breast cancer
oracknows | August 26, 2015It's always disappointing to see a good journal fall for bad medicine, particularly when it's in your field. For example, the Journal of Clinical Oncology (affectionately referred to by its abbreviation JCO) is the official journal of the American Society of Clinical Oncology (ASCO) and probably the most read clinical journal by those involved in the clinical care of cancer patients. Just as most oncologists, surgeons, and radiation oncologists who specialize in the care of cancer patients belong to ASCO, most of them also at least peruse JCO on a regular basis because major results of large…
oracknows | August 21, 2015I've written more times than I can remember about the phenomenon of overdiagnosis and the phenomenon that is linked at the hip with it, overtreatment. Overdiagnosis is a problem that arises when large populations of asymptomatic, apparently healthy people are screened for a disease or a condition, the idea being that catching the disease at an earlier stage in its progression will allow for more successful treatment. Two prominent examples include—of course—screening for breast cancer with mammography and screening for prostate cancer with prostate-specific antigen (PSA) testing, and I've…
oracknows | August 2, 2015Homeopathy is The One Quackery To Rule Them All.
There, I've started off this post the way I start off most posts about homeopathy, with a statement of just how enormous a pile of pseudoscientific (or rather prescientific) quackery that it is. You'd think that in 2015 no one would believe that diluting a substance (with vigorous shaking between each serial dilution step, of course, in order to "potentize" it) makes its effects stronger or that water has some sort of mystical "memory" that remembers the therapeutic substance but forgets all the other impurities, chemicals, and urine with which…
oracknows | July 28, 2015I hate stories like this, but what I hate even more is the way stories like this are all too commonly reported. Readers have been sending me links to stories about a woman named Alex Wynn that have been published over the last few days, in particular this story about her in the Daily Mail (better known as the Daily Fail when it comes to medical stories). As is the Fail's wont, the headline blares Newlywed shuns chemotherapy for CARROTS as she vows to beat cancer with alternative therapies while trying for a baby - even though doctors warn there's 'no evidence' they work, with a picture of an…
oracknows | July 19, 2015Mammography is a topic that, as a breast surgeon, I can't get away from. It's a useful tool that those of us who treat breast cancer patients have used for over 30 years to detect breast cancer in asymptomatic women and thus (or so we hope) decrease their risk of dying of breast cancer through early intervention. We have always known, however, that mammography is an imperfect tool. Oddly enough, its imperfections come from two different directions. On the one hand, in women with dense breasts its sensitivity can be maddeningly low, leading it to miss breast cancers camouflaged by the…
oracknows | June 14, 2015Over the years, I've written a lot about the intersection between the law and science in medicine. Sometimes, I support a particular bill, such as SB 277. Sometimes I oppose a bill, such as right-to-try or laws licensing naturopaths. The case I will discuss here is unusual in that it is a case of the law getting ahead of what the science says in a manner that will likely do little, if any, good for patients, cause a lot of confusion until the science is worked out better, and end up costing patients money for little or no benefit. I am referring to laws mandating the reporting of high-breast-…
jhalper | June 3, 2015What is a breakthrough in cancer research? It is a new piece of a puzzle made up of a million pieces. It may, however, be a piece that allows a picture to start emerging – one that lets us see the shape of the next piece needed to fill in more of the puzzle, or start making changes to rearrange the picture from one of cancerous growth to one of normalcy.
The Institute’s Prof. Yosef Yarden’s recent research provides a vital piece for the puzzle of resistance – how cancer cells, especially those in recurring cancers, stop responding to chemotherapy. His answer is specific to a kind of lung…
cmonforton | April 17, 2015The AFL-CIO outlined in an April 13 letter the “serious flaws and deficiencies” in a bill introduced by Senators David Vitter (R-LA) and Tom Udall (D-NM) to reform the Toxic Substances Control Act (TSCA). The country’s largest labor federation noted its deep involvement in the passage of TSCA in 1976, but its disappointment that the 40 year old law has “failed to provide meaningful and effective regulation” of toxic substances. (Even efforts to ban asbestos failed under the law.)
The labor federation has an important voice and perspective when it comes to chemical hazards. Workers are the…
oracknows | April 3, 2015Why, oh why, did I look at GreenMedInfo again?
