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Bioethics Cancer Medicine

Blogging on vacation?

OK, I know it’s like the post calling the kettle black, but what the heck is PalMD doing blogging on vacation? And are his two most recent posts so good? This is what I mean:

I recently had the unfortunate opportunity to visit a relative in hospice. I was incredibly impressed. Nice, well-appointed rooms, with a caring, attentive staff that did everything in its power to keep the dying as comfortable and free of distress, both physical and emotional, as humans can do. As a cancer surgeon, I’ve been involved with a number of patients who went to hospice, and I can only hope that the hospices they ended up going to were as good as this one.

Another point that PalMD makes that’s spot on is about telling a patient that they might have cancer. This is a task that is commonplace in my specialty, and, worse, it’s breast cancer, which has all sorts of added baggage attached to it than most other kinds of cancer. Women often see me because either they have felt a lump in the breast or because their mammogram was read as possibly suspicious for cancer. Once the “C” word is uttered by a physician, often little else is heard, even the part about its being only a 20% chance that there’s cancer (a typical number for most abnormal mammograms that require a biopsy). As for having to tell a woman that she has breast cancer, that’s never an easy task. Fortunately, though, I can usually offer hope. Most of the breast cancer that I diagnose as a surgeon is potentially curable, and early stage breast cancer is over 90% curable. I can offer hope to women in these cases and receive in return the satisfaction of curing them, which is one reason why this specialty can be so rewarding. Even in the case where the cancer has metastasized, treatments have improved to the point where women can sometimes go years without much progression of their disease; so even in such cases, although neither I nor anyone else can cure the patient, at least I can still offer hope.

I may have to write about this in more detail sometime soon, as PalMD’s reminded me that I have been wanting to do a post about this topic for a while now.

In the meantime, PalMD should spend more time on the beach. I know, I know, I’m about as bad an example as can be had, but maybe I’ll change.

Or maybe not.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

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