Lansing Personal Injury Lawyer - Cancer

Doctor Wins Suit Against Cancer Hospital for Sex Discrimination

David Mittleman — Tue, 01 Dec 2009 15:23:16 GMT

A former radiation oncologist at the University of Pittsburgh Cancer Institute won a potential $3 million verdict against the hospital in federal court on charges that her employer retaliated against her when she raised concerns over gender discrimination in the hiring process. Overall, the jury voted to award Dr. Kristina Gerszten $1.5 million in back pay and an additional $827,292 in front pay. However, the decision will ultimately be up to the U.S. District Judge, Arthur J. Schwab, to decide what the hospital will pay for its actions.

Dr. Gerszten originally filed charges in 2008 alleging that hospital officials at the University of Pittsburgh Cancer Institute purposefully passed over her and her female colleagues for promotions and prestigious positions in favor of less experienced male doctors. However, the jury failed to find any evidence of sex discrimination, but nevertheless awarded punitive damages for the hospital’s retaliation against her for originally filing the complaint.

After Dr. Gerszten filed the complaint, the news traveled to her superior, Dr. Dwight Heron, who was ultimately responsible for deciding on Dr. Gerszten’s promotions and contract renewals. The jury found that Dr. Heron retaliated against Dr. Gerszten by refusing to hire her as medical director at a sister hospital, the University of Pittsburgh Medical Center or the Cancer Center in Natrona Heights, as well as refusing to renew her contract as an oncologist for the hospital when it expired in 2007.

Originally posted at InjuryBoard by David Mittleman

Outrage - I Don't Like What I'm Seeing in Health Care (Part II)

David Mittleman — Fri, 20 Nov 2009 08:58:53 GMT

A few days ago I wrote about my concerns about recent developments in women's health care, namely the timely detection of breast cancer. Well, I wasn't the only person who felt that way. In fact, the United States Preventive Services Task Force study released on Monday has set off a response that can only be described by one word: outrage.

http://www.youtube.com/watch?v=MCNl77p1WhE

From Secretary of Health and Human Services Kathleen Sebelius to thousands of women and doctors across the country, women whose diagnostic screenings in their 40s helped save their lives after timely diagnosing them with breast cancer have one message to convey: they are people, not statistics.

As the administration distances itself from the Task Force study, one thing is clear, nobody wants the Task Force's findings to affect insurance coverage of preventive medicine. If a woman, like my wife whose baseline mammogram at age 40 detected breast cancer at an early stage, wants to utilize sound and reasonable preventive health practices, that decision should not be taken away. While our treatment for breast cancer has improved over the decades, there's no dispute over the benefit of early detection of breast cancer.

Originally posted at InjuryBoard by David Mittleman

Great American Smokeout: Many Reasons to Kick the Habit

David Mittleman — Thu, 19 Nov 2009 15:35:35 GMT

Maybe we can blame the bad economy, but no matter whatever or whoever is at fault, the fact is that more Americans are smoking cigarettes. In fact, a recent report by the Centers for Disease Control found that after years of declining, the number of American smokers is back up again.

There are many good reasons to quit, but many smokers struggle to kick the habit for good. Indeed, according to the American Cancer Society, there are at least 12 important reasons to quit smoking. For example:

