#CancerChat Transcript

Healthcare social media transcript of the #CancerChat hashtag.
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Liz Szabo @lizszabo
Welcome to #cancerchat! We're talking about cancer screening in the elderly today. Can everyone please introduce themselves?
Judith Graham @judith_graham
RT @LizSzabo: Our #CancerChat about cancer screening at the end of life begins in 15 mins! Join the conversation. https://t.co/LsNamyQgRt h…
Amy Patel, MD @amykpatel
Hello. Amy Patel, @BIDMChealth #Breast #Radiologist. Happy to be joining which I’m sure will be a very lively discussion! #cancerchat
Lown Institute @lowninstitute
Hello! The Lown Institute is a think tank advocating a radically better health system that overturns high-cost, low-value care. @RightCareNow is our sister advocacy org, using community organizing to fight for better care :) #cancerchat https://t.co/TjUdEwJqGP
Liz Szabo @lizszabo
How this works: As moderator, I'll label each topic with T1 or T2. Please use these topic numbers in your response. Easier to follow along. #cancerchat
Deborah Korenstein @dkorenstein
Hi this is Deborah Korenstein- I'm looking forward to the conversation #cancerchat
Dr. Deanna Attai @drattai
hello, Deanna Attai, @UCLAHealth breast surgeon joining this morning #CancerChat
Cary Gross @cpgyale
Greetings #cancerchat - Cary Gross here, Primary care physician and cancer outcomes researcher, excited to join the discussion
Gary Schwitzer @garyschwitzer
.@garyschwitzer of @healthnewsrevu joining @LizSzabo et al for #cancerchat on cancer screening in the elderly.
Liz Szabo @lizszabo
It's great to see all of you joining our #CancerChat today.
Amy Patel, MD @amykpatel
👇#cancerchat https://t.co/6jxu6mzLZm
Breast Cancer Action @bcaction
Join @KHNews and @LizSzabo now for #CancerChat on overtreatment for seniors! https://t.co/lHphPTP1yE
Liz Szabo @lizszabo
T1. How common is cancer screening at the end of life? #cancerchat
Deborah Korenstein @dkorenstein
Sorry I didn't say before- I'm a primary care physician at a cancer center- an unusual combo! #cancerchat
Sharon Dennis @sddphoto
RT @LizSzabo: It's great to see all of you joining our #CancerChat today.
Mara Schonberg @mara_schonberg
56% of women >75 are screened, 50% with <10 year life expectancy #cancerchat
Deborah Korenstein @dkorenstein
I think it depends on how you define EOL- screening in older patients is certainly very common #cancerchat
Liz Szabo @lizszabo
T1. I was surprised to see that nearly 20% of women with dementia still get mammograms. https://t.co/LsNamyQgRt #CancerChat
Inspire @teaminspire
RT @LizSzabo: T1. I was surprised to see that nearly 20% of women with dementia still get mammograms. https://t.co/LsNamyQgRt #CancerChat
Liz Szabo @lizszabo
Thanks and welcome to #CancerChat https://t.co/oxb4pa2Pgk
Inspire @teaminspire
RT @BCAction: Join @KHNews and @LizSzabo now for #CancerChat on overtreatment for seniors! https://t.co/lHphPTP1yE
Christine Spolar @christinespolar
NOW...pls join this Twitter Chat with @LizSzabo @KHNews #Cancerchat https://t.co/XnjtZ4rWRy
Marilyn Thompson @marilynt2004
RT @mmbaily: Today at 1 p.m. ET, chat with the wonderful @LizSzabo https://t.co/eGz9be2PZa
Lown Institute @lowninstitute
T1 Why so much unnecessary cancer screening? Because we're inundated with the message that screening saves lives #cancerchat https://t.co/GmXakEa2PP https://t.co/JmTQsUfuIs
Liz Szabo @lizszabo
T1. One stat that shocked me: 2/3 of women who've had a hysterectomy (and no longer have a cervix) got a cervical cancer screening.Why??? #CancerChat
Inspire @teaminspire
@LizSzabo Hello to #cancerchat and Happy Holidays,John Novack from Inspire here, mostly in lurking mode.
Anna Gorman @annagorman
RT @LizSzabo: T1. How common is cancer screening at the end of life? #cancerchat
Liz Szabo @lizszabo
RT @lowninstitute: T1 Why so much unnecessary cancer screening? Because we're inundated with the message that screening saves lives #cancer
Anna Gorman @annagorman
RT @LizSzabo: Thanks and welcome to #CancerChat https://t.co/oxb4pa2Pgk
Dr. Deanna Attai @drattai
@LizSzabo T1 challenge is that elderly is not the same as end of life - healthy 80yo can keep going >10 years #cancerchat
Amy Patel, MD @amykpatel
T1: #Radiologists certainly do NOT advocate #mammography for older patients who have short life expectancy. PCPs should have this discussion w/their patients to determine this based on co-morbidities, etc. #cancerchat
Liz Szabo @lizszabo
T2. Many people see cancer screening as a way to stay healthy. And studies show these tests can reduce risk of dying from cancer. So what not get screened forever? What are the risks of screening for cancer late in life? #cancerchat
Cary Gross @cpgyale
T1: Caregivers can be reluctant to stop screening because it feels like they are "giving up", even though they may be doing more harm than good if they continue to have loved ones receive unhelpful tests #cancerChat https://t.co/TbV7jWSsIN
Liz Szabo @lizszabo
T1. Why do people want to continue cancer screening even in their 80s? Do they misunderstand how screening works? Do they think they're preventing cancer? #CancerChat
Amy Patel, MD @amykpatel
T1: We as a #Radiology community agree that screening #mammo should occur in women as long as she is in good health (no set age cut off) as we know the risk of #breast cancer increases w/age. @BreastImaging @BIDMChealth @RadiologyACR #cancerchat
Emily Bazar @emilybazar
Right NOW: Join @LizSzabo of @KHNews for her #CancerChat about cancer screening in older adults. Do those tests do more harm than good? https://t.co/jneSfy7gBb
Liz Szabo @lizszabo
RT @DrAttai: @LizSzabo T1 challenge is that elderly is not the same as end of life - healthy 80yo can keep going >10 years #cancerchat
Liz Szabo @lizszabo
RT @cpgYALE: T1: Caregivers can be reluctant to stop screening because it feels like they are "giving up", even though they may be doing mo…
Liz Szabo @lizszabo
RT @amykpatel: T1: #Radiologists certainly do NOT advocate #mammography for older patients who have short life expectancy. PCPs should have…
Cary Gross @cpgyale
T1: We have fairly reliable approaches to measure life expectancy in general ballpark. But people often reluctant to apply those results to themselves #cancerChat
Amy Patel, MD @amykpatel
RT @cpgYALE: T1: Caregivers can be reluctant to stop screening because it feels like they are "giving up", even though they may be doing mo…
Mara Schonberg @mara_schonberg
Hi all- Happy to be joining! I am an internist and researcher at #BIDMChealth #cancerchat
Liz Szabo @lizszabo
RT @amykpatel: T1: We as a #Radiology community agree that screening #mammo should occur in women as long as she is in good health (no set…
Deborah Korenstein @dkorenstein
T1. Similarly- prostate cancer screening happens in over half of men with high risk of mortality https://t.co/ExA9Cor2yE #cancerchat
Natrice Rese 🇨🇦 @natricer
RT @amykpatel: T1: We as a #Radiology community agree that screening #mammo should occur in women as long as she is in good health (no set…
Lown Institute @lowninstitute
T2 Screening often finds cancers that would not have required treating, but we treat them anyway bc we don't know which are dangerous. So patients get biopsies, surgery, radiation, for non-life-threatening cancers #cancerchat https://t.co/hwyNuWCxKP
Amy Patel, MD @amykpatel
THIS👇 #cancerchat https://t.co/p63P7UGQuZ
Mara Schonberg @mara_schonberg
56% of women >75 years are screened with mammography including 50% of women 75+ with <10 year life expectancy #cancerchat
Amy Patel, MD @amykpatel
RT @cpgYALE: T1: We have fairly reliable approaches to measure life expectancy in general ballpark. But people often reluctant to apply tho…
Gary Schwitzer @garyschwitzer
T2 #cancerchat: Peruse many media messages we’ve reviewed that focus only on screening benefits, minimizing/ignoring harms, and you see one huge factor influencing people. https://t.co/tZW9Wcv8pU
Liz Szabo @lizszabo
T1. Why are men getting PSAs when they have only a few years left to live? Do men push for these tests? Do doctors pressure them to test? Or do they get automated reminder cards? #CancerChat https://t.co/eYqjgjrePI
