Hematology/Oncology Clinical Features Archive

Risk of Alzheimer dementia after androgen deprivation therapy

Risk of Alzheimer dementia after androgen deprivation therapy

A recent cohort study evaluated the risk of developing Alzheimer dementia after ADT in 16,888 men with prostate cancer, 14.2% of whom were treated with ADT.

Physical activity's effect on cancer mortality

Physical activity's effect on cancer mortality

Exercise may not only prevent cancer from developing, but it may also reduce the risk of death after cancer is diagnosed.

Skin cancer detection: every clinician's responsibility

Skin cancer detection: every clinician's responsibility

More cases of skin cancer are diagnosed each year than of breast, prostate, lung, and colon cancers combined, and early detection is critical.

Gorlin basal cell nevus syndrome: diagnosis and management

Gorlin basal cell nevus syndrome: diagnosis and management

Learn about nevoid basal cell carcinoma syndrome, including how to diagnose and manage this genetic condition.

MRI after breast cancer diagnosis

MRI after breast cancer diagnosis

Despite the guideline, clinicians may choose to order MRI's for patients with dense breasts.

Contaminated water and cancer

Contaminated water and cancer

Contaminated water leads to high rates of birth defects, thyroid cancer, and spontaneous abortions.

Primary care clinician risk assessment for hereditary breast cancer

Primary care clinician risk assessment for hereditary breast cancer

Primary care clinicians should be proficient at assessing the potential for hereditary breast cancer risk in their patients.

Palliative chemotherapy may reduce quality of life in some patients with end-stage cancer

Palliative chemotherapy may reduce quality of life in some patients with end-stage cancer

Palliative chemotherapy in the last month of life may increase the patient's risk of intensive medical treatment and death in an ICU.

Denosumab may reduce the risk of fracture in women with breast cancer on aromatase inhibitor therapy

Denosumab may reduce the risk of fracture in women with breast cancer on aromatase inhibitor therapy

Denosumab has been shown to reduce fracture risk in women with breast cancer with bone metastases.

Cervical cancer screening: Why less is best

Cervical cancer screening: Why less is best

ACOG's current recommendations regarding Pap smear testing for cervical cancer may be the best evidence-based practice for patients.

Nivolumab versus docetaxel in patients with advanced squamous cell non-small cell lung cancer

Nivolumab versus docetaxel in patients with advanced squamous cell non-small cell lung cancer

Recent studies show that nivolumab was associated with increased overall survival rate when compared to docetaxel in patients with advanced squamous cell non-small cell lung cancer.

Beach medicine pearls (and seashell lacerations)

Beach medicine pearls (and seashell lacerations)

Fun at the beach exposes children and adults to a number of hazards—some avoidable, such as sunburn, and some less so.

Astragalus may help treat cancer, heart failure

Astragalus may help treat cancer, heart failure

Research is being done on the use of astragalus root for the treatment of cancer and congestive heart failure.

Methylsulfonylmethane may alleviate osteoarthritis burden

Methylsulfonylmethane may alleviate osteoarthritis burden

Methylsulfonylmethane may help treat osteoarthritis and may eventually create a way to detect melanoma.

Mammogram referral
 results not conveyed

Mammogram referral
 results not conveyed

A patient was referred 
for a mammogram, but 
clinicians fail to follow up on the report.

Diabetes program helped beat cancer

Diabetes program helped beat cancer


Encouraging a patient to get an overdue Pap exam resulted in an early discovery of uterine cancer that could have gone undetected.

Breast cancer risk falls with NSAIDs

Breast cancer risk falls with NSAIDs

One study of 6,459 U.S. women aged 55 years to 81 years revealed that the use of alendronate or placebo did not affect the proportion of women who developed breast cancer (1.8% and 1.5%, respectively).

Medical error arises from lack of awareness

Medical error arises from lack of awareness

A clinician who did not know a certain policy causes a chemotherapy problem.

Thinking through a diagnosis

Thinking through a diagnosis

After reviewing a patient's history, this clinician prevented a potentially fatal mistake.

Following your instincts

Following your instincts

An NP and her patient "knew something was wrong" and pursued an MRA that detected cancer.

Primary care after PCa

Primary care after PCa

PCPs should encourage physical activity, smoking cessation, and a healthy diet for PCa survivors.

What does persistent polyclonal B-cell lymphocytosis look like?

What does persistent polyclonal B-cell lymphocytosis look like?


Middle-aged females who smoke are the most common demographic group diagnosed with persistent polyclonal B-cell lymphocytosis.

Diagnosing left eye retinoblastoma in an uninsured child

Diagnosing left eye retinoblastoma in an uninsured child

Taking the time to notice an outward gaze in the left eye, this nurse practitioner helped save a child.

