asco-logoWhen is an advocate not an advocate? When should a spouse step back and let the husband make a treatment decision? When should an adult child of a man with prostate cancer let their father decide what is best for him? These are questions that, fortunately, I don’t have to ask all that often. Most men I see for prostate cancer ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 65-year-old man is evaluated after a recent colonoscopy, which disclosed a 2.5-cm pedunculated polyp in the sigmoid colon. The polyp was removed in its entirety in a single piece. Biopsy results showed a well-differentiated adenocarcinoma confined to the submucosa without evidence of lymphovascular involvement and a 1-mm margin. There is no ...

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The American Cancer Society (ACS), an advocacy organization that has fairly recently (and very positively) taken a more appropriate, evidence-based approach to cancer screening, recently revised its mammography recommendations. While it still recommends more mammograms than the U.S. Preventive Services Task Force (which doesn’t recommend starting until age 50, and then screening only every other year), it has raised the starting age from 40 ...

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To cope with loss, oncologists simply forget. Perhaps, “forget” is not the right word. “Compartmentalize,” “separate” or simply “contain,” may be better. We put all those wonderful people who have died, all that suffering, all those lives, in a corner closet of our minds, close the door and lock them away. Perhaps. However, all those memories remain; they are part of me. Quietly, they change how I practice medicine, what I ...

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asco-logoWe have all seen patients whose distress is off the charts, or off the Distress Thermometer (NCCN). They sit in our offices, dazed and seemingly so depressed that we ask the mandatory question: “Are you thinking of hurting yourself?” Some patients just shake their head, not making eye contact, and even though they say they aren’t going to hurt ...

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Recently, a group of researchers in the World Health Organization (WHO) released a study that caused a bit of a kerfuffle. The group, the International Agency for Research on Cancer (IARC), published a paper classifying processed meat as a carcinogen. What’s processed meat? According to the authors, it’s “meat that has been transformed through salting, curing, fermentation, smoking, or other processes to enhance flavor or improve preservation.” That includes products ...

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shutterstock_125549408 Invading, spreading and destroying: Terrorism is cancer. A malignant growth, it corrupts healthy cells, yielding fear, pain and death. It lays waste to resources and lives. Every place, every organ of every society, is threatened. Nonetheless, just as we are winning the battle against other cancers, disease-by-disease, year-by-year, we know how to destroy this illness. It will take time and research. We must ...

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A new study in JAMA Internal Medicine finds that two-thirds of cancer drugs considered by the U.S. Food and Drug Administration (FDA) over the past five years were approved without evidence that they improve health outcomes or length of life. (This study closely corroborates and acknowledges the findings published last year by John Fauber of the Milwaukee Journal Sentinel and Elbert Chu of MedPage Today.) Follow-up studies showed ...

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I sit at my desk in a cubicle with high ceilings and an open entryway.  It is dark except for the somewhat eerie glow of light emitted by CRT monitors.  With concentration and some sense of urgency, I methodically plow through the queue of studies to be interpreted.  Some are marked STAT, some not.  I address the former first. Our ER is a busy one.  Many cases come from that department.  ...

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Last year, I retired from full-time practice and moved to a new area. At about the same time, my wife was diagnosed with breast cancer, and because she was in good health prior, she had relatively little contact with the health care system as a patient. Before our move she worked as a part-time school nurse, so we were able to share provider horror stories from different perspectives. Since we moved ...

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