Mara Schonberg @mara_schonberg
56% of women 75+ are screened for breast cancer inlcuding 50% of women 75+ with <10 year life expectancy. #cancerchat
Karen Kahn @karenakahn
RT @lowninstitute: T2 Screening often finds cancers that would not have required treating, but we treat them anyway bc we don't know which…
Wendy Haaf @whaaf
RT @BCAction: Join @KHNews and @LizSzabo now for #CancerChat on overtreatment for seniors! https://t.co/lHphPTP1yE
Liz Szabo @lizszabo
T2. @Richard31901063, can you talk about the risks of cancer screening in older men? Some men says, 'It's just a blood test." #cancerchat
Truth Seeker @truthseeker1991
#صنعاء المهدي المنتظر ناصر محمد اليماني https://t.co/9dAUPHMtdD #ЛьзяФолловитНовыйГод #Trai_Turner #cancerchat #Netz https://t.co/KNa4iOdCfV
Mara Schonberg @mara_schonberg
56% of women 75+ are screened with mammography including 50% of women 75+ with <10 year life expectancy #cancerchat
Kaiser Health News @khnews
RT @emilybazar: Right NOW: Join @LizSzabo of @KHNews for her #CancerChat about cancer screening in older adults. Do those tests do more har…
Kaiser Health News @khnews
RT @LizSzabo: T1. Why are men getting PSAs when they have only a few years left to live? Do men push for these tests? Do doctors pressure t…
Kaiser Health News @khnews
RT @LizSzabo: T2. @Richard31901063, can you talk about the risks of cancer screening in older men? Some men says, 'It's just a blood test."…
Liz Szabo @lizszabo
Why are docs ordering screenings for people with stage 4 cancer? #CancerChat https://t.co/7ShVF0TKjT
Deborah Korenstein @dkorenstein
T1. Sometimes older people simply expect screening as part of routine care and docs don't have/take the time to explain the downsides #cancerchat
Inspire @teaminspire
RT @DKorenstein: T1. Sometimes older people simply expect screening as part of routine care and docs don't have/take the time to explain th…
Liz Szabo @lizszabo
Is it hard for docs to stop ordering tests? #CancerChat https://t.co/qRfCMU1rVB
Dr. Deanna Attai @drattai
@LizSzabo #CancerChat stage IV can have a long life expectancy, depending on disease
Liz Szabo @lizszabo
RT @DrAttai: @LizSzabo #CancerChat stage IV can have a long life expectancy, depending on disease
Sarah Gollust @sarahgollust
@garyschwitzer T2 #cancerchat. Yes! And as a result of lack of exposure to these harm messages, women don't find them to be credible. Few are aware, few find them believable. @RebekahNagler https://t.co/7totGOM964
Liz Szabo @lizszabo
RT @sarahgollust: @garyschwitzer T2 #cancerchat. Yes! And as a result of lack of exposure to these harm messages, women don't find them to…
Liz Szabo @lizszabo
RT @DKorenstein: T1. Sometimes older people simply expect screening as part of routine care and docs don't have/take the time to explain th…
Mara Schonberg @mara_schonberg
It is not always the doc ordering the test, many times the patient receives a mailed reminder and goes for screening #cancerchat
Inspire @teaminspire
RT @DKorenstein: T1. Similarly- prostate cancer screening happens in over half of men with high risk of mortality https://t.co/ExA9Cor2yE #…
Reba Van Andel @rebaperson
During my deceased spouse's last year of life, declining due to Parkinson's, doctors performed 3 colostomies on him. He was game, but I thought it was a waste. https://t.co/jdsyHswqBx
Amy Patel, MD @amykpatel
T1: And that is why it is imperative that shared decision making & education occur with PCPs, #patients, and loved ones. There is no one-size-fits-all approach to #breastcancer screening in older women. #cancerchat https://t.co/XxaRH9wxKO
Mara Schonberg @mara_schonberg
without PCP knowing.. #cancerchat
Dr. Deanna Attai @drattai
@LizSzabo #CancerChat not all stage IV the same
Liz Szabo @lizszabo
RT @garyschwitzer: T2 #cancerchat: Peruse many media messages we’ve reviewed that focus only on screening benefits, minimizing/ignoring har…
Amy Patel, MD @amykpatel
RT @DrAttai: @LizSzabo #CancerChat stage IV can have a long life expectancy, depending on disease
UM V-BID Center @um_vbid
As long as these unnecessary and sometimes harmful tests are reimbursed they will continue to be ordered. "It is difficult to understand something, if your salary depends on you not understanding it. " Upton Sinclair, The Jungle https://t.co/8xnKf9UKCl
Sarah Gollust @sarahgollust
@LizSzabo T1: Suggests care-givers' routines are hard to shift! Maybe as hard/harder as patients, since they want to do everything they can for their loved ones. #CancerChat
Liz Szabo @lizszabo
RT @Mara_Schonberg: It is not always the doc ordering the test, many times the patient receives a mailed reminder and goes for screening #c
Liz Szabo @lizszabo
RT @amykpatel: T1: And that is why it is imperative that shared decision making & education occur with PCPs, #patients, and loved ones. The…
Barbara Muchow @bfm4440
RT @LizSzabo: T1. One stat that shocked me: 2/3 of women who've had a hysterectomy (and no longer have a cervix) got a cervical cancer scre…
Liz Szabo @lizszabo
RT @sarahgollust: @LizSzabo T1: Suggests care-givers' routines are hard to shift! Maybe as hard/harder as patients, since they want to do e…
Gary Schwitzer @garyschwitzer
While @KHNews helps readers recognize overdiagnosis/overtreatment, @NEJM calls “less is more” efforts a “crusade” of “oversimplifying.” #cancerchat https://t.co/8GtYLWY8nw
Cary Gross @cpgyale
T1 - well, one powerful reason we have so much #overscreening is that we've been pushing these tests for 40 years, with limited discussion of risk until recently. #cancerchat @thehowie https://t.co/nd8xUBurvr
(((Howard Forman))) @thehowie
I have had clinicians asking for staging studies on DNR/DNI patients so that family can come to grips with the facts that we are dealing with hours/days, and not weeks. #cancerchat #futilecare https://t.co/1eqgb3HpBd
Deborah Korenstein @dkorenstein
In response to Liz, not ordering the test can require a difficult conversation that takes time @sloan_kettering #cancerchat
UM V-BID Center @um_vbid
#cancerchat As long as these unnecessary and sometimes harmful tests are reimbursed they will continue to be ordered. "It is difficult to understand something, if your salary depends on you not understanding it. " Upton Sinclair, The Jungle
Mara Schonberg @mara_schonberg
9% of women 65+ with stage IV lung/colon cancer are screened after diagnosis #cancerchat
Diane Webber @dwebbkhn
@LizSzabo In my mother's case, it was in response to her pain. She had breast cancer, brain met already diagnosed and was clearly near death. She had pain in her legs. Onc off-handedly said, "we'll give her a PET scan" to see if she has bone mets. #cancerchat
Liz Szabo @lizszabo
T2 I hear a lot of people say they get screened b/c they want to stay healthy, have good quality of life. But cancer treatment can really harm quality of life. #CancerChat
Breast Cancer Action @bcaction
Questions about this? Our #mammography brochure has more information about the risks/benefits of #breastcancer screening. https://t.co/0UiKZXS6Pt https://t.co/omVROhh3GA
Liz Szabo @lizszabo
RT @thehowie: I have had clinicians asking for staging studies on DNR/DNI patients so that family can come to grips with the facts that we…
Liz Szabo @lizszabo
RT @cpgYALE: T1 - well, one powerful reason we have so much #overscreening is that we've been pushing these tests for 40 years, with limite…
Amy Patel, MD @amykpatel
@Mara_Schonberg Important that #Radiologists pay attention to the language in which they use for this patient population. I think the majority of our community tries to make this effort and only wants what’s best for the #patient #cancerchat @LizSzabo
Kay Curtin @kaycurtin1
@LizSzabo I still had my Pap smear it did feel slightly pointless but I do know people being treated for two different types of cancer simultaneously and with new drug treatments Stage 4 isn’t an automatic death sentence where there’s life there’s hope #cancerchat
Liz Szabo @lizszabo
RT @garyschwitzer: While @KHNews helps readers recognize overdiagnosis/overtreatment, @NEJM calls “less is more” efforts a “crusade” of “ov…
Breast Cancer Action @bcaction
