All Podcasts

  • Approaches to Abdominal Surgery

    Dr. Jeffrey Sternberg, a colorectal surgeon, discusses abdom...

    Dr. Jeffrey Sternberg, a colorectal surgeon, discusses abdominal surgery who describes how decisions should be made about whether or not laparoscopy can be done for any specific procedure. A few small incisions allow a camera, lights and instruments can be introduced into an abdomen. The goal of this type of surgery is the same as traditional or “open” surgery. The technique of the surgery and the results should be the same. All surgeons being trained today are being trained in both laparoscopic and open procedures. After laparoscopic surgery, recovery time is often quicker, recover quicker at home and have a better cosmetic scar. Sometimes, however, for some surgeries such as removal of parts of the colon, the surgery may lake longer when done laparoscopically. As always, the surgeon needs to know about your medical conditions and the medicines you take. For example, scars inside the abdomen from prior surgery may make a laparoscopic approach unsafe or unwise. A surgeon needs to be experienced at the procedure he is about to do; conversely, if open surgery is being suggested, ask why.

  • MRSA

    Dr. Shelley Gordon talks about MRSA, an unusual form of a co...

    Dr. Shelley Gordon talks about MRSA, an unusual form of a common bacteria --- staphylococci --- that has become an increasing source of infections world-wide. MRSA can be suspected by the physician and proven to be the cause of the infection by culturing the involved area. MRSA can cause infections that begin inside or outside the hospital, and these two large groups can help the physician know how to treat you and what to expect. Both circumstances require different antibiotics. MRSA beginning in the hospital usually do not recur once there is a good response to antibiotics, while MRSA beginning outside the hospital more frequently recur once antibiotics are stopped. If recurrent MRSA is a problem, speak with your physician; there are treatments that can lessen the chances of infection.

  • Colonoscopy

    Colonoscopy is the medical term to describe the procedure to...

    Colonoscopy is the medical term to describe the procedure to look inside the lower bowel from the anus, through the rectum, to and then through the large bowel or colon. Dr. Jeffrey Sternberg, a colorectal surgeon at California Pacific Medical Center describes the procedure, including preparation for the procedure, when and how to take needed medications before the procedure, why physicians suggest strongly the use of sedatives that makes this test almost always pain-free but also precludes driving yourself anywhere for the next several hours, and how this procedure can decrease markedly your chances of getting this very common cancer. Colonoscopy allows cancer of the colon to be found early when cure is more likely. Colonoscopy also allows polyps --- growths that can become cancerous in time --- to be removed painlessly before they have become cancer. Use of this procedure is expected to change colon cancer from the second commonest cancer to cause death in the United States into a problem that can be prevented and treated earlier.

  • Epilepsia Tres

    La mayoría de los pacientes con epilepsia pueden ser tratad...

    La mayoría de los pacientes con epilepsia pueden ser tratados por los neurólogos generales o los neurólogos pediátricos. Pero si las crisis continúan después de utilizar por lo menos dos medicamentos, se recomienda que el paciente sea referido a un centro especializado en el tratamiento de la epilepsia para explorar la posibilidad si es que el paciente es candidato para un tratamiento quirúrgico (cirugía) o una dieta especializada llamada ketogenica. En estos centros, se pueden realizar estudios especializados como pruebas genéticas o estudios de imagen como la tomografía por emisión de positrones cuando son indicados. En ocasiones, el monitoreo de las ondas cerebras con videografía se utiliza para establecer que tipo de crisis epiléptica sufre el paciente para determinar cual es el medicamento mas adecuado para ese tipo de crisis. Cuando la gente escucha que alguien tiene epilepsia, existe temor de que esta sea causada por un tumor cerebral. Los tumores cerebrales son causas de la epilepsia pero únicamente el 15% de los pacientes con epilepsia padecen de tumores del cerebro y es muy infrecuente el no poder identificar el tumor si este existe. Por ultimo, es importante notar que en California, el departamento de vehículos motorizados (DMV) suspende los privilegios para conducir un vehiculo por un mínimo de 3 meses después de que una persona sufre de una crisis. Para concluir, la epilepsia es una enfermedad neurológica como cualquier otra enfermedad medica; el tratamiento con medicamentos funciona muy bien para la mayoría de los pacientes y les permite tener una calidad de vida normal; y en algunos pacientes en donde los medicamentos no funcionan como se espera, la cirugía puede resultar en el control de las crisis que se desea.

