Quotes on Oncology, Via Forbes, and a Spiraling Helix

Forbes kept a close eye on the annual ASCO meeting in Chicago. On THE MEDICINE SHOW, Forbes’ Matthew Herper provides a précis of a speech by outgoing ASCO President Dr. George Sledge. Here are my two favorite parts: “So what happens when, a few years from now, a patient walks into a doctor’s office and […]

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Considering Aromasin for Healthy Women, and the New Breast Cancer Prevention Study

I’m minding the annual meeting of the American Society of Clinical Oncology from a distance this year. So far, the big breast cancer story syncs with a NEJM paper published yesterday on-line, on the use of exemestane (brand name: Aromasin, manufactured by Pfizer) to prevent invasive breast cancer. These patent-protected pills block the body’s normal […]

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News on Niaspan, Cholesterol Drugs and Biomarkers

The Times alerted me, this evening: Lowering bad cholesterol levels reduces heart attack risks, and researchers have long hoped that raising good cholesterol would help, too. Surprising results from a large government study announced on Thursday suggest that this hope may be misplaced…. Common wisdom has been that such patients should take a statin drug […]

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On Media Snobs and Darwinism in the Blogosphere

Last week Aaron Sorkin wrote for The Atlantic a piece in which he details his daily news feed, in What I Read. He’s not into blogs: When I read the Times or The Wall Street Journal, I know those reporters had to have cleared a very high bar to get the jobs they have. When I […]

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TV Meets Real Life Oncology, and Anticipating the MCATs

Yesterday I wrote on some tough decisions facing a TV show‘s protagonist. She’s got metastatic melanoma and might participate in a clinical trial when the show resumes. Now imagine you’re an oncologist, or a real patient with this killing disease – you really need to be on top of new developments, to understand the pros […]

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E-Patient Dave Explains What It Means to Be An E-Patient

Med-blog grand rounds this week is hosted by e-patient Dave, who is Dave deBronkart, a real man who was diagnosed with a renal cell (kidney) cancer a few years back. He’s a terrific speaker and an Internet friend. By coincidence I was searching for the definition of an e-patient, and came upon it there, in […]

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On Pleasant Behavior And Being A Patient in the Hospital

Dr. Wes has a short post today, How to Optimize Your Care While Hospitalized that got me thinking. He writes: …A lone doctor listening to some highly experienced and capable nurses, reflecting on their work: “If the patient’s nice, it’s a lot easier to want to go back in that room with them. Their reputation […]

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Getting the Blood Tests Right at the Phlebotomy Center

Last week I had some blood tests taken before a doctor’s appointment. I went to a commercial lab facility, one of several dozen centers for collecting specimens have opened up in otherwise-unrented Manhattan office spaces lately. I have to say I really like getting my blood work done at this place, if and when I […]

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The Medical Word of the Week is Theranostic

The author learned a new word this weekend while attending the annual meeting of the Association of Health Care Journalists in Philadelphia. In a richly-informative session on ethics of clinical trials, one of the speakers, Dr. Jason Karlawish – a bioethicist, geriatrician and Alzheimer’s researcher at the University of Pennsylvania, taught me a new term: […]

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Internet-Based Medical Information May Prove More Trustworthy Than Printed Texts

Today Ed Silverman of Pharmalot considers the case of a ghost-written medical text’s mysterious disappearance. The 1999 book, “Recognition and Treatment of Psychiatric Disorders: A Psychopharmacology Handbook for Primary Care,” (reviewed in a psychiatry journal here) came under scrutiny last fall when it became evident that the physician “authors” didn’t just receive money from a […]

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In Defense of Primary Care, and of Sub-Sub-Sub-Specialists

An article in the March 24 NEJM called Specialization, Subspecialization, and Subsubspecialization in Internal Medicine might have some heads shaking: Isn’t there a shortage of primary care physicians? The sounding-board piece considers the recent decision of the American Board of Internal Medicine to issue certificates in two new fields: (1) hospice and palliative care and (2) advanced heart failure and plans in-the-works for official credentialing in other, relatively narrow fields like addiction and obesity.

The essay caught my attention because I do think it’s true that we need more well-trained specialists

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Crowd-Sourcing a Medical Puzzle

The Times ran an intriguing experiment on its Well blog yesterday: a medical problem-solving contest. The challenge, based on the story of a real girl who lives near Philadelphia, drew 1379 posted comments and closed this morning with publication of the answer. Dr. Lisa Sanders, who moderated the piece, says today that the first submitted […]

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A Good Place to Find Information on Clinical Trials

If you’re thinking of participating in a clinical trial for cancer or any other medical condition, a good place to find out about the research is ClinicalTrials.gov. The site, sponsored by the NIH, NLM and FDA, is one outcome of the FDA Modernization Act (FDAMA) of 1997. The database aims to provide information on clinical […]

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Bristol-Meyers Says Ipilimumab Prolongs Survival in Metastatic Melanoma

This morning health business mavens are chirping with bright results for ipilimumab, a monoclonal antibody that can extend life in people with metastatic melanoma. If the new data – which I haven’t seen – are true, it’s good news for patients. In 2010, melanoma affected 68,000 people in the U.S. and led to death in […]

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When Less Chemo is Just As Good, In Treatment for Acute Myeloid Leukemia (AML)

Today’s issue of the New England Journal of Medicine includes an article with the bland title Cytarabine Dose for Acute Myeloid Leukemia. AML is an often-curable form of leukemia characterized by rapidly-growing myeloid white blood cells. Cytarabine – what we’d call “Ara-C” on rounds  – has been a mainstay of AML treatment for decades. The […]

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Benlysta, A New Treatment for Lupus

Lupus, an autoimmune disease, turned up on the front page, right side of today’s Wall Street Journal. It cropped up, also, on the first page of the New York Times business section, and elsewhere. Scientific American published a nice on-line review, just now. The reason is that yesterday the FDA approved a new, monoclonal antibody […]

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New Data for Avastin (Bevacizumab)

A new report was published on-line this afternoon by the Journal of Clinical Oncology (JCO). It covers a Phase III (randomized) clinical trial of Avastin (Bevacizumab) in women with metastatic BC. Over 1200 patients were included in the analysis, all with Her2 negative disease. The design of the randomized study protocol was a bit unusual, […]

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The Flip Side of Unrealistic Optimism

Last week, Pauline Chen wrote on medical ethics and clinical trials. She reflects on her training at a cancer research hospital, where some cancer patients go with unrealistic optimism.

Like Dr. Chen, I spent part of my training at a famous cancer center where I worked as a resident and fellow on rotations. And yes, some patients were unreasonably optimistic and some – perhaps even most, it seemed – didn’t fully “get” the purpose of their trial, which in Phase I studies were not designed to help them. This is a real dilemma for treating oncologists.

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A Video About a Robot and a Patient

Since Watson won on Jeopardy, there’s been lots of talk of robots assuming doctors’ roles. Ten years into our future, machines with programmed empathy and nuanced diagnostic skills will solve diagnostic dilemmas, deduce optimal treatment and make us well. Yesterday I found a new Xtranormal video, this one crafted by Dr. Charles of his excellent […]

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