March 2nd, 2011 by Jessie Gruman, Ph.D. in Better Health Network, Opinion
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The other day I came across this photo of a couple clasping each other in a dramatic tango on the cover of an old medical journal — a special issue from 1999 that was focused entirely on doctor-patient partnership. The tone and subjects of the articles, letters and editorials were identical to those written today on the topic: “It’s time for the paternalism of the relationship between doctors and patients to be transformed into a partnership;” “There are benefits to this change and dangers to maintaining the status quo;” “Some doctors and patients resist the change and some embrace it: Why?”
Two questions struck me as I impatiently scanned the articles from 12 years ago: First, why are these articles about doctor-patient partnership still so relevant? And second, why did the editor choose this cover image?
I’ve been mulling over these questions for a couple days, and I think an answer to the second question sheds light on the first. Here are some thoughts about the relationship between patients and doctors (and nurse practitioners and other clinicians) evoked by that image of the two elegant people dancing together:
It takes two to tango. Ever seen one guy doing the tango? Nope. Whatever he’s doing out there on the dance floor, that’s not tango. Without both dancers, there is no tango. The reason my doctor and I come together is our shared purpose of curing my illness or easing my pain. We bring different skills, perspectives and needs to this interaction. When in a partnership, I describe my symptoms and recount my history. I talk about my values and priorities. I say what I am able and willing to do for myself and what I am not. My doctor has knowledge about my disease and experience treating it in people like me; she explains risks and tradeoffs of different approaches and tailors her use of drugs, devices, and procedures to meet my needs and my preferences. Both of us recognize that without the active commitment of the other we can’t reach our shared goal: To help me live as well as I can for as long as I can.
Each dancer adjusts to his or her partner. In tango, each partner has different moves; the lead shifts subtly and constantly between them throughout the dance. In a partnership, when I am really ill, I delegate more decisions to my physicians; when I am well we freely go back and forth, discussing treatment options and making plans. Read more »
*This blog post was originally published at CFAH PPF Blog*
March 2nd, 2011 by GarySchwitzer in Better Health Network, Opinion
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Dr. Barron Lerner has written a book about breast cancer: “The Breast Cancer Wars: Hope, Fear, and the Pursuit of a Cure in Twentieth-Century America.” And he’s written a book about celebrity patients: “When Illness Goes Public: Celebrity Patients and How We Look at Medicine.” He wed the two topics in a blog post on the New York Times health blog entitled “Suzanne Somers, Cancer Expert.” Excerpts:
“Earlier this week, NBC’s “Dateline” devoted an entire hour on Sunday evening to allow the actress Suzanne Somers to express her rather unconventional beliefs about cancer.
It is not the first time a major media outlet has given air time to Ms. Somers, whose journey into the medical realm has been featured on a variety of news programs, talk shows and entertainment channels. A few years ago, Oprah Winfrey invited Ms. Somers on her show to share the secrets behind her youthful appearance — a complex regimen of unregulated hormone creams and some 60 vitamins and supplements.
But is it entirely outrageous that respected media organizations continue to give the “Three’s Company” sitcom star a platform to dispense medical advice? Not really, in a world in which celebrities have become among the most recognizable spokespeople — and sometimes experts — about various diseases.
…
…patients — especially those who want to explore every possible avenue — have the right to know that there are unorthodox cancer therapies that some people believe are helpful.
But not without several caveats, and that is where Ms. Somers, and many of those in the media who discuss her books and views, have failed. Ms. Somers says she is promoting hope, but false hope benefits no one.
Many people with end-stage cancer are, understandably, desperate, and thus potentially vulnerable to a sales pitch — even an expensive one. But here is a case when an informed patient may truly be a wiser patient. Perhaps if doctors were more willing to address the fact that these nontraditional treatments exist, and share what we do and don’t know about their effectiveness, an actress like Ms. Somers would have less influence, and science would override celebrity.”
There’s been quite an online response to Dr. Lerner’s blog post. One reader wrote, succinctly:
“From Thigh Master to Snake Oil.”
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
March 2nd, 2011 by Bongi in Book Reviews, Opinion
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This post is a bit of a diversion from my usual posts, but I think it may still be worthwhile. You see, I want to promote a book.