'My gynecologist saved my life'

'My gynecologist saved my life'

A second look at nodules in the thyroid found cancer.

Diagnosing liver cancer

Diagnosing liver cancer

After an elevated liver enzyme report, a practitioner order a CT that confirmed liver cancer.

The two most common forms of skin cancer

The two most common forms of skin cancer

The start of the "sun-worshipping season" is a good time to review the primary-care basics of basal cell and squamous cell carcinomas.

What to know about home genetic-test kits

What to know about home genetic-test kits

Consumers becoming more involved in do-it-yourself genetic testing need primary-care clinicians to put the results into context for them.

Save a life with early detection of melanoma

Save a life with early detection of melanoma

Brush up on the basics of preventing, recognizing and addressing melanoma among your patient ranks.

Prostate cancer data, dilemmas and decisions

Prostate cancer data, dilemmas and decisions

Prostate cancer is the most common male-related malignancy in the US, the second most common cause of cancer-related death among men.

What you should know about medical marijuana

What you should know about medical marijuana

Federal criminalization of this drug—most commonly used in the treatment
of HIV, pain and glaucoma—has limited research into its effectiveness.

Seeing patients as people

Seeing patients as people

Understanding the intricacies of different disease states is crucial, but we must never forget we are treating people that are connected to the world.

An unproductive cough leads to a life-threatening diagnosis

An unproductive cough leads to a life-threatening diagnosis

An oncologist and hematologist are consulted when an otherwise healthy 19-year-old patient presents with a cough that won't go away and an enlarged left arm.

Heavy menses and uterine bleeding signal a greater problem

Heavy menses and uterine bleeding signal a greater problem

A thorough work-up helps a clinician make an unusual diagnosis in a young patient.

Breast CA radiation Tx associated with CV risk

Breast CA radiation Tx associated with CV risk

Incidental exposure of the heart to radiation is a common unintended consequence of radiation therapy for breast cancer.

Alleviating diarrhea subsequent to radiation

Alleviating diarrhea subsequent to radiation

For patient's with chemotherapy induced diarrhea, try alternating between these two medications before moving on to something stronger.

Early diagnosis of malignant melanoma

Early diagnosis of malignant melanoma

Surveillance on the part of primary-care clinicians is critical to the 
timely identification of cancerous lesions in at-risk individuals.

Improving the quality of geriatric cancer survivorship

Improving the quality of geriatric cancer survivorship

A collaborative approach to cancer treatment, incorporating the entire oncology team and the PCP, provides the best outcomes for quality patient care.

Is there an occupational cancer risk with flying?

Is there an occupational cancer risk with flying?

Has any research been conducted to determine whether the incidence of various types of skin cancer is greater in people who fly for a living compared with the general public?

Severe colon cancer goes undetected

Severe colon cancer goes undetected

A clinician finds herself culpable after agreeing to an unorthodox ­arrangement with a patient.

Primary-care prevention of cervical cancer

Primary-care prevention of cervical cancer

To reduce the mortality and incidence of this disease, clinicians must be aware of the most recent vaccination and screening guidelines.

Should fatty liver be considered in spontaneous bleeding?

Should fatty liver be considered in spontaneous bleeding?

A who takes acetaminophen for chronic neck and back pain awakens to a bloody nose and blood-soaked pillow. Could liver disease be to blame?

When to advise palliative care

When to advise palliative care

When do patients benefit most from palliative care consults?

Extreme weight loss in an elderly woman over a 24-month period

Extreme weight loss in an elderly woman over a 24-month period

A 65-year-old widow presented with a mass on her right breast and complaints of generally not feeling well.

What's causing elevated creatine levels?

What's causing elevated creatine levels?

A patient has elevated creatine and fasciculations. Could an electrolyte imbalance be the cause?

Examining the prostate of an obese man

Examining the prostate of an obese man

Excess fat around the gluteal region can make performing digital rectal exams in obese patients difficult. How can this challenge be overcome?

Presyncope coupled with an enlarged spleen suggests infection

Presyncope coupled with an enlarged spleen suggests infection

A 69-year-old woman presents with night sweats, dizziness, fatigue and chronic pain in the upper abdomen.

Marigold: Calendula may help mitigate dermatitis, other ailments

Marigold: Calendula may help mitigate dermatitis, other ailments

Medicinal properties of marigold-derived compounds include antiviral, anti-inflammatory and antitumor effects.

Improving melanoma awareness in men

Improving melanoma awareness in men

Men typically seek treatment after melanoma has already progressed to later stages, accounting for higher mortally rates compared with women.