  • Optimizing Your Cancer Care

    In this podcast, Dr. Rodvien and discusses nine separate ste...

    In this podcast, Dr. Rodvien and discusses nine separate steps that you can be taken to enhance your life while you all are actively seeking medical treatment for your cancer. Take care of yourself; do things when possible for yourself. It's important to be honest with yourself; it's equally important to live for today and build for tomorrow realizing that they may not be a tomorrow. You can get an opinion wherever you want, but get care close to home where there are family and friends. Interacting with your family and friends, and clearly identifying what are realistic goals that you want to achieve will in the long run make you a happier person.

  • Epilepsia Dos

    La mayoría de los pacientes con epilepsia tienen que ser tr...

    La mayoría de los pacientes con epilepsia tienen que ser tratados con medicamentos por un espacio de 2 a 5 anos; en ciertos casos, el tratamiento es por el restro de la vida del paciente. El los pacientes que han tenido crisis convulsivas provocadas por fiebre, alguna toxina como el alcohol o por alguna otra causa medica y no neurológica, no se recomienda tratar con medicamentos anticonvulsivantes puesto que estos pacientes no tienen epilepsia. El 10% de los niños (10 de cada 100) puede tener una o mas crisis convulsiva con fiebres altas y estas crisis se denominan crisis febriles. En estos niños, el tratamiento consiste en reducir la fiebre, prevenir la aspiración o el movimiento del vomito hacia los pulmones si es que el niño vomita durante la convulsión, y el atender al medico lo mas pronto posible. En muy pocas ocasiones, las crisis epilépticas son mortales y afortunadamente, el tratamiento medico previene mas crisis y resulta en pocos efectos secundarios. Es importante recalcar que la epilepsia en una enfermedad como cualquier otro problema medico, tal como la presión alta o la diabetes, y que no es el resultado de estar poseído por un espíritu. Aun cuando las crisis pueden ser muy violentas, la mayoría de los pacientes no tienen dolor excepto si la crisis resulta en una caída o un golpe. El tratamiento mas importante de la epilepsia es con medicamentos llamados anticonvulsivantes o antiepilépticos y los antibióticos únicamente se utilizan cuando las crisis epilépticas son el resultado de una infección del cerebro. En pocas ocasiones, la crisis resultan por la deficiencia en una vitamina y el tratamiento en esta situación consiste en suplementar al niño con la vitamina deficiente. Los tratamientos alternativos, tal como el uso de hierbas, es o suplementos alimenticios no es recomendable puesto que en ocasiones estos pueden exacerbar el control de las crisis.

  • Epilepsia

    La epilepsia es la enfermedad neurológica que se manifiesta...

    La epilepsia es la enfermedad neurológica que se manifiesta con crisis epilépticas. El 3%, ó 3 de cada 100 personas, padecen de epilepsia. Esta es la tercer enfermedad neurológica mas común puedo comenzar a cualquier edad, pero es mas común antes de los 5 años de edad o después de los 60’s. Estas crisis ocurren cuando existe una descarga eléctrica excesiva en las células del cerebro, resultando en la disrupción de la actividad normal del cerebro y en síntomas neurológicos. Existen diferentes tipos de crisis epilépticas y diferentes formas de epilepsias. Las convulsiones son un tipo de crisis epiléptica en donde la persona pierde el conocimiento, puede caer, tiene movimientos involuntarios violentos de los brazos y piernas y se puede asociar con perdida del control de la orina o con el morderse la lengua. La mayoría de las crisis epilépticas son espontáneas puesto que son la manifestación de un problema neurológico como los tumores o infartos cerebrales. Existen otros tipos de crisis epilépticas, como por ejemplo las que involucran la alteración en la habilidad de mantener contacto con el mundo exterior y donde el paciente esta confuso por un minuto o dos. Este tipo de crisis se denomina crisis parcial compleja. Un tercer tipo de crisis consiste movimientos involuntarios súbitos de uno o varios músculos de las extremidades o el tronco del cuerpo, sin perder el conocimiento, y se denominan crisis mioclonicas. Por lo que el tipo de crisis epiléptica depende de que parte del cerebro esta involucrado por la anormalidad eléctrica. El medico puede llegar a un diagnostico correcto de la epilepsia a través de escuchar cuales son los síntomas y signos que el paciente manifiesta durante la crisis. El electroencefalograma (EEG), o el estudio de la actividad eléctrica del cerebro, ayuda a confirmar el diagnostico. La imagen por resonancia magnética (MRI) es el estudio que mejor ayuda a identificar la causa de la epilepsia. En aproximadamente el 20% de los pacientes con epilepsia, el EEG y/o el MRI pueden ser normales por lo que la historia clínica es lo que mejor ayuda al medico a diagnosticar esta enfermedad.

