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Latest Posts

Study Explores New Method Of Fluorescing Cancer Cells In Tumors

00299er743jf73u Two months ago we reported on the first ovarian cancer surgeries performed with fluorescence guidance. As described in the Nature Medicine paper, the international team of researchers from The Netherlands, Germany, and Indiana used folate coupled to fluorescein isothiocyanate (FITC) to make ovarian cancer cells glow so they could be easily identified.

Now, in this week’s issue of Science Translational Medicine, another international team from Japan and Maryland reports their development of a spray-on probe that may provide even better sensitivity and fluorescent contrast than the folate-FITC counterpart. The editors of STM summarize this work well in the following note: Read more »

*This blog post was originally published at Medgadget*

Head And Neck Cancer Surgeon Steps Out Of His Comfort Zone And Into Kenya

Traveling makes one modest – you see what a tiny place you occupy in the world.
-Gustave Flaubert

Tumor ImageWe have come to Kenya, expecting to work outside of our “comfort zones.”

Our patient has arrived from miles away, riding on the back of her husband’s bicycle. She has an enlarging, bleeding mass growing off of the side of her neck. There are no pathologists available, so we are uncertain what kind of tumor it is, although it appears to be a cancer. She has been wearing a scarf to hide the mass for the past year; her head covering is speckled with blood.

We are anxious. Unexpected things can happen in an operating room this far from home. We expect Read more »

Some Patients Just Won’t Take “No” For An Answer

62-year-old black man with a two inch (that’s inch; not centimeter) lump under his left arm. It is determined that he needs to have it biopsied in order to tell for sure what it is. The differential diagnosis includes a simple reactive lymph node, lymphoma, leukemia, granuloma, sarcoidosis, and several other more esoteric entities, all of which require tissue for definitive pathologic diagnosis.

The dialogue:

Patient Who Will Not be Reassured: What is it, Doctor Dino?

Me: We won’t know for sure until we get the report from the biopsy.

PWWNBR: But what do you think it is?

Me: I have no idea. We have to see what the pathologist says.

PWWNBR: Could it be cancer?

Me: It could be any one of several different things. Yes, cancer could be one of them, but there’s no way of knowing without the biopsy.

PWWNBR: Dr. Dino, do I have cancer? Read more »

*This blog post was originally published at Musings of a Dinosaur*

Woman Claims She Found A Simple Way To Kill Cancerous Tumors, Jury Not Convinced

I hope @oracknows, Respectful Insolence, will write more about this. He is much better than I at sussing out fraudulent medical treatments.

I have lived and practiced in Little Rock, AR for over twenty years and I did not know this was in my backyard until my local paper (Arkansas Democrat-Gazette) reported on the outcome of the trial last week. The article title caught my eye as I was skimming the news: Jurors: Cancer therapy a fraud, Award in suit is $2.5 million (subscription only unfortunately).

A federal jury awarded $2.5 million in damages Tuesday to a California woman who paid $6,250 to undergo alternative treatments from a Jacksonville woman who promised a “100 percent success rate” in destroying cancerous breast tumors.

Antonella Carpenter, the former Jacksonville woman who has since moved to Broken Arrow, Okla., and continues to proclaim on her website that she has found a simple, painless way to kill cancerous tumors, wasn’t present for the verdict against her and her company, Lase Med Inc. …….

I don’t recall ever hearing of Lase Med Inc: LIESH Therapy.

The plaintiff in the lawsuit is Read more »

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

Herbal Medicine, Thunder God Vine, May Find Use In Cancer Research

Thunder god vine may not be a useful herbal medicine but the compounds isolated from it are fascinating – if not as medicines, then most certainly as laboratory tools. Nature Chemical Biology recently published an article where a research team from Johns Hopkins, the University of Colorado at Boulder, and Drew University in New Jersey, has determined the molecular mechanism of action of triptolide, an unusual triepoxide compound from the plant.

Tripterygium wilfordii Hook F, or thunder god vine, is known as lei gong teng in Chinese traditional medicine and has a history of use as an anti-inflammatory herb. As with many traditional medicines, usage patterns do not necessarily indicate scientific validity. In fact, a Cochrane review published just last month on herbal therapies for rheumatoid arthritis indicated that the efficacy of thunder god vine was mixed. More concerning is that the herb had significant adverse effects in some trials, from hair loss to one case of aplastic anemia.

Nevertheless, the herb’s components have been studied since the 1970s for since they also appears to kill tumor cells in culture with nanomolar potency and have immunosuppresant activity in animal models. The group of the late natural products chemist at the University of Virginia, S. Morris Kupchan, first identified the unusual structures of triptolide and tripdiolide from Tripterygium wilfordii as described in this 1972 paper from the Journal of the American Chemical Society. Cytotoxic activity toward tumor cells in culture was used to guide the chemical fractionation of extracts. The unusual presence of three consecutive epoxides in the structures of both compounds led Kupchan to hypothesize later in Science that they target leukemia cells by covalent binding to cellular targets involved in cellular growth. Read more »

*This blog post was originally published at Science-Based Medicine*

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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