An Oncologist Considers Rare Lymphomas in Women With Breast Implants

I have to admit that when I first read about the FDA’s report tying rare cases of anaplastic large cell lymphoma to breast implants, my mind raced with a strange blend of excitement, intense interest and concern. My thoughts shifted from “wow, that’s really interesting” to “exactly what did the FDA find” to “should I be worried?”

So I’ve decided to write this morning’s post from my perspective as an oncologist

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FDA Reports on Association of Breast Implants and a Rare Form of Lymphoma

It’s a Pandora’s box, but one that needs be opened. The problem is that if we biopsy every abnor­mality – such as a minor thick­ening or fluid accu­mu­lation adjacent to a breast implant – we’ll hike up the costs and, more impor­tantly, the com­pli­ca­tions asso­ciated: With every needle stick there’s a risk of infection, addi­tional scar for­mation and more. On the other hand, you wouldn’t want to overlook a treatable, early-stage lym­phoma. Women need to know of the risks of implants, which can only be deter­mined if doctors thor­oughly inves­tigate these sorts of complications.

Posted in Breast Cancer, cancer treatment, Medical News, Oncology (cancer), Plastic and Reconstructive Surgery, Women's HealthTagged , , , , , , , , 1 Comment on FDA Reports on Association of Breast Implants and a Rare Form of Lymphoma

Why It’s a Good Idea to Get a Second Opinion, and Maybe a Third, But Rarely a Fourth

A few years ago I started writing a book on what it was like to be a cancer patient and an oncologist. This morning I came upon this section on second opinions: Is it OK to get a second opinion? Definitely. And there’s no need to be secretive about it, or to worry about hurting […]

Posted in cancer treatment, Communication, Empowered Patient, Life as a Doctor, Life as a Patient, Oncology (cancer), Patient-Doctor RelationshipTagged , , , , , , 1 Comment on Why It’s a Good Idea to Get a Second Opinion, and Maybe a Third, But Rarely a Fourth

Cautious Optimism for a New Melanoma Treatment

This morning’s news feed delivered some seemingly excellent news for some people with melanoma. At least until now, this form of skin cancer has been considered incurable when metastatic. In the last year, we heard details about the ups and downs of ongoing clinical trials of new drugs to treat the disease. The Times reports […]

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Steve Jobs Takes a Medical Leave

The big health story of the week, headlining the business news, is that Steve Jobs, Apple’s founder and usual CEO, is taking another medical leave. This is hardly a surprising development, given that the 55 year old corporate leader has had a complex medical course since at least 2003. In August, 2004 he told Apple […]

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After Breast Cancer, Get a Gym Membership!

The findings show that it’s safe for women who’ve had breast cancer surgery to work out in a way that includes a careful, progressive upper body strengthening. Weight lifting is not only safe; it can reduce lymphedema in women at risk. But “old wives’ tales” still persist in some doctors’ minds and established medical resources. These need be dispelled.

Posted in Breast Cancer, cancer survival, Essential Lessons, Fitness, Medical News, Oncology (cancer), Women's HealthTagged , , , , , , , , 1 Comment on After Breast Cancer, Get a Gym Membership!

The Loss of Elizabeth Edwards

Dear Readers, I am sad to learn of the death of Elizabeth Edwards, who died earlier today of metastatic breast cancer at the age of 61. She has taught countless people about what it’s like to live with cancer. My thoughts are with her family now. -ES Related Posts:No Related Posts

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Does Cathy Make the Right Cancer Treatment Decision in the Big C?

“I don’t want to get sicker trying to get better and then just end up dying anyway” – Cathy, the 42 year old protagonist, with advanced melanoma, on the Big C.

Spoiler alert: Don’t read this post if you don’t want to know what happens to Cathy in the Big C…After months of unusual and comfort zone-breaking behavior, Cathy

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First Season Ending of the Big C

Last night I stayed up late to see the season finale of the Big C. For the first time in watching this series about a 42 year old woman with advanced melanoma, in a near-final scene involving the protagonist Cathy’s teenage son, I cried.

The storyline is moving, finally, in a real and not necessarily happy direction.