RT @lowninstitute: T2 Screening often finds cancers that would not have required treating, but we treat them anyway bc we don't know which…
Cary Gross @cpgyale
Ironically that sounds like a great diagnostic test for poor doctor-patient communication.... https://t.co/gdA5g39lRH
Mara Schonberg @mara_schonberg
Only 20% of women with stage IV lung/colorectal cancer have 5-year survival #cancerchat
Liz Szabo @lizszabo
T3. Why is timing so crucial with cancer screening? How long does it take for a cancer screening to help you -- i.e, save your life? #cancerchat https://t.co/LsNamz7RJ1
Liz Szabo @lizszabo
RT @KayCurtin1: @LizSzabo I still had my Pap smear it did feel slightly pointless but I do know people being treated for two different type…
Deborah Korenstein @dkorenstein
@garyschwitzer @KHNews @NEJM But I think the author has a point when she says that we need to be sure not to oversimplify- defining appropriateness can be tricky and should be individualized #cancerchat
Liz Szabo @lizszabo
RT @Mara_Schonberg: Only 20% of women with stage IV lung/colorectal cancer have 5-year survival #cancerchat
(((Howard Forman))) @thehowie
Technology always ahead of the outcomes research. In a "more is better" world, it is an uphill battle (with perverse $$ incentives) to curtail impulse to screen. https://t.co/hk4Pdeqqdv
Liz Szabo @lizszabo
Prostate cancer has risks: #Cancerchat https://t.co/G0CG9fGbKL
Cary Gross @cpgyale
T3: Many professional societies recommend that we stop #cancer #screening when life expectancy is <10 years, because it usually takes a decade for #screening benefits to become manifest #cancerchat @LizSzabo
Diane Webber @dwebbkhn
@LizSzabo I said no to the scan and started discussing hospice. I think there's just a reflexive "let's find out." Sometimes it is not a question that needs to be answered. She needed pain treatment, not screening. #CancerChat
Liz Szabo @lizszabo
RT @dwebbKHN: @LizSzabo I said no to the scan and started discussing hospice. I think there's just a reflexive "let's find out." Sometimes…
Mara Schonberg @mara_schonberg
At some health systems, patients are scheduled for their next mammogram immediately after getting screened, PCP not involved #cancerchat
Amy Patel, MD @amykpatel
@DKorenstein @garyschwitzer @KHNews @NEJM Absolutely! #cancerchat
Deborah Korenstein @dkorenstein
T3 It generally takes 10 years to benefit from cancer screening, while the potential harms happen much sooner #cancerchat
Sarah Gollust @sarahgollust
@LizSzabo This is a good point. #CancerChat - people may be weighing current health against assumed later health in making a screening decision, not the counterfactual of quality of life under cancer treatment.
Raj OnBlockchain @rajgoel_ny
RT @cpgYALE: T1 - well, one powerful reason we have so much #overscreening is that we've been pushing these tests for 40 years, with limite…
Liz Szabo @lizszabo
I'd like to hear from patients, consumers and advocates. How long do you plan to get screened for cancer? Is there an age where you'd want to stop? #CancerChat
Ash Paul @pash22
RT @LizSzabo: T2 I hear a lot of people say they get screened b/c they want to stay healthy, have good quality of life. But cancer treatmen…
Natrice Rese 🇨🇦 @natricer
RT @LizSzabo: I'd like to hear from patients, consumers and advocates. How long do you plan to get screened for cancer? Is there an age whe…
Dr. Deanna Attai @drattai
RT @LizSzabo: I'd like to hear from patients, consumers and advocates. How long do you plan to get screened for cancer? Is there an age whe…
Liz Szabo @lizszabo
#Good point. #CancerChat https://t.co/J19APl73GE
Diane Webber @dwebbkhn
@Mara_Schonberg Yes, I think the automation of health care sometimes gets in the way of commonsense decision making @LizSzabo #CancerChat
(((Howard Forman))) @thehowie
#cancerchat When i told a similar story to visiting colleagues in #NHS, they told me that their response (to family in similar situation) was "Grandmum is going to die soon; Let's talk about how we can make her comfortable.") Why are we so afraid?@cpgYALE https://t.co/TxJyl2iYm7
Ash Paul @pash22
RT @LizSzabo: Is it hard for docs to stop ordering tests? #CancerChat https://t.co/qRfCMU1rVB
Jay Hancock @jayhancock1
RT @LizSzabo: I'd like to hear from patients, consumers and advocates. How long do you plan to get screened for cancer? Is there an age whe…
Liz Szabo @lizszabo
This is important information. After my story was published, some people thought we were saying that society should stop caring about you/caring for you in the last decade of life. #cancerchat https://t.co/fBxereZJa5
Deborah Korenstein @dkorenstein
@sarahgollust @LizSzabo Great point- I agree people often assume that screening benefit = perfect health #cancerchat
Liz Szabo @lizszabo
RT @DKorenstein: @sarahgollust @LizSzabo Great point- I agree people often assume that screening benefit = perfect health #cancerchat
Gary Schwitzer @garyschwitzer
Breast surgeon quote: “All of us have visceral fear of not doing the most we can. And so just getting society more comfortable w/idea of de-escalation as being something that could be potentially more healthy is very difficult concept.” #cancerchat https://t.co/XcyTKPoI6a
Sarah Gollust @sarahgollust
RT @LizSzabo: I'd like to hear from patients, consumers and advocates. How long do you plan to get screened for cancer? Is there an age whe…
Dr. Deanna Attai @drattai
RT @garyschwitzer: Breast surgeon quote: “All of us have visceral fear of not doing the most we can. And so just getting society more comfo…
Liz Szabo @lizszabo
RT @garyschwitzer: Breast surgeon quote: “All of us have visceral fear of not doing the most we can. And so just getting society more comfo…
Sarah Gollust @sarahgollust
RT @garyschwitzer: Breast surgeon quote: “All of us have visceral fear of not doing the most we can. And so just getting society more comfo…
Anirban Maitra @aiims1742
Very interesting conversation led by @LizSzabo on the wisdom (or lack thereof) of cancer screening in elderly populations Old habits are hard to break. Use #CancerChat to follow along. https://t.co/YDRg7Snv8f
(((Howard Forman))) @thehowie
Even when actuarial tables suggest life expectancy is < 10 years, our natural (national?) instinct is to aspire for better than that. #cancerchat https://t.co/Ivj76PgPSv
Liz Szabo @lizszabo
@Richard31901063, can you talk about how dangerous prostate cancers really are? People often assume all cancers are the same (ie, deadly). But that's not always the case, right? #cancerchat
Amy Patel, MD @amykpatel
We do NOT recommend screening #mammo based on fattening our paychecks. We recommend it bc it saves lives, and a lot of lives at that. #cancerchat #bcsm https://t.co/kR7wBCEEiy https://t.co/Z7UzyHCuhf
Mara Schonberg @mara_schonberg
In the case of dementia, it is often the family member making the decision and can be a hard decision for family members #cancerchat
Cary Gross @cpgyale
As a society, we are so fearful of discussing death that we end up making end of life more painful and uncomfortable than it would be otherwise. Trading away the patients physical comfort for our own psychological comfort (avoiding discussion). #Cancerchat https://t.co/4jnj6lc1ux
Judith Garber @judithegarber
RT @BCAction: Join @KHNews and @LizSzabo now for #CancerChat on overtreatment for seniors! https://t.co/lHphPTP1yE
Liz Szabo @lizszabo
I've heard from friends who said their moms were screened after developing dementia, or that someone wanted to screen them while they were in hospice. #cancerchat https://t.co/i9JaYQoQpl
Liz Szabo @lizszabo
RT @Aiims1742: Very interesting conversation led by @LizSzabo on the wisdom (or lack thereof) of cancer screening in elderly populations O…
Deborah Korenstein @dkorenstein
@thehowie @cpgYALE We need tools to facilitate these conversations! #cancerchat
Norm Eisen @normeisen
paging Ivanka https://t.co/nLJ21o4UDX
Liz Szabo @lizszabo
Is a lot of overtreatment/overtesting due to our reluctance to talk about death? #CancerChat https://t.co/jk819sxK4I
Cary Gross @cpgyale
There is always the lake Wobbegone effect - we all feel we will outlive our life expectancy so we make decisions accordingly #cancerchat https://t.co/emFopWqVZC
