February 2010 – Medical Lessons

Today’s Press on Targeted Therapy for Cancer

February 24, 2010February 28, 2010 Elaine Schattner M.D.

Today the NY Times printed the third part of Amy Harmon’s excellent feature on the ups and downs and promise of some clinical trials for cancer. The focus is on a new drug, PLX4032, some people with melanoma who chose to try this experimental agent, and the oncologists who prescribed it to them.

What I like about this story is that, besides offering some insight on the drug itself, it balances the patients’ and doctors’ perspectives; it explains why some people might elect to take a new medication in an early-stage clinical trial and why some physicians push for these protocols because they think it’s best for their patients.

And it provides a window into the world of academic medicine, where doctors’ collaborate among themselves and sometimes with corporations.

Here’s some of what I learned:

Posted in cancer treatment, clinical trials, Communication, Medical News, Oncology (cancer), ScienceTagged cancer medicine, clinical trials, communicating in medicine, decisions, health, medical news, melanoma, Oncology (cancer), patient-doctor relationship, PLX40321 Comment

New Boss on The Office is a Breast Cancer Survivor

February 22, 2010September 13, 2021 Elaine Schattner M.D.

There’s a new survivor on TV and she means business.

In the latest episode of The Office, Kathy Bates walked into the Scranton branch of Dundler Mifflen and onto my living room TV screen as Jo Bennett, CEO of Sabre, a fictitious Tallahassee-based company. An assistant and two large canines accompany her as she meets the crew. She’s firm, graying and very much-in-charge.

When the camera gets her alone, in focus, here’s what she has to say:

“I’m Jolene Bennett, Jo for short.

“I’m a breast cancer survivor, close personal friends with Nancy Pelosi, and Truman Capote and I slept with three of the same guys. When I was a little girl I was terrified to fly, and now I have my own pilot’s license.

“I am CEO of Sabre International and I sell the best damn printers and all-in-one machines Korea can make.

“Pleased to meet ya.

Posted in Breast Cancer, cancer survival, Reviews, TVTagged Breast Cancer, breast cancer survivor, business, health, Kathy Bates, survivor, The Office, TV, Women's Health, workplace1 Comment

News on Aspirin After Breast Cancer

February 18, 2010September 13, 2021 Elaine Schattner M.D.

There’s promising news on the breast cancer front.

A study published on-line this week in The Journal of Clinical Oncology (JCO) suggests that regular, low-dose aspirin use reduces the risk of recurrence and death from breast cancer among women who’ve had stage I, II or III (non-metastatic) disease.

This is a phenomenal report in three respects:

1. The dramatic results: among women who’ve had breast cancer, regular aspirin use was associated with a reduced risk of recurrence and of death from cancer by more than half;

2. The relevance; these findings might affect millions of women living after breast cancer, today;

3. The cost: aspirin is widely available without patent restriction. Aspirin costs around $5 for 100 tablets, several months’ supply.

Posted in Breast Cancer, cancer survival, cancer treatment, Medical News, Oncology (cancer), Women's HealthTagged aspirin, Breast Cancer, cancer medicine, cancer treatment, medical news, Women's Health2 Comments

You’re Sick and I’m Not, Too Bad

February 16, 2010March 28, 2019 Elaine Schattner M.D.

“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*
—–
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 chronic illness, empathy, health care costs, health care reform, health insurance, informed decisions, medical ethics, Public Health1 Comment

Health Care Costs, Communication and Informed Choices

February 12, 2010August 30, 2011 Elaine Schattner M.D.

For those of you who’ve been asleep for the past year: the health care costs conundrum remains unsolved. Our annual medical bills run in the neighborhood of $2.4 trillion and that number’s heading up. Reform, even in its watered-down, reddened form, has stalled.

Despite so much unending review of medical expenses – attributed variously to an unfit, aging population, expensive new cancer drugs, innovative procedures, insurance companies and big Pharma – there’s been surprisingly little consideration for patients’ preferences. What’s missing is a solid discussion of the type and extent of treatments people would want if they were sufficiently informed of their medical options and circumstances.

Maybe, if doctors would ask their adult patients how much care they really want, the price of health care would go down. That’s because many patients would choose less, at least in the way of technology, than their doctors prescribe. And more care.

What I’m talking about is the opposite of rationing. It’s about choosing.

Posted in cancer treatment, Communication, Empowered Patient, health care costs, Informed Consent, Medical Ethics, Patient AutonomyTagged cancer medicine, chemotherapy, communicating in medicine, decisions, doctor-patient relationship, empowered patient, end-of-life, life as a patient, palliative care1 Comment

On Precious

February 8, 2010October 31, 2021 Elaine Schattner M.D.

This is my first film review, if it is that.

I was tempted to write about Ethan Hawke, hematologist among vampires in Daybreakers, but gore’s not my favorite genre. A mainstream choice would have been Harrison Ford solving the enzyme deficiency of Pompe disease in Extraordinary Measures, but I didn’t get sucked in.

I chose Precious, instead. This luminous movie relates to the practice of medicine everyday, big-time.

Posted in Communication, Essential Lessons, Life, Life as a Patient, Life in NYC, Medical Education, Medical Ethics, Movies, Patient Autonomy, Reviews, Women's HealthTagged abuse, disability, empathy, health care disparities, life as a patient, movie, obesity, Precious, Precious the movie, review, Women's Health1 Comment

Henrietta’s Cells Speak

February 5, 2010September 13, 2021 Elaine Schattner M.D.

“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 books, cancer research, cervical cancer, communicating in medicine, HeLa cells, Henrietta Lacks, Johns Hopkins, life as a patient, medical education, medical ethics, medical research, patient-doctor relationship, Women's Health1 Comment

Are Doctors Necessary?

February 2, 2010October 31, 2021 Elaine Schattner M.D.

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 communicating in medicine, decisions, doctor-patient relationship, doctors' lives, e-health, empowered patient, expertise, Future of Medicine, health, health data, internet medicine, IT, medical information, social mediaLeave a Comment

Medical Lessons