Dr. Elaine Schattner's notes on becoming educated as a patient
Dr. Elaine Schattner's notes on becoming educated as a patient
© Elaine Schattner, 2009, 2022 By : Template Sell.
Jackie is supposed to be a crackerjack nurse who has some serious problems including drug addiction. That premise might be fair enough, in a House-like way, if her life-saving skills had unique value. But they don’t: the underlying problem with this show is that Jackie has no exceptional or redeeming qualities as a nurse. Sure, she cares about some of her patients, but that’s nothing extraordinary…
The question is, what’s the right, PC and emotionally-sound, sensitive but not sappy term to describe the situation of a person who’s living after breast cancer?
Some might say, who cares if you’ve had it?
Kudos to my newest doctor, a dermatologist whom I met yesterday for evaluation of a small, benign-appearing mole I recently noted on my right leg. What she did right: 1. She saw me promptly, at the time of my scheduled appointment. (Thank you, you seem to value my time, as I do yours.) 2. In […]
A prominent article in yesterday’s New York Times considers some troubling problems regarding inaccuracy in breast cancer diagnosis and pathology. The main point is that some women get needless, disfiguring and toxic treatments after being told they have breast cancer when, it turns out, their condition was benign. My main take is that, whenever possible, […]
Hiking, or even just walking, in the hot summer heat to see ancient ruins, national monuments or spectacular vistas can sap the energy of healthy people. For someone who’s got a health issue – like chronic lung disease, reduced heart function or anemia – or anyone who’s pregnant, elderly or just frail, summer travel can knock you out in the wrong sort of way….Don’t plan
I learned of a new study implicating stress in reduced breast cancer survival by Twitter. A line in my feed alerted me that CNN’s health blog, “Paging Dr. Gupta,” broke embargo on the soon-to-be-published paper in the journal Clinical Cancer Research. The story – that women who undergo a stress relief program live longer after […]
Yesterday I visited my internist. I had no particular complaint. My back hurt no more than usual. The numbness in my left foot was neither better nor worse than it was last month. I wasn’t suffering from vertigo or abdominal pain. I went because I had an appointment to see her, nothing more.
Until just a few years ago, I rarely
There’s promising news on the breast cancer front.
A study published on-line this week in The Journal of Clinical Oncology (JCO) suggests that regular, low-dose aspirin use reduces the risk of recurrence and death from breast cancer among women who’ve had stage I, II or III (non-metastatic) disease.
This is a phenomenal report in three respects:
1. The dramatic results: among women who’ve had breast cancer, regular aspirin use was associated with a reduced risk of recurrence and of death from cancer by more than half;
2. The relevance; these findings might affect millions of women living after breast cancer, today;
3. The cost: aspirin is widely available without patent restriction. Aspirin costs around $5 for 100 tablets, several months’ supply.
This is my first film review, if it is that.
I was tempted to write about Ethan Hawke, hematologist among vampires in Daybreakers, but gore’s not my favorite genre. A mainstream choice would have been Harrison Ford solving the enzyme deficiency of Pompe disease in Extraordinary Measures, but I didn’t get sucked in.
I chose Precious, instead. This luminous movie relates to the practice of medicine everyday, big-time.
“One of the ways that I gained the trust of the family is that I gave them information.” (R. Skloot, a journalist, speaking about her interactions with Henrietta Lacks’ family, Columbia University, 2/2/10)
After a while my oncologist stepped out into the waiting area and guided me to the hall by her office. “The cells are low,” she said. “We’ll have to wait another week, that’s all.”
I knew she was right. But a week seemed like a lifetime to me then….
This afternoon I found a Tweet from a colleague, a journalist who happens to be a mom in my community:
Tweet from SuSaw:
“RT @JenSinger: Hey, baby. What’s your blood type? Nothing against the Big Pink Machine… http://ow.ly/URkg
As a trained hematologist (blood doc), oncologist and breast cancer survivor, I couldn’t resist checking this out. Here’s what I discovered…
Why bother, you might ask – wouldn’t it be easier to drop the subject?
“Make it go away,” sang Sheryl Crow on her radiation sessions.
I’ll answer as might a physician and board-certified oncologist who happens to be a BC survivor in her 40s: we need establish how often false positives lead, in current practice, to additional procedures and inappropriate treatment…These numbers matter. They’re essential to the claim that the risks of breast cancer screening outweigh the benefits.
The risks of radiation from CT scanning will almost certainly add to the current confusion and concerns about the risks of breast cancer screening.
Mammography differs from CT scanning in several important ways:
1. Mammograms involve much less radiation exposure than CT scans.
2. Mammography is well-regulated by the Food and Drug Administration (FDA) and other agencies. The Mammography Quality Standards Act (MQSA) requires…
3. Women who undergo screening mammograms can control when and where they get this procedure. Screening mammograms are elective by nature..
I know what it’s like to get the “red devil” in the veins.
You can learn about Adriamycin, a name brand chemotherapy, on WebMD. Or, if you prefer, you can check on doxorubicin, the generic term, using MedlinePlus, a comprehensive and relatively reliable public venture put forth by the National Library of Medicine and National Institutes of Health. If you’re into organic chemistry, you might want to review the structure of 14-hydroxydaunomycin, an antibiotic and cancer therapy first described 40 years ago…
Three key issues have escaped the headlines: 1. The expert panel carried out a careful analysis using data that are, necessarily, old; 2. The recommendations don’t apply to digital mammography; 3. Mammograms are not all the same.
We need to set the bar higher for mammography…
But consider – if the expert panel’s numbers are off just a bit, by as little as one or two more lives saved per 1904 women screened, the insurers could make a profit!
By my calculation, if one additional woman at a cost of, say, $1 million, is saved among the screening group, the provider might break even. And if three women in the group are saved by the procedure, the decision gets easier…
Now, imagine the technology has advanced, ever so slightly, that another four or five women are saved among the screening lot.
How could anyone, even with a profit motive, elect not to screen those 2000 women?
Smack in the midst of October-is-breast-cancer-awareness-month, the Journal of the American Medical Association published a provocative article with a low-key title: “Rethinking Screening for Breast Cancer and Prostate Cancer.” The authors examined trends in screening, diagnosis and deaths from cancer over two decades, applied theoretical models to the data and found a seemingly disappointing result.
It turns out that standard cancer screening is imperfect.
The subject matters, especially to me. I’m a medical oncologist and a breast cancer survivor, spared seven years ago from a small, infiltrating ductal carcinoma by one radiologist, an expert physician who noted an abnormality on my first screening mammogram…