  • Causes of Cancer

    Dr. Rodvien describes the causes of cancer, discussing inter...

    Dr. Rodvien describes the causes of cancer, discussing interactions of our genetic material that we inherited with the environment that surrounds us. More than one event is needed from each of these large groups in order to produce a cancer. Radiation, viruses and chemicals are the major environmental exposures, and amongst these exposures, tobacco is the single most important cause in part because it is commonly associated with several cancers, avoidable, and because even if it has been used in the past, avoidance now decreases the risk of subsequent cancers. Cancer of the lung is the most well-known of the cancers associated with tobacco but there are others as well. Asbestos is another known cancer-causing substance, and there are a number of viruses that can interact with our genetic material to cause still other cancers. Amongst these viruses, there are viruses that cause hepatitis in many of us and liver cancer in a few of us. There is also a virus we all associate with infectious mononucleosis, and that virus causes or is associated with lymphoma.

  • What is Cancer?

    Dr. Rodvien discusses what cancer is and what the causes of ...

    Dr. Rodvien discusses what cancer is and what the causes of cancer are. Cancer is made up of cells that grow in an uncontrolled manner or that do not die on time. Usually although we may look like all of ourselves are living with us as we move from day to day, week to week, and month to month, all of our cells are being born, then living for a relatively short time, and then undergoing death to be replaced by other cells. It is only when cells accumulate within an area of our body, and then develop the capacity to spread to other organs such as our liver lung, brain or bone, that we are either living with cancer or being threatened by that cancer. Cancers then, are a group of diseases that we name by the organ where they begin. When they spread elsewhere we still name them by the initial organ where they began but we now say that the cancer is metastatic to another area. An example would be: cancer that has spread or is metastatic to the liver. Pathologists also describe cancers by what they look like under the microscope and these words are added to the others to give a more complete description of the cancer.

  • HIV part 2

    Dr. Shelley Gordon discusses some previously unusual aspects...

    Dr. Shelley Gordon discusses some previously unusual aspects of HIV which are now becoming more commonplace. Properly treated, people with HIV can live a normal life without symptoms. Unlike disease is becoming more prevalent amongst people with HIV, but perhaps because of some of the medicines that might change cholesterol levels in the blood, perhaps because of circulating virus in the blood or other reasons. So you read smoking should be avoided simply because it would be interactive with the other reasons why aren't disease might occur. People with HIV need to take their medicines on a daily basis and because they feel so well they need to discuss with their doctor when their medicines might be causing problems. The goal in caring for people with chronic HIV is to place the disease as well as the drugs controlling the disease in the background of their lives, not the foreground.

  • HIV

    Dr. Shelley discusses the ways you can and cannot get HIV. T...

    Dr. Shelley discusses the ways you can and cannot get HIV. This virus is transmitted through sex or contact with blood. It is not spread by more casual interactions such as kissing, hugging, or touching tears. So long as there is no blood in Mt. the washing of sheets or towels by someone who is not HIV positive is safe. HIV is a chronic illness and in that sense it should be approached as you would approach a person with high blood pressure or bronchitis.

  • The Swine Flu

    Dr. Shelley Gordon defines what swine flu is, how common fev...

