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Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission

Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.

Click the orange button to the right to learn more about what you can start doing today.

Myeloma Diagnosis- Pathology-Oncology Dysfunction- Get A Second Opinion

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Cancer (MM) can’t be diagnosed from cells alone. Pathologists also draw on epidemiology, historical observation, and expert judgment to make the call…

Should oncology overrule pathology when it comes to a multiple myeloma diagnosis? The article linked below by Ben Masur MD MBA, is remarkably insightful and illuminates the experience I endured upon my diagnosis of multiple myeloma in early 1994. I didn’t understand the dysfunction between my oncologist and my pathologist and the harm that this dysfunction would cause me.

In short, my oncologist overruled the pathologist’s diagnosis of full-blown multiple myeloma. Dr. Makley clearly stated the presence of myeloma in other parts of my body. Dr. Berger simply overruled Dr. Makley’s findings.

And I paid the price. But I still paid the full price for all of my MM treatments…

Two things would have prevented my misdiagnosis:

  1. A second opinion-“I also know of inconsequential diagnostic comments within pathology reports that burdened patients with silent worry until they were explained away by a pathologist.”
  2. A multiple myeloma specialist-

If you are a newly diagnosed MM patient think about it. Could you have been misdiagnosed? Did your oncologist discuss your labs with a pathologist? Is your oncologist a MM specialist? It is expected that we patients accept what our oncologist’s say without question. I did and I got burned.

Why do multiple myeloma specialists have average survival rates that are almost twice that of general oncologists?

Are you struggling with a myeloma diagnosis? Talking to someone who struggled with his own MM diagnosis may help. Scroll down the page, post a question or comment and I will reply to you ASAP.

Hang in there,

David Emerson

  • MM Survivor
  • MM Coach
  • Director PeopleBeatingCancer

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Two Truths and a Lie About Pathology

“Pathologists are sometimes referred to as “the doctor’s doctor,” but I’ve noticed that our “patients,”—oncologists, surgeons, and other physicians—often don’t make appointments with us…

It turns out I’m not alone. A study recently published in the Journal of General Internal Medicine surveyed internal medicine residents and attending physicians about how often they collaborated with pathologists. For both outpatient and inpatient care, the majority of respondents rarely or never communicated with pathologists.

Because most patients receive care either directly (through a tissue biopsy diagnosis) or indirectly (through oversight of clinical labs and blood banks) from a pathologist, this lack of communication is disheartening and dangerous.

Poor collaboration between pathologists and clinicians means both small misunderstandings and large misconceptions, and as pathologists diagnose nearly all cancers, the stakes couldn’t be higher.

In the hope of encouraging more collaboration, here are some misunderstood “truths” about pathology I’ve heard from my clinical colleagues, and one very common “lie.”

Truth #1-There are no “malignant cells.”

This “truth” may surprise any oncologist who’s read a pathology report announcing a specimen “positive for malignant cells”: Cancer can’t be diagnosed from cells alone. Pathologists also draw on epidemiology, historical observation, and expert judgment to make the call...

Pathologists and oncologists can better work together by ensuring that patients explicitly understand the risks any given tumor poses to their health and, eventually, by developing multiple evidence-based surveillance or treatment options that allow patients to tailor treatment to their individual view of these risks…

Truth #2-The best laboratory test is a second opinion.

Although some tumors can be definitively diagnosed, others cause diagnostic uncertainty. When a pathologist makes a cancer diagnosis, he or she relies on both technical skill and clinical judgment. Some malignant features are subtle and hard to spot, whereas others are simply ambiguous…

Subspecialists who see the same tumors over and over again may have more developed technical expertise, just as a surgeon who has performed many surgeries likely operates with more finesse. Some rare tumors may only come across a general pathologist’s desk once in a career, and whether or not the pathologist has seen it before can be the deciding factor in a correct diagnosis…

A second opinion is easy to get—slides and tissue blocks can be mailed to different pathology practices—and some institutions now require an in-house pathologist to review an outside diagnosis before treatment is started. Second opinions can avert both diagnostic error and alert treating physicians to any ambiguity in the interpretation...

And a lie: Pathologists can’t help you talk to patients.

Pathologists can be stereotyped by other physicians as introverted and antisocial. This has not been my experience, as I’ve witnessed most communicate with ease…

I also know of inconsequential diagnostic comments within pathology reports that burdened patients with silent worry until they were explained away by a pathologist…

Pathologists, for their part, work to write reports for many audiences at once: oncologists, surgeons, other pathologists, patients, and even researchers. This creates feedback loops of miscommunication,..

Miscommunication in healthcare can be dire, and it’s a particular shame when a simple phone call or face-to-face meeting with a pathologist could have prevented it. More active engagement with pathologists at tumor boards is one easy way to increase pathologist-oncologist communication, but clinicians should also consider working with pathologists to set up pathology report review sessions for interested patients. As patients become more invested in the details of these complex documents, pathologists may be best equipped to explain many of their idiosyncrasies…”

 

 

 

 

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