Initiated by the European Society for Medical Oncology’s (ESMO) Young Medical Oncologists Working Group, this succinct text has been written by a distinguished team of young medical oncologists and senior figures in the field, and is designed to provide oncologists with a secure practical grounding in the correct courses of action to follow in an emergency.
The key topics covered include:
* cardiovascular complications
* neurological complications
* renal and urologic complications
* metabolic complications
* respiratory complications
* gastro-intestinal complications
* hematologic complications
* cancer pain.
The text demonstrates how to judge various prognostic and predictive factors, how to determine the relevance of staging, and how to measure patient response for each cancer type.
Written by an international team of experts, this progressive text incorporates the fast-moving world of research into the field of cancer genetics and prevention.
Topics discussed include:epidemiology genetics of cancer sporadic cancers hereditary cancers primary prevention of cancer screening programmes for the general population screening programmes for those at higher risk the role of prevention secondary prevention of cancer
The new edition includes:
-new information on diagnostic evaluation-resources for families and adult children who care for people with dementia-updated legal and financial information-the latest information on nursing homes and other communal living arrangements-new information on research, medications, and the biological causes and effects of dementia
Also available in a large print edition
Praise for The 36-Hour Day:
Natural Hormone Balance for Women is Dr. Reiss's breakthrough, step-by-step program for women who want to take control of their lives by restoring hormonal balance. This revolutionary, commonsense natural hormone replacement program is designed to meet the individual needs of most women looking to rejuvenate body and mind—and offers astounding benefits for women of all ages:
More energy and stamina * Improved memory * Healthier, more youthful skin * Balanced moods * Less depression and anxiety * Stabilization of weight and more muscle definition * Better sleep patterns * PMS and menopausal symptoms reduced or eliminated * Enhanced sexuality
Dr. Reiss takes the confusion out of the medical information you need to know. In clear, nontechnical language, he thoroughly explains:
-the important difference between standard chemical hormone prescriptions and natural hormone replacements
-which hormone replacements are best for you and how to adjust them to your maximum individual benefit
-how to take hormones without worry
-how to choose the most effective hormonal gel, cream, pill, or sublingual drops, and when to use them.
Dr. Reiss has helped thousands of women transform their lives by achieving natural hormone balance. Now you can tap into the replenishing "fountain of youthfulness" that is not only essential for better life, but easier and safer to achieve than ever before.
A masterful synchronization of history and cutting-edge science shines new light on humanity's darkest diagnosis.
In the wake of the Cancer Genome Atlas project's failure to provide a legible roadmap to a cure for cancer, science writer Travis Christofferson illuminates a promising blend of old and new perspectives on the disease. Tripping over the Truth follows the story of cancer’s proposed metabolic origin from the vaunted halls of the German scientific golden age to modern laboratories around the world. The reader is taken on a journey through time and science that results in an unlikely connecting of the dots with profound therapeutic implications.
Transporting us on a rich narrative of humanity’s struggle to understand the cellular events that conspire to form malignancy, Tripping over the Truth reads like a detective novel, full of twists and cover-ups, blind-alleys and striking moments of discovery by men and women with uncommon vision, grit, and fortitude. Ultimately, Christofferson arrives at a conclusion that challenges everything we thought we knew about the disease, suggesting the reason for the failed war against cancer stems from a flawed paradigm that categorizes cancer as an exclusively genetic disease.
For anyone affected by this terrifying disease and the physicians who struggle to treat it, this book provides a fresh and hopeful perspective. It explores the new and exciting non-toxic therapies born from the emerging metabolic theory of cancer. These therapies may one day prove to be a turning point in the struggle against our ancient enemy. We are shown how the metabolic theory redraws the battle map, directing researchers to approach cancer treatment from a different angle, framing it more like a gentle rehabilitation rather than all-out combat. In a sharp departure from the current “targeted” revolution occurring in cancer pharmaceuticals, the metabolic therapies highlighted have one striking feature that sets them apart—the potential to treat all types of cancer because they exploit the one weakness that is common to every cancer cell: dysfunctional metabolism.
