I have been thinking a lot about cancer screening tests. It seems that there has been a constant stream of articles about screening in both the lay press and professional journals -- as well as the inevitable stories in the lay press about the reports in professional journals -- but this is more personal. I have had two recent experiences that ...

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Sometimes, we play a little politics on this blog.  I am a student of current events and enjoy following the dysfunction and absurdities in American politics.  To paraphrase the legendary former British prime minister, "never has so little been done by so many to benefit so few." Readers know how skeptical I am about medical dogma.  When I was an intern a quarter century ago, I didn’t grasp why routine measurement ...

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The BMJ recently published the latest results from the Canadian National Breast Screening Study (CNBSS). A brief summary of the CNBSS: Women were randomly assigned to annual mammography or breast exams and then the outcomes tracked. The results in the BMJ: mammography did not improve survival. This is a very interesting study and when I first started working on this post I wanted to delve more into the science of ...

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Are physicians ready for the e patient movement?I gave a talk recently to a group of my peers about addressing the needs of patients after a diagnosis of cancer, emphasizing points where transitions occur -- from treatment, to end of therapy, surveillance, recurrence, and extending all the way up to the end of life -- and how important it is to consider the entire journey of a person ...

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From MedPage Today:

  1. Bariatric Surgery Beneficial in Type 1 Diabetes. Overweight patients with type 1 diabetes may make good candidates for bariatric surgery, but unlike with type 2 disease, the procedure doesn't offer a chance of remission.
  2. Young Adults Undertreated for High BP. Primary care physicians may be dropping the ball on getting young adults with hypertension the medication they need to control their ...

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On December 23, 1971, President Richard M. Nixon signed the National Cancer Act of 1971, and declared the "war on cancer."  The allusion to combat appealed to the soul of the American people not long after their success in World War II and the humiliation of Vietnam; they intuitively understood the sacrifice, teamwork and massive effort, which is implied in the concept of War and they were ready for another victory.  Committing dollars, ...

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The influence of Janis Babson can be felt by many physicians I was 8-years-old in June 1963 when the Readers’ Digest arrived in the mail inside its little brown paper wrapper. As usual, I sat down in my favorite overstuffed chair with my skinny legs dangling over the side arm and started at the beginning,  reading the jokes, the short articles and stories on harrowing adventures and rescues, pets that had been ...

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A couple of weeks ago my nurse came to me with a request for a consultation.  Since our schedule has been packed full lately, she’s been asking me where I can squeeze patients in. She said, “I’m not sure about this one -- he says you treated him twenty years ago and he wants to see you.  But there is no new pathology so I don’t know how urgent it is.” I ...

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My cancer has been knocked into oblivion From the beginning, there were so many signs that my cancer didn’t have a chance. First, there was the rock-hard lymph node above my collarbone that disappeared with one night of steroids, even before I started chemotherapy. Then, there was the chest x-ray done only a few days after starting my first round of chemo. It’s not pretty, and you can see that the ...

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Mammograms: Breast cancer screening as an individual patient decision In a major cancer screening development, a study from the British Medical Journal found that an annual screening mammography didn't result in a mortality benefit:

Women screened annually by mammography for 5 years had had a breast cancer mortality hazard of 1.05 compared with the control group during the screening period. During follow-up for a mean of 22 years, the mammography group ...

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