    Dr. Shelley Gordon defines what swine flu is, how common fever and muscle aches are, and how different it is from regular flu just looking at the time of the year swine flu has occurred. Like all flu viruses, many more probably get “infected” than become sick as the virus spreads in the community. Blood tests are not always needed if the swine flu has been widespread in your community. Early diagnosis helps you and your neighbors. Then, appropriate medicines can be begun to shorten your illness and decrease the risk that you will spread it to others. However, the best way to “treat” the swine flu is to get vaccinated; but a vaccine against swine flu will NOT be available until October 2009. So far, swine flu has affected a younger part of the population. Still, people at risk for infection based on other illnesses or certain medicines, and pregnant women need to be sensitive that they might have the flu; medicines are essential in these groups and these groups are the ones who should receive the vaccine first once it is available. Like any of the vaccines made in eggs, the dangers of the flu far outweigh the dangers of getting the vaccine, even in pregnant women, though the vaccine should not be given to those allergic to eggs. If people have the swine flu, protect those you live with by good hand-washing and “cough” hygiene”. (The term “cough hygiene” means that anyone who feels sick should cough into their elbow rather than openly into the air should a Kleenex not be available.) People should NOT be isolated from the rest of the family when at home; common sense suggest that there should be good hand-washing and maintaining a distance (perhaps 6 feet) from people who might be coughing up the virus, there is little to nothing to be gained by eating separately or excessively washing linens.

  • The Flu

    Dr. Shelley Gordon defines what the flu is, and how central ...

    Dr. Shelley Gordon defines what the flu is, and how central fever, the time of the year, episodes in the community and muscle aches are to the diagnosis. Blood tests are not always needed if the flu is widespread in your community. Early diagnosis helps you and your neighbors. Then, appropriate medicines can be begun to shorten your illness and decrease the risk that you will spread it to others. Medicines that are helpful will vary with the time of year and your ability to take a medicine through an inhaler. The best way to handle the flu is to get vaccinated; but each year’s vaccine does little to nothing for next year’s flu. Older people, people at risk for infection based on other illnesses or certain medicines, and pregnant women need to be sensitive that they might have the flu; those medicines are essential in this group. If people have the flu, protect those you live with by good hand-washing and “cough hygiene”. Beyond good hand-washing and maintaining a distance from people who might be coughing up the virus, there is little to nothing to be gained by eating separately or excessively washing linens.

  • Dementia

    Dementia refers to the gradual loss of intellectual ability ...

    Dementia refers to the gradual loss of intellectual ability and function, whatever the cause. Early on in may be a loss interest in activities while forgetting conversations or appointments or making mistakes in routine activities. The most significant risk factor is aging. Other illnesses such as alterations in thyroid function, lack of specific vitamins, and vascular disease can also cause dementia. Smoking can contribute to small vessel disease in the brain and worsen the problem. MRI may show specific areas of the brain involved. Whatever the cause there is treatment and planning as well as a need for assistance with activities of daily living. Medicines exist now and more are being developed to treat the dementia.

  • Epilepsy

    Epilepsy is another name for recurrent unprovoked seizures. ...

    Epilepsy is another name for recurrent unprovoked seizures. By unprovoked, neurologists mean there is no identifiable cause of the seizure such as a very low blood sugar, a stroke, meningitis, or alcohol withdrawal. Seizures occur because of the excessive discharge of the neurons in the brain. People then have self-limited abnormalities that can be observed by others such as staring into space or movement disorders. Epilepsy itself is more likely to occur in young children or people over the age of 65 years. Not all epilepsy syndromes are life long, and frequently epilepsy is controllable but not curable with medicines. For the 30% or so of people with epilepsy who do not have good seizure control even with the best available medications, surgery may be beneficial. The goal is control of the seizures with medicines or other techniques that produce minimal or no side effects. When people have recurrent unprovoked seizures, they have epilepsy. It is not a single disease but very different symptoms can occur because of the common pathway of abnormal electrical activity in the brain. Seizures can be partial or they can be global and they can involve motor activity abnormalities such as flailing of arms and legs, or they can involve periods of time where the person with the seizure just appears to have “spaced out". For the 50 million people worldwide with epilepsy the vast majority are either young children or people over the age of 65 years. Not all epilepsy syndromes are lifelong. Epilepsy is usually controlled but not cured with medication but for the 30% of people with epilepsy who do not respond to seizure control medications, more aggressive treatments such as surgical intervention may be beneficial. This type of evaluation is best performed by neurologist and/or neurosurgeons who concentrate on taking care of people with refractory epilepsy.

  • Back Pain

    Almost everyone, during their lifetime, will have an episode...