With contributions from Thomas Seyfried, PhD, author of Cancer as a Metabolic Disease; Miriam Kalamian, EdM, MS, CNS, author of Keto for Cancer; and Beth Zupec Kania, consultant nutritionist of The Charlie Foundation.
This edition of the Handbook consists of 39 chapters written by 67 internationally recognized experts in the field of aging. It is organized in seven sections, reflecting the major theoretical developments in gerontology over the past 10 years.
Comprehensive coverage of aging theory, focusing on the biological, psychological, and social aspects of agingA section dedicated to discussing how aging theory informs public policy A concluding chapter summarizing the major themes of aging, and offering predictions about the future of theory development
Required reading for graduate students and post doctoral fellows, this textbook represents the current status of theoretical development in the study of aging.
Featuring useful takeaway messages and informed by recent research into the causes of and the search for therapies to prevent or cure dementia, this edition includes new information on
• devices to make life simpler and safer for people who have dementia• strategies for delaying behavioral and neuropsychiatric symptoms• changes in Medicare and other health care insurance laws• palliative care, hospice care, durable power of attorney, and guardianship• dementia due to traumatic brain injury• choosing a residential care facility• support groups for caregivers, friends, and family members
The central idea underlying the book—that much can be done to improve the lives of people with dementia and of those caring for them—remains the same. The 36-Hour Day is the definitive dementia care guide.-- Jeffrey Cummings, MD, ScD, Director, Cleveland Clinic Lou Ruvo Center for Brain Health
The AJCC Cancer Staging Atlas, 2nd Edition, is an official publication of the American Joint Committee on Cancer, the recognized international leader in state-of-the-art information on cancer staging. This Atlas has been created as a companion to the updated 7th Edition of the AJCC Cancer Staging Manual, which continues to disseminate the importance of anatomical and pathological staging in the management of cancer. This state-of-the-art, invaluable 2nd Edition includes a CD containing PowerPoint slides of all illustrations, additional color, and a user-friendly, easy-to-read layout. The AJCC Cancer Staging Atlas, 2nd Edition will serve as an indispensable reference for clinicians, registrars, students, trainees, and patients.
"Overall this is a useful, well written, practical elderly medicine book, ideal for use in primary care. It is reasonable priced and an excellent addition to the bookshelf, virtual or real". Reviewed by: Dr Harry Brown, July 2014Effectively treat your geriatric patients, and provide helpful guidance to their families, through engaging geriatric case studies that illustrate the principles and key clinical information you need.Form a definitive diagnosis and create the best treatment plans possible using the evidence-based medicine guidelines throughout.Find the information you need quickly and efficiently with a 2-color layout and consistent format, and test your knowledge with USMLE-style questions in every chapter.Offer your geriatric patients the most up-to-date treatment options available with six new chapters addressing Principles of Primary Care of Older Adults, Interprofessional Team Care, Billing and Coding, Frailty, Pressure Ulcers, and Anemia. Access the complete geriatric text online anytime, anywhere at Expert Consult, along with an online Cognitive Status Assessment with four tests and patient teaching guides, a dermatology quiz, and informative videos on Gait and Balance and Dizziness.
Being Mortal, written by Atul Gawande, brings to light an array of concepts involving death, mortality, aging, and terminal illness. Gawande includes extensive research and chronicles the stories of his patients, other doctors’ patients, and his own family members. The resulting book informs readers about many circumstances and scenarios that can help people find the best route through their or their family members’ final days, months, or years…
1. Nursing homes were not created to assist the elderly with their dependency on others or provide a better option than poorhouses. They were created to clear out hospital beds.
2. Assisted living arose from the need for an alternative to nursing homes that could give patients more independence and control over their lives.
3. At the end of their lives, most people want more than to merely survive, which is where medical institutions, nursing homes, and assisted living can fall flat.
4. People need to ask themselves what would make life worth living when they are ill, old, frail, or dependent on others for daily care.
PLEASE NOTE: This is key takeaways and analysis of the book and NOT the original book.
