Podcasts about brca

Send us a textUnlock the complexities of menopausal hormone therapy for breast cancer survivors in this episode of the Speaking of Women's Health podcast. Join Host Dr. Holly Thacker and her esteemed guest, Dr. Holly Pederson, as they navigate the intricate world of genetic testing and its crucial role in guiding treatment decisions. Dr. Pederson, a leading expert in the field, emphasizes the importance of revisiting genetic tests conducted before 2013 to ensure breast cancer survivors receive the most informed care. They explore the advancements in genetic science and discuss the layers of genetic risk, revealing how these insights can revolutionize both treatment and screening practices.Their conversation further examines the challenges faced by elderly women considering hormone replacement therapy. This episode offers a thoughtful reflection on the unique considerations for breast cancer survivors, especially those with BRCA mutations, and the importance of individualizing patient care.Fit, Healthy & Happy Podcast Welcome to the Fit, Healthy and Happy Podcast hosted by Josh and Kyle from Colossus...Listen on: Apple Podcasts SpotifySupport the show

President Trump agrees $142bn arms deal with Saudi Arabia during a trip to the Gulf. Also: new hope for patients with breast cancer BRCA gene, and Basel hosts first Eurovision semi-final.

View the Show Notes Page for This Episode Become a Member to Receive Exclusive Content Sign Up to Receive Peter's Weekly Newsletter Rachel Rubin is a board-certified urologist and one of the nation's foremost experts in sexual health. In this episode, she shares her deep expertise on the often-overlooked topic of women's sexual health, exploring why this area remains so neglected in traditional medicine and highlighting the critical differences in how men and women experience hormonal decline with age. Rachel explains the physiology of the menstrual cycle, the complex hormonal shifts of perimenopause, and the wide-reaching health risks associated with menopause, including osteoporosis, cardiovascular disease, dementia, and recurrent urinary tract infections. She also breaks down the controversy surrounding hormone replacement therapy (HRT), particularly the damaging legacy of the Women's Health Initiative study, and provides guidance on the safe and personalized use of estrogen, progesterone, and testosterone in women. With particular emphasis on local vaginal hormone therapy—a safe, effective, and underused treatment—Rachel offers insights that have the potential to transform quality of life for countless women. We discuss: Rachel's training in urology and passion for sexual medicine and women's health [3:00]; Hormonal changes during ovulation, perimenopause, and menopause: why they occur and how they impact women's health and quality of life [5:30]; Why women have such varied responses to the sharp drop in progesterone during the luteal phase and after menopause, and the differing responses to progesterone supplementation [14:45]; The physical and cognitive health risks for postmenopausal women who are not on hormone therapy [17:45]; The history of hormone replacement therapy (HRT), and how misinterpretation of the Women's Health Initiative study led to abandonment of HRT [20:15]; The medical system's failure to train doctors in hormone therapy after the WHI study and its lasting impact on menopause care [29:30]; The underappreciated role of testosterone in women's sexual health, and the systemic and regulatory barriers preventing its broader use in female healthcare [35:00]; The bias against HRT—how institutional resistance is preventing meaningful progress in women's health [46:30]; How the medical system's neglect of menopause care has opened the door for unregulated and potentially harmful hormone clinics to take advantage of underserved women [53:30]; The HRT playbook for women part 1: progesterone [57:15]; The HRT playbook for women part 2: estradiol [1:05:00]; Oral formulated estrogen for systemic administration: risks and benefits [1:13:15]; Topical and vaginal estrogen delivery options: benefits and limitations, and how to personalize treatment for each patient [1:17:15]; How to navigate hormone lab testing without getting misled [1:24:15]; The wide-ranging symptoms of menopause—joint pain, brain fog, mood issues, and more [1:31:45]; The evolution of medical terminology and the underrecognized importance of local estrogen therapy for urinary and vaginal health in menopausal women [1:37:45]; The benefits of vaginal estrogen (or DHEA) for preventing UTIs, improving sexual health, and more [1:41:00]; The use of DHEA and testosterone in treating hormone-sensitive genital tissues, and an explanation of what often causes women pain [1:50:15]; Is it too late to start HRT after menopause? [1:56:15]; Should women stop hormone therapy after 10 years? [1:58:15]; How to manage hormone therapy in women with BRCA mutations, DCIS (ductal carcinoma in situ), or a history of breast cancer [2:00:00]; How women can identify good menopause care providers and avoid harmful hormone therapy practices, and why menopause medicine is critical for both women and men [2:06:00]; and More. Connect With Peter on Twitter, Instagram, Facebook and YouTube

Discussing:Association between risk-reducing surgeries and survival in young BRCA carriers with #BreastCancer DESTINY-Breast11 Update from IndustryPALMIRA in Breast #Cancer (Palbo rechallenge)PEACE V STORM in #Prostate CancerMAGNITUDE :Niraparib and Abiraterone Acetate plus Prednisone in Met CR Prostate CancerOS EGFR-mutant AdvancedNon-Small Cell #LungCancer Treated with 1L Osimertinib Cemiplimab monotherapy as 1L treatment of patients with brain metastases from advanced #NSCLC with  PDL1 ≥50%Beyond fluorodeoxyglucose: Molecular imaging of cancer in precision medicine and more

Dr. Jonathan Herman is a New York-based OB/GYN who has delivered over 12,000 babies and spent decades championing women's health. A leader in hereditary cancer screening, Dr. Herman is known for his work with BRCA and Lynch Syndrome, helping patients understand and manage their genetic cancer risk. He has delivered over 600 lectures nationwide, appeared on The Doctors, and served as a medical advisor on the documentary Inheritance, which follows three women navigating the impact of the BRCA gene.   CONNECT WITH DVORA ENTIN: Website: https://www.dvoraentin.com/ Instagram: https://www.instagram.com/dvoraentin YouTube: https://www.youtube.com/@misconceptionspodcast      

