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You are never too old for chemotherapy
One of the mysteries of my practice was that I could never predict how well or poorly a patient would tolerate chemotherapy. My bias was that the older a patient was, the less well he or she would be...
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Colonoscopy isn’t perfect.
I think of this when I see our friend Sarah. About five years ago her husband died of colon cancer even though he had a “negative” colonoscopy two years before. Everyone blamed the poor doc who did the...
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Breast radiation after cancer – I was wrong
Often in my practice, women would ask after their lumpectomy for breast cancer if they really needed the proscribed radiation therapy. I always said yes. It would lower the chances of the cancer...
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The world’s third most deadly cancer is becoming a greater problem here.
Every year, about 700,000 people die of liver cancer. I am referring to cancers that start in the liver, not those that have spread there. Spread to the liver is a very common problem in patients with...
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Don’t believe the headlines about Avastin
Today’s LA Times published an article that headlined “Drug is promising for ovarian cancer”. The article referred to two separate studies published in today’s New England Journal of Medicine (Dec...
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It’s time to stop getting that PSA test for prostate cancer
I was reminded of this when I learned of a new article “hot off the press”, published in the Journal of the National Cancer Institute. The news was so exciting that they published the results online...
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Sorry ladies, more chemotherapy is better after surgery for breast cancer
Every 5 years, a group known as the Early Breast Cancer Trialists’ Collaborative Group (ECBTCG), publishes a summary of all the studies of treatment of women after breast cancer surgery. Early on they...
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What kind of surgery for prostate cancer
I have always thought that if I were to have surgery for prostate cancer (not likely given my age of 74) I would choose the Robotic Assisted Laparoscopic Surgery. After all the robot’s “hand” doesn’t...
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“Personalized” cancer treatment has a long way to go – maybe too far.
A few months ago I wrote about a new treatment for widespread melanoma that targeted a particular molecule that controlled that cancer’s growth. Shortly afterward, someone I know found out that the...
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Forget about being screened for ovarian cancer – unless…..
Unless you have a lot of close relatives with ovarian and breast cancer. That would suggests you might have the BRCA mutation, a mutation is associated with a high risk of both of these cancers....
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Smoking and disease – how the world has changed
A few weeks ago, I met with my medical students to discuss a case of suspected lung cancer in a smoker. As we talked about smoking and its risks, I was struck by how far we have come from when I was a...
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Who should get mammography and how often?
Over 15 years ago I did a study on the benefits of mammography. Much of the research came from Europe where they did randomized controlled trials. Half the women received mammography and half didn’t....
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Should you get radiation to the breast for early stage cancer if you are over...
Often in my practice older women with breast cancer asked whether they really needed radiation to the breast after their mastectomy. It was a lot of trouble. They would have to drive or be driven to...
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We haven’t made much progress in treating acute myeloid leukemia
Today’s paper carried the obituary of Nora Ephron, who wrote some of my favorite movies, “Sleepless in Seattle, Julia and Julia” and lots of others. She was very successful and clearly made a lot of...
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A victory for cancer survivors
Many years ago I had a conversation with one of my patients about her career. Actually, It was about not leaving her job. She had Hodgkin disease, which was in remission; she was feeling terrific and...
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Chronic Lymphocytic Leukemia – not much going on.
The other day I came across a little review of the treatment of chronic lymphocytic leukemia. This is not a terribly common disease. Only about 16,000 people are diagnosed in the U.S. each year. But, I...
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Perhaps we should ban cigarettes before we worry about guns
The recent tragedy in Aurora Colorado has raised the question of how to control the proliferation of guns and the deaths they cause. Indeed it is an important problem; about 30,000 people are killed...
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Our latest carcinogen- tanning beds
Recently a cousin of mine died of malignant melanoma. He lived in Israel and had a lot of exposure to the sun particularly as a youngster and of course, with little protection. I wrote about his...
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Why cancer often comes back and usually can’t be cured by chemotherapy
Many years ago I saw a woman who had had breast cancer treated with surgery about 20 years earlier. She was sent to me because she had developed an enlarged lymph node that contained breast cancer. To...
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Will we ever cure cancer as the Susan Komen organization promises?
I was turned on to this question by the recent turmoil at the Susan G Komen For the Cure organization. Very little frosts me more than falsely promising hope. And the Komen organization seems to be...
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