Oncologists Blogs 
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This page shows you the most recent publications within this specialty of the MedWorm directory.
What's Sauce for the Goose May Not Be Sauce for the Gander
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Avastin has been in the news a lot lately, and most of the press has been negative. In November, the FDA revoked its approval of Avastin to treat newly diagnosed metastatic breast cancer. Then, in December, Genentech, who manufactures Avastin, announced it would not seek FDA approval for the treatment of ovarian cancer, based on studies showing an improvement in progression-free survival but not overall survival. Of course, whether Avastin helps women with ovarian cancer remains a controversial question, depending how you value progression-free survival. Compare this report with this one, for example.&nbs...
Source: Doctor David's Blog - January 25, 2012 Category: Oncologists Tags: Hot Topics in Cancer Research Breaking News Breast Cancer Source Type: blogs
Yes, we have no...Zofran?Email this article to a colleague.
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This article, published in the scientific journal Nature in October, discusses the effect of drug shortages on clinical trial enrollment. Closer to home, the clinical trial I am running looking at Doxil and temsirolimus for sarcoma patients is on hold because Doxil is unavailable. We haven't enrolled a new patient in months, and there is no end to the shortage in sight.
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The shortages are not limited to chemotherapy drugs (which, of course, is evidence that the problem is not due to the inability of oncologists to make a profit giving drugs to patients). Drugs for ADHD, the components for iv ...
Source: Doctor David's Blog - January 22, 2012 Category: Oncologists Tags: Hot Topics in Cancer Research Breaking News Source Type: blogs
Entering the FrayEmail this article to a colleague.
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The vast majority of biomedical research conducted in the United States is funded by taxpayers through grants distributed by the National Institutes of Health. This includes investigator-initiated laboratory research (the work we do in our labs) as well as clinical trials, both large and small (NIH is a large supporter, for example, of the Children's Oncology Group). In the not-too-distant past, the results of all of this research were published in scientific journals which were available to anyone who could gain entrance to a medical library. With the rise of the internet, journals began publishing onlin...
Source: Doctor David's Blog - January 13, 2012 Category: Oncologists Tags: Hot Topics in Cancer Research Blogging Breaking News Source Type: blogs
2012Email this article to a colleague.
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The last couple years were pretty difficult. Personal problems, professional problems, existential problems.But, rather than view 2012 as some kind of "new" year, I'm starting to accept that all pain is simply the flip side of happiness. As I see countless cancer patients struggle with their lives and deaths, I start to see it all as the grand cosmic cycle of life and death, birth and creation.Ecclesiastes. The Tao. Samsara. We are all just cycling through, brief ripples on the cosmic ocean of life.I have tried so hard over the years to insulate myself from pain. Exercising, studying, saving money, trimming negativity from...
Source: CancerDoc - January 12, 2012 Category: Oncologists Source Type: blogs
It’s time to stop getting that PSA test for prostate cancerEmail this article to a colleague.
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I was reminded of this when I learned of a new article “hot off the press”, published in the Journal of the National Cancer Institute. The news was so exciting that they published the results online before the journal was released. And what was so exciting? We learned that screening for prostate cancer doesn’t save any lives.The study described in the article was the Prostate, Lung, Colorectal, and Ovarian Screening trial (PLCO). I already wrote about the Lung cancer part of the trial (CT scanning), which worked; CT scanning saved lives. But the Prostate cancer trial (PSA testing and rectal exam) did not.Here is how ...
Source: Dr.Kattlove's Cancer Blog - January 10, 2012 Category: Oncologists Source Type: blogs
"We need a better test"... or do we?Email this article to a colleague.
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This study made headlines, in large part because it runs contrary to conventional wisdom -- that cancer screening tests, by detecting the disease at an early stage, save lives. A number of things struck me about this study and the way it was reported.
This is one of several relatively recent studies that has called into question the premise behind cancer screening tests. Two years ago, I had a post about a revision of the US Preventive Services Task Force's position on Pap smears and mammograms. In that post, I talked more about how screening tests might be applied to particular patient populations...
Source: Doctor David's Blog - January 10, 2012 Category: Oncologists Tags: Hot Topics in Cancer Research Cancer Prevention Breaking News Source Type: blogs
Don’t believe the headlines about AvastinEmail this article to a colleague.
