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This page shows you the most recent publications within this specialty of the MedWorm directory.

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DenmarkEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
R.N. just died. She was my first breast cancer patient out of fellowship and training. My first breast cancer patient where I was the "doctor". No backup. Nobody to turn to for advice. I write the orders, I explain the side effects. I hold the hands.She was only 33 years old when she was diagnosed 4 years ago. She and her husband had just moved from Denmark only months before for his company. Something with maritime equipment that brought him to the mid-Atlantic. Then she found the lump. A small, 1 cm mass in her breast. So young.Triple-negative. A bad prognosis.But, still stage I. She got chemo, lots of chemo. bilateral m...
Source: CancerDoc - March 20, 2010 Category: Oncologists Source Type: blogs

The Irony of Patient AutonomyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
One of the cornerstones of medical ethics is the concept of patient autonomy. MedicineNet.com provides a succinct definition: “The right of patients to make decisions about their medical care without their health care provider trying to influence the decision. Patient autonomy does allow for health care providers to educate the patient but does not allow the health care provider to make the decision for the patient.” At lunch the other day, I was talking about a particularly challenging case when this concept came up. After thinking for a few minutes, I was struck by a sense of irony that I wanted to share in case ot...
Source: Doctor David's Blog - March 8, 2010 Category: Oncologists Tags: Being a Pediatric Oncologist Patient Stories Ethics Source Type: blogs

I was wrong – transplants work for multiple myelomaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Multiple myeloma is a disabling disease of the bone marrow. It stems from a cell called the plasma cell, occurs in older folk, and because it is mainly confined to bone often causes them to hurt, if not break. I remember a patient with the disease whose bones were so fragile, she broke her arm while combing her hair.Over the last 10 years, treatment has improved. During most of my practice years, the main treatment was a pill called melphalan. It didn’t cause many side effects and often the disease would remit for a while – maybe even a few years. But it always came back and there wasn’t much we could do at that poin...
Source: Dr.Kattlove's Cancer Blog - March 4, 2010 Category: Oncologists Source Type: blogs

Brain radiation may be hazardous to your mind.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Early in my practice, one of my patients, a 60 year old with lung cancer complained of headache. Her lung cancer had been cured by chemotherapy – she had what we call a small cell cancer, which is very sensitive to chemotherapy and can, at times, be cured.But this less common form of lung cancer tends to spread quickly and widely. The chemotherapy probably killed most of the cancer cells that had fanned out through her body. But chemotherapy doesn’t usually penetrate into the brain and that was where the cancer had spread. A CT scan of her brain showed a tumor. The usual treatment at that time was radiation treatment t...
Source: Dr.Kattlove's Cancer Blog - February 18, 2010 Category: Oncologists Source Type: blogs

The Snow That HealsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A curious thing happened to me today. I had several really wonderful interactions, all due to shoveling snow! How strange.I live in a nice, family oriented community in Baltimore, rowhomes mainly, populated by 30ish and 40ish couples with young children. Having no children myself, I often smile a lot to everyone playing outside, but rarely interact. Other than to grunt as I come home late and can't find a parking spot or laugh when a neighbor's dog jumps the fence into my yard or look curiously when children play endlessly on a patch of grass and stones in my front yard. But, yesterday and today... during "Snowmageddon" he...
Source: CancerDoc - February 8, 2010 Category: Oncologists Source Type: blogs

If I developed acute leukemia.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I’ve often wondered what I would do if I developed acute leukemia. When I was in my 40’s or 50’s there was no question that I would go for the most aggressive treatment. Even in my 60’s, especially early that would also have been my choice. But now, a little past 70, I’m not so certain about what I would do.At one time, early in my practice, I treated several patients over 60 with acute leukemia. Almost all of them did well – for a while. I treated them with the standard chemotherapy (which, unfortunately, hasn’t changed much in the last 30 years). They developed the usual side effects, which made them pretty...
Source: Dr.Kattlove's Cancer Blog - February 7, 2010 Category: Oncologists Source Type: blogs

AvoidanceEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I feel so withdrawn.Empty.Attached. The Buddha teaches that life is suffering. Dukkha. The root of that suffering is in our desire, our attachment to our wants. The more we desire, the more suffering we feel when that thing, that person, that feeling is lost. As it inevitably will be lost.We all decay and die.Life is an illusion.I hurt someone very dear to me today. Someone I care for deeply. Who I love.I feel it as a result. I know it will pass. As all things do.But I feel it nonetheless. (Source: CancerDoc)
Source: CancerDoc - February 3, 2010 Category: Oncologists Source Type: blogs

Why David Hates Health Insurance CompaniesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A Rant Photo Credit I am involved in a case right now that epitomizes all that is wrong with commercial health insurance. All in one case. How convenient. My patient is a young adult with a sarcoma diagnosed in her liver. There is one large mass and several smaller ones. The tumor is not resectable right now, so she will need chemotherapy. Two issues have arisen this week: one related to diagnostic imaging (radiology) and the other related to quality of life. With both issues I have faced significant roadblocks, placed by the patient's insurance company, that impede my ability to pro...
Source: Doctor David's Blog - February 2, 2010 Category: Oncologists Tags: Being a Pediatric Oncologist Side Effects of Treatment Patient Stories Sarcomas Source Type: blogs

Death and the MaidenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
My partner's sister just died. 28 years old, pregnant with twins. A complication in the third trimester. The liver enzymes go up, the blood counts go down. Babies come out of Mom.Dead.Mom goes into organ failure. Dialysis. Ventilator. Bleeding. Dead as well.I don't know this women. Or rather, I didn't know her. We forget sometimes how dangerous pregnancy can be. In times past, many children never survived to adulthood. Maternal complications were so frequent and severe.But, we live in such a different world now. We all expect pregnancy and childbirth and the first years of life to be so wonderful. We are just stunned when ...
Source: CancerDoc - February 1, 2010 Category: Oncologists Source Type: blogs

Health Care DebacleEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I have to say, if this is "Change You Can Believe In", I might need to drag GWB back into office. I'm about as progressive as they come, but there is something real to this whole Scott Brown/Massachusetts backlash/potential collapse of the health care bill.Leave it to Congress to produce something no one has read, understands or cares about. To produce something that does little to control entitlement cost and growth. Something that does little to help tort reform. Almost nothing to deal with the perverse incentives for physicians and hospitals that underlies the cost and poor quality of our system. Rather, it's a bit of a...
Source: CancerDoc - January 26, 2010 Category: Oncologists Source Type: blogs

How much should cancer treatment cost? How much is too much?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This is a question that has been bothering oncologists for several years, but has gotten even more troublesome lately. New drugs are being developed that cost tens of thousands of dollars a year yet aren’t saving or prolonging many lives. I’ve written about this before, but now we are seeing surveys of what other oncologists think.The latest survey just appeared in “Health Affairs” (January 2010), a journal devoted to articles on the delivery of health care and its cost. The authors surveyed nearly 1400 oncologists from throughout the U.S. and asked them how the high costs of the newer drugs affected their decision...
Source: Dr.Kattlove's Cancer Blog - January 21, 2010 Category: Oncologists Source Type: blogs

Nurse C.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Caring for cancer patients is hard enough. Caring for someone that you work with is that much harder. I suppose caring for a loved one that you work with would be the ultimate in emotional pain, but thankfully, I have yet to experience that one.K.C. is... or, as of this morning, was a 50 year old patient of mine with metastatic ovarian cancer. She worked as a floor nurse in Oncology at the hospital where I attend. A wonderful woman. Just a positive ray of sunshine for anyone who knew her. A family woman. Kind and loving husband. Wonderful teenage children. Loving. Just the kind of person who dies.Diagnosed in 2007 with sta...
Source: CancerDoc - January 18, 2010 Category: Oncologists Source Type: blogs

Why don’t you tell your oncologist what you want?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Why don’t cancer patients talk to their oncologist about what to do when treatment fails and the cancer is progressing? Do they want aggressive therapy; do they want cardiac resuscitation, IVs, everything done, only comfort measures? They are actually more likely to talk about it to some strange doctor who just admitted them to the hospital or to their primary care doctor. This is something that was discovered about ten years ago and now a new study found that it is still true. Cancer patients are reluctant to talk to their cancer docs about their care even if the situation looks grim. The new study, published in the Jan...
Source: Dr.Kattlove's Cancer Blog - January 14, 2010 Category: Oncologists Source Type: blogs

