A British photographer and educator, Spence was a transforming voice in the arts of the last century. Her documentary-style photo albums dealt with themes of class struggle, conformity, and feminism. In 1982, she was diagnosed with breast cancer. A few years later, leukemia also set in. This cancer was not just in her blood and bones — it had seeped into her existence. It hijacked her arteries of security; it exiled her into grey plains of isolation she had never known before. Her whole career, she had sought to catch that special look — that nuance in a scene that told another story. But could she capture this tyrant phantom of disease now in her photos? How to express something for which words falter? ...continue reading →
Cathy Li is a medical student in the Class of 2020 at the University of Toronto
"Doctor, what do you recommend for my grandmother's pancreatic tumour?" My heart was fluttering nervously as I scribbled down his suggestions. This was the third meeting I had arranged.
Growing up, I had a very close relationship with my grandmother and lived with my grandparents until I was six years old. I received the news of her diagnosis during my third year of university. The words “intraductal papillary mucinous neoplasm” haunted me and echoed incessantly in my head for days; I could neither think nor focus. The feelings of powerlessness grappled to hold me down. Yet deep down, I was aware that simply being a passive bystander would be the greatest personal defeat. With that, a new wave of resilience inundated my thoughts. ...continue reading →
How do lifestyle factors influence breast cancer prognosis? In a review article published in the CMAJ, Dr. Ellen Warner and Ms. Julia Hamer identify which lifestyle changes can be recommended to patients as an adjunct to standard breast cancer treatments, to reduce their risk of distant recurrence and death.
Dr. Warner is a medical oncologist at the Odette Cancer Centre at Sunnybrook Health Sciences Centre and professor of medicine at the University of Toronto. Ms. Hamer is a Master of Medical Science student and lecturer at the University of Toronto.
Diagnostic delay of central nervous system tumours in children has serious implications for the children and their families. Dr. Ran Goldman, Pediatrician at BC Children's Hospital, Professor of Pediatrics at the University of British Columbia and Chief Medical Officer for the website medschoolforparents.com, discusses how practitioners can maintain a high index of suspicion for these rare tumours, yet not overinvestigate benign conditions.
Dr. Goldman co-authored a review article (subscription required) on pediatric central nervous system tumours published in CMAJ.
Barbara Sibbald, News and Humanities editor for the Canadian Medical Association Journal, reads the CMAJ Humanities Encounters article "First, do no harm" (subscription required). The article is written by Dr. Sarah Tulk, a family medicine resident at McMaster University.
In the article, Dr. Tulk reflects on the time she treated a terminally ill patient in the emergency department.
Interview with Dr. Camilla Zimmermann, head of the palliative care program at UHN in Toronto, associate professor and Rose family Chair in the Department of Medicine at the University of Toronto, as well as senior scientist at Princess Margaret Cancer Centre.
In a research article (open access) she co-authored, Dr. Zimmermann conducted interviews with patients and their caregivers in an effort to understand attitude and perceptions about palliative care. Early palliative care improves quality of life, symptom management and satisfaction with care in patients with advanced cancer. However, stigma associated with the term palliative care may be a barrier to timely referral.
Domhnall MacAuleyis a CMAJ Associate Editor and a professor of primary care in Northern Ireland, UK
Could cancer simply be due to bad luck rather than environmental factors, risky behaviour or bad habits? In recent weeks, media attention focused on a scientific discussion on the risk of cancer based on papers published in Science and Nature. While the discussion itself is fascinating, isn’t it interesting that this debate took place across mainstream scientific publications rather than in established medical journals. Perhaps medicine is already convinced by the epidemiology or, maybe medical journals are less open to such debate. This is the story: ...continue reading →
The curtains were drawn, I walked into the room,
Looked at the lady, and said, “How do you do?”
She was very kind, just a little bit addled,
But the doctors around us were really quite baffled
Had she had a stroke? Was it from the MVC?
There was nothing at all to see on the multiple CTs
Save a little bit of shadowing, in the corner over here
But the pictures were too blurry. No, not a single thing was clear!
So they made a few calls, and then made a couple more
They met with the consultants on every single floor
They put their heads together, and came up with an answer
“It’s so obvious!” they said. “She has metastatic cancer!” ...continue reading →
Nikhil Joshi is a Fellow in Clinical Immunology at the University of Manitoba. He wrote a blog for CBC about his experience with cancer
I was reading about Allergic Bronchopulmonary aspergillosis (ABPA) when it hit me.
Modern Medicine is taking a beating.
A day goes by in clinic. I’ve told three people today that the medications they are taking are keeping them from having uncontrolled asthma or an attack of angioedema and please not to stop them. I’m explaining that the disease is worse than the medications, which we give to children as young as 2. I sigh. I hate this. I scan the news headlines after my dictations are finished. I read about the NDP and Liberal party stances on physician corporations, which will probably lead to financial hardship on new physicians starting practice with entirely crippling levels of debt amid a background of rising overhead and reduced fee schedules. I’m further disheartened.
When did the world care so little about medicine? When did being a physician become so difficult and unrewarding? ...continue reading →
At six months and counting, life has mostly returned to normal, although persistent heaviness in dependent parts still creates intermittent discomfort. A long bicycle ride with insufficient padding had me worrying about Fournier’s gangrene for days. Wearing old lycra with my new contours, I did a brutal number on one upper thigh and side of scrotum. ...continue reading →