1. Smoking fogs the mind: a 2008 study in the Archives of Internal Medicine, found that smoking during middle age is linked to memory problems and lessened reasoning abilities.
2. It may bring on diabetes: according to a 2007 analysis published in the Journal of the American Medical Association, current smokers have a 44% greater chance of developing Type 2 diabetes.
3. It invites infections: the CDC argues that there is strong data to suggest that smokers are more susceptible to pneumonia-causing bacteria than nonsmokers because smoking causes damage to the mucous membranes, making it easier for infectious organisms to latch on.
4. It may affect your sex life: simply stated, smokers are more likely to experience erectile dysfunction than nonsmokers. Furthermore, the severity of this problem increases as the number of cigarettes smoked per day also increases.
5. It may lead to wrinkles, and not just on your face but also on other areas such as the arms.
6. It may hasten menopause: according to a 2001 Surgeon General’s report, women smokers experience natural menopause at an earlier age than nonsmokers. Furthermore, a 2004 report indicated that women smokers also faced increased infertility when compared with nonsmokers.
7. It can dull vision: according to several studies in the medical journal Eye, active smokers face a 2 to 3 times greater risk of developing macular degeneration.
8. It hurts bones: smoking weakens the skeleton and can lead to increased incidence of osteoporosis in postmenopausal women. Furthermore, smokers of both sexes experience more hip fractures than nonsmokers.
9. It can damage the internal organs: specifically, cigarettes can damage the digestive system, leading to heartburn, peptic ulcers, and gallstones.
10. It may contribute to a poor night’s sleep: according to a study in the medical journal, Chest, smokers are four times as likely to experience nonrestorative sleep than nonsmokers, leading to that feeling of grogginess in the morning.
11. It shaves years, and quality, off of life: male smokers live, on average, 10 years less than their nonsmoking counterparts. Moreover, the nonsmokers experienced a better quality of life than the smokers.
12. Smoking causes cancer: in 2004, the CDC released a report linking cigarettes to more than 2 million diagnoses of cancer between 2001 and 2004 in the U.S.

Today is the American Cancer Society’s 34^th annual Great American Smokeout, and in an effort to get more Americans to stop smoking, they offer the following resources: visit the ACS webpage for tips on how to quit for good, or call the ACS Quitline at (800) 227-2345. According to Tom Glynn, director of cancer science and trends at ACS, phone counseling can double the chances of a smoker’s quitting success.

Originally posted at InjuryBoard by David Mittleman

I Don't Like What I'm Seeing in Healthcare

David Mittleman — Tue, 17 Nov 2009 11:58:43 GMT

As the husband of a 10+ year breast cancer survivor I know first hand the benefit of a baseline mammogram at age 40. I challenge anyone to argue that early detection doesn't give you the best opportunity to cure breast cancer. The studies conducted are overwhelming.

Detecting breast cancer during Stage I gives women a 100% chance of 5-year survival from breast cancer after diagnosis. If the cancer is detected during Stage II, that chance of survival drops to 86%. Stage III means a further drop in survival rate down to 57%. If cancer is not detected until it reaches Stage IV, the chances of 5-year survival are 20%. Stages II and III are actually made up of IIA, IIB, IIIA and IIIB respectively, with the average survival rates of the two groups shown above. The point it this - early detection saves lives.

I am amazed how this government task force could actually release this study and say what they are saying. Is their motivation perhaps to reduce what would be covered by a national "health care plan"? I surely hope not. I am strongly in favor of health care for all, but I do not advocate playing with statistics just to get the result you want. In fact, women whose lives were saved by screening in their 40s are coming out in droves to support continued screening.

How could the United States Preventive Services Task Force come to the conclusion that "breast self-exams do no good", as that makes no sense and is contrary to the long-standing position of the American Cancer Society. In fact it is a MAJOR reversal from the ACS's long-standing (as in decades worth of knowledge) position on screening and self-examination. In fact, the chief medical officer of the ACS, Otis W. Brawley, M.D., gave the following response:

But the limitations [of breast cancer screening] do not change the fact that breast cancer screening using mammography starting at age 40 saves lives. “As someone who has long been a critic of those overstating the benefits of screening, I use these words advisedly: this is one screening test I recommend unequivocally, and would recommend to any woman 40 and over, be she a patient, a stranger, or a family member.

Early last month I also addressed the questioning of long-time protocals in prostate cancer screening. The ACS wasn't about to change their guidelines back then, and I don't see any reason for women in their 40s to risk the chance of missing early detection of breast cancer.

Originally posted at InjuryBoard by David Mittleman

Radiologists Reluctant to Admit Mammography Errors to Patients

David Mittleman — Tue, 03 Nov 2009 12:54:31 GMT

According to a new study released this month, radiologists may not be so honest when it comes to admitting their mistakes. Specifically, radiologists may not disclose mammography errors to patients, resulting in delayed treatment for progressive cancers.

