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Smart medicine is better health.

Welcome to Knowledge of Medicine –your internet resource for everything medicine. We provide the best health/medical resources available on the internet for both the professional and patient communities. Our comprehensive searches and selection of those medical internet sites with extraordinary content are provided as educational and informational tools. Medical care delivery must be educational,participatory and collaborative with all health partners. Take charge of your medical knowledge –only you can do it!

Harlan R. Weinberg,MD,FCCP

Educate –Participate –Communicate

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QuickStats:Death Rates* from Unintentional Falls† Among Adults Aged =65 Years,by Sex — United States,2000–2013

Morbidity and Mortality Weekly Report (MMWR)

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Giving others hope after hepatocellular carcinoma

mikemason429.jpgIn 2004,Mike Mason was diagnosed with hepatocellular carcinoma,a type of liver cancer. His doctors said he had four to six months to live. Just days away from his 60th birthday,he was devastated.

“I thought to myself,‘Happy birthday,Mike. You have cancer,’”he recalls.

Mike accepted the diagnosis,but he refused to accept his prognosis. So,Mike returned home to Coffeyville,Kansas,and contacted MD Anderson for a second opinion.

Mike’s hepatocellular carcinoma treatment
“As luck would have it,I was assigned to Jean-Nicolas Vauthey,M.D.,one of the best at liver resections and liver cancer,”says the retired English teacher.

He started hepatocellular carcinoma treatment in in October 2004. First,he did eight rounds of chemotherapy to shrink the tumor. After that,he had surgery to remove part of his liver.
He was declared cancer-free in February 2006. Mike credits his entire care team,including physician assistant Steven Wei with saving his life.

Paying it forward

Despite the excellent medical care he received,fear and anxiety lingered throughout Mike’s treatment. He didn’t want other patients to feel this way.  

He found an avenue to do that during a chance encounter in the Hospitality Center at MD Anderson.

There,Mike learned of myCancerConnection,MD Anderson’s one-on-one support program that connects trained survivor volunteers with patients who have the same or a similar diagnosis,treatment plan or experience. He learned the program didn’t have anyone with his cancer type to speak with other patients. That’s when he dedicated himself to volunteering.

Now 70 years old,Mike is one of the most active myCancerConnection volunteers. Since he started volunteering in December 2005,he’s been matched with other liver cancer patients 70 times. While most volunteers receive three to five calls a year,Mike has received at least six each year. One year,he handled 15 calls.

“I feel there has to be some reason why I was left here. I think part of it was to share my story,”he says.

During these calls,Mike shares information on education and support programs,resources and second opinion options. He also encourages the patients he speaks with to consider becoming myCancerConnection volunteers. His goal is to end each conversation with the person feeling better than before they spoke.

“I want to be a source of hope for people who got that kicked in the gut feeling you get when someone tells you,you have liver cancer and there’s nothing we can do for you,”Mike says.

“The feeling that maybe you’re extending hope —that’s what this is all about.”

To connect with other cancer patients and caregivers through myCancerConnection,please call 800-345-6324 or visit myCancerConnection online.

To schedule an appointment at MD Anderson,please call 1-877-632-6789 or request an appointment online.

Cancerwise | Cancer blog from MD Anderson Cancer Center

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Susan Bonner-Weir,Ph.D,Receives William Silen Lifetime Achievement in Mentoring Award

Joslin Diabetes Center | Inside Joslin

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Errata:Vol. 64,No. 15

Morbidity and Mortality Weekly Report (MMWR)

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Predictors of Lymph Node Metastasis in Surgically Resected T1 Esophageal Cancer

The application of endoscopic therapies for early cancers of the esophagus is limited by the possible presence of regional lymph node metastases. Our objective was to determine the prevalence and predictors of lymph node metastases in patients with pT1 carcinoma of the esophagus and the gastric cardia.
The Annals of Thoracic Surgery

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Triple-negative breast cancer:5 things you should know

430_ueno.jpgWhen doctors diagnose breast cancer,they look for three types of receptors —estrogen receptor,progesterone receptor and human epidermal growth factor receptor 2 (HER2) —expressed in the breast cancer. These are what cause most breast cancers to grow. They’re also what our doctors typically target when treating breast cancer.

But some breast cancer patients lack these receptors. When this happens,the breast cancer is called triple-negative. And,without any receptors,it can be more challenging to treat. This is why triple-negative breast cancer (TNBC) is one of the cancers we’re focusing on as part of our Moon Shots Program to dramatically reduce cancer deaths.

We recently spoke with Naoto T. Ueno,M.D.,Ph.D.,section chief of Translational Breast Cancer Research in Breast Medical Oncology,to better understand TNBC. Here’s what he had to say.

Are some people more likely to develop TNBC?
TNBC affects women and men of all races and ages. Compared to other types of breast cancer,we tend to see this disease more in premenopausal women than older women. We’re still trying to understand why these groups are more likely to develop TNBC.

Triple-negative patients are more likely to have a BRCA1 or BRCA2 gene mutation compared to non-TNBC patients. But you can still develop TNBC even if you don’t have the BRCA1 or BRCA2 mutation. We’re still trying to understand the link between TNBC and BRCA.
How is TNBC typically treated?
It depends on several factors —tumor size,if and where the cancer has metastasized,and other things we learn about the tumor from pathology reports.

In most cases,chemotherapy is the most effective option. Often,women undergo chemo,then surgery –either a lumpectomy or mastectomy. Some also undergo radiation therapy.