Liz Szabo @lizszabo
RT @cpgYALE: T3: Many professional societies recommend that we stop #cancer #screening when life expectancy is <10 years, because it usuall…
Liz Szabo @lizszabo
RT @amykpatel: We do NOT recommend screening #mammo based on fattening our paychecks. We recommend it bc it saves lives, and a lot of lives…
I Love Cats @_iheartcats
Fancy Black Cat Cat T Shirt Get here=> https://t.co/oMQo9qUN2K #catscups #catslegging #catsvnecks #catstanktop #cancerchat https://t.co/ivuRdR2YT0
Liz Szabo @lizszabo
RT @thehowie: Even when actuarial tables suggest life expectancy is < 10 years, our natural (national?) instinct is to aspire for better t…
Liz Szabo @lizszabo
RT @cpgYALE: There is always the lake Wobbegone effect - we all feel we will outlive our life expectancy so we make decisions accordingly #…
Atul Grover, MD, PhD @atulgrovermd
RT @cpgYALE: There is always the lake Wobbegone effect - we all feel we will outlive our life expectancy so we make decisions accordingly #…
Rebekah Nagler @rebekahnagler
RT @sarahgollust: @garyschwitzer T2 #cancerchat. Yes! And as a result of lack of exposure to these harm messages, women don't find them to…
Roberta @robertaschell
it’s ok to stop ordering tests. I know we do this to try to help. maybe to avoid dealing with our emotions. watching people die is hard. we need to do better. https://t.co/3jvP3EJw2U
Mara Schonberg @mara_schonberg
@LizSzabo Long-term prognostication is challenging for PCPs and most of us were not trained to talk about stopping tests/meds #cancerchat
(((Howard Forman))) @thehowie
It is our natural inclination to hope and hang on. $$ incentives encourage this, rather than encouraging quality end-of-life. Need to change incentives and access to information for patients and their families. #cancerchat https://t.co/aWZMM2VJQb
(((Howard Forman))) @thehowie
RT @cpgYALE: There is always the lake Wobbegone effect - we all feel we will outlive our life expectancy so we make decisions accordingly #…
ΕΛΛ.Ο.Κ. @ellokgr
RT @cpgYALE: There is always the lake Wobbegone effect - we all feel we will outlive our life expectancy so we make decisions accordingly #…
Liz Szabo @lizszabo
T2 @cpgYALE A 78-yr-old said, “I, for one, do not like to hear what my life expectancy is." He plans to have his next colonoscopy in January. He feels healthy and walks 2 miles at a stretch several days a week. “No one knows when I am going to die.” #CancerChat
Amy Patel, MD @amykpatel
@cpgYALE @LizSzabo T3: again, shared decision-making & education are imperative, and every older #patient is different based on risk factors & co-morbidities #cancerchat
Cary Gross @cpgyale
Excellent point - maybe we should have new "De-Prescription Pads" that doctors use to take their patients off their meds! #cancerchat @dramyabernethy https://t.co/860ctyDq5Z
Liz Szabo @lizszabo
T4. Many people have unrealistic ideas about the benefits of cancer screening. Can you help us understand how people need to be screened to save one life? #cancerchat https://t.co/MU4eSkiNvK
Judith Graham @judith_graham
RT @DKorenstein: T1. Similarly- prostate cancer screening happens in over half of men with high risk of mortality https://t.co/ExA9Cor2yE #…
(((Howard Forman))) @thehowie
We need to address this through better #MedEd, and continued education throughout our careers. But financial incentives do not help. #cancerchat https://t.co/ydvondnjL5
Mara Schonberg @mara_schonberg
@LizSzabo It is easier to talk about stopping screening with older adults in poor health or with many chronic conditions #cancerchat
Liz Szabo @lizszabo
That's a really important fact. Everyone whose cancer is diagnosed through screening assumes the test saved his/her life. That's not necessarily true, though, is it? We don't always know which tumor is harmless vs. lethal? #Cancerchat https://t.co/rvFWN2UMtZ
Liz Szabo @lizszabo
RT @cpgYALE: Excellent point - maybe we should have new "De-Prescription Pads" that doctors use to take their patients off their meds! #can
Sarah Gollust @sarahgollust
@LizSzabo Ordering a test sure is easier...for everyone involved #CancerChat. Anybody know if physicians with more palliative care training in residency or med school (or even more narrative medicine / social medicine) tend to order fewer tests?
(((Howard Forman))) @thehowie
RT @cpgYALE: As a society, we are so fearful of discussing death that we end up making end of life more painful and uncomfortable than it w…
Liz Szabo @lizszabo
RT @Mara_Schonberg: @LizSzabo It is easier to talk about stopping screening with older adults in poor health or with many chronic condition…
Dr. Deanna Attai @drattai
most definitely, no one (doc or patient) wants to admit mortality #CancerChat https://t.co/uZNk8TgFIn
Sarah Gollust @sarahgollust
RT @LizSzabo: That's a really important fact. Everyone whose cancer is diagnosed through screening assumes the test saved his/her life. Tha…
Liz Szabo @lizszabo
What language do you use? Telling someone, "You're not going to live long enough to benefit" probably doesn't go over well! #CancerChat https://t.co/cgSSSo4z1C
Amy Patel, MD @amykpatel
@Mara_Schonberg Absolutely! I’m sure you’ve had difficult discussions with families of #patients. At the end of the day, they want what’s best for their loved one as do we as a #medical community. We must tirelessly do our best to educate and achieve mutual understanding #cancerchat
Liz Szabo @lizszabo
RT @amykpatel: @Mara_Schonberg Absolutely! I’m sure you’ve had difficult discussions with families of #patients. At the end of the day, the…
Deborah Korenstein @dkorenstein
I think doctors feel like doing things gives patients/families hope. Again, better communication would help address this @sloan_kettering #cancerchat
Liz Szabo @lizszabo
RT @DrAttai: most definitely, no one (doc or patient) wants to admit mortality #CancerChat https://t.co/uZNk8TgFIn
Liz Szabo @lizszabo
RT @DKorenstein: I think doctors feel like doing things gives patients/families hope. Again, better communication would help address this @…
Cary Gross @cpgyale
T2: Good point - nobody knows for sure what the future holds. But we need to do a better job in medicine providing patients with information they need in order to make informed decisions. #cancerchat https://t.co/XxQjLV2ewd
Liz Szabo @lizszabo
RT @cpgYALE: T2: Good point - nobody knows for sure what the future holds. But we need to do a better job in medicine providing patients wi…
CHJ @reportinghealth
RT @emilybazar: Right NOW: Join @LizSzabo of @KHNews for her #CancerChat about cancer screening in older adults. Do those tests do more har…
Lown Institute @lowninstitute
T4 Visual aids like theaters can help show the risks and benefits of cancer screening more clearly than statistics only @DocLazris #cancerchat https://t.co/AzFCcLgUm3 https://t.co/FQ2Iz6irVH
AMY MARASH @cancerissofunny
#CancerChat
Mara Schonberg @mara_schonberg
@DKorenstein @thehowie @cpgYALE Agree! We are working on some. Please see https://t.co/ChvRdb9Jdm and the cancer screening tab. #cancerchat
Maxim Jacobs, CFA @maxjacobsedison
RT @LizSzabo: T4. Many people have unrealistic ideas about the benefits of cancer screening. Can you help us understand how people need to…
Who Trended it ? @whotrendedit
Wooohoo @LizSzabo is responsible for trending #cancerchat in the US-of-A. You can trust the robot.
Liz Szabo @lizszabo
@cpgYALE Can you talk about how screenings can cause harm in elderly? One person responded to my story by scoffed at the notion that fainting (due to bowel prep) was a real risk. #cancerchat
Deborah Korenstein @dkorenstein
@LizSzabo All cancers can be described that way (turtles, rabbits, birds) to some extent. And we understand a bit about aggressiveness but not everything #cancerchat @sloan_kettering
Roberta @robertaschell
RT @LizSzabo: Is it hard for docs to stop ordering tests? #CancerChat https://t.co/qRfCMU1rVB
Amy Patel, MD @amykpatel
RT @cpgYALE: T2: Good point - nobody knows for sure what the future holds. But we need to do a better job in medicine providing patients wi…
AMY MARASH @cancerissofunny
#CancerChat It's a delicate balance between what you want to hear and what you might find out.