The Fear That KillsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I just saw a 50 year old woman with a large 7 cm right breast mass and a scan that shows her liver and bones to be riddled with tumor. Breast cancer. Metastatic.She's very intelligent. Pretty. Educated.Oh, did I mention that she's a nurse?WTF?Divorced, living alone, she knew that this was cancer. She knew she should have it examined and biopsied. But, she was afraid.She noticed it a year ago... that's right. ONE YEAR AGO.It was small then. It was probably curable and early stage. Just like so many other women. Just one of the "1 in 9" that get it.I can't tell you how many times I've seen this in patients. Not just the subt...
Source: CancerDoc - January 13, 2010 Category: Oncologists Source Type: blogs

LoveEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
is an ephemeral thing. It swoops in, takes charge of your existence, turns on a form of madness in your brain and then often leaves you exhausted. Love is passion, heat and whispers, mumbling and smooth textures. It burns.Love is hot. That is, before it goes cold and unfeeling.Love is nurturing. Maturing. Snuggling. Cuddling. Love is nursing. Touching the neck. Sweeping the hair back.Love is loyal. Sometimes. Sometimes it is deceitful.Love is gain.Love is loss.Love is what we all aspire to have.Love is what makes us all miserable.Love is dedication. It is pure. It is good.Love is betrayal. It is base. It is evil.I have be...
Source: CancerDoc - January 12, 2010 Category: Oncologists Source Type: blogs

Lets talk about bald kids.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I’m talking about children who have been treated for cancer. Invariably, the chemotherapy makes them bald. They make great poster children to advertise children’s cancer centers, but they often don’t end up smiling as they do in the posters. Although their hair grows back, other organs are not so lucky. Virtually all organs can be damaged by their treatment. Their heart, their thyroid gland as well as other glands can suffer. And they have a high risk of developing a new cancer. Girls have an especially high rate of developing breast cancer as they mature. Also, many children will have problems with development and l...
Source: Dr.Kattlove's Cancer Blog - December 31, 2009 Category: Oncologists Source Type: blogs

The Ties That BindEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Home. As I stare out of my window at the office, looking at the people try to navigate the snows here in Maryland, milling about, hats on heads, gloves, wool coats flapping in the wind, I think about the concept of "home". I grew up in Los Angeles. Well, part of the time there. Bronx, to Westchester County, to Oklahoma, then California. But, West L.A. was my home from middle school to high school and was formative. Sunny, wealthy, diverse. There were 10-20% Iranians in my high school. It was predominantly Jewish otherwise. 99% of the people went on to college. Every Ivy League school was represented on my block, both in th...
Source: CancerDoc - December 23, 2009 Category: Oncologists Source Type: blogs

What Does A Cure Mean?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
"I'm cured, right?" "Yes.""So, why can't I walk?""Well, it's not as simple as that.""The cancer was in my back, right? You said it was in my back? Now, it's not. Now, it's CURED..."It's been 2 months since K.S. finished her chemotherapy for lymphoma. She had had some low back pain for a couple months. She saw her primary doc who had ordered an initial set of spine films and started some physical therapy.I mean, she's only 40-something, busy in life with kids, family, etc. Moving boxes, bending to get a casserole, having sex... there are a million reasons why a woman her age can get a little back ache.Who would have thought...
Source: CancerDoc - December 23, 2009 Category: Oncologists Source Type: blogs

Fishing, and the Kindness of StrangersEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The ability of the internet to catalyze spontaneous events is not limited to Rickrolling or snowball fights. I want to tell a story of the power of the internet, and how it can harness all that is good in people, allowing total strangers to reach out to someone in need and do something special. One of my patients is a 19 year old young man whose cancer has proved resistant to most every treatment he has tried. Last year, when he was in remission and feeling well, Make-a-Wish granted his wish to go deep sea fishing with his family. T had a great time, and his only regret was that he did not hook a fish large enough to nee...
Source: Doctor David's Blog - December 23, 2009 Category: Oncologists Tags: Patient Stories Philanthropy Source Type: blogs

