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ASCOconnection.org is a forum for the exchange of views on topical issues in the field of oncology. The views expressed in the blogs, comments, and forums belong to the authors. They do not necessarily reflect the views or positions of the American Society of Clinical Oncology. Please read the Commenting Guidelines.

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That question is perhaps the most common one raised by patients facing a diagnosis of cancer for the first time. There are so many campaigns about how to “avoid” cancer: no white sugar, no chemicals, all-plant diets, regular exercise, don’t smoke, don’t drink. I can see how one can get the...
I recently attended the David Stroud Adolescent and Young Adult [AYA] Symposium at Keck Medicine of University of Southern California...
It’s hard to believe that two months have passed since my second blog. If you’ve been reading along, you know that I recently began a dialogue regarding challenges to the profession of medicine and the delivery of health care.
It was a particularly harrowing morning, and I was already running 40 minutes behind after my first couple of patients. My nurse practitioner was out, so I had added a number of her routine follow-up visits to my normal schedule, and I was having trouble keeping up.
She was so young—only 32 when diagnosed with ovarian cancer. She had given birth to a son only four months earlier and by all rights should have been celebrating being a new mother. But, instead, she had developed acute pelvic pain, undergone emergent removal of her uterus and ovaries, and was now...
For years now, we have had a raging debate in the renal cell carcinoma (RCC) community regarding the use of adjuvant therapy. In a patient with no evidence of metastatic disease following surgery, the standard...
I happened to be standing in her office when Tina, our research nurse, received an email from one of our patients. This patient had recurrent ovarian cancer and was on her third-line of treatment. She was seen at our center for clinical trials, and Tina and I had spent some time discussing one...
I received an email this week and this is all it said:  “I’m 51 years old and I was diagnosed with breast cancer 8 years ago, I love my husband very much I have no sex drive I do not want to be touched by him I hate sex it hurts is not comfortable it's not enjoyable, I have talked to my spouse...
Every so often I see a patient who views cancer as a constant threat to be handled. The cancer becomes so significant that she feels she can never let her guard down. I always worry about this—partly because that singular focus on fighting cancer can sometimes detract one from other aspects of life...
She had come to see me in consultation. A professor at a local university, she was well until four years earlier, when she developed abdominal bloating and pain—tell-tale signs of ovarian cancer. Surgery followed, then adjuvant chemotherapy with intraperitoneal treatments (“Terrible regimen,” she...
We’ve come a long way from the 1940s and 1950s when men didn’t cry—not when they stubbed a toe or came back from the war, and certainly not in front of strangers. In the last 20-plus years we have seen a loosening up of the "stiff upper lip" prescription and we now see men crying in all sorts of...
I’ve been doing a lot of thinking about resilience lately, in part, because of this article that appeared in the Harvard Business Review, which found that resilience is critical to individual and organizational success....
I am often asked by friends and acquaintances how I am able to do what I do for a living, which is care for patients with advanced lung cancer. Depending on the setting and how well I know the person asking, I might say that the treatments are improving all the time (i.e., the casual dinner party...
Mom. Dad. Happy. Sad. Friend. Trust. I remember playing this game. A friend would say one thing, and then I would say the first thing that came to my mind. For some reason, it would pass the time. I remember how some words would spark an emotion or a memory. Sometimes happy, sometimes not so happy...
University of California, San Francisco 1968: The days of rage, Haight-Ashbury nearby; a second-year medical student in pathology naively asking the section pathologist, “Who was this Virchow guy who had so many eponyms?” A quixotic look, the enigmatic answer, and later in the library (no Internet...
I am looking out of my window on a cold and cloudy Boston afternoon and find myself pondering about life—how unpredictable it is, and how one minute can hold no assurance for what happens after. Before I left for vacation, I saw Joan.* She has been under my care for a number of years, living with...
A friend of mine died after outliving her prognosis for more than a year. I was with her at almost all her appointments with various oncologists. She had asked me to be the notetaker for these appointments so that she could focus on the discussion as it happened and then have the notes to review...
“Physicians and health care systems will be held increasingly accountable for the results of medical decision-making and success in improving patient disease outcomes...”

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