The study, conducted by the departments of medicine and bioethics & humanities at the University of Washington, surveyed 364 radiologists at seven different Breast Cancer Surveillance Consortium sites located in separate geographical areas. The radiologists were given a hypothetical situation in which comparison screening mammograms were placed in an incorrect order, so that it appeared as if breast calcifications were decreasing in number in a patient when they had actually increased. The doctors were then told that there was an error, which resulted in a delay in treating the cancer. The radiologists were then asked to respond to three questions: 1) how likely they were to disclose the mistake, 2) what information they would share, and 3) what were their actual experiences and attitudes with malpractice.

The results of the study indicated that:

24% responded that they would “not say anything further to the patient”
31% responded that they would tell the patient that “the calcifications are larger now and are suspicious for cancer”
30% responded that they would tell the patient “the calcifications may have increased on your last mammogram, but their appearance was not as worrisome as they are now”
15% responded that they would tell the patient that “an error had occurred during the interpretation of your last mammogram, and the calcifications had actually increased in number, not decreased”

74% of the radiologists claimed that they were more reluctant to tell patients of mistakes because of fears over medical malpractice. Apparently, failure to report errors to patients was not an uncommon practice for many of the radiologists surveyed. In fact, 49% admitted that they had been sued for medical negligence. However, other factors also had an effect in the radiologists’ degree of honesty. For example, physicians have expressed concerns over increasing stress in patients after admitting a medical error. Furthermore, the study author also hypothesized that some physicians feel uncomfortable with their communication skills, and struggle to admit to a patient that they had mad a mistake. Despite these other factors, 15% is not a comforting amount of radiologists who say they would be completely honest about their mistakes. Hopefully, continued studies like this will help to improve doctor and patient communication.

Originally posted at InjuryBoard by David Mittleman

Cancer Screening Has Risks As Well As Benefits - So Does Life (Part II)

David Mittleman — Mon, 26 Oct 2009 09:14:00 GMT

As I wrote yesterday, for years the message from health care providers and cancer awareness groups has been consistent and clear: early detection through regular screening saves lives. In an unexpected move, the American Cancer Society is beginning to question this long-held conventional wisdom. As it turns out, aggressive testing for breast cancer and prostate cancer may do more harm than good.

It seems odd to say, but early detection of cancer is not a silver bullet. While mammography and the PSA prostate test have lead to higher rates of diagnosis, it is not clear that this has resulted in an equally high rate of successful treatment. The most dangerous cancers tend to develop so quickly that most of the damage is done by the time they are detected. In contrast, many harmless cancers - most of which would otherwise go unnoticed for a lifetime - are detected and treated due to aggressive screening. The discordant result is that many people are receiving treatment they don’t need, while others are receiving treatment that won’t help.

Now for a personal note: This is not to say that screening is useless. As a matter of fact, as I disclosed in “Watch and Wait” Approach to Low-Risk Prostate Cancer is as Effective as Aggressive Treatments, I am such a patient. Even before I was diagnosed I was writing on the topic The Most Feared Complication of Prostate Biopsy. After performing my research and due diligence, at age 53 and being otherwise healthy (not to mention having a wife who, at age 51, is a 10-year survivor of breast cancer and two wonderful children ages 21 and 17) robotic surgery became the best option for me. I am two weeks post surgery and I feel great. The doctors and staff at Florida Hospital Global Robotics Institute in Celebration, Florida, were fantastic. My lead surgeon Vipul Patel, M.D. has performed more robotic prostatectomies than anyone else in the world - over 3,000. Despite his prominence in the field, he and his chief assistant Marcelo Orvieto, M.D. were very accessible before and after my surgery and I can’t say enough good about the entire team. I would like to take a moment to thank Dr. Patel and the staff.

Targeted testing combined, in some cases, with a conservative “wait and see” approach may be the best option for some people. Be sure to talk to your doctor about your cancer screening options, and ask questions. Taking an active role in your care will help keep you healthy for years to come.