Is cancer care advancing?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Every year the American Society of Clinical Oncology publishes what it considers to be the major advances in cancer care for the year. This year’s news was not very encouraging.Let’s look at prostate cancer, particularly those of us guys who get screened regularly. The big advance, according to ASCO was that two large clinical trials found that routine screening for prostate cancer with the PSA blood test “has a small effect, if any, on reducing prostate cancer mortality”. What a bummer for all of us who get our blood tested religiously.Maybe this is why they add, that “US cancer screening rates are low or declin...
Source: Dr.Kattlove's Cancer Blog - December 22, 2009 Category: Oncologists Source Type: blogs

I'm Focused On LivingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
"I'm focused on living right now, ON THIS...", she said, pointing to her maimed left breast, as I asked her about loneliness and dating. Then she smiled... "but next year, when my reconstruction is done, watch out." I'm focused on you, S.G. It's hard to see someone sick at any age. I don't deal with pediatrics so that is often abstract to me. Honestly, for the patients that are 70 years old and older, part of me thinks that their suffering is a tragedy, but that this is part of the cycle of aging and life. Maybe I'll feel differently when I'm that age.But, for the 30 and 40 year olds like S.G., struck down with the lymphom...
Source: CancerDoc - December 21, 2009 Category: Oncologists Source Type: blogs

Ode To The Gas PasserEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I just heard that a colleague of mine killed himself two days ago. An anesthesiologist. Trained at the same hospital that I came from. Wife. Family. The whole shebang. I don't know the whole story, but apparently, he had been depressed for some time. He had tried once before.All of this was triggered a year ago by a complication involving a pregnant young woman. First child. 27 years old. Supposed to go well. It didn't.She died.He was involved. He thought he did it. An epidural gone wrong or some crap like that. Just some horrible unforeseen shit went down and he happened to be involved. So, it ate at him. Maybe there was ...
Source: CancerDoc - December 17, 2009 Category: Oncologists Source Type: blogs

A Long Year for MikeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A year ago this week, Mike's sinuses were acting up again. It wasn't uncommon for Mike to have sinus problems during winter, but last December things were worse than usual. A trip to his pediatrician led to a CT scan. The scan found a mass, not a sinus infection, and that's how Mike and I met. Mike spent last Christmas worrying about the mass in his sinuses, and whether it was cancer. After a year of surgery, chemotherapy, and radiation, Mike celebrated a very important day earlier this month: End of Chemo Day. We celebrated with Mike in clinic. His family brought trays of sandwiches a...
Source: Doctor David's Blog - December 17, 2009 Category: Oncologists Tags: Being a Pediatric Oncologist Patient Stories Source Type: blogs

ChristmasEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Another holiday approaches. I am not Christian, as anyone who reads my blog would surmise. But, the message of Jesus is one that resonates strongly with me. I suppose it is universal in its appeal. I try to think of Jesus as a historical figure. An itinerant preacher amongst the Jewish poor, preaching a message of faith, charity and love. This, despite Roman oppression. Despite poverty and sickness and despair. Despite venality and sensuality. How this message of hope for a better, more just afterlife must have provided such comfort for those who were the most downtrodden in life. I would hope that we all would reflect som...
Source: CancerDoc - December 15, 2009 Category: Oncologists Source Type: blogs

CamusEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I've been listening to my books on tape quite a bit recently. Actually, more of a lectures on tape. Albert Camus. That is the latest fascination. I've finished the piece on "The Stranger" and they've moved to the "Myth of Sisyphus". It's not light reading, to say the least. A bedrock of Existential thought, Camus provided some core principles that later philosophers such as Sartre expanded and modified. The nutshell of his thinking is that life is fundamentally absurd. Devoid of intrinsic meaning. That there is no God. And that are deluding ourselves by thinking that there is a rhyme or reason to the nature of the universe...
Source: CancerDoc - December 14, 2009 Category: Oncologists Source Type: blogs

The HolidaysEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I find the holidays somewhat depressing. Maybe it's the juxtaposition of cancer opposite the Hallmark messages that surround me. Maybe I'm just a curmudgeon. I saw four people yesterday with new cancer diagnoses. All under the age of 50. Young. I'd like to think that I've become more toughened to the nature of suffering, but I'm not sure that is the case. If anything, I feel more sensitive as I get older. I'm not sure why. Maybe it's my own mortality. Maybe I've just come to recognize that there is no judgment of the value of a life. That it is essentially absurd and intrinsically meaningless. But, to each of us, there is ...
Source: CancerDoc - December 13, 2009 Category: Oncologists Source Type: blogs

Not Medically NecessaryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
After a courageous 5-year battle, R lost his fight with cancer. He lived a good life while he was being treated, finishing high school, starting college, and checking items off his bucket list. This holiday season is hard for his family. His absence is palpable … and painful. What could make this time any worse? The letter they got from their insurance company. Apparently I ordered a CT scan back in September. The insurance company sent the family a letter telling them that they have deemed the scan “not medically necessary,” and they are refusing to cover it. I’m used to the things health insurance companies d...
Source: Doctor David's Blog - December 11, 2009 Category: Oncologists Tags: Being a Pediatric Oncologist Patient Stories Source Type: blogs

Maybe vitamins cause cancer!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I take vitamins. I’ve read that about half of Americans also take them. Why not? Can’t hurt and may help, right? Maybe not. A few years ago, doctors thought that smokers taking beta carotene, a vitamin A-like chemical might be protected from developing lung cancer. So a big study was started that tested whether heavy smokers might lower their rate of lung cancer if they took beta carotene. Not only did the vitamin not lower their rate of lung cancer, it seemed to increase it by nearly 20 percent. Other vitamins have also failed to prevent cancer. Vitamin E was tested as a defense against prostate cancer and failed. Whe...
Source: Dr.Kattlove's Cancer Blog - December 8, 2009 Category: Oncologists Source Type: blogs

More What You'd Call "Guidelines" than Actual RulesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Of course, Captain Barbossa was referring to The Pirate Code, but he could just as easily have been referring to documents released last month by the US Preventive Services Task Force or the American Congress of Obstetricians and Gynecologists (ACOG). In an unanticipated coincidence, these two groups, operating independently, reached similar conclusions about commonly utilized screening tests: mammograms and Pap smears. Both groups reviewed the data and concluded that routine use of these screening tests, as currently recommended, may not be warranted. Much newsprint has been expended since then discussing the p...
Source: Doctor David's Blog - December 6, 2009 Category: Oncologists Tags: Hot Topics in Cancer Research Cancer Prevention Breaking News Breast Cancer Source Type: blogs

A Smarter War on CancerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The headline in the Washington Post caught my eye: “Fighting a smarter war on cancer,” [sorry, you must register to read the article] an opinion piece by Dr. John Marshall, a faculty member at the Lombardi Cancer Center in Georgetown. It is about the intersection between health care reform and cancer care - it seemed like just the thing to read while drinking my morning coffee. But halfway through the article I found myself feeling marginalized, and that got me thinking. Although Dr. Marshall makes some good points, I think he missed a golden opportunity to propose changes that could make a real difference in our ...
Source: Doctor David's Blog - November 30, 2009 Category: Oncologists Tags: Hot Topics in Cancer Research Breaking News Source Type: blogs

If the chemotherapy is working, don’t stop.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I once had an elderly patient with colon cancer that had spread to her liver; she had lived for five years on chemotherapy. In fact, about one year after starting treatment, the CT scans of her liver could no longer spot her cancer. She felt well on the treatment so we kept it up, since in those days, all we had was 5-FU, a relatively non-toxic drug as these things go.But, after 5 years, she tired of the whole process, particularly since she lived about 20 miles away and the injections were given weekly. After a long discussion about the pros and cons of stopping treatment, we agreed to hold the chemotherapy and see what h...
Source: Dr.Kattlove's Cancer Blog - November 27, 2009 Category: Oncologists Source Type: blogs

