Do Not Overestimate Artificial Intelligence in Clinical Medicine…Yet
Ultimately, machine learning is human learning. They are not independent, they are intertwined.
All articles by Robert Uzzo, MD, MBA, FACS
Should Active Surveillance for Cancer Be Rebranded?
While the idea of AS continues to slowly gain acceptance, most patients are easily moved toward treatment.
Zoom Medicine: An Apt Metaphor in 2020
The practice of medicine is to the life sciences what finance and economics are to the mathematical disciplines. Both are wedged between STEM subjects and the humanities requiring skills emanating from both the right and left brain. Read any student’s application to medical school or residency program as they explain why medicine’s intersection of science…
Evolving Strategies in the Management of Low-Grade UTUC
Upper tract urothelial cancer (UTUC) represents approximately 5%-10% of all urothelial cancers, although the incidence is increasing. Modifiable risk factors include exposure to toxins such as tobacco smoke, industrial toxins (including aromatic hydrocarbons, coal, coke, chlorinated solvents, and tars), arsenic, the analgesic phenacetin, and aristolochic acid. Produced by plants of the genus Aristolochia, aristolochic acid…
Cancers, Viruses, and the Evolution of Fear
In The Emperor of All Maladies: A Biographic of Cancer, the oncologist Siddhartha Mukherjee, MD, intuits, “Down to their innate molecular core, cancer cells are hyperactive, survival-endowed, scrappy, fecund, inventive copies of ourselves.”1 Replace “cancer cells” with “viruses” and the quote holds equally true. Darwinian perpetrators of genomic dysregulation, many viruses have integrated foundationally into…
Basic Science: The Tail That Wags the RCC Dog
I recently had reason to survey the progress made in renal cell cancer (RCC) over the last 70 or more years. In 1950, a patient who presented with metastatic RCC had a 0%-5% overall response rate (ORR) to the therapies of the time, with an anticipated overall survival (OS) of approximately 10 months. By 2005,…
RCC in Advanced CKD: A Transplant Dilemma
Non-dialysis patients with advanced CKD diagnosed with renal malignancies grapple with the dual threat of renal failure and cancer progression. When choosing between functional or oncologic risks, many patients will ask about renal transplantation. Discussions of this option are complicated by statistical realities: According to UNOS, of nearly 1 million solid organ transplants performed over…
Kidney Cancer vs. ESRD
Incidentally detected renal tumors are increasingly diagnosed in patients with chronic kidney disease.
The Negative Prostate Biopsy Dilemma
The role of PSA as a cancer screening tool has recently been evaluated by several large high profile studies with varying interpretations of the data. Regardless of where one stands on the debate, among the clinical dilemmas of PSA-based screening is the negative biopsy conundrum where the reality remains that the best one can offer is, “Good news Mr. Smith, I don’t think you have prostate cancer.”
A More Rational Approach To Renal Mass Surgery
In the absence of level I evidence, physician treatment recommendations are subject not only to the objective (interpretations of the cohort literature and practice guidelines) but also the subjective (training patterns, comfort levels, biases and individual experiences).
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