Adjuvant Herceptin / Trastuzumab Treatment Duration

A few years ago when Herceptin (trastuzumab) was launched for the early stage of Her2+ breast cancer, the timing of treatment was fixed at one year. Why one year? No clue. Just a consensus figure decided by a few oncology investigators.

At the European Oncology meeting held in the end of Sep 2012 – data from large studies were presented. The two main studies were comparing one year versus six months of Herceptin – this showed that probably one year is better than six months. The other study of one year versus two years showed that one is probably enough.

So the consensus a few years ago, was right. Twelve months is the magic figure (for now).

– taken from my older blog

Adjuvant GIST – Gastro Intestinal Stromal Tumours

GIST is classically operated upon and thought to be cured by surgery. Unfortunately more and more clinicians are finding that patients have recurrence of disease. Nowadays, there are way to find possible recurrence risk rates, and treat accordingly.

If a patient has a high to moderate risk of recurrence, then they must be offered Imatinib (Glivec or Gleevec). The duration of treatment continues to be a matter of discussion – most people agree for one (1) year of treatment, but there is now data to show that three (3) years of treatment is necessary.

I suspect that treatment would be needed for long term (much longer than three years), as the survival curves at one year and three year of treatment are quite similar, when treatment is stopped.

The important thing is to ask your surgeon to consider Imatinib therapy or refer you to a MedicalOncologist for discussion.

– taken from my older blog

Infections from Doctors

Infections can be transmitted from doctors and nurses to patients. It is well known. Hospitals across the world are trying to convince medical staff to clean their hands – wash with soap and water or use rubbing alcohol.

The other common things which are sources of infections are doctors’ white coats (which are not washed very often), neck ties (never washed), stethoscopes (hardly ever cleaned), telephones, and the list goes on.

Think about it.

– taken from my older blog

Doctors as Patients: VIP syndrome

One of the nightmares for medical units across the world is to have a doctor as a patient. Everything has to be extra-careful in the discussion, tests, planning and implementation. Each thing is checked and double-checked.

I know that I am a terrible patient. I do not quite remember completing a full course of antibiotics or doing the things recommended to me.

The problem is that for some strange reason (?Murphy’s law), when we are extra-careful; things go extra wrong. Some people term it the “VIP syndrome”.

– taken from my older blog

Hindu Customs and Hair Loss

I have spent time doing oncology work in India and working with patients was very rewarding.

One day in the out-patient clinic, I met with three women consecutively who were to start chemotherapy. All three women would lose their hair and it was very distressing for each of them and their families.

Two days later, I suggested to one of these women to shave their hair and make a wig out of her own hair. It seemed like a good idea to me. It was NOT a good idea for her and her family. In traditional Hindu culture, a woman would shave her hair at the time of being widowed.

No more such suggestions. Ever!!

– taken from my older blog