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Cancer Clinical trials Science

How should we treat stage 0 breast cancer?

I’ve written more times than I can remember about the phenomenon of overdiagnosis and the phenomenon that is linked at the hip with it, overtreatment. Overdiagnosis is a problem that arises when large populations of asymptomatic, apparently healthy people are screened for a disease or a condition, the idea being that catching the disease at […]

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Cancer Medicine Skepticism/critical thinking

The “war on cancer”: We’re doing better than commonly portrayed

If you were to rely on much of what you see in the mainstream media and on social media, you probably have the impression that we are not doing very well against cancer. Indeed, a common trope I see in a lot of articles is that we are somehow “losing” the war on cancer. Just […]

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Cancer Clinical trials Medicine Science Skepticism/critical thinking

Does mammography save lives? A new study shows that this is a harder question than you might think

Mammography is a topic that, as a breast surgeon, I can’t get away from. It’s a useful tool that those of us who treat breast cancer patients have used for over 30 years to detect breast cancer in asymptomatic women and thus (or so we hope) decrease their risk of dying of breast cancer through […]

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Cancer Complementary and alternative medicine Medicine Quackery Skepticism/critical thinking

Sayer Ji: Willfully misunderstanding overdiagnosis and misdiagnosis since…forever

If there’s one lesson that I like to emphasize while laying down my near-daily dose of Insolence, both Respectful and not-so-Respectful, it’s that practicing medicine and surgery is complicated. Part of the reason that it’s complicated is that for many diseases our understanding is incomplete, meaning that physicians have to apply existing science to their […]

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Bioethics Cancer Clinical trials Medicine Science Skepticism/critical thinking

Evidence-based medicine guidelines versus patient wishes

There’s a misconception that I frequently hear about evidence-based medicine (EBM), which can equally apply to science-based medicine (SBM). Actually, there are several, but they are related. These misconceptions include the idea that EBM/SBM guidelines are a straightjacket, that they are “cookbook medicine,” and that EBM/SBM should be the be-all and end-all of how to […]