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.
A question central to today’s discussion – which does at least acknowledge the decline in breast cancer mortality – is the extent to which mammography is responsible for this trend, as opposed to other factors such as increased awareness about cancer, better cancer treatments and other variables.
“You can get discomboobulated in this place,” a NYC police officer told me today.
This morning, some 25,000 or so men, women and children converged on Central Park for the Susan G. Komen Foundation’s 20th annual Race for the Cure. It was my first time witnessing the event:
…Live Each Day Like There’s a Lot of Them Left….What she articulated is the idea that maybe the best thing to do after cancer is to live, essentially, as you would do otherwise, except with a bit of added balance:
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 …
The Big C’s plot includes at least two “atypical” and potentially complex features. First, Cathy chooses not to take chemotherapy or other treatment. This intrigues me, and may be the show’s most essential component – that she doesn’t just follow her doctor’s advice. Second, she doesn’t go ahead and inform her husband, brother or son about the condition, at least not so far…
The question is, what’s the right, PC and emotionally-sound, sensitive but not sappy term to describe the situation of a person who’s living after breast cancer?
Some might say, who cares if you’ve had it?
Today is the start of this year’s Shark Week on the Discovery Channel. Dialog from NBC’s 30 Rock, Season 1, Episode 4 “Jack the Writer” (2006)*: Tracy Jordan: But I want you to know something… You and me, it’s not gonna be a one-way street. Cos I don’t believe in one-way streets. Not between people, and not […]
A prominent article in yesterday’s New York Times considers some troubling problems regarding inaccuracy in breast cancer diagnosis and pathology. The main point is that some women get needless, disfiguring and toxic treatments after being told they have breast cancer when, it turns out, their condition was benign. My main take is that, whenever possible, […]
Hiking, or even just walking, in the hot summer heat to see ancient ruins, national monuments or spectacular vistas can sap the energy of healthy people. For someone who’s got a health issue – like chronic lung disease, reduced heart function or anemia – or anyone who’s pregnant, elderly or just frail, summer travel can knock you out in the wrong sort of way….Don’t plan
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 […]
I can’t even begin to think of how much money this might save, besides sparing so many women from the messy business of infusions, temporary or semi-permanent IV catheters, prophylactic or sometimes urgent antibiotics, Neulasta injections, anti-nausea drugs, cardiac tests and then some occasional deaths in treatment from infection, bleeding or, later on, from late effects on the heart or not-so-rare secondary malignancies like leukemia. And hairpieces; we could see a dramatic decline in women with scarves and wigs.
This week I’ve been reading about new developments in breast cancer (BC) pathology. At one level, progress is remarkable. In the 20 years since I began my oncology fellowship, BC science has advanced to the point that doctors can distinguish among cancer subtypes and, in principle, stratify cases according to patterns of genes expressed within […]
Yesterday I visited my internist. I had no particular complaint. My back hurt no more than usual. The numbness in my left foot was neither better nor worse than it was last month. I wasn’t suffering from vertigo or abdominal pain. I went because I had an appointment to see her, nothing more.
Until just a few years ago, I rarely
As pretty much anyone traveling in Europe this week can tell you, it’s sometimes hard to know what will happen next. Volcanologists – the people most expert in this sort of matter – simply can’t predict what the spitfire at Eyjafjallajokull will do next.
It comes down to this: the volcano’s eruption could get better or it could get worse…
What the authors tried to do was analyze trends in breast cancer mortality in relation to mammography’s availability in distinct regions of Denmark over several decades. Using Poisson regression, a form of statistical analysis, they looked for a correlation and found none. They concluded that they couldn’t detect a benefit of screening mammograms among Danish women who might benefit (see below).
Here’s what I think are the two most serious flaws in this observational study:
Am I pro- or con- colonoscopy for routine screening, you might wonder. Well, that depends.
Am I pro- or con- famous singers and other celebrities extolling the benefits of particular medical interventions? Well, that depends, too.
But I’m sure I prefer “Puff the Magic Dragon.” Also “Leaving on a Jet Plane” fills me with imperfect memories of 6th grade.
Last week the journal Cancer published a small but noteworthy report on women’s experiences with a relatively new breast cancer decision tool called Oncotype DX. This lab-based technology, which has not received FDA approval, takes a piece of a woman’s tumor and, by measuring expression of 21 genes within, estimates the likelihood, or risk, that her tumor will recur.
As things stand, women who receive a breast cancer diagnosis face difficult decisions…
I first heard about STI-571 (Gleevec, a targeted cancer therapy) from a cab driver in New Orleans in 1999. “Some of the doctors told me there’s a new cure for leukemia,” he mentioned.
We were stuck in traffic somewhere between the airport and the now-unforgettable convention center. His prior fare, a group of physicians in town for the American Society of Hematology’s annual meeting, spoke highly of a promising new treatment. It seemed as if he wanted my opinion, to know if it were true. Indeed, Dr. Brian Druker gave a landmark plenary presentation on the effectiveness of STI-571 in patients with chronic myelogenous leukemia (CML) at the conference. I was aware of the study findings.
“Yes,” I said. “There is a new drug for leukemia.”
Since then, oncologists’ enthusiasm for targeted therapies – medications designed to fight cancer directly and specifically – has largely held. But the public’s enthusiasm is less apparent. Perhaps that’s because many people are unaware of these new drugs’ potential, or they’re put off by their hefty price tags.
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 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.
