December 4th, 2010 by Elaine Schattner, M.D. in Better Health Network, Health Tips, Opinion, True Stories
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To complain or “be good” is an apparent dilemma for some patients with serious illness.
Yesterday I received an email from a close friend with advanced breast cancer. She’s got a lot of symptoms: Her fatigue is so overwhelming she can’t do more than one activity each day. Yesterday, for example, she stayed home all day and did nothing because she was supposed to watch a hockey game in the evening with her teenage son and other family members. Her voice is weak, so much it’s hard to talk on the phone. She has difficulty writing, in the manual sense — meaning she can’t quite use her right arm and hand properly.
“It’s something I would never mention to the doctor because it is very subtle,” she wrote. “But it has not improved and if anything has worsened over time.”
There are more than a few possible medical explanations for why a person who’s receiving breast cancer therapy might not be able to use her right arm. But that’s not the point of today’s lesson. What’s noteworthy here is that the patient — an educated, thoughtful woman who’s in what should be the middle of her life and is trying as best she can to survive — doesn’t think these symptoms are worth mentioning. Read more »
*This blog post was originally published at Medical Lessons*
November 16th, 2010 by Peggy Polaneczky, M.D. in Better Health Network, Health Tips, News, Opinion, Research
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A new analysis of long-term data from the Women’s Health Initiative confirms what we already knew the first time around: Use of combination hormone replacement (HRT*) is associated with a small, but real, risk of breast cancer. This new 11-year followup data carries that knowledge out to its not unexpected conclusion — namely, that some (although not most) breast cancers can be fatal, and therefore the the use of HRT can increase breast cancer mortality.
While it may seem a bit of a “duh,” this study was, in fact, necessary to quell the WHI critics who continued to argue that the breast cancers caused by HRT were somehow less aggressive than those occurring off HRT (which they are not.) It was also a wake-up call for many women who were continuing to use HRT and thinking that somehow its risks did not apply to them. A fair number of these women appear to be coming off of HRT, at least in my practice. Others are staying the course and accepting the risks as they have been defined. Either of which is fine with me.
The spin going on around this study — both for and against HRT use — is tremendous and ultimately confusing to women. The pro-HRT crowd (some of whom have relationships to Pharma) is using language like: “The increased risk from using HRT for five years is the same as if your menopause occurred five years later,” which is technically true, but so what? The bioidentical hormone crowd (usually also selling the same) are using the study to further hype how their regimens are safer than the evil Big Pharma products — based on no data. Which leaves the rest of us to try to find ways to help our patients understand the risks, place them into perspective for themselves, and make a decision about how and if to treat their menopausal symptoms. Read more »
*This blog post was originally published at tbtam*
October 19th, 2010 by Medgadget in Better Health Network, News, Research
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James C. Tilton, a scientist at NASA’s Goddard Space Flight Center, for some years now has been working on new image enhancement software to help automatically analyze satellite data of the Earth. Hierarchical Segmentation Software (HSEG), as the tool is called, identifies relatively homogeneous areas of an image and highlights them.
Our eyes and brains are pretty good at image analysis, but large dense maps can be quite a challenge. Although originally designed for aerial cartography, the first commercial use of the software came in the form of a mammogram enhancement and analysis system.
The lakes of northern Wisconsin (top) are very much like dense breast tissue (side) to a NASA scientist it turns out, and porting over the code and optimizing it led to the MED-SEG™ system from Bartron Medical Imaging (New Haven, Connecticut). Having received FDA approval, plans are now being made to conduct clinical trials evaluating how MED-SEG can benefit radiologists in cancer diagnosis. Read more »
*This blog post was originally published at Medgadget*
September 8th, 2010 by GarySchwitzer in Better Health Network, Health Policy, Health Tips, News, Opinion, Research
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Journalist Andrew Holtz has been a colleague for longer than probably either one of us wants to remember. He is currently one of our story reviewers on HealthNewsReview.org. In fact, he was one of the reviewers on four stories we analyzed last week on the same study. He thought there were some important take-home messages that rose above the walls of our formal systematic review, so he wrote this guest blog post, and we thank him for it:
The Sept. 1 issue of the Journal of the American Medical Association included an article that is likely to have a strong influence on the advice given to women who have a very high risk of breast and ovarian cancer linked to mutations of the BRCA1 and BRCA2 genes. Of the four stories we reviewed, only the AP report scored well on our review criteria.
I know what my first journalism professor, Marion Lewenstein, would have done with at least two of the stories: Given them an “F” for factual errors without further consideration of their merits. Read more »
*This blog post was originally published at Gary Schwitzer's HealthNewsReview Blog*
August 27th, 2010 by RamonaBatesMD in Better Health Network, Health Policy, News, Opinion
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Recently the [state of] New York signed a law requiring hospitals and doctors to discuss breast reconstruction options with the patient prior to her undergoing cancer surgery. It troubled me that this law was needed. Is it not the duty of the physicians and surgeons to educate the patient on the options available?
We need to make sure the patient and their family know of the treatment options which may vary depending on the diagnosis and stage: Radiation, chemotherapy, surgery (lumpectomy, mastectomy, axillary dissection) — a combination of treatments.
Even if the patient and her physicians don’t chose to do immediate reconstruction, isn’t the discussion and information part of the discussion? At least inform the patient of the option.
Do we physicians and surgeons need another law to ensure we do right by our patients? Read more »
*This blog post was originally published at Suture for a Living*