Dr. Rohan Garje shares the updated recommendations for the ASCO guideline on systemic therapy for patients with metastatic castration-resistant prostate cancer. He discusses the systemic therapy options for patients based on prior therapy received in the castration-sensitive and non-metastatic castration-resistant settings. He emphasizes personalizing treatment choices for each individual, considering patient-specific symptoms and signs, treatment-related toxicities, potential drug interactions, cost, and access. He also reviews recommendations on response assessment. The conversation wraps up with a discussion of potential future updates to this guideline, as the guideline transitions into a “living guideline” on mCRPC. Read the full guideline update, “Systemic Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer: ASCO Guideline Update”. Transcript This guideline, clinical tools, and resources are available at www.asco.org/genitourinary-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology.      Brittany Harvey: Hello and welcome to the ASCO Guidelines Podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Rohan Garje from Miami Cancer Institute Baptist Health South Florida, lead author on, “Systemic Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer: ASCO Guideline Update.” Thank you for being here today, Dr. Garje. Dr. Rohan Garje: Absolutely. Thank you so much for having me, Brittany. Brittany Harvey: And then before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Garje, who has joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then, to start on the content of this guideline, first, could you provide us an overview of the purpose of this guideline update? Dr. Rohan Garje: Sure. So ASCO has guidelines for prostate cancer and the specific guideline which we have updated for metastatic castrate-resistant prostate cancer was originally published in 2014. It's almost a decade. It's been a long time due for an update. Over the last decade, we have seen a lot of advances in the treatment of prostate cancer, specifically with regards to genomic testing, newer imaging modalities, and also the treatment landscape. Now we have newer options based on genomic targets such as PARP inhibitors, we have radiopharmaceuticals, a newer variant of chemotherapy, and also some specific indications for immunotherapy which were not addressed previously. Because all these advances have been new, it was really important for us to make an update. In 2022, we did make a rapid update with lutetium-177, but these additional changes which we have seen made it an appropriate time frame for us to proceed with a newer guideline. Brittany Harvey: Absolutely. It's great to hear about all these advances in the field to provide new options. So I'd like to next review the key recommendations from this guideline. So let's start with the overarching principles of practice that the panel outlined. What are these key principles? Dr. Rohan Garje: As a group, all the panel members came up with some ground rules: What are necessary for all our patients who are being treated for metastatic CRPC? First, the founding aspect was a definition for what is metastatic CRPC. So we defined metastatic CRPC as castrate level of testosterone with evidence of either new or progressive metastatic disease on radiological assessments or patients who have two consecutive rising PSAs in the setting of existing metastatic disease. We also emphasized on the need for germline and somatic testing for patients with metastatic prostate cancer at an earliest available opportunity because it is critical to select appropriate treatment and also right treatment for patients at the right time. And we actually have a concurrent guideline which addresses what genes to be tested and the timing. The other principles are patients should continue to receive androgen deprivation therapy or undergo surgical castration to maintain castrate level of testosterone. Now the key aspect with these guidelines is personalizing treatment choices. As you can see the evolution of treatment options for prostate cancer, the drugs that were initially developed and approved for prostate cancer were primarily in castrate-resistant settings, but now most of these drugs are being utilized in castrate-sensitive. So, when these patients develop castration resistance, the challenges are there are no appropriate particular drug-specific guidelines they meet. So, it's very important for the clinicians to be aware of what treatments have been received so far prior to castration resistance so that they can tailor the treatment to patient specific situations. In addition, prior to choosing a therapy, it is important for the physicians to consider patient specific symptoms or signs, treatment-related toxicities, potential drug interactions, cost, and also access to the drugs. There may be multiple treatment options available for the patients, but for a patient specific scenario, there may be a drug that may be more promising than the others. So, it is important to tailor the drug choices based on patients' unique circumstances. The panel also recommends to early integrate palliative and supportive care teams for symptom management and also discuss goals of care with the patient as each patient may have unique needs and it's important for physicians to address those concerns upfront in the care. The panel also suggests patients to receive RANK ligand inhibitors such as denosumab or bisphosphonates such as zoledronic acid to maintain the bone strength to prevent skeletal-related events. Finally, I would like to also emphasize this point about the lack of randomized clinical trial data for optimal sequencing of therapies for patients with metastatic CRPC. As I previously alluded, we have taken into account all ongoing clinical trials, prior published data, and came up with a format of preferred drugs based on prior treatments and, I think, by following these several clinical principles which I just mentioned, we can optimally choose and utilize best treatments for patients with metastatic CRPC. Brittany Harvey: Absolutely. These principles that you just outlined are important for optimal patient care, and then I want to touch on one of those things. You talked importantly about the treatments received so far. So in the next set of recommendations, the role of systemic therapy was stratified by the prior therapy received in the castration-sensitive and non-metastatic castration-resistant setting. So starting with what does the panel recommend for patients who are previously treated with androgen deprivation therapy alone in these previous settings and whose disease has now progressed to metastatic castration-resistant prostate cancer? Dr. Rohan Garje: There are multiple treatment options based on prior treatment received. So for patients who received only ADT for their castration-sensitive disease, the panel strongly urges to get HRR testing to check for homologous recombinant repair related changes, specifically for BRCA1 and BRCA2 mutations, because we have three studies which have really shown significant clinical benefit for patients who have BRCA1 and BRCA2 mutations with drugs such as the combination of talazoparib and enzalutamide or olaparib with abiraterone or niraparib with abiraterone. Unless we test for those mutations, we'll not be able to give these agents upfront for the patients. In the HRR testing, if patients have HRR alterations but they are in genes which are non-BRCA, the guideline panel recommends to utilize talazoparib and enzalutamide based combination therapies. Now, if they don't have HRR alterations then there are multiple treatment choices available. It could either include androgen receptor pathway inhibitors such as abiraterone with prednisone. We could also consider docetaxel chemotherapy. The alternate choices for androgen receptor pathways include enzalutamide or the newer agents such as apalutamide and docetaxel. So, as you can see there are multiple options available, but the panel definitely emphasizes to test for HRR testing because this gives patients access to more precision therapies at this point. There may be various scenarios where a unique drug may be available for a specific patient situation. For example, patients who have very limited disease burden and may have one or two metastatic lesions, after a multidisciplinary discussion, targeted local therapies such as radiation or potentially surgery could also be offered. In select patients who have very indolent disease where they are castrate-resistant based on slow rising PSA, low-volume disease or asymptomatic disease can consider sipuleucel-T. And in patients who have bone-only metastatic disease, we could also consider radium-223, which is primarily now utilized for patients who have symptomatic bone disease. Brittany Harvey: Great. I appreciate you reviewing all those options and talking about how important it is to tailor treatment to the individual patient. So then the next category of patients, what is recommended for those who have been previously treated with ADT and an androgen receptor pathway inhibitor and whose disease has now progressed to metastatic castration-resistant prostate cancer? Dr. Rohan Garje: So for patients who received ADT along with an androgen receptor pathway inhibitor, which we consider would be a most common cohort because most patients now in castration-sensitive setting are receiving androgen receptor pathway inhibitor. It was different in the past where five or six years back ADT alone was the most common treatment, but fortunately, with enough awareness and education, treatment choices have improved. Patients are now receiving ADT and ARPI as the most common choice of drug. Once again, at this point the panel emphasizes to consider HRR testing in there is enough data for us to suggest that patients who have alterations in the HRR pathway definitely will benefit with the PARP inhibitor. You know the multiple options, but specifically we speak about olaparib. And then if they are HRR-negative, we prefer patients receive agents such as docetaxel or if they are intolerant to docetaxel, consider cabazitaxel chemotherapy, options such as radium-223, and if they have a specific scenario such as MSI-high or mismatch repair deficiency, pembrolizumab could also be considered. The panel also discussed about the role of a second ARPI agent. For example, if patients progressed on one androgen receptor pathway inhibitor, the second androgen receptor pathway inhibitor may not be effective and the panel suggests to utilize alternate options before considering androgen receptor pathway inhibitor. There may be specific scenarios where a second ARPI may be meaningful, specifically, if alternate choices are not feasible for the concern of side effects or toxicities or lack of access, then a potential ARPI could be considered after progression on ARPI, but the panel definitely encourages to utilize alternate options first. Brittany Harvey: Great. Thank you for outlining those options as well for those patients. So then the next category, what is recommended for patients who have been previously treated with ADT and docetaxel? Dr. Rohan Garje: For patients who received ADT and docetaxel and were never treated with androgen receptor pathway inhibitors, the panel again emphasizes on HRR testing. If they have BRCA1 and 2 mutations, the combination therapies of talazoparib with enzalutamide, olaparib with abiraterone, or niraparib with abiraterone are all good choices. If they don't have BRCA mutations but they have other HRR mutations, the panel suggests to potentially utilize talazoparib with enzalutamide. And if they do not have any HRR alterations, the options could include androgen receptor pathway inhibitors such as abiraterone or enzalutamide. I want to emphasize that these are preferred options, but not the only options. As you can see, there are multiple options available for a particular clinical situation - so the ability of the physicians to access particular combinations, the familiarity of those drugs or the patient's unique situation where they have other medications which can potentially interact with a choice of agents. So I think based on access, based on cost and patients' concurrent illness with potential drug interactions can make one particular combination of therapy better over the other options. Brittany Harvey: Absolutely. That's key to keep in mind that access, contraindications, and cost all play a role here. So then the next set of recommendations. What are the key recommendations for patients who have previously been treated with ADT, an androgen receptor pathway inhibitor, and docetaxel who now have mCRPC? Dr. Rohan Garje: Yes. In this group, the options remain, again, broad. We utilize PSMA imaging here specifically and if they are positive on PSMA imaging, lutetium-177 is a good option. If they do not have PSMA-positive disease on PSMA imaging but if they have HRR alterations, olaparib could be utilized. And if they are negative on PSA imaging, they don't have HRR alterations, then alternate options could include cabazitaxel, radium-223. And if they have MSI-high or deficiency in mismatch repair, pembrolizumab could be utilized in this setting. Brittany Harvey: Thank you for outlining those options as well. So then next the panel addressed treatment options for de novo or treatment emergent small cell neuroendocrine carcinoma of the prostate. What are those key recommendations? Dr. Rohan Garje: Yes. This is a very high unmet need group because there are limited clinical trials, especially prospective clinical trials addressing treatment options for this group. Most of our current guidelines are always an extrapolation from lung small cell cancer based guidelines, but the panel recommends to utilize cisplatin or carboplatin along with etoposide as a preferred choice for this group. Also, an alternate option of carboplatin along with cabazitaxel could be considered for this cohort. The panel also encourages participation in clinical trials. There are numerous trials ongoing now in smaller phase studies and I think it's important for patients to consider these trials as well, because this will give them access to newer agents with potential biological targets. In addition to these agents in specific scenarios or potentially case by case basis, because we don't have prospective data, so we have made it as a select case by case basis to consider adding immunotherapy along with platinum-based chemotherapy followed by maintenance immunotherapy, which is currently a standard of care in small cell lung cancer. But the data is so limited in prostate cancer, so the panel suggested that it has to be a case by case basis only. The alternate options also include lurbinectedin, topotecan, tarlatamab upon progression on platinum-based chemotherapy. Brittany Harvey: Yes. It's important to have these recommendations in these unique situations where there is really a lack of data. So then the final set of recommendations I'd like to cover, what does the panel recommend for how clinicians should assess for response while patients are on systemic therapy and what scans are recommended for this response assessment? Dr. Rohan Garje: Yes. Again, this is another strong emphasis of the panel for global assessment of the patients. Traditionally, patients and physicians per se are heavily reliant on PSA as an accurate marker for response. This is in fact true in earlier phases of prostate cancer either in castrate-sensitive setting or localized prostate cancer setting. But as patients evolve into castrate-resistant, we don't want to heavily rely on PSA alone as a marker of response. The panel suggests to incorporate clinical response, radiological response, and also include PSA as a component, but not just rely primarily on PSA. So the panel also suggests that patients should get a bone scan and a CT scan every three to six months while on treatment to assess for appropriate response or for progression. And now one key important aspect, we are all aware about the evolving role of PSMA-based imaging with several of these new agents that are currently available. We do acknowledge these scans definitely have an important role in the care for patients with metastatic prostate cancer. Currently, the utility is primarily to select patients for lutetium-based therapy and also in situations where the traditional scans such as technitium 99 bone scan or CT scan are equivocal, then a PSMA-based imaging can be helpful. Now we are also aware that there are newer studies coming up, prospective data coming up for the role of PSMA-based imaging for response assessment. We are hoping to update the guidelines if we get access to newer data, but currently we have not recommended the utility of PSMA-based imaging for response assessments. Brittany Harvey: Understood. And I appreciate you describing where there is data here and where there's a lack of data to currently recommend. And we'll look forward to future updates of this guideline. Coming back to – at the start you mentioned how much has changed since the last guideline update. So Dr. Garje, in your view, what is the importance of this update and how will it impact both clinicians and patients with metastatic castration-resistant prostate cancer? Dr. Rohan Garje: The updated guidelines are designed to have a significant impact on clinical practice and also patient outcomes by providing clinicians with a comprehensive evidence-based framework for managing patients with metastatic CRPC. And also, by using these guidelines can make informed decisions, can select therapies tailored to patients' unique genomic status, clinical situation, where they are in the course of the cancer based on what they received previously. Also utilizing these guidelines, we can potentially improve patient outcomes, improve survival, and importantly have efficient use of healthcare resources. Brittany Harvey: Absolutely. We're always looking for ways to improve patient outcomes and survival. I want to wrap us up by talking a little bit about the outstanding questions in this field. So earlier you had mentioned about prospective data to come about PSMA PET scans, but what other outstanding questions are there for patients with metastatic castration-resistant prostate cancer? And what evidence is the panel looking forward to for future updates? Dr. Rohan Garje: We do have now rapidly evolving data specifically about the utility of the radiopharmaceutical lutetium-177 prior to chemotherapy. We are hoping that with newer data we can make some changes to the guideline based on that. We are also looking at newer drugs that are coming up in the pipeline, for example, androgen receptor degraders. We are looking at data that might potentially help based on bispecific T-cell engagers and newer radiopharmaceuticals. So I think in the next few years, we will definitely update all the guidelines again. But this time we are trying to do it more proactively. We are following a newer model. We are calling it as ‘living guidelines' where we are actually utilizing week by week updates where we look at the literature and see if there is any potential practice impacting change or publication that comes up. And we are trying to incorporate those changes as soon as they are available. That way patients and practicing physicians can get the latest information available through the guidelines as well. Brittany Harvey: That's great to hear. Yes, we'll await this data that you mentioned to continuously update this guideline and continue to improve patient outcomes for the future. So Dr. Garje, I want to thank you so much for your time to update this guideline. It was certainly a large amount of recommendations, and thank you for your time today, too. Dr. Rohan Garje: Thank you so much for having me here. And it's always nice talking to you. Brittany Harvey: And finally, thank you to our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/genitourinary-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

This international retrospective cohort study evaluated the safety of assisted reproductive technology (ART) in BRCA1/2 carriers who conceived after a breast cancer diagnosis at age 40 or younger. Among 543 women, 107 conceived using ART and 436 conceived spontaneously. ART methods included oocyte/embryo cryopreservation, in vitro fertilization, ovulation induction, and oocyte donation. Patients who used ART were generally older, had more hormone receptor-positive tumors, and a longer interval from diagnosis to conception. After a median follow-up of 5.2 years post-conception, ART use was not associated with an increased risk of disease-free survival events, suggesting that ART is a safe option for pregnancy after breast cancer in this population.

