paywalled: Dietary Supplements and Cancer Prevention: Balancing Potential Benefits Against Proven Harms

Dietary Supplements and Cancer Prevention: Balancing Potential Benefits Against Proven Harms

Abstract

Nutritional supplementation is now a multibillion-dollar industry, and about half of all US adults take supplements. Supplement use is fueled in part by the belief that nutritional supplements can ward off chronic disease, including cancer, although several expert committees and organizations have concluded that there is little to no scientific evidence that supplements reduce cancer risk. To the contrary, there is now evidence that high doses of some supplements increase cancer risk. Despite this evidence, marketing claims by the supplement industry continue to imply anticancer benefits. Insufficient government regulation of the marketing of dietary supplement products may continue to result in unsound advice to consumers. Both the scientific community and government regulators need to provide clear guidance to the public about the use of dietary supplements to lower cancer risk.

paywalled: Computer tomography, magnetic resonance imaging, and positron emission tomography or positron emission tomography/computer tomography for detection of metastatic lymph nodes in patients with ovarian cancer: A meta-analysis

Computer tomography, magnetic resonance imaging, and positron emission tomography or positron emission tomography/computer tomography for detection of metastatic lymph nodes in patients with ovarian cancer: A meta-analysis

Abstract 

Objectives

To compare the diagnostic performances of computed tomography (CT), magnetic resonance (MR) imaging, and positron emission tomography (PET or PET/CT) for detection of metastatic lymph nodes in patients with ovarian cancer.

Methods

Relevant studies were identified with MEDLINE and EMBASE from January 1990 to July 2010. We estimated the weighted summary sensitivities, specificities, OR (odds ratio), and summary receiver operating characteristic (sROC) curves of each imaging technique and conducted pair-wise comparisons using the two-sample Z-test. Meta-regression, subgroup analysis, and funnel plots were also performed to explain the between-study heterogeneity.

Results

Eighteen eligible studies were included, with a total of 882 patients. PET or PET/CT was a more accurate modality (sensitivity, 73.2%; specificity, 96.7%; OR [odds ratio], 90.32). No significant difference was detected between CT (sensitivity, 42.6%; specificity, 95.0%; OR, 19.87) and MR imaging (sensitivity, 54.7%; specificity, 88.3%; OR, 12.38). Meta-regression analyses and subgroup analyses revealed no statistical difference. Funnel plots with marked asymmetry suggested a publication bias.

Conclusion

FDG-PET or FDG-PET/CT is more accurate than CT and MR imaging in the detection of lymph node metastasis in patients with ovarian cancer.

paywalled: Same-Day Discharge in Clinical Stage I Endometrial Cancer Patients Treated with Total Laparoscopic Hysterectomy, Bilateral Salpingo-Oophorectomy and Bilateral Pelvic Lymphadenectomy

Blogger's Note/Opinion: while this is not ovarian cancer surgery but endometrial cancer surgery, the surgery described is the same; drive thru mastectomies, cancer surgeries - amazing really -  disgusting might be a more accurate term with a reminder that studies can and often do make policy, the abstract does not define many factors involved in gyn cancer surgeries and notable is the lack of any indication of followup period (of time), readmission rates (days) can vary depending on the hospital.....
                           ~~~~~~~~~~~~~~~~~

Same-Day Discharge in Clinical Stage I Endometrial Cancer Patients Treated with Total Laparoscopic Hysterectomy, Bilateral Salpingo-Oophorectomy and Bilateral Pelvic Lymphadenectomy

Clinical Study
Same-Day Discharge in Clinical Stage I Endometrial Cancer Patients Treated with Total Laparoscopic Hysterectomy, Bilateral Salpingo-Oophorectomy and Bilateral Pelvic Lymphadenectomy
Mark A. Rettenmaier, Alberto A. Mendivil, John V. Brown, III, Lisa N. Abaid, John P. Micha, Bram H. Goldstein

Gynecologic Oncology Associates, Newport Beach, Calif., USA

Address of Corresponding Author
Oncology 2012;82:321-326 (DOI: 10.1159/000337573)

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   Abstract
Objectives:

The purpose of this retrospective study was to evaluate the capacity for same-day discharge in clinical stage I endometrial cancer (EC) patients treated with total laparoscopic hysterectomy (TLH), bilateral salpingo-oophorectomy (BSO) and bilateral pelvic lymph node dissection (BPLND).  