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This study was mainly done in Europe and had the same results. The cancer took a little more time to progress in the women given Avastin, but after 3 years, the groups had equal numbers of deaths.What does all this mean? It means that blocking blood vessels with a drug like Avastin, though a great concept, isn’t the answer to ovarian cancer or most other cancers, unless there is a better blocker out there somewhere.I have always said that the main treatment for cancer is surgery. All the other treatments like chemotherapy and radiation make much less difference than does surgery – cutting it all out. Ovarian cancer, as...
Source: Dr.Kattlove's Cancer Blog - January 1, 2012 Category: Oncologists Source Type: blogs
My name is FDA, and I approve of this messageEmail this article to a colleague.
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As the new year begins and election season accelerates, we will be hearing phrases like that more and more. In the context of a political commercial, it is often pretty clear what is being approved and the basis for the approval.
But what about new drugs? How does the FDA decide whether or not to approve a new cancer drug, and what exactly is being approved? In the era of targeted therapies, which are incredibly expensive to develop, and therefore incredibly expensive for patients and their insurance companies, these are crucial questions.
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I think the case of bevacizumab (Avastin) is a perf...
Source: Doctor David's Blog - December 29, 2011 Category: Oncologists Tags: Hot Topics in Cancer Research Breaking News Source Type: blogs
Managing PainEmail this article to a colleague.
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Pain.
Little scares a new oncology patient as much as the idea of pain. Unfortunately, pain permeates my practice. Often, pain is the initial symptom that leads to a new cancer diagnosis. Cancer patients undergo frequent painful procedures -- biopsies, bone marrow aspirates, surgeries ... even a simple blood draw involves a small amount of pain. Because of this, managing pain is something I have some experience doing.
So I was surprised when I read this article in The Washington Post this morning and discovered that "some [pain doctors] began decrying the increasingly widespread use of opioids and...
Source: Doctor David's Blog - December 24, 2011 Category: Oncologists Tags: Being a Pediatric Oncologist Side Effects of Treatment Pain Control Source Type: blogs
Cancer LoveEmail this article to a colleague.
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L.D. was one of those patients that I sometimes get a crush on. Not in a teenage, pimply, excited kinda crush, but a chemotherapy, bald-person, gaunt, I-wonder-why-that-person-has-such-equanimity kinda crush.Like, how is a 49 year old single female chiropractor with metastatic colon cancer and liver and omental metastases so cheerful coming into the clinic? So appropriate and mentally balanced despite being totally shafted by nature, biology, God and country?Why does she smile and laugh after vomiting? Or pull clumps of hair cheerfully out of her scalp? Or gently respond patiently that she drove here alone for the umpteent...
Source: CancerDoc - December 13, 2011 Category: Oncologists Source Type: blogs
Phoenix RisingEmail this article to a colleague.
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There is something about insomnia that makes one want to express thoughts for anyone on Earth to read. Banal, predictable, but personal and sometimes pithy thoughts.I've passed nearly the 6 (or is it 7) year mark in practice. G-d, it's hard to believe.What are some of the highlights?Engagement brokenLawsuitCynicism and Depression (they need capital letters)Failed romanceNearly quitting my practice out of burnout/ethical disgust/boredom/emotional impairmentHating my jobSelling the practice and becoming financially secureBuying a lot of crapGiving said crap awayBuying more crapTaking a lot of tripsFeeling the escapism of sai...
Source: CancerDoc - December 13, 2011 Category: Oncologists Source Type: blogs
The world’s third most deadly cancer is becoming a greater problem here.Email this article to a colleague.
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Every year, about 700,000 people die of liver cancer. I am referring to cancers that start in the liver, not those that have spread there. Spread to the liver is a very common problem in patients with cancer. But, in my practice, I rarely saw cancers that started in the liver. That may change for newer generations of American oncologists.Most liver cancer is found in developing countries, particularly in Asia. Half of all cases are diagnosed in China where the rate of liver cancer is about 5 times that in the U.S. Most of the liver cancers in China are caused by infection with hepatitis B virus. But this should become less...
Source: Dr.Kattlove's Cancer Blog - December 8, 2011 Category: Oncologists Source Type: blogs
Breast radiation after cancer – I was wrongEmail this article to a colleague.