(((Howard Forman))) @thehowie
If a man lives long enough, he will die WITH Prostate & Thyroid cancer (perhaps others) but he is very unlikely to die from either of them. Very hard to educate patients, when MDs reticent to acknowledge this. #cancerchat https://t.co/9pGyCuvijg
Kay Curtin @kaycurtin1
@LizSzabo My dad 91 had cognitive decline and couldn’t communicate his symptoms for last month he actually had lymphoma which we only discovered after his death so didn’t receive hospice support had a horrendous death may have been avoided if we had been informed of diagnosis #cancerchat
Diane Webber @dwebbkhn
@LizSzabo In my experience, they have been closely related. I'm remembering my late great friend and colleague Peggy Girshman, who had to fight docs to take her ailing dad off heart meds, when that death would be more merciful than his other options #CancerChat
Kaiser Health News @khnews
RT @LizSzabo: What language do you use? Telling someone, "You're not going to live long enough to benefit" probably doesn't go over well! #…
John S. Wilson @johnwilson
RT @cpgYALE: As a society, we are so fearful of discussing death that we end up making end of life more painful and uncomfortable than it w…
#Humanity#OneLove ☤☮ @drdiana7
RT @LizSzabo: Is it hard for docs to stop ordering tests? #CancerChat https://t.co/qRfCMU1rVB
Liz Szabo @lizszabo
I'm so sorry. That sounds awful. But common. I hear from many people who don't understand diagnosis. #cancerchat https://t.co/3Fb8ECjmr1
Kaiser Health News @khnews
RT @LizSzabo: That's a really important fact. Everyone whose cancer is diagnosed through screening assumes the test saved his/her life. Tha…
Kaiser Health News @khnews
RT @LizSzabo: T4. Many people have unrealistic ideas about the benefits of cancer screening. Can you help us understand how people need to…
I Love Dogs @_iheartdogs_
The Dogfather Hungarian Vi... Get yours => https://t.co/qGDQduPgE5 #dogtshirts #dogmug #doghoodies #dogtanktop #dogvnecks #cancerchat https://t.co/z9icC7bIZw
Mara Schonberg @mara_schonberg
A trusting relationship with a PCP facilitates discussions around stopping. #cancerchat
Liz Szabo @lizszabo
RT @dwebbKHN: @LizSzabo In my experience, they have been closely related. I'm remembering my late great friend and colleague Peggy Girshman…
bibash shrestha @bbusnewwar
15 Democratic #SongsAboutDisappointingGifts Desus and Mero #cancerchat #friyay Phoebe Philo #2017Success https://t.co/jPhTYtOZte
Liz Szabo @lizszabo
RT @Mara_Schonberg: A trusting relationship with a PCP facilitates discussions around stopping. #cancerchat
Mara Schonberg @mara_schonberg
Focusing on how the harms outweigh the benefits is a successful approach, especially when talking about stopping colonoscopies #cancerchat
#Humanity#OneLove ☤☮ @drdiana7
RT @Aiims1742: Very interesting conversation led by @LizSzabo on the wisdom (or lack thereof) of cancer screening in elderly populations O…
Mara Schonberg @mara_schonberg
It is more challenging to discuss stopping mammography than colonoscopy. #cancerchat
Cary Gross @cpgyale
Screenings can cause harm directly - through a complication of the procedure -- or somewhat indirectly, by finding something that wouldn't have caused a problem if it had otherwise gone undetected. Such as a non-aggressive cancer #cancerchat https://t.co/E3ZaTkhfOp
Memnos🖖🏼 @memnosoncos
@amykpatel @Mara_Schonberg It’s especially hard being the one to carry out their wishes when we’d rather do something else. But it’s a final act of love. #cancerchat
Mara Schonberg @mara_schonberg
I actually have a grant (NCI R21) to develop and test scripts for PCPs to use for these discussions #cancerchat
Liz Szabo @lizszabo
Good point. A man in my story chose "Active Surveillance" rather than immediate prostate cancer treatment. If tests show his cancer is growing, only then will he have treatment. Could spare him from side effects. #cancerchat https://t.co/4QxxRqqAFw
Deborah Korenstein @dkorenstein
@LizSzabo That does sound awful- and the doctors shouldn't have needed a definitive diagnosis to treat your father's terrible symptoms. #cancerchat
Memnos🖖🏼 @memnosoncos
RT @LizSzabo: Good point. A man in my story chose "Active Surveillance" rather than immediate prostate cancer treatment. If tests show his…
Liz Szabo @lizszabo
RT @Mara_Schonberg: Focusing on how the harms outweigh the benefits is a successful approach, especially when talking about stopping colono…
UM V-BID Center @um_vbid
T3. This important population-based point can be seriously misconstrued by folks who tend to overgeneralize. Many people benefit from screening on the day it occurs (e.g. colon, breast cancer). #cancerchat https://t.co/zGluQfdQsE
Amy Patel, MD @amykpatel
@Mara_Schonberg Interesting. Why do you think that is from a PCP perspective? #cancerchat @LizSzabo
Liz Szabo @lizszabo
The harms from PSA testing can be permanent. “When a man has no erections, that is paralysis,” said Harold Honeyfield, 87, of Davis, Calif. “You’ve lost the ability to be a man.” #cancerchat
Kay Curtin @kaycurtin1
@LizSzabo It was if it didn’t matter because he was old and going to die anyway there was no pain relief offered until we demanded it even if he didn’t have lymphoma that is wrong and distressing for patient and family would have been totally different with diagnosis on time #cancerchat
Liz Szabo @lizszabo
RT @DKorenstein: @LizSzabo That does sound awful- and the doctors shouldn't have needed a definitive diagnosis to treat your father's terri…
Naomi Kaufman Price @writeo
Well, Dad was almost 101 & in great health until 95. Mom died at 89; Lewy body dementia. I’m 68; no more paps. But colonoscopy, for sure. Mammo: Jury’s out. #CancerChat https://t.co/QOxLcnHvKL
Liz Szabo @lizszabo
RT @writeo: Well, Dad was almost 101 & in great health until 95. Mom died at 89; Lewy body dementia. I’m 68; no more paps. But colonoscopy,…
USA Email Lists For Sale @allemaillists
#RT @USATODAY: RT @LizSzabo: As we age, when does cancer screening become more of a burden than a benefit? Join our Twitter chat from 1 to 2 p.m. ET, Friday Dec. 22. #cancerchat https://t.co/XtwB77z0FH https://t.co/xuJwVWl4sA
Mara Schonberg @mara_schonberg
@amykpatel @Mara_Schonberg @LizSzabo Since most public health messages/media for years have focused only on benefits #cancerchat
Harlan Krumholz @hmkyale
RT @cpgYALE: T2: Good point - nobody knows for sure what the future holds. But we need to do a better job in medicine providing patients wi…
Liz Szabo @lizszabo
It sounds like he would have benefitted from palliative care. #CancerChat https://t.co/sKzRYryqwo
Harlan Krumholz @hmkyale
RT @LizSzabo: What language do you use? Telling someone, "You're not going to live long enough to benefit" probably doesn't go over well! #…
marymcnamara @marymcnamara
RT @LizSzabo: I'd like to hear from patients, consumers and advocates. How long do you plan to get screened for cancer? Is there an age whe…
Mara Schonberg @mara_schonberg
It can be perceived as "fake news" to hear that the harms of screening may outweigh any chance of benefit #cancerchat
Harlan Krumholz @hmkyale
RT @cpgYALE: Excellent point - maybe we should have new "De-Prescription Pads" that doctors use to take their patients off their meds! #can
Mara Schonberg @mara_schonberg
It requires a trusting relationship to feel that your PCP is not ageist or trying to conserve costs #cancerchat
Breast Cancer Action @bcaction
RT @cpgYALE: Screenings can cause harm directly - through a complication of the procedure -- or somewhat indirectly, by finding something t…
Liz Szabo @lizszabo
T5. Do you know someone who has been screened for cancer late in life? Were they helped or harmed? #cancerchat https://t.co/LsNamz7RJ1
Liz Szabo @lizszabo
My colleagues at @khnews made this great video explaining the benefits of mammography. You need to screen 1000 women for 10 yrs to save 1 life. https://t.co/MU4eSk1cEc #cancerchat https://t.co/0WeKPdW2lP
Natrice Rese 🇨🇦 @natricer
RT @LizSzabo: T5. Do you know someone who has been screened for cancer late in life? Were they helped or harmed? #cancerchat https://t.co/L…
Mia Spano-Curtiss @fckboobiecancer
Fabulous Question!!! https://t.co/Q4tezuXUFQ
Dr. Deanna Attai @drattai
@LizSzabo active surveillance being used for DCIS in the @ALLIANCE_org COMET study https://t.co/EHZ8SlHjeX #CancerChat #bcsm
iamtrendbot @iamtrendbot
RT @LizSzabo: So you got your first cancer screening age 40. You follow up every year. But for how long? Until what age? At some point, doe…
Memnos🖖🏼 @memnosoncos
Really great conversation happening over at #cancerchat - interesting accidental stumble into.
