October 13th, 2008 by Dr. Val Jones in Expert Interviews
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My friend Dr. Joe Scherger and I enjoyed a sunny Sunday brunch at a garden eatery in DC. Unfortunately for the neighboring restaurant-goers, we engaged in a very loud and animated conversation about vasectomies. Joe is a family physician and men’s health expert who has recently become aware of “post vasectomy pain syndrome” through an online group that he leads. I noticed two men nearby crossing their legs reflexively and pretending not to be eavesdropping.
Apparently, as many as 10-15% of men may experience a prolonged period of testicular pain after undergoing a vasectomy. As common a complication as this is, Joe believes that very few men are sufficiently warned about it during the informed consent process. The pain may be caused by swelling (once the vas deferens is cut there is no exit point for newly generated sperm) or inflammation. In some cases, the body forms “anti-sperm” antibodies and attacks the sperm generating tissues in the testes. In other cases, small nerves in the area are damaged and heal poorly (causing neuromas).
So if you or your loved one is considering a vasectomy, it’s important to learn all the facts first. You may want to stop by Joe’s online group to ask a question as well.
September 18th, 2008 by Dr. Val Jones in True Stories
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I love my new blog web designer. She is incredibly talented, and has the uncanny ability to capture concepts with images. In fact, if you’d like to comment on this post to offer her a “high five” for this website design, I’m sure she’d appreciate it. Her name is Beata.
When Beata and I sat down to try to figure out how to express my “style” she asked me what kind of visuals I was drawn to. I showed her the Medi-mation website since I have a soft spot for 3-D science animation. She said she’d like to start with some microscopic images and stylize them for me so that they were suggestive of medical images, but not too literal.
Beata offered me a series of background patterns to choose from for my landing page. I did an abrupt halt over this one though: Read more »
July 20th, 2008 by Dr. Val Jones in Expert Interviews
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This is part 2 of an interview with urologist Mark Schoenberg. Please click here for part one of the interview.
Dr. Val: How is bladder cancer treated?
Dr. Schoenberg: Bladder cancer can be grouped into two categories: non-invasive disease and invasive disease. About 80-90% of the time the cancer is formed by the cells of the inner lining of the bladder, ureters, and kidneys and is non-invasive. This type of bladder cancer doesn’t spread or invade the bladder wall, so it doesn’t threaten the life of the patient, but it can recur.
Non-invasive cancers are usually removed surgically via a scope that is inserted into the bladder via the urethra, and then afterwards there are a variety of medicines that can be infused into the bladder. Those medicines are like a kind of weed killer for bladder cancer.
Unfortunately up to 20% of patients have invasive tumors at the time that they are diagnosed. Once the bladder cancer has spread outside the bladder wall, surgery is needed to remove the primary tumor and then IV chemotherapy and sometimes radiation therapy are needed to treat the life threatening, metastatic disease.
Dr. Val: Is there any way to screen for bladder cancer?
Dr. Schoenberg: Unfortunately at this time urine tests for bladder cancer are very expensive, and they don’t detect cancer reliably. However, many researchers (including myself) are currently on a hunt for specific bladder cancer markers that are inexpensive and reliable. Once we find such a marker or group of markers, it would make sense to begin screening — at the very least — high risk groups such as smokers or people with occupational exposures to chemicals.
Dr. Val: What are the most promising advancements in bladder cancer treatment? Is there new research in the pipeline that could improve its diagnosis or treatment?
Dr. Schoenberg: There are two different areas of research interest in bladder cancer. The diagnostics arena — finding cancer more efficiently, effectively, and less invasively — and the therapeutics arena — developing new tools, drugs, and agents to get rid of cancer cells.
On the diagnostic front, molecular diagnostic researchers are looking at abnormal cancer proteins and DNA that can be detected in urine samples. Because of this research, in the next 5-10 years it wouldn’t surprise me if we no longer had to rely on cystoscopes for the diagnosis of bladder cancer. Also we’d like to develop molecular and genetic profiles in order to risk-stratify people more successfully (i.e. figure out who is at greater risk for bladder cancer, and make sure they get tested).
On the treatment front, there are a number of companies developing targeted therapies for bladder cancer. It’s possible that these therapies will reduce the risk of progression and recurrence in people with bladder cancer.
Unfortunately, bladder cancer has only attracted a fraction of the research dollars that other cancers have in patients in the same demographic (like pancreatic cancer). In fact, NIH funding for bladder cancer research is pitifully small and shrinking, despite the fact that there are 600,000 Americans who have bladder cancer right now. Not only that, but bladder cancer is one of the most expensive cancers to treat – because it requires repeated cystoscopies, catheter-based infusions, repeat surgeries, and sometimes chemo and radiation. Bladder cancer treatment costs Americans about 1 billion dollars a year.
Dr. Val: Why isn’t bladder cancer receiving the research funding it deserves?
Dr. Schoenberg: Successful cancer groups have highly visible champions for the disease – like Lance Armstrong for testicular cancer, or Susan G. Koman for breast cancer. Research funding seems to be strongly influenced by highly visible people getting out there and making a ruckus. We need powerful spokespeople to help Diane Quale at the Bladder Cancer Association Network to get the word out.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
July 16th, 2008 by Dr. Val Jones in Celebrity Interviews, Patient Interviews
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Bob Schieffer is broadcast journalism’s most experienced Washington reporter. He has covered Washington for CBS News for more than 30 years, and has been the anchor for Face The Nation (one of the longest-running news programs in the history of television) since 1991. I had the privilege of interviewing him about his bladder cancer at the CBS studios today. It is Bob’s sincere hope that his story will inspire others to seek medical help at the first sign of bladder cancer, and also gain comfort from knowing that they are not alone.
