[Editor's Note: By a strange coincidence the following exchange was secretly recorded on the same day this report was released: "Personal Comments By Physicians Distract From Patient Needs."] Dr. Xavier Yonder Zither: Hi, Ms. Ursaline. How are you feeling these days? Ms. Penelope Ursaline: Not so good, Doctor. My feet are swollen and I have this pain that shoots down my hip whenever I run after purse snatchers. Dr. Xavier Y. Zither: I hear ya - you should have seen me after I finished a 10K run on Saturday! They had to practically carry me off the course. In well-intentioned efforts…
The woods are lovely, dark, and deep, But I have promises to keep, And miles to go before I sleep, And miles to go before I sleep. -Robert Frost, 1923 I saw a patient today who is about six months out from her last treatment for a vicious lymphoma that darn near killed her before she even got a chance to take any chemotherapy and targeted therapy. As often is the case, she responded so rapidly to her first treatment it seemed as if she had been snatched from the bony arms of the Sepulchral Angel by the magic within these drugs. Now she stood before me as a splendid example of one who has…
Fellow ScienceBlogger Orac has posted the latest on Abraham Cherrix, the Virginia teenager who rejected conventional medical therapy for his relapsed Hodgkin lymphoma in favor of what we in the business call "spot-weld" radiation therapy, as well as unproven alternative supplements, presumably ingestibles. Since this story has piqued my interest I would like to comment on what appears to be a tragedy in the making. Mr. Cherrix is back under the care of his radiation oncologist in Mississippi, getting XRT to a "small tumor on his right lung that showed up on a scan taken last week". He gives…
Parents who smoke in front of their children expose them to the toxic chemicals found in passive cigarette smoke, but surely this is only seen in older kids, right? "Researchers issue new warning on risks of smoking near babies" Parents who smoke near their newborn babies are turning their children into heavy passive smokers and putting them in danger of breathing problems and cot [crib] death, a new study shows. Tiny babies with at least one parent who smokes have more than five times the usual level of cotinine - a chemical metabolite of nicotine - [compared to babies with non-smoking…
We live in exciting times, and not just because David Hasselhoff is back on prime-time television. GlaxoSmithKline has just announced it is developing five new agents to fight cancer and expects to have them introduced within three years. A story like this has the same effect on oncologists as an unguarded steak does on the family Labrador. I shall try not to salivate as I type this, but it is difficult to contain elation when a deep-pocketed industry giant confesses a craven craving to attack the same disease one has been toiling against for so many years. The drugs will treat a range of…
Ovarian cancer is difficult to diagnose in its early stage due to the lack of a highly sensitive or specific screening test. The National Cancer Institute's website summarizes the meager data on screening tests, such as CA-125 levels or pelvic ultrasounds. Now a coalition of cancer organizations including the American Cancer Society have released four warning signs that may represent the presence of ovarian cancer. The experts say women should see their doctor if they suddenly experience any of these symptoms daily for at least three weeks: Bloating Pelvic or abdominal pain Difficulty eating…
Things you don't want to hear from your hospital nurse: 1. "Oh, do we have a big surprise for you today!" 2. "Let's see if I've got this straight - you're on for a castration at 1:00, right?" 3. "Here, give me that newspaper - it'll just bore you." 4. "Now where did I leave that thermometer?" 5. "Dmitri will be giving you your bath this morning." 6. "Why don't you take a guess first." 7. "Time for a walk in the halls!" 8. "Hmm...there seems to be something stuck under your mattress." 9. "Let me get you a band-aid." 10. "You haven't had a cigarette in three days - aren't you proud?"
Most patients want physicians to shake their hands when they first meet, and about half want their first names used in greetings, according to a report in the June 11 issue of Archives of Internal Medicine. Researchers at the Norwestern University Feinberg School of Medicine conducted a survey of 415 adults across the United States on their preferences when meeting physicians and also analyzed videotapes of over one hundred new patient visits recorded in 19 different offices in Chicago and Burlington, Vermont. I am thrilled to report that the results justify my own personal belief, namely…
What's the difference between a plastic surgeon and an oncologist? A plastic surgeon says, "I guarantee I can make you younger." An oncologist says, "I can't make you any younger, but I will try like hell to make you older."