L'Amazzone Furiosa @amazzonefuriosa
@LizSzabo Harms from mammographic screening can be permanent too. Still concern for those from PSA testing is much higher #CancerChat
Amy Patel, MD @amykpatel
@Mara_Schonberg @LizSzabo And understandably so. However, this #patient population certainly needs to be more tailored and we are trying to convey this in the media, to patients, and PCPs. We will continue to strengthen our efforts regarding screening education and the elderly #cancerchat
Liz Szabo @lizszabo
Instead of focusing on screening, Louise Walter at UCSF said she addresses immediate needs: fall prevention, depression screening, etc. Walter might tell a patient, “‘Right now, you have really bad heart failure and we need to get that under control." https://t.co/LsNamyQgRt https://t.co/viqT3tHBwp
Liz Szabo @lizszabo
That's great news/ https://t.co/p8DpN5CQyQ
Ash Paul @pash22
RT @LizSzabo: Is a lot of overtreatment/overtesting due to our reluctance to talk about death? #CancerChat https://t.co/jk819sxK4I
Deborah Korenstein @dkorenstein
@Mara_Schonberg Great point about suspicion of NOT screening to save money- important to frame it to patients in terms of balancing benefits and harms to them, not the system #cancerchat
Johnattan García Ruiz @harimetsu
RT @LizSzabo: T4. Many people have unrealistic ideas about the benefits of cancer screening. Can you help us understand how people need to…
WorldHouseMD @worldhousemd
RT @LizSzabo: Instead of focusing on screening, Louise Walter at UCSF said she addresses immediate needs: fall prevention, depression scree…
Liz Szabo @lizszabo
RT @DKorenstein: @Mara_Schonberg Great point about suspicion of NOT screening to save money- important to frame it to patients in terms of…
Dr. Deanna Attai @drattai
RT @DKorenstein: @Mara_Schonberg Great point about suspicion of NOT screening to save money- important to frame it to patients in terms of…
Liz Szabo @lizszabo
@Mara_Schonberg What are the main harms or risks from getting a mammogram so late in life? So many people assume tests are all positive (like a flu shot), with no downside. #cancerchat
FollowHeidi @followheidi
Absolutely https://t.co/DO3Vl6xoIj
Dr. Deanna Attai @drattai
#bcsm https://t.co/mxk8ONSILP
Lown Institute @lowninstitute
Ways health journalists can counter unnecessary cancer screening, from @HealthNewsRevu: Be specific in talking about benefits & harms, add human voice with patient stories #cancerchat https://t.co/5QrpohaBfg
Kay Curtin @kaycurtin1
@LizSzabo Totally but was only available with a cancer diagnosis which only came to light after the fact still upsets me to think of how his life could end like that so perhaps it’s not so black & white screening or not in elderly with Co-morbidities #cancerchat
Liz Szabo @lizszabo
RT @lowninstitute: Ways health journalists can counter unnecessary cancer screening, from @HealthNewsRevu: Be specific in talking about ben…
Cary Gross @cpgyale
RT @LizSzabo: Instead of focusing on screening, Louise Walter at UCSF said she addresses immediate needs: fall prevention, depression scree…
Ash Paul @pash22
RT @DKorenstein: @Mara_Schonberg Great point about suspicion of NOT screening to save money- important to frame it to patients in terms of…
roxanne watson @roxannewatson74
RT @LizSzabo: Is it hard for docs to stop ordering tests? #CancerChat https://t.co/qRfCMU1rVB
Mara Schonberg @mara_schonberg
Data from women 50-74 suggest that it takes 10.7 years before 1 in 1000 women screened may avoid breast cancer death as a result #cancerchat
Liz Szabo @lizszabo
To the physicians on this chat: Do any of you frame your discussion this way? #CancerChat https://t.co/oY6zb56HLn
Jeanine Limone Draut @jeaninedraut
RT @lowninstitute: Ways health journalists can counter unnecessary cancer screening, from @HealthNewsRevu: Be specific in talking about ben…
Liz Szabo @lizszabo
RT @Mara_Schonberg: Data from women 50-74 suggest that it takes 10.7 years before 1 in 1000 women screened may avoid breast cancer death as…
Dr. Deanna Attai @drattai
@KayCurtin1 @LizSzabo most definitely needs to be case-by-case discussion #CancerChat
Mara Schonberg @mara_schonberg
Since breast cancer is slower growing in older and due to competing mortality risks in older women #cancerchat
Liz Szabo @lizszabo
RT @Mara_Schonberg: Since breast cancer is slower growing in older and due to competing mortality risks in older women #cancerchat
Mara Schonberg @mara_schonberg
it would likely take even longer for 1 in 1000 women 75+ to benefit. Meanwhile the harms are immediate #cancerchat
Liz Szabo @lizszabo
RT @Mara_Schonberg: it would likely take even longer for 1 in 1000 women 75+ to benefit. Meanwhile the harms are immediate #cancerchat
(((Howard Forman))) @thehowie
This is great example of why we need #PCP at the center of care delivery. And better yet, to have continuity with one provider or group of providers. #SDM requires good information, trust, and time. #cancerchat https://t.co/21hJH4wz3I
Mara Schonberg @mara_schonberg
The most concerning harm is overdetection/overdiagnosis. Since nearly all older women undergo surgery once brca found #cancerchat
Eleni Linos @linos_eleni
RT @LizSzabo: So you got your first cancer screening age 40. You follow up every year. But for how long? Until what age? At some point, doe…
Matthew Katz, MD @subatomicdoc
RT @cpgYALE: T1: Caregivers can be reluctant to stop screening because it feels like they are "giving up", even though they may be doing mo…
Liz Szabo @lizszabo
From our story: "Among older women, about 70 percent report significant stress at the time of a biopsy. Simply lying on a table for a 45-minute biopsy can cause pain for women with significant arthritis." https://t.co/LsNamyQgRt #CancerChat
ΕΛΛ.Ο.Κ. @ellokgr
#Cancerscreening in elders not as necessary as in younger women but this doesn't exclude that cancer won't knock at the door of +80s.. two such cases in my immediate circle..did they have a mammo? NO! cancer progressed undetected..#Cancerchat #ECIBC https://t.co/zDPQW5XzhV https://t.co/EQznAAEXLc
Mara Schonberg @mara_schonberg
Most also are treated with anti-estrogen therapy and these medications can have bothersome side effects. #cancerchat
Matthew Katz, MD @subatomicdoc
Hello! Matt Katz, radiation oncologist in MA. Sorry to join so late! #cancerChat
Mara Schonberg @mara_schonberg
Many women also receive radiation #cancerchat
ZB @irbroadshow
RT @LizSzabo: From our story: "Among older women, about 70 percent report significant stress at the time of a biopsy. Simply lying on a tab…
Sarah Temkin @temkins
In light of your other medical problem, the risks of finding something that needs a workup but is not really a problem outweigh the benefits And reassure the patient that a problem or symptom develops it will be taken seriously and worked up When #Lessismore in screening https://t.co/ssTsUixtyf
Mara Schonberg @mara_schonberg
Follow up testing after an abnormal mammogram can also be burdensome #cancerchat
Deborah Korenstein @dkorenstein
@thehowie I agree- it's helpful to focus on addressing the problems the patient actually has, and discussing what might happen in pursuit of a cancer diagnosis or if cancer were treated. #cancerchat
Liz Szabo @lizszabo
Good example of a harm of screening. When women have dementia, it must be hard to even give instructions for mammo -- hold your breath, stand this way, etc. #CancerChat https://t.co/1mIlwCjA2q
Liz Szabo @lizszabo
RT @DKorenstein: @thehowie I agree- it's helpful to focus on addressing the problems the patient actually has, and discussing what might ha…
Mara Schonberg @mara_schonberg
Breast biopsies are stressful and stress about breast cancer can persist for months. #cancerchat
Zarifa Roberson 🇧🇸 @itsanidealworld
RT @LizSzabo: From our story: "Among older women, about 70 percent report significant stress at the time of a biopsy. Simply lying on a tab…
Liz Szabo @lizszabo
