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Still No Consensus On Optimal Treatment For Ductal Carcinoma In Situ (DCIS)

Ductal Carcinoma in Situ (DCIS) in the breast, histopathology w/ hematoxylin & eosin stain, Wiki-Commons image

More, a magazine “for women of style & substance,” has an unusually thorough, now-available article by Nancy F. Smith in its September issue on A Breast Cancer You May Not Need to Treat.

The article’s subject is DCIS (Ductal Carcinoma in Situ). This non-invasive, “Stage 0” malignancy of the breast has shot up in reported incidence over the past two decades. It’s one of the so-called slow-growing tumors detected by mammography; a woman can have DCIS without a mass or invasive breast cancer.

While some people with this diagnosis choose to have surgery, radiation or hormonal treatments, others opt for a watchful waiting strategy. The article quotes several physicians, including oncologists, who consider Read more »

*This blog post was originally published at Medical Lessons*

Declining Cancer Screening: Why It’s The Right Decision For Some

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 »

*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*

Encourage Earlier Mammograms For Women With A Family History Of Breast Cancer

Somewhere along the line I learned to encourage women with a family history of breast cancer to begin getting mammograms at an age 10 years prior to when their mother was diagnosed and to encourage their daughters to begin getting mammograms at an age 10 years prior to when they themselves were ever diagnosed.

I learned this prior to the discovery of BRCA genes.  It was a trend that had been noted among women with strong family histories.  The new study (see full reference below) in the journal Cancer verifies that genetic breast cancers show up earlier in the next generation – on average by 8 years.

The study from MD Anderson looked at 2 generations of families with the BRCA gene to assess the age at diagnosis.  Using the pool of 132 BRCA-positive women with breast cancer who participated in the high-risk protocol at The University of Texas MD Anderson Cancer Center (Gen 2), 106 women could be paired with a family member in the previous generation (Gen 1) who was diagnosed with a BRCA-related cancer (either breast cancer or ovarian cancer).

The median age of cancer diagnosis was Read more »

*This blog post was originally published at Suture for a Living*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

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…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

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…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

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…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

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…

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Eat To Save Your Life: Another Half-True Diet Book

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…

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