As promised in my May 24th post, here's my response to the argument that therapies of Phase I studies are given to learn about dosing--and not to help the patient, so they cannot be called "treatment."
Some clinicians think investigational therapies administered in Phase I trials should not be called "treatment." To explain why I believe those therapies can, indeed, be called treatment, let's first look at the general idea of treatment.
I posted on this blog only twice in April, the month before my May 6th keynote at MD Anderson. What made the topic--"Talking with Patients about Phase I Trials"--so challenging that it consumed all my writing hours for most of this year?
An article by Paula Span, A Decision Deferred, highlights an issue that needs to be a routine part of the decision to have a pacemaker implanted, as well as the follow-up care: When, if ever, will a patient want to turn it off?
I just returned from Japan, where I delivered two keynotes on supporting the children whose parent has cancer. The second event was sponsored by The Hope Tree, an organization named by founder Kaori Osawa, a social worker and cancer survivor, after the title of my second children's book.
Feelings of guilt can hamper Healthy Survivorship by interfering with your ability to get good care and/or live as fully as possible. But if your past actions may have -- or surely did -- play a role in your current ill health, what do you do about the guilt?
They take me back to the recently published editorials and research studies regarding the pervasive trend to record on our cell phone events as they unfold--instead of fully experiencing them. (See my post of October 29th.)
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.
A NYTImes Opinionator piece by Massimo Pigliucci and Maarten Boudry is a must-read short essay on the Dangers of Pseudoscience. It explains why pseudoscience is not "a harmless pastime of the gullible."
Stephen Asma is a professor of philosophy who recently had a cold. In The Enigma of Chinese Medicine, he reflects on his experience drinking turtle blood (a traditional Chinese remedy) to speed his recovery.
Asma talks about the problems of "demarcation" and "falsifiability" -- two ideas vital to Healthy Survivors.
One word that characterizes modern medicine is "rushed." Are the forces shaping modern medicine too many and too powerful to change the direction of our current path toward increasingly time-pressured, impersonal care?
Can we save time-consuming high-quality, compassionate care. Can we save time?
In today's culture, many people seem to expect definitive diagnoses--and quickly. How did this happen?
A short list of culprits might include:
a reimbursement structure that values high-tech interventions and short hospital stays
a third-party insurance system that makes it easier for families to demand (and doctors to order) more tests
social media that invites medical opinions of friends and family, as well as strangers—some with their own agendas
a federal government increasingly involved in the details of patient care, with policies shaped mostly by non-physicians.
Here and there, physicians and patients express nostalgia for a bygone era when medicine was simpler and clinicians had more time. Not me. The science and technology transforming modern medicine saved my life and spawned a survivor community over 13-million strong.
As I see it, our hope for tomorrow is tied to making changes that help clinicians with the demands on their time, as well as influencing the culture to value the time it takes for clinicians to optimize the use of science and technology in the care of each patient.
Next: Is today’s tide of change too powerful for clinicians to make a difference?
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:
Journalist and infectious disease specialist Dr. Abigail Zuger tackled one rarely discussed aspect of the serious problem of drug-resistant bugs: overuse of penicillin alternatives due to patients claiming penicillin allergy when, in fact, they are not really allergic.
Two patients with the exact same tumor have different outcomes. Why?
Five hundred years ago, a 3-centimeter lump in one patient that looked and felt identical to that of another patient was considered the same tumor. Yet one patient did well and the other died.
With progress in science, doctors determined that tumors that look alike to the naked eye can look different under the microscope. Tumors were lumped together if they looked alike, felt the same, and had the same microscopic appearance. Yet still some patients did well while others died.
With progress in science, doctors determined that tumors that look alike under the microscope can have different surface proteins (antigens). Tumors were lumped together if they looked alike under the microscopic appearance and shared a specific array of surface antigens. Yet still some patients did well while others died.