In this groundbreaking episode of Keeping Abreast with Dr. Jenn Simmons, Dr. Jenn sits down with world-renowned integrative oncologist Thomas Lodi to challenge everything you think you know about cancer, health, and healing.They expose the flaws in the traditional disease model, dive into the controversial risks of mammograms, and explore why cancer is not your enemy — but a natural response of the body. Dr. Lodi shares innovative insights into tumor biology, detoxification, metabolic therapies, and how restoring true health can dramatically change outcomes for breast cancer patients and survivors alike.Thomas Lodi, MD, MD(H) is an internationally recognized pioneer in integrative oncology. With decades of experience blending the best of conventional and alternative medicine, Dr. Lodi is known for helping patients restore health at the metabolic and cellular level. His revolutionary approach emphasizes detoxification, immune support, and empowering patients to understand and heal their bodies without fear. Follw Dr. Lodi at @drthomaslodiIn This Episode, You Will Learn:✔️ Why mammograms may cause more harm than good ✔️ The real meaning of tumor markers and SV40 in cancer risk ✔️ How estrogen receptors and hormonal balance are misunderstood ✔️ Why the ARIA test is revolutionizing breast cancer screening ✔️ The urgent need to rethink BRCA gene fears and cancer myths ✔️ How chronic inflammation, environmental toxins, and metabolic health drive disease ✔️ What true empowerment in cancer prevention and recovery really looks likeThis is the conversation every smart woman needs to hear to take back her health, challenge outdated narratives, and embrace a future of hope, power, and true prevention.✨ Hit subscribe to Keeping Abreast with Dr. Jenn Simmons for more life-changing conversations. ✨ Please leave a review if this episode resonates — it helps us reach and empower more women!Episode Timeline:00:00 The Journey Begins: Thomas Lodi's Origin Story09:02 The Myth of Disease: Understanding Cancer Differently12:58 Rethinking Cancer: A New Perspective on Treatment28:50 The Controversy of Screening: Mammograms and Their Impact39:15 The Genius of Tsunayo Kobayashi42:10 Understanding Tumor Markers and Cancer Staging43:40 The Role of SV40 and Immune Derangement44:57 Detoxing from Vaccines and Immune Support46:30 Estrogen Receptors and Cancer Narratives51:36 The Impact of Hormonal Imbalance on Health57:52 Restoring Balance in the Body01:10:16 Traditional Medicine and Cancer Treatment01:16:55 The Importance of Detoxification and Environmental Awareness01:21:05 Exposing the Truth About To talk to a member of Dr. Jenn's team and learn more about working privately with RHMD, visit: https://jennsimmons.simplero.com/page/377266?kuid=327aca17-5135-44cf-9210-c0b77a56e26d&kref=vOKy0sAiorrKTo get your copy of Dr. Jenn's book, The Smart Woman's Guide to Breast Cancer, visit: https://tinyurl.com/SmartWomansBreastCancerGuideTo purchase the auria breast cancer screening test go here https://auria.care/ and use the code DRJENN20 for 20% Off.Connect with Dr. Jenn:Website: https://www.realhealthmd.com/Facebook: https://www.facebook.com/DrJennSimmonsInstagram: https://www.instagram.com/drjennsimmons/YouTube: https://www.youtube.com/@dr.jennsimmons

BRCA revision mutations may explain some of the limited benefit seen in long-term follow-up studies with PARP inhibitors. Bibliography: 1: BRCA reversion mutations predict resistance. https://doi.org/10.1158/2159-8290.CD-18-0715 2: SOLO3 Final OS Data. https://doi.org/10.1200/JCO.24.00933 3: Elucidating acquired PARP inhibitor resistance in advanced prostate cancer. https://doi.org/10.1016/j.ccell.2024.10.015

Linda Petticrew's battle with breast cancer at 34, and her daughter Rachel Evans' decision to have a prophylactic mastectomy at 25, reveal a narrative of resilience and proactive health decisions. Diagnosed with the BRCA1 gene, Rachel chose surgery as a precaution, influenced by her mother's experience with the disease. Their story highlights the importance of genetic testing and the strength found in family support. Key Questions Answered What is the relationship between Linda Petticrew and Rachel Evans? Linda underwent mastectomies due to being diagnosed with breast cancer, while Rachel had a prophylactic mastectomy due to testing positive for the BRCA1 gene. At what ages were Linda and Rachel when they had their mastectomies? Did anyone else in Linda's family have breast cancer prior to her diagnosis? How did Linda feel when she found out Rachel tested positive for the BRCA gene? How did the recovery experiences differ between Linda and Rachel? How did Rachel share her decision to undergo a prophylactic mastectomy and its implications? Timestamped Overview 00:00 Mother and daughter discuss their mastectomies experiences.05:16 Grateful for urging timely, crucial conversation, answers.08:32 Thankful for company benefits during hospital stay.11:32 Posted about BRCA gene on Instagram: questions followed.15:26 Shell supportive during cancer, knee replacement recovery.19:18 Mobile services provided for convenient health testing.21:40 Executive assistants supporting education, philanthropy in Houston.26:44 Podcast about breast health by The Rose. Support The Rose HERE. Subscribe to Let’s Talk About Your Breasts on Apple Podcasts, Spotify, iHeart, and wherever you get your podcasts.See omnystudio.com/listener for privacy information.

Dr. Neja Zupan is a trailblazer in holistic health and personal empowerment, whose journey of overcoming aggressive hormone-dependent ductal breast cancer has become a source of inspiration worldwide. Diagnosed in 2013 with a grim prognosis and only a 5% chance of survival without medical intervention, she chose an unconventional path—rejecting chemotherapy, radiation, and hormonal therapy. Instead, she embraced natural healing methods, mindset transformation, and inner resilience, emerging not just as a survivor but a thriving advocate for holistic health. All her female ancestors passed away from cancer. She is the first to survive—and also the first to reject allopathic medicine. She was BRCA gene positive, with two cancer centers and one lesion. She underwent the surgical removal of two cancer centers and then began her unconventional path. Connect with Neja at www.nejazupan.com Get Dr Zupan's free E-Book www.HighFrequencyEnergyFormula.com __________ To learn more about the 10 Radical Remission Healing Factors, connect with a certified RR coach or join a virtual or in-person workshop visit www.radicalremission.com. To watch Episode 1 of the Radical Remission Docuseries for free, visit our YouTube channel here.  To purchase the full 10-episode Radical Remission Docuseries visit Hay House Online Learning. To learn more about Radical Remission health coaching with Liz or Karla, Click Here Follow us on Social Media: Facebook  Instagram YouTube _____ Thank you to our friends from The Healing Oasis for sponsoring this episode of the podcast.  The Healing Oasis is a first of its kind in beautiful British Columbia, Canada where we encourage the body to heal from cancer using alternative therapies & cancer fighting meals at a wellness retreat center in nature. Our top naturopathic cancer doctor will prescribe a protocol tailored specifically for you. There's no place quite like it. Start your healing journey today! Learn More about The Healing Oasis by visiting these links: Website   Testimonials Video Overview

This podcast is the first episode in a series featuring companies I am eager to explore and share with my community. Today, I am thrilled to welcome Dr. Andrew Salzman, a Harvard-trained medical doctor, pioneering scientist, and esteemed inventor. Dr. Salzman is the Chief Medical Officer at Wonderfeel, where he applies over three decades of medical innovation. His research into DNA repair with NAD-activated enzymes led the way for a groundbreaking treatment for BRCA-related breast and ovarian cancers, which he licensed to Genentech. Dr. Salzman was among the first researchers to publish papers on the gut microbiome and leaky gut syndrome in the 1980s, and he has published over 170 peer-reviewed papers and holds more than 50 patents. In our conversation today, we dive into what NAD is, its significance, why it matters, and how it impacts fertility, menopause, and sexual health. Dr. Salzman walks us through the symptoms of NAD deficiency and explains how an enzyme called CD38 can emerge when NAD levels are low, triggering inflammation and oxidative stress. We explore the difference between pharmaceutical agents and nutraceuticals, examining why oral NMN is preferable and how sleep and alcohol can influence NAD levels. We cover the risk factors for breast, ovarian, and uterine cancers, looking at what we can do to reduce them, and we also talk about Wonderfeel and how their supplements and botanicals enhance wellness for women.  This is an invaluable discussion with Dr. Salzman, so you will likely want to listen to it more than once. IN THIS EPISODE YOU WILL LEARN: How our NAD levels change as we get older The role of NAD in energy production  How oxidative stress and inflammation affect NAD levels in the ovaries Why NAD is essential for sexual health Lifestyle choices that could affect NAD levels How inflammation can increase CD 38 levels and deplete NAD Why oral administration of NMN or NR is the most practical and effective method for maintaining NAD levels How alcohol affects NAD levels and increases the risk of cancer How, with Dr. Salzman's input, Wonderfeel developed a product combining NMN with botanicals to enhance NAD levels Connect with Cynthia Thurlow   Follow on Twitter Instagram LinkedIn Check out Cynthia's website Submit your questions to support@cynthiathurlow.com Connect with Dr. Andrew Salzman On the Wonderfeel website .

 What happens when the preventative surgery you chose to avoid cancer reveals you already have it?  In this episode of "Every Soul Has a Story," Dara Levan welcomes author Gila Pfeffer, whose memoir "Nearly Departed" chronicles her journey through losing both parents to cancer at a young age and her own battle with breast cancer. With refreshing candor and signature wit, Gila shares how her Orthodox Jewish identity shaped her experiences and how becoming a mother to four children galvanized her commitment to preventative healthcare - ultimately saving her life when a preventative mastectomy revealed aggressive cancer.  Weaving together themes of resilience, authentic storytelling, and finding humor in life's darkest moments, Gila reflects on the profound significance of reaching age 50 - making her the first woman in four generations of her family to achieve this milestone. Her powerful metaphor of a broken mug still worth saving resonates deeply as she discusses her advocacy work and how sharing her story has inspired countless women to prioritize breast health. Like the cracked vessel on her book cover - weathered yet still holding precious contents - Gila's narrative embodies the beauty of imperfect survival.  Gila Pfeffer is a Jewish American humor writer whose memoir "Nearly Departed" chronicles her journey through loss, cancer, and survival with unflinching candor and unexpected hilarity. A fifteen-year breast cancer previvor and survivor, Gila's "Feel It on the First" campaign has directly led to earlier diagnoses for countless women through its tongue-in-cheek reminders about breast health. As an Orthodox Jewish mother of four who underwent preventative mastectomy at 34 only to discover early-stage cancer, Gila's writing - featured in The New York Times, The New Yorker, and McSweeney's - transforms tragedy into empowerment through her signature wit. She splits her time between London, New York City, and Instagram.  In This Episode:  (00:00) Meet Gila Pfeffer: Author of "Nearly Departed" (05:26) "Making fun of something is taking your power back" (08:12) What does authentic branding really mean? (13:07) Breaking the cycle: First to reach 50 (19:11) The delicate balance of telling your truth in memoir (23:51) How four children saved their mother's life (29:16) Beyond the pink ribbon: Rethinking breast cancer awareness (34:42) One person at a time: The impact of sharing your story (38:45) The metaphor of the broken mug  (39:55) Closing thoughts   Like and subscribe to hear all of our inspirational episodes!  Resources: https://www.gilapfeffer.com/ @GilaPfeffer on Instagram Nearly Departed Sign up for Dara's Newsletter Listen to other podcast episodes Here Connect with Dara on Instagram and Facebook Visit DaraLevan.com 

Join us in this insightful episode of the Oncology Brothers podcast as we dive deep into the current treatment landscape of pancreatic cancer. Drs. Rohit and Rahul Gosain are joined by Dr. Emil Lou, a medical and neuro-oncologist from the University of Minnesota, to discuss the challenges and advancements in managing this complex disease. In this episode, we covered: •⁠  ⁠The importance of a multidisciplinary approach in treating early-stage pancreatic cancer. •⁠  ⁠The role of neoadjuvant and adjuvant therapies, including the latest insights on chemotherapy regimens like FOLFIRINOX, nal-IRI and gemcitabine. •⁠  ⁠The significance of germline and next-generation sequencing (NGS) testing in personalizing treatment plans. •⁠  ⁠The current state of clinical trials and emerging therapies, including PARP inhibitors for BRCA mutations and the implications of ctDNA testing. •⁠  ⁠Prognostic discussions around metastatic pancreatic cancer and the importance of managing side effects to improve patient quality of life. Key takeaways include the necessity of balancing treatment efficacy with adverse events, the critical role of genetic testing, and the need for vigilance regarding venous thromboembolism (VTE) in pancreatic cancer patients. Don't miss this comprehensive discussion that aims to shed light on the ongoing efforts to improve outcomes for patients battling pancreatic cancer.   YouTube: https://youtu.be/HCKQxmOqRTI   Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Subscribe to our channel for more discussions on oncology and stay updated on the latest in cancer treatment!