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Noting the Death of Jill Clayburgh Who Lived For 21 Years With a Chronic Form of Leukemia

I was saddened yesterday to learn of the death of Jill Clayburgh. The 66 year old actress died on Friday in her Connecticut home. According to ABC news and the LA Times among other reports, she’d had chronic lymphocytic leukemia (CLL) for 21 years. This means she lived with CLL for nearly a third of […]

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Crizotinib, An Experimental Drug for Some Lung Cancers and Other Tumors With Alk Mutations

Why am I blogging about this drug, a pill, that works imperfectly in perhaps most of 5% of non-small-cell lung cancer patients and, maybe, in some other rare tumors? Because this is the future of oncology and, ultimately I think, will provide cost-effective medicine that’s based in evidence and science. The key is that the investigators tried the experimental drug in lung cancer patients with a specific genetic profile, one that predicts a response to this agent…
How drugs like crizotinib could save money: 1. This drug is a pill; slash the costs of IVs, pumps, bags of saline, nurses to administer…2. Don’t give it to patients without a relevant genetic mutation; 3. Monitor patients for resistance and stop giving drugs when they no longer help the individuals for whom their prescribed.

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Annals of Pink: Chilean Miners Don Ribbons

The Santiago Times reports that the rescued Chilean miners donned suits and pink ribbons, the latter in honor of breast cancer awareness month, at a ceremony at the the presidential palace, la Moneda. Sure, the pink scene’s getting to be a bit much around here. But I don’t belittle this gesture; the miners’ intentions are […]

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Stem Cells, Breast Reconstruction and a Magazine Cover

The cover of the November print edition of Wired features large, unnatural-appearing cleavage. Inside and toward the back of the issue, a curious article ties together stem cells and the future of breast reconstruction. It got my attention. The detailed and admittedly interesting piece, by Sharon Begley, describes what’s science or science fiction: first humans, […]

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New Findings on Postmenopausal Hormone Replacement Therapy and Breast Cancer

This week the Journal of the American Medical Association (JAMA) published results of a large study with significant implications for women who consider taking hormone replacement therapy (HRT). The new findings are based on careful examination over 16,000 individuals, part of the larger Women’s Health Initiative, who were randomly assigned to take either a placebo, […]

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October 13 Would Be National Metastatic Breast Cancer Awareness Day

Last October, the U.S. Senate (on 10/13/09) and House (retroactively, on 10/28/09) voted to support the designation of October 13, 2009, as a National Metastatic Breast Cancer Awareness Day. The point was to draw public attention to the distinct needs of metastatic BC patients: women who live every day with this condition but, for the most part, are not heralded in pink.

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Why I Went for My Screening Mammogram

I was afraid to get a mammogram because I didn’t want to learn I had cancer….I feared having a “false positive,” and undergoing multiple tests to evaluate abnormal images that would turn out to be nothing…I didn’t have time for all that…

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Swedish Mammography Report Finds Benefit In Screening Younger Women

The Swedish study with its positive findings should be scrutinized, yes, but no more or less than the other papers on the same subject that have been highlighted, selectively, in the media. How journalists cover mammography studies, and that they do so with an open mind, matters a lot.

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It’s Not About the Money

If physicians’ potential profit motives cloud the mammography debate, as the authors contend, that doesn’t mean that mammography is ineffective. Rather it signifies that doctors and scientists should analyze data and make clinical decisions in the absence of financial or other conflicts of interest.

Posted in Breast Cancer, cancer screening, health care costs, health care delivery, Medical Ethics, Oncology (cancer), PolicyTagged , , , , , , , , , Leave a Comment on It’s Not About the Money

What’s Missing in the Recent Mammography Value Study

I’d say the oppo­site is true: It’s pre­cisely because there are effec­tive treat­ments for early-stage dis­ease that it’s worth find­ing breast can­cer early. Oth­er­wise, what would be the point?

Metasta­tic breast can­cer is quite costly to treat and, even with some avail­able tar­geted ther­a­pies, remains

Posted in Breast Cancer, cancer awareness, cancer screening, cancer survival, Diagnosis, Medical News, Oncology (cancer)Tagged , , , , , , Leave a Comment on What’s Missing in the Recent Mammography Value Study
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