Delivering bad news: Dont pass the buckWhen I was a fellow, part of our training involved doing consults for patients, most of whom had just learned they had cancer or recurrence of disease. These consults were never easy, but the importance of sitting with someone who had just learned of their diagnosis was an integral part of learning the medicine and art of oncology. Even after many ...

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Last week a patient said to me, "You live your whole life thinking you're going to have time to enjoy life later on, and then this happens." Then he started to cry because we had just reviewed his recent CT scans and some of his lab results and he had a new diagnosis of a type and stage of cancer that meant he likely had about eight months to live. ...

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A baby’s smile reflects the purity in their heart.   An infant’s world is a marvelous place of possibility and love.   Children see themselves as special, capable, even omnipotent.   Time teaches failure, loss, and mortality.  How much we lose of that original perfection, that first excitement, that natural confidence, determines how we face the challenges and tragedies of life; whether we will be happy.  It may even determine how we cope ...

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Today’s article highlights the lingering problem of physicians buying and selling prescription medications to patients -- at a profit. The medical profession has struggled with this controversial practice  for more than 150 years. In George Eliot’s 1874 novel “Middlemarch,” an idealistic young doctor named Tertius Lydgate questions the ethics of fellow physicians who make handsome profits prescribing and dispensing their own remedies to the townsfolk. His medical colleagues shun him for it. Around ...

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I am so sorry I didn’t make this different for youThe telephone message arrived in my EMR’s inbox. A patient’s daughter had called and wanted to ask some questions about her mother. Her mother, Louise (name changed), had died about two weeks before. I hesitated before calling her, recalling her mother’s cancer course. Louise had been diagnosed with cancer at a relatively young age, in her late 40s. She received curative chemotherapy ...

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At the critical time when our nation has made meaningful and measurable progress against colorectal cancer incidence, threats to reimbursement for colonoscopy screening for Medicare beneficiaries are looming, which may jeopardize the effectiveness of public health strategies to increase screening and prevention of colorectal cancer in the U.S. New data from the American Cancer Society indicate that colorectal cancer has declined by 30% in just the last decade among those aged 50 ...

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Today its time to say, Ultraviolet bad“Ultraviolet bad.” That was the core message that came out of the introduction this morning of the Surgeon General’s Call to Action to Prevent Skin Cancer at a meeting held at the National Press Club in Washington DC. There were some other messages that now raise skin cancer awareness and prevention high on the public health awareness list, such as ...

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I knew immediately it was a problem.  It was not just that Faith’s cancer had spread with innumerable masses in her liver, golf ball-like tumors in her lungs, punched out holes in her bones.  It was not that the chemo, third round and toxic, had failed.  Those were awful things.  Rather it was her response as I began to tell her.  As soon as I said, “I looked at the ...

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Recent research finds that many internists do not feel comfortable or prepared to care for survivors of childhood cancer. Although the rarity of childhood cancer may explain this, the fact remains that as more and more pediatric cancer patients survive into adulthood busy internists often have some survivors in their practices. These patients would have been treated during the last decades of the 20th century or the beginning of ...

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In a recent verdict a jury in Massachusetts awarded $16.7 million in damages to the daughter of a Bostonian lady who died from lung cancer at 47, for a missed cancer on a chest x-ray. The verdict reminds one of the words of John Bradford, the heretic, who was burnt at the stakes. “There but for the grace of God go I.” Many radiologists will sympathize with both the patient who ...

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