I met David on the internet. It was to become on of the closest, most intense relationships of my life.  For you see, a few months before he crossed my path his daughter finished the same protocol for the same type of brain tumor that my daughter just had started.  They had successfully traversed the waters that to me were completely unknown -- and frankly terrifying.  On the pediatric brain tumor listserv, ...

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He wasn’t particularly likable upon first encounter. He wasn’t apt to answer questions asked. He had a long pause and a long drawl and a tangential, winded story — and backstory — all of which he was bound and determined to tell to its detailed completion. With an irregular heart rate in the 170s and a respiratory rate in the 30s, I tried to steer him in the direction of ...

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My name is Lucy. I have stage IV liver cancer. I wanted everything done — even though the doctors told me this disease is terminal. My family, my church and my friends were praying for “the cure.” Though I believed in God and the hereafter, I wasn’t ready to go. 74-years-old with beautiful children, grandchildren, and a great-granddaughter. I woke up confused. In the background — wherever I was — I could hear ...

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asco-logoI’ve written in the past about how words are powerful — that they can have multiple meanings, how they can change depending on context. I am often reminded of how true that is in everyday oncology practice, especially when it comes to meeting new patients. Some are diagnosed with cancers that carry a relatively good prognosis, ...

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asco-logoMedicine is an honorable profession. We meet people at a vulnerable point in their lives -- when it comes to cancer, it is often at their most vulnerable. In oncology, care is typically multidisciplinary, and one of the most important advances in my own professional career has been this team approach. To see a patient with ...

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Many months have passed since the spring day when I was hit with the news from my yearly mammogram, but those typewritten words are forever etched in my memory: "The density appears greater in left breast." My doctor comforted me with statistics showing that mammograms aren't 100 percent accurate — but she also lost no time in sending me to a surgeon named Dr. Prewitt. Upon meeting him, I immediately felt ...

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An excerpt from Breasts: The Owner's Manual: Every Woman's Guide to Reducing Cancer Risk, Making Treatment Choices, and Optimizing Outcomes. Genetics play a less important role than you probably think. Consider this ...

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Physicians are the building blocks of value-based care, yet the cumulative human and financial cost of our decisions are mostly hidden from us. Instead, our reality is analogous to being on a diet and a budget at a restaurant that doesn’t put prices or calorie counts on the menu. We need and want cost transparency. A survey from Deloitte University discovered cost is a part of ...

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For almost 20 years, the value of the digital rectal exam (DRE), a long time staple of the complete examination of the trauma patient, has been questioned. Performing a rectal examination on all trauma patients is no longer advocated except for a few specific indications. As recently as two months ago, trauma surgeon Michael McGonigal blogging at the Trauma Pro reinforced the message. Because a rectal examination is so uncomfortable ...

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asco-logoSarah* is a new patient, referred to me because she is having difficulty deciding on treatment for breast cancer. I don’t know much else about her, and a quick review of her electronic medical record tells me that she is 48 years old and has hormone-positive disease in her left breast. There are numerous missed appointments, and it appears that her ...

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