It should be easy, right? I mean, I am a professional with what feels like eons of training. So how can an oncologist with years of experience fail at perhaps the most important question a patient can ask, ”How long do I have, Doc?” It’s not that I want to avoid the question. Well, okay, sometimes I do. It’s not the most pleasant of conversations to have. But really, I don’t ...

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March is colorectal cancer (CRC) awareness month, so it’s an appropriate time to reflect on how to increase the number of people who get screened for this cancer that’s largely preventable through screening. Between 2005 and 2012, Kaiser Permanente, Northern California, doubled the percentage of our eligible patients who were screened for CRC. So how did we do it? We employ a combined screening model with fecal immunochemical test (FIT) outreach and ...

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From a mother: What my childs oncologist should know Please let us know that we’re not alone. We realize that our doctors are not our friends, but telling us that the medical team will be sticking with us during this journey that we were never on board with, is an empowering message when we are at our most powerless. Show us that you care about our child, too. We know that you identify our ...

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It looks like an airport lounge without the rolling suitcases. There are about 20 of us cancer survivor-types fiddling with our phones or reading the newspaper. A few of us are sipping delicious contrast fluid in preparation for a scan, but most of us are waiting to meet with our oncologists for follow-up or monitoring visits. All of us are between the ages of 20 and 70 and all of ...

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Hot oil splatters as thick fatty fish slips into the smoking pan, next to boiling rice and simmering garlic greens.  Quickly golden, she flips the fillet and turns down the heat.  Small feet pound down the stairs, drawn by the crackling aroma, but it’s a mother’s trap; she motions the child to set the table. One by one, the family gathers, as plates and utensils clatter onto the wood and ...

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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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