Methods:
We retrospectively reviewed the charts of stage I EC patients who were treated with TLH, BSO and BPLND and discharged on the same day. The intra- and postoperative clinical variables (e.g., age, complications, surgery time, patient hospital stay) were evaluated in an attempt to discern which factors may predispose a patient to same-day discharge.

Results:
Twenty-one patients were successfully discharged on the same day of surgery. Mean operative time was 1.48 h and length of hospital stay was 6.35 h. There were no intraoperative complications or hospital readmissions.  

Conclusions:
We present a single, institutional experience solely assessing the capacity for same-day discharge in clinical stage I EC patients treated with TLH, BSO and BPLND. Since the postoperative complication rate was minimal with no hospital readmissions, we suggest that particularly selected stage I EC patients are amenable to outpatient management.
Copyright © 2012 S. Karger AG, Basel

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  Author Contacts
Bram H. Goldstein, PhD
Gynecologic Oncology Associates
351 Hospital Road, Suite 507
Newport Beach, CA 92663 (USA)
Tel. +1 949 642 5165, E-Mail bram@gynoncology.com

CancerWorld: Framing the argument over futile care - overdiagnose, overtreat, overpromise...media focus

Framing the argument over futile care:

We “overdiagnose, overtreat and overpromise”. This was the claim made by numerous newspaper headlines in response to the Lancet Oncology report last September on delivering affordable cancer care. While we do need open and frank discussions about how to curb the spiralling costs of cancer care, it was unfortunate that the media focused so heavily on the cost of futile treatment in the last weeks of life, blaming it all on a culture of excess. This sparked reports that patients would be denied potentially life-prolonging treatments purely on the basis of cost and generated fears that patients might be abandoned in their final months. There is no doubt that we do overtreat and overpromise in the advanced cancer setting. We know, for instance, that many patients receive cancer treatments in the last weeks of their life, and that some of these treatments have no reasonable chance of helping the patient and are associated with severe side-effects that can lead to hospitalisation and even death. We also know that receiving chemotherapy is associated with a delay in referral to palliative care. But blaming this on a culture of excess is too simplistic. Making the right decisions in later stages of advanced cancer is difficult for doctors and patients alike. It is often impossible to predict how long a patient will live, and while we have an increasing number of therapies to choose from, we don’t yet know enough about who stands to benefit and by how much. There can be a huge disconnect between the expectations of patients and families and those of clinicians, adding to the difficulty of conducting honest conversations with patients about their prognosis, treatment options and end-of-life preferences. There are no easy answers. But could we be making things harder for ourselves by posing options in terms of a choice between either fighting cancer or optimising quality of life? An emerging body of evidence shows that integrating palliative care into the mainstream care of cancer patients not only improves their quality of life, but might even help them live longer. Early involvement of palliative care specialists has also been shown to cut down on futile medical interventions and help families cope better with their loss of a loved one. ASCO is now recommending that patients should be offered concurrent palliative care and standard cancer treatments early in the course of their advanced cancer journey. This is in line with efforts to stimulate meaningful interaction between mainstream oncology and palliative care specialists that ESMO and other European professional bodies have been pursuing for some time. However, progress so far has been infuriatingly slow. Greater integration of palliative care requires changes in the way we organise care and train clinicians. We need to get on with this as a matter of urgency. If we fail to take a lead in addressing shortcomings in the way we care for patients with advanced cancer, the simplistic arguments about a wasteful culture of excess could win, and patients will be the losers.

audio/video: Loud and Clear

Loud and Clear

In late fall 2011, The Change Foundation engaged Ontario seniors with chronic health conditions and their informal caregivers about their experiences with transitions in our healthcare system. This report is about their stories, experiences, and ideas.

Loud and Clear: seniors and caregivers speak out about navigating Ontario's healthcare system

Change Foundation engaged Ontario seniors.....

Loud and Clear

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About Loud and Clear

In Loud and Clear: Seniors and caregivers speak out about navigating Ontario’s healthcare system, we explain our rationale for the timing and target of our engagement, describe our methodology, present our findings and how we plan to use them, and share the Foundation’s next steps and how they fit, feed into, and even blaze the way for patient-centred healthcare in Ontario.

Dedication

We dedicate this report to the seniors and their family members and friends across Ontario who shared their experiences and stories with us. They spoke forcefully and thoughtfully, with both emotion and measure, about where the system has failed them and how it could serve them better. They spoke loud and clear.