I’ve just read the book, “Steeped in Blood: The Life and Times of a Forensic Scientist” by David Klatzow. What a stunning book. It really gives insight into the South Africa of old and possibly what South Africa of future may end up being like. I suggest that everyone get ahold of it and read it.
However, David, I do feel I must challenge you on one point. Towards the end of your book, you say one of your surgeon friends told you a story of one of our Cuban import surgeons who tried to do a tonsillectomy through the neck rather than through the mouth, the normal way of doing it. I know this story and have heard it often myself in the corridors in Pretoria. Unfortunately it’s urban legend and nothing more.
I have worked with the Cubans, and they aren’t too shabby. Don’t get me wrong — they aren’t a scratch on a South African specialist (although the standards are dropping as you rightly point out, and quite soon they may be far better than homegrown specialists), but the point is that they wouldn’t do something so bizarrely stupid. I even suspect I know who your surgeon friend might be, especially if he presently finds himself in Pretoria rather than Johannesburg, where you no doubt got to know him.
Anyway, still an absolutely brilliant read for anyone who wants to get a peek into the workings of the apartheid government of old. Go and buy it now.
*This blog post was originally published at other things amanzi*
March 2nd, 2011 by Jon LaPook, M.D. in News, Research, Video
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A new study finds that half of men in America are infected with the HPV virus. Dr. Jon LaPook reports on the growing concern that the virus in men could be responsible for an increase in head and neck cancers.
HPV Affects Half Of U.S. Men
A study out [yesterday] in The Lancet by Moffitt Cancer Center researcher Anna Giuliano, Ph.D., and her colleagues finds that 50 percent of men ages 18 to 70 in Brazil, Mexico, and the U.S. have genital infection with human papillomavirus (HPV). HPV is the virus that causes cervical cancer in women. It also causes warts and cancer of the genitals and anus in both men and women. Over the past several years, researchers have realized that the virus can also cause cancer of the head and neck.
Aimee R. Kreimer, Ph.D., of the National Cancer Institute, estimates that about 65 percent of the approximately 8,000 cancers of the tonsils and base of the tongue (oropharynx) seen in the U.S. in 2010 were from HPV infection; eighty percent of these are in men. The rates for HPV-associated cancers like these are increasing; for sites like the mouth and larynx that are associated with tobacco and alcohol use, the rates are decreasing (though still too high since too many people still smoke and abuse alcohol).
An infection rate of 50 percent for a virus that can cause cancer sounds scary. But knowing a few more facts about HPV helps put the risk in perspective. About 90 percent of men and women infected with HPV virus get rid of it on their own within about two years. There are many different strains of HPV — some that cause cancer and some that don’t. Only about 6 percent of men have genital infection with HPV 16 — the strain linked to more than 90 percent of cancers of the head and neck. And only about 0.6 percent of men have HPV 16 in specimens taken from their mouths; what percentage of those men go on to develop head and neck cancer is unknown. Read more »
March 2nd, 2011 by Medgadget in Better Health Network, Research
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Our modern armamentarium for treating cancer is impressive, but sometimes despite our best treatments, tumor cells continue to lurk in the bloodstream, seeding metastases throughout the body. Researchers at Emory have developed a way to monitor for these circulating tumor cells using gold nanoparticles.
This technique has been used before, but difficulty was encountered because white blood cells are close to the same size as some tumor cells, so they would both be tagged, necessitating a laborious multi-antibody staining process.
“The key technological advance here is our finding that polymer-coated gold nanoparticles that are conjugated with low molecular weight peptides such as EGF are much less sticky than particles conjugated to whole antibodies,” says Shuming Nie, Ph.D., a professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University. “This effect has led to a major improvement in discriminating tumor cells from non-tumor cells in the blood.”
Once these tumor cells are tagged with the gold nanoparticles, laser illumination reveals which cells are tumors in the bloodstream. This technique was tested on 19 patients with head and neck cancer, and showed excellent correlation with previous techniques. If this method can be validated in larger studies, it shows promise as a faster, more economical method to detect circulating tumor cells.
Full story: Nanoparticles May Enhance Circulating Tumor Cell Detection …
Abstract in Cancer Research : Quantification of circulating tumor cells in peripheral blood using EGFR-targeting gold nanoparticles
*This blog post was originally published at Medgadget*
