A Case for Slower Medicine
Anger is an understandable reaction to a system that dehumanizes patients, that treats bodies as containers of billable ailments and broken parts. But most doctors go about their daily work with good intention – to heal.
Contemplating Breast Cancer, Beyond October 2012
I’m optimistic, because it looks as though, in my lifetime, BC treatment will be tailored to each patient. There’ll be less surgery and better drugs.
How Much Do You Want Your Doctors To Say About Risks of Treatment?
This kind of paternalism, when a doctor assesses the risks and benefits, and spares the patient’s “knowing” seems anachronistic. But it may, still, be what many people are looking for when and if they get a serious illness. Not everyone wants a “tell me everything” kind of physician.
NIH Sponsors New Website to Help Patients Understand Clinical Trials
This week the NIH launched a new website, NIH Clinical Research Trials and You. In a Feb 6 press release, NIH Director Dr. Francis S. Collins said “The ability to recruit the necessary number of volunteers is vital to carrying out clinical research.” The idea behind the website is to help patients understand how clinical research […]
NIH to Drop Requirement for Websites Disclosing Researchers’ Ties to Industry
Today’s word comes from Nature News that the NIH is dropping a proposed requirement for universities to disclose researchers’ financial ties to industry on websites. This is a loss for patients, who may not be aware of their doctors’ relationships with pharmaceutical companies and others who fund clinical trials, fellowships, conference junkets and other perks […]
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, […]
Lowering Cancer Care Costs by Reducing Tests After Treatment
This is the second in a series of posts on Bending the Cost Curve in Cancer Care. We should consider the proposal, published in the NEJM, gradually over the course of this summer, starting with “suggested changes in oncologists’ behavior,” #1: 1. Target surveillance testing or imaging to situations in which a benefit has been […]
A Good Place to Find Information on Clinical Trials
If you’re thinking of participating in a clinical trial for cancer or any other medical condition, a good place to find out about the research is ClinicalTrials.gov. The site, sponsored by the NIH, NLM and FDA, is one outcome of the FDA Modernization Act (FDAMA) of 1997. The database aims to provide information on clinical […]
The Flip Side of Unrealistic Optimism
Last week, Pauline Chen wrote on medical ethics and clinical trials. She reflects on her training at a cancer research hospital, where some cancer patients go with unrealistic optimism.
Like Dr. Chen, I spent part of my training at a famous cancer center where I worked as a resident and fellow on rotations. And yes, some patients were unreasonably optimistic and some – perhaps even most, it seemed – didn’t fully “get” the purpose of their trial, which in Phase I studies were not designed to help them. This is a real dilemma for treating oncologists.
Stunning Comments on the Risk of Breast Implants, and Cancer
The FDA recently identified a link between breast implants and a rare form of lymphoma. From today’s report in the New York Times: When talking to patients about a rare type of cancer linked to breast implants, plastic surgeons should call it “a condition” and avoid using the words cancer, tumor, disease or malignancy, the […]