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Reducing Cancer Care Costs: Why Not Offer Neulasta in Smaller Vials?

This is the fifth in a series of posts on how we might reduce the costs of cancer care, based on 10 suggestions offered in a May, 2011 NEJM sounding board. We’re up to point 4:  oncologists should replace the routine use of white-cell-stimulating factors with a reduction in the chemotherapy dose in metastatic solid cancers. In […]

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The Trouble With Placebos

The latest NEJM features a big story about a small trial, with only 39 patients in the end, on the potential for placebos to relieve patients’ experience of symptoms. This follows other recent reports on the subjective effectiveness of pseudo-pharmacology. My point for today is that placebos are problematic in health care with few exceptions. First, […]

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On Admitting Nice, Ethically-Minded People to Med School

This week the Times ran a leading story on a new med school admission process, with multiple, mini-interviews, like speed dating. The idea is to assess applicants’ social, communication and ethical thinking (?) skills: …It is called the multiple mini interview, or M.M.I., and its use is spreading. At least eight medical schools in the United […]

Posted in Future of Medicine, Medical Education, Medical Ethics, Premedical, ScienceTagged , , , , , , , , 3 Comments on On Admitting Nice, Ethically-Minded People to Med School

Reducing Costs by Holding Back on Chemotherapy for Cancer Patients Who are Frail

This is the fourth in a series of posts on Bending the Cost Curve in Cancer Care, by Drs. Thomas J. Smith and Bruce E. Hillner, in a recent NEJM health policy piece. The authors’ third suggestion: to limit chemotherapy to patients with good performance status, with an exception for highly responsive disease, is surely one of the most […]

Posted in cancer treatment, Economics, health care costs, Medical Ethics, Oncology (cancer), PolicyTagged , , , , , , , , 5 Comments on Reducing Costs by Holding Back on Chemotherapy for Cancer Patients Who are Frail

Reducing Cancer Costs by Giving One Drug at a Time, Sequentially

This is the third in a series of posts on Bending the Cost Curve in Cancer Care, based on the late-May NEJM health policy piece. Today we’ll consider the second of the authors’ suggestions: to limit second and third-line treatments to sequential monotherapies for most solid tumors. This particular suggestion, one of the few proposed with which I […]

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Patients’ Words, Unfiltered, Medical Journalism and Evidence

Yesterday’s post was not really about Avastin, but about medical journalism and how patients’ voices are handled by the media. L. Husten, writing on a Forbes blog, cried that the press fawned, inappropriately, over patients’ words at the FDA hearing last week, and that led him to wonder why and if journalists should pay attention to […]

Posted in Breast Cancer, cancer treatment, Empowered Patient, health care costs, Medical News, Oncology (cancer), PolicyTagged , , , , , , , , 2 Comments on Patients’ Words, Unfiltered, Medical Journalism and Evidence

Vicious Verbiage Targets Cancer Patients’ Voices, at Cardiobrief

A journalist who covers medical matters of the heart grabbed my attention on the Fourth of July. In The Voice of the Patient: Time To Bring Out the Muzzle?, Larry Husten at Forbes’ Cardiobrief blog, insinuates that the women who spoke at the FDA’s Avastin hearings are simpletons. In his short strip, Husten skips the possibility […]

Posted in Breast Cancer, Communication, Empowered Patient, from the author, journalism, languageTagged , , , , , , , , , 6 Comments on Vicious Verbiage Targets Cancer Patients’ Voices, at Cardiobrief

No Room For Emotion or Exceptions to the Rule (on Avastin)

My cousin testified before the FDA oncology advisory board on Tuesday about her experience taking Avastin. This is a tragedy, to deny the only drug that is keeping a 51 year old woman alive. You have to wonder, are the advisory panel members so rational in all their behavior and choices? Are they always so […]

Posted in Breast Cancer, cancer survival, cancer treatment, clinical trials, from the author, health care costs, Medical News, Oncology (cancer), PolicyTagged , , , , , , , , , 12 Comments on No Room For Emotion or Exceptions to the Rule (on Avastin)

Cathy Wants a New Doctor and a Second Opinion

Last night the Big C returned, not surprisingly with an opening dream sequence. Laura Linney, portraying Cathy Jamison in the Showtime series, is running. The scene turns out to be a nightmare, and she awakens with a headache and her husband by her side. OK so far. Within a few minutes, Cathy’s young oncologist informs […]

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Gregg Allman Stars in Hepatitis C Awareness Campaign, with Merck

This weekend I learned that Gregg Allman, of the Allman Brothers, has hepatitis C. Not just that; he underwent a liver transplant last year for treatment of liver cancer. This information came my way via CNN, in a clip narrated by Dr. Sanjay Gupta. The cable TV crew filmed the old rocker in Macon, Georgia, […]

Posted in Communication, Hematology (blood), Infectious Disease, Medical News, Music, Public Health, Public Illness, TVTagged , , , , , , , , , , Leave a Comment on Gregg Allman Stars in Hepatitis C Awareness Campaign, with Merck
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