Importance of patient participation using information from the Internet

Patient input and participation in one's care are extremely important. As a physician who was diagnosed with throat cancer I encountered many instances where my physicians failed to diagnose my condition and my input was instrumental in improving my care. That input often came from information I found on the Internet.

One example relates to the blood pressure I developed 16 month after receiving radiation treatment to my neck. I was initially labeled as suffering from “essential hypertension”, the most common cause of high blood pressure in individuals over the age of 65 years. I suspected that the radiation treatment I had received lead to the development of hypertension, but my physicians dismissed it. I started to check my blood pressure myself and noticed that it frequently spiked to over 190/110. After my physicians were unable to come with the correct diagnosis and treatment for this unstable blood pressure, I started searching the Web for answers. I was fortunate to discover a rare entity called “paroxysmal hypertension” that can result from radiation damage to the carotid artery baroreceptors. Only after I contacted the physician who researched that topic did I finally start to receive adequate treatment for this condition.

Another example was a rash I developed while getting treatment with a beta blocker (Inderal). Skin biopsy labeled the rash as psoriasis. Both my cardiologist and dermatologist did not make a connection between the medication I was taking and the rash. While searching Google Images for pictures of a psoriatic rash I found a picture of a rash labeled as “beta-blocker psoriatic like rash” which lead me to suspect a connection between the medication and the rash. When I consulted my dermatologist and cardiologist about this condition they both admitted that they did not think about it because it was very rare. Happily in my rash subsided after I stopped taking the medication.

My experience as a patient taught me the limitations of medical knowledge and experience of many of my colleagues. They simply do not always know all the answers or do not think about them. It is left to patients to help themselves by searching for the right answer. It is also essential to remember that even those of us who have medical knowledge should only assist the experts in treating us and not do it alone.





A new throat cancer gene discovered

Investigators from the King’s College London, England, and Hiroshima University, Japan, have identified a specific gene that is linked to throat cancer in a genetic study of a family with ten members who have developed this type of cancer.


The study, recently published in the American Journal of Human Genetics, uncovered a mutation in the ATR gene, demonstrating the first evidence of a link between abnormality in this gene and an inherited  form of cancer. The ATR 
(ataxia telangiectasia and Rad3 related) gene encodes a protein critical to the way cells repair their DNA. This finding illustrates the presence of genetic factors linked to throat cancer and encourages further exploration the role of ATR in other types in cancer.

Researchers performed a genome-wide linkage study in a family with an unusual hereditary condition affecting 24 members of the family over five generations. Characteristics include developmental abnormalities of hair, teeth and nails as well as dilated skin blood vessels. Nearly every person with the condition involved in the study had developed throat cancer (oropharyngeal squamous cell carcinoma) in their 20s or 30s. They uncovered a single mutation in ATR  in all the individuals  with the condition and in none of the unaffected people. Ten of the 13 people with this mutation had developed throat cancer.