screening

If you were to rely on much of what you see in the mainstream media and on social media, you probably have the impression that we are not doing very well against cancer. Indeed, a common trope I see in a lot of articles is that we are somehow "losing" the war on cancer. Just for yuks, I Googled the term "losing the war on cancer," and it didn't take long to find a lot of articles, both in the mainstream press and, more predictably, on alternative medicine-friendly websites making just that argument. Indeed, in 2011, which was the 40th anniversary of President Nixon's declaration of "war on…
One of the core beliefs of the antivaccine movement is that there is an "autism epidemic." The observation that autism prevalence has been climbing for the last two to three decades led some parents with autistic children to look for a cause, specifically an environmental cause, for autism. Because several vaccines are given in the age range when children are typically diagnosed with autism, they fell victim to the all-too-human tendency to confuse correlation with causation and latch on to vaccines as the main cause of their child's autism. Then, when these parents banded together, they…
If there's one lesson that I like to emphasize while laying down my near-daily dose of Insolence, both Respectful and not-so-Respectful, it's that practicing medicine and surgery is complicated. Part of the reason that it's complicated is that for many diseases our understanding is incomplete, meaning that physicians have to apply existing science to their treatment as well as they can in the context of incomplete information and understanding. The biology of cancer, in particular, can be vexing. Some cancers appear to progress relentlessly, meaning that it's obvious that all of them must be…
Mammography 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…
Women aren’t the only ones at risk for depression and in need of screening services when a new baby comes into their lives. Young fathers face significant mental health challenges as well, according to a new study. Published in the May issue of Pediatrics, researchers found that fathers who live in the same households as their children experience a decrease in depressive symptoms in the period immediately before their children are born. However, depressive symptoms among young fathers, who were around 25 years old when they became fathers, increased an average of 68 percent throughout their…
As I write this, I am winging my way home from the 2014 meeting of the American Association for Cancer Research (AACR, Twitter hashtag #AACR14) in San Diego. (OK, I'm revising this to fit the format and, of course, the Insolence of this particular blog. Shockingly, I didn't have as much time to blog in San Diego as I had thought I would. Go figure.) Basically, the AACR meeting is one of the largest meetings of basic and translational cancer researchers in the world. I try to go every year, and pretty much have succeeded since around 1998 or 1999. As an "old-timer" who's attended at least a…
Blogging is a rather immediate endeavor. Over the last nine years (nearly), I've lost track of how many times I saw something that I wanted to blog about but but by the time I got around to it was no longer topical. Usually what happens is that my Dug the Dog tendencies take over, as I'm distracted by yet another squirrel, although sometimes there are just too many targets topics and too little time. Fortunately, however, sometimes the issue is resurrected, sometimes in a really dumb way, such that I have an excuse to correct my previous oversight. This is just such a time, and the manner in…
Here we go again. Every so often, criticism of the antivaccine movement builds to the point where it extends beyond the blogosphere to enter the national zeitgeist in a way in which people other than blogging geeks like myself start to take notice. It happened a few years ago, when washed up actress Jenny McCarthy teamed up with the antivaccine propaganda group Generation Rescue to sell her story of how she believes that vaccines caused her son Evan's autism and managed to score an appearance on The Oprah Winfrey Show. It happened again three years ago, as preparations for the H1N1 pandemic…
by Kim Krisberg Just a few years ago in Butte County, Calif., it wasn't unusual for public health workers to administer more than 1,000 free HIV tests every year. In true public health fashion, they'd bring screening services to the people, setting up in neighborhoods, parks and bars, at special community events and visiting the local drug treatment facility and jail. The goal was prevention and education, and no one got turned away. That was before 2009, which is when California state legislators cut millions in HIV prevention and education funds from the state budget. The cut meant that…