Inside this Instaread of Being Mortal:
• Key Takeaways of the book
• Introduction to the important people in the book
• Analysis of the Key Takeaways
In this readable guide to common conditions that affect the foot and ankle, podiatrists Jonathan D. Rose and Vincent J. Martorana outline the professional and self-care treatment options available. What works for one person’s foot pain does not necessarily work for someone else’s, so Doctors Rose and Martorana discuss proper foot care practices in a way that helps readers make good decisions about which treatment option will work best for them.
Often called a marvel of biomedical engineering, the human foot is a complex and astonishingly versatile part of our anatomy. This book addresses the entire foot, inside and out, describing in plain English its special design characteristics and biomechanical operations. Everything is covered—from corns and calluses to cancer and skin and nail problems, including special sections on children’s feet, sports injuries, footwear, and orthotics.
The Foot Book is an all-inclusive resource for everyone suffering from foot and ankle disorders, as well as physicians and other medical personnel who care for them.
In telling these stories, Lippe and Le alternate chapters. Lippe writes about the early signs that something was wrong; Le continues with a description of pancreatic cancer, its symptoms, and its treatments. Lippe talks about his prognosis, contemplates the prospect of death, and describes how he began to cope; Le explains the importance, for both doctor and patient, of balancing hope and truth. Lippe speaks frankly about the toll the disease takes on his marriage and family; Le offers a general picture of what most patients can expect with their illness. The book concludes with Lippe and Le’s reflections on their partnership in treating cancer, lessons they have learned, and their thoughts about the positive things that sometimes emerge from illness.
Pancreatic Cancer offers clear explanations of what the disease is, describes what people with the disease will feel physically and mentally, and discusses current treatments and future directions of research. The authors hope that their honest yet hopeful perspective will help all people with cancer and those who care about them.
Dr. Angelo E. Volandes believes that a life well lived deserves a good ending. Through the stories of seven patients and seven very different end-of-life experiences, he demonstrates that what people with a serious illness, who are approaching the end of their lives, need most is not new technologies but one simple thing: The Conversation. He argues for a radical re-envisioning of the patient-doctor relationship and offers ways for patients and their families to talk about this difficult issue to ensure that patients will be at the center and in charge of their medical care.
It might be the most important conversation you ever have.
50 Critical Cancer Answers provides the essential information a person needs to create a personal action plan to deal with cancer effectively. Each of the 50 short, easy-to-digest chapters includes a concise explanation of the most effective and sought after cancer treatment in the realms of traditional medicine, natural medicine, emotional support and spiritual care. A succinct commentary is provided to help the reader understand potential benefits, and if it is a realistic treatment option or not. Each chapter includes:
- An interview with an expert in the field of the chapter's topic
- A "smartphone scannable" QR code linking the reader to You Tube video containing author commentary on the relevant topic
- 5 tips from cancer survivors--all 50 cancer survivors have received treatment from the authors' Oasis of Hope cancer centers.
Don't let a cancer diagnosis define your circumstances. Instead, develop a plan to identify, attack, and beat cancer.
Gather step-by-step techniques for assessing and implementing radiotherapeutic options with this comprehensive, full-color, clinically oriented text.
Review the basic principles behind the selection and application of radiation as a treatment modality, including radiobiology, radiation physics, immobilization and simulation, high dose rate, and more.Use new imaging techniques to anatomically locate tumors before and during treatment.
Apply multidisciplinary treatments with advice from experts in medical, surgical, and radiation oncology.
Explore new treatment options such as proton therapy, which can facilitate precise tumor-targeting and reduce damage to healthy tissue and organs.
Stay on the edge of technology with new chapters on IGRT, DNA damage and repair, and molecularly targeted therapies.
Fitness Test enhanced e-book editions now available!
Through an integrated text and video combination, Senior Fitness Test Manual, Second Edition
(Enhanced), offers the most
comprehensive and reliable test battery for assessing physical fitness in
adults ages 60 and older. The tests in this resource assist health practitioners
and fitness and rehabilitation specialists in identifying weaknesses that cause
mobility problems, developing exercise programs that improve functional
fitness, preventing future mobility issues, and evaluating progress.