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Often in my practice, women would ask after their lumpectomy for breast cancer if they really needed the proscribed radiation therapy. I always said yes. It would lower the chances of the cancer returning in that breast. But, I didn’t think it was life-saving. So I wouldn’t worry if older women wanted to opt out. The radiation was a lot of trouble. Daily visits over the course of 6 or 7 weeks was a major effort for them. And, after all, their tamoxifen should lower their chance of a recurrence.I was wrong. This week (Nov 12) in the British journal Lancet, a group of researchers from Oxford analyzed all the work ever do...
Source: Dr.Kattlove's Cancer Blog - November 20, 2011 Category: Oncologists Source Type: blogs
Colonoscopy isn’t perfect.Email this article to a colleague.
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I think of this when I see our friend Sarah. About five years ago her husband died of colon cancer even though he had a “negative” colonoscopy two years before. Everyone blamed the poor doc who did the procedure, but it turns out that he might not have been at fault. Colonoscopy reduces the chance of dying from this cancer, but doesn’t entirely eliminate it.I was reminded of this by a recent report in the Journal of Clinical Oncology. The study, done in Germany, found that the chances of developing colon cancer within ten years of a negative colonoscopy were about one-fourth to one-third that of people who didn’t h...
Source: Dr.Kattlove's Cancer Blog - October 20, 2011 Category: Oncologists Source Type: blogs
You are never too old for chemotherapyEmail this article to a colleague.
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One of the mysteries of my practice was that I could never predict how well or poorly a patient would tolerate chemotherapy. My bias was that the older a patient was, the less well he or she would be able to take the stuff. Not true. Often my oldest patients would float right through their treatment while younger ones suffered major side effects. I couldn’t explain it except perhaps that having lived a long life exposed these older folk to adversity, which made them better able to tolerate their treatment.But, there was little written information that confirmed my experience. Most studies of chemotherapy excluded older p...
Source: Dr.Kattlove's Cancer Blog - October 7, 2011 Category: Oncologists Source Type: blogs
Tamoxifen or Aromatase Inhibitors or both for early breast cancer?Email this article to a colleague.
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Perhaps the greatest drug ever developed for the treatment of cancer is tamoxifen. Since it was introduced about 30 years ago, it has probably saved hundreds of thousands of lives. Its main use has been in the adjuvant setting to prevent recurrence. Early on it was used to treat cancer that had become widespread, but now it is used less because most women have had the drug before the disease spread; in these instances it didn’t prevent the spread. It has been known for decades that breast cancer in many women was sensitive to hormone treatment. Removing the ovaries in younger women could cause the cancer to melt away. Li...
Source: Dr.Kattlove's Cancer Blog - September 15, 2011 Category: Oncologists Source Type: blogs
More is not better – at least in treating breast cancer.Email this article to a colleague.
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When chemotherapy first appeared on the scene as a major treatment for cancer, there were many studies in animals that showed that higher doses of drug were more effective. Higher doses led to more cures – at least in rats! But, unfortunately humans aren’t as tolerant as these little uncomplaining animals and if a few extra rats died because of the high doses, no one mourned.But women with breast cancer can be tough and many willingly accept high doses of chemotherapy if it promises them a longer life span or even a cure. They often want to see their kids graduate, get married, have children. No surprise then, that tho...
Source: Dr.Kattlove's Cancer Blog - September 7, 2011 Category: Oncologists Source Type: blogs
Maybe Barrett’s esophagus isn’t such a terrible thingEmail this article to a colleague.
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A few weeks ago, I attended a wedding and sat next to a man who told me all about his issues with Barrett’s esophagus. Barrett’s esophagus, which can lead to cancer is a change in the lining cells of the lower esophagus. It is usually caused by constant acid reflux from the stomach. He was getting frequent endoscopies, which means that his doctor was looking down his throat at his esophagus to make sure he didn’t develop a cancer in his esophagus. As you may know (and I have written about this) cancer of the esophagus is a terrible disease. It is generally incurable and kills people by starving them. That is why he w...
Source: Dr.Kattlove's Cancer Blog - July 21, 2011 Category: Oncologists Source Type: blogs
Maybe it is time to reconsider screening for lung cancerEmail this article to a colleague.