This is part two of our interview series. Click here for part one.
Dr. Val: Do you have any advice for patients facing bladder cancer?
Schieffer: Bladder cancer is a very insidious disease, you can have it for a long time without knowing that you have it. At the first sign of blood in the urine, you need to go to the doctor. I think men are often reluctant to go to the doctor, and their tendency may be to attribute blood in their urine to a muscle strain of some kind. But waiting is a dangerous proposition. When I think of my own situation, I realize that even waiting another week or two could have put me into a whole different risk category and I might not be where I am today.
Cancer research is such an evolving field – that if you can keep yourself alive today, there may be a cure tomorrow. That’s the good news about this. The bad news is that we spend about as much on cancer research in a year as we do on one day in Iraq. I don’t know anyone in the cancer community who doesn’t believe that if we invested enough money in it we’d find cures.
Dr. Val: Was it hard for you to speak publicly about your cancer?
Schieffer: Tony Snow and I became really good friends, and we both felt that we had an obligation to talk about our conditions in order to promote cancer awareness. Hamilton Jordan was also a good friend of mine, and he devoted his life to raising awareness. He survived 5 cancers though the 6th one got him. I was a very private person before all this started, and when Hamilton found out I had cancer he called me and said that I really needed to get out and talk about it because I have the opportunity to have an impact on so many people.
As it turned out, I went on Don Imus’ radio show one morning and talked about it, and soon afterwards Wolf Blitzer asked me to be on his show on CNN. I must have received 600 emails from people thanking me for talking about my situation – some were glad to know how to recognize potential bladder cancer, and others told me they no longer felt alone in their cancer experience because they knew that I was going through it too. At that point, I thought to myself that speaking out about my cancer might have been the most important thing I’ve done so far as a journalist. If one person goes to see their doctor when they first notice blood in their urine, then I may have had a part in saving a life.
Bladder cancer is a “below the belt” disease and people are reluctant to talk about it. I think it’s really important to help people get past this barrier. It is nothing to be ashamed of, there’s nothing wrong with you as a person – it’s just that a certain percent of us are going to get bladder cancer.
Dr. Val: How do people get plugged in to the cancer community to get the help they need?
Schieffer: What I’ve noticed is that when you get cancer, you become acqainted with everyone else who has it. There’s a kind of natural networking that occurs when you participate in meetings and events. However, I’d encourage people affected by bladder cancer to go to the Bladder Cancer Advocacy Network. The founder, Diane Quale, left her job as an attorney to create the advocacy group after her husband was diagnosed with bladder cancer. She has raised hundreds of thousands of dollars for the cause, although sadly her husband lost his battle with bladder cancer a few weeks ago.
Hamilton Jordan told me this, “You have to take control of your disease. Nobody is going to be more interested in it than you. It’s your life, so you’re the one who has the most invested in this. Just Google ‘bladder cancer’ and learn as much as you can about it.”
When you go to a doctor, especially with cancer, it’s invaluable to get a second opinion. I got a second opinion from a wonderful physician at Johns Hopkins, Dr. Mark Schoenberg. And Dr. Schoenberg told me this: “A doctor is like a good craftsman. A good craftsman is always happy to show his work to other craftsmen. It’s the guy who isn’t really sure what he’s doing who doesn’t want to discuss his work with somebody else in the field.”
Dr. Val: What’s your bottom line about cancer?
Schieffer: Cancer is not something to be embarrassed about. It’s something that happens to us and needs to be dealt with. When the doctor tells you that you have cancer, it is not the death sentence that it once was. Cancer research is advancing every day and we’re finding new ways to fight the disease. There’s no need to say, “I have cancer — this is it” but rather, “I have cancer and what do I need to do about it?” And then you have to do it.
*Visit the bladder cancer center at Revolution Health*This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
June 12th, 2008 by Dr. Val Jones in News
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TRUE: New York City adults have more genital herpes than the national average (26% versus 19%). One commenter replied, “Well, that’s what you get from ‘Sex in the City.'”
FALSE: A practical joke sparks Internet health myth: cell phones can cook an egg or pop popcorn. People really will believe anything.
FALSE: Some folks in India swallow live fish to stimulate coughing and to “clean the esophagus” and cure asthma. Must be an interesting feeling to have a live fish swimming around one’s stomach! Of course this doesn’t work. h/t to Happy Hospitalist
TRUE: More and more Muslim women are having their hymens restored so that they will appear to be virgins on their wedding night. I wonder about those women who are born with small or nearly absent hymens? Will they be punished? And what about the men who made the women non-virgins? This NYT story is quite upsetting.
TRUE: The media misrepresents health information 2/3 of the time. Fewer and fewer people are willing to take the time to get a story straight. When perception is nine-tenths of reality, science and truth are in jeopardy.
TRUE: Marijuana smokers enjoy lax laws in Mendocino County, California. It’s legal to keep up to 2 pounds of marijuana and 25 live plants in one’s home. How much marijuana does one really need for medical purposes?
FALSE: Gummy bears do not have internal organs. However, this artist has a wonderful imagination.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.