Asymptomatic red lesions

Asymptomatic red lesions

Two patients present with asymptomatic red lesions -- a 60-year-old man, whose lesion was present for five years before beginning to bleed, and a 27-year-old man whose lesion doubled in size during a two year period. Can you differentiate between the two?

Oral involvement of ­systemic diseases

Oral involvement of ­systemic diseases

Oral manifestations are often an early signal of systemic disease, so ­recognizing them can point the way to a prompt diagnosis.

Secondary malignancy following breast and uterine cancer

Could a patient's anterior thigh pain signify osteosarcoma?

A routine check-up 
reveals a significant 
genetic abnormality

A routine check-up 
reveals a significant 
genetic abnormality

A corrections officer came into the primary care office for a routine physical and left with an unexpected diagnosis.

Contraception choices and breast cancer

Are certain oral contraceptive pills better for women with a family history of breast cancer?

A patient ignores a suspicious breast lump

A patient ignores a suspicious breast lump

When a patient does 
not comply with medical 
recommendations, how 
do you protect yourself?

What causes a metallic taste and burning tongue?

What are the differential diagnoses for a woman aged 60 years with a metallic taste in her mouth and the sensation of a burning tongue?

Symptoms suggesting urolithiasis mask a 
life-threatening ailment

Symptoms suggesting urolithiasis mask a 
life-threatening ailment

Two days after symptom onset, a patient's skin is still mildly diaphoretic, he complains of fatigue and he cannot tolerate food.

Making the right choice in hormone therapy

Making the right choice in hormone therapy

A young cancer survivor prompts consideration of best practice in prescribing estrogen replacement therapy for herself and for others.

Next step for endometrial hyperplasia

How would you proceed with a 64-year-old woman who has complex endometrial hyperplasia and secretory changes?

Newly developed brown papules

Newly developed brown papules

Two patients present with newly developed brown papules. The first patient, a 45-year-old man, presented with a new mole that continues to grow and is associated with occasional pruritus and bleeding. The second patient, a 47-year-old man, presented with a 6-month history of a brown, growing "mole." Can you differentiate between the two?

A running accident leads to the discovery of a humeral lesion

A running accident leads to the discovery of a humeral lesion

A woman fractured her upper arm in a fall while exercising. A large osteolytic growth was discovered on x-ray.

Evaluating salivary gland tumors and diseases

Evaluating salivary gland tumors and diseases

When diagnosing, consider the location and duration of the lesion, patient age, underlying systemic disorders and clinical appearance.

When to screen for prostate cancer

When to screen for prostate cancer

In an update of its 2001 guidelines, the American Cancer Society stresses the importance of sharing the screening decision with the patient.

Which radiologic test to use for abdominal pain

How do I know which radiologic tests to choose when evaluating abdominal pain?

An algorithm for managing breast pain

An algorithm for managing breast pain

Breast pain can be an frightening experience, but the primary-care provider can often allay the patient's fears and capably manage the condition.

Kidney mass detected on ultrasound doubles in size over nine months

Kidney mass detected on ultrasound doubles in size over nine months

Imaging was ordered when the patient's clinician could not palpate her ovaries.

Coffee: Potent chemical properties may offer health benefits

Coffee: Potent chemical properties may offer health benefits

Drinking coffee has shown to be protective against Parkinson disease, Alzheimer disease and certain forms of cancer.

What to do after a positive FOBT

Should a man with a positive fecal occult blood test and a normal colonscopy without GI symptoms be referred to a gastroenterologist?

When is it appropriate to repeat a Pap smear?

When is it appropriate to repeat a Pap smear?

When reviewing Pap smear results with absent endocervical cells, what is the recommended next step?

New-onset alopecia in women

What is the appropriate workup in an otherwise healthy woman aged 75 years with new-onset hair loss?

Brewer's yeast: Medical uses in cancer, therapy for premenstrual syndrome and antibiotic-associated diarrhea

Brewer's yeast: Medical uses in cancer, therapy for premenstrual syndrome and antibiotic-associated diarrhea

Brewer's yeast, or Saccharomyces cerevisiae, is specifically grown as a nutritional substance rich in chromium, selenium, proteins and B-complex vitamins.

Stat Consult: Polycystic ovary syndrome

Stat Consult: Polycystic ovary syndrome

A quick review of polycystic ovary syndrome, a heterogeneous androgen excess syndrome that can cause hirsutism, secondary amenorrhea, obesity, hyperinsulinemia and infertility, providing the latest global evidence for diagnosis and treatment.

Metformin's impact on levels of vitamin B12

How much B12 supplement is adequate for patients on metformin?