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I never thought it would be worthwhile. I had a neighbor once who had a small lung cancer found on a routine chest x-ray It was removed and he never had a problem with the disease again. Maybe his life was saved. But, many year ago, the Mayo Clinic did a study where they performed chest x-rays on a large number of smokers and found a lot of small cancers that were removed. But when they compared the number of deaths from lung cancer in this group with a similar group of smokers who didn’t get chest x-rays, there was no difference. They hadn’t saved any lives with their chest x-rays.The explanation for this is that many...
Source: Dr.Kattlove's Cancer Blog - July 15, 2011 Category: Oncologists Source Type: blogs
Special KidsEmail this article to a colleague.
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All of the kids I take care of are special. Is that cliche? Maybe so, but it's true. I truly have learned something from each and every one of them -- though not always what I thought I would learn.
Some kids stand out.
My first "real" patient, who was 13 at the time, and is now, at the advanced age of 27, joining the military.
The patient who got a transplant for her horrible leukemia... who was so sick going into her transplant that I said to her during her "consent conference"... "Well, if your kidneys fail during the transplant, at least your donor can give you one of his, too, and since your immun...
Source: Doctor David's Blog - June 25, 2011 Category: Oncologists Tags: Being a Pediatric Oncologist Patient Stories Source Type: blogs
The cancer called “unknown”Email this article to a colleague.
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Every so often – maybe once a year – I would see a patient who had widespread cancer yet I had no clue about where the cancer started. In spite of CT scans and other tests, I would come up empty handed. No obvious source was found. These cancers would be called cancers of unknown primary.Because these cancers were widespread, they were mainly incurable although there were some exceptions. In spite of their poor outlook, they might be helped by some kind of drug treatment like chemotherapy. But, I needed to know which drugs would be most effective and this depended on the kind of cancer it was. My first step would be to...
Source: Dr.Kattlove's Cancer Blog - June 15, 2011 Category: Oncologists Source Type: blogs
Melanoma – maybe some progressEmail this article to a colleague.
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In this study, patients were given a drug that would boost their T cells, an important part of the immune system. We know that there have been occasional patients with widespread melanoma whose cancer disappeared spontaneously. Doctors think that this may be due to activation of the immune system and the patent rejecting their melanoma. Indeed trying to boost the immune system using a drug called interleukin-2 has been a useful attempt at treating melanoma with some patients experiencing very long-term remissions.But the new approach described in this study seemed to work, although the results were once again, not that spe...
Source: Dr.Kattlove's Cancer Blog - June 10, 2011 Category: Oncologists Source Type: blogs
Take exemestane (Aromasin) to prevent breast cancer? Not in my familyEmail this article to a colleague.
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!Today’s newspapers are filled with reports of a new study that found the drug Aromasin could prevent breast cancer. I just read it and am not convinced. Aromasin is an aromatase inhibitor. This means that it blocks a woman’s ability to make estrogen (the main female hormone) if she has gone through menopause. It won’t block estrogen production from the ovaries, which is why it only works in post-menopausal ladies. It does this by blocking the enzyme aromatase that makes estrogens in a woman’s fat cells. I’m not sure we know why these fat cells make estrogens, but because of this, a post menopausal women will mak...
Source: Dr.Kattlove's Cancer Blog - June 7, 2011 Category: Oncologists Source Type: blogs
Myelodysplasia: Is it cancer?Email this article to a colleague.
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One of the major and most devastating disappointments in my practice was to see patients who were cured of their cancer – usually lymphoma – who would then develop this devastating and largely untreatable disease. What is myelodysplasia? It is a disease of the bone marrow cells where they become dysfunctional. The early stem cells don’t make enough red cell, white cells and platelets. When I would look at the bone marrow cells, I would see enough of these early cells. They would just look peculiar. They would be misshapen or too big or the nuclei of the cells would be too big. How does this happen? We think is result...
Source: Dr.Kattlove's Cancer Blog - June 3, 2011 Category: Oncologists Source Type: blogs
Have cancer? Tired all the time? You are not alone.Email this article to a colleague.
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Other than pain, nothing else would bother my patients as much as fatigue. Sure, chemotherapy and radiation took the starch out of them, but even without treatment at least half of people with cancer will be tired all the time. They feel better in the morning, but as the day wears down, so do the patients. Of course chemotherapy or radiation therapy add to the fatigue, and, even if these treatments are curative, many people will continue to complain of fatigue. I remember a young man with Hodgkin disease who even after many years, never got over it, even though he was cured. One study found that after, 5 years one-third of...
