you soon.  I’d hate to have colon cancer.” At this point, I’d hate for him to have a positive occult blood card.  I could really care less about colon cancer.  Colon cancer isn’t going ...

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Three decades at cancer’s bedside has taught me about fear. I have seen denial postpone critical diagnosis.   I have watched mistrust and anger yield poor choice. I have fought against terror that spreads malignancy by delaying treatment.  I have shared fury and devastation as horrid growths rip apart bodies, destroy families and end life. After so many thousands of patients, so many wasted lives, you would think I would have given ...

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Recently, the World Health Organization (WHO) released its report condemning processed meat as a group 1 human carcinogen -- a classification that includes such notorious companions as tobacco smoking, smokeless tobacco, and second-hand smoke. This is not surprising considering that processed meat contains many of the same known or probable carcinogens as cigarette smoke, like heterocyclic amines and N-nitrosamines. Red meat was labeled in the runner-up category ...

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There is only one correct, perfect, absolute approach to life and decisions near its end.   This truth relieves the doctor of final decision.   The right way lifts the burden of anxiety, confrontation or guilt.   The perfect path makes giving care at a very hard time, much easier. That correct course, the only way to treat every patient and every family, is exactly what the patient and family say it is. This ...

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