One wonders how many men have their blood tested for PSA levels looking for prostate cancer without being asked if that’s what they really wanted.
The Foundation for Informed Medical Decision Making (which supports my web publishing efforts) has now posted on its YouTube page a video clip with a man who has some regrets about his prostate cancer screening and treatment experience. It’s the same man featured in the New York Times Sunday magazine piece, “Can Cancer Ever Be Ignored?”
Relevant excerpt from the NYT piece:
“Tim Glynn, a self-described country lawyer from Setauket, N.Y., was 47 in 1997 when he went to his primary-care doctor, troubled by a vague feeling of being down. After his physical exam, Glynn was sent to have his blood drawn. Along with thyroid and cholesterol levels, the doctor ordered a P.S.A. test. Read more »
Flashback to summer of 2008. I’m looking forward to August 5–the day that I’ll no longer be a faceless bureaucrat. The day that the US Preventive Services Task Force (USPSTF) will issue its new recommendations on screening for prostate cancer–recommendations I’ve labored on as a federal employee for the past year and a half.
For much of 2007 I combed the medical literature for every study I could find on the benefits and harms of prostate cancer screening. In November of that year I presented my findings to the USPSTF, a widely respected, independent panel of primary care experts. They discussed and debated what the evidence showed and then voted unanimously to draft new recommendations. I didn’t get to vote, but it has been my job in 2008 to shepherd the draft statement and literature review through an intensive vetting process and to finalize both.
As August 5 approaches, my colleagues in public relations warn me that the last time the USPSTF said anything about prostate cancer screening, the phones started ringing off the hook. I’m not so secretly hoping that the same will happen this time.
And I’m not disappointed! After we release the statement, Read more »
I was lucky enough to see Venus Williams play her first professional tennis match when she was a teenager. It was obvious she was something special and her coach-father said “If you think she’s good, wait until you see her little sister.” (Serena Williams).
Venus and her sister, Serena have dominated women’s tennis over the past decade but she is currently sidelined with a diagnosis of Sjogrens Syndrome. (pronounced Show-grins). It is a chronic auto-immune disorder where white blood cells (immune function cells) target the body’s moisture-producing glands. Symptoms include dry eyes, dry mouth, extreme fatigue and joint pain. Sometimes it co-exists with other auto-immune diseases like thyroid disease or rheumatoid arthritis.
Symptoms can wax and wane and getting the right diagnosis can take time. I can imagine Venus going to her doctor and complaining of fatigue and dry mouth. Considering her athletic schedule, she was probably told to get some rest and fluids. The diagnostic key should have been Read more »
Researchers from Columbia University have developed a “lab on a chip” HIV and syphilis test, and are now reporting the first results from tests in the field conducted in Rwanda. The mChip, as it is called, is the size of a credit card and replicates all steps of an ELISA test, at a lower total material cost and within 20 minutes. After application of a blood sample, the chip is inserted into a $100 battery-powered handheld analyzer. It needs only 1 μl of unprocessed whole blood and does not require any user interpretation of the signal, providing a clear-cut yes or no result.
Right now, HIV testing in developing countries either relies on expensive laboratory testing taking a long time, or uses cheaper methods based on lateral flow, which, although very rapid, do not provide very reliable results. The mChip combines Read more »
*This blog post was originally published at Medgadget*
That’s the question Dartmouth’s Dr. Gil Welch asks in a column on the CNN website. He reflects on [recent] news about a test in development that might find a single cancer cell among a billion healthy ones — as so many news stories framed it. Welch analyzes:
“But it’s not that simple. The test could just as easily start a cancer epidemic.
Most assume there are no downsides to looking for things to be wrong. But the truth is that early diagnosis is a double-edged sword. While it has the potential to help some, it always has a hidden side-effect: overdiagnosis, the detection of abnormalities that are not destined to ever bother people in their lifetime.
Becoming a patient unnecessarily has real human costs. There’s the anxiety of being told you are somehow not healthy. There’s the problem that getting a diagnosis may affect your ability to get health insurance. There are the headaches of renewing prescriptions, scheduling appointments and keeping them. Finally, there are the physical harms of treatments that cannot help (because there is nothing to fix): drug side-effects, surgical complications and even death. Not to mention it can bankrupt you.
Americans don’t need more diagnoses, they need the right diagnoses.
I don’t know whether this test will help some patients. It might, but it will take years to figure that out.Read more »
It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…
I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…
I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…
When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…
I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…