Source: Dr.Kattlove's Cancer Blog - May 28, 2011 Category: Oncologists Source Type: blogs
More options for pancreatic cancerEmail this article to a colleague.
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Many years ago I was consulted by a psychiatrist in his late 60’s who had pancreatic cancer. The cancer was inoperable, but he felt well. My advice – don’t take chemotherapy. The only drug we had then for treating pancreatic cancer was 5-fluorouracil (5-FU) and it was useless for treating this disease. I told him he would have more bad effects than good ones. He didn’t listen and went to another oncologist who provided his chemotherapy.Now I would advise him differently. New drugs have come along that can improve the outcome, although pancreatic cancer remains, with rare exceptions, a fatal disease. About 15 years ...
Source: Dr.Kattlove's Cancer Blog - May 19, 2011 Category: Oncologists Source Type: blogs
Metformin – can it prevent cancer?Email this article to a colleague.
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The other day, my friend Bill showed me an article in a magazine called “Life Extension” that touted the benefits of the anti-diabetic drug metformin (also known as Glucophage) in preventing cancer. Naturally I was skeptical. The magazine also promotes (and markets) vitamins, nutritional supplements, anti-aging treatments and all sorts of stuff to prevent disease. But Bill is a smart guy, not easily fooled. So I read the article and more importantly, looked at its sources. To my surprise, the article referenced lots of high-class articles in real scientific journals. Metformin turns out to be a hot item!I started readi...
Source: Dr.Kattlove's Cancer Blog - April 14, 2011 Category: Oncologists Source Type: blogs
Another Kind of TearsEmail this article to a colleague.
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Tears are a fact of life in my business. Parents cry when I tell them their child has cancer. Children cry when they undergo painful procedures. We all cry when a child dies.
But sometimes the tears are tears of joy.
Jade came to my clinic for another opinion. She has a benign tumor, but it's in a bad place. As I have shared before, sometimes it isn't better to have a "benign" tumor. In order to remove Jade's tumor, she would need disfiguring surgery. She and her father were told there was no choice.
Thankfully, they were told wrong.
Even though Jade's tumor...
Source: Doctor David's Blog - March 9, 2011 Category: Oncologists Tags: Being a Pediatric Oncologist Patient Stories Source Type: blogs
The Emperor's New BookEmail this article to a colleague.
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It may not be a new book anymore, and I actually read it a few months ago, but I would like to share my thoughts on Siddhartha Mukherjee’s The Emperor of All Maladies. Dr. Mukherjee subtitled his book, “A Biography of Cancer.” Much has been made in other reviews about the significance of this subtitle, and what it means to the approach he took to his topic – the history of cancer therapy.
I am fascinated by the history of medicine. When I teach residents about current sarcoma therapy, I always teach them the history of how we got to where we are. Dr. Mukherjee took this approach to its logic...
Source: Doctor David's Blog - February 22, 2011 Category: Oncologists Tags: Fun Stuff Source Type: blogs
Keep those lymph nodes, ladies.Email this article to a colleague.
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Ever since her breast cancer surgery our friend Gwen has had some swelling of her right arm. That is the side where the cancer was found and where her surgeon removed the lymph nodes from under that arm. This swelling of the arm, called lymphedema, happens often when those lymph nodes are taken. The lymphatic system, which gets disrupted in this surgery, plays an important role in channeling fluid from our arms as well as other parts of the body.Now a new study finds that Gwen cold have done without this surgery. To understand why lymph nodes are taken, we have to understand the history of breast cancer surgery. Around the...
Source: Dr.Kattlove's Cancer Blog - February 18, 2011 Category: Oncologists Source Type: blogs
Why Study Rare Diseases?Email this article to a colleague.
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This article states that there are only 250 known people with Laron Syndrome worldwide.
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So why study such a rare disorder? Well, interestingly, people with Laron Syndrome don’t get cancer (they also don’t get diabetes, but this is a blog about cancer, so we’ll focus on that). This interesting observation raises a really obvious question: Why not?
At first blush, there could be a very simplistic answer: IGF-1 makes your body grow. For you to grow from the size of an infant to the size of an adult, your cells have to divide many, many times. Each time a cell divides, it...
Source: Doctor David's Blog - February 17, 2011 Category: Oncologists Tags: Hot Topics in Cancer Research Cancer Prevention Breaking News Source Type: blogs
Should we take aspirin to lower our chances of dying of cancer?Email this article to a colleague.
