Top stories in health and medicine, June 3, 2014From MedPage Today:

  1. A 'Home Run' in Prostate Cancer Tx. Overall survival in metastatic prostate cancer improved by more than a year when patients received docetaxel at the start of androgen deprivation therapy (ADT), according to trial results that oncologists here called "unprecedented."
  2. Early Palliation in Ca Patients Eases Caregiver Burden. Early ...

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I've had many Twitter conversations with cancer screening advocates who fear that the U.S. Preventive Services Task Force's "D" (don't do it) recommendation against PSA-based screening for prostate cancer will lead to a dramatic spike in prostate cancer deaths as primary care physicians screen more selectively, or perhaps stop screening at all. I seriously doubt these apocalyptic forecasts (for one thing, prostate cancer causes only 3% of deaths in men, and ...

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A woman in her 70s came into my clinic recently. Her primary doc found a mass so she came to the hospital for a biopsy and passed out on the table so they scanned her head and found a mass there, too. She started radiation and then came to meet me in the outpatient clinic. She had trouble expressing herself because she’d had a stroke two decades ago, but it didn’t ...

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The incidence of esophageal adenocarcinoma has increased more than five-fold over the past four decades in the U.S. While the rate of rise in incidence of esophageal cancer has slowed somewhat in recent years, this malignancy is still associated with a dismal prognosis. Barrett’s esophagus, the precursor lesion to esophageal cancer, is easily identifiable on routine upper endoscopy and can be monitored for the development of precancerous changes. We generally ...

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to live in this world you must be able to do three things to love what is mortal; to hold it against your bones knowing your own life depends on it; and, when the time comes to let it go, to let it go -Mary Oliver, New and Selected Poems, Vol. 1 As a parent, you are not supposed to have a favorite child, and since some of us physicians feel a strange but kindred protectiveness for our patients, likewise we ...

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Cancer care for international patientsThe world is a big place and here in the U.S., we are fortunate to live in a part of it where we have access to technology and advanced medical care, clinical trials, and new therapies, even before they are approved by the Food and Drug Administration. Indeed, even new agents approved for one indication can be prescribed off-label in ...

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From MedPage Today:

  1. Vaccines and Biologics: Questions Remain. Vaccinations for patients with autoimmune diseases -- specifically patients being treated with biologics -- bring with them a variety of issues, including disease-specific, medication-related, and vaccine-associated factors.
  2. Wider Look at Lung Cancer Genes Found Helpful. Testing for a range of genetic drivers of lung cancer broader than the current standard pointed to actionable treatment targets for ...

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I received a fax recently, from the office of another hematologist-oncologist, at another academic medical center. Attached to the fax cover page, with my name and fax number scribbled in slanted script, was a five-page consultation report on one of my patients. That oncologist -- I’ll call him Dr. Z -- had seen and evaluated my patient to provide a second opinion on the patient’s diagnosis and treatment. The lengthy report ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 32-year-old woman is evaluated for increased hair growth on the face and chest and a 3-month history of irregular menses. She has a 5-year history of hypothyroidism. Her only medication is levothyroxine. On physical examination, temperature is 37.0 °C (98.6 °F), blood pressure is 110/72 mm Hg, and pulse rate is 80/min; ...

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Before I retired in 2000, I worked in a state agency as a peer counselor, or more formally, an employee assistance program (EAP) coordinator. The "coordinator" part was there because my job description wasn't actually to do counseling; it was to assess the problem and refer the client for help. But of course both of those processes involved counseling. We just couldn't call it that. In 1986, shortly after I'd begun the ...

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