Articles

10 Essential Questions When Diagnosed With Bladder Cancer

Over 80,000 new cases of bladder cancer are diagnosed every year.  Of the new cases, over 62,000 are men, and over 18,000 are women.  Whites have higher incidence rates than blacks, although black patients have higher mortality rates, particularly black women.  The majority of cases are found with painless gross hematuria (although most patients with...
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WHEN CANCER ISN’T REALLY CANCER

One of the hardest jobs as a physician is to tell a patient and family that they have been diagnosed with cancer. As a urologist dealing with prostate, bladder and kidney cancer, I often give potentially life-threatening diagnosis while simultaneously reassuring hope and optimism, a skill that requires a deft mastery of the art of...
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CORPORATIZATION OF MEDICINE: TRADING EXCELLENCE FOR MEDIOCRITY

Have you ever been to a doctor’s office and felt that your evaluation was rushed? Have you been seen in the emergency room and felt that you were just a number in a long series of patients? Have you ever seen the same doctor for years and felt like the doctor just met you for...
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RELATIONSHIP STATUS: IT’S COMPLICATED

The operative word describing the relationship between pharmaceutical companies and physicians is“complicated”.  These companies are responsible for innovative medicines, including cancer therapies providing hope to patients where none previously existed.  For example, when I started nearly 15 years ago very little could be offered to prostate cancer patients when hormonal therapy failed.   In the last...
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Medicine and Racial Bias: The Patient Experience

“Yolanda’s biggest problem is she needs to stop doing drugs,” exclaimed one of the doctors as he was talking to a nurse about Yolanda’s pain, implying that Yolanda was an addict to street drugs. In the early stages of my private practice career, I was shocked as I heard him utter these words, as she...
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A Case of a Uterovaginal Fistula

“Dr. Rahman, this is the nurse in OR 12, Dr. H is doing a robotic/laparoscopic hysterectomy, he thinks he’s injured the ureter, and is requesting help. Are you available?” There was a surge of adrenaline in my system as I answered this call in my office, as I know what came next was going to...
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I HAD RADIATION TREATMENT FOR PROSTATE CANCER. HOW DO I KNOW IF MY CANCER HAS RETURNED, AND WHAT DO I DO?

As I have highlighted in other posts, prostate cancer is heterogeneous and often lethal with more than 30,000 deaths per year. Whether surgery, radiation, cryosurgery, chemo or hormonal ablation therapy, treatment for cancer is challenging, and it takes patience and support, from healthcare providers and family, for patients to get through treatment. Fortunately, patients and...
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CAUSATION VS. CORRELATION: THAT IS THE QUESTION!

In the early 1990s large scale studies demonstrated that patient’s undergoing vasectomies had a higher risk of prostate cancer. The common explanation was that there was some statistical correlation between these two findings (perhaps stemming from a younger population exposed to a urologist, i.e. those undergoing vasectomies, were more likely to engage in prostate cancer...
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10 QUESTIONS TO ASK WHEN DIAGNOSED WITH PROSTATE CANCER

Prostate cancer often presents unique challenges to patients and physicians alike. It can be indolent and non-aggressive, or life-threatening, and everything in between. With the multiple treatments (surgery, radiation, hormonal ablation, HIFU, cryoablation) that are available, patients, family members, physicians and even the non-expert urologist are often confused and frustrated. Unlike most cancers that have...
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"It's time for medicine to return to
its roots. A respectful relationship
between doctor and patient."