Many women with early breast cancer do not appear to need removal of their lymph nodes, as is often recommended, according to a federally funded study released Tuesday.

lymphedema

Read the full Washington Post story about a new study published in JAMA (abstract is here). This story is being covered in most major news sources today, and it may signal a significant treatment shift for some patients. (One of the possible adverse long-term effects of lymph node removal is lymphedema. Here’s a page with links to the two-part article we ran about the condition a while back, as well as a related blog post by senior editor Sylvia Foley that looked at what people had been writing about their experiences with this condition.)

Speaking of advice about your health and about treatments, the health care journalism blog Covering Health alerts us today to an article at the NY Times comparing health information found at the WebMD and Mayo Clinic sites. Do you prefer the glitzy, highly produced one with lots of corporate sponsors, or the nonprofit? You know which one gets more visitors . . .

And speaking of patients, as we should, what about those who are transgendered? Does it confuse or challenge you to care for such a patient? There’s a very sensitive and painful post at the blog Nursetopia about caring for a transgendered patient who has terminal cancer and a bad case of guilt. Here’s an excerpt:

Yes, Ms. D. was transgender. She was in the middle of her transformation, and I honestly felt sadness when I did care for Ms. D. Not because she was transgender and I was uncomfortable. No, I was saddened because Ms. D. thought her cancer diagnosis was a plague from God for her transgender sins.  It was heartbreaking to hear – from her and from her nurses. No matter her nurses’ and physicians’ medical model cancer explanations, she would not be swayed. God was punishing her with lung cancer. He had to be. Her cancerous lungs were right beneath her silicone breast implants. No amount of discussions from healthcare providers or clergy convinced her otherwise.

For the perspective of another transgendered patient, here’s a Reflections essay called “Intake Interview” that we published a couple years back. Like the blog post mentioned above, it reminds us that patients often don’t undertake such changes lightly, or without very real personal cost.

Lastly, this month’s Reflections essay, “The Wisdom of Nursery Rhymes,” is by nurse, blogger, and artist Julianna Paradisi. It’s about a moment in which two very different pediatric cases intersect, unexpectedly giving the author a glimpse of hope in the midst of much that’s tragic or brutal in life.—JM, senior editor/blog editor

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