Friday 28 November 2014

Saying NO to excessive Pharmaceutical Costs

Hospital says NO to excessive Pharmaceutical costings
This story has been doing the rounds for a while, and things seem to be getting slightly clearer now. Great stance for these doctors and the hospital to support them to refuse the massive costs of some medications (for minimal extra advantage). What if everyone took a stance against these costs? Is that feasible? Is it wise?

Worth thinking about.

Sunday 23 November 2014

Single Best Medical Resource

I have found that the single best medical resource that I use is UpToDate.
www.uptodate.com
Full access is expensive, but it is definitely worth the money spent. Online, Desktop and mobile phone access is available.
There is a cheaper version for doctors-in-training or if you buy access in groups.

Wednesday 19 November 2014

Monday 10 November 2014

Oesophageal Cancer - New Standard of Care

The standard therapy of offering patients Cisplatin with 5Fluorouracil with Radiotherapy has been around for a long time. Has worked well over time, but not well enough.

The recent CROSS study has proven that Carboplatin and Paclitaxel with Radiotherapy (neoadjuvant or definitive) is the new standard of care. It is much more effective for squamous cell cancers as compared to adenocarcinomas (but works well in both conditions).

This regimen is well tolerated and most patients complete therapy. I have now changed my clinical practice and use this regimen as the default.

Sunday 9 November 2014

Some Partners and Cancer Sufferers

What is wrong with some guys? I met with three women with cancer in the past two weeks, who were diagnosed with nasty cancer - and their partners have walked out on them (after diagnosis). This is when these women need the maximum amount of support. This is when their world is falling apart... more of it falls apart :(
Some of these stories are so sad, that it drives us to despair.
This is supposedly delinked from the medical world, but it is absolutely interlinked with our care. If a patient is falling to bits in her/his mind, how can they deal with everything else?
The nurses in the Unit are just amazing and have adopted these women as part of our larger family. All we can do is support them through this incredibly difficult time, the best we can.