In 2014, at the age of 51, Diane was diagnosed with stage 4 ovarian cancer with a BRCA mutation. Doctors told her she had just months to live. In this episode, Diane Doyle shares how she took control of her own healing, the challenges she faced in navigating both conventional and alternative treatments, and why she believes cannabis was the key to her survival. Her story is a testament to the power of perseverance, self-education, and never giving up hope.01:13 – Diane's initial diagnosis and how it was discovered04:35 – Reaction to being told she had only months to live06:58 – How Diane approached her healing journey from the beginning10:42 – Why she chose to combine conventional and alternative treatments14:25 – Discovering cannabis and how she began using it18:09 – The reaction from her doctors20:55 – What Diane believes made the biggest difference in her outcome24:36 – Side effects, setbacks, and how she adjusted29:45 – The emotional and spiritual aspects of healing33:10 – Where she is today, 11 years later36:22 – Advice for others facing a similar diagnosis39:00 – Final thoughts and gratitude Visit our website: CannabisHealthRadio.comFollow us on Facebook.Follow us on Instagram.Find us on Rumble.Keep your privacy! Buy NixT420 Odor Remover

Dr Charlie Andrews talks to Dr John Leeds. John Leeds is a Consultant Pancreaticobiliary Physician and Endoscopist based at the Freeman Hospital in Newcastle and an Honorary Clinical Senior Lecturer based in the Population Health Sciences Institute at Newcastle University. He is involved in research in pancreaticobiliary disorders including benign and malignant conditions as well as outcomes from therapeutic/advanced endoscopy.John is a member of the British Society of Gastroenterology and Pancreatic Society of Great Britain and Ireland. He serves on the endoscopy and Pancreas committees for BSG and is the website lead for PSGBI.He is also a founder member of the BSG Pancreas Clinical Research Group which is coordinating research for the society.Key Learnings from this episode:Challenges in Early Detection of Pancreatic Cancer • Pancreatic cancer is often diagnosed at an advanced stage due to the deep location of the pancreas and the lack of early symptoms. • Tumors in the body and tail of the pancreas can grow significantly before causing symptoms, often invading major arteries or veins, making them inoperable. • Tumors in the head of the pancreas may present earlier due to bile duct obstruction, leading to jaundice, but even these are often detected late. Early Symptoms and Red Flags • Early symptoms are vague or absent, making early diagnosis difficult. • Possible early indicators include: • Weight loss (often a sign of advanced disease). • New-onset diabetes, particularly in individuals with a normal BMI or without typical risk factors for type 2 diabetes. • Jaundice, which is a significant red flag and often indicates a serious underlying condition. • Classic signs like painless jaundice and Courvoisier's sign (palpable gallbladder) are important but not always present. Limitations of Current Screening Methods • There is no reliable biomarker or screening test for pancreatic cancer: • CA19-9 is not suitable as a screening tool due to its lack of specificity (elevated in other conditions). • Imaging techniques like CT scans or MRIs are used but have limitations, including incidental findings that may lead to unnecessary anxiety (“scanxiety”) and over-investigation. • Screening is currently limited to high-risk groups, such as those with familial pancreatic cancer syndromes or hereditary pancreatitis. High-Risk Groups for Screening • Familial pancreatic cancer accounts for less than 10% of cases. Criteria for screening include: • Multiple family members with pancreatic cancer, especially diagnosed under age 50–60. • Genetic syndromes like BRCA mutations, familial adenomatous polyposis (FAP), and Peutz-Jeghers syndrome. • Hereditary pancreatitis patients have an increased risk but are harder to screen due to pre-existing pancreatic abnormalities. Emerging Research and Future Directions • Studies are exploring potential biomarkers, such as microbiome signatures in the pancreas, which might help identify high-risk individuals in the future. • Trials like the EuroPAC study focus on surveillance protocols for high-risk individuals using imaging techniques like MRI or endoscopic ultrasound. • Research into new-onset diabetes as a potential marker for pancreatic cancer is ongoing but currently has a low yield due to the high prevalence of type 2 diabetes unrelated to malignancy. Considerations for Screening and Surveillance • Screening should be carefully targeted to avoid over-diagnosis and unnecessary investigations. • The psychological impact of screening (e.g., anxiety from incidental findings) must be considered. • Smoking cessation is emphasized as smoking is a significant risk factor for pancreatic cancer. Advances in Treatment Approaches • PET-CT scans are increasingly used to detect systemic disease that might not be evident on standard CT scans. • Neoadjuvant treatments (therapy before surgery) are being... Chapters (00:00:00) - Ingest(00:00:53) - Pancreatic Cancer(00:04:03) - New diabetes and pancreatic cancer(00:08:01) - Pancreatic Cancer: Screening(00:15:42) - Determining breast cancer early is hard(00:16:03) - Pulmonary neuroendocrine tumors of the pancreas(00:22:26) - Pancreatic cancer 20, Management(00:29:00) - Pancreatic cancer, management principles(00:33:48) - Primary Care Take Home: Pancreas, pain(00:40:29) - Primary Care: Pancreas Cancer Episode 2

Have you or someone you know been diagnosed with breast cancer and not sure how to advocate for yourself? Then you'll love this episode with integrative oncologist Dr. Jenn Simmons where she reveals some of the things that go behind closed doors in the breast cancer world. We cover: Different types of breast cancers What it means to have receptor positive or negative cancer BRCA mutations and breast cancer risk The business of medicine and how we fall into the system Statistics of DCIS being fatal How women are being harmed with diagnosis of DCIS What you can do if you get diagnosed with breast cancer Should you really take a watch and wait approach? How to move forward after surgery to restore health Can you take HRT when you have breast cancer? What to take instead of tamoxifen to lower recurrence? The risk of breast cancer when using birth control How to advocate for yourself for the best health outcome   Dr. Jenn Simmons is a controversial breast cancer surgeon turned integrative oncologist. You either like her or you don't, but she is redefining the landscape of breast cancer diagnosis, treatment, and prevention. Her approach combines: • Pioneering the use of bioidentical hormone replacement for breast cancer patients • A mission to eliminate over-imaging, over-biopsy, over-diagnosis, and over-treatment of breast cancer Dr. Jenn empowers women to reclaim their hormonal health and embrace a life worth living. Her innovative methods not only save lives but also preserve quality of life, offering hope and vitality to those facing breast cancer. Author of the bestselling book "The Smart Woman's Guide to Breast Cancer, which is a comprehensive guide giving expert insights and compassionate support to anyone faced with a breast cancer diagnosis   PAST EPISODES What Breast Cancer Surgeons Don't Tell You - https://hackmyage.com/what-breast-cancer-surgeons-dont-tell-you-dr-jenn-simmons/ Best Ways To Screen Breasts https://hackmyage.com/best-ways-to-screen-for-breast-cancer-steps-following-a-diagnosis-dr-jenn-simmons/ The Smart Woman's Guide to Breast Cancer:  https://tinyurl.com/SmartWomansBreastCancerGuide Podcast: Keeping Abreast with Dr. Jenn https://keepingabreastwithdrjenn.buzzsprout.com/ Safe, painless radiation free breast imaging: https://www.perfeqtionimaging.com/ Contact Dr. Jenn Simmons: Email: info@realhealthmd.comEmail: info@perfeqtionimaging.com Website: https://www.realhealthmd.com/ Instagram: https://www.instagram.com/drjennsimmons Facebook: https://www.facebook.com/drjennsimmons YouTube: https://www.youtube.com/@dr.jennsimmons5127 Give thanks to our sponsors: Qualia senolytics and brain supplements. 15% off with code ZORA here.  Try BEAM minerals at 20% off with code ZORA here. Get Primeadine spermidine by Oxford Healthspan. 15% discount with code ZORA ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠here⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠.  Get Mitopure Urolithin A by Timeline. 10% discount with code ZORA at https://timeline.com/zora Get Magnesium Breakthrough by Bioptimizers. 10% discount with code HACKMYAGE at https://bioptimizers.com/hackmyage Try OneSkin skincare with code ZORA for 15% off https://shareasale.com/r.cfm?b=2685556&u=4476154&m=102446&urllink=&afftrack= Join ⁠⁠⁠Biohacking Menopause⁠⁠⁠ before April 1, 2025 to win OneSkin OS-01 peptide facial supplement and OS-01 eye cream! 15% off with code ZORA at OneSkin. Join the Hack My Age community on: Facebook Page: ⁠⁠⁠⁠⁠@⁠Hack My Age⁠     Facebook Group: ⁠⁠⁠⁠⁠⁠@⁠Biohacking Menopause⁠⁠⁠⁠⁠⁠ ⁠  Private Women's Only Support Group: https://hackmyage.com/biohacking-menopause-membership/ Instagram: ⁠⁠⁠⁠⁠@⁠HackMyAge⁠    Website: ⁠⁠⁠⁠⁠⁠HackMyAge.com⁠   

Featured on the first episode of Season 2 is an incredible mom, friend and local community member, Gladys Clausen. Gladys vulnerably and courageously shares that after discovering she carried the BRCA gene (putting her at a higher risk for certain cancers), there was no right or wrong way to move forward. On the road to healing, she documented her journey in her first book, Modified - The Journey to My New Normal: A Memoir of Being BRCA Positive. Gladys bravely reminds us to be kind to ourselves, have grace in difficult moments, continue to follow our gut and to listen to our inner knowing.Gladys is a proud New Hampshire resident and newly published author of her first non-fiction book, Modified, as well as a children's author of her first children's book, Will Mommy be OK? Gladys shares her life with her loving husband, Patrick, and their three wonderful children. Gladys is a passionate gardener, self-starter, and flamenco dancer, bringing energy and joy to everything she does. She remains a vibrant member of her community, using her story and her passions to uplift and inspire others. Gladys' books can be found on Amazon https://a.co/d/2ySqNQa and to see all of Gladys' work, visit https://dreamingcrowproductions.com. You can also follow her on Facebook and Instagram @dreamingcrowproductionsGladys will be at the Gilford Public Library in Gilford, NH on April 15, 2025 at 5:30 PM to talk about her book, Modified: The Journey to My New Normal. For more info, contact Gladys or the Gilford Library at https://www.gilfordlibrary.org/.References:Amazon Book Link: https://a.co/d/2ySqNQaDreaming Crow Productions: https://dreamingcrowproductions.com/Facebook: @dreamingcrowproductionsInstagram: @dreamingcrowproductionsLani Voivod Sound Baths: https://lani-voivod-muse.square.site/Live in Love Retreat (Tuftonboro, NH): https://katelemay.com/products/sandyislandWant to Connect with True for You? I'd love to hear from you!Email: trueforyoupodcast@gmail.comInstagram: @trueforyoupodcastFacebook: @trueforyoupodcast