Fitness Test (SFT) is a simple, economical method of assessing the physical
attributes that older adults need in order to perform daily activities. It
consists of seven tests—covering lower- and upper-body strength, aerobic
endurance, lower- and upper-body flexibility, agility, and balance—that can be
conducted with minimal space, equipment, and technical requirements.
presents clear instructions on preparing and administering the tests and
interpreting and using the test results. Video clips are integrated right into
the text to provide even futher instruction and full visual demonstrations of
test protocols, including setup, execution, safety, evaluation, and
modification of testing protocols
to accommodate clients’ limitations.
The second edition of the Senior
Fitness Test Manual has been expanded to include ways to modify test
protocols for older adults with limiting conditions and offers more in-depth information on improving test scores, including
illustrated instructions for exercises that can be prescribed to seniors to
help them improve their fitness.
addition, the manual retains national normative data based on age and sex for
over 7,000 adults ages 60 to 94, and it now includes criterion-referenced,
clinically relevant fitness standards. These new criterion-referenced standards
allow practitioners and older adults to identify the test scores at a specific
age that are correlated with maintaining adequate functional mobility into the
90s, providing a new and deeper understanding of the test scores. This allows
practitioners and their clients to focus on maintaining or improving functional
fitness with customized goals meant to preserve and improve individual
Faithful to its title, this text espouses a truly multidisciplinary approach, integrating information from the fields of oncology, neurosurgery, radiation oncology, and neurology. Experts in each specialty have gathered that information which is most important for all physicians caring for patients with brain metastasis.
Brain Metastasis includes complete discussions for all situations in which radiosurgery might be recommended, including for the treatment of gross brain metastasis; for the prevention of tumor-related injury of brain function; and as an alternative to whole-brain radiotherapy.
Features of this uniquely accessible guide include:
A timely discussion of exciting recent developments in aggressive care An emphasis on quality-of-life issues and palliative care Special chapters on radiosurgery for both brain metastasis and spinal tumors Full color insert of high-quality images
This concise and comprehensive text provides a multidisciplinary information source for brain metastasis. It is an essential resource for any practitioner who cares for patients with this devastating yet surprisingly common condition.
In Ethical Foundations of Palliative Care for Alzheimer Disease, leading ethicists and clinicians from the United States and Europe explore ethical and scientific concerns about the diagnosis and prognosis of Alzheimer disease, challenges arising from applying palliative procedures to its symptoms, key philosophical and theological concepts central to our understanding of the disease and to end-of-life decisions, and the changing patterns of relevant medical, social, and economic policies. Cross-cultural, multidisciplinary, and state-of-the-art, this volume is a unique and important resource for bioethicists, clinicians, and policy makers everywhere.
Contributors: David A. Bennahum, M.D., University of New Mexico; Pierre Boitte, Ph.D., Catholic University of Lille, France; Roger A. Brumback, M.D., Creighton University Medical Center; Wim J. M. Dekkers, M.D., Ph.D., University Medical Centre Nijmegen, The Netherlands; Elizabeth Furlong, R.N., Ph.D., J.D., Creighton University Medical Center; Eugenijus Gefenas, M.D., Ph.D., Vilnius University, Lithuania; Bert Gordijn, Ph.D., University Medical Centre Nijmegen, The Netherlands; Amy M. Haddad, R.N., Ph.D., Creighton University Medical Center; Søren Holm, M.D., Ph.D., Dr.Med.Sci., University of Manchester; Franz J. Illhardt, D.D., Ph.D., Freiburg University; Rien Janssens, Ph.D., University Medical Centre Nijmegen, The Netherlands; Givi Javashvili, M.D., Ph.D., State Medical Academy of Georgia, Tbilisi; Judith Lee Kissell, Ph.D., Creighton University Medical Center; Gunilla Nordenram, D.D.S., Ph.D., Karolinska Institute, Stockholm; Richard L. O'Brien, M.D., Creighton University Medical Center; Marcel G. M. Olde Rikkert, M.D., Ph.D., University Medical Centre Nijmegen, The Netherlands; Winifred J. Ellenchild Pinch, R.N., Ed.D., Creighton University Medical Center; Patricio F. Reyes, M.D., Creighton University Medical Center; Anne-Sophie Rigaud, M.D., Ph.D., Hôpital Broca, Paris; Linda S. Scheirton, Ph.D., Creighton University Medical Center; Jos V. M. Welie, M.Med.S., J.D., Ph.D., Creighton University Medical Center.