[Editor's Note - the management and staff of "The Cheerful Oncologist, Inc." wish to remind the gentle reader that the following comments are only meant to be general guidelines on how to cope with a malpractice lawsuit. No matter what he implies, the C. O. is not only completely unqualified to give out legal advice, he is in fact still on the lam from a slew of parking tickets acquired during his college days, thereby making him a fugitive from both justice and humility.] Always one to kibitz, I was hit this weekend with the notion of giving out a bit of highly biased advice on how to cope…
In the following excerpts from a new study on testosterone levels in old men, a certain recurring theme appears. I have placed this notion in italics. Can you guess why this story made me laugh? "Older Men May Not Live As Long If They Have Low Testosterone" Low levels of testosterone may increase the long-term risk of death in men over 50 years old, according to researchers with the Department of Family and Preventive Medicine at the University of California, San Diego School of Medicine. The new study is only the second report linking deficiency of this sex hormone with increased death…
A new drug looks poised to become the first effective treatment for liver cancer, one of the most common and deadliest cancers in the world and one whose incidence has been rising in the United States. Today at the annual ASCO meeting the results of a clinical trial of 602 patients with hepatocellular carcinoma will be released. The trial compared the oral targeted agent sorafenib to placebo. Not surprisingly, sorafenib was more effective than placebo in producing a benefit for patients. What was this benefit that is getting all the publicity today? Was it shrinkage of the tumor? Nope -…
I have a question for any students in the audience today. Are you ready? Here it is: what is the most important part of the medical history? The medical history, by the way, is what physicians document when they meet a patient for the first time. The doctor asks a series of questions and the answers are shaped into a narrative that documents the details of the clinical situation in order to deduce what exactly is wrong with the patient and maybe even correct the problem. The medical history is recorded in this order: Chief Complaint History of Present Illness Allergies Medicines Past…
What's more disturbing, a frustrated patient or a frustrated oncologist? I only bring this up because I had one of those days at work today where it seemed legions of smartly dressed nurses, secretaries, pharmacists and lab techs were conspiring to drive me insane with their bureaucratic edicts all designed to obstruct my plans to deliver proper medical care [Waaa! The poor widdle kid! -Ed.] Now in the comfort of my home I realize I have violated Rule Number Four of the House of God: "The patient is the one with the disease." As penance let me share my view on the top reasons why patients…
Summer is here, and everyone is getting into the swim. Before donning that stylish and flattering bathing suit, though, let us review some lessons on summer water safety from our friends up north: A report from Canada reveals that 86 percent of parents believe that swimming lessons are enough to keep their kids from drowning. The organization "Safe Kids Canada" strongly disagrees with this and recommends establishing 'five layers of protection' to protect children from accidental drownings. The precautions are meant to be used simultaneously and the word is out to educate adults on the…
Things You Don't Want to Hear During an Ambulance Ride to the Hospital 1. "Sir, would you like some music?" 2. "Wait! I think we forgot the defibrillator!" 3. "Relax, willya...this is a shortcut." 4. "Now, you're not going to say anything about this, are you?" 5. "Isn't that your wife over there on the corner?" 6. "Do you mind if I lie down next to you?" 7. "You saw that bicyclist back there, didn't you?" 8. "Man, did we tie one on last night!" 9. "Say, do you happen to have change for a twenty?" 10. "Pienso que él va a morir." 11. "Hey, slow down - I think this girl needs a lift…
San Diego, 1932 - Dr. Philip J. Hooley, a popular otolaryngologist, is enjoying a round of Saturday afternoon golf with friends when he is approached by a club valet with an urgent message. Little William Mackapease, six years old and heir to the Mackapease frozen food fortune, has swallowed a chicken bone. Without hesitation Dr. Hooley makes his apologies and jumps in a waiting cart which takes him straight to his Cadillac. Accompanied by an increasing number of police motorcycles, Hooley rushes to the Emergency Room of Our Lady of Perpetual Motion Hospital, where he finds the lad in the…
Concerned that this country's lackadaisical attention to our environment is a threat to the populace? Interested in forming a new society where human behavior is tightly regulated, so as to not upset the delicate balance of nature on this planet? Looking to grab a few more carbon offsets before jetting off to Venice for the summer? Hey, that's great - you're a true soldier in this newest global war. Just think twice about relocating certain to socialist countries - if you value your life. Beijing Blames Pollutants for Rise in Killer Cancers Foul air, filthy water and contaminated soil have…
Walt Whitman (1819-1892), regarded as one of our nation's greatest poets, broke many barriers with his writing, resulting in criticism, controversy and of course worldwide and everlasting fame. His use of freestyle verse, his audacious (for the times) description of sexuality and his egocentric weltanschauung, paired with his genius for the poetic voice have cemented his reputation as a poet who should be on the bookshelf in every home. The following two excepts are the beginning and then (below the fold) the ending of the 52 sections of "Song of Myself," the first poem published in Whitman'…
We interrupt this program to bring you this special report: "Study offers hope of remedy for baldness" Suddenly tens of millions of men in this country stop in their tracks and strain to hear the voice on the radio: "Researchers at the University of Pennsylvania report in the journal Nature that mice with deep skin wounds can send reprogrammed stem cells to the naked area and actually grow hair once again." [Fanfare, followed by deafening cheers...] "For more on this we turn to our male-pattern baldness correspondent, Arlo P. Cia. Arlo?" "Thank you, Dan. Dr George Cotsarelis, the lead…