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Guide 02- Surgeons: Editor's
office
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Editor’s Note |
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Presenting Options
and Making
Recommendations |
“Over the past 30 years, we have gone from a fairly
paternalistic approach to medicine to the other extreme, and
many of my colleagues have become so neutral that they do
not make a recommendation. The burden of deciding has been
removed completely from the physician — who is best
qualified to make that choice or recommendation — to
the patient, who sometimes is, but most often is not in the
best position to make that choice. I understand that patients
have autonomy — as they well should — and I think
we have the obligation to inform them fully and as best as
we can. We need to go beyond that. We need to get to know
patients and understand what drives them and help them to
make decisions. Obviously our recommendation will reflect
our biases and prejudices, but we are better qualified than
someone who just had ‘oncology 101’ during the
previous 20-30 minutes.”
— Gabriel Hortobagyi, MD |
This series provides me with the enviable opportunity to chat with
some of the great minds in cancer medicine. What I have always found
most fascinating about these conversations is learning how these
research leaders integrate cutting edge trial results into daily
patient care. On the enclosed program, Gabe Hortobagyi is unflinching
in his criticism of colleagues who, in his mind, have been slow
to react to the ATAC trial data, which on most recent follow-up
continue to demonstrate a disease-free survival and toxicity advantage
to anastrozole versus tamoxifen.
The theme of research and its implications in clinical practice
has always underscored this series. In this edition, Armando Giuliano
delineates the border between accepted practice and research as
it relates to sentinel node biopsy, Richard Margolese comments on
the management of women with DCIS, and Susan Love reviews what we
do and do not know about management of women at high risk for breast
cancer.
I am interested in your suggestions for future speakers and program
topics. Please email me any comments at nlove@med.miami.edu.
I look forward to hearing from you soon.
—Neil Love, MD
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