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“I don’t know what’s happening next, but where do you go to find the answers? Seems like there are roadblocks set up in the system that make it hard.”
Ontario senior 
 

“Our doctor sent us for an appointment with a specialist. We waited five months and never heard anything, so I called and they had no record of the appointment. It would be a good idea if someone from the doctor’s office called the patient once an appointment is made to confirm.”
Ontario senior 

“I’ve never been asked as a caregiver, 'What’s convenient for you?' Or 'How would this work in your family?' instead it’s 'This is what we’re going to do for you.' There's no discussion of collaboration.”
Ontario caregiver

Immunotherapy of cancer in 2012 - Kirkwood - 2012 - CA: A Cancer Journal for Clinicians - Wiley Online Library

Immunotherapy of cancer in 2012 - Kirkwood - 2012 - CA: A Cancer Journal for Clinicians

excerpt re: ovarian cancer:

Immunotherapy for Ovarian Cancer

Recent work has shown a correlation between increased survival and the presence of tumor-infiltrating effector-type lymphocytes in a given patient. The absence of tumor- infiltrating regulatory cells has supported the role of immune surveillance in the progression of ovarian cancer and provided additional rationale for immunotherapy for this aggressive disease. 314...............

Correspondence/Author's Response: Paraneoplastic Thrombocytosis in Ovarian Cancer — NEJM

Paraneoplastic Thrombocytosis in Ovarian Cancer — NEJM

Correspondence

Paraneoplastic Thrombocytosis in Ovarian Cancer

N Engl J Med 2012; 366:1840 May 10, 2012

To the Editor:

The mean platelet volume (MPV), analogous to the calculation of the mean corpuscular volume, is calculated as the plateletcrit divided by the total number of platelets. Although the MPV is readily available on a routine blood count, many laboratories do not report the MPV to clinicians because of the lack of standardization and the dependency of the results on the age of the sample and the method of measurement. Stone et al. (Feb. 16 issue)1 found that thrombocytosis was associated with shortened survival and advanced disease in patients with ovarian cancer. A recent population-based study has shown the MPV to be a predictor of venous thromboembolism.2 Other studies have shown the MPV to be a predictor of cardiovascular risk, with an elevated MPV associated with increased mortality after acute myocardial infarction and an increased rate of restenosis after coronary angioplasty.3 Similarly, an elevated MPV is associated with a worse outcome for acute ischemic cerebrovascular events, independent of other clinical factors.4 We would like to know whether the investigators obtained data on the MPV in their study cohort, and if so, whether they found any correlation between the MPV and survival, independent of thrombocytosis.

Harris V. Naina, M.D.
Samar Harris, M.D.
UT Southwestern, Dallas, TX
harris.naina@utsouthwestern.edu

No potential conflict of interest relevant to this letter was reported.
4 References

Author/Editor Response

Platelet size, as measured by the MPV and platelet distribution width, correlates with platelet reactivity.1 Retrospective data suggest that the MPV has potential prognostic and diagnostic value in hematologic and cardiovascular disorders.2 However, it is not known whether the MPV is a useful prognostic marker in patients with cancer. Although the focus of our investigation was on the mechanisms and effect of thrombocytosis on clinical outcomes in ovarian cancer, in response to the inquiry from Naina and Harris, we examined the association among the MPV, thrombocytosis, and survival in 150 patients with newly diagnosed advanced epithelial ovarian cancer. In this data set, the median MPV was 8 fl (range, 6 to 11). MPV levels were inversely correlated with platelet count (r=–0.45, P<0.001). Survival rates were not associated with the MPV (where a high MPV was defined as an MPV greater than either the median or the cutoff value used by our institution [>10.4 fl]). The value of alternative cutoff levels for MPV for prognostic evaluation is unknown.

Rebecca L. Stone, M.D.
Vahid Afshar-Kharghan, M.D.
Anil K. Sood, M.D.
University of Texas M.D. Anderson Cancer Center, Houston, TX

Correspondence/Aurthor's Response: Thromboprophylaxis in Patients Receiving Chemotherapy — NEJM

Thromboprophylaxis in Patients Receiving Chemotherapy — NEJM

Correspondence

Thromboprophylaxis in Patients Receiving Chemotherapy

N Engl J Med 2012; 366:1839-1840May 10, 2012

Article

To the Editor:

In their article on the results of the SAVE-ONCO study (ClinicalTrials.gov number, NCT00694382), which showed that semuloparin reduced the risks of deep-vein thrombosis in the lower or upper limbs and pulmonary embolism among patients receiving chemotherapy for cancer, Agnelli and colleagues (Feb. 16 issue)1 do not mention the development of central-venous-catheter thrombosis. Indeed, deep-vein thrombosis related to a central venous catheter is a frequent complication, reported in 4% of patients with symptomatic events and 20 to 30% of patients with asymptomatic events detected by means of venography or ultrasonography; this complication is associated with the risk of pulmonary embolism and loss of central venous access.2 A recent Cochrane review did not show any efficacy of heparins or vitamin K antagonists for the prevention of central-venous-catheter thrombosis.3 Accordingly, national guidelines mention no prophylactic treatment; specifically, they recommend no prophylactic doses of low-molecular-weight heparin or low-dose warfarin.2 Only the placement of the distal tip of the central venous catheter at the junction between the superior vena cava and the right atrium, and insertion on the right side are indicated.2,4 Therefore, was central-venous-catheter thrombosis observed in the study, and was semuloparin an effective prophylactic treatment?

Claude Bachmeyer, M.D.
Jean-Charles Pellen, M.D.
Tenon Hospital, Paris, France
claude.bachmeyer@tnn.aphp.fr

No potential conflict of interest relevant to this letter was reported.
4 References

Author/Editor Response

Bachmeyer and Pellen wonder whether central venous catheter–related thrombosis was observed in the study and whether semuloparin was an effective prophylactic treatment for this complication. In our study, a central venous catheter was present in 19.7% of patients in the semuloparin group and 18.8% of patients in the placebo group. Symptomatic deep-vein thrombosis of the upper limbs, including central-venous-catheter thrombosis, was part of the composite primary efficacy outcome. During the efficacy analysis period, symptomatic deep-vein thrombosis of the upper limbs occurred in 9 of 1604 patients in the placebo group (0.6%) and 3 of 1608 patients in the semuloparin group (0.2%) (hazard ratio, 0.33; 95% confidence interval, 0.07 to 1.18). All these patients had a central venous catheter. The risk reduction in deep-vein thrombosis of the upper limbs (including central-venous-catheter thrombosis) associated with semuloparin was consistent with the risk reduction in the other components of the composite primary efficacy outcome of the study, but the number of observed events is small.

Giancarlo Agnelli, M.D.
University of Perugia, Perugia, Italy
agnellig@unipg.it
Alexander G.G. Turpie, M.D.
McMaster University, Hamilton, ON, Canada

Continuing Bisphosphonate Treatment for Osteoporosis — For Whom and for How Long? — NEJM

Continuing Bisphosphonate Treatment for Osteoporosis — For Whom and for How Long? — NEJM

Bisphosphonates for Osteoporosis — Where Do We Go from Here? — NEJM

Bisphosphonates for Osteoporosis — Where Do We Go from Here? — NEJM

Seth's Blog: Why ask why? (including one important hint)

Why ask why?

"Why?" is the most important question, not asked nearly enough.

Hint: "Because I said so," is not a valid answer.

• Why does it work this way?
• Why is that our goal?
• Why did you say no?
• Why are we treating people differently?
• Why is this our policy?
• Why don't we enter this market?
• Why did you change your mind?
• Why are we having this meeting?
• Why not?

paywalled: (March 2012) Impact of FDG-PET and -PET/CT imaging in the clinical decision-making of ovarian carcinoma: an evidence-based approach.

Impact of FDG-PET and -PET/CT imaging in the clinical decision-making of ovarian carcinoma: an evidence-based approach

Abstract

The most definitive role of fluorodeoxyglucose (FDG)-PET/computed tomography (CT) at present is surveillance and detecting recurrence in patients who have completed primary therapy but demonstrate a rising serum tumor marker (e.g., CA-125 levels). In this scenario, PET/CT demonstrates high sensitivity and accuracy in detecting lesions that are otherwise challenging, and appears superior (with less interobserver variability) compared with CT alone. Despite the fact that peritoneal deposits may be missed by PET/CT, the overall performance is better than CT alone. FDG-PET does not play a significant additional role in the primary diagnosis of ovarian cancers; however, the role of combined PET/CT modality has recently begun to be re-explored for initial disease staging, particularly because PET/CT can pick up small unsuspected lesions and thereby provide a better disease assessment of the whole body in a single examination. The baseline PET/CT also subserves an important role for future monitoring of therapy response. Therapy monitoring by PET could help to optimize neoadjuvant therapy protocols and to avoid ineffective therapy in nonresponders early in its course, although PET/CT has cost-effectiveness issues that need further evaluation. The prognostic value of FDG-PET/CT has been investigated in the following areas: in the preoperative setting to predict optimal cytoreduction; to assess the value of a positive FDG-PET following primary surgery; and when employed as a replacement for second-look laparotomy following completion of primary surgery and chemotherapy. The data, although promising, are still sparse in all the three domains for a definite recommendation.