    Almost everyone, during their lifetime, will have an episode of back pain. Recurrent back pain does not usually require immediate medical intervention, but a person should be checked with a first episode to exclude a potentially serious problem that might affect the bowel, bladder or the legs. Back pain is usually self-limiting, lasting days to weeks, but often, this pain interferes greatly in your life. For most people with back pain, the key is to get pain relief in the first few days using anti-inflammatory doses of Advil, and combining that with back exercises and local cold followed a few days later with heat. When it comes to back pain there is more opinion than fact about the causes, treatments and the responses to various therapies. Back pain is so frequent that people learn how to take care of themselves often and will very frequently get input from friends or family, many of whom have had back pain themselves. Back pain can rarely be the first sign of a potentially life-threatening problem. Key historical findings to suggest that there is an underlying problem is very severe back pain, back pains that occur in the presence of a fever or unexplained weight loss, or back pain that occurs after trauma. For people with a history of cancer, back pain may suggest that the cancer has spread to the spine. X-rays may not be helpful. Better tests would be to get special CT scans or to get at magnetic resonance imaging study. The basic therapeutic approach is rest for a few days until the pain is under control using narcotics or anti-inflammatory drugs, weight loss if that is appropriate, and the use of cold and then heat on the back along with physical therapy.

  • Reducing Coumadin Risk Through Genetic Testing

    Dr. Robert Rodvien identifies some reasons why people need d...

    Dr. Robert Rodvien identifies some reasons why people need different doses of Coumadin. This podcast emphasizes that certain genes control how Coumadin is broken down by the body and how Vitamin K is recycled. These two genes can vary from person to person and therefore they can make us all differently sensitive to Coumadin, a difference that may explain why some people have bleeding issues with Coumadin within the first month of receiving the drug. Still, there are other variables --- perhaps other genes --- that affect how sensitive any individual is to Coumadin. Scientists call these families of genes CYP2C9 and VCOR. They can be analyzed in the blood or saliva. The genes are not related to each other but, because Coumadin and Vitamin K offset the action of each other, the two proteins produced by the genes can interact to alter the effectiveness of the Coumadin. Taking more Vitamin K in your diet or multi-vitamins is neither necessary not good; it is better to take less Coumadin. Taking these tests of the genes to see if this information allows physicians to decrease the bleeding problems with Coumadin is being tested at this time.

  • Vitamin K and Coumadin

    Foods contain Vitamin K and it is this vitamin that can affe...

    Foods contain Vitamin K and it is this vitamin that can affect Coumadin's ability to prevent clots or promote bleeding. Vitamin K is not one substance nor is it available to people from one source. Vitamin K exists in your diet, it is made by bacteria in your intestine and it is stored in the liver. The best method to ensure that Coumadin is used safely and effectively is to eat foods like spinach that are rich in Vitamin K with some regularity. Avoid Vitamin K containing pills, even over-the-counter ones. Should you need antibiotics, be sure to remind the prescribing physician that you’re on Coumadin; otherwise antibiotics can kill the vitamin producing bacteria in your bowel. If you have liver disease, storage of Vitamin K may be diminished. If you have doubts about whether or not Vitamin K sources have changed for you, you can always get a blood test ---an INR--- to test the effect of the Coumadin.

  • How Coumadin interacts with other medicines

    For any given person, any medicine can cause you to be more ...

    For any given person, any medicine can cause you to be more or less sensitive to Coumadin. Some of the drugs to remember are pain relievers (especially aspirin), antibiotics, and medicines to keep stents open (like Plavix). If you need one of these drugs, talk with your physician. If your physician prescribes a medicine, remind him or her you are taking Coumadin. If you intermittently take Chinese herbs, make sure you get frequent blood tests. (You probably should get blood tests every 4 weeks or more frequently, even if the INR is stable and no medicines have been started or stopped.) If there are concerns that the Coumadin effect may be changed, get an INR. Although the effect of most medicines is to increase your risk to bleed from Coumadin, some medicines can decrease the effect of Coumadin to slow clotting. That effect can also be estimated by doing the same blood test ---the INR.

  • How Aspirin and Plavix Interact with Coumadin

    Coumadin’s main risk is that it can cause or exaggerate bl...