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Maybe. I used to think this wasn’t a good idea in spite of the suggestions in the literature that aspirin lowers your risk of colon cancer. Aspirin can cause bleeding. This can be from the intestine or even (rarely) into the brain. And, since the cancers prevented were colon cancers and I would still get my colostomy to catch it early, so why take the chance?Now a paper has been published in the January 1 issue of the British journal, The Lancet that is making me reconsider. There have been lots of randomized trials testing the effects of aspirin, mainly to prevent heart attacks and strokes. Aspirin prevents little cells...
Source: Dr.Kattlove's Cancer Blog - January 27, 2011 Category: Oncologists Source Type: blogs
More bad news for overweight women with breast cancer.Email this article to a colleague.
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This time, the women are Danish. Perhaps too many of those pastries. One of the nice things about the Scandinavian heath systems is that in addition to covering all their citizens, they have terrific records. This week’s Journal of Clinical Oncology (Jan 1, 2011) carries a report from Denmark on the relationship between obesity and death from recurrent breast cancer.The researchers examined the records of 53,000 women who were diagnosed with early stage breast cancer. Because many of the women received chemotherapy, their weight and height were recorded. Chemotherapy is dosed according to these two numbers by converting ...
Source: Dr.Kattlove's Cancer Blog - December 31, 2010 Category: Oncologists Source Type: blogs
How docs make moneyEmail this article to a colleague.
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One of the biggest disappointments in my career came during a course in medical economics at the UCLA School of Public Health. In that course, the professor was able to prove unequivocally that if a new procedure is introduced that provides money to doctors, they will use that procedure. Not to say doctors are any different from other people. That is just the issue. They are the same. Forget about altruism. Forget about wanting to help people. Sure, that is there, but making money seems to take over. Conversely, if a procedure is no longer profitable, suddenly its use will drop. This phenomenon was well demonstrated in a s...
Source: Dr.Kattlove's Cancer Blog - December 24, 2010 Category: Oncologists Source Type: blogs
David's First Book Review: The Immortal Life of Henrietta LacksEmail this article to a colleague.
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I've discovered reading again. Or maybe what I've done is made a conscious decision to set aside time to read. Some books I've recently read have nothing to do with cancer, like Cloud Atlas. Then there's The Immortal Life of Henrietta Lacks.
Rebecca Skloot did a marvelous job telling the story of Henrietta Lacks, a woman from Baltimore whose cervical cancer cells became the very first immortalized cell line. I think this book is a "must read" for anyone engaged in cancer research, if for no other reason than it reminds us that every cell line we work with was once a tumor growing in an individual....
Source: Doctor David's Blog - December 20, 2010 Category: Oncologists Tags: Fun Stuff Ethics Source Type: blogs
What is Life?Email this article to a colleague.
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Life is hard to define. Perhaps former Supreme Court Justice Potter Stewart summed it up best (though he was referring to hard-core pornography, not living organisms) when he said, "I shall not today attempt further to define [it]... and perhaps I could never succeed in intelligibly doing so. But I know it when I see it."
Erwin Schrodinger gave a series of lectures in 1943 that were published under the title "What is Life?"
NASA has an Astrobiology group that is charged with searching for evidence that there is life on other planets. Key to that mission is understanding what life is. How el...
Source: Doctor David's Blog - December 2, 2010 Category: Oncologists Tags: Breaking News Source Type: blogs
You're Kidding, Right?Email this article to a colleague.
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(Another of David's rants about insurance companies)
I've written many times about the absurdities I've encountered dealing with insurance companies. I've had another experience that I'd like to share.
The patient came into clinic for chemotherapy. The PA examined him and heard an irregular heartbeat. Neither of us know the patient well, so we looked through his chart to see if anyone has ever noticed an irregular heartbeat before. No one had. We ordered an EKG, and it showed an abnormal rhythm. The patient has had several EKGs in the past, and this rhythm was a new finding. One...
Source: Doctor David's Blog - December 1, 2010 Category: Oncologists Tags: Being a Pediatric Oncologist Patient Stories Source Type: blogs
What is a good death?Email this article to a colleague.
