More on Mammography, Breast Cancer, Misleading Arguments, Emotion and Women’s Health

While therapy has improved quite a bit since 1985, the greatest benefit derives from most women avoiding the need for life-long treatment by having small tumors found and removed before they’ve spread.

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A Case for Slower Medicine

Anger is an understandable reaction to a system that dehumanizes patients, that treats bodies as containers of billable ailments and broken parts. But most doctors go about their daily work with good intention – to heal.

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Don’t Judge Her! An Essay on Angelina Jolie, BRCA, Cancer Risk and Informed Decision-Making

There’s no right answer…Jolie’s essay reflects the dilemma of any person making a medical choice based on their cir­cum­stances, values, genetic test results and what infor­mation they’ve been given or oth­erwise found and interpreted.

Posted in Breast Cancer, journalism, Medical News, Oncology (cancer), Public Illness, Women's HealthTagged , , , , , , , , , 5 Comments on Don’t Judge Her! An Essay on Angelina Jolie, BRCA, Cancer Risk and Informed Decision-Making

Study Finds Wide Variation in Reoperation Rates after Lumpectomy for Breast Cancer

All of this meshes with my experience – knowing women who’ve had breast-conserving surgery and then got mixed information about the results and what to do next. You’d think lumpectomy would be a standard procedure by now, and that decisions about what to do after the procedure, surgically speaking (let alone decisions about chemo, hormonal treatments and radiation) would be straightforward in most cases.

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Two Faces of Pancreatic Cancer

Early this week I was saddened to hear of a former colleague’s death from pancreatic cancer. Dr. Ralph Steinman, a physician-researcher at the Rockefeller University, received a Nobel Prize for his work on the innate immune system. For many, news of Ralph’s death at 68 years arrived synchronously with word of his award. Yesterday we […]

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On a Velázquez Portrait, and the Value of Expertise

This is an unusual entry into a discussion on the limits of patient empowerment. In late December the Times ran a story, beginning on its front page, about a portrait in the Metropolitan Museum of Art by Diego Velázquez, the 17th Century Spanish painter. The news was that the tall representation of the teenage Prince […]

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Informed Consent on Paper, but Not in Reality

Over the long weekend I caught up on some reading. One article stands out. It’s on informed consent, and the stunning disconnect between physicians’ and patients’ understanding of a procedure’s value.

The study used survey methods to evaluate 153 cardiology patients’ understanding of the potential benefit of percutaneous coronary intervention (PCI, or angioplasty)…

Posted in Cardiology, Communication, Informed Consent, Medical Ethics, Patient Autonomy, Under the RadarTagged , , , , , 4 Comments on Informed Consent on Paper, but Not in Reality

Lots of Excitement about Anacetrapib, a Cholesterol-Lowering Drug

I’m a bit puzzled by all the excitement about Merck’s new drug, Anacetrapib (MK-0859), that’s said to lower risk for cardiovascular disease by lowering bad cholesterol. Earlier this week at the annual meeting of the American Heart Association, researchers presented promising findings on the drug, including results from the phase III DEFINE trial. The list of disclosures for that abstract is long and fairly shocking. On Wednesday, the results were published on-line in the NEJM.*

The new drug interests me, as an oncologist, because it’s an enzyme inhibitor …

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Links Add Value to On-Line Reading and Medical Blog Content

This post is intended mainly for medical bloggers, but it has applications elsewhere. It’s about links and uniform resource locators (URLs), terms that I didn’t fully appreciate until the last year or so. That’s because like most of my colleagues and readers, I grew up reading printed books, newspapers and magazines. Now, perhaps as much as 90 percent of the non-fiction I read is on-line.

The Web has a lot of advantages for readers – you can see multimedia presentations, or double-click to enlarge a graph of interest. What I think is best, though, is the third

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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…

Posted in Breast Cancer, cancer screening, Essential Lessons, Life as a Doctor, Life as a Patient, Oncology (cancer), Women's HealthTagged , , , , , , , , Leave a Comment on Why I Went for My Screening Mammogram

Perspective on Screening for Sickle Cell Trait in Student Athletes

In some ways this seems like a pro-active, well-intentioned policy that could save lives. On the other hand, as discussed in the NEJM piece, the new screening policy raises a host of challenging issues:

* how will colleges inform minor players’ parents about results?
* how will the schools handle players’ privacy?…

Posted in Diagnosis, Genetics, Hematology (blood), Medical News, Under the RadarTagged , , , , , , , 2 Comments on Perspective on Screening for Sickle Cell Trait in Student Athletes

New NY State Law on Information for Women Undergoing Mastectomy

The reality is that many women, particularly poor women without newspapers or internet access in their homes, don’t know about any of this. They don’t know their insurance covers pretty much all of these options, by law. Now they will, or should as of Jan 1, 2011. Good. The other curiosity is that …

Posted in Breast Cancer, cancer treatment, Communication, Medical News, Patient Autonomy, Plastic and Reconstructive SurgeryTagged , , , , , , , 2 Comments on New NY State Law on Information for Women Undergoing Mastectomy

MedlinePlus, A Public Resource

MedlinePlus, a virtual superstore of medical information, is one of the most frequented health-related websites worldwide. The site, co-sponsored by the National Library of Medicine and the National Institutes of Health, is comprehensive and, with some exceptions (see below) relatively free of commercial bias. I find it a useful starting point for almost any health-related search…

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You’re Sick and I’m Not, Too Bad

“The insurance market as it works today basically slices and dices the population. It says, well you people with medical conditions, over here, and you people without them, over here…
– Jonathan Cohn, Editor of The New Republic, speaking on The Brian Lehrer Show, February 16, 2010*
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There’s a popular, partly true, sometimes useful and very dangerous notion that we can control our health. Maybe even fend off cancer.

I like the idea that we can make smart choices, eat sensible amounts of whole foods…

Posted in Essential Lessons, health care costs, Ideas, Medical Ethics, Policy, Public Health, RadioTagged , , , , , , , 1 Comment on You’re Sick and I’m Not, Too Bad
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