You remember GreenMedInfo? It's yet another wretched hive of scum and quackery, but with a twist. Its proprietor, Sayer Ji, thinks he's an expert at interpreting the biomedical literature. Unfortunately, as he demonstrates time and time again with depressing regularity, he is nothing of the sort. In reality, what Ji is an expert at is cherry picking medical studies and torturing them until they confess agreement with whatever quack idea he's currently espousing. In the wake of the news coverage of Angelina Jolie's decision to have her ovaries…
oracknows | March 30, 2015As I sat on my couch last night, laptop sitting in front of me, I awaited the Ken Burns adaptation of Siddartha Mukherjee's excellent book The Emperor of All Maladies into a three part television documentary to air on PBS. I'm not sure whether I'll blog the show or not, but if I do I'll probably wait until all three episodes have aired. In the meantime, this seems as good a time as any to go back to a story that I saw a week ago but somehow, thanks to grants, traveling to Houston, and other distractions that I wanted to blog about more, never got around to. Since The Emperor of All Maladies,…
oracknows | March 26, 2015I happen to be in Houston right now attending the Society of Surgical Oncology annual meeting. Sadly, I'm only about 12 miles away from the lair of everybody's favorite faux clinical researcher and purveyor of a cancer cure that isn't, Stanislaw Burzynski. Such is life. In any case, this conference is all about cancer and how we treat it surgically. That includes prophylactic surgery designed to prevent cancer in people at very high risk. Prophylactic surgery to prevent cancer is never a decision that should be undertaken lightly and almost never is, rants from quacks notwithstanding that…
cmonforton | November 21, 2014Health and safety hazards encountered by custodians, palm tree workers, day laborers, nurses, and bakery workers are just some of the dozens of different occupations examined in research presented at this year’s annual meeting of the American Public Health Association (APHA). The association’s Occupational Health and Safety Section marked its 100th anniversary and members designed the first phase of an electronic timeline to memorialize key events in the Section’s history. A special scientific session explored the OHS Section’s history, starting with its founding co-chairs George Kober, MD…
kkrisberg | November 7, 2014In the span of just a couple years, five of Heather Buren’s colleagues at the San Francisco Fire Department were diagnosed with breast cancer. At first, Buren thought the diagnoses were part of the unfortunate toll that comes with age. Still, something felt amiss — “it just felt so disproportionate to me,” she said.
Around the same time, Buren helped a good friend and mentor within the department as she underwent a double mastectomy. Buren said it was at that moment that she decided to take decisive action.
“(The cancer) just brought her to her knees,” she told me. “Now she’s good and back in…
oracknows | November 7, 2014
Gayle DeLong has been diagnosed with what she refers to as “autism-induced” breast cancer.” She’s even given it an abbreviation, AIBC. Unfortunately, as you might be able to tell by the name she’s given her breast cancer, she is also showing signs of falling into the same errors in thinking with respect to her breast cancer as she clearly has with respect to autism. As a breast cancer surgeon, regardless of my personal opinion of DeLong’s anti-vaccine beliefs, I can only hope that she comes to her senses and undergoes science-based treatment, but I fear she will not, as you will see. Her…
oracknows | October 12, 2014A few weeks ago, I wrote a post in which I explained why wearing a bra does not cause breast cancer. After I had finished the post, it occurred to me that I should have saved that post for now, given that October is Breast Cancer Awareness Month. The reason is that, like clockwork, pretty much every year around this time articles touting various myths about breast cancer will go viral, circulating on social media like Facebook, Twitter, Pinterest, and Tumblr like so many giant spider-microbes on the moon a week ago. Sometimes, they’re new articles. Sometimes they’re old articles that, like…
oracknows | October 2, 2014
As I mentioned yesterday, here it’s that time of year again: October. Breast Cancer Awareness Month. While the topic of my post then was how antivaccine activists have tried to glom on to the attention that Breast Cancer Awareness Month gets in order to create their fake “awareness month” known as “Vaccine Injury Awareness Month,” unfortunately antivaccinationists are not the only quacks who take advantage of the various “awareness” months to peddle their quackery. Naturally, because Breast Cancer Awareness Month is one of the oldest and definitely the best known of these various disease…
oracknows | September 10, 2014
Besides being a researcher and prolific blogger, I still maintain a practice in breast cancer surgery. It’s one of the more satisfying specialties in oncology because, in the vast majority of cases I treat, I can actually remove the cancer and “cure” the patient. (I use the quotes because we generally don’t like to use that term, given that some forms of breast cancer can recur ten or more years later, but in many cases the term still fits, albeit not as well as we would like.) Granted, I get a little (actually a lot of) help from my friends, so to speak, the multimodality treatment of…
kkrisberg | August 15, 2014Next time someone asks you what exactly public health does, repeat this number: 4.3 million. That’s the number of women — mothers, sisters, wives, aunts, grandmothers, daughters and friends — who might have otherwise gone without timely breast and cervical cancer screenings if it weren’t for public health and its commitment to prevention.
This year marks the 23rd anniversary of the National Breast and Cervical Cancer Early Detection Program, which the Centers for Disease Control and Prevention launched in 1991 to ensure that low-income women would have the same opportunity to detect cancers…
oracknows | July 11, 2014I didn’t think I’d be revisiting this topic so quickly. However, given that I’m at TAM and I don’t have a lot of time to do one of my usual 2,000 word epics for a change, I thought that this story, which popped up the other day while I was traveling was at least worth mentioning:
Robert Young will appear in a California court today on 18 charges of theft and "treating the sick without a certificate" at his alternative retreat near San Diego.
Among other offences, the 63-year-old, who believes in the "pH Miracle" of avocado juice, is accused of taking more than $50,000 from a man dying of…
jhalper | April 29, 2014I’ve heard that for some the experience of undergoing an MRI scan is claustrophobic, but I find it oddly comfy and cocoon-like. OK, there are those gear-grinding screeches and thumps interrupting the music in the earphones. And the cumbersome set-up for imaging breasts, along with the usual admonition to keep perfectly still, does not leave me in a position I would choose for a nap. Still, I’m on the verge of dropping off when the whole table starts shaking under me. They had warned me about this before I climbed onto the apparatus, but for a second I’m not sure whether to laugh (without…