34 Patients

Discover the profound and moving portrait of one doctor's life and work in the NHS 'Wonderful - insightful and compassionate' Dr Richard Shepherd, bestselling author of Unnatural Causes ________ They can't teach you how to be a doctor at medical school . . . As a junior doctor, Dr Tom Templeton learnt how to do his job from books, professors and other doctors and nurses. But the most important lessons - tolerance, kindness, resilience and bravery - he learnt from his patients. Here, he shares the stories of just 34, and how they changed his life while he was helping theirs. From a stillbirth to the old woman who lived a century, from the inhabitants of stately homes to the homeless, these stories whether heartwarming or heartbreaking, funny or tragic, are always inspiring and illuminating. We are all patients, but discover for the first time how the doctors see us . . . ________ 'An admirably told story' Spectator 'Informative and personal, humbling and healing' Observer

Approximately 40% of lung cancer patients will develop central nervous system (CNS) metastases during the course of their disease. Most of these are brain metastases, but up to 10% will develop leptomeningeal metastases. Known risk factors for CNS metastases development are small cell lung cancer (SCLC), adenocarcinoma histology, epidermal growth factor receptor (EGFR) mutant or anaplastic lymphoma kinase (ALK) rearranged lung cancer, advanced nodal status, tumor stage and younger age. CNS metastases can have a negative impact on quality of life (QoL) and overall survival (OS). The proportion of lung cancer patients diagnosed with CNS metastases has increased over the years due to increased use of brain imaging as part of initial cancer staging, advances in imaging techniques and better systemic disease control. Post contrast gadolinium enhanced magnetic resonance imaging (gd-MRI) is preferred, however when this is contra-indicated a contrast enhanced computed tomography (CE-CT) is mentioned as an alternative option. When CNS metastases are diagnosed, local treatment options consist of radiotherapy (stereotactic or whole brain) and surgery. Local treatment can be complicated by symptomatic radiation necrosis for which no high level evidence based treatment exists. Moreover, differential diagnosis with metastasis progression is difficult. Systemic treatment options have expanded over the last years. Until recently, chemotherapy was the only treatment option with a poor penetration in the CNS. Angiogenesis inhibitors are promising in the treatment of primary CNS tumors as well as radiation necrosis but clinical trials of anti-angiogenic agents in NSCLC have largely excluded patients with CNS metastases. Furthermore, research has also focused on methods to prevent development of CNS disease, for example with prophylactic cranial irradiation. Recently, checkpoint inhibitors have become available for NSCLC patients, and tyrosine kinase inhibitors (TKIs) have improved prognosis significantly in those with a druggable driver mutation. Newer TKIs are often designed to have better CNS penetration compared to first-generation TKIs. Despite advances in treatment options CNS metastases remain a problem in lung cancer and cause morbidity and mortality. This Research Topic provides an extensive resource of articles describing advances in CNS metastases management in lung cancer patients, from prevention to diagnosis and treatment.

Can refocusing conversations between doctors and their patients lead to better health? Despite modern medicine’s infatuation with high-tech gadgetry, the single most powerful diagnostic tool is the doctor-patient conversation, which can uncover the lion’s share of illnesses. However, what patients say and what doctors hear are often two vastly different things. Patients, anxious to convey their symptoms, feel an urgency to “make their case” to their doctors. Doctors, under pressure to be efficient, multitask while patients speak and often miss the key elements. Add in stereotypes, unconscious bias, conflicting agendas, and fear of lawsuits and the risk of misdiagnosis and medical errors multiplies dangerously. Though the gulf between what patients say and what doctors hear is often wide, Dr. Danielle Ofri proves that it doesn’t have to be. Through the powerfully resonant human stories that Dr. Ofri’s writing is renowned for, she explores the high-stakes world of doctor-patient communication that we all must navigate. Reporting on the latest research studies and interviewing scholars, doctors, and patients, Dr. Ofri reveals how better communication can lead to better health for all of us.

This unique book is a comprehensive guide for healthcare providers who treat patients with complex medical conditions but lack the resources to address fertility and sexuality concerns and help patients navigate their fertility decision-making process. It presents up-to-date information concerning fertility preservation and restoration for patients with hereditary cancer syndromes, disorders of sex development, hematologic diseases, genetic disorders of gonadal dysfunction, immunologic diseases, gynecologic diseases, endocrine disorders, and autoimmune and inflammatory diseases. Utilizing a practical, user-friendly format, each chapter discusses the epidemiology, classification, risk factors and/or clinical manifestations, and diagnosis and treatment modalities specific to each condition, as well as the effect of it or its treatment on fertility and unique options that may exist. Complex medical conditions are inherently difficult to manage, and reproductive interventions are often not part of the conversation. As such, Fertility Preservation and Restoration for Patients with Complex Medical Conditions will be an excellent resource for primary care physicians, obstetrician/gynecologists, endocrinologists, oncologists, and other health professionals working with patients with fertility concerns. This book, together with Oncofertility: Fertility Preservation for Cancer Survivors; Oncofertility: Ethical, Legal, Social, and Medical Perspectives; Oncofertility Medical Practice: Clinical Issues and Implementation; Oncofertility Communication: Sharing Information and Building Relationships across Disciplines; and Pediatric and Adolescent Oncofertility: Best Practices and Emerging Technologies, provides scientific and medically relevant information on fertility preservation from all vantage points and is an indispensable series for those interested in fertility management in cancer or complex settings.