In my last post I shared two of Miller's epiphanies. Here's more:
Racing the Clock, Saving the Heart focuses on progress in minimizing the time between a heart patient making contact with the medical team and undergoing heart-muscle-saving interventions. It's a fascinating account of the science, politics and practical issues of progress in treating patients with heart disease.
The event provides a stage to honor my extraordinary survival—and everyone who has played a role in it. The public display, like an annual booster shot, immunizes me from taking any of it for granted.
I got cancer because of bad luck?
In Living at Random, George Johnson discusses an idea that is not at all new: "Random, spontaneous glitches ...may be the most pervasive carcinogen of all." But he does it in a way that helps us accept it.
Mammogram Mess offers a way to think about the conclusions of a large study suggesting that mammography does not save lives, as reported in the NYTimes article, Vast Study Casts Doubts on Value of Mammograms?
Reader Gillian commented, "But haven't they also told us that [breast] self-exam [BSE] is not useful/important?"
Infectious disease specialist Dr. Abigail Zuger muses in her December 10th NYTimes essay about how to calculate the number of patients doctors can see in one day--and still deliver high-quality, compassionate care.
On September 28th I began a series, Saving Time, to talk about a great challenge in modern medicine: the time pressures on clinicians who strive to provide expert and compassionate care to each patient.
Compared to 30 years ago, routine tasks consume increasing amounts of time:
My September 15th post in response to Penicllin Allergies Overblown introduced the problem of physicians over-prescribing broad-spectrum antibiotics when penicillin would be the more appropriate drug.
My August 14th post responds to Scientists Seek to Rein in Diagnosis of Cancer, in which Tara Parker-Pope discusses the recommendations of an NCI panel that some premalignant conditions should be renamed to remove the word "cancer" or "carcinoma." The move was prompted by concerns about patients being over-diagnosed and over-treated, a problem for both Healthy Survivors and public health.
For some people, the issue is money. Increasing the use of tests and treatments helps those on the prescribing/delivering side and hurts patients and insurance companies footing the bill. They object to lobbyists and politicians having any say in determining what's best for patients.
As a Healthy Survivor, I believe the fundamental issue is captured by a Memorial Sloan Kettering oncologist, Dr. Norton: "...doctors do need to focus on better communication with patients about precancerous and cancerous conditions. He...tells patients that even though ductal carcinoma in situ may look like cancer, it will not necessarily act like cancer — just as someone who is “dressed like a criminal” is not actually a criminal until that person breaks the law.
I've devoted much of my writing life to demonstrating how substituting one word or phrase can make a world of difference to patients. Yet I still believe that changing the language cannot replace effective communication.
If dealing with the uncertainty and high stakes of a potentially life-threatening disease that requires life-altering treatment, nothing replaces the time-consuming weighing of risks and benefits for the individual and developing a personalized plan of action.
On the NYTimes Well Blog, 21-year-old Emma Pierson eloquently shares the impact of having learned she carries the BRCA1 mutation, a finding associated with a 98% chance of developing cancer in her lifetime. You'll read how...
A front-page story in today's Science Times poses a provocative question in the rapidly changing world of medical diagnostics: Can computer software ever replace physicians to ensure timely, correct diagnoses?
Dr. Nuland opens Chapter 2 of How We Die saying, "No one dies of old age, or so it would be legislated if actuaries ruled the world." Later in the chapter he introduces a perspective on aging that can serve Healthy Survivors well.
Until recently, if I saw someone who had lost excess weight, without hesitation I'd say something positive like, "Wow, you look terrific!"
After a cancer diagnosis, patients ask, "What should I eat? What foods should I avoid?
The answers found in magazines and offered by clinicians and purveyors of alternative therapies often paint a confusing picture of contradictions.
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.
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?
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?
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?
The FDA revokes approval of Avastin for breast cancer. What's a survivor to do?
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:
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?
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.
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?"
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.
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.
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.