November 23rd, 2011 by Harriet Hall, M.D. in Opinion
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A recent announcement is likely to generate a lot of controversy. The Advisory Committee on Immunization Practices of the CDC has recommended that boys and young men be vaccinated against human papillomavirus (HPV). Previously the guidelines said boys “could” be given the HPV vaccine. Now they have recommended that boys age 11 to 12 “should” be vaccinated, as well as boys age 13 to 21 who have not already had the full series of 3 shots. The vaccine can also be given to boys as young as 9 and to young men age 22 to 26.
The vaccine was originally promoted as a way to prevent cervical cancer. Boys don’t have a cervix, so why should they be subjected to a “girl’s” vaccine? There are some good science-based reasons:
- Boys can transmit the virus to female sex partners later in life, leading to cervical cancer in women.
- More importantly, boys themselves can also be directly harmed by the virus. It can cause genital warts, cancer of the head and neck (tongue, tonsils and throat), anal and penile cancer, respiratory papillomatosis, and giant condyloma of Buschke and Lowenstein. In rare cases, immunocompromised patients can develop epidermodysplasia verruciformis.
- HPV has even been Read more »
*This blog post was originally published at Science-Based Medicine*
November 11th, 2011 by BruceCampbellMD in True Stories
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Traveling makes one modest – you see what a tiny place you occupy in the world.
-Gustave Flaubert
We 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 »
September 1st, 2011 by AndrewSchorr in Interviews, News
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Pat Elliott, me and a HUGE cactus at Banner MD Anderson!
I am just back from the Phoenix-metro area. It’s now the 5th largest in the United States and despite home foreclosures, there is still a feeling of growth in many areas. Gilbert, a nearby suburb, has expanded to over 200,000 people and a growing major medical center. I spent several days interviewing patients and staff about the soon-to-open, Banner MD Anderson Cancer Center. The hope is that by bringing MD Anderson’s world-renowned expertise, clinical trials and processes to this new center, cancer care around Phoenix and the southwest will be improved. Look for my video interviews coming soon.
But, in the meantime, one interview stuck out for me; the one with the Banner Health President and CEO, Peter Fine. Peter is in his late 50s and is a health care industry professional who has been guiding Banner Health and its 23 hospitals well for over a decade. For the past several years, Peter has been strategizing the building of a major cancer center on one of his hospital campuses. Peter knew he would need a renowned partner to make it successful and three years ago he chose MD Anderson Cancer Center, in Houston, consistently ranked as the nation’s #1 cancer center (and where I was treated in a leukemia clinical trial).
Even before the partnership contract was inked, a strange thing happened. Peter found a swollen lymph node in his neck and it didn’t go away. Read more »
*This blog post was originally published at Andrew's Blog*
April 30th, 2011 by DavedeBronkart in True Stories
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Two years ago we wrote “Let’s hear it for the ‘d-patients’” — doctors who become e-patients themselves. We said “D-patients prove that patient empowerment is anything but anti-doctor. Heck, sometimes it’s a doctor preservation movement.”
A new article in our Journal of Participatory Medicine provides a compelling example: A Physician’s Experience as a Cancer of the Neck Patient: The Importance of Patient Participation. The author, Itzhak Brook MD, makes our point:
I am telling my personal story in the hope that health care providers will realize the difficult challenges faced by a patient diagnosed with cancer and undergoing extensive surgeries. I am also discussing the importance of active participation of the patient and their family members in all phases of care.
JoPM co-editor Charlie Smith adds, in his introductory note: (emphasis added)
You may wonder why a physician’s account of his illness and the frustrations he experienced merit publication in this journal. But, if a doctor has this degree of anxiety, this much difficulty getting information about his care and this degree of struggle making good decisions, then patients can easily understand why they feel so overwhelmed and incapable, at times, of truly “participating” in their own care. What we are advocating for is difficult in the best of circumstances and requires all hands on deck for the task! Read more »
*This blog post was originally published at e-Patients.net*
March 2nd, 2011 by Jon LaPook, M.D. in News, Research, Video
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A new study finds that half of men in America are infected with the HPV virus. Dr. Jon LaPook reports on the growing concern that the virus in men could be responsible for an increase in head and neck cancers.
HPV Affects Half Of U.S. Men
A study out [yesterday] in The Lancet by Moffitt Cancer Center researcher Anna Giuliano, Ph.D., and her colleagues finds that 50 percent of men ages 18 to 70 in Brazil, Mexico, and the U.S. have genital infection with human papillomavirus (HPV). HPV is the virus that causes cervical cancer in women. It also causes warts and cancer of the genitals and anus in both men and women. Over the past several years, researchers have realized that the virus can also cause cancer of the head and neck.
Aimee R. Kreimer, Ph.D., of the National Cancer Institute, estimates that about 65 percent of the approximately 8,000 cancers of the tonsils and base of the tongue (oropharynx) seen in the U.S. in 2010 were from HPV infection; eighty percent of these are in men. The rates for HPV-associated cancers like these are increasing; for sites like the mouth and larynx that are associated with tobacco and alcohol use, the rates are decreasing (though still too high since too many people still smoke and abuse alcohol).
An infection rate of 50 percent for a virus that can cause cancer sounds scary. But knowing a few more facts about HPV helps put the risk in perspective. About 90 percent of men and women infected with HPV virus get rid of it on their own within about two years. There are many different strains of HPV — some that cause cancer and some that don’t. Only about 6 percent of men have genital infection with HPV 16 — the strain linked to more than 90 percent of cancers of the head and neck. And only about 0.6 percent of men have HPV 16 in specimens taken from their mouths; what percentage of those men go on to develop head and neck cancer is unknown. Read more »