Wendy Harpham on Healthy Survivorship

Is John McCain a Healthy Survivor?

McCain's diagnosis released a flood of articles about survivorship in the setting of a poor-prognosis cancer.  Assuming McCain is fulfilling the first criterion of a Healthy Survivor by receiving excellent medical care, is he living fully, knowing the average life expectancy is 15 months?  Click here to read complete post on my new website.

A Healthy Survivor's Perspective the News about Breast Implants

My last post drew attention to the media reports of breast implants putting people at increased risk of a rare lymphoma. I'm not suggesting you shouldn't feel anxious, especially if you are considering implants or have implants. Anxiety is natural. My point is to use your anxiety positively. Click here to read complete post on new website.

When Implants Cause Cancer

Journalists often use heartbreaking stories to make a point. Those stories thrill me when they educate and mobilize people to proper action. They worry me when they risk causing undue fear and leading people away from proper action. Click here to read complete post on new website.

Laura Miller's Epiphanies and Regrets while Dealing with Cancer Again--Part II

In my last post I shared two of Miller's epiphanies. Here's more:

Laura Miller's Epiphanies and Regrets While Dealing with Cancer Again - Part I

Former Dallas Mayor Laura Miller wrote a smart and powerful editorial, with hope that "Perhaps some of what I've done (and, unfortunately, haven't done) can help others."

How to Minimize Scanxiety

My prior post addressed steps clinicians can take to help minimize their patients' scanxiety. Here's an excerpt from my patient handout, Waiting for Test Results:

Speed Matters for Healthy Survivors with Heart Disease

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. 

Why Patients Do Cancer Walks

In Why Patients Keep Walking, I share with professionals in oncology why I keep doing the Dallas Lymphoma Walk.   A few excerpts:

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.

Chance and Cancer

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.

When Patients Read What Their Doctors Write

NPR's recent story, When Patients Read What Their Doctors Write, focuses on the benefits to both doctors and patients.

Doctor Priorities vs. Patient Priorities

An essay by Danielle Ofri MD highlights some key challenges to modern healthcare that fall under the category: narrowing the gap between ideal care and the care that patients actually receive.

The Case for Breast Self-Exam

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?"

The Problem of Incidentalomas

One unintended consequence of progress in diagnostic technology has been the rise of so-called incidentalomas--findings of potentially serious conditions found while evaluating for unrelated problems.

A Doctor’s Formula for Care

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.

The Cure in the Code

I've just ordered The Cure in the Code, after reading the WSJ book review by science correspondent Ronald Bailey. Publisher's Weekly proclaimed it a provocative, optimistic look at modern medicine. 

The Gadget and the Bad Samaritan

If someone cried out to you for help, would you whip out your cell phone and film it?

Saving Time--Part III

For this series on the time pressures on today's clinicians, let's look at the evolving culture in which they work.

Saving Time--Part II

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:

The Story Behind the Overblown Story of Penicillin Allergiies -- Part II

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.

This week, the Washington Post relayed the CDC's warning of an impending catastrophe of drug-resistant infections.

The Story Behind the Overblown Story of Penicillin Allergies

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.

ED in America

When you saw this post's title, what did you think you'd be reading about? Erectile dysfunction? Emergency Departments?

The Real Issue Behind Redefining Precancerous Conditions

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.

Redefining Precancerous Conditions

A rose is a rose, but is a cancer a cancer? 

Music for Coping

An interesting article in the current issue of Arts & Health reviews the findings of a study that looked at Music as a Method of Coping with Cancer.

Reaction to Boston Bombing

I can feel afraid. But if I act afraid, the terrorists win.

Compassion and Computers II

What could be wrong with IBM's supercomputer "Watson" helping physicians care for patients?

Knowing You Carry a Cancer Gene

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...

Newtown Massacre and Healthy Survivorship

What does a Healthy Survivor do about the constant news coverage of the Connecticut massacre? 

Altered Immune Cells Beat Leukemia - Part II

Here are more reflections on the December 11th  NYTimes article about the 11th-hour rescue of a dying 6-year-old girl with an investigational treatment. I hope you find them useful in the pursuit of Healthy Survivorship.

Altered Immune Cells Beat Leukemia

Yesterday's NYTimes article about the 11th-hour rescue of a dying 6-year-old girl with an investigational treatment created a lot of buzz. Here are a few reflections on the story that might be useful to Healthy Survivors.

Doctors vs Computers

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?

How We Die: Discriminate Specialization

In my last post I share my discomfort with a passage from How We Die. Reading on, however, Nuland offers a useful insight about a risk of increasing specialization:

How We Die: Natural Law

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.

Think Twice Before Praising Weight Loss

Until recently, if I saw someone who had lost excess weight, without hesitation I'd say something positive like, "Wow, you look terrific!"

Then I read "Why You Should Think Twice Before You Praise Someone For Losing Weight."

Dietary Pattern for Health

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.

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.