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

I Only Want What’s in Your Mind and Heart”: The Origins and Science of Total Pain in Oncology

So here’s the thing about pain: it’s complicated. Last weekend I was on call when my phone rang. It was an elderly woman in her 80s with advanced cancer that had been stable. Her chart said “pain well-controlled on optimized opioid regimen” – one of those clinical phrases we use that sometimes means everything and sometimes means nothing at all. She started talking about bone … Continue reading I Only Want What’s in Your Mind and Heart”: The Origins and Science of Total Pain in Oncology