    Coumadin’s main risk is that it can cause or exaggerate bleeding. The reasons are many, but one of the main reasons is the addition of drugs, like aspirin and Plavix, that interact with Coumadin directly, modify other defenses the body has to prevent bleeding or both. Coumadin, taken with either drug or both drugs, should never be taken without the advice of your physician. The pathways to help us stop bleeding after injury are so important to the maintenance of life that multiple interacting pathways exist to prevent blood loss. Coumadin affects one set of pathways that cause proteins that are soluble in the blood to become insoluble. Aspirin and Plavix affect a different pathway involving cells called platelets so that cannot be as effective in promoting the transformation of these proteins into a solid mass. Tests exist to look at some aspects of these pathways but the interactions are not able to be tested. The common way to handle this issue is for everyone to be aware that you are on Coumadin and or both of the other drugs so that the INR is not prolonged as much by Coumadin and so that the physicians can watch you more carefully.

  • Neuropathy

    Dr. Robert Miller defines what a neuropathy is (an abnormali...

    Dr. Robert Miller defines what a neuropathy is (an abnormality in a nerve), why different neuropathies cause different symptoms, what the usual causes of neuropathy are, and what the relationship between cancers, cancer treatments and neuropathies are.

  • ALS

    Dr. Robert Miller is interviewed about how ALS (or Lou Gehr...

    Dr. Robert Miller is interviewed about how ALS (or Lou Gehrig's disease) involves nerves controlling voluntary muscle movements. Weakness in one muscle group, speech changes and difficulty swallowing are some of the problems that initially affect people and cause them to seek medical attention. Care is complex, relying upon multiple therapists to give people the best quality of life. At this time, one medicine has been shown in trials to slow down but not halt the progression of disease. Maintaining hope, accepting symptoms to relieve symptoms, maintaining good nutrition, ensuring good lung function and involvement in a multi-disciplinary clinic have all been shown to improve people's quality of life.

  • A Lump in the Neck

    Dr. Mark Singer, a noted head and neck surgeon in San Franci...

    Dr. Mark Singer, a noted head and neck surgeon in San Francisco, describes in straight-forward terms what to do when a lump is discovered in the neck. There are several possible causes ---infection, inflammation, a remnant of a cyst from the time of birth as well as cancer. Depending upon where in the neck the lump is as well as the lump's characteristics (size, location in the neck, hardness and tenderness), the person's age, the possible history of a sore throat a few weeks earlier, a history of smoking and many other factors, physicians can prioritize which of the several causes are most likely. Often a trial of antibiotics is appropriate. There is also a simple, painless procedure to place a small needle into the lump that can identify the cause. Cells can be evaluated under the microscope and cultures can be taken as well through the needle.. Tumor cells and often the type of tumor can also be identified, an important issue for some patients. The procedure is called an FNA for fine needle aspirate.

  • The Value of Hospice

    Hospice is a Medicare benefit that offers care at home, the ...

    Hospice is a Medicare benefit that offers care at home, the availability of several support services for those in need, and active cancer care if that is medically appropriate. Dr. Andrew Lasher is interviewed in order to understand and maximize this invaluable service.

  • Voice Prostheses

    You needn't live in silence even if your larynx is removed. ...

    You needn't live in silence even if your larynx is removed. Dr. Mark Singer, a head and neck surgeon, describes how people who need total removal of the larynx, the natural voice box, can regain speech.

  • Managing Pain

    Cancer patients understandably feel concern when new pain ar...

    Cancer patients understandably feel concern when new pain arises, yet their pain may not be the cancer itself. It might be coming from their treatment; it may be exacerbated by depression.In this episode of Smarter Cancer Care, Dr. Robert Rodvien speaks about managing the pain associated with cancer.

  • Clotting and Anti-Coagulation Clinics

    For patients who have experienced blood clots, there's much ...

    For patients who have experienced blood clots, there's much to know about lifestyle changes and proper medication. In this episode of Smarter Medical Care, Hematologist/Oncologist Dr. Robert Rodvien, founder of the Coumadin Clinic at the California Pacific Medical Center in San Francisco, discusses deep vein thrombosis and the relative merits of anti-coagulation clinics.

  • Introduction to Coumadin

    An increasing number of patients are being prescribed Coumad...