What progress are we making in offering more personalized TNBC treatment?

Through our Breast and Ovarian Cancers Moon Shot,we’re looking at ways to personalize TNBC treatment more. For newly diagnosed patients whose cancer hasn’t metastasized,we plan to use genomic testing of the tumor. This will allow us to find out who will respond well to treatment and who won’t. If we can tell the patient’s not going to respond to standard chemo,we can switch the patient to a novel treatment protocol before surgery. That way,we can get a better response before the surgery. This will be a game-changer if it works.

For these patients,we can classify their breast cancers differently to select the best treatment for them. We know TNBC isn’t one disease,but right now it’s treated as one. In the next phase,we’ll be able to look at biomarkers to divide triple-negative cases based on disease characteristics. We’ll use that to choose the best treatment for each patient.

What clinical trials are available at MD Anderson for TNBC patients?
For those who still have a lot of the cancer left after surgery,we’re working on several clinical trials. These will allow patients to receive a new targeted therapy combined with chemo before surgery. 

For those with metastatic disease,we have many exciting new targeted therapies and immunotherapy-based clinical trials.

Because each trial has very different eligibility requirements,it’s important to talk to your primary oncologists about your options.

What’s your advice for newly diagnosed TNBC patients?
TNBC tends to be aggressive,so find out what stage you’re at. Ask if the cancer has metastasized.

If your TNBC is resistant to chemotherapy or has metastasized,look into clinical trials. Be sure you know and weigh all of your treatment options.

If your cancer hasn’t metastasized,ask if you need surgery or chemo first. TNBC generally responds to chemo,but the disease often comes back. This is why it’s important to get input from both your surgical oncologist and medical oncologist.

I strongly recommend getting multidisciplinary care someplace like MD Anderson. That way,your surgeon,oncologist and radiation oncologist can work together closely throughout your treatment. A team approach is the best way to ensure every aspect of your care has been taken care of.

Triple-negative breast cancer is one of the areas MD Anderson is focusing on as part of our Moon Shots Program to dramatically reduce cancer deaths. Learn more about our Breast and Ovarian Cancers Moon Shot.

To schedule an appointment at MD Anderson,please call 1-877-632-6789 or request an appointment online.

Cancerwise | Cancer blog from MD Anderson Cancer Center

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EARLY RELEASE:Possible Sexual Transmission of Ebola Virus — Liberia,2015

Morbidity and Mortality Weekly Report (MMWR)

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Mammograms at Coastal Diagnostic Center in Pismo Beach,California:FDA Safety Communication –Quality Problems

Patients may need a repeat mammogram or additional medical follow-up.
MedWatch Safety Alert RSS Feed

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Why I don’t feel offended when people say the wrong things about my cancer diagnosis

michele51.jpgBy Michele Longabough

Since my own stage four anal cancer diagnosis five years ago,I have done plenty of reading surrounding what not to say to someone with a stage four cancer diagnosis. Through these articles,I’ve noticed the list can be quite extensive. After all,there are so many types of cancers and personalities.

But the top comments that seem to appear over and again include,but are not limited to:

  • “You can beat this!”
  • “Everything will OK!”
  • “If you pray and believe enough,God will heal you!”
  • “_____ can cure you!”

Sometimes,the wrong words just come out
Trust me when I say this:I have heard it all. And yes,some of the things that people said to me after my anal cancer diagnosis hurt my feelings.

But after thinking about why anybody would say such things,I thought about what I would say if I were faced with a close friend’s diagnosis. I knew I,too,would say the wrong things.
Think about it. Someone discovers I have cancer,it’s stage IV and it’s anal cancer on top of that. Let’s face it,it’s a real stunner.

Almost every word we speak spontaneously is pretty thoughtless. We rarely calculate what we are going to say in such situations. It just comes out.

Why I stopped feeling offended and hurt

I rarely feel offended anymore when people offer up these comments and advice. I always figure they are just wishing the best for me. They’re not really sure what to say,so they speak spontaneously from their hearts. I just try not to overanalyze any advice and words offered to me.

I often don’t even know what to say back to them. So I have been known to,you could say,nurture the awkward words of encouragement spoken to me. I don’t speak out or correct these well-wishers.

When I see someone lashing back on social media to a well-wisher offering comfort,it makes me angry. I think,“Wow. They just said something from a place of helplessness,and that’s what they get back —a public spanking?”

I am not on a mission to slap down well-wishers’words with a chastising rebuttal to their statements. Instead,I thank them and engage them in a conversation about my cancer. It’s a chance for both of us to learn.

Once I decided that I was going to take this approached,I stopped feeling hurt. I’ve stopped thinking people are being thoughtless or ignorant.

Because I feel they intend no harm,I generally say thank you and often end up comforting them about my anal cancer diagnosis. Weird,yes. But I just roll with it. It’s one less thing I have to worry about on my cancer journey.

We all say the wrong things
I know what it feels like to not know what to say. I know what it’s like to have that awkward moment when someone tells you awful news about themselves or a loved one. You feel helpless.

It happened to me just recently. A dear friend’s mother was stricken suddenly with symptoms and then an ominous tumor discovered with testing. When she told me,I embraced her in a big hug and said what was in my heart —all the wrong things.

To schedule an appointment at MD Anderson,please call 1-877-632-6789 or request an appointment online 

Cancerwise | Cancer blog from MD Anderson Cancer Center

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Announcements:Global Road Safety Week — May 4–10,2015

Morbidity and Mortality Weekly Report (MMWR)

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