A friend of mine has been living well with lung cancer for five years -- working, running several miles a day, traveling, doing good stuff with his family, and generally enjoying the pleasures of everyday life. He knows the cancer will eventually kill him, but has been making the most of every remaining minute. Then, a month ago, things suddenly turned dramatically south. Severe shortness of breath, constant coughing, sleeplessness, fatigue, ...

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We’re born into our bodies, and we take that for granted. Our first job is to take a breath, something we’ll hopefully do many millions of times and never think about.  That first breath changes everything: Our blood starts to flow through our heart and lungs in a different way and for the first time we taste a new world. Before we’re born, all our needs are met via an artery and ...

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Estrogen therapy and breast cancer: The pharmacist said no It’s not often that I find myself speechless. I have heard all sorts of stories in my office -- as a sexuality counselor, I am often humbled by the trust that people place in me and how much they disclose about their private lives. But one conversation I had with a patient literally made my jaw drop. The patient is a ...

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Up to this point, it had only been a hypothesis: That celebrity firepower can definitively drive consumer health behavior in a certain direction. The case here concerns whether women wish to embark on a genetic hunting expedition to see if they are at high risk of developing a particular disease such as breast cancer, and the motivator in this case is Angelina Jolie. The actress underwent genetic testing for mutations related ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 69-year-old woman is evaluated for a lump under her arm found on self-examination. She is otherwise healthy and has no other symptoms. Medical and family histories are unremarkable, and she takes no medications. On physical examination, temperature is 37.4 °C (99.3 °F), blood pressure is 110/70 mm Hg, pulse rate is 72/min, ...

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Two women, two cancers, two different pathwaysI sometimes wonder what I would do if I was told I had cancer. How much would I subject myself to in order to survive, or to achieve remission? As a parent, I can answer only that I would likely go through hell and back if it meant being there for my kids -- to watch them grow up, graduate ...

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August 17, 2010. Maris is a 57-year-old woman in excellent health.  She has not seen a doctor in years. Divorced, she lives by herself, but spends occasional evenings with her daughter and son-in-law.  A successful businesswoman, Maris gardens, serves on the board of a community theater and plays a mean game of bridge. It is 10:11 a.m. when Maris presents to the emergency room. Three hours earlier, her legs became wobbly while ...

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Sex or death: The difficult decisions of prostate cancer treatment Sex or death: The difficult decisions of prostate cancer treatment As part of my role as a clinical nurse specialist in a busy prostate clinic, I see men (with their partner) as part of their decision-making process for active treatment for prostate cancer. The purpose of the appointment is for me to explain the results of their prostate biopsy, dispel any ...

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7:00 a.m. Lights on.   Coffee, black and a banana. Paperwork.  27 patient visits, 3 emergencies, 35 phone calls.  Lots of computer time. Some laughs and a few tears. Paperwork.  Last family meeting.  Coffee, black.   In between: Thursday. Was not completely successful in explaining to my frantic patient with the multi-page lab printout, how the problem was not that her tests were bad, but that the computer had used the wrong “normal” range ...

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Health screening is part of good preventive care, though over-screening can lead to increased costs, and potential patient harm. Health care professional societies have recently developed excellent public service announcements describing the dangers of over-testing, and new research suggests that though additional medical interventions are associated with increased patient satisfaction, they also lead (ironically) to higher mortality rates. And so, in a system attempting to shift to a “less is more” ...

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