I got a letter the other day from a local urologist requesting clearance for a patient of mine to have surgery.  The doctor wanted to know whether there were any contraindications, from the standpoint of the patient’s cancer, such as bleeding, infection or poor wound healing, which would preclude local anesthesia, bilateral incisions, sharp separation, ligation, and electrocauterization of the vasa deferentia.  In other words, could my patient, a 42-year-old ...

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Carrie is a 72-year-old retired real estate agent with a high school education. She raised three kids, but they do not talk to her anymore.  Since her husband died, Carrie has lived alone.  A melanoma was removed from her right shoulder 2 years ago.  In my office, we stare at the CT scan display of a mass in her right lung. “What does that mean?” “Well, we wouldn’t know for sure until ...

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Top stories in health and medicine, June 19, 2014From MedPage Today:

  1. Do Thiazides Trigger Metabolic Side Effects in Older Adults? Metabolic adverse events were relatively common among older, predominantly male veterans who started taking a thiazide diuretic for hypertension.
  2. Insurers Push Back Against Growing Cost of Cancer Tx. Some cancer patients and their insurers are seeing their bills for chemotherapy ...

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Cancer screening in those with metastatic disease“Your cancer has come back.” These are words no one treated for cancer wants to hear, yet they are words I have said far too often in my own career. In this case, I had said this to a patient I had cared for ever since her initial diagnosis. At that time, she had stage III breast cancer. After her surgery, ...

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I've been a practicing oncologist for all of seven months, and so was surprised when my chief asked that I take part in our quality review panel. The quality review panel is an internal group that is tasked with the responsibility of looking into allegations that a patient's care was not in keeping with best practice or what is generally considered the standard of care. Cases (often in the form ...

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In 2010, I lost my mother to cancer.  She was a fighter and had survived well past her prognosis, but her hospital costs outlived her. Let me go back to late 2004. That was the year the doctors suspected she had cancer. My mother, who was not a smoker, was officially diagnosed with non-small cell lung cancer early on in 2005. When the biopsy confirmed that the small lesion in the ...

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A prostate cancer breakthrough: The good and not so good newsThe annual meeting of the American Society of Clinical Oncology is a place where many commercial interests jostle for attention to make their latest promising therapy the star of the show. But a standard widely available generic drug stole the show by producing incredible results in improving survival for men with advanced prostate cancer. And that has some of us ...

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Top stories in health and medicine, June 17, 2014From MedPage Today:

  1. Victoza Lowers Glucose in Genetic Form of Diabetes. Liraglutide (Victoza) works roughly as well as standard sulfonylurea treatment for an inherited type of diabetes but with less hypoglycemia.
  2. Canola Oil Cuts Heart Risk in Diabetes. Adding canola oil to the diet improved glycemic control and reduced cardiovascular risk in ...

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Top stories in health and medicine, June 16, 2014From MedPage Today:

  1. The Hobby Lobby Case: The Stakes for Birth Control. One of the most watched issues before the Supreme Court this term may turn on the question of religious freedom. But it will also likely determine how women will be able to access a key provision of the Affordable Care Act -- ...

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When you tell people that your dad died of lung cancer, often the the follow up question is, "Did he smoke?" In my case, the answer is, sort of. I have fuzzy memories of my dad in our basement, smoking his pipe in his black leather chair and watching the original Doctor Who (I’m still processing the cultural implications of that last detail).  Rumor has it he smoked cigars in the ’60s, ...

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