it’s so hard to believe that i have only four months left to my first year of fellowship.
the past two months have been great! month seven was palliative care; month eight was thoracic, head, and neck malignancies.
palliative care is the term we use when our focus switches from cancer-directed care to symptom-related care. it’s often a time for transition to hospice care. anyone who is not familiar with the hospice movement should make themselves aware of it. since hospice care is not only for cancer patients, we will likely all be faced with a time when hospice care is warranted for ourselves or a loved one. hospice is an amazing effort that focuses not only on the needs of the dying but also on the needs of the living who will be left behind. in no way is hospice a doctor’s way of “giving up”. it’s actually the most humane thing that a physician can recommend when further treatment for the underlying condition would cause excessive discomfort in exchange for a low likelihood of any reasonable medical gain. “first, do no harm” doesn’t always necessitate further therapy.
thoracic, head, and neck malignancies encompass all cancers of the head (except the brain), neck, and chest cavity…a fascinating (and all too common) group of malignancies. Most arise in patients who are either current or former smokers, drinkers, or tobacco users (this includes all my friends with the all-too-pleasant habit of “dipping”). the cancers of the head and neck are bad enough, but the surgery that is often necessary is horribly disfiguring in many cases. lung cancer is still the most common killer of all cancers, and there are very few new innovations on the horizon. your best bet is to reduce your chances of ever developing it.
i’ve said this before. enjoy alcohol in very small quantities. don’t smoke. if you already do, quit. it’s easier said than done, but there is help out there. set a quit date. visit you primary care doctor and ask for a medication to help you quit. use a nicotine replacement aid (patches, gum, etc.). talk to other people who are quitting. the best chance at success is to combine multiple support techniques. very few people quit on their first attempt. don’t be discouraged. keep trying. it’s the single best thing you can do for yourself in your fight against cancer.
on to melanoma and cancers of the genitourinary system.