    An increasing number of patients are being prescribed Coumadin, yet far too many are unclear about what the drug does, how it works, and why it's critically important that dosing be properly monitored. In this episode of Smarter Medical Care, Hematologist/Oncologist Dr. Robert Rodvien, founder of the Coumadin Clinic at the California Pacific Medical Center in San Francisco, explains the basics about Coumadin (or Warfarin) and what to anticipate when taking this medication.

  • Clinical Trials

    Every cancer drug must go through a clinical trial and there...

    Every cancer drug must go through a clinical trial and there are many reasons for cancer patients to participate. Your doctor may recommend applying for a trial, but that doesn't mean you'll be accepted. Clinical drug trials can provide hope, a proactive plan of action, and, ideally, some relief and perhaps even a shot at a cure. As Dr. Rodvien explains in this episode, participants are closely monitored and can opt out at any time, for any reason.

  • Genetic Testing

    Some day, we may be able to conduct genetic testing for most...

    Some day, we may be able to conduct genetic testing for most cancers. As of now, there are limited tests available for some cancers and, even then, there's no definitive course of action dictated by the results. In this episode of Smarter Cancer Care, Dr. Rodvien discusses genetic testing for breast and ovarian cancer, the pros and cons, genetic counseling, and how women with a significant incidence of these cancers in their families might proceed.

  • Managing Your Time

    The number of necessary medical appointments can be daunting...

    The number of necessary medical appointments can be daunting for a cancer patient - and then there's the time spent waiting to be seen and waiting for results. Learning to manage your time and understanding how best to spend your time can be a huge help in adjusting to life with cancer. In this episode of Smarter Cancer Care, learn about adjusting your expectations as well as those of others in your work and personal life. Taking opportunities to rest is key to your well being. Carefully consider the risk/benefit ratios of traveling while in treatment.

  • It's the Patient's Decision

    There are many instances, from diagnosis through late stage ...

    There are many instances, from diagnosis through late stage cancer, when a patient has to choose a course of treatment. While doctors often make recommendations, it is the patient who gets to decide. This can be challenging for family members who, in some cases, won't understand or support a patient's choice. In this episode of Smarter Cancer Care, Dr. Rodvien discusses the role of the doctor and those closest to the cancer patient when it comes to making treatment decisions.

  • Any Port in a Storm

    Cancer patients often feel that their turning their veins ov...

    Cancer patients often feel that their turning their veins over to others. Blood must be drawn on a regular basis and, when necessary, drugs, fluid, and blood must be given intravenously. One good option for many patients is to have a permanent catheter implanted to provide safe and convenient access to a large vein. This can help avoid discomfort and protect your veins. Hear th pros and cons of implanted ports on this episode of Smarter Cancer Care.

  • Coverage Denied

    Cancer patients and Oncologists experience frustration when ...

    Cancer patients and Oncologists experience frustration when coverage for a particular therapy is denied by medical insurance companies. In this episode of Smarter Cancer Care, learn about steps that you can take in such instances, when to appeal such decisions, and how your doctor can help you navigate these waters.

  • How You Can Help

    The key, according to Dr. Robert Rodvien, is to listen to yo...

    The key, according to Dr. Robert Rodvien, is to listen to your friend or family member who has cancer. Often, that's the greatest gift you can offer. As well, you may be able to help with household chores, rides, or speaking to others. In this episode of Smarter Cancer Care, you'll learn ways to help and when to step back and provide the patient with privacy.

  • Coping with Fatigue

    Cancer can be exhausting. So can chemotherapy...and radiatio...

    Cancer can be exhausting. So can chemotherapy...and radiation...and depression. Anemia often causes fatigue in cancer patients and for that, there's immediate help. In this episode of Smarter Cancer Care, Dr. Robert Rodvien provides strategies for coping with fatigue and urges cancer patients to consider altering their expectations of how much they can accomplish before having to rest.

  • Lung Cancer Basics

    There are approximately 175,000 new cases of lung cancer dia...

    There are approximately 175,000 new cases of lung cancer diagnosed in the U.S. each year, with an 85% chance of mortality. In this episode of Smarter Cancer Care, Dr. Robert Rodvien explains the difference between cancer in the lung and cancer of the lung and talks about preventing this deadly disease beyond not smoking tobacco.

  • How Cancer Drugs are Developed

    There are tight regulations on how drugs are developed in th...