The new mammography guidelines got it right!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This week a panel of outside experts, commissioned by the United States Preventive Services Task Force, concluded that mammography should not be routinely recommended for women under age 50 and those over age 50 probably only need mammography every 2 years – until they reach 74. I know this is controversial and emotional, but the facts are that most women under age 50 will not benefit from screening mammography and women over 50 need it only every 2 years. Why can I say this? Doesn’t mammography catch breast cancer early and save lives, regardless of age? The simple answer is “not really”.Many years ago, shortly af...
Source: Dr.Kattlove's Cancer Blog - November 19, 2009 Category: Oncologists Source Type: blogs

When Bad Things Happen to Famous PeopleEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In a press release issued earlier this week, former NBA star and actor Kareem Abdul-Jabbar announced that he has been diagnosed with leukemia. Specifically, he has chronic myeloid leukemia (CML). Abdul-Jabbar went on to say that his disease can be managed by taking daily oral medication and he expects to live a long healthy life. With leukemia? How is that possible? Abdul-Jabbar has benefited from one of the first and most exciting applications of the translational research I have blogged about in the past. Before 2000, CML was treated with a combination of a chemotherapy drug called cytarabine and another drug called ...
Source: Doctor David's Blog - November 16, 2009 Category: Oncologists Tags: Hot Topics in Cancer Research Breaking News Source Type: blogs

Kareem has leukemia!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Almost exactly 10 years ago, I was attending my first meeting of the American Society of Hematology as an employee of the American Cancer Society. But, instead of attending meetings, I spent much of my time on the phone with reporters. It was at that meeting that the results were reported of the first clinical trials in patients with chronic myelogenous leukemia (CML) of imatinib, the drug later named Gleevec. Because the results were so outstanding they became national news and as the “expert” at the ACS, I was asked to talk to reporters who dialed the ACS number for information.Great “breakthrough” drugs for trea...
Source: Dr.Kattlove's Cancer Blog - November 12, 2009 Category: Oncologists Source Type: blogs

Another look at EPOEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Another review, this time of nearly 14,000 cancer patients has found that treatment with erythropoietin (EPO, Epogen, Procrit, Arensp) may be harmful to your health.Erythropoietin is a naturally occurring hormone that we all have. Its role is to help us make red blood cells. Without it, we would all suffer from low blood counts – anemia. Many years ago, drug companies learned how to make this hormone and it proved to be very successful in treating patients with anemia due to chronic diseases – particularly people with far advanced kidney disease. It raised their blood count and they felt better.Cancer patients can get ...
Source: Dr.Kattlove's Cancer Blog - November 5, 2009 Category: Oncologists Source Type: blogs

As Breast Cancer Awareness Month Draws to a CloseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
As breast cancer awareness month draws to a close, I wanted to highlight a few breast cancer posts from other medical bloggers:Suture For a Living asks: "Is Breast Cancer Over-Diagnosed?"Bayblab writes about research on a diabetes medication killing breast cancer stem cells.Science Update Blog discusses claims that we are "Two years from breast cancer cure".Highlight Health's Allison Bland says "The Review is in: Lifestyle Changes Prevent Breast Cancerand Healthcare Hacks discuss the benefits of weightlifting in breast cancer survivors. If you've found any interesting breast cancer blogs or posts, link to them in the comm...
Source: Doctor David's Blog - October 29, 2009 Category: Oncologists Tags: Stem Cell Research Hot Topics in Cancer Research A Few Good Blogs Breaking News Breast Cancer Source Type: blogs

Goodbye, Mr. BEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Today was a somewhat bad day. I mean, I've had quite a few bad days in my years on this planet. But, this one was up there in terms of pure badness. It started as the usual. Not too busy. Rounds. Paperwork. Returning some calls. Waving to some of my chemo patients.Mr. B. A wonderful man. A wonderful family. A "country boy", as his daughter calls him. Tough. Salt of the earth. Decent. You name the cliche, he fits the bill. Truly a good guy.But a smoker. Big time smoker. Did I mention how much I f.ing hate smoking? I met him a couple months ago... well, "met" isn't quite the description, since he was intubated and sedated. H...
Source: CancerDoc - October 27, 2009 Category: Oncologists Source Type: blogs