Originally posted at InjuryBoard by David Mittleman

American Cancer Society Not Changing Screening Guidelines Despite Rumors (Part I)

David Mittleman — Sun, 25 Oct 2009 18:34:05 GMT

The Chief Medical Officer of the American Cancer Society, Otis Brawley, recently warned against over-screening for prostate and breast cancers. While Brawley stated that he does not want his message to confuse people into thinking that all screening is bad, he did argue that the American Cancer Society may have exaggerated the health benefits of screening.

While Brawley does feel that breast cancer screening is particularly important for women over 50, he finds that over-screening is still troubling. This is particularly true for prostate cancer because many prostate tumors never develop into something dangerous. Furthermore, for patients who receive “false positives” the experience can be devastating and produce great anxiety, at the very least. Moreover, many of these same patients choose to undergo further testing, such as surgical biopsy, which is an invasive procedure. However, Brawley describes over-screening as “not new”—it originally developed in the 1970s.

Nevertheless, since the release of the controversial NY Times article outlining Dr. Brawley’s position, the American Cancer Society has issued a statement clarifying their position on cancer screenings:

The American Cancer Society stands by its recommendation that women age 40 and older should receive annual mammograms, and women at high risk should talk with their doctors about when screening should begin based on their family history.

Mammograms work and women should continue to get them. Mammography has helped avert deaths from breast cancer, and we can make more progress against the disease if more women age 40 and older get an annual mammogram. Seven clinical trials tell us that screening with mammography and clinical breast exam do reduce risk of breast cancer death. This test is beneficial in that it saves lives, but it is not perfect. It can miss cancers that need treatment, and in some cases finds disease that does not need treatment. Understanding these limitations will help researchers develop better screening tests.

The society has, since 1997, recommended that men talk to their doctor and make an informed decision about whether or not prostate cancer early detection testing is right for them. This recommendation also still stands.

While recent studies indicate the advantages of screening for some cancers have been overstated, there are advantages, especially in the case of breast, colon and cervical cancers.

Originally posted at InjuryBoard by David Mittleman

Whistleblower Points Out Problems with "Community" Cancer Research Sites

David Mittleman — Fri, 23 Oct 2009 16:43:28 GMT

Two years after becoming vice president for research at Carle Foundation Hospital in Urbana, Illinois, Dr. Suzanne Stratton decided to put her foot down. After repeatedly clashing with doctors who oversaw patients enrolled in more than 130 federally sponsored cancer studies, Dr. Stratton had enough. She knew that there were “major deficiencies” in 12 out of the 29 experiments being overseen by the doctor that she argued with. In fact, those “major deficiencies” included serious risks to patients, as well as risks to science, because the doctors in charge of the studies were eager to publish results. However, when she decided to speak out against the situation, she was immediately fired and ushered out of the hospital the same day.

Community research sites, like Carle Foundation Hospital, are responsible for much of the current treatments for prostate, lung, and breast cancers. While most people assume that most research developments come out of major cancer centers like Memorial Sloan Kettering, this isn’t always the case. Primarily, this is because most of the patients at the smaller “community” sites are representative of the general population: they tend to be older, less affluent, and more diverse than those treated at big academic medical centers. However, the problem is that federal officials have never conducted systematic reviews on these “community” research sites.

But now federal officials are catching on to the problems that Dr. Stratton witnessed at the Carle Foundation Hospital, too. Alerted by Dr. Stratton, federal officials are continuing her investigation into the nation’s cancer research efforts at various hospitals, and not just at Carle Cancer Center. In fact, the federal Office for Human Research Protections is investigating the nearly 400 federally designated community research sites nationwide. While Carle executives declined to comment, federal authorities are taking a step in the right direction, according to Dr. Stratton. Primarily, she wants to make sure that patients are safe during the trials. Additionally, she maintains that it is important that the integrity of data is preserved so that community hospitals aren’t producing “results” that aren’t really effective in treating cancer.

Originally posted at InjuryBoard by David Mittleman

97-Year-Old Man Dies After Nursing Home Allegedly Ignored Sore on Penis

David Mittleman — Wed, 21 Oct 2009 10:07:21 GMT

The son of 97-year-old Charles Bradley is suing the Everett Care & Rehabilitation nursing home facility in Everett, Washington after his father’s genitals allegedly disintegrated from penile cancer and ultimately contributed to his death.