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Well of course, there probably is no such thing. Most of us want to live as long as we can. But when your fate is inevitable – like when you have far advanced cancer – maybe the important thing is being comfortable and being surrounded by loved ones. Unfortunately, if you are in the hands of American oncologists, particularly in academic medical centers, your chances of achieving this goal are slim.This is illustrated by a recent report from the folks at the Dartmouth Institute for Health Policy and Clinical Medicine. They like to examine patterns in medical care and in this instance looked at what kind of end-of-life ...
Source: Dr.Kattlove's Cancer Blog - November 27, 2010 Category: Oncologists Source Type: blogs
I never would have believed it.Email this article to a colleague.
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It looks like CT scanning for lung cancer will save lives. The National Cancer Institute just stopped their trial of CT scanning of smokers and former smokers who had quit within the last 15 years. They stopped because the people getting the scans were 20 percent less likely to die of lung cancer. Good news. Saving lives is the gold standard of any cancer screening procedure. Forget about catching something early – we still don’t know if that will help. Saving lives is all that counts.The study was conducted very simply. Around 50,000 men and women who had been or were former heavy smokers and between 55 and 74 were re...
Source: Dr.Kattlove's Cancer Blog - November 7, 2010 Category: Oncologists Source Type: blogs
The new world of targeted therapy – where is it heading and how much can we afford?Email this article to a colleague.
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We all know that most cancer therapy is like a nuclear weapon, killing everything in its wake. In the last 20 years, we have been moving away from this (although radiation and chemotherapy are still the major treatments) toward treatments that target specific molecules in the cancer cell.Perhaps the best example of this is the use of hormonal manipulation to treat breast cancer. Very early on in the history of treating this cancer, doctors learned that removing the ovaries of young women with advanced breast cancer could cause it to regress; giving high doses of estrogen to older women with breast cancer could also be succ...
Source: Dr.Kattlove's Cancer Blog - November 4, 2010 Category: Oncologists Source Type: blogs
It's Time To Hang It UpEmail this article to a colleague.
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This is my last entry. This blog has served its useful purpose in my life. It's allowed me to explore many emotions and thoughts during this transition point in my life, from student to physician and maybe to the beginning of healer.But, it's a vanity in a way. A service to ego and it's time to face life without a crutch. Time to turn inwards as we still fight to grip with all that is outwards.I am grateful for the responses over the years. The many insights. The love. And, sometimes lack of love.Time to unplug and whip out the old pen and paper... (Source: CancerDoc)
Source: CancerDoc - October 28, 2010 Category: Oncologists Source Type: blogs
What can we do about ovarian cancer?Email this article to a colleague.
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You don’t hear much about ovarian cancer, yet in 2010, nearly 22,000 women will be diagnosed with this cancer and nearly 14,000 women will die. It is a tough cancer to find early. Only 15 percent are found when it is still confined to the ovary. Because of this there have been many studies trying to pick it up before it has spread. None have succeeded, even though there are sophisticated ultrasound tests and even blood tests that can find the cancer. It is usually too late when these tests uncover the cancer. In fact, many experts have said the best early warning are clinical symptoms – like nausea and bloating. Try ru...
Source: Dr.Kattlove's Cancer Blog - October 22, 2010 Category: Oncologists Source Type: blogs
Stop those hormones ladies! They cause breast cancer.Email this article to a colleague.
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The other day our friend Joan called me. She was getting really fatigued from her chemotherapy. She was getting the chemotherapy because she recently developed stage 2 breast cancer. Joan came to mind when I read an article in the Journal of the National Cancer Institute that discussed the relationship between post-menopausal hormone therapy and breast cancer. In 2002, a large study was published by the Woman’s Health Initiative that pointed out the risk of breast cancer in women who took hormones for their menopausal symptoms. Everyone had sort of suspected that these drugs increased the risk of breast cancer, but this ...
Source: Dr.Kattlove's Cancer Blog - October 13, 2010 Category: Oncologists Source Type: blogs
Should I keep getting my PSA tested?Email this article to a colleague.
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It will probably cause me more trouble than it is worth. I have a large prostate and because of this (partly at least) my PSA (prostate specific antigen, which goes up with prostate cancer) is higher than experts think it should be. Many urologists (surgeons who treat prostate cancer) think that anyone with a PSA greater than 4 should receive a prostate biopsy to look for cancer. Some urologists set this number even lower at 2.5.A few years ago, when my level bumped up to 6, my doctor recommended at biopsy. Luckily, it was negative and I have remained at around 6 without another go at this most unpleasant procedure. But qu...
