As I walked into my office last Monday I found my nurses giving me a peculiar look, one that I usually reserve for incidents like watching someone back into another’s car. The explanation for their solicitude was soon revealed by a stack of charts lying on my desk. During my weekend off, seven of our patients died.
It has been a year since Congress passed the Affordable Food Act, which mandates that all Americans have adequate insurance for the purchase of groceries. Needless to say private industry, always willing to fill a new need, has answered the call.
I have come to the conclusion that a successful systematic approach to earlier transitions from disease-directed cancer therapy to end-of-life and palliative care can only come from better communication in the context of more trusting relationships.
Would it not be advantageous for people fighting what I call the “vile coward” to take a break from its ugly face? With nothing but the best intentions in mind, I hereby proclaim that all patients have permission to take a vacation from cancer, to schedule a time where cancer is not allowed in the door.
“Personalized medicine” holds its promise only at the substantial cost of widespread use of the awesome tools of molecular science, and at a time of intense scrutiny of the costs and benefits of medical treatments, can we really afford it?
How will we deal with patients and families who, given their tremendous access to information, learn about and demand expensive (and up until now reasonable) treatments once we have recast them as too expensive to justify their marginal benefits? Are we prepared to engage in such discussions directly?
The proposition that a consumer smartphone could somehow become part of the diagnostic toolkit of an oncologist may seem ridiculous. There are, however, many researchers and start-ups that would disagree.
I confess that I have never taken chemotherapy. Strictly speaking this disqualifies me from commenting any further, so I should sign off now. If, however, you don’t mind hearing from one who has administered chemotherapy by the thousands and can bear witness to its effects, then please read on.
Just over a year ago, Alex Trebek introduced the world to Watson. IBM insists that Watson is a decision-support tool, meant to assist and not supplant physicians. Could it work as an oncology support?
Cancer treatment is undergoing significant developments and entering the new golden era of genomics which has true potentials for the promise of personalized medicine. Large-scale sequencing is changing our understanding of malignant disorders particularly acute myeloid leukemia.