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, ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

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 ...

Read more...

This morning I went for my annual mammogram. It’s not something I generally look forward to. In fact, I mildly dread it. In my personal experience, mammograms have ranged from quite uncomfortable to downright painful. And then there’s the general unpleasantness of standing topless in a cold room. The first time I had this screening imaging study done, the plate pressed so hard into my sternum that I was almost in ...

Read more...

From MedPage Today:

  1. Mammography: Study Finds No Lives Saved. Annual mammography failed to reduce breast cancer mortality in women, ages 40 to 59, compared with physical examination or routine care, according to 25-year follow-up data from a Canadian screening program.
  2. Gestational Hypertension: Monitoring vs Delivery? Pregnant women with nonsevere hypertensive disorders between 34-37 weeks should be monitored closely rather than delivered immediately to avoid ...

    Read more...

In 2005, my husband and I bought a small farmhouse in northern New England next door to Tom and Sally. They were in their early seventies, married nearly fifty years, with a large family. Tom's grandfather had built a farmhouse in 1900 on the family's small pig farm. In the 1970s, Tom and Sally had parceled off the land and built a modern house for themselves, a stone's throw from the ...

Read more...

Ben's first symptom was coughing up blood.  The cancer had been silently growing for months, if not a few years.  He had no pain or shortness of breath.  The chest x-ray showed a "5cm L hilar mass" and the subsequent CT scan showed enlarged lymph nodes and likely spread to the liver. "So Doc, what is it?  A cancer?  How much time do you give me?"  All these questions on a ...

Read more...

From MedPage Today:

  1. SGR Deal Reached. Physicians will get a 0.5% pay increase each year for 5 years under a deal by a bipartisan team of House and Senate negotiators to repeal the sustainable growth rate (SGR) formula for physician payment under Medicare.
  2. Mixed Results for Brachytherapy in Breast Cancer. Older breast cancer patients had an increased rate of subsequent mastectomy if they received ...

    Read more...