Category: Oncology/Hematology

The nuance behind an insurance company denial

I just read of a a jury award in excess of $25 million against an insurance company who denied a recommended cancer treatment to a patient who ultimately died.  I do not wish to review here the particulars of this case, and admit that my knowledge is l…

MKSAP: 42-year-old man with thrombophilia

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 42-year-old man arrives for follow-up consultation. Three months ago he developed a proximal right leg deep venous thrombosis following a s…

PSA-based screening for prostate cancer: Interpreting the changing guidelines

Comparing the 2018 U.S. Preventive Services Task Force (USPSTF) recommendation statement on prostate cancer screening in the October 15th issue of American Family Physician with its previous recommendation, the first question family physicians ought to…

A CT scan for kidney cancer? It may depend on where you live.

About one in fifty people reading this essay will be diagnosed with kidney cancer at some time in their life. In fact, one out of one people writing this essay has already been diagnosed with kidney cancer. (I had a small tumor removed from my left kid…

A patient’s experience of chemotherapy and radiation

I had my first mammogram at age 35, and for the next 35 years I had mammograms regularly. On my way, I’d pass the entrance to the Thomas Johns Cancer Hospital, outside of Richmond, VA, never thinking that I’d one day cross that threshold my…

This is what the face of resilience looks like

At the age of 17, my younger sister Elisabeth noticed a change in her body — enlargement of the front of her neck. “I just thought I was building muscle from working out,” she innocently rationalized. A series of laboratory tests and imaging followed a…

MKSAP: 79-year-old man with a sacral ulcer

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 79-year-old man is evaluated for pain in the buttocks region. He was diagnosed with non-Hodgkin large B-cell lymphoma 6 months ago. Althoug…

Silence isn’t golden when it comes to health

When I was a preemie — all two-and-a-half pounds of me — my mom was understandably worried. She said her doctor wheeled her down the hall to the newborn nursery, and my mom could hear me screaming all the way down the hall. She said, “I’ve got to hand …

A bad outcome changed this physician’s life

I’m struggling — truly struggling. This year has been beyond hard. I honestly never thought this time last year that I would be in this predicament. Things were good, I had a great job, and I was working on our fixing up our dream retirement home. We h…

The Ellen Show broadcasts potentially harmful information about ovarian cancer screening

Ethical OB/GYNs everywhere sighed heavily when they realized from the action on their Facebook and Twitter feeds that the Ellen Show broadcasted incorrect and potentially harmful information about ovarian cancer screening to almost 4 million people. Mi…