The book opens with an introduction to the principles of hybrid imaging that pays particular attention to PET/MR imaging and standard PET/MR acquisition protocols. A wide range of illustrated clinical case reports are then presented. Each case study includes a short clinical history, findings, and teaching points, followed by illustrations, legends, and comments.
The multimedia version of the book includes dynamic movies that allow the reader to browse through series of rotating 3D images (MIP or volume rendered), display blending between PET and MR, and dynamic visualization of 3D image volumes. The movies can be played either continuously or sequentially for better exploration of sets of images.
The editors of this state-of-the-art publication are key opinion leaders in the field of multimodality imaging. Professor Osman Ratib (Geneva) and Professor Markus Schwaiger (Munich) were the first in Europe to initiate the clinical adoption of PET/MR imaging. Professor Thomas Beyer (Zurich) is an internationally renowned pioneering physicist in the field of hybrid imaging. Individual clinical cases presented in this book are co-authored by leading international radiologists and nuclear physicians experts in the use of PET and MRI.
- Inflammatory conditions (including contact dermatitis, alopecia, erythema multiforme, pemphigus, bullous pemphigoid, porphyria, pruritus, psoriasis, rosacea, seborrhea, urticaria, xerosis, and more)
- Infections (fungus, herpes simplex and zoster, scabies, lice, and warts)
- Skin signs in systemic disease (skin tags, cutaneous metastases, xanthomas)
- Regional dermatoses (intertrigo, leg ulcers, pressure sores)
- Benign tumors (chondrodermatitis, cysts, ganglion, fibrous papule, seborrheic keratoses, lentigines, and benign vascular lesions)
- Pre-malignant and malignant tumors (actinic keratoses, angiosarcoma, basal cell carcinoma, dermatofibroma and dermatofibrosarcoma protuberans, intraepidermal neoplasia, Kaposi's sarcoma, keratoacanthoma, lentigo maligna, cutaneous lymphoma, Mycosis fiungoides, melanoma, nevi and moles, and squamous cell carcinoma)
Taking a unique multi-disciplinary approach, the book covers conventional histopathology and cytopathology, as well as all important complementary diagnostic tests, such as immunophenotyping (immunohistochemical stains and flow cytometry), karyotyping, FISH and DNA/molecular studies. It offers concise textual and extensive visual coverage of both neoplastic and non-neoplastic hematology disorders, with the neoplastic hematology sections presented according to the most recent WHO classifications. There is also an introduction to the normal structures of hematopoietic tissues and the various multidisciplinary techniques.
The atlas contains more than 900 high-quality color images that mirror the findings that fellows and clinicians encounter in practice. It provides information in a quick, simple and user-friendly manner, attracting those who are in training or are not considered experts in the field. Residents, fellows, practicing clinicians, and researchers in pathology, hematology, hematology/oncology, as well as graduate students in pathology and other clinicians workings in clinical hematology laboratories will all find it useful.Saves clinicians and researchers time in quickly accessing the very latest details on the diverse clinical and scientific aspects of hematopathology, as opposed to searching through thousands of journal articles For clinicians, fellows, and residents, correct diagnosis (and therefore correct treatment) of diseases depends on a strong understanding of the molecular basis for the disease – hematologists, pathologists, oncologists, and other clinicians will benefit from this clear, focused, annotated format
Companion web site features over 900 images from the book!
Various approaches such as sophisticated imaging techniques, improved surgical procedures, ground-breaking strategies for radiotherapy, chemotherapy, immunotherapy, chemoimmunotherapy, and photodynamic therapy are being used for eradicating glioblastoma. Hopefully, this book will be an important source of information on glioblastoma and therefore be highly useful to the students, postdoctoral fellows, principal investigators, and clinicians involved in this field.