Breast biospies are really painful, in my experience. https://t.co/Tq2uIFWPIm
Matthew Katz, MD @subatomicdoc
@thehowie PCPs are essential to have involved. How do we make that possible? Already PCPs have many directions they're pulled in. Also, PCPs no longer round at the hospital and interact w/cancer specialists directly #cancerchat
Mara Schonberg @mara_schonberg
Women have to lay for a long time for a stereotactic breast biopsy and this can exacerbate arthritis. #cancerchat
Mara Schonberg @mara_schonberg
The experience can be extremely stressful for women with dementia #cancerchat
Dr. Deanna Attai @drattai
@LizSzabo shouldn't be w/proper use of local anesthetic! #CancerChat
Liz Szabo @lizszabo
Risks from the PSA: Blood tests can lead to prostate biopsies that cause infections in about 6% of men. These infections send about 1 in 100 men. #cancerchat https://t.co/LsNamyQgRt
Matthew Katz, MD @subatomicdoc
RT @Mara_Schonberg: Many women also receive radiation #cancerchat
Liz Szabo @lizszabo
Mammograms can lead to biopsies. #CancerChat https://t.co/cmV8eGMPqq
Liz Szabo @lizszabo
RT @Mara_Schonberg: Women have to lay for a long time for a stereotactic breast biopsy and this can exacerbate arthritis. #cancerchat
Liz Szabo @lizszabo
RT @subatomicdoc: @thehowie PCPs are essential to have involved. How do we make that possible? Already PCPs have many directions they're pu…
Pres. Cancer Panel @prescancerpanel
Join @KHNews reporter @LizSzabo NOW for #CancerChat. What are your experiences with #cancer screening? https://t.co/3JcPSePuUe
Gary Schwitzer @garyschwitzer
Ethicist @ABatemanHouse tweeted about her 95-year old grandmother with dementia being “subjected to a mastectomy.” #CancerChat https://t.co/BkijWYyrxc
Matthew Katz, MD @subatomicdoc
RT @LizSzabo: From our story: "Among older women, about 70 percent report significant stress at the time of a biopsy. Simply lying on a tab…
Liz Szabo @lizszabo
RT @garyschwitzer: Ethicist @ABatemanHouse tweeted about her 95-year old grandmother with dementia being “subjected to a mastectomy.” #Canc
Matthew Katz, MD @subatomicdoc
RT @PresCancerPanel: Join @KHNews reporter @LizSzabo NOW for #CancerChat. What are your experiences with #cancer screening? https://t.co/3J…
Chris Hendel @chrishendel
RT @garyschwitzer: Ethicist @ABatemanHouse tweeted about her 95-year old grandmother with dementia being “subjected to a mastectomy.” #Canc
Deborah Korenstein @dkorenstein
PCPs do make most screening decisions, but sometimes patients get notified that it's time for the next screen (e.g. by radiology), making balanced discussions of pros/cons challenging #cancerchat
PrizeFighter01 ⚡️ @merriox
RT @garyschwitzer: Breast surgeon quote: “All of us have visceral fear of not doing the most we can. And so just getting society more comfo…
Liz Szabo @lizszabo
Horrible. #CancerChat https://t.co/StzHnQxTk2
marymcnamara @marymcnamara
The elderly are expendable and consequently they go tragically untreated. : ( I thank god for the angels at Villa Marie Claire Hospice in Saddle River, NJ who made my father-in-law's last days bearable. https://t.co/vO3l0L3zAV
Peter R Eby @peterebymd
Women aged 75 and older account for 19.7% of all new cases of #breastcancer & disproportionate 36.7% of deaths. Source: https://t.co/fyfJ3GoZAk #CancerChat https://t.co/zk7hoohsRx
MommaMarDee @b1e56df9ce6549f
RT @subatomicdoc: @thehowie PCPs are essential to have involved. How do we make that possible? Already PCPs have many directions they're pu…
Guy Friedman @guyfriedman
RT @thehowie: This is great example of why we need #PCP at the center of care delivery. And better yet, to have continuity with one provide…
(((Howard Forman))) @thehowie
Incentives matter a lot. Current incentives drive us to specialists, volume, and not nearly enough toward maximizing patient quality of life. #cancerchat https://t.co/rSm3B7CuOs
Guy Friedman @guyfriedman
RT @subatomicdoc: @thehowie PCPs are essential to have involved. How do we make that possible? Already PCPs have many directions they're pu…
Liz Szabo @lizszabo
Those automated reminder cards are convenient. But do they sometimes leave doctors out of the equation? I've heard from caregivers who said they kept getting these reminders when patient had dementia. #CancerChat https://t.co/rWci8ZBcup
Inspire @teaminspire
RT @lowninstitute: Ways health journalists can counter unnecessary cancer screening, from @HealthNewsRevu: Be specific in talking about ben…
craig s matsuda @craigmatsuda
RT @LizSzabo: Instead of focusing on screening, Louise Walter at UCSF said she addresses immediate needs: fall prevention, depression scree…
Liz Szabo @lizszabo
@thehowie Re: Incentives. Some health plans rate their doctors on how many patients get screened. Do these plans consider age as a stopping point? Or do you get downgraded for failing to screen an 80-yr-old? #cancerchat
Matthew Katz, MD @subatomicdoc
@LizSzabo Not sure about the circumstances; ultimately an activated healthcare proxy or durable power of attorney made that choice? #cancerchat
Amy Patel, MD @amykpatel
We must be careful in how we utilize the term #overdiagnosis as we don’t know which cancers will progress to invasive cancer vs. which ones will remain DCIS. Again, co-morbidities/life expectancy in this population are important considerations #cancerchat https://t.co/GTYIKhJcSZ
Amy Patel, MD @amykpatel
RT @PeterEbyMD: Women aged 75 and older account for 19.7% of all new cases of #breastcancer & disproportionate 36.7% of deaths. Source: htt…
Liz Szabo @lizszabo
@linos_eleni, how common is nonfatal skin cancer screening/daignosis in elderly? #CancerChat
MaryAnne Molter @mamolter
RT @PeterEbyMD: Women aged 75 and older account for 19.7% of all new cases of #breastcancer & disproportionate 36.7% of deaths. Source: htt…
ΕΛΛ.Ο.Κ. @ellokgr
But at 95 the patient risks to die from the impact of the surgery rather than from breast cancer! this is pure extravaganza! After +75 chemo & other harsh cancer regimens risk to create more harm than good to elder patients.. #palliative care to assure QoL is best... https://t.co/0lTf7zxdwH
Amy Patel, MD @amykpatel
Yes, there is potential anxiety/discomfort associate w/ #breast biopsies, but studies have shown this anxiety is short lived. The anxiety from an advanced #breast cancer is FAR MORE, hence why screening #mammo & subsequent workup if warranted are imperative #cancerchat https://t.co/6DFg0sgqDP
Matthew Katz, MD @subatomicdoc
@LizSzabo When someone's capacity for making these decisions changes significantly, it's a good time to review all 'default' health screenings with the valid decision-maker(s). #cancerchat
Kaiser Health News @khnews
RT @PresCancerPanel: Join @KHNews reporter @LizSzabo NOW for #CancerChat. What are your experiences with #cancer screening? https://t.co/3J…
Deborah Korenstein @dkorenstein
@LizSzabo @thehowie Ratings of screening rates generally exclude very elderly people, but it's hard to keep track of the criteria- definitely easier for PCPs to order in everyone #cancerchat
Liz Szabo @lizszabo
Can you explain what you mean by overdiagnosis? That's an unfamiliar term to most people. #cancerchat https://t.co/8gmKzbSSAh
Amy Patel, MD @amykpatel
@DrAttai @LizSzabo Agree with @DrAttai entirely. And I tell my #patients to please tell me if they experience pain so we can mitigate it. #cancerchat
Rene Sugar @renesugar
@LizSzabo Sometimes it is a lack of testing that leads to cancer. Iron overload is one example #cancerchat https://t.co/Ka2PHBdh4p https://t.co/fmwBwJ40UF
Liz Szabo @lizszabo
RT @DKorenstein: @LizSzabo @thehowie Ratings of screening rates generally exclude very elderly people, but it's hard to keep track of the c…
Matthew Katz, MD @subatomicdoc
@thehowie Agreed. Too much reimbursement for what we do to patients, not enough for what we do for them. #cancerchat
Liz Szabo @lizszabo
