Word: breast
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What if doctors had a pill that prevents breast cancer and nobody wanted to take it? That has pretty much been the situation with tamoxifen, an estrogen-like drug that was proved in 1998 to cut in half the chance of developing breast cancer if taken for five years by women with increased risk of the malignancy. The trouble is, tamoxifen also triggers menopausal symptoms like hot flashes and slightly increases the chances that a woman will develop blood clots and uterine cancer. As a result, women haven't been too eager to take the medication--nor have many doctors...
...comes word that another estrogen-like drug, called raloxifene, is as effective as tamoxifen at reducing the risk of breast cancer--at least in high-risk, postmenopausal women--with fewer of those side effects. According to preliminary results from the Study of Tamoxifen and Raloxifene (STAR), raloxifene triggered fewer uterine cancers, blood clots and hot flashes than tamoxifen. It also decreased the chances of developing cataracts...
...clinical uncertainties need to be addressed as well. Tamoxifen reduces the risk of noninvasive breast cancers (ductal carcinoma in situ and lobular carcinoma in situ), while raloxifene does not. "Expert opinion is going to be very important in interpreting this," says Dr. Len Lichtenfeld of the American Cancer Society. "We're certainly looking forward to all the information being examined and discussed...
Friedman's doctors weren't incompetent. They didn't operate on the wrong breast or give her the wrong drugs or commit any egregious medical errors--and that is the whole point. While there are bad doctors practicing bad medicine who go undetected, that's not what scares other physicians the most. Instead, they have watched the system become deformed over the years by fear of litigation, by insurance costs, by rising competition, by billowing bureaucracy and even by improvements in technology that introduce new risks even as they reduce old ones. So doctors resist having tests done if they...
...doctor who does a biopsy may be paid as much as $1,600 for 15 minutes' work, notes Dr. Jerome Groopman of Harvard Medical School. "If you're an internist, you can easily spend an hour with a family where a member has been diagnosed with Alzheimer's or breast cancer, and be paid $100. So there's this disconnect between what's valued and reimbursement...