Wendy Harpham on Healthy Survivorship

Choosing Wisely Campaign - Part II

In my last post, I introduced the Choosing Wisely™ campaign, an effort by clinicians to avoid overuse or inappropriate use of tests and therapies. Obviously, a successful campaign would save lots of money. But the campaign is motivated by a higher goal that reflects the mission of Healthy Survivorship.

Problems with Generics

Did you know that when you take a generic drug, you essentially forfeit the ability to sue the company making the drug for damages if you experience an adverse event?

Grief and Acceptance - Part V (Promoting Acceptance)

The preceding four posts on grief and acceptance set the stage for a closer look at how patients can be Healthy Survivors at the end-of-life. In other words, how can you both get good care and live as fully as possible after a diagnosis of terminal disease?

Grief and Acceptance - Part IV (PEACE tool)

The preceding post discussed grief experienced in the setting of bereavement. Let's return our focus to grief and acceptance at the end of life.

Ranting and Healing - Part II

In yesterday's post, I shared my reaction to a rant found on a cancer-related listserv. I explained my concerns regarding such expressions of anger, disappointment and frustration.

So what are Healthy Survivors to do if, for example, they learn they had not received important information about aftereffects of treatments they received?

Revoking FDA Approval: Conclusion

The FDA revokes approval of Avastin for breast cancer. What's a survivor to do?

Revoking FDA Approval: Right or Wrong? - Part IX

In my last post, I asked, "Why not, at least, make Avastin available to breast cancer patients who are doing well on it?"

Revoking FDA Approval: Right or Wrong? - Part V

Now let's look at the players who influenced the FDA's decision to revoke approval of Avastin for breast cancer. The complex process requires a book-length manuscript to fully explain. Rather than abandon my effort, here are the bare bones:

Revoking FDA Approval: Right or Wrong? - Part IV

My last post provided an outline of the FDA's approval process. I cringed while writing it, knowing 250 words couldn't capture the investment of time, people and capital. 

Revoking FDA Approval: Right or Wrong? Part II

To judge the FDA's recent revocation of approval for Avastin for breast cancer, let's go back to basics. What is the job of the FDA?

Metavivor Healthy Survivors

What we call ourselves impacts how we see ourselves. So I was intrigued but not surprised when I heard a new word to add to my survivorship lexicon: metavivor.

Managing Communication

An interesting press release from the University of Texas supports my long-standing contention that it is better to ask a patient, "How are things?" than to ask "How are you?"

Your Medical Mind

My recent posts have discussed some of the difficulties of modern medical decision-making in the context of PSA testing for prostate cancer. A new book by Harvard oncologist Jerome Groopman and Harvard endocrinologist Pamela Hartzband offers help to Healthy Survivors: Your Medical Mind: How to Decide What is Right for You.

Does PSA Testing Save Lives or Not? - Part III

While the furor over PSA testing plays out in the media, my sympathies lie with men newly diagnosed with prostate cancer . At the end of the day, the patient has to decide what to do.

Does PSA Testing Save Lives or Not?

A message about the value of PSA tests in healthy men creates problems that might have been avoided with a better choice of words.

My Bad?

My August 6th post shares a report on a new technology for breast cancer screening. I confess: I did not check out the story.

Free CURE

One of the purposes for this blog is to bring attention to high-quality resources to help educate and empower Healthy Survivors.Today I'm shining the spotlight on CURE. Not only is this a superb magazine for cancer survivors and their caregivers, it is also free.

2011 Cancer Resource Guide

Cure in association with the American Cancer Society has published a superb booklet for people with cancer: the 2011 edition of their Cancer Resource Guide.

Understanding Post-Treatment Survivorship

If a picture is worth a thousand words, this 17-minute video by Eric Slade Productions is worth at least an undecillion (1 followed by 36 zeros). 

Unsafe at Any Dose

Please  bookmark the NYTimes editorial by Helen Caldicott, MD, founder of Physicians for Social Responsibility, and read it when you can. Why?

Why are You Here?

Yesterday I offered the opening comments for the Dallas Lymphomathon. Here's an excerpt:

Stigma of Illness (Part III)

My last post offered tips for recognizing stigma. My key message was that Healthy Survivors have a right to choose whether or not they advocate to destigmatize the disease that has become part of their life.

Today I'll tackle the challenge of dealing with this stigma.

Stigma of Illness (Part II)

In my April 11th post, I refer to an article in Women's Day titled, "The Stigma of Illness."

Stigma can keep patients from becoming Healthy Survivors, so let's talk about dealing with stigma in healthy ways.

Stigma of Illness

How can patients who feel stigmatized become Healthy Survivors?

The Pro-Diabetes Board

In 2006, leaders in the state of Washington created the Health Technology Assessment (HTA) program to evaluate the cost-effectiveness of various medical therapies. With our country facing a huge budget deficit, what could be better than determining which treatments are worth paying for?

Cancer Rehab

After people have a heart attack, stroke or joint replacement, rehab is a routine part of their recovery plan. Cancer survivors, too, can have significant musculoskeletal issues during and after the acute illness. Yet cancer rehab programs are few and far between. Why is that?

