asco-logo Jodi (name and descriptors changed to protect patient identity.) had been diagnosed with ovarian cancer several years earlier, had received adjuvant carboplatin and paclitaxel therapy, relapsed three years later, and since then, had been on several forms of therapy -- most recently receiving weekly paclitaxel. She was tolerating treatment well, but a CT scan done to re-evaluate her extent ...

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The recent announcement by a California company offering DNA blood tests (also known as "liquid biopsies") for the early detection of cancer takes us to a place most of us expected we would get to, but much earlier than we are prepared for. Simply stated, our technology and rush to get new tests to market -- even before we have a basic understanding of how to use those tests to improve the ...

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There are two, old, particularly nasty rumors, about cash and cancer. The first, which seems to be fading, is that scientists cured the disease long ago, but the pharmaceutical industry suppresses the cure so they can get rich selling worthless therapies. This never made sense to me, since the company or person that cures cancer will be rich beyond anyone’s wildest dreams. In addition, I have personally known several thousand ...

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The 20th century saw striking advances in curing childhood cancer, primarily as a result of the discovery that broadly toxic chemotherapy agents could kill malignant cells. As a result, pediatric cancer, once a virtually incurable disease, now enjoys an overall long-term survival rate that tops 80 percent. In the 21st century, attention is turning to newer agents that promise to open additional, less toxic avenues to cure.  As we mark Childhood ...

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From her vantage point, cost had nothing to do with money. On most days, she struggled to her feet when I entered the room, greeted me effusively, and escorted me to her bedside chair, all the while chattering about the inadequacy of our hospital’s slushies, the beauty of the day outside, and the latest update on her children’s accomplishments at school. Despite her debilitating malignant small bowel obstruction from ovarian ...

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Karen Vogt’s breast cancer journey began like many others, with her breasts painfully squeezed into a mammography machine. At age 52, it was far from her first mammogram, but this scan would be the most consequential by far. It revealed microcalcifications, little areas of breast tissue speckled with deposits of calcium that her radiologist worried were suspicious for a nascent cancer, especially since these specks hadn’t been so conspicuous twelve ...

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Doctors do not know everything. We make mistakes and mistakes in judgment. Sometimes we make the mistake of speaking when we should keep silent. At times, patients ask us questions that we can’t or shouldn’t answer; and yet we do. It shouldn’t be our objective to force certainly into an issue that is amorphous and murky. Here’s a response that I recommend in situations where certainty is elusive. “I don’t know.” I saw ...

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Dear doctor: Attached please find the medical records of Mr. Ron C., who is transferring medical care to your office. Ron is a 63-year-old gentleman with recurrent lung cancer, which has spread to his opposite lung and bones. There are multiple treatment choices for his disease, which we have discussed in detail. However, Ron is leaving my care, because he does not trust me. As you are well aware, metastatic lung cancer ...

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At the heart of American medicine is the concept of bedside manner, and with it the concern that doctors are cold and unemotional. Indeed, doctors are exposed to disease and misfortune on a daily basis. A patient who presents with stage IV metastatic stomach cancer is just one of the many hundreds or thousands of such patients that will walk through the hospital doors in the coming years. Quotidian exposure ...

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Overtesting -- it’s an epidemic threatening consumers of U.S. health care. The notion that testing can be anything but beneficial belies the common assumption that more information is always better, as exemplified by billionaire Mark Cuban’s proclamation earlier this year that he obtains “baseline” quarterly blood tests and encourages others to do so. Knowledge is power, right? Not always. Aside from adding economic strain to our already beleaguered health ...

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