Primary care
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Communication is an important cornerstone to the physician-patient relationship when considering advance directives. Discussing advance directives with patients is a process best initiated in routine, well-adult care that can be made more daunting when the patient is critically ill; yet, when patients are afflicted with cancer, communication on advance directives can be optimized when the primary care physician and oncologist together work with the patient. The need to counsel patients on advance directives regardless of the venue (whether inpatient or outpatient) highlights that an ongoing alliance between the oncologist and the primary care physician can help facilitate consent to, and allow periodic review of, advance directives by cancer patients. This process ensures that the patient's preferences are respected at life's end.
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Each type of male genital cancer has features that are unique in diagnosis and treatment. The incidences of these cancers are related to age, race, and environment. Early diagnosis and treatment are documented as important for all male genital cancers except prostate cancer, where this remains a subject of controversy.
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Primary care clinicians treat patients with cancer and cancer pain. It is essential that physicians know how to effectively manage pain including assessment and pharmacologic and nonpharmacologic treatment modalities. ⋯ Pharmacologic regimens are based on the World Health Organization's "ladder of analgesia," beginning with nonopioid medications and adding the opioid narcotics and adjuvant medications as necessary. Inclusion of nonpharmacologic treatments, physical and psychological are important for effective management.
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Cigarette smoking is responsible for enormous health consequences. Lung cancer is fatal in over 80% of cases, and effective treatment is limited. The medical impact of cigarette smoking will diminish with effective measures to prevent smoking and nicotine addiction and to promote smoking cessation. Efforts should focus on the teenage population, with a combination of social, economic, and legislative interventions.