RT @subatomicdoc: @LizSzabo When someone's capacity for making these decisions changes significantly, it's a good time to review all 'defau…
Chuck Jacobson @chuckiej
RT @subatomicdoc: @thehowie PCPs are essential to have involved. How do we make that possible? Already PCPs have many directions they're pu…
Lo Williams @lowms
RT @LizSzabo: T1. Why do people want to continue cancer screening even in their 80s? Do they misunderstand how screening works? Do they thi…
(((Howard Forman))) @thehowie
@LizSzabo Most quality measures have age parameters but they don’t account for co-morbidities nearly well enough. #cancerchat @arjunvenkatesh
Matthew Katz, MD @subatomicdoc
RT @LizSzabo: Can you explain what you mean by overdiagnosis? That's an unfamiliar term to most people. #cancerchat https://t.co/8gmKzbSSAh
Matthew Katz, MD @subatomicdoc
RT @amykpatel: @DrAttai @LizSzabo Agree with @DrAttai entirely. And I tell my #patients to please tell me if they experience pain so we can…
Sarah Gollust @sarahgollust
Looks like @peterubel should join #cancerchat! cc: @LizSzabo https://t.co/ZVWsOj32k1
UCSF Cancer Center @ucsfcancer
Enjoying this tweetchat on cancer screening - follow #cancerchat https://t.co/cQGH17YDxE
Amy Patel, MD @amykpatel
@DKorenstein That’s why discussions need to take place between our communities to better serve this #patient population. “Us” versus “them” mentality doesn’t benefit our #patients and we all want what’s best for them #cancerchat
Liz Szabo @lizszabo
In some cases. But some patients are super gung ho, want to be screened forever. #cancerchat https://t.co/o13kSLG3ff
Mara Schonberg @mara_schonberg
Overdiagnosis is finding a breast cancer on screening that never otherwise would have caused problems/symptoms in one's life #cancerchat
Michael Sinha MD JD @drsinhaesq
RT @garyschwitzer: Ethicist @ABatemanHouse tweeted about her 95-year old grandmother with dementia being “subjected to a mastectomy.” #Canc
Marcos Vinícius @marcos_sp0001
#cancerchat Com a palavra Brasil! https://t.co/5o6rZgCiZm
Liz Szabo @lizszabo
Thanks. I think that's news to so many people out there. Many of our readers believe all cancer is deadly, needs to be cut out immediately. #CancerChat https://t.co/9cO9nj6fPm
Amy Patel, MD @amykpatel
Additionally, there is less morbidly involved if a #breast cancer is detected early versus late and saves the #patient overall money due to less invasive interventions when early cancers are detected. #cancerchat
Mara Schonberg @mara_schonberg
Once a breast cancer is found we do not know which ones will grow and which will not and so nearly all women undergo treatment #cancerchat
Matthew Katz, MD @subatomicdoc
RT @Mara_Schonberg: Overdiagnosis is finding a breast cancer on screening that never otherwise would have caused problems/symptoms in one's…
Liz Szabo @lizszabo
RT @Mara_Schonberg: Once a breast cancer is found we do not know which ones will grow and which will not and so nearly all women undergo tr…
Mara Schonberg @mara_schonberg
In these cases women experience the burden of treatment with no chance of living longer or better. #cancerchat
Liz Szabo @lizszabo
That hour went by really fast! Thanks to everyone who joined us for #CancerChat. Please feel free to stay and continue conversation. Our NYT story on screening in elderly generated 310 comments! Weigh in here: https://t.co/9TjNAE71PY
Matthew Katz, MD @subatomicdoc
@LizSzabo Same issue with adjuvant therapy after surgery for DCIS, early favorable breast cancer in older women. Even when presented in absolute terms, most women still choose RT. #cancerchat
Liz Szabo @lizszabo
RT @Mara_Schonberg: In these cases women experience the burden of treatment with no chance of living longer or better. #cancerchat
Donna Asher @dasher2581
RT @LizSzabo: That hour went by really fast! Thanks to everyone who joined us for #CancerChat. Please feel free to stay and continue conver…
Liz Szabo @lizszabo
We've started a great Facebook group to discuss important issues in cancer. You can lurk or join here: https://t.co/4Fmv2YG9HX #CancerChat
Amy Patel, MD @amykpatel
@LizSzabo But again, we do not know which cancers will remain pre-invasive versus invasive. And we can’t just assume most will remain pre-invasive and not attribute to the death of a #patient. #cancerchat
PRMA Plastic Surgery @diepflapbreast
RT @DrAttai: #bcsm https://t.co/mxk8ONSILP
Matthew Katz, MD @subatomicdoc
@LizSzabo Thanks for moderating! Great conversation, sorry I couldn't join for the whole discussion. Happy holidays, everyone! #cancerchat
Amy Patel, MD @amykpatel
@LizSzabo Thank you for facilitating this discussion! #cancerchat
Mara Schonberg @mara_schonberg
Thank you all! #cancerchat
Louis Fisher @sueludad
RT @LizSzabo: T1. Why are men getting PSAs when they have only a few years left to live? Do men push for these tests? Do doctors pressure t…
Kay Curtin @kaycurtin1
@LizSzabo I think I’d rather take my chances with the surgeon always better to know and have a chance to be proactive #CancerChat
Amy Patel, MD @amykpatel
@Mara_Schonberg I agree with you. But considerations are multifactorial. Additionally, it may not sit well with a #patient that she has a cancer in her #breast that we are just “watching.” Indeed, this population is definitely unique in how we approach screening patients. #Cancerchat
Sally James @jamesian
@LizSzabo Want to share - @AACR has special award for stories about #cancer Encourage those whose coverage you admire? https://t.co/i0ed7l4AYj Share this news? #cancerchat
Martin Fierro @martinfierro769
RT @LizSzabo: That's a really important fact. Everyone whose cancer is diagnosed through screening assumes the test saved his/her life. Tha…
Cindy Fitch @cindyfitch1
@LizSzabo I'd like to know my statistical risk (because I'm a science nerd) & make a decision based on risk/benefit analysis #CancerChat
barttels @barttels2
RT @LizSzabo: My colleagues at @khnews made this great video explaining the benefits of mammography. You need to screen 1000 women for 10 y…
Liz Szabo @lizszabo
Thanks for joining us for #CancerChat! @Mara_Schonberg @drattai @kaycurtain1 @DKorenstein @cpgyale @sarahgollust @cancerisSOFUNNY @gjdober @Richard31901063 @thehowie @PresCancerPanel @boback @petebymd
Ted Chan @upwardmobility
Just popping in and listening for ideas for how a health transparency site could help educate patients. 👋. #cancerchat
Dr. Deanna Attai @drattai
thanks @LizSzabo for hosting #CancerChat - great discussion!
harriseve @harriseve
RT @LizSzabo: We've started a great Facebook group to discuss important issues in cancer. You can lurk or join here: https://t.co/Btxo4EQEYW #CancerChat
Dr. Deanna Attai @drattai
RT @LizSzabo: We've started a great Facebook group to discuss important issues in cancer. You can lurk or join here: https://t.co/4Fmv2YG9H…
Johnattan García Ruiz @harimetsu
RT @LizSzabo: That hour went by really fast! Thanks to everyone who joined us for #CancerChat. Please feel free to stay and continue conver…
Shelley Fuld Nasso @sfuldnasso
RT @LizSzabo: Horrible. #CancerChat https://t.co/StzHnQxTk2
Inspire @teaminspire
RT @LizSzabo: We've started a great Facebook group to discuss important issues in cancer. You can lurk or join here: https://t.co/4Fmv2YG9H…
Liz Szabo @lizszabo
Good point. #CancerChat https://t.co/Qmc2e5XG2a
Saraneth @iamsaraneth
RT @LizSzabo: Horrible. #CancerChat https://t.co/StzHnQxTk2
David Rosenthal MD @davidrosenthal
RT @cpgYALE: There is always the lake Wobbegone effect - we all feel we will outlive our life expectancy so we make decisions accordingly #…
Lo Williams @lowms
How are you defining “few yrs left to live?” I agree in many case, pt will die of something else 1st; pointless to treat prostatic ca. But then there’re guys like my dad—treated @78yo and still going strong at 93. https://t.co/WRUqzANPiT
Inspire @teaminspire
RT @LizSzabo: Is it hard for docs to stop ordering tests? #CancerChat https://t.co/qRfCMU1rVB
#CancerChat content from Twitter.