 

birthdays - Rocco and Patina

2012 Canadian Cancer Statistics - 5th ranking in women dying of cancer in Canada

2012 Report Canadian Cancer Statistics


new cases - 2,600 deaths - 1,750

8th ranking in # of new cases of cancers in women

5th ranking in # deaths of cancers in women

paywalled: Permanent scalp alopecia related to breast cancer chemotherapy by sequential fluorouracil/epirubicin/cyclophosphamide (FEC) and docetaxel

Permanent scalp alopecia related to breast cancer chemotherapy by sequential fluorouracil/epirubicin/cyclophosphamide (FEC) and docetaxel: a prospective study of 20 patients:

Background:
To analyze the clinical and histological features of permanent alopecia following a sequential fluorouracil/epirubicin/cyclophosphamide (FEC) and docetaxel regimen for adjuvant breast cancer treatment.

Conclusion:
Permanent and severe alopecia is a newly reported complication of the FEC 100–docetaxel breast cancer regimen.

DARA BioSciences Announces New Analysis of Patient Self-Reported Diary Results in a Phase 2a Clinical Trial of KRN5500 in Patients With Cancer and Neuropathic Pain - Drugs.com

http://tinyurl.com/7tmt942

DARA BioSciences Announces New Analysis of Patient Self-Reported Diary Results in a Phase 2a Clinical Trial of KRN5500 in Patients With Cancer and Neuropathic Pain

"....Previous analyses of the study data were based predominantly on patient-reported Numeric Rating Scale (NRS) pain scores collected by healthcare professionals in a clinic setting during weekly visits, whereas this new analysis focused specifically on self-reported daily pain scores from patients' diaries. Responders in this analysis were defined as patients attaining a clinically-meaningful (at least 20%) improvement in mean NRS scores from baseline within any given week. Of the 12 patients who received KRN5500 in this 19-patient trial, 7 (58%) were classified as responders. Further, 5 of the 7 (71%) showed sustained pain relief over several weeks. Of the 7 patients who received placebo, none were responders. Therefore, the new analysis showed a temporal consistency of pain relief in a larger fraction of patients than had been noted in the earlier analysis of weekly clinic-reported pain. These findings are impressive since patients enrolled in this proof-of-concept trial had unrelenting pain at baseline despite the concomitant use of other approved analgesic agents........

 

Beware the creeping cracks of bias (in science research) : Nature News & Comment

Beware the creeping cracks of bias : Nature News & Comment

Long-Term Use of Osteoporosis Medication May Reduce Bone Fracture Risk for Some Patients - U California

Long-Term Use of Osteoporosis Medication May Reduce Bone Fracture Risk for Some Patients:

"Continuing a popular but controversial treatment for osteoporosis could reduce spine fracture risk for a particular group of patients, but others could see little to no change if they discontinue it. Based on available evidence, a UCSF researcher reevaluated his 2006 finding from a randomized 10-year study of alendronate, a type of bisphosphonate - a class of drugs that prevent loss of bone mass.....

New Cautions About Bisphosphonates - NYTimes.com

New Cautions About Bisphosphonates - NYTimes.com

paywalled: The Predictive Capacity of Personal Genome Sequencing - Science Translational Medicine

[Research Articles] The Predictive Capacity of Personal Genome Sequencing:

New DNA sequencing methods will soon make it possible to identify all germline variants in any individual at a reasonable cost. However, the ability of whole-genome sequencing to predict predisposition to common diseases in the general population is unknown. To estimate this predictive capacity, we use the concept of a "genometype." A specific genometype represents the genomes in the population conferring a specific level of genetic risk for a specified disease. Using this concept, we estimated the maximum capacity of whole-genome sequencing to identify individuals at clinically significant risk for 24 different diseases.

