April 21st, 2010 by EvanFalchukJD in Better Health Network, Health Policy, Health Tips, Opinion, Research
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The Wall Street Journal’s Health Blog says that cancer lab tests “aren’t always right.” They report on reports issued by two professional societies that point out that as many as 20% of a certain kind of test are inaccurate. According to the Health Blog the problem is the tests “aren’t black and white, and rely on a pathologist’s judgment.”
Now, judgment is a critical factor in most everything in medicine, but perhaps nowhere else are the consequences of incorrect judgment so serious as in pathology. As Dr. William Osler famously observed: “As is your pathology, so goes your clinical practice.” But how widespread is this problem? Read more »
*This blog post was originally published at See First Blog*
February 25th, 2010 by Harriet Hall, M.D. in Better Health Network, Opinion, Research
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Everybody knows that colonoscopy is the best test to screen for colorectal cancer and that colonoscopies save lives. Everybody may be wrong. Colonoscopy is increasingly viewed as the gold standard for colorectal cancer screening, but its reputation is not based on solid evidence. In reality, it is not yet known for certain whether colonoscopy can help reduce the number of deaths from colorectal cancer. Screening with fecal occult blood testing (FOBT) and flexible sigmoidoscopy are supported by better evidence, but questions remain. It seems our zeal for screening tests has outstripped the evidence.
Statistics show that the life-time risk for an adult American to develop colorectal cancer (CRC) is approximately 6%. Colorectal cancer is the second leading cause of cancer deaths in the United States. In the US there are currently 146,970 new cases and 50,630 deaths each year. Between 1973 and 1995, mortality from CRC declined by 20.5%, and incidence declined by 7.4% in the United States. Read more »
*This blog post was originally published at Science-Based Medicine*
February 14th, 2010 by Michael Sevilla, M.D. in Better Health Network, True Stories
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One of the great things of being in a group practice is meeting and taking care of patients who may not necessarily be on your own personal patient panel. Walking into the room, I hear the patient say, “Doc, you gotta help me.” I see a red right forearm and on the “complaint” section, the nurse wrote “burn.”
So, I ask, “Well how did you burn your arm?” “Well, doc, I got cancer.” Hmm, that’s interesting. I didn’t make the connection until the next sentence. “It was my last treatment with chemotherapy about 2 weeks ago and for some reason, the needle slipped and the stuff went all over my arm. The cancer doc prescribed these pills, but they don’t seem to be helping. I asked the pharmacist about some salves and this is what they said.” He showed me a handful of creams and ointments purchased at the pharmacy.
Since I didn’t know this patient at all, I was leafing through a very thick paper chart to try to catch up. “Yeah, I’ve been coming to see Doc [name] for a long time now. I’m glad you were able to see me today since his schedule was full.” This very pleasant patient then told me about how they diagnosed his cancer – a tear came to his eye – it’s like he was re-living that moment again. Read more »
*This blog post was originally published at Doctor Anonymous*
February 4th, 2010 by Debra Gordon in Better Health Network, Quackery Exposed, True Stories
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So my cousin emailed me the other night. She had a breast cancer recurrence about 6 years ago. Before you feel too sorry for her, however, know this: She’s doing great, moving from one targeted treatment/chemotherapy/laser knife procedure to another. Her doctors are fabulous. Her attitude is amazing. And, as she constantly tells us, she feels great and is loving life. No, this isn’t about her. It’s about her friend, the one she emailed me about.
Her friend was diagnosed with an early stage of an aggressive form of non-small cell lung cancer a year ago. After chemotherapy, a CT scan this summer showed her lungs clear of cancer; but a followup CT scan last week showed some spots. This woman had participated in a clinical trial during her first round of treatment and her doctor wanted her to join another clinical trial. But my cousin’s friend is freaked out; she doesn’t want to feel like a “guinea pig.” So when her daughter suggested she see a doctor who specializes in an unproven and experimental therapy called insulin potentiation therapy, she was ready to call for an appointment. Read more »
*This blog post was originally published at Debra Gordon's Musings on Medicine and Health Care*
February 1st, 2010 by Dr. Val Jones in True Stories
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A dear friend of mine (let’s call her Amanda) has metastatic breast cancer. She’s far outlived her life expectancy, thanks to advances in targeted chemotherapy, but is beginning to need more medical care. She’s the divorced mom of two teens, with a loving extended family who keeps a close eye on her.
When Amanda was recently admitted to her local hospital with abdominal pain, a new policy resulted in some unintended consequences. While she was still in the Emergency Department, a nurse came by to ask if Amanda wanted to be an organ donor. The family members – keenly aware of her grave prognosis – assumed that the nurse knew about the cancer, and was asking this question because it had been determined that Amanda was about to die.
Tearful sobs ensued. Amanda’s sister called me the next day to tell me the news. Read more »
