Henrietta’s Cells Speak

“One of the ways that I gained the trust of the family is that I gave them information.” (R. Skloot, a journalist, speaking about her interactions with Henrietta Lacks’ family, Columbia University, 2/2/10)

Posted in Books, Communication, Essential Lessons, Ideas, Informed Consent, Life as a Patient, Medical Education, Medical Ethics, Oncology (cancer), Patient Autonomy, Patient-Doctor Relationship, Privacy, Reviews, Science, Women's HealthTagged , , , , , , , , , , , , 1 Comment on Henrietta’s Cells Speak

Are Doctors Necessary?

Ten years ago, my colleagues and I squirmed in our swivel chairs when a few tech-savvy patients filed in bearing reams of articles they’d discovered, downloaded and printed for our perusal.

Some of us accepted these informational “gifts” warily, half-curious about what was out there and half-loathing the prospect of more reading. Quite a few complained about the changing informational dynamic between patients and their physicians, threatened by a perceived and perhaps real loss of control.

How a decade can make a difference. In 2008 over 140 million Americans…

Posted in Communication, Empowered Patient, Essential Lessons, Health IT, Life as a Doctor, Patient-Doctor Relationship, Public Health, Social MediaTagged , , , , , , , , , , , , , Leave a Comment on Are Doctors Necessary?

A Visit With My Oncologist

After a while my oncologist stepped out into the waiting area and guided me to the hall by her office. “The cells are low,” she said. “We’ll have to wait another week, that’s all.”

I knew she was right. But a week seemed like a lifetime to me then….

Posted in Breast Cancer, cancer survival, cancer treatment, Life as a Patient, Women's HealthTagged , , , , , , , , 2 Comments on A Visit With My Oncologist

How to Avoid Death in the ICU

It was sometime in April, 1988. I was putting a line in an old man with end-stage kidney disease, cancer (maybe), heart failure, bacteria in his blood and no consciousness. Prince was on the radio, loud, by his bedside. If you could call it that – the uncomfortable, curtained compartment didn’t seem like a good place for resting.

Posted in cancer treatment, Communication, Empowered Patient, Essential Lessons, health care costs, Life as a Doctor, Medical Ethics, Palliative Care, Patient Autonomy, Patient-Doctor RelationshipTagged , , , , , , , , , , , , , , , 4 Comments on How to Avoid Death in the ICU

Why Give Blood?

Giving blood is something that’s close to my heart. When I was 14 years old, I received seven units of packed red blood cells from strangers…

Today, thousands will donate blood to honor the birthday of Dr. Martin Luther King, Jr… The holiday presents, also, a special opportunity to gather much-needed registrants for the National Marrow Donor Registry…

Posted in Hematology (blood), Life, Life as a Patient, Medical Education, Medical History, Public HealthTagged , , , , , , , 1 Comment on Why Give Blood?

Moms Tweet About Blood and Cancer

This afternoon I found a Tweet from a colleague, a journalist who happens to be a mom in my community:

Tweet from SuSaw:
“RT @JenSinger: Hey, baby. What’s your blood type? Nothing against the Big Pink Machine… http://ow.ly/URkg

As a trained hematologist (blood doc), oncologist and breast cancer survivor, I couldn’t resist checking this out. Here’s what I discovered…

Posted in Communication, Future of Medicine, Health IT, Hematology (blood), Social Media, Women's HealthTagged , , , , , , , , , , 1 Comment on Moms Tweet About Blood and Cancer

Skyping Medicine

Yesterday, Dr. Pauline Chen reported in the New York Times on virtual visits, a little-used approach for providing care to patients hundreds or thousands of miles apart from their physicians.

Telemedicine depends on satellite technology and data transfer. It’s a theoretical and possibly real health benefit of the World Wide Web, that giant, not-new-anymore health resource that’s transforming medicine in more ways than we know.

Posted in Communication, Diagnosis, Future of Medicine, Health IT, Patient-Doctor RelationshipTagged , , , , , , , , , 1 Comment on Skyping Medicine

Looking Ahead: 7 Cancer Topics for the Future

Here’s my short list, culled from newsworthy developments that might improve health, reduce costs of care and better patients’ lives between now and 2020, starting this year: 1. “Real” Alternative Medicine. By this I don’t mean infinitely-diluted homeopathic solutions sold in fancy bottles at high prices, but real remedies extracted from nature and sometimes ancient […]

Posted in Future of Medicine, Health IT, Oncology (cancer), Science, Selected TopicsTagged , , , , , , , , , , , , Leave a Comment on Looking Ahead: 7 Cancer Topics for the Future

Why Medical Lessons?

One of the things I liked best about practicing medicine is that I was constantly learning.

Making rounds at seven in the morning on an oncology floor would be a chore if you didn’t get to examine and think and figure out what’s happening to a man with leukemia whose platelets are dangerously low, or whose lymphoma is responding to treatment but can’t take anymore medicine because of an intense, burn-like rash. You’d have to look stuff up, sort among clues

Posted in Communication, from the author, Ideas, Life, Life as a Doctor, Life as a Patient, Medical Education, Medical Ethics, Patient-Doctor RelationshipTagged , , , , , , , , 1 Comment on Why Medical Lessons?

Looking Ahead on Breast Cancer Screening

The risks and costs of breast cancer screening are exaggerated and misrepresented in the recent news…. My conclusion is that rather than ditching a life-saving procedure that’s imperfect, we should make sure that all doctors and radiology facilities are up to snuff.

We need to distinguish between errors in the measurement (cancer or not) and errors in decisions that we – patients and doctors – make after upon detecting a premalignant or early-stage malignancy in a woman’s breast.