PLoS ONE: Citizen Participation in Patient Prioritization Policy Decisions: An Empirical and Experimental Study on Patients' Characteristics

PLoS ONE: Citizen Participation in Patient Prioritization Policy Decisions: An Empirical and Experimental Study on Patients' Characteristics

"The results of the survey questions showed that the vast majority of respondents agreed to prioritize patients with life threatening diseases and patients with acute diseases over all other patients. All criteria that described the patient's social engagement outside the family or socio-economic status (e.g., income, unemployment) were rejected as possible criteria for prioritization. A similar pattern could be observed in the discrete choice experiment: health status received the highest importance weight, whereas socio-economic status received a very low weight in terms of deciding which patient should be treated first. There is considerable agreement that those in need, i.e., the severely ill patient, should be treated first [1], [5]–[7]. Socio-economic status was not considered acceptable, but is a commonly practiced criterion in the daily routine of physicians [40], if not explicitly, at least implicitly so [41], [42]."


"In particular, medical criteria are highly accepted for prioritizing patients whereas socio-economic criteria and lifestyles are rejected. Especially the DCE showed that health status and quality of life were the only attributes that respondents would ultimately likely include in a decision-making process about which patients to prioritize for care. Policy makers in Germany have been very reluctant to even discuss the topic; indeed, all ministers of health over the last decade or so have refused to even talk about this issue. The present study shows that the “voice of the patient” – reliably captured through the methods used here – can be encapsulated in statistical models and thus introduced into policy-making settings [15]. The methods and findings illustrated in this research can be used to 1) increase citizen participation in the political discussion concerning this substantive policy topic, 2) define the scope of policy actions within the realm of the feasible, and 3) frame communications between policy-setting bodies and the population."

paywalled: Diathermy-Induced Injury May Affect Detection of Occult Tubal Lesions at Risk-Reducing Salpingo-Oophorectomy

Diathermy: In the natural sciences, the term diathermy means "electrically induced heat" and is commonly used for muscle relaxation. It is also a method of heating tissue electromagnetically or ultrasonically for therapeutic purposes in medicine.

Diathermy-Induced Injury May Affect Detection of Occult Tuba... : International Journal of Gynecological Cancer

Background: Electrosurgery-induced tubal thermal injury obscures cellular detail and hampers histomorphological assessment for occult pathology.

Objective: 

The objectives of this study were to report on diathermy-related thermal injuries to the fallopian tube observed at RRSO and explore its potential impact on the detection of occult tubal epithelial lesions.

Design: 

This study was composed of high-risk women from breast and/or ovarian cancer families attending a tertiary high-risk familial gynecologic cancer clinic. This was a retrospective case-control analysis of high-risk women who underwent RRSO. Cases were all women detected to have occult lesions (tubal atypia/carcinoma in situ/cancer) between January 2005 and December 2010. Control subjects were all women with normal tubal/ovarian histology between August 2006 and December 2007.

Conclusions: This report highlights the potential impact of electrosurgical thermal injury on detection of occult tubal pathology following RRSO. It is important for surgeons to avoid thermal injury to the distal end of the tube.

Myriad RBM Announces the Launch of OncologyMAP® v. 2.0

Myriad RBM Announces the Launch of OncologyMAP® v. 2.0

Myriad Genetics (NASDAQ: MYGN) announced today that Myriad RBM, a wholly owned subsidiary of Myriad Genetics, has launched OncologyMAP® v. 2.0, a powerful research tool developed with funding and direction from the National Cancer Institute and the Cancer Prevention Research Institute of Texas. OncologyMAP® v. 2.0 is a comprehensive, cost-effective testing service that builds on the success of the original OncologyMAP® service by increasing the scope and diversity of biomarker analysis for drug re-tasking, indication expansion, and patient stratification studies and provides researchers with the ability to accelerate the pace of discovery, validation, and translation of cancer biomarkers into clinically useful tests......................

No One is More Interested in Curing Your Cancer Than You « Dr. Robert A. Nagourney – Rational Therapeutics – Blog

No One is More Interested in Curing Your Cancer Than You « Dr. Robert A. Nagourney – Rational Therapeutics – Blog

No One is More Interested in Curing Your Cancer Than You

May 9, 2012 Leave a comment (Dr Robert A Nagourney blog)
 

A diagnosis of cancer thrusts a, heretofore, healthy individual into the strange and unfamiliar territory of medical oncology. Many of my patients describe this transition as “entering the cancer bubble.” Suddenly, you are on the inside and everyone on the outside is talking at you about what to do, where to go, whom to see, and what treatments to receive.
From the inside of the bubble however, all of this has a hollow ring as you ponder many options, few good and some, positively frightening. Unfortunately, few patients have the time to complete a MD, or PhD, between diagnosis and the initiation of treatment. Lacking the requisite expertise, they turn to the “authorities” for advice.