Between Algorithm and Presence: The Future of Palliative Care

A Case That Stayed With Me During a recent clinic, I was asked to urgently see a 65-year-old woman with metastatic lung cancer after multiple lines of therapy. For weeks, she had been declining: confused, exhausted, not eating, losing weight, and no longer sleeping. Her oncologist had decided that further cancer-directed therapy wasn’t feasible. When I walked into the room, she was in her home … Continue reading Between Algorithm and Presence: The Future of Palliative Care

The Language of the Body: Why Patient-Reported Symptoms Predict Survival

A few months ago, I met a man in his late sixties with advanced gastrointestinal cancer that had spread to his liver and lymph nodes. His wife had recently died. He lived alone in a three-story house. He knew his disease was incurable, but he was motivated; he wanted “more time.” At each visit, he told his oncologist he felt okay. His pain was controlled. … Continue reading The Language of the Body: Why Patient-Reported Symptoms Predict Survival

The Pattern We’re Finally Seeing

Photo by National Cancer Institute on Unsplash My mother had symptoms for months before her stage IV colon cancer diagnosis in the early 1990s. My father’s younger brother was a surgeon, we had medical expertise in the family, yet the cancer still went undetected until it was far advanced. At the time, I chalked it up to the limitations of medicine in that era, before … Continue reading The Pattern We’re Finally Seeing

The Paradox of Modern Cancer Care: Why Serious Illness Conversations Remain Elusive

Recently, I cared for a patient in his early 60s with advanced gastric cancer. When diagnosed months earlier, he had the standard “goals of care” conversation with his oncology team—focused primarily on treatment options, not his deeper values. His disease followed the unpredictable pattern so common in modern cancer care: treatment, stabilization, progression, and new treatment. Then, suddenly, everything changed. He deteriorated rapidly during hospitalization … Continue reading The Paradox of Modern Cancer Care: Why Serious Illness Conversations Remain Elusive

The Jellyfish, the Poppy, and the Future of Pain Relief: A New Chapter Begins

Ancient Remedies and Modern Crises: The Poppy’s Legacy For centuries, humanity has sought relief from pain, and the poppy, with its potent analgesic properties, became deeply entwined with our history and culture. In 1805, a young German pharmacist’s apprentice, Friedrich Sertürner, refined this ancient remedy, isolating morphine and revolutionizing pain management. This breakthrough, however, paved the way not only for the widespread use of morphine … Continue reading The Jellyfish, the Poppy, and the Future of Pain Relief: A New Chapter Begins

When Less is More: A Simple Solution to Complex Healthcare

While many healthcare institutions nationwide face challenges in enhancing goals-of-care discussions with seriously ill patients, an unexpectedly simple study from the VA demonstrated that a different approach could change how we think about these conversations. In 2013, at the Palo Alto VA Medical Center, Dr. Manali Patel proposed what seemed like an unlikely solution: What if individuals without medical training could assist veterans with advanced … Continue reading When Less is More: A Simple Solution to Complex Healthcare

When Food Loses Its Appeal: Medicine’s New Understanding of Cancer’s Oldest Companion

The Chef’s Voice  I was driving home from clinic on a rain-soaked Monday when I heard something that made me pull over and listen. It wasn’t about medicine or cancer or the patients I’d just spent the day treating. It was chef Matty Matheson, who plays Neal Fak on the acclaimed TV show “The Bear,” being interviewed by Kara Swisher. “Food is an uncompromising love,” … Continue reading When Food Loses Its Appeal: Medicine’s New Understanding of Cancer’s Oldest Companion

Hidden in Plain Sight: How Our Brain’s Endocannabinoid System Could Transform Pain Medicine

Opioids have a dual role in medicine, serving both as pain relievers and also their use may lead to addiction, complicating pain management conversations, especially for cancer patients. Recent research from Weill Cornell Medicine demonstrates a potential method to separate pain relief from addiction risk by manipulating brain compounds, offering hope for improved treatment strategies and quality of life. Continue reading Hidden in Plain Sight: How Our Brain’s Endocannabinoid System Could Transform Pain Medicine

Beyond Numbers: Making AI Work for Patients with Advanced Cancer

The Evolving Challenge of Cancer Prognostication Over the last decade, I’ve witnessed a remarkable transformation in my supportive oncology practice. The advent of targeted therapies and immunotherapy has moved us beyond the traditional triad of surgery, chemotherapy, and radiation. While these advances have dramatically improved the survival of many patients, they’ve paradoxically made one of our core responsibilities—prognostication—more complex than ever. Understanding Modern Cancer Trajectories … Continue reading Beyond Numbers: Making AI Work for Patients with Advanced Cancer

New Insights: Exercise to Combat Chemotherapy Neuropathy

It turns out that there is yet another thing that exercise helps for – chemo-induced peripheral neuropathy (CIPN). It not only helps to diminish the symptoms of neuropathy that already took place, but it can prevent it (!), which many other things that have been vigorously tried before (vitamins, fish oil, medications, etc.) failed to do so. It is potentially quite paradigm changing finding that … Continue reading New Insights: Exercise to Combat Chemotherapy Neuropathy