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Dr. Carol
Licensed physician, hematologist & oncologist, author of book "Ask An Oncologist"
Recent Activity
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Many cancer scientists regard these checkpoint inhibitors as the biggest breakthroughs in cancer treatment in this century! Continue reading
Posted Jan 29, 2020 at Ask An Oncologist
Breast cancer treatment has moved on from a paternalistic, "doctor knows best," attitude to doctors asking, "how can we do the least amount of treatment with the maximum chance of cure and the fewest side effects?" Continue reading
Posted Dec 30, 2018 at Ask An Oncologist
You don't need a referral to see an oncologist, though you might have to wait longer if you are self-referred. Your insurance may not pay for it, though, if you don't have a diagnosis of cancer (or a suspicion of a diagnosis). But an oncologist is the wrong person to see for this type of medical care, since it is not part of our specialty. Cancer screening, cancer prevention, and referrals for genetic counseling for cancer risk assessment are done by a primary care doctor (internist, family doctor, etc.). Or you can make an appointment with a genetic counselor to help you determine if you might have a cancer gene and the type of screening tests that are recommended if you do carry this gene. The best first step, though, would be to talk to the doctor who cared for your family member and see if this was a cancer that might run in families--if you can't reach that doctor, then ask your family doctor to contact her or him. Good luck.
Toggle Commented Jul 19, 2018 on About Me at Ask An Oncologist
Valsartran is a heart and blood pressure drug that was recalled by the FDA because it was found to contain NMDA, a carcinogen.What should you do if you are taking Valsartran? Continue reading
Posted Jul 16, 2018 at Ask An Oncologist
HEY CHICAGO READERS! I'm giving a free Q&A lecture on cancer @Mather's--More Than a Café “Ask An Oncologist: Your Cancer Questions Answered” July 31, 2018 1 pm Mather’s More Than a Café 3235 N. Central Ave. Chicago, Il. It's free — but call to reserve a place, space is limited.... Continue reading
Posted Jul 12, 2018 at Ask An Oncologist
The classification is based on the objective description of the tumor, not on how it got there. Yours is ulcerated. So it is a IB instead of a IA, suggesting that it MIGHT be more aggressive than a IA, and your physician should be more cautious, and perhaps watch you a bit more carefully. It is still early stage. And you should probably be thankful that it was ulcerated, because you might not have noticed or paid any attention until it got much larger, or it might have grown much deeper into your skin until it was noticed. Good luck, and I hope you do well.
Toggle Commented Apr 25, 2018 on About Me at Ask An Oncologist
Your doctor has been nagging you to get that screening colonoscopy and you've been avoiding it. Now you have an alternative: Cologuard™ What is it? Should you do it? Can it replace colonoscopy? Why should you even get screened at all? Continue reading
Posted Mar 28, 2018 at Ask An Oncologist
A recent question from reader Dana Phillips, who asks, I’ve read that sugar fuel cancer. Have there been studies to see if consuming sugar, to promote cell division, during chemo therapy would enhance its effectiveness?" My answer: Great question, Dana. "Sugar makes cancer cells grow" is an urban legend, and... Continue reading
Posted Jan 5, 2018 at Ask An Oncologist
Thanks for your very intriguing question. "Sugar makes cancer cells grow" is an urban legend, and I don't know where it got started. ALL cells in the body need sugar to grow, and the brain absolutely needs it to function. The fact is that cancer cells often (not always) grow faster, or with less control, than normal cells, regardless of how much sugar is available to them. Sometimes chemotherapy takes advantage of differing metabolism between cancerous and normal cells to kill cancer cells. Anti-metabolite chemo drugs like methotrexate can kill some cancer cells by preventing them from getting nutrients; in this case it's folate, a B vitamin. There are some chemo drugs that only kill growing cells, and those are not combined with drugs that stop cancer cells from growing, for obvious reasons. But stimulating cancer cell growth will also stimulate normal cell growth, and the chemo will kill more normal cells, too, thereby increasing the toxicity. Strategies like this have been investigated for decades, with little success. In short, if you're on chemotherapy and want to improve your chances by eating a lot of sugar, you are unlikely to make a difference one way or another. And if it makes you feel that you are doing something good for yourself, then go ahead by all means.
Toggle Commented Jan 5, 2018 on Your Cancer Questions at Ask An Oncologist
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Osteoporosis is a condition in which the bones become brittle due to loss of calcium. In osteoporosis, fractures happen easily with only a minor fall, and a hip fracture can kill you or lead you to a lifetime in a nursing home. That's why it's important to detect and treat osteoporosis early. Continue reading
Posted Oct 19, 2017 at Ask An Oncologist
Beth said... Are you still taking questions? Comments are closed on the blog post that the link sends me to. If you are taking questions, this would be mine: I am 45 and don’t have cancer. My mom died of lymphoma when she was 54. My grandmother died of an unknown cancer at 35. My great grandmother died of an unknown cancer at 59. These are unknown because no one told my mom what the cancers were, not that the doctors at the time did or didn’t know. When I mention this to my doctors the response is always, “Lymphoma is not a hereditary cancer.” End of discussion. I have never found this reassuring. If I am going to be your patient in ten years, what would you like me to have spent the last decade doing? Thanks My answer: Your doctor is correct, lymphoma is not a heritable cancer, though it may be increased in some cancer-prone families. I think it was just bad odds that your mother just happened to contract the disease. Two of your family members died of cancer, but that does not make it a cancer family, since I don't know how many of your relatives did not have cancer. Still, if I were you, the first thing I'd do is see a genetic counselor who specializes in cancer families (your local cancer center can put you in touch). Then, I'd try to get some DNA testing to see if I carried some of the common cancer-related mutations, such as breast / ovarian cancer. You can try 23AndMe, for example. If you have a breast cancer gene mutation then there are things you could do to help prevent the cancer, including more screening and perhaps some medications or surgery. If I could afford it, I would pay for more extensive DNA testing, such as complete genome sequencing (Illumina, for example). Doubt if your insurance would cover it. But the real question is: do you really want to know if you have a cancer gene in your family? This information could be very disruptive if there is nothing you can do to prevent it. This is something to discuss with the genetic counselor. Otherwise, no lifestyle change is going to help if you don't have a target cancer to try to prevent.