ASCO's Survivorship Committee

Yesterday I was in Washington, D.C. to participate in the inaugural meeting of ASCO's Cancer Survivorship Committee. [ASCO is the American Society of Clinical Oncology.] While the specifics of the meeting are confidential, I'd like to share two things:

Walking on Planet C

Nile Rogers knows how to use words to communicate feelings. Who among us doesn't instinctively begin to dance with joy when listening -- and singing -- to "We are Family" at a family celebration? 

Elizabeth Edwards' Star Power

When Elizabeth Edwards died, many patients described experiencing powerful emotions, even though they'd never met her. In an article to clinicians entitled "Star Power," I explore why.

Rare Cancer Initiatives

My recent posts are about the trouble of defining "rare cancers." The attention these cancers are now getting gives Healthy Survivors many reasons for hope.

Ultra-Rare Cancers

My recent posts discuss the trouble with the adjective "rare" when talking about types of cancer. What's a researcher, clinician or patient to do?

Good news for Healthy Survivors! Now, along with ultra-strong hairsprays and ultra-rich ice-creams, we have:

How Rare is "Rare"?

What does it mean to say a cancer is rare? 

Promise Me

Regular readers of this blog know if I review a book, I'm going to recommend it. Today's post is no different. Thumbs up for Promise Me by founder and CEO of Susan G. Komen for the Cure Nancy G. Brinker, with best-selling author Joni Rodgers.

The Future of Cancer Research

In "The Cancer Sleeper Cell," oncologist Mukherjee shares his insights about the future of cancer research.

Riddle of Relapse

For all survivors, relapse means they weren't cured. For most, it means they never will be. Oncologist Siddhartha Mukherjee wrote a NYTimes article about tackling the challenge of cancer relapse.

The Big Picture

I chose internal medicine as a career because I love having "the big picture."

One of my great concerns about the changes in modern medicine is this: It is becoming increasingly common for none of the clinicians on a patient's healthcare team to have that big picture so vital to expert and compassionate care.

Bringing Back the Physical Exam

I shudder when I hear stories of physicians who order a CT scan to evaluate a patient's pain without examining the painful area. So I was happy to read that Dr. Abraham Verghese is on a mission to save the art of the physical exam.

Good Reason to Keep Smoking

Why would I ever agree with someone's decision to keep smoking cigarettes?

Miners' Lessons from the Eye of the Storm

How the trapped Chilean miners coped with life more than 2,000 feet below the earth's surface offers rich lessons on Healthy Survivorship. When you or a loved one enters the "storm" of illness or injury:

Miners' Lessons on Healthy Survivorship

The rescue of 33 minors in Chile dramatizes some lessons about positive transitions as a Healthy Survivor, such as after a risky surgery or after completing therapy for a life-threatening condition.

Abigail's Alliance

On my recent post about clinical trials, commenter Steve Walker wrote, "The Phase III trial is being run primarily to satisfy the rigid, formulaic and in many cases scientifically obsolete requirements imposed by the FDA's Office of Oncology Drug Products for most cancer drugs...." 

Is the randomized clinical/controlled trial (RCT) obsolete?

Testing a Fast Track to Rx

Recently, I've pointed out the clashes between business and ethical considerations and beween clinicians' obligations to their individual patients and to the method that leads to advances. What if researchers can find ways to satisfy both the science and today's patients?

The Problem with Accelerated FDA Approval

In Phase I trials researchers test an experimental treatment in a few patients for the first time. The purpose is NOT to see if the treatment kills cancer cells, but only to:

• evaluate the drug's safety
• determine a safe dosage range
• identify side effects

What if the patients in a Phase I trial experience shrinkage of their tumors? Should this speed up FDA approval of the trial drug?

Anguished Debate on Witholding Rx for the Control Arm

My last post introduced a dilemma regarding modern clinical trials: Is it ethical to randomize some patients to the "control arm" of a trial where they will NOT receive the trial drug?

According a NYTimes article, one particular trial of a therapy (called PLX4032) for malignant melanoma "ignited an anguished debate among oncologists about whether a controlled trial that measures a drug's impact on extending life is still the best method for evaluating hundreds of genetically targeted cancer drugs being developed."

Witholding Rx in Clinical Trials

Sunday's NYTimes ran an article tackling a complex ethical dilemma in cancer care: The witholding of treatment in clinical trials. Because I was treated in 3 clinical trials in the 1990s, the topic is close to my heart.

Researching Clinicial Trials

People who hear my story often say, "You had an advantage getting into those clinical trials, because you were a doctor with connections." Given the paucity of patient-centered resources in 1993, this was true. 

Today a plethora of excellent resources can help patients and families learn about clinical trials and find any available trials that might be right for you. Resources include:

The Treatment Option You May Be Missing

As a scientist, I credit clinical trials with advancing our understanding of cancer and ability to treat it effectively. As a patient, I credit clinical trials with playing an essential role in my survival. 

From both perspectives it troubles me greatly that only ~3% of adult cancer patients participate in clinical trials.

Open Notes and Compassionate Care

For me, the crux of the problem is this: Do open notes conflict with the ideal of compassionate care? 

Open Notes: "Our" Chart

My recent posts set the stage for asking: Does the opportunity for patients to read their medical charts help or hurt patients' ability to become Healthy Survivors?

The OpenNotes Project - Why Do We Need It?

In my August 9th post, I introduced you to the OpenNotes project. If you are wondering why we need the study, here is a two-word answer: informational technology.