Refusal of care during periods of acute confusion

Clinician seeks advice regarding a patient that refuses chemotherapy for multiple myeloma because of concerns that her hair will fall out.

Abdominal mass in a pregnant woman forces induction

Abdominal mass in a pregnant woman forces induction

After developing pancreatitis, the patient was admitted to the hospital and the tumor removed.

GI referral in a woman with iron-deficiency anemia

When should a menstruating woman with iron-deficiency anemia be referred for GI workup?

When tests are clearly necessary

When tests are clearly necessary

Two clinicians failed to refer a longstanding patient, even though they knew of a history of familial risk.

Mild fatigue follows progressively heavy monthly periods

Mild fatigue follows progressively heavy monthly periods

The patient's family practitioner advised a multivitamin with iron, but she did not comply.

Blisters on the hands and fingers of a woman with discolored urine

Blisters on the hands and fingers of a woman with discolored urine

Mild hypertrichosis and hyperpigmentation of the face were also noted, and plasma porphyrins were grossly elevated.

Early-stage breast cancer treatment

Early-stage breast cancer treatment

Given the complex nature of the disease, the ability to clearly explain the therapeutic options available to patients with breast cancer is invaluable.

Hyponatremia on the rise

I seem to be seeing a lot more hyponatremia. Some of these patients are taking diuretics, while others have psychogenic polydipsia or syndrome of inappropriate antidiuretic hormone secretion (SIADH). Others have no known cause. Is there an explanation for this increase?

Erectile dysfunction after prostate cancer

Erectile dysfunction after prostate cancer

As a side effect of radical prostatectomy, the favored treatment for many, erectile dysfunction can affect a man's mental and physical quality of life.

Hormone therapy guidelines updated

Hormone therapy guidelines updated

Data support starting hormone therapy to treat menopause-related symptoms and/or reduce the risk of osteoporosis or fractures.

Dysuria is the first sign of trouble

Dysuria is the first sign of trouble

When a clinician fails to order a repeat PSA test for a patient with suspected prostatitis, legal issues arise.

Oral lesions caused by human papillomavirus

Oral lesions caused by human papillomavirus

Commonly found in the oral cavity, HPV lesions may persist or relapse spontaneously and occasionally require surgical excision.

An EAASY way to prevent blood clots

Solutions for prevent blood clots on long flights.

Elevated hematocrit concerns

What are the clinical concerns for a 55-year-old, postmenopausal, Caucasian nonsmoker with a hematocrit of 52% and hemoglobin of 17 g/dL?

Patient's faith inspires clinician

Man keeps cheerful disposition despite terminal illness.

Complaints of patient dismissed

Complaints of patient dismissed

A thoughtless comment in a high-maintenance patient's file puts a clinician at a great disadvantage.

Patient with ovarian cancer seeks reassurance

Woman refuses to be discharged after a simple stent procedure.

Sentinal lymph node resecton or axillary lymph node dissection in women with breast cancer?

New reports from the National Surgical Adjuvant Breast and Bowel Project B-32 trial show that SLN resection is as effective for survival as ALND and may reduce postsurgical morbidity and symptoms in node-negative women.

Prophylactic oophorectomy may reduce ovarian cancer mortality

The prevalence of BRCA1 or BRCA 2 mutations is estimated at about 0.2%-0.33% of the population, but these mutations account for 5%-10% of breast cancers and 10%-15% of ovarian cancers among white women in the United States.

Cancer missed because patient lacked health insurance

Nurse commits to dedicating more time to free clinics.

Patient miraculously recovers from pancreatic cancer

Small community reaffirms belief in power of prayer.

Wife struggles with husband's impending death

Palliative care nurse practitioner breaks through emotional barrier.

Nurse breaks the rules, grants a patient's dying wish

Courage and compassion paved the way for positive changes.

Red breast is a red flag in a case of new-onset pain and swelling

Red breast is a red flag in a case of new-onset pain and swelling

Despite a normal exam three months earlier, skin changes and palpable lumps in the axilla were noted.

Selenium

Selenium

Selenium is a stable trace-metal element that is found in such cruciferous foods as broccoli, garlic, and onions, as well as in meats, seafood, and nuts. In the human body, selenium is essential for protein synthesis and multiple enzymatic functions.

Patient overreacts to needle during bone marrow biopsy

Sensitivity to patients' anxiety levels can help you determine if relaxation exercises are necessary.

Abdominal pain in a posthysterectomy patient

Ms. L, 34 years old and para 1 gravida 2, presented to the emergency room one evening following a four-day battle with "the flu." She became concerned after experiencing increasing pain in her left flank and pelvic area. On questioning, she recounted being constipated and very nauseated.

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