Toggle Commented Sep 27, 2017 on Your Cancer Questions at Ask An Oncologist
Your doctor is correct, lymphoma is not a heritable cancer, though it may be increased in some cancer-prone families. I think it was just bad odds that your mother just happened to contract the disease. Two of your family members died of cancer, but that does not make it a cancer family, since I don't know how many of your relatives did not have cancer. Still, if I were you, the first thing I'd do is see a genetic counselor who specializes in cancer families (your local cancer center can put you in touch). Then, I'd try to get some DNA testing to see if I carried some of the common cancer-related mutations, such as breast / ovarian cancer. You can try 23AndMe, for example. If you have a breast cancer gene mutation then there are things you could do to help prevent the cancer, including more screening and perhaps some medications or surgery. If I could afford it, I would pay for more extensive DNA testing, such as complete genome sequencing (Illumina, for example). Doubt if your insurance would cover it. But the real question is: do you really want to know if you have a cancer gene in your family? This information could be very disruptive if there is nothing you can do to prevent it. This is something to discuss with the genetic counselor. Otherwise, no lifestyle change is going to help if you don't have a target cancer to try to prevent.
Toggle Commented Sep 27, 2017 on About Me at Ask An Oncologist
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The caregiver is one of the most important members of a cancer patient's care team. The caregiver drives the patient, spends hours in the waiting room, is available for emergencies, coordinates schedules, and many other tasks. This is a tremendous responsibility. Here are ten tips to help you survive. Continue reading
Posted Sep 20, 2017 at Ask An Oncologist
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Did you know that you have the legal right to see your medical records? ALL of your records: test results, X-rays, hospital notes, and even doctors' notes. Do you know what's in your records? Do you know how to access them? Do you even want to see them? What's in... Continue reading
Posted Jun 10, 2017 at Ask An Oncologist
Thanks. But in case you haven't noticed, the healthcare system I proposed is remarkably like the British system -- which has free med school tuition, accessible care, excellent medical research, and the newest scans and toys. Scans won't price us out of business because, if there's no profit to be made there won't be so many unnecessary tests ordered! Don't worry about research. There will always be research, just like there will always be music, and there will always be Paris. That's how we're put together. I couldn't live without scientific research, it was my life... there will be a way to continue it.
All good points. But as long as insurance is a for-profit business, caps aren't going to help. They'll just quit offering (like they did for Obamacare). Maybe a cap on how much of their intake can be used for shareholder's profits. R&D -- good idea. But remember the high pries we pay don't reflect the R&D, they reflect the fact that the US does not negotiate prices with pharma, unlike most other countries.
No thanks, I'm not getting into funding. All I can say is that we all pay for health care one way or another. Lower tuition = more doctors and more realistic doctors' salaries = less expensive health care. Nobody likes the idea of taxes paying for everyone's health care, but in reality we do.
Good points you make. Of course you are right about elected officials--they may understand more than you give them credit for, but they are often in the pockets of the pharma and insurance lobbies. I get your point about PAs and NPs, but my point was that this can lead to poor quality care: PA's get 2-years of training; NPs get extra speciality training, but nothing like 4 years of med school, 4 years of residency, and extensive certification. PAs and NPs are trained to assist the MD, and do routine service under a doctor's supervision, and they do this well. But when patients are encouraged to use them as substitutes for doctors--because it's cheap and easy, and cuts costs for health care corporations--the result can be disastrous. Or in routine settings, having PA s and NPs means the doctor has a crammed schedule so the patient sees the doctor for only 2 minutes, or not at all, then this is not good quality care.
Thank you, Ann. I don't believe the health care problem is getting any better, and it's coming to a head. I've been thinking about this for decades. Just adding my voice to the clatter.
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The biggest mistake Obamacare made is that it mandated that all of our health care be determined by insurance companies. Instead, we should think out of the box and come up with an alternative that provides affordable and accessible health care for all. Continue reading
Posted Apr 1, 2017 at Ask An Oncologist
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Thanks. I was hoping this would be helpful, since I had these questions so often from patients myself.
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A quick guide using plain English to help you interpret the screening blood chemistry tests that your doctor ordered. Continue reading
Posted Feb 24, 2017 at Ask An Oncologist
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You can't afford to have cancer without insurance. Medical bills from cancer run from tens of thousands to hundreds of thousands of dollars What is the future of Cancer Care if Obamacare is repealed? Continue reading
Posted Jan 10, 2017 at Ask An Oncologist
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Lymphoma treatment on fast-track for approval, changes patient's cells into fighters that eradicate the cancer cells. Continue reading
Posted Dec 6, 2016 at Ask An Oncologist
Alternative, natural, holistic or herbal treatments. Should you try them? DON'T! Here's why. Continue reading
Posted Nov 21, 2016 at Ask An Oncologist