Talking About Physician Burnout, and Changing the System

With many difficult situations, the first step in solving a problem is in acknowledging it exists. After that, you can understand it and, hopefully, fix it. Our health care system now, as it functions in most academic medical centers and dollar-strapped hospitals, doesn’t give doctors much of a break, or slack, or “joy,” as…

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A Closer Look at the Details on Mammography, in Between the Lines

A seemingly slight adjustment in a statistic, for teaching purposes, can significantly change a test’s calculated value….

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Reading Between the Lines, and Learning from an Epidemiologist

She writes: “I believe that every edu­cated person must at the very least under­stand how these inter­preters of medical knowledge examine, or should examine, it to arrive at the conclusions.”

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FDA Approves Pertuzumab for Advanced, Her2+ Breast Cancer

My opinion is not quite formed on this new antibody. The FDA’s decision was based on results of one trial of 808 patients, half of whom didn’t get the experimental drug…

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EMILIA Trial: T-DM1 Appears Helpful in Women with Her2+ Metastatic Breast Cancer

The new agent is a hybrid of an old monoclonal antibody, Herceptin, that’s chemically attached to DM1, a traditional kind of chemotherapy. The preliminary results of this randomized trial are encouraging. …It’s hard to know how this promising, likely expensive, intravenous drug will fit in with others for patients with Her2+ breast cancer.

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10 Newly-Defined Molecular Types of Breast Cancer in Nature, and a Dream

The 10 molecular BC categories bear prognostic (survival) information and, based on their distinct mutations and gene expression patterns, potential targets for novel drugs….I wonder if, in a few years, some breast cancers might be treated without surgery.

Posted in Breast Cancer, cancer causes, cancer diagnosis, cancer treatment, Future of Medicine, Oncology (cancer), Pathology, Science, Under the RadarTagged , , , , , , , , , , 3 Comments on 10 Newly-Defined Molecular Types of Breast Cancer in Nature, and a Dream

A JAMA Press Briefing on CER, Helicopters and Time for Questions

What’s clear is that depending on how investigators adjust or manipulate or clarify or frame or present data – you choose the verb – they might show differing results. This doesn’t just pertain to data on trauma and helicopters…

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Review: Dr. Eric Topol’s Creative Destruction of Medicine

Topol’s comfortable writing about the intersection of science and medicine as few physicians are….One theme that emerges through the book is the capacity for technology – by “knowing” and processing so much real-time information about each person’s condition – to inform more effective, individualized treatments.

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New Article on Mammography Spawns False Hope That Breast Cancer is Not a Dangerous Disease

Few forms of invasive breast cancer warrant no treatment unless the patient is so old that she is likely to die first of another condition, or the patient prefers to die of the disease….“Mammograms Spot Cancers That May Not Be Dangerous,” said WebMD, yesterday. This is feel-good news, and largely wishful.

Posted in Breast Cancer, cancer screening, Communication, Diagnosis, Essential Lessons, journalism, Medical News, Oncology (cancer), Women's HealthTagged , , , , , 6 Comments on New Article on Mammography Spawns False Hope That Breast Cancer is Not a Dangerous Disease

What Does it Mean if Primary Care Doctors Get the Answers Wrong About Screening Stats?

The new findings have no bearing on whether or not cancer screening is cost-effective or life-saving. What the study does suggest is that med school math requirements should be upped and rigorous, counter to the trend

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Counterfeit Drugs, A New Concern for Patients

Counterfeit vials were sold and distributed to more than a dozen offices and medical treatment facilities in the U.S. This event, which seems to have affected a small number of patients and practices, should sound a big alarm.

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Cyberchondria Rising – What is the Term’s Meaning and History?

Yesterday the AMA news informed me that cyberchondria is on the rise. So it’s a good moment to consider the term’s meaning and history. Cyberchondria is an unfounded health concern that develops upon searching the Internet for information about symptoms or a disease. A cyberchondriac is someone who surfs the Web about a medical problem […]

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NEJM Reports on 2 New Drugs for Hepatitis C

Last week’s NEJM delivered an intriguing, imperfect article on a new approach to treating hepatitis C (HCV). The paper’s careful title, Preliminary Study of Two Antiviral Agents for Hepatitis C Genotype 1, seems right. The analysis, with 17 authors listed, traces the response of 21 people with hepatitis C (HCV) who got two new anti-viral agents, with or […]

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What is the Disease Control Rate in Oncology?

Last week I came upon a new term in the cancer literature: the Disease Control Rate. The DCR refers to the total proportion of patients who demonstrate a response to treatment. In oncology terms: The DCR is the sum of complete responses (CR) + partial responses (PR) + stable disease (SD). Another way of explaining […]

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The Emperor of All Maladies: A Narrative of Cancer History and Ideas

This week I finished reading the Emperor of All Maladies, the 2010 “biography” of cancer by Dr. Siddhartha Mukherjee. The author, a medical oncologist and researcher now at Columbia University, provides a detailed account of malignancies – and how physicians and scientists have understood and approached a myriad of tumors – through history. The encyclopedic, […]

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Breast Cancer Stats: Notes from the 2012 ACS Report, and a Key Question

Earlier this month, the ACS released its annual report on Cancer Facts and Figures. The document, based largely on analyses of SEER data from the NCI, supports that approximately 229,000 adults in the U.S. will receive a diagnosis of invasive breast cancer (BC) this year. The disease affects just over 2,000 men annually; 99% of […]

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Weight Loss Strategies – What Should Doctors Say to Patients?

Yesterday’s Times offered two distinct perspectives on weight loss. One, a detailed feature on gastric surgery by Anemona Hartocollis, details the plight of a young obese woman who opts for Lap-band surgery. In this procedure, surgeons wrap a constricting band of silicone around the stomach so that patients will feel full upon eating less food […]

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A Note on ‘Trial by Twitter’ and Peer Review in 2012

Nature just published a feature: Trial by Twitter. The piece considers the predicament of researchers who may find themselves ill-prepared to deal with a barrage of unsolicited and immediate on-line “reviews” of their published work. The author of the Nature News piece, science journalist A. Mandavilli, does a great job covering the pros and cons of Twitter “comments” […]

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Magic Johnson is Alive 20 Years after Announcing He Had HIV

Yesterday’s Washington Post Sports has a clip from CNN, 20 years ago, when basketball star Magic Johnson announced on TV that he had HIV, the virus that causes AIDS. The date was Nov 7, 1991. “Where were you when Magic made his announcement? What were your thoughts on Johnson and HIV/AIDS that day and how […]

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