Giles F. Whalen
Surgery is a branch of medicine that developed primarily around the management of wounds, infections, and bladder stones. Along the way, it also became the primary treatment modality for malignant solid tumors. For many cancers, surgical resection remains the foundation of curative treatment. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist aims to introduce the history of cancer surgery, to answer the question of “What is a surgical oncologist?”, and to discuss the different categories of cancer surgery.
Mary Linton Peters, Richard S. Pieters, James Liebmann, and Geoffrey Graeber
The “stage” of a cancer is a short-hand way of describing the extent of cancer in a patient. Stage is based on macroscopic involvement of tissues by cancer. Staging of cancer occurs prior to the beginning of treatment, or at the first definitive surgery. Clinical staging, which includes radiography and exam findings, takes place initially. Pathologic staging, which is obtained from surgical specimens, can be acquired during the course of surgical treatment. Patients then carry either the clinical stage or the pathologic stage for the duration of their illness. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist will describe principles of cancer staging.
Catherine W. Carr, Maryann Bishop-Jodoin, and Richard S. Pieters
Information is exploding at an exponential rate. Because there is a flood of medical information on the Internet, it can be difficult to wade through the many resources to determine what information is best to use in practice. The intent of this chapter in Cancer Concepts: A Guidebook for the Non-Oncologist is to help the health care provider find reliable online cancer information. To help inform clinical decision making, health science librarians continue to address this rapidly growing body of literature by analyzing resources and identifying the highest quality information available on the Internet.
The concept of Evidence-Based Medicine (EBM) is important to understand, as well as the process needed to find literature supporting EBM. Why EBM? EBM is "the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients."
Making evidence-based clinical decisions is not about intuition, but finding reliable, up-to-date literature and using it in combination with clinical expertise and patient choice. Once a source for free online quality literature is located, a health care provider can consider the best current evidence to thoroughly answer clinical questions.
Chi Young Ok, Bruce A. Woda, and Elizabeth Kurian
Patients and physicians depend on pathologists to make the diagnosis of cancer and of the specific type of cancer. Pathologists are expert in pattern recognition and in the natural history of diseases, including cancers. This chapter in Cancer Concepts: A Guidebook for the Non-Oncologist will describe the pathology of cancer.
The University of Massachusetts Medical School, A History: Integrating Primary Care and Biomedical Research
Ellen S. More
When an all-male class of 16 students entered the new University of Massachusetts Medical School in 1970, they might well have wondered whether they were making a huge mistake. Undoubtedly they took an enormous risk. The entire school—faculty, students, staff, laboratories, offices and classrooms—was housed in a small converted warehouse. The faculty probably had their doubts as well. Not so Dr. Lamar Soutter, the school’s founding dean and guiding spirit. No matter how many times the state legislature threatened to withhold the school’s funding, or how many governors threatened to shut it down altogether, Soutter knew he could outlast them all.
The University of Massachusetts Medical School, chartered in 1962 and opened in 1970, was one of a cohort of medical schools founded in response to fears of a physician shortage. In Massachusetts, this translated into a call for more opportunities for the state’s students to attend an affordable school where, it was hoped, they would deliver primary care to the people of their home state. Yet, Dean Soutter and the original faculty, most of whom were basic scientists recruited from Boston medical schools, were equally devoted to basic research and tertiary care medicine. This book tells the story of the school’s struggle, and eventual success in reconciling the demands of primary care education with world-class research.
A revised version of this online history titled Beating the Odds: The University of Massachusetts Medical School, a History, 1962-2012 (TidePool Press, 2017), is available in hard cover from the publisher, from Amazon, or at the UMMS book store.
Ellen S. More, Ph.D., a historian of medicine, is Professor Emeritus of psychiatry at the University of Massachusetts Medical School. Specializing in the history of the American medical profession, the history of women physicians, and the history of medical education, she was the founding head of the Office of Medical History and Archives, Lamar Soutter Library, at UMass Medical School. She is the author or editor of four books, including Restoring the Balance: Women Physicians and the Profession of Medicine, 1850-1995 (Harvard), winner of the Rossiter Prize from the History of Science Society, Women Physicians and the Cultures of Medicine (Johns Hopkins), co-edited with Elizabeth Fee and Manon Parry, winner of the Best Publication award from the Archivists and Librarians of the History of the Health Sciences, The Empathic Practitioner: Empathy, Gender, and Medicine (Rutgers), co-edited with Maureen Milligan, and Beating the Odds: The University of Massachusetts Medical School, a History, 1962-2012 (TidePool Press, 2017), a revised, corrected, and updated version of The University of Massachusetts Medical School: Integrating Primary Care and Biomedical Research. More was also the Visiting Curator for the National Library of Medicine’s exhibition “Changing the Face of Medicine,” available online at https://cfmedicine.nlm.nih.gov/.
Mark Dershwitz and Richard S. Pieters
Pain is one of the first concerns most cancer patients express when newly diagnosed or meeting a new physician. They are concerned about how much pain they presently have, how much pain they are likely to experience, and their physicians’ commitment to treating cancer pain. The reality is that many cancer patients will never experience pain during their course and for those that do, the great majority can be well-managed with the tools described in this chapter in Cancer Concepts: A Guidebook for the Non-Oncologist. It is incumbent on every physician to understand the mechanisms of cancer pain and the fundamentals of treating it.