Posted in Breast Cancer, cancer screening, Diagnosis, health care costs, Oncology (cancer)Tagged , , , , , , , , Leave a Comment on Looking Ahead on Breast Cancer Screening

A Bit More on False Positives, Dec 2009, Part 1

Why bother, you might ask – wouldn’t it be easier to drop the subject?

“Make it go away,” sang Sheryl Crow on her radiation sessions.

I’ll answer as might a physician and board-certified oncologist who happens to be a BC survivor in her 40s: we need establish how often false positives lead, in current practice, to additional procedures and inappropriate treatment…These numbers matter. They’re essential to the claim that the risks of breast cancer screening outweigh the benefits.

Posted in Breast Cancer, cancer screening, health care costs, Medical News, Statistics, Women's HealthTagged , , , , , , , , Leave a Comment on A Bit More on False Positives, Dec 2009, Part 1

Information Overload

Last week I received an email from a former patient. He has hemochromatosis, an inherited disposition to iron overload. His body is programmed to take in excessive amounts of iron, which then might deposit in the liver, glands, heart and skin. He mentioned “some amazing videos on hematology and hemochromatosis and genetics” he’d discovered on YouTube.

This is the future of medicine, I realized. … Whether physicians want their patients to search the Internet for medical advice is beside the point. We’re there already, whether or not it’s good for us and whether what we find there is true.

Posted in Communication, Empowered Patient, Future of Medicine, Health IT, Hematology (blood), Social MediaTagged , , , , , , , , , , , Leave a Comment on Information Overload

Legitimate Concerns and Unfortunate Timing on Radiation from C.T. Scanning

The risks of radiation from CT scanning will almost certainly add to the current confusion and concerns about the risks of breast cancer screening.

Mammography differs from CT scanning in several important ways:

1. Mammograms involve much less radiation exposure than CT scans.
2. Mammography is well-regulated by the Food and Drug Administration (FDA) and other agencies. The Mammography Quality Standards Act (MQSA) requires…
3. Women who undergo screening mammograms can control when and where they get this procedure. Screening mammograms are elective by nature..

Posted in Breast Cancer, cancer screening, Diagnosis, Medical News, Oncology (cancer), Women's HealthTagged , , , , , , , , Leave a Comment on Legitimate Concerns and Unfortunate Timing on Radiation from C.T. Scanning

How Well Do You Really Want to Know the “Red Devil?”

I know what it’s like to get the “red devil” in the veins.

You can learn about Adriamycin, a name brand chemotherapy, on WebMD. Or, if you prefer, you can check on doxorubicin, the generic term, using MedlinePlus, a comprehensive and relatively reliable public venture put forth by the National Library of Medicine and National Institutes of Health. If you’re into organic chemistry, you might want to review the structure of 14-hydroxydaunomycin, an antibiotic and cancer therapy first described 40 years ago…

Posted in Breast Cancer, cancer treatment, Essential Lessons, Life as a Doctor, Life as a Patient, Medical Education, Oncology (cancer), Women's HealthTagged , , , , , , , , , 2 Comments on How Well Do You Really Want to Know the “Red Devil?”

On Juno and Screening Test Stats

“Well, well” says the convenience store clerk. “Back for another test?”

“I think the first one was defective. The plus sign looks more like a division symbol, so I remain unconvinced,” states Juno the pregnant teenager.

“Third test today, mama-bear,” notes the clerk.

…”There it is. The little pink plus sign is so unholy,” Juno responds.

She’s pregnant, clearly, and she knows she is.

(see clip from Juno the movie*)

Think of how a statistician might consider Juno’s predicament…

Posted in cancer screening, Diagnosis, Medical Education, Movies, StatisticsTagged , , , , , , , , , , , , Leave a Comment on On Juno and Screening Test Stats

Another Take on Mammography

Three key issues have escaped the headlines: 1. The expert panel carried out a careful analysis using data that are, necessarily, old; 2. The recommendations don’t apply to digital mammography; 3. Mammograms are not all the same.

We need to set the bar higher for mammography…

Posted in Breast Cancer, cancer screening, Diagnosis, Medical News, Oncology (cancer), Women's HealthTagged , , , , , , , Leave a Comment on Another Take on Mammography

Getting the Math on Mammograms

But consider – if the expert panel’s numbers are off just a bit, by as little as one or two more lives saved per 1904 women screened, the insurers could make a profit!

By my calculation, if one additional woman at a cost of, say, $1 million, is saved among the screening group, the provider might break even. And if three women in the group are saved by the procedure, the decision gets easier…

Now, imagine the technology has advanced, ever so slightly, that another four or five women are saved among the screening lot.

How could anyone, even with a profit motive, elect not to screen those 2000 women?

Posted in Breast Cancer, cancer screening, cancer treatment, Diagnosis, health care costs, Medical Ethics, Medical News, Policy, Women's HealthTagged , , , , , , 1 Comment on Getting the Math on Mammograms

To Screen is Human

Smack in the midst of October-is-breast-cancer-awareness-month, the Journal of the American Medical Association published a provocative article with a low-key title: “Rethinking Screening for Breast Cancer and Prostate Cancer.” The authors examined trends in screening, diagnosis and deaths from cancer over two decades, applied theoretical models to the data and found a seemingly disappointing result.

It turns out that standard cancer screening is imperfect.

The subject matters, especially to me. I’m a medical oncologist and a breast cancer survivor, spared seven years ago from a small, infiltrating ductal carcinoma by one radiologist, an expert physician who noted an abnormality on my first screening mammogram…

Posted in Breast Cancer, cancer screening, Diagnosis, Medical News, Oncology (cancer), Women's HealthTagged , , , , , , , , , Leave a Comment on To Screen is Human
newsletter software