    There are tight regulations on how drugs are developed in the United States and this happens in phased clinical trials. From preclinical trials in the laboratory, through animal models, and Phases III and IV, involving cancer patients, everything is heavily monitored. Criteria for acceptance into a clinical trial is strict and, even when results are fairly consistently positive, FDA approval takes time. Learn about the pros and cons of participation in clinical drug trials in this episode.

  • Consequences of Some Cancer Therapies

    When embarking on a cancer treatment plan, it helps to be ab...

    When embarking on a cancer treatment plan, it helps to be able to anticipate both the physical and emotional reactions that might ensue. Dr. Rodvien explores some of consequences that one might experience as a result of cancer therapy and how these factors should be considered when choosing a pathway.

  • Legitimate Treatment Options

    In some cases, the evidence points to one particular cancer ...

    In some cases, the evidence points to one particular cancer treatment plan. In others, a patient will have more than one legitimate option. In this episode, Dr. Rodvien explores the concepts of surgery, chemotherapy and radiation, and what factors are relevant when choosing a course of action.

  • Oncology History and Medical Insurance 101

    When Dr. Rodvien graduated from medical school, hematologist...

    When Dr. Rodvien graduated from medical school, hematologists treated cancer patients. In this episode he traces the evolution of oncology and the various sub-specialties that have arisen. Also, we continue our exploration of medical insurance for cancer patients and discuss 'compassionate care programs' in which pharmaceutical companies help patients to cover the high costs of medicines.

  • Paying for Cancer

    Ideally, cancer patients should be able to focus on the qua...

    Ideally, cancer patients should be able to focus on the quality and nature of their medical care, rather than its cost. Yet, paying for cancer care can be daunting. In this episode of Smarter Cancer Care, Dr. Rodvien discusses how much insurance is enough, HMO vs. PPO, why some physicians won't treat Medicare patients, how high out of pocket costs can run, and whether cost should be a factor when choosing medical care.

  • Getting Accurate Information

    There's a temptation to listen to well-meaning friends and/o...

    There's a temptation to listen to well-meaning friends and/or to devour whatever information is available on Internet when searching for information about a newly diagnosed cancer. The problem is that you may end up with disinformation. In this episode of Smarter Cancer Care, Oncologist/hematologist Dr. Robert Rodvien provides sound advice on where to turn for accurate information about your cancer.

  • Negotiating the System

    Your best consultant for helping you navigate your way throu...

    Your best consultant for helping you navigate your way through the cancer world is your primary care physician. In this episode of Smarter Cancer Care, Dr. Robert Rodvien explores how to move through the system in the most efficient and effective way possible. It helps to understand that time delays are often necessary and that things will tend to take longer than you would like. A kind and patient attitude can go a long way toward minimizing anxiety and stress.

  • Emotional Impact of Diagnosis

    Shock, confusion and fear are some of the emotions that canc...

    Shock, confusion and fear are some of the emotions that cancer patients often experience upon receiving a diagnosis. Close friends and family members often share these feelings and are uncertain of how to respond. In this episode, clinical Oncologist Dr. Robert Rodvien offers sound advice on how to help cancer patients with their initial psychological responses. Caring friends and relatives should always remember that the needs of the patient come first and that they do not have to respond to everything that is said.

  • Choosing a Cancer Team

    What is the difference between a a clinical Oncologist, a ra...

    What is the difference between a a clinical Oncologist, a radiation Oncologist, and an Oncologist who specializes in a particular form of cancer? Is the mass the same as a tumor? In this episode, Dr. Robert Rodvien answers these questions and others to help cancer patients, their family members, and close friends have a command of the basic terminology of cancer. With compassion, Dr. Rodvien offers practical suggestions for selecting the best medical practitioners and touches on a number of subjects to be explored in depth in future episodes: the impact of medical insurance, managing the information flow, second opinions, and getting the most from your medical appointments.

  • Entering the World of Cancer

    You've just been diagnosed with cancer. What happens next? H...

    You've just been diagnosed with cancer. What happens next? How do you deal with normal life while being completely pre-occupied? What do you do when you get home after being diagnosed? How quickly should you proceed, both medically and psychologically? It's scary and a completely different world, but we may be able to help answer these and other questions.