Immunotherapy of Cancerprovides information on cancer research related to inflammation and immunity, containing outstanding reviews by experts in the field. It is suitable for researchers and students who have an interest in cancer immunobiology.Provides information on cancer research, including outstanding and original reviewsCovers the current progress and emerging concepts in cancer inflammation, immunology, and immunotherapy Suitable for researchers and students studying, and interested in, the field of immunotherapy for cancerIdeal for those studying cancer inflammation, tumor immunology, cancer immunotherapy, dendritic cell, antigen presentation, immune checkpoint, myeloid-derived suppressor cells, macrophages, and tumor environments
Oncologists, cancer researchers, and nutritionists are separated by divergent skills and professional disciplines that need to be bridged in order to advance preventative as well as treatment strategies. While oncologists and cancer researchers may study the underlying pathogenesis of cancer, they are less likely to be conversant in the science of nutrition and dietetics. On the other hand, nutritionists and dietitians are less conversant with the detailed clinical background and science of oncology. This book addresses this gap and brings each of these disciplines to bear on the processes inherent in the oxidative stress of cancer.Nutritionists can apply information related to mitochondrial oxidative stress in one disease to diet-related strategies in another unrelated disease Dietitians can prescribe new foods or diets containing anti-oxidants for conditions resistant to conventional pharmacological treatments Dietitians, after learning about the basic biology of oxidative stress, will be able to suggest new treatments to their multidisciplinary teamsNutritionists and dietitians will gain an understanding of cell signaling, and be able to suggest new preventative or therapeutic strategies with anti-oxidant rich foods
Written in joint collaboration by residents and staff radiation oncologists at the Department of Radiation Oncology at the Cleveland Clinic Taussig Cancer Institute, the book contains more than 900 questions addressing the full gamut of the science and practice of radiation oncology today.
Radiation Oncology Self-Assessment Guide Features: Comprehensive coverage of radiation oncologyFlash-card" format facilitates recall of key data, treatment assessment and patient management, and important original studiesOrganized by the major subject areas in radiation oncology, the question sets feature structured questions and nswers designed to test recall and sharpen skillsAuthors are from the Department of Radiation Oncology at the Cleveland Clinic Taussig Cancer Institute
Did you know that you can have breast cancer without having a lump?
Did you know that all breast cancers do not show up on a mammogram or an ultrasound?
Have you ever heard of Inflammatory Breast Cancer?
Nina Anderson, the author of this book, would have answered "no" to all of the above questions. If she had known some of these facts, she would have been more suspicious about her symptoms. She was a very health conscious individual. She had a mammogram and Pap test every year and did monthly self breast examinations. When she started having swelling, an inverted nipple, redness and a fever in her right breast, the last thing she ever suspected was that she might have breast cancer. She had hardly ever been sick in her entire life until she was diagnosed with this very aggressive and lethal form of breast cancer known as Inflammatory Breast Cancer. This book is the story of her dreadful ordeal and miraculous survival.
Nina considers the sequence of events that led to her early diagnosis a miracle that saved her life. Many women do not survive IBC because there is no lump involved and it cannot be detected by a mammogram or ultrasound. The only way to get a conclusive diagnosis is to perform a surgical biopsy of the breast and skin tissue. The symptoms of Inflammatory Breast Cancer (abbreviated as IBC) are similar to a breast infection known as mastitis. Most women are diagnosed with mastitis or cellulitis and treated with antibiotics for two to three months. By that time IBC is so aggressive that it has spread to other organs of the body and is in the final stage of breast cancer. The details of her diagnosis and the eleven months of treatment that followed are chronicled in this amazing story of survival.
During her very first chemotherapy treatment, an incident involving a bumble bee instilled a hope in Nina that would help to sustain her during the long, grueling months of treatment. She shares her experience in an effort to inform every woman about the symptoms of Inflammatory Breast Cancer and how to cope and fight the disease. It is her hope that this book will save lives. No woman should have to suffer the consequences of this disease because she has never heard of IBC or didn't know about the symptoms. Nina also wants to give every woman who is diagnosed with IBC the hope that YOU CAN SURVIVE.