Breast cancer surgery: Surgeons are getting it right.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This week’s Journal of the American Medical Association (October 14, 2009) published an article that surveyed what kind of surgery was being done for breast cancer. They looked at patients in Los Angeles and Detroit and found that three-fourths were getting lumpectomies (called breast conserving surgery) while the rest were having their entire breast removed (mastectomy).This is a remarkable turnaround from when I was in practice. I remember one surgeon telling me that he would never do a lumpectomy for breast cancer. Many other surgeons also felt that way. Unfortunately they were relying on an old tradition that really ...
Source: Dr.Kattlove's Cancer Blog - October 20, 2009 Category: Oncologists Source Type: blogs

The Sarcoma Program Goes 21st CenturyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Modern technology impacts everything we do. The very fact that you are reading these words attests to how technology touches your life.Well, the Johns Hopkins Sarcoma Center has engaged Web 2.0, too. If you follow this link, you will hear a podcast featuring my partner, Dr. Kristy Weber, the chief of orthopedic oncology at Johns Hopkins.Bruce Shriver, one of the founders of the Liddy Shriver Sarcoma Initiative, asked me about chemotherapy for high grade sarcomas, and you can see that video here. An article in their online newsletter, ESUN, discussing my laboratory's research, is here.Over time our group will be producing m...
Source: Doctor David's Blog - October 15, 2009 Category: Oncologists Tags: Fun Stuff Announcements Source Type: blogs

Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Doctor David's Blog)
Source: Doctor David's Blog - October 13, 2009 Category: Oncologists Tags: Being a Pediatric Oncologist Patient Stories Source Type: blogs

Tamoxifen for breast cancer: How’s your CYP2D6?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I often told patients who asked, that I didn’t know how they would react to a drug. Would they get better, would they have side effects? I could tell them about average patients, but I would also say that every patient is a new experiment because in some way, big or small, everyone reacts differently to a drug.Well now, we can predict a little more about how breast cancer patients will respond to tamoxifen. It turns out that tamoxifen isn’t all that active as a substance that kills breast cancer. Before it can do its job, the tamoxifen needs to be changed in the body into much more active substances called endoxifen an...
Source: Dr.Kattlove's Cancer Blog - October 12, 2009 Category: Oncologists Source Type: blogs

I went in to say "Good bye"Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We knew this day was coming. Over the summer her cancer came back even though she was getting chemotherapy. We switched gears, giving radiation and chemotherapy aimed at controlling pain, no longer at curing disease. But that doesn’t make this day any easier.Overnight, last night, it became harder to breathe and her pain worsened. A chest x-ray showed almost no air getting to her left lung. Hoping there was fluid that could be removed, she had a CT scan today; but there was no fluid, only tumor. Tumor that hadn’t been there 10 days ago.I went in to the hospital today, to see her one last time before she went home. We w...
Source: Doctor David's Blog - October 11, 2009 Category: Oncologists Tags: Being a Pediatric Oncologist Patient Stories Philanthropy Source Type: blogs

It's Wednesday... The Doctor is Playing GolfEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
What a horrid, 50's-era cliche!But today, it was true. This afternoon I played golf in a fundraising tournament for the Heather Brooke Foundation. This is a foundation named in honor of a patient with Ewing's Sarcoma that I once helped care for. When Heather passed away, her mother channeled her grief into helping others. The Heather Brooke Foundation exists to help conquer childhood cancer and to help and educate the families of children with debilitating illnesses.Today was a beautiful day for golf... if you like playing in gale force winds! Of course, if you're as terrible as I am (other than Putt Putt, today is the 3rd...
Source: Doctor David's Blog - October 8, 2009 Category: Oncologists Tags: Philanthropy Fun Stuff Sarcomas Source Type: blogs

More About Patients and the PressEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I have blogged before when stories about my patients (and their families) appeared in local newspapers. But this time it’s different. This time, my patient is the author!Let me explain.Phil (he gave me permission to blog about this) was receiving radiation therapy at another institution. He was suffering one of the common side effects – burning skin. Realizing that the redness and burning are caused by inflammation, he had a clever idea. With the permission of his radiation oncology team, he tried an over the counter anti-inflammatory cream. It worked! His skin improved dramatically. Photo CreditThe best part is what ...
Source: Doctor David's Blog - October 5, 2009 Category: Oncologists Tags: Side Effects of Treatment Patient Stories Source Type: blogs

