A report in the Journal of the American Medical Association (JAMA) shows that too few women with recently diagnosed breast cancer and at high risk of a BRCA genetic mutation received appropriate genetic counseling. And that testing for the mutation is a missed opportunity not only to improve treatment for these patients but also to prevent some breast,
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With thousands of cancers, thousands of families and thousands of deaths, I came to see deep time. I absorbed the finite nature of existence and gained a long view. Not just yesterday’s tests, today’s battle and tomorrow’s treatment, but the loss to come. I do not know when the reaper will arrive, but understand he will. I mourn each patient before we meet. I have learned not to cry. Call it ...

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asco-logo One of the questions that I face (and which I am certain many of us do) concerns the use of alternative therapies. Iron chelation therapy, high-dose vitamin C infusions, Chinese herbs — interest in these therapies and others like them are driven by word-of-mouth (“a friend of a friend”), claims on websites and patients curiosity. Cancer is ...

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Pediatricians face a difficult task determining when to refer a child for a suspected bone marrow failure syndrome. We now realize that only a subset of children with bone marrow failure syndromes present with the findings described in textbooks.  These children often appear well and lack classical physical stigmata. By the time they look sick, their marrow’s ability to produce blood cells can be so weakened that it could be ...

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Dr. Tom Price may become the first medical doctor to lead the U.S. Department of Health and Human Services in 24 years. One might think that having completed medical school and practiced orthopedic surgery before entering politics might give him some extra insight into what works and what doesn't in medicine. But judging by a letter to then-HHS Secretary Kathleen Sebelius that he signed in 2011 objecting to the ...

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Politicians and policymakers are discussing what parts of the Affordable Care Act to change and what to keep. While most of us have little control over those discussions, there is one health care topic that we can control: what we talk about with our doctor. The Institute of Medicine (IOM) released the landmark publication Crossing the Quality Chasm 15 years ago. The report proposed six aims for improvement in ...

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Danny rarely came to the clinic. He paid a sliding scale fee for the visit but this, in addition to the money he paid for his medicines, was already too much for him to afford. Now, in early November 2013, he had become concerned. Danny had previously owned a jewelry boutique with his wife, Jacky. She made her own pieces and sold them in the store. Over time, the economy had ...

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I recently reported on Stephanie Waggel, the doctor fired by a prestigious U.S. hospital for getting cancer (story also the Washington Post). In a transcription of her whistleblower video, Stephanie describes how she nearly died due to obstruction of medical care: It started during my intern year of residency. Which, bizarrely, was the happiest year of my life. And all my friends are like, “You’re an ...

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I recently consulted a specialist at a major medical center in New York, and a few days later, here came a questionnaire in the mail. "How much time did I spend in the waiting area?" it asked. How long was I kept waiting in the examining room? How close to my appointment time did the doctor see me? The one thing it didn't ask was whether I cared. There's no mystery about ...

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Cancer. The ominous word instantaneously triggers fear and anxiety. According to the American Cancer Society, cancer is the second most common cause of death in the United States, accounting for one in four deaths. Despite the attention cancer has garnered, an inequality exists. Patients without Internet access may not learn about possible therapeutic interventions. As we proceed with the “Moonshot” to better control cancer, we must assure that all patients ...

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