I recently went to an infectious disease educational session sponsored by the Massachusetts Medical Society and the New England Journal of Medicine called "Epidemics Gone Viral." The focus was preparedness for the next epidemic, which may come from anywhere. John Brownstein talked about how its arrival will be monitored and reported using Twitter and artificial intelligence. With the meeting going viral with excitement as Bill Gates got ...

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The cancer moonshot initiative raised skepticism because of the limited funding to end cancer. Unfortunately the recently announced panel membership confirms that while the project may launch, skewed representation may tilt the mission off course. It is no surprise that the panel heavily tilts toward immunology, medical oncology, surgery and big science. But three core specialties you would find at any tumor board are missing: pathology, radiology, and radiation ...

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Everyone deserves a chance to be healthy. Physicians, of course, focus on helping patients. Unfortunately, I often see patients’ frustrations with the health care system itself directed toward doctors. Meanwhile, doctors are under increasing pressures on multiple fronts. Yes, we’re imperfect, but making physicians the primary focus of patient anger will not solve problems we all face as humans who will, at some point, need health care. (Note: I’m using doctors ...

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asco-logoIncreasingly, cancer care is becoming more evidence-based and personalized. But there are still a lot of areas where we need to question the conventional wisdom. How much of what we learned during training is based upon evidence versus anecdote and assumption? When I finished medical school, internship was challenging but very rewarding. It helped me recognize much better when people are really ...

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asco-logoFrom a philosophical standpoint, one of the things I hate most about cancer is the use of “war” analogies. The “battle” may mobilize patients and families, but it may also interfere with education and informed decision making. And both patients and clinicians often take recurrence or disease progression personally as a failure. Even when everything is done perfectly, the outcomes aren’t. Why ...

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asco-logoAt my hospital, we are committed to offering a lot of clinical trials in the community. But it’s hard -- nationally, only about 3% of patients with cancer participate in clinical trials. Even at some academic centers, it may be below 10%. With less research funding available, we need to find new ways to make it easier and cheaper ...

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asco-logoEach time I reach the point of recommending radiation treatment for someone with a brain tumor or head and neck cancer, I ask for a higher level of trust from each patient than usual: let us make a mask to keep you safe. Radiation therapy is already a leap of faith -- who wants invisible rays shooting through them? Fear of unknown ...

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asco-logoOrdering CT, MRI, or PET scans for my patients when they feel well always makes me nervous. As a radiation oncologist, I’ve chosen to frequently make observations that potentially find active, progressive cancer. And this creates an existential crisis that scares me -- but not as much as it scares my patients. With each test, I set in to motion a real-life application ...

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google glass The buzz is that Google Glass will transform medicine.  But unless it’s carefully vetted it could be a disaster for patients, clinicians and hospitals.  Until the FDA or research confirms its safety, Google Glass is banned from my clinic as a privacy and medical practice hazard. Here are four reasons why: 1.  Privacy violations. Google Glass make it extremely easy to take pictures or ...

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Radiation oncologists offer curative cancer treatment to many.  Despite irradiating the spleen for over 50 years, why don’t we routinely offer pneumococcal vaccination to avoid complications after treatment?  Since we just had World Pneumonia Day to raise awareness for children, I want to do the same for cancer patients. A healthy spleen helps fight off pneumonia, sepsis and meningitis. Publications on infection from spleen radiation date back at least thirty years, but were ...

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