Here is an excerpt from her book:
CHAPTER ONE – THE MONTH OF APRIL
RARE ENCOUNTERS OF THE INTIMATE KIND
You know how when you get past fifty years old, those intimate moments with your spouse are few and far between? Well that's kind of how it was with us. But it was one of those rare evenings when things just seemed to fall in place and it happened! Afterwards my husband, Richard, said that something wasn't right with my right breast. I told him that I had already noticed it and that I thought I might have mastitis. He had no idea what that was, so I explained that it was an infection of the mammary glands which you can sometimes have when you are breastfeeding. I had some redness and swelling and the breast had felt kind of feverish for about a week or two. I told him I guess I would have to make an appointment with my gynecologist and get some antibiotics. It was kind of aggravating to be going through menopause and have to deal with a breast infection. I promised that as much as I hated going to the doctor, I would make an appointment the next day.
When I woke up the next morning, the breast was so swollen that the nipple had inverted. I remembered when I was breast feeding that this same thing had happened when it was feeding time. The breasts would fill with milk and the right nipple would become an "inny" instead of an "outy." I would have to use a nipple shield in order for the baby to be able to nurse. So an inverted nipple with swelling was normal for me. I thought for certain that this was mastitis. I called to get an appointment with my gynecologist and, much to my disappointment; she was not practicing at this time because she had decided to stay home with her children. This was the fourth gynecologist I had had in the past four years. The last three were women and it was just my luck that every time I was ready for my next annual check up, I was informed that they were staying home with their children. I usually liked to go to a female gynecologist because I felt like a woman could understand my problems. Fortunately this time I was seeing someone who was part of a group of gynecologists so I just told the receptionist to pick one for me because I was having some problems and I needed to see someone soon. She said she would call me back to arrange the appointment.
In the meantime, I looked at my calendar and realized it was almost time for my annual mammogram, so I decided that I would try to schedule that appointment as well, especially since it usually takes about two or three weeks to get in. So I called the imaging center where I usually go to have my mammogram to see when I could come in for an appointment. The receptionist said she had an appointment open the very next day. I said, "I'll take it!" I explained to her that I thought I was having a problem. She requested that I call my gynecologist (of course I did not know who that would be at this time) and request an order for a "diagnostic mammogram." She said to tell them to fax it to them so they would be able to do a more extensive mammogram when I came in the next day. So I called the gynecologist group's office and discovered I had been assigned a new doctor and I asked if it would be possible for them to fax a request for the diagnostic mammogram and of course they were able to do this. My appointment with the gynecologist would be in July. This was April 4th.
So on April 5th, 2002, at 2:00 PM I went to have my annual mammogram at the same place I had been going for the past five years. The technician was very nice and she had gotten the fax of the order for the diagnostic tests. I went through the usual eye popping experience only this time it seemed a little more uncomfortable. I waited for the nurse to come back to tell me if the images were OK before getting dressed. When she came in, she said that the radiologist would like to see me. As I was getting dressed, I was thinking that I didn't remember this ever happening before. Maybe they have changed the procedure. When I walked into the slightly darkened room, the radiologist had several x-rays on a lighted background. He began to focus in on an area on my right breast that he said was positioned at about 5 o'clock that indicated there might be a problem. He talked about two types of problems, non-malignant and malignant. I don't remember everything that was said but I do remember the part where he said that he thought that I had a malignant tumor and that the survival rate dropped depending on the size of the tumor. I asked him to explain what he meant. He said with 1 centimeter it is about 90% survival, 1.5 it drops to 80% and so on. I wanted to say, "Are you talking to me?" I have mastitis; I don't have malignant breast cancer! You must have the wrong x-rays up there! But I didn't say anything. The radiologist suggested that we try to get a better image with an ultrasound, so the ultrasound technician escorted me to the ultrasound room where once again I undressed. She tried for 45 minutes to pick up an image but was unsuccessful. I felt certain by now that they had the wrong person and the wrong x-rays. So I got dressed again and the radiologist came in and said that even though the technician could not get an image that did not matter. He advised me that I should go straight to a surgeon and just skip the biopsy. He sai