Heme/Onc

Cancer Survivors – Who are they, what are their needs, and how can medical providers meet these needs?

December 6, 2017
Cancer Survivors – Who are they, what are their needs, and how can medical providers meet these needs?

By Maria Garcia-Jimenez, MD/MHS, Abinav Baweja, MD, and Nicole LaNatra, MD

Peer Reviewed

Clinical vignette

A 65-year old woman with history of invasive breast cancer presents to her primary care provider for regular follow up. She was diagnosed with breast cancer over 10 years ago and received chemotherapy, radiation, and hormonal therapy with aromatase inhibitors. She follows with several providers including an oncologist, surgical oncologists, and a gynecologist. In your clinic, she reports concerns of neuropathy and arthralgia, and mentions that since retiring she worries …

Read more »

Core IM podcast: 5 Pearls on Iron Deficiency Anemia

November 15, 2017

Listen to 5 Pearls segment of Iron Deficiency Anemia! By Dr. Cary Blum MD, Marty Fried MD and Shreya P. Trivedi MD; Illustration by Mike Natter MD

Time Stamps:

  1.  Should patients be screened for iron deficiency? If so, who and how often? (1:40)
  2.  What are the indications for diagnostic endoscopy in iron deficient patients? (3:23)
  3. How should you advice patients to take oral iron? What is optimal dosing? (5:53)
  4.  In which patients would you consider IV iron? What are the risks? (11:41)
  5.  Throwback Question: What is a medication overuse HA? (14:44)

Read more »

Reducing Readmission in Sickle Cell Disease: The Role of the Patient-Centered Medical Home

October 6, 2017
Reducing Readmission in Sickle Cell Disease: The Role of the Patient-Centered Medical Home

By Leonard Naymagon, MD

Peer Reviewed

Vaso-occlusive crisis (VOC), or pain crisis, is the most common clinical manifestation of sickle cell disease (SCD) and is responsible for the majority of emergency department (ED) visits and inpatient hospitalizations among sickle cell patients . A retrospective analysis of over 100,000 in-hospital encounters for VOC in 2005 and 2006 demonstrated 30-day and 14-day rehospitalization rates of 33.4% and 22.1% respectively . These findings were most pronounced among 18- to 30-year-olds, with 41.1% rehospitalized within 30 days and 28.4% …

Read more »

Sex or Drugs: Why Do We See An Increased Incidence of Oropharyngeal Cancer?

July 13, 2016
Sex or Drugs: Why Do We See An Increased Incidence of Oropharyngeal Cancer?

By Tyler Litton, MD

Peer Reviewed

Oropharyngeal squamous cell carcinoma (OPSCC) is relatively rare but incidence has increased in the US over the past 40 years. Tonsillar cancer is the most common type of OPSCC followed by base of tongue cancer, which together account for 90% of all OPSCCs. The incidence of both tonsillar and base of tongue cancers individually have also increased in the US. OPSCC is more common in men than women and smoking and alcohol are well known risk factors for …

Read more »

Shifting Paradigms in Cancer: Vaccines

January 22, 2015
Shifting Paradigms in Cancer: Vaccines

Joshua Horton

Peer Reviewed

We are not winning the war against cancer, if war is even an appropriate metaphor. When Richard Nixon signed the National Cancer Act into effect in 1971, many predicted that cancer would be a thing of the past within 5 years. It was likened to polio, smallpox, and other long-since-forgotten scourges of mankind; with appropriate funding and research, surely cancer, too, would vanish. With that act in 1971, the National Cancer Institute received a budget of $200 million, a figure that …

Read more »

Lung Cancer Screening with Low-Dose CT Scans

May 9, 2014
Lung Cancer Screening with Low-Dose CT Scans

By Susanna Jeurling

Peer Reviewed

The U.S. Preventive Services Task Force (USPSTF) recently finalized its position regarding annual low-dose computed tomography (LDCT) scanning for early detection of lung cancer. The grade B recommendation states that individuals between the ages of 55 and 80 with a 30 pack-year history or more of smoking who are current smokers or who have quit within the last 15 years should undergo annual LDCT screening, based on the results of the National Lung Screening Trial . Lung cancer is the …

Read more »

From The Archives: Should My Patient with a Solid Tumor be Anticoagulated in the Absence of Venous Thromboembolism?

March 6, 2014
From The Archives: Should My Patient with a Solid Tumor be Anticoagulated in the Absence of Venous Thromboembolism?

Please enjoy this post from the archives dated September 8, 2011

By David Altszuler, Class of 2012

Faculty Peer Reviewed

An empiric association between occult malignancy and thrombophlebitis has been recognized since Trousseau first reported the syndrome in 1865. The mechanism by which cancer predisposes to thrombophilia has not been fully elucidated; however, it is now clear that this is a symbiotic relationship. The second leading cause of death in hospitalized cancer patients (and a leading cause of death in ambulatory cancer patients) is venous …

Read more »

An antidote on the horizon? An update on the progress toward achieving reversibility for the new oral anticoagulants

February 21, 2014
An antidote on the horizon? An update on the progress toward achieving reversibility for the new oral anticoagulants

By Gabriel Schneider, MD

Peer Reviewed

The new oral anticoagulants (NOACs) are an appealing alternative to the burdensome vitamin K antagonists such as warfarin. These novel agents include direct thrombin inhibitors such as dabigatran (which inhibits thrombin) and factor Xa inhibitors such as rivaroxaban and apixaban (which prevent thrombin generation). Compared to warfarin, NOACs have fewer food and drug interactions, as well as a more predictable pharmacodynamic profile that serves to obviate the need for the frequent outpatient monitoring in most patients. In addition …

Read more »