According to court documents, Charles Bradley entered the nursing home in 2004 because of the usual ailments associated with old age. He continued to live in the nursing home until two weeks prior to his death on March 31, 2008. He apparently had a sore on his penis, which the hospital staff ignored until he was rushed to the emergency room on March 13, 2008. The injury to his penis was purportedly undiagnosed penile cancer.

The attorney for Bradley’s son argues that Everett Care & Rehabilitation staff allowed Bradley’s injury to worsen for months without care. According to the complaint, staff at the center noticed the wound while changing Bradley’s diaper in November 2007. The staff member who initially noticed the wound notified the care manager, however, that manager failed to notify Bradley’s doctor. Instead, Bradley’s wound continued to fester for the next four months and his genitals continued to disintegrate. Finally, when Bradley arrived at the Providence Medical Center on March 13^th, he was initially diagnosed with pneumonia. However, doctors soon discovered the wound on his penis and determined that he had penile cancer.

The plaintiff’s attorney argues that Everett Care & Rehabilitation violated their promise to care for Charles Bradley. The lawsuit specifically seeks to hold the center accountable for allegedly failing to protect the elderly. Indeed, while the center refuses to discuss specifics on the incident, citing patient privacy concerns, they have not explicitly denied error. In fact, they have already received one citation from the Department of Social and Health investigators for failing to meet quality of care requirements designated by federal laws.

Originally posted at InjuryBoard by David Mittleman

Women Diagnosed With "New" Breast Cancer Could Potentially Benefit From a "Watch and Wait" Approach

David Mittleman — Mon, 12 Oct 2009 12:56:10 GMT

Doctors recently discovered a “new” type of breast cancer: Ductal Carcinoma in Situ, or a specific type of cancer whereby malignant cells grow in the milk ducts of the breast. However, doctors are divided over whether to diagnose this type of cancer as a “very early breast cancer” or a precancerous state.

DCIS is rarely life-threatening, although some women have gone through draining procedures and treatments such as radiation or partial lumpectomies. Usually, these aggressive treatments are reserved to treat serious life-threatening forms of cancer. However, doctors diagnosed Barbara Laufer with DCIS and she subsequently underwent two lumpectomies to her left breast, as well as daily radiation treatment for seven weeks. Now she is on a hormonal treatment called Tamoxifen to keep the cancer from returning and cannot have children for five years because of the risk of potential birth defects from the medication.

Currently, more than 60,000 women are diagnosed each year with DCIS. Doctors are afraid to spare women from the rigors of regular cancer therapies because so little is known about this new form of cancer. However, for women like Laufer, lives are put on hold when it isn’t even clear whether or not such aggressive treatments are necessary. On the other hand, some women are too afraid to try the “watch and wait” approach—fearful that their cancer will be a death sentence. A recent Breast Cancer Symposium in San Francisco may offer guidance for doctors who aren’t sure what to tell their patients with DCIS. Specifically, from a study of 8,203 women, researchers found that patients between 45-50 had half the risk of relapse after undergoing aggressive cancer treatments when compared with their younger (44 and under) counterparts. This may offer hope to younger women like Laufer who don’t want to undergo treatments that won’t necessarily keep them cancer-free in the long run. Laufer is now 37 and will have to wait until she is 44 ½ to have a child because of the Tamoxifen medication she is required to take. If she could wait for a treatment until later on in her life or not have to undergo treatment at all, she could still potentially bear children of her own. As Susan Reid, an OBGYN at Seattle’s Fred Hutchinson Cancer Research Center recently stated: "[w]e're asking women to make decisions that are crucial to their lives, without a lot of hard evidence…we’re giving them a lot of uncertainty." Perhaps a “watch and wait” approach isn’t such a bad idea when women’s lives are drastically changed without the promise of remaining cancer-free afterall.

Originally posted at InjuryBoard by David Mittleman