Source: Dr.Kattlove's Cancer Blog - October 8, 2010 Category: Oncologists Source Type: blogs
GriefEmail this article to a colleague.
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Lunchtime. I don't each lunch, really. Maybe tea time. Or downtime. Or depressed time.This morning was a bear. The sounds of crying. Not ostentatious crying. Just sobbing. I'm sorry. There is nothing more I can do...I must say that to people ten times a week. Most of the time it's just a stunned silence, then a polite thank you.Every now and then, it's anger.Sometimes, histrionics.But, then there is just the solitude of grief. It doesn't matter how many family or friends are in the room. When the realization dawns on the patient that life is over, there is this retraction of space, this contraction of feeling. Alone, facin...
Source: CancerDoc - October 7, 2010 Category: Oncologists Source Type: blogs
Rare But SeriousEmail this article to a colleague.
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The patient and her parents were hardly focused on what we were saying. Not surprising, since she was still recovering from the news that the pain in her leg was not from a sports injury, but from osteosarcoma.
Kameron was a high school athlete, and now, instead of anticipating a college scholarship to play hockey, she was anticipating a year's worth of chemotherapy and a major leg surgery. She and her parents were in the office, listening (but probably not hearing) to the side effects she should expect from her upcoming chemotherapy. At the end of the conference we discussed some of the "rare but seriou...
Source: Doctor David's Blog - September 29, 2010 Category: Oncologists Tags: Side Effects of Treatment Patient Stories Source Type: blogs
Two Steps Forward...Email this article to a colleague.
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The "no consumption" thing is terrifically difficult. Coffee and other beverages are being phased out.My canvas bag travels with me to the fruit and vegetable aisle.Takeout, carryout, order out, etc. has been crushed.Books from Amazon have slowed to a trickle and will soon dry up.And yet, there is still a small amount of recycling that I had to put out this morning...I liken this attempt to my yoga practice. Or my meditation practice. Or my practice of medicine for that matter.You keep trying. Despite some injuries here, or boredom. A setback. A steak dinner. A piece of styrofoam.But, hopefully, with practice, you become t...
Source: CancerDoc - September 17, 2010 Category: Oncologists Source Type: blogs
The FatmanEmail this article to a colleague.
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I don't know why I always think of this patient as the "Fatman".Well, other than the obvious fact that he is quite overweight, tipping over 300 lbs on a 5-10 frame.Maybe it's his lack of self-consciousness about it. His laughter and cheer and egolessness, if that is even a word.Which spellchecker tells me it isn't.A wonderful guy, a healer. A therapist. Not just any therapist, but an uber-therapist. Well regarded nationally, urbane, published, graceful, the Fatman is a mensch in every way, except in regards to himself.I first met him more than 3 years ago. He came to me ostensibly for thrombocytopenia, or a low platelet co...
Source: CancerDoc - September 13, 2010 Category: Oncologists Source Type: blogs
This Is a Lot Harder Than I ThoughtEmail this article to a colleague.
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My list of violations so far:1. forgetting my steel mug when i sometimes get coffee or tea (even though i'm trying to get rid of the habit altogether anyway)2. forgetting to bring my reusable plastic bags to the health food store and then needing another bag3. driving when i could easily walk or bike to my local coffee house/drug store/grocery4. getting tired of composting, especially since i don't grow anything5. forgetting to use my drying rack (better today, though)6. having a constant urge to buy another lawnmower (my old-school push bladecutter just does a terrible job; i feel like i'm lowering my neighbor's property ...
Source: CancerDoc - September 6, 2010 Category: Oncologists Source Type: blogs
Blue GoldEmail this article to a colleague.
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I was watching a documentary yesterday. "Blue Gold".It was about water resources around the world and how competition for water will be a main battleground of this century.So much focus has been on global warming and declining hydrocarbon resources. Yet, one of the main consequences of both problems will be a decline in the amount of available freshwater in the world.Some contributing factors:1. contamination of available sources of groundwater and rivers by agricultural pollution.2. growing worldwide population3. a warming planet4. privatization of water in the hands of multinational companies who have no incentive to mai...
Source: CancerDoc - September 3, 2010 Category: Oncologists Source Type: blogs
