Dr. Elaine Schattner's notes on becoming educated as a patient
Dr. Elaine Schattner's notes on becoming educated as a patient
© Elaine Schattner, 2009, 2022 By : Template Sell.
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 …
…This goes well beyond a new approach to finding a cure for Parkinson’s disease.
This story, largely based in genomics and computational advances, reflects the power of the human mind, how the gifted son of two mathematicians who fell into a particular medical situation, can use his brains, intellectual and financial resources, and creativity, to at least try to make a difference.
I learned of a new study implicating stress in reduced breast cancer survival by Twitter. A line in my feed alerted me that CNN’s health blog, “Paging Dr. Gupta,” broke embargo on the soon-to-be-published paper in the journal Clinical Cancer Research. The story – that women who undergo a stress relief program live longer after […]
Harlem Hospital Center stands just three miles or so north of my home. I know the place from the outside glancing in, as you might upon exiting from the subway station just paces from its open doors. The structure seems like one chamber of its neighborhood’s heart; within a few long blocks’ radii you’ll find rhythms generated in the Abyssinian Baptist Church; readings at the Schomburg Center and artery-clogging cuisine at the West 135th Street IHOP.
So I was saddened to hear about the missed heart studies. Or should I say unmissed? No one noticed when nearly 4,000 cardiac tests went unchecked at the Harlem center,
Earlier this month employees at most of 7500 Walgreens pharmacies geared up to stock a new item on their shelves: a saliva sampler for personal genetic testing. On May 11, officials at Pathway Genomics, a San Diego-based biotech firm, announced they’d sell over-the-counter spit kits for around $25 through an arrangement with the retailer. A curious consumer could follow the simple package instructions and send their stuff in a plastic tube, provided in a handy box with pre-paid postage, for DNA analysis.
A new report from the “Make our Food Safe” project, based at Georgetown University, makes clear that food-borne illnesses – from bacteria, parasites and a few viruses – are ever-present and costly.
The study, authored by Robert Scharff and funded by the Pew Charitable Trusts, finds that food-borne illnesses tally nearly $152 billion per year. This huge sum includes some subjectively-measured expenses like pain, suffering and missed work. Even without those, the toll registers above $100 billion – it’s a big sum, either way.
The main culprits are
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:
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.
Why bother, you might ask – wouldn’t it be easier to drop the subject?
“Make it go away,” sang Sheryl Crow on her radiation sessions.
I’ll answer as might a physician and board-certified oncologist who happens to be a BC survivor in her 40s: we need establish how often false positives lead, in current practice, to additional procedures and inappropriate treatment…These numbers matter. They’re essential to the claim that the risks of breast cancer screening outweigh the benefits.
The risks of radiation from CT scanning will almost certainly add to the current confusion and concerns about the risks of breast cancer screening.
Mammography differs from CT scanning in several important ways:
1. Mammograms involve much less radiation exposure than CT scans.
2. Mammography is well-regulated by the Food and Drug Administration (FDA) and other agencies. The Mammography Quality Standards Act (MQSA) requires…
3. Women who undergo screening mammograms can control when and where they get this procedure. Screening mammograms are elective by nature..
A colleague sent me an email about my math. You’re more or less right, he said, but you need to account for the false positives. I agree with him. (It’s true.) The problem is, among others, how to present those numbers in the press. Statistics don’t sell; still, an explanation is due. In my next […]
Three key issues have escaped the headlines: 1. The expert panel carried out a careful analysis using data that are, necessarily, old; 2. The recommendations don’t apply to digital mammography; 3. Mammograms are not all the same.
We need to set the bar higher for mammography…
But consider – if the expert panel’s numbers are off just a bit, by as little as one or two more lives saved per 1904 women screened, the insurers could make a profit!
By my calculation, if one additional woman at a cost of, say, $1 million, is saved among the screening group, the provider might break even. And if three women in the group are saved by the procedure, the decision gets easier…
Now, imagine the technology has advanced, ever so slightly, that another four or five women are saved among the screening lot.
How could anyone, even with a profit motive, elect not to screen those 2000 women?
Smack in the midst of October-is-breast-cancer-awareness-month, the Journal of the American Medical Association published a provocative article with a low-key title: “Rethinking Screening for Breast Cancer and Prostate Cancer.” The authors examined trends in screening, diagnosis and deaths from cancer over two decades, applied theoretical models to the data and found a seemingly disappointing result.
It turns out that standard cancer screening is imperfect.
The subject matters, especially to me. I’m a medical oncologist and a breast cancer survivor, spared seven years ago from a small, infiltrating ductal carcinoma by one radiologist, an expert physician who noted an abnormality on my first screening mammogram…
