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Cancer Medicine Surgery

More is not always better: MRI and the increasing mastectomy rate

“Early detection of cancer saves lives.” How many times have you heard this statement or something resembling it? It’s a common assumption (indeed, a seemingly common sense assumption) that detecting cancer early is always a Very Good Thing. Why wouldn’t it be, after all? For many cancers, such as breast cancer and colon cancer, there’s […]

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Clinical trials Medicine Surgery

The problem of funding in surgical research

I hate it when I fall behind in my journal reading. Of course, it happens all the time, as you might expect, with my time sandwiched between running my lab, writing grants, seeing patients, and operating. Sometimes, though, I get a chance to try to catch up a bit. Such was the case the other […]

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Cancer Clinical trials Medicine Surgery

On the enormous variability of cancer behavior

Perhaps one of the most common misconceptions held about cancer among lay people is that it is one disease. We often hear non-physicians talk about “curing cancer” as though it were a single disease. Sometimes, we even hear physicians, who should know better, using the same sort of fuzzy thinking and language about “curing cancer” […]

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Cancer Clinical trials Medicine Surgery

Barriers to the adoption of new surgical procedures

Last week, I wrote about factors that lead to the premature adoption of surgical technologies and procedures, the “bandwagon” or “fad” effect among surgeons, if you will. By “premature,” I am referring to widespread adoption “in the trenches,” so to speak, of a procedure before good quality evidence from science and clinical trials show it […]

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Cancer Clinical trials Medicine Surgery

When popularity outpaces science in surgery

In science- and evidence-based medicine, the evaluation of surgical procedures represents a unique challenge that is qualitatively different from the challenges in medical specialties. Perhaps the most daunting of these challenges is that it is often either logistically impossible or unethical to do the gold-standard clinical trial, a double-blind, randomized placebo trial, to test the […]