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  • Making Difficult Decisions

    Posted 3/3/2015 by hhill
      It is not quite noon on Tuesday, and I have already spent a lot of time this week thinking and talking with patients about making difficult medical decisions. The first instance was a phone call with a 50 year old woman whom I have not met. She has been recently diagnosed with a Stage I breast cancer, and her oncologist has strongly recommended that she take an endocrine therapy, one of the so-called AIs. She is very reluctant to do so, wants to focus on "healthy living", but could not identify specific concerns or fears. We talked at some length, and my role seemed to be to remind her that I am not a doctor, encourage her to speak more with her doctors, but to share some of my observations over the years (that can be summarized by cancer is a sneaky and unpredictable foe) and to reassure her that most women do fine with these medications. Read more... Comments (0)
  • The Cost of Cancer Drugs

    Posted 3/2/2015 by hhill
      Everyone is aware of the escalating concerns about the cost of health care in the US. Drugs in general, and cancer drugs in specific, are one of the factors related to this growing crisis. I suspect that almost everyone agrees that we have a system that cannot continue indefinitely without some changes. I also suspect that shared beliefs quickly collide when we try to be more detailed about costs. "Value" is the word most often being used in conversation. What is the "value" of any particular treatment? Should there be criteria that are applied to all possibilities? Is it more of a case by case decision? And who gets to make the decision? Read more... Comments (0)
  • Managing Hair Loss

    Posted 2/27/2015 by hhill
      This is a repeated entry, with some updates, but a recurring topic of interest. Since I suspect that people new to cancer find this blog, I hope that these tips will be of value to women facing chemotherapy and hair loss for the first time. Just this week, I met with five women in this situation. They are all worried about chemo in general, but losing their hair looms largest and hardest. Read more... Comments (0)
  • Two Wonderful Essays

    Posted 2/26/2015 by hhill
      It feels a little bit lazy when my day's entry is really just sharing something wonderful that I have read. When the "something" is a medically important article, I can at least write an introduction that fleshes it out a bit and maybe adds interest. Today, I just want to share two pieces that I have found incredibly moving. Especially for the second one, you may want a tissue in hand. Read more... Comments (0)
  • Cancer Survival Rates Improving

    Posted 2/26/2015 by hhill
      This is all excellent news: a new study reported in JAMA Oncology indicates that five year survival rates for (almost) all types of cancer are improving. That is the good news. The less good news is that the incidence of cancer is not declining, and the survival rates are not good enough. Read more... Comments (0)
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Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215

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