How long should chemotherapy be given for ovarian cancer?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
It is hard to stop treatment when it has been successful. I once had a patient with colon cancer that had spread to her liver who responded so well to chemotherapy that after five years she was still in remission. She lived far away from my office and as she aged, became reluctant to continue the drug (5-FU). So we stopped. Within six months, the cancer reappeared and didn’t shrink when we restarted the chemotherapy. A few months later, she died.Did stopping the chemotherapy allow the cancer to come back? Probably not. Nearly every study of prolonged chemotherapy has shown that it stops working after about 4-6 months of ...
Source: Dr.Kattlove's Cancer Blog - October 4, 2009 Category: Oncologists Source Type: blogs

Medical Wealth TransferEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Something like 50% of Medicare health dollars are spent in the final two years of a person's life. What no one is really talking about is that, in order for the system not to become bankrupt, there must ultimately be a diversion of resources from the elderly to the young. Unfortunately, this is in stark contrast to the trends of the past several decades, where debt is increasingly being transferred to future generations. Not only have we overspent at the cost of our progeny in things like defense, our trade deficit and our overconsumption of material goods, but we have essentially placed our current health debt burden on s...
Source: CancerDoc - September 25, 2009 Category: Oncologists Source Type: blogs

The black and white of breast cancerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study was reported in the September 20 issue of the Journal of the American Society of Oncology.What does this mean for black women in the U.S.? They probably do have a genetic basis for a more aggressive form of breast cancer since many of their ancestors came from West African countries such as Nigeria (although the actual country Nigeria may not have existed then). Their cancer contains hormone receptors more often than their Nigerian counterparts, perhaps because of the racial mixing associated with Blacks’ early years in the country. But they still have a problem that cannot be solved solely by gaining the usua...
Source: Dr.Kattlove's Cancer Blog - September 24, 2009 Category: Oncologists Source Type: blogs

Do oncologists hasten their patients’ deaths? You bet they do – at least the good ones.Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Many years ago, a patient of mine with widespread cancer could no longer be cared for at home. She had failed all treatments, the cancer in her bones was causing terrific pain and the family couldn’t deal with it any more, even though they had help from hospice. At this point the only way to control her pain would be with intravenous morphine, my drug of choice. And it worked. The problem was that she slept all the time. Eventually, she became too sleepy and her breathing slowed. Not wanting to be responsible for ending her life, I ordered a drug called Narcan, which reversed the effects of the morphine. Immediately she ...
Source: Dr.Kattlove's Cancer Blog - September 16, 2009 Category: Oncologists Source Type: blogs

A Famous ParentEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In the past, I have blogged about patients of mine who have made the news. This past week, while I was reading the newspaper before going to work, my eye was caught by an article in the Sports section about a man with a familiar name.(Note: All personal information in this post is also seen in the article in the Washington Post, so there is no violation of confidentiality. Also, some links will require a subscription to washingtonpost.com to see.)The article was about the head football coach at the University of Richmond, Michael London. The article spoke about Mr. London in glowing terms, talking about how he grew up in R...
Source: Doctor David's Blog - September 8, 2009 Category: Oncologists Tags: Being a Pediatric Oncologist Patient Stories Fun Stuff Announcements Source Type: blogs

A Family Undertaking: POVEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I just saw one of the most riveting documentaries in my life. It is called "A Family Undertaking: POV". It is all about dying and the industry of death in this country. It follows a growing movement in this country that emphasizes "home deaths" and "home burials" as opposed to the usual affair that occurs in a funeral home. A brief history is given of the evolution of embalming and modern funeral procedures that started during the Civil War. Apparently, prior to this, as would be expected, when people died, their families at home often took care of the burial, providing whatever ceremony was consistent with the family's be...
Source: CancerDoc - September 6, 2009 Category: Oncologists Source Type: blogs