Send us a textSarah Powell, CEO of Inherited Cancers Australia, shares her journey from triple-negative breast cancer diagnosis at age 29 to discovering her BRCA1 mutation and becoming a powerful advocate for others facing inherited cancer risk.• Diagnosed with breast cancer at 29 with no family history, Sarah later discovered she carries a BRCA1 mutation connected to her Ashkenazi Jewish ancestry• After treatment, Sarah became involved with Pink Hope (now Inherited Cancers Australia) to find peer support from others who understood the unique challenges of genetic risk• The "Angelina Jolie effect" dramatically increased awareness about BRCA mutations and genetic testing, helping many families understand their options• Inherited Cancers Australia recently rebranded from Pink Hope to better include men in the conversation about genetic risk and reflect the wider range of cancers involved• The recent recommendation to offer genetic testing to all women with breast cancer will identify many more families at risk, but raises concerns about healthcare system capacity• Long waitlists for preventative surgeries remain a major challenge, with some women developing cancer while waiting for risk-reducing proceduresIf you're concerned about your family history of cancer, visit InheritedCancers.org.au for support, information, and connection to others facing similar challenges.This is a special episode for the 3rd Podcasthon.Support the showDemystifying Genetics is sponsored by TrakGenehttps://www.trakgene.com/

Maria Boyce joins Dorothy to discuss her breast cancer journey and the impact of social determinants on health, the non-medical factors that play an important role in a person’s health and wellness, such as where people live, work, and receive their education. She emphasizes early detection and the value of support from family and doctors. Maria also shares her treatment success and genetic testing results. Her experience battling cancer has strengthened her advocacy for access to life-saving breast cancer screenings and care for all women. Please share this episode with family and friends, and consider making a donation at therose.org. It could save the life of an uninsured woman. Key Questions Answered 1.) Why is addressing social determinants of health important in cancer treatment? 2.) How did early detection play a role in Dorothy's cancer journey? 3.) What factors did Maria credit for helping her battle cancer? 4.) How did Maria's belief in her doctor influence her treatment decisions? 5.) What lessons did Maria learn from her mother's battle with multiple sclerosis? Timestamped Overview 00:00 Support from friends crucial during cancer battle 05:30 Initial meeting about breast cancer diagnosis, empathy. 07:13 Mother had hormone-based breast cancer, serious diagnosis. 10:35 Overcame personal struggle, now advocating for others. 16:28 Ensuring access to mammograms, access versus treatment. 18:51 Addressing social determinants of health is essential. 23:43 Support and transportation are crucial for treatment. 28:23 Doctor emphasized urgency of treatment for small tumor. 29:48 Initial chemotherapy showed tumor shrinkage, but concerns remained. 32:32 Finding out I didn't carry BRCA gene.See omnystudio.com/listener for privacy information.

In the third episode of A Deep Dive Into HRD Testing in Ovarian Cancer, a three-part podcast series sponsored by AstraZeneca, we're speaking with Dr. David O'Malley, and Bobbie R, an ovarian cancer patient. Dr. O'Malley will highlight how HRD testing empowers ovarian cancer patients to make more informed decisions with their doctors to help guide their treatment journey, and Bobbie will provide insight into her experience with HRD testing.   Dr. David O'Malley is a professor in the department of Obstetrics and Gynecology at The Ohio State University College of Medicine and the director of the Division of Gynecologic Oncology at the OSUCCC – James.   Bobbie is a stage 3C ovarian cancer patient who lives in Rochester, New York. Bobbie is an animal rights activist, vegetarian, and exerciser who recently retired from the healthcare field, having worked as a registered nurse and owner of a healthcare staffing firm. Following her diagnosis in July of 2021, Bobbie participated in biomarker testing which indicated that she was breast cancer gene (BRCA) negative and homologous recombination deficiency (HRD) positive. After undergoing surgery and chemotherapy as first-line treatment, Bobbie's oncologist explained that she was eligible for a poly-ADP ribose polymerase (PARP) inhibitor due to her HRD status and on March 7, 2022, Bobbie started on a PARP inhibitor for maintenance treatment. As she continues treatment in 2024, Bobbie celebrates over 45 years of marriage with her husband and looks forward to traveling the United States, reading good books, and spending time with her dogs.   For more information, visit https://www.azprecisionmed.com/tumor-type/ovarian-cancer/hrd-testing.html   For patient resources, please visit TestForHRD.com.   This podcast does not necessarily reflect the opinions of AstraZeneca and are the spokespeople's opinions and experiences.

In the third episode of A Deep Dive Into HRD Testing in Ovarian Cancer, a three-part podcast series sponsored by AstraZeneca, we’re speaking with Dr. David O’Malley, and Bobbie R, an ovarian cancer patient. Dr. O’Malley will highlight how HRD testing empowers ovarian cancer patients to make more informed decisions with their doctors to help guide their treatment journey, and Bobbie will provide insight into her experience with HRD testing. Dr. David O’Malley is a professor in the department of Obstetrics and Gynecology at The Ohio State University College of Medicine and the director of the Division of Gynecologic Oncology at the OSUCCC – James. Bobbie is a stage 3C ovarian cancer patient who lives in Rochester, New York. Bobbie is an animal rights activist, vegetarian, and exerciser who recently retired from the healthcare field, having worked as a registered nurse and owner of a healthcare staffing firm. Following her diagnosis in July of 2021, Bobbie participated in biomarker testing which indicated that she was breast cancer gene (BRCA) negative and homologous recombination deficiency (HRD) positive. After undergoing surgery and chemotherapy as first-line treatment, Bobbie’s oncologist explained that she was eligible for a poly-ADP ribose polymerase (PARP) inhibitor due to her HRD status and on March 7, 2022, Bobbie started on a PARP inhibitor for maintenance treatment. As she continues treatment in 2024, Bobbie celebrates over 45 years of marriage with her husband and looks forward to traveling the United States, reading good books, and spending time with her dogs. For more information, visit https://www.azprecisionmed.com/tumor-type/ovarian-cancer/hrd-testing.html For patient resources, please visit TestForHRD.com. This podcast does not necessarily reflect the opinions of AstraZeneca and are the spokespeople's opinions and experiences.

In the third episode of A Deep Dive Into HRD Testing in Ovarian Cancer, a three-part podcast series sponsored by AstraZeneca, we’re speaking with Dr. David O’Malley, and Bobbie R, an ovarian cancer patient. Dr. O’Malley will highlight how HRD testing empowers ovarian cancer patients to make more informed decisions with their doctors to help guide their treatment journey, and Bobbie will provide insight into her experience with HRD testing. Dr. David O’Malley is a professor in the department of Obstetrics and Gynecology at The Ohio State University College of Medicine and the director of the Division of Gynecologic Oncology at the OSUCCC – James. Bobbie is a stage 3C ovarian cancer patient who lives in Rochester, New York. Bobbie is an animal rights activist, vegetarian, and exerciser who recently retired from the healthcare field, having worked as a registered nurse and owner of a healthcare staffing firm. Following her diagnosis in July of 2021, Bobbie participated in biomarker testing which indicated that she was breast cancer gene (BRCA) negative and homologous recombination deficiency (HRD) positive. After undergoing surgery and chemotherapy as first-line treatment, Bobbie’s oncologist explained that she was eligible for a poly-ADP ribose polymerase (PARP) inhibitor due to her HRD status and on March 7, 2022, Bobbie started on a PARP inhibitor for maintenance treatment. As she continues treatment in 2024, Bobbie celebrates over 45 years of marriage with her husband and looks forward to traveling the United States, reading good books, and spending time with her dogs. For more information, visit https://www.azprecisionmed.com/tumor-type/ovarian-cancer/hrd-testing.html For patient resources, please visit TestForHRD.com. This podcast does not necessarily reflect the opinions of AstraZeneca and are the spokespeople's opinions and experiences.

https://www.coachsimranmd.com/ ORDER MY NEW BOOK SWEET INDULGENCE!!! https://www.amazon.com/Chef-AJs-Sweet-Indulgence-Guilt-Free/dp/1570674248 or https://www.barnesandnoble.com/w/book/1144514092?ean=9781570674242 GET MY FREE INSTANT POT COOKBOOK: https://www.chefaj.com/instant-pot-download MY BEST SELLING WEIGHT LOSS BOOK: https://www.amazon.com/dp/1570674086?tag=onamzchefajsh-20&linkCode=ssc&creativeASIN=1570674086&asc_item-id=amzn1.ideas.1GNPDCAG4A86S Disclaimer: This podcast does not provide medical advice. The content of this podcast is provided for informational or educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health issue without consulting your doctor. Always seek medical advice before making any lifestyle changes. Simran Malhotra MD DipABLM CHWC Dr. Simran Malhotra is a triple board-certified physician in internal medicine, hospice & palliative care, and lifestyle medicine as well as a certified health and wellness coach. She was recognized as a "Top Doc" by Baltimore Magazine in Palliative Medicine for three consecutive years (2019, 2020, 2023). Dr. Malhotra is a diplomate of the American College of Lifestyle Medicine (ACLM) and has completed several certifications, including T. Colin Campbell's Plant-Based Nutrition (2019), CHEF Culinary Coaching (2020), and WellCoaches Health and Wellness Coaching (2022). With nearly a decade of experience in both inpatient and outpatient palliative care, Dr. Malhotra leverages the invaluable lessons learned from end-of-life care to advocate for the importance of lifestyle medicine and a positive mindset in enhancing overall well-being. As a mother of two and a BRCA 1 previvor, Dr. Malhotra is deeply committed to her mission. After undergoing a risk-reducing bilateral mastectomy & total hysterectomy at 32 years old due to her strong family history of cancer, she founded Wellness By LifestyleMD, a platform dedicated to educating busy parents about the transformative power of lifestyle & mindset changes on wellbeing, quality of life and longevity. In addition to her entrepreneurial pursuits, Dr. Malhotra writes a column for Everyday Health called "Awaken Your Wellness" and has been featured in various media outlets (TIME, Glamour, Yahoo, MSN, etc.), blogs and podcasts, sharing her unique insights from both her work in palliative care as well as her experiences as a patient and genetic mutation carrier passionate about using lifestyle as medicine. Website: Wellness By Lifestyle MD | By SimranMD https://www.coachsimranmd.com/ This is the viral video she reffered to where her husband sings to her: https://www.youtube.com/watch?v=0GojJnrqpeE Shop Dr.Simran's Favorite Lifestyle and Wellness Tools Here: https://www.searchbubble.com/drsimran.malhotra?fbclid=PAZXh0bgNhZW0CMTEAAaaKcnXfpgCEfg6ORr5JmAn03UOQ-64T9bNP1tXmWV9BZ5XD50C3wwfxwpg_aem_UW7k5m26dzvVWFVHGYc4bQ Awaken Your Wellness Columnist at Everyday Health https://www.everydayhealth.com/columns/awaken-your-wellness/ Co-Author of the book “How Healers Heal” https://www.amazon.com/dp/1961549018?linkCode=ssc&tag=onamzchefajsh-20&creativeASIN=1961549018&asc_item-id=amzn1.ideas.1GNPDCAG4A86S&ref_=aip_sf_list_spv_s_ofs_mixed_d_asin Instagram: Simran Malhotra

It's been an "Olympic" ride to get here, and this is our penultimate breast cancer episode! Today, we talk about the BRCA mutations and how they impact both breast cancer and outcomes using targeted therapy. BRCA is a tumour suppressor gene.Today, we explore olaparib and its role in the adjuvant and metastatic setting for breast cancer.Studies discussed in the episode:OLYMPIAOLYMPIADFor more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer, Gilead Pharmaceuticals and Merck Pharmaceuticals. Our partners have no editorial rights or early previews, and they have access to the episode at the same time you do. Hosted on Acast. See acast.com/privacy for more information.

Between 5-10% of breast and 20-25% of ovarian cancers are inherited. The majority of hereditary breast and ovarian cancer cases are caused by deleterious mutations (variants) in the BRCA1 and BRCA2 genes, which normally prevent cancer through protecting and repairing our DNA. Genetic testing is used to identify pathogenic BRCA carriers who would subsequently benefit from personalized screening, preventative and management plans. However, its widespread implementation has resulted in a significant increase in findings of variants of uncertain significance (VUS) – DNA sequence variants with uncertain effects on disease risk. VUSs pose a critical clinical challenge as they limit clinicians' ability to effectively interpret genetic test results. For upcoming interviews check out the Grad Chat webpage on Queen’s University School of Graduate Studies & Postdoctoral Affairs website.

One in 8 women in the United States will have her ovaries removed prior to the onset of natural menopause, and this number is growing. On top of that, each year about 600,000 hysterectomies are performed and more than 300,000 women are diagnosed with breast cancer, many under the age of 50. If you or someone you love experienced this kind of procedure, you may be asking “now what?”. What are the impacts on the rest of your body when you experience abrupt menopause? Do other health risks increase? And what about breast cancer? This week, we are joined by Dr. Corinne Menn, a board-certified OB-GYN, a breast cancer survivor of over 23 years, and a BRCA gene carrier. Dr. Menn is using her own experience to help women navigate health challenges, especially when dealing with the impacts of being a cancer survivor or experiencing abrupt menopause. If you or someone you know has had her ovaries removed, had a hysterectomy, or even experienced breast cancer, then this episode is for you. More Resources & Links Follow Dr. Corinne Menn on Instagram Get more info about working with Dr. Menn through Telehealth on Alloy FREE Weekly Jumpstart Newsletter! Master your midlife health in just 3 minutes a week with this easy-to-read newsletter FREE 5-Day Core Tune Up - A free mini-course to dramatically improve your functional core strength, create better alignment, and relieve back and hip pain for good! Need help getting started! Get Megan's FREE 5-Day Jumpstart Tips guide! The Jumpstart 30 Program for Beginners - Jumpstart your health & fitness journey with Megan's signature 30-day program for true beginners! The Back & Hip Fix 30-day program - Reduce your chronic back & hip pain in less than 10 minutes a day! Follow Megan on Instagram Follow Megan on YouTube

Today, I am honored to connect with Dr. Corinne Menn, a board-certified OB-GYN and Menopause Society-certified practitioner. Dr. Menn is a 23-year breast cancer and premature menopause survivor and a BRCA carrier who draws on her personal experiences to assist other women in navigating their health challenges. In our discussion, we explore the ways the Women's Health Initiative has impacted Baby Boomers and how fear-based decision-making, particularly around breast cancer risks, has shaped women's health. We discuss the timing hypothesis for hormone replacement therapy, breast cancer risks, and misleading stats and look into empowerment and the differences and biases that shape the experiences of women in perimenopause and beyond. We examine why osteoporosis is a silent disease and how hormone replacement therapy can reduce fracture risk by 30–50%, and tackle the effects of poor metabolic health, the challenges of receiving a diabetes diagnosis, and how statin therapy can influence the course of menopause and beyond. Dr. Menn also shares her personal story of resilience and empowerment.  This conversation with Dr. Corinne Menn is invaluable for all women- especially those with a history of breast cancer. IN THIS EPISODE YOU WILL LEARN: How the Women's Health Initiative has caused fear-based decision-making among menopausal women Why SSRI medications are inadequate in managing menopausal symptoms How the fear of litigation has impacted clinical decision-making in modern medicine The cardio-protective benefits of HRT   How HRT can help avoid the risk of breast cancer  Why starting HRT early is essential for cardiovascular health How racial differences impact women in menopause How early bone density screening can help prevent rapid bone loss during menopause The metabolic changes that occur during menopause How the lack of menopause education led Dr. Menn to experience premature menopause due to her breast cancer treatments Bio: Corinne Menn, DO, FACOG, MSCP Dr. Corinne Menn is a board-certified OBGYN and Menopause Society Certified Practitioner. Dr.Menn is also a 23-year survivor of breast cancer and premature menopause, a BRCA carrier,and uses her experience to help women navigate their health challenges. She has dedicated her medical practice to menopause management, the unique healthcare needs of female cancer survivors, and those at high risk for breast cancer. Now practicing exclusively through telehealth, Dr. Menn provides women's health consultations and patient education. She is also a medical advisor and a prescribing doctor on Alloy, a menopause telehealth platform. Dr. Menn is an active member of the Menopause Society and a fellow of The American College of Obstetrics & Gynecology. She is a dedicated advocate and volunteer for the Young Survival Coalition, serving on their Council of Advisors, leading the Provider-Survivor support group, and serving on the Breast Cancer Alliance Research Grant Committee. She is a frequent speaker and podcast guest and has an active social media platform where she shares her mission of educating fellow clinicians and women on menopause and women's health. Connect with Cynthia Thurlow   Follow on Twitter Instagram LinkedIn Check out Cynthia's website Submit your questions to support@cynthiathurlow.com Connect with Dr. Corinne Menn On her website  Instagram The Middle List Menopause and Cancer

Join Jennie Berkovich, DO, as she interviews Natalie Zelenko, MD, to discuss the vital topic of breast cancer screening. Together, they explore the latest guidelines on when women should begin routine mammograms, how technology has advanced to improve early detection, and the differences between screening and diagnostic mammograms. Dr. Zelenko breaks down what happens after an abnormal mammogram, the role of biopsies, and how breast MRIs compare to traditional imaging. They also delve into the impact of genetics, family history, and risk factors on screening decisions, offering a comprehensive look at modern breast cancer detection and prevention. Don't miss this empowering and informative conversation! With over 15 years of experience in the field of breast imaging, Dr. Natalie Zelenko is a skilled and compassionate physician dedicated to providing exceptional care for her patients.  She specializes in high-risk breast cancer screening and breast cancer diagnosis, utilizing multimodality imaging and advanced breast interventional techniques to offer a comprehensive approach to regular surveillance and early detection.  Dr. Zelenko's expertise spans a range of breast imaging modalities, including mammography, digital tomosynthesis, ultrasound, breast MRI, and minimally invasive image-guided biopsy techniques, allowing her to provide tailored, evidence-based care for each patient.  Taking a warm yet firm approach to building strong relationships with her patients Dr. Zelenko creates a supportive environment where the patients feel heard and informed. Her patients appreciate her clear communication and dedication to helping them navigate complex diagnostic and treatment decisions with confidence. Dr. Zelenko is deeply committed to multidisciplinary patient care, collaborating closely with breast surgeons, medical and radiation oncologists, pathologists, as well as other healthcare professionals to ensure each patient receives the most comprehensive approach.As an advocate for breast health awareness, Dr. Zelenko is actively involved in community education initiatives, speaking at local events and participating in outreach programs to educate the public on the importance of regular screening and early detection.Dr. Zelenko received her medical degree from Cornell University Medical College and completed her residency in Diagnostic Radiology as well as fellowship in Breast Imaging at Maimonides Medical Center. She is board-certified in Diagnostic Radiology and is a fellow of the American College of Radiology, maintaining memberships in the Radiological Society of North America, Society of Breast Imaging & European Society of Radiology. Dr. Zelenko is dedicated to staying at the forefront of her field, attending numerous leading medical conferences in the United States & abroad. She is committed to continued learning, ensuring that her patients receive the most advanced and up-to-date care possible. Sponsor the JOWMA Podcast! Email digitalcontent@jowma.org Become a JOWMA Member! www.jowma.org Follow us on Instagram! www.instagram.com/JOWMA_org Follow us on Twitter! www.twitter.com/JOWMA_med Follow us on Facebook! https://www.facebook.com/JOWMAorg Stay up-to-date with JOWMA news! Sign up for the JOWMA newsletter! https://jowma.us6.list-manage.com/subscribe?u=9b4e9beb287874f9dc7f80289&id=ea3ef44644&mc_cid=dfb442d2a7&mc_eid=e9eee6e41e

Dr. Jasmine Sukumar and Dr. Dionisia Quiroga discuss advances in adjuvant therapy for patients with early breast cancer and BRCA1/2 mutations, including how to identify patients who should receive genetic testing and the significant survival benefits of olaparib that emerged from the OlympiA trial. TRANSCRIPT Dr. Jasmine Sukumar: Hello, I'm Dr. Jasmine Sukumar, your guest host of the ASCO Daily News Podcast today. I'm an assistant professor and breast medical oncologist at the University of Texas MD Anderson Cancer Center. On today's episode, we'll be exploring advances in adjuvant therapy for high-risk early breast cancer in people with BRCA1/2 germline mutations. Joining me for this discussion is Dr. Dionisa Quiroga, an assistant professor and breast medical oncologist at the Ohio State University Comprehensive Cancer Center.  Our full disclosures are available in the transcript of this episode.  Dr. Quiroga, it's great to have you on the podcast. Thanks for being here. Dr. Dionisia Quiroga: Thank you. Looking forward to discussing this important topic. Dr. Jasmine Sukumar: Let's start by going over who should be tested for BRCA1/2 genetic mutations. How do you identify patients with breast cancer in your clinic who should be offered BRCA1/2 genetic testing? Dr. Dionisia Quiroga: So, guidelines on who to offer testing to somewhat differ between organizations at this point. I would say, generally, I do follow our current ASCO-Society of Surgical Oncology (SSO) Guidelines, though. Those guidelines recommend that BRCA1/2 mutation testing be offered to all patients who are diagnosed with breast cancer and are 65 years old or younger. For those that are older than 65 years old, there are additional factors to really take into account to decide on who to recommend testing for. Some of this has to do with personal and family history as well as ancestry. The NCCN also has their own specific guidelines for who to offer testing to. For example, people assigned male at birth; those who are found to have a second breast primary; those who are diagnosed at a young age; and those with significant family history should also be offered BRCA1/2 testing.  I think, very important for our discussion today, ASCO and SSO also made a very important point that all patients who may be eligible for PARP inhibitor therapy should be offered testing. So clearly this includes a large amount of our patient population. In my practice, we often refer to our Cancer Genetics Program. We're fortunate to have many experienced genetic counselors who can complete pre-test and post-test counseling with our patients. However, in settings where this may not be accessible to patients, it can also be appropriate for oncology providers to order the testing and ideally perform some of this counseling as well. Dr. Jasmine Sukumar: Thank you Dr. Quiroga. Let's next review where we are in current clinical practice guidelines. What current options do we have for adjuvant therapy specific to people with high-risk early breast cancer and BRCA1/2 genetic mutations? Dr. Dionisia Quiroga: Our current guidelines recommend adjuvant olaparib for one year for individuals with HER2-negative high risk breast cancer. This approval largely came from the data and the results of the OlympiA trial. This was a prospective phase 3, double blind, randomized clinical trial. It enrolled patients who had been diagnosed with HER2-negative early-stage breast cancer who also carried germline pathogenic or likely pathogenic variants of either the BRCA1 and/or BRCA2 genes. The disease also had to be considered high-risk and there were several criteria that had to be evaluated to deem whether or not these patients were high-risk. For example, those who are treated with neoadjuvant chemotherapy, if they had disease that was triple-negative, they needed to have some level of invasive residual disease at time of surgery. Alternatively, if the disease was hormone receptor-positive, they needed to have residual disease and a calculated CPS + EG score of 3 or higher. This scoring system is something that estimates relapse probability on the basis of clinical and pathologic stage, ER status, and histologic grade, and this will give you a score ranging from 0 to 6. In general, the higher the score, the worse the prognosis. This calculator though is available to the public online to allow providers to calculate this risk.  For the subset of patients who received adjuvant chemotherapy, for them to qualify for the OlympiA trial, if they had triple-negative disease, they needed to have a tumor of at least 2 cm or greater and/or have positive lymph nodes for disease. For hormone receptor-positive disease that was treated with adjuvant chemotherapy, they were required to have four or more pathologically confirmed positive lymph nodes at time of surgery. From this specified pool, patients were then randomized 1:1 to get either adjuvant olaparib starting at 300 mg twice a day or a matching placebo twice a day after they had completed surgery, chemotherapy and radiation treatment if needed. Dr. Jasmine Sukumar: And what were the outcomes of this study? Dr. Dionisia Quiroga: The study ended up enrolling over 1,800 patients and from these 1,800 patients, 70% had a BRCA1 mutation while 30% had a BRCA2 mutation. About 80% of the patients had triple-negative disease compared to hormone receptor-positive disease. Interestingly, about half of all patients enrolled had received neoadjuvant chemotherapy while the other half received adjuvant chemotherapy.  Looking at the outcomes, this was overall a very positive study. We actually now have outcomes data from a median of about 6 years out. This was just reported in December at the 2024 San Antonio Breast Cancer Symposium. There was found to be a 9.4% absolute difference in six-year invasive disease-free survival favoring the olaparib arm over the placebo arm. What was also interesting is that this was consistent across multiple subgroups of patients and the benefit was really seen whether or not they had hormone receptor-positive or triple-negative disease. The absolute difference in distant disease-free survival was also high at 7.8% and additionally favored olaparib. Most importantly, there was found to be a significant overall survival benefit. The six-year overall survival was 87.5% in the olaparib group compared to 83.2% in the placebo group. This translates to about a 4.4% difference and a relative 28% overall survival benefit in using olaparib.  Now, future follow up is going to be very important. Follow up for this study is actually planned to continue out until June 2029 so we can continue to observe if these survival curves will continue to branch apart as they have so far at each follow up. And I think this is especially important for those patients diagnosed with hormone receptor-positive cancers because we know those patients are at particular risk for later recurrences.  As an additional side note, the researchers also noted that there were fewer primary malignancies in the olaparib group, not just of the breast but also primary ovarian or fallopian tube cancers as well, which is not completely surprising knowing that this drug is also heavily used and beneficial in different types of gynecologic cancers. Ultimately, the amount of adverse events reported have been low with only about 9.9% of patients receiving olaparib needing to discontinue drug due to adverse events, and this is compared to 4.2% reported in the placebo group. Dr. Jasmine Sukumar: You mentioned that the OlympiA trial showed an overall survival benefit, but interestingly the OlympiAD trial looking at olaparib versus chemotherapy in patients with advanced metastatic HER2-negative breast cancer did not show a significant overall survival benefit. Could you discuss those differences? Dr. Dionisia Quiroga: I agree, that's a very good point. So OlympiA's comparator arm was, of course, a placebo. So while this isn't the same as comparing to chemotherapy, it does still potentially suggest that there is a degree of benefit that olaparib can provide when it's introduced in the early local disease setting compared to advanced metastatic disease. I think we need more future trials looking at potential other combinations to see if we can improve the efficacy of PARP inhibitors in the metastatic setting. Dr. Jasmine Sukumar: For patients who do choose to proceed with use of adjuvant olaparib due to the promising efficacy, what side effects should oncologists counsel their patients about? Dr. Dionisia Quiroga: The most common notable side effects, I would say with olaparib and other PARP inhibitors are really cytopenias. Gastrointestinal side effects such as nausea and vomiting can occur as well as fatigue. There are some less common but potentially more serious side effects that we should counsel our patients on. This includes pneumonitis. So counseling patients on if they're short of breath or experiencing cough to let their provider know. Venous thromboembolism can also be increased rates of occurrence. And then of course myelodysplastic syndromes or acute myeloid leukemia is something that we often are concerned about. That being said, I think it should be noted that interestingly in the OlympiA trial so far, there have been less new cases of MDS and AML in the olaparib group than actually what's been reported in the placebo group at this median follow up of over six years out. So we'll need to continue to monitor this endpoint over time, but I do think this provides some reassurance. Dr. Jasmine Sukumar: Since the initiation of the OlympiA trial, other adjuvant treatments have also been studied and FDA approved for non-metastatic HER2-negative breast cancer. So for example, the CREATE-X trial established adjuvant capecitabine as an FDA approved treatment option in patients with triple-negative breast cancer who had residual disease following neoadjuvant chemotherapy. So if a patient with triple-negative breast cancer with residual disease is eligible for both adjuvant olaparib and adjuvant capecitabine treatments, how do you decide amongst the two? Dr. Dionisia Quiroga: If a patient's eligible for both, I honestly often favor olaparib, and I do this because I find the data for adjuvant olaparib a little bit more compelling. There are also differences in toxicity profile and treatment duration between the two that I think we should discuss with patients. For example, olaparib is supposed to be taken for a year total, whereas with capecitabine we typically treat for six to eight cycles with each cycle taking three weeks. There are some who may also sequence the two drugs in very high-risk disease. However, this is very much a data free zone. We don't have any current clinical trials really comparing these two or if sequencing of these agents is appropriate. So I don't currently do this in my own clinical practice. Dr. Jasmine Sukumar: Nowadays, almost all patients with stage 2 to 3 triple-negative breast cancer will be offered neoadjuvant chemotherapy plus immune checkpoint inhibitor therapy pembrolizumab per our KEYNOTE-522 trial data. With our current approach, pembrolizumab is continued into the adjuvant setting regardless of surgical outcome, so that patients receive a year total of immunotherapy. So in patients with residual disease and a BRCA germline mutation, do you suggest using adjuvant olaparib concurrently with pembrolizumab? Do we have any data to support that approach? Dr. Dionisia Quiroga: I do. I do use them concurrently. If a patient is eligible for adjuvant olaparib, I would use it the same way as if they were not on pembrolizumab. That being said, there are no large studies currently that have shown what the benefit or the toxicity of pembrolizumab plus olaparib are for early-stage disease. However, we do have some safety data of this combinatorial approach from other studies. For example, the phase 2/3 KEYLYNK-009 study showed that patients with advanced metastatic triple-negative breast cancer who were receiving concurrent pembrolizumab and olaparib had a manageable safety profile, particularly as the toxicities of these drugs alone don't tend to overlap. Dr. Jasmine Sukumar: And what about endocrine therapy for those that also have hormone receptor-positive disease? Dr. Dionisia Quiroga: Adjuvant endocrine therapy should definitely be continued while patients are on olaparib if they're hormone receptor-positive. An important component of this will also likely be ovarian suppression, which should include recommendation of risk reducing bilateral salpingo oophorectomy due to the risk of ovarian cancer development in patients who carry BRCA1/2 gene mutations. In most cases, this should happen at age 40 or before for those that carry a BRCA1 mutation, and at age 45 or prior for those with BRCA2 mutations. Dr. Jasmine Sukumar: And do you also consider adjuvant bisphosphonates in this context? Dr. Dionisia Quiroga: Yes. Like adjuvant endocrine therapy, adjuvant bisphosphonates were also instructed to be given according to standard guidelines in the OlympiA trial, so I would recommend use of bisphosphonates when indicated. You can refer to the ASCO Ontario Health Guidelines on Adjuvant Bone-Modifying Therapy Breast Cancer to guide that decision in order to utilize this due to multiple clinical benefits. It doesn't just help in terms of adjuvant breast cancer treatment but also reduction of fracture rate and down the line, improved breast cancer mortality.  Dr. Jasmine Sukumar: Particularly in hormone receptor-positive breast cancer, another adjuvant therapy option that was not available when the OlympiA trial started are the CDK4/6 inhibitors, ribociclib and abemaciclib, based on the NATALEE and monarchE studies. So how do you consider the use of these adjuvant therapy drugs in the context of olaparib and BRCA mutations? Dr. Dionisia Quiroga: Yeah, so we are definitely in a data-free zone here. And that's in part because the NATALEE and the monarchE studies are still ongoing and reporting data out at the same time that we're getting updated OlympiA data. So unlike some of our other adjuvant treatments that we discussed, where olaparib could be safely given concurrently, the risk of myelosuppression and using both a CDK4/6 inhibitor and a PARP inhibitor at the same time would be too high. In some cases, even if a patient has a BRCA1/2 mutation, they may not meet that specified inclusion criteria that OlympiA set for what they consider to be high-risk disease. And we know from the NATALEE and the monarchE trial there are also different markers that they use to denote high-risk disease. So it's possible, for example, in the NATALEE trial that looks specifically at adjuvant ribociclib, they included a much larger pool of hormone receptor-positive early-stage breast cancers, including a subset that did not have positive axillary lymph nodes.  In cases where patients would qualify for both olaparib and a CDK4/6 inhibitor, I think this is worth a nuanced discussion with our patients about the potential benefits, risks and administration of these drugs. I think another point to bring up is the cost associated with these drugs and the length of time patients will be on for, because financial toxicity is always something that we should bring up with patients as well. When sequencing these in high-risk disease, my practice is to generally favor olaparib first due to the overall survival data. There is also some data to support that patients with BRCA1/2 germline mutations may not respond quite as well to CDK4/6 inhibitors compared to those without. But again, this is still outside of the purview of current guidelines. Fortunately, we have more potential choices for patients, and that's a good thing, but shared decision making also needs to be key. Dr. Jasmine Sukumar: And while our focus today is on adjuvant treatment for people who carry germline BRCA mutations, what about other related gene mutations such as PALB2 pathogenic variant? Dr. Dionisia Quiroga: That's a great question. Clinical trials in the advanced metastatic setting have shown that there is efficacy of olaparib in the setting for PALB2 mutations. This is largely based on the TBCRC 048 phase 2 trial and that provided a Category 2B NCCN recommendation for patients with these PALB2 gene mutations. However, we're really still lacking enough clinical data for use in early-stage disease, so I don't currently use adjuvant olaparib in this case. I am definitely eager for more data in this area as the efficacy of PARP inhibitors in PALB2 gene mutations is very compelling. I think also, in the same line, there's been some data for somatic BRCA1/2 mutations in the metastatic setting, but we still have a lack of data for the early stage setting here as well. Dr. Jasmine Sukumar: Thank you Dr. Quiroga, for sharing your valuable insights with us today on the ASCO Daily News Podcast. Dr. Dionisia Quiroga: Thank you, Dr. Sukumar. Dr. Jasmine Sukumar: And thank you to our listeners for your time today. You'll find links to the studies discussed today in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review and subscribe wherever you get your podcasts. Thank you. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:   Dr. Dionisa Quiroga @quirogad @quirogad.bsky.social Dr. Jasmine Sukumar @JasmineSukumar  @jasmine.sukumar.bsky.social Follow ASCO on social media:  @ASCO on X   @ASCO on Bluesky    ASCO on Facebook    ASCO on LinkedIn    Disclosures: Dr. Dionisia Quiroga:  No relationships to disclose Dr. Jasmine Sukumar: Honoraria: Sanofi (Immediate Family Member)  

Dr. Stéphanie Gaillard and Dr. Bill Tew share updates to the evidence-based guideline on neoadjuvant chemotherapy for newly diagnosed, advanced ovarian cancer. They highlight recommendations across ten clinical questions, addressing initial assessment, primary cytoreductive surgery, neoadjuvant chemotherapy (NACT), tests and/or procedures that should be completed before NACT, preferred chemotherapy regimens, timing of interval cytoreductive surgery (ICS), hyperthermic intraperitoneal chemotherapy (HIPEC), post ICS-chemotherapy, maintenance therapy, and options for those without a clinical response to NACT. They highlight the evidence supporting these recommendations and emphasize the importance of this guideline for clinicians and patients. Read the full guideline update, “Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: ASCO Guideline Update” at www.asco.org/gynecologic-cancer-guidelines." TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/genitourinary-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology. Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Stéphanie Gaillard from Johns Hopkins University and Dr. Bill Tew from Memorial Sloan Kettering Cancer Center, co-chairs on “Neoadjuvant Chemotherapy for Newly Diagnosed, Advanced Ovarian Cancer: ASCO Guideline Update.” Thank you for being here today, Dr. Gaillard and Dr. Tew. Dr. Bill Tew: Thank you for having us. Dr. Stéphanie Gaillard: Yeah, thank you. It's great to be here. Brittany Harvey: Great. Then, before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Gaillard and Dr. Tew, who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then to dive into the content here, first, Dr. Tew, could you describe what prompted this update to the neoadjuvant chemotherapy for ovarian cancer guideline? And what is the scope of this update? Dr. Bill Tew: Yeah. It's been almost a decade since ASCO first published its neoadjuvant chemotherapy guidelines for women with newly diagnosed ovarian cancer, and over that 10-year period, there's really been a major shift in how oncologists treat patients in the U.S. If you look at the National Cancer Database, between 2010 and 2021, the proportion of patients with advanced ovarian cancer who underwent primary surgery fell from about 70% to about 37%. And there's been a doubling in the amount of neoadjuvant chemotherapy used. So we wanted to take a look at that and really both highlight the appropriate patient populations for primary surgery versus new adjuvant chemotherapy, as well as review any studies that have been published since then. There's been, I think, about 61 trials published, nine randomized trials alone in the last 10 years. And the scope of the guideline was really not only the neoadjuvant chemotherapy and surgical questions, but also to touch upon some new treatments that have come to the forefront in newly diagnosed ovarian cancer, including heated intraperitoneal chemotherapy or HIPEC, as well as the integration of maintenance therapy, particularly bevacizumab and PARP inhibitors. Brittany Harvey: Understood. That's a large amount of new evidence to review in this Update. Then, next, Dr. Gaillard, I'd like to review the key recommendations across the 10 clinical questions that the guideline addressed. So, starting with: What is recommended regarding initial assessment for patients with newly diagnosed pelvic masses and/or upper abdominal or peritoneal disease? Dr. Stéphanie Gaillard: Sure. So in talking about the first guidelines, the first one that we addressed was how to do the initial assessment for these patients. And first, and probably most critically, it's important to recognize that these patients really should be evaluated by a gynecologic oncologist prior to initiation of any therapy, whether that means a primary cytoreductive surgery or neoadjuvant chemotherapy, because really, they are the best ones to determine the pathway that the patient should take. The initial assessment should involve a CA-125, a CT of the abdomen and pelvis with oral and IV contrast, if not contraindicated, and then also chest imaging, in which a CT is really the preferred modality. And that helps to evaluate the extent of disease and the feasibility of the surgical resection. Now, there may be some other tools that could be helpful to also refine this assessment. So, for example, a laparoscopy can really help to determine the feasibility of surgical resection as well as the extent of disease. Further imaging, such as diffusion-weighted MRI or FDG-PET scans can be helpful, as well as ultrasounds. And then also an endometrial biopsy. And that was newly added because there really has been a divergence of treatment for endometrial cancer versus ovarian cancer. And so it's really important to determine upfront where the source of the disease is coming from. Brittany Harvey: I appreciate you describing those recommendations surrounding initial assessment. So following this assessment, Dr. Tew, which patients with newly diagnosed advanced epithelial ovarian cancer should be recommended primary cytoreductive surgery? Dr. Bill Tew: The key thing here is if the GYN oncology surgeon feels that they have a high likelihood of achieving a complete cytoreduction with acceptable morbidity, the panel overwhelmingly agrees that primary cytoreduction surgery should be recommended over chemotherapy. And we know that surgery is really the cornerstone to achieving clinical remission. And our concern is that neoadjuvant chemotherapy may be overused in this fit population. Sometimes it is challenging to determine truly if a patient has a high likelihood of complete cytoreduction or what is acceptable morbidity. But an evaluation with performance status, fitness, looking at age or frailty, nutritional status, as well as a review of imaging studies to plan and determine for who is the right patient for primary surgery is key. Brittany Harvey: And then the title of this guideline, Dr. Gaillard, for which patients is neoadjuvant chemotherapy recommended? Dr. Stéphanie Gaillard: Yeah. So there's really two patient populations that we think are best suited to receive neoadjuvant chemotherapy. Those may be patients who are fit for a primary cytoreductive surgery, but they're unlikely to have a complete cytoreduction if they were to go to surgery directly. And so that's where neoadjuvant chemotherapy can be very helpful in terms of increasing the ability to obtain a complete cytoreduction. The second population is those who are newly diagnosed who have a high perioperative risk, and so they're not fit to go to surgery directly. And so it may be better to start with neoadjuvant chemotherapy and then do an interval cytoreductive surgery. Again, I just want to emphasize the importance of including a gynecologic oncologist when making these determinations for patients. Brittany Harvey: Absolutely. So then the next clinical question. Dr. Tew, for those patients with newly diagnosed stage 3 to 4 epithelial ovarian cancer, what tests and or procedures are recommended before neoadjuvant chemotherapy is delivered? Dr. Bill Tew: The key test is to confirm the proper diagnosis, and that requires histological confirmation with a core biopsy. And this was a point the panel strongly emphasized, which is a core biopsy is a much better diagnostic tool compared to cytology alone. But there will be cases, exceptional cases, where a core biopsy cannot be performed. And in those settings, cytology combined with serum CA-125 and CEA is acceptable to exclude a non-gynecologic cancer. The other reason why cord biopsy is strongly preferred is because we already need to start thinking about germline and somatic testing for BRCA1 and 2. This information is important as we start to think about maintenance strategies for our patients. And so having that information early can help tailor the first-line chemotherapy regimen. Brittany Harvey: So then you've described who should be receiving neoadjuvant chemotherapy, but Dr. Gaillard, for those who are receiving neoadjuvant chemo, what is the preferred chemotherapy regimen? And then what does the expert panel recommend regarding timing of interval cytoreductive surgery? Dr. Stéphanie Gaillard: Sure. So for neoadjuvant chemotherapy, we generally recommend a platinum taxane doublet. This is especially important for patients with high grade serous or endometrioid ovarian cancers, and that's really because this is what the studies had used in the neoadjuvant trials. We recognize, however, that sometimes there are individual patient factors, such as advanced age or frailty, or certain disease factors such as the stage or rare histology that may shift what is used in terms of chemotherapy, but the recommendation is to try to stick as much as possible to the platinum taxane doublet. And then in terms of the timing of interval cytoreductive surgery, this was something that the panel discussed quite a bit and really felt that it should be performed after four or fewer cycles of neoadjuvant chemotherapy, especially in patients who've had a response to chemotherapy or stable disease. Sometimes alternative timing of surgery can be considered based on some patient centered factors, but those really haven't been prospectively evaluated. The studies that looked at neoadjuvant chemotherapy usually did the interval cytoreductive surgery after three or four cycles of chemotherapy. Brittany Harvey: For those patients who are receiving interval cytoreductive surgery, Dr. Tew, earlier in the podcast episode, you mentioned a new therapy. What is recommended regarding hyperthermic intraperitoneal chemotherapy? Dr. Bill Tew: Yeah, or simply HIPEC as everyone refers to it. You know, HIPEC isn't really a new therapy. HIPEC is a one-time perfusion of cisplatin, which is a chemotherapy that has been a standard treatment for ovarian cancer for decades. But the chemotherapy is heated and used as a wash during the interval cytoreductive surgery. And since our last guideline, there has been a publication of a randomized trial that looked at the use of HIPEC in this setting. And in that study there was improved disease-free and overall survival among the patients that underwent HIPEC versus those that did not. So we wanted to at least emphasize this data. But we also wanted to recognize that HIPEC may not be available at all sites. It's resource-intensive. It requires a patient to be medically fit for it, particularly renal function and performance status. And so it's something that could be discussed with the patient as an option in the interval cytoreductive surgery. One other point, the use of HIPEC during primary surgery or later lines of therapy still is unknown. And the other point is this HIPEC trial came prior to the introduction of maintenance PARP inhibitors. So there's still a lot of unknowns, but it is a reasonable option to discuss with appropriate patients. Brittany Harvey: I appreciate you reviewing that data and what that updated recommendation is from the panel. So then, Dr. Gaillard, after patients have received neoadjuvant chemotherapy and interval cytoreductive surgery, what is the post ICS chemotherapy recommended? Dr. Stéphanie Gaillard: The panel recommends some post ICS chemotherapy, as you mentioned. This is typically to continue the same chemotherapy that was done as neoadjuvant chemotherapy and so preferably platinum and taxane. And typically we recommend a total of six cycles of treatment, although the exact number of cycles that is given post-surgery can be adjusted based on different patient factors and their response to treatment. Importantly, also, timing is a factor, and we recommend that postoperative chemotherapy begin within four to six weeks after surgery, if at all feasible. Brittany Harvey: Absolutely. Those timing recommendations are key as well. So then, Dr. Tew, you mentioned this briefly earlier, but what is the role of maintenance therapy? Dr. Bill Tew: Maintenance therapy could be a full podcast plus of discussion, and it's complicated, but we did want to include it in this guideline in part because the determination of whether to continue treatment after completion of surgery and platinum based therapy is key as one is delivering care in the upfront setting. So first off, when we say maintenance therapy, we are typically referring to PARP inhibitors or bevacizumab. And I would refer listeners to the “ASCO PARP Inhibitor Guideline” that was updated about two years ago, as well as look at the FDA-approved label indications. But in general, PARP inhibitors, whether it's olaparib or niraparib, single agent or olaparib with bevacizumab, are standard treatments as maintenance, particularly in those patients with a germline or somatic BRCA mutation or those with an HRD score positive. And so it's really important that we emphasize germline and somatic BRCA testing for all patients with newly diagnosed ovarian cancer so that one can prepare for the use of maintenance therapy or not. And the other point is, as far as bevacizumab, bevacizumab is typically initiated during the chemotherapy section of first-line treatment. And in the guidelines we gave specific recommendations as far as when to start bevacizumab and in what patient population. Brittany Harvey: Great. Yes. And the PARP inhibitors guideline you mentioned is available on the ASCO guidelines website and we can provide a link in the show notes for our listeners. So then, the last clinical question, Dr. Gaillard, what treatment options are available for patients without a clinical response to neoadjuvant chemotherapy? Dr. Stéphanie Gaillard: Yeah, this is a tough situation. And so it's important to remember that ovarian cancer typically does respond to chemotherapy initially. And so it's unusual to have progressive disease to neoadjuvant chemotherapy. So it's really important that if someone has progressive disease that we question whether we really have the right diagnosis. And so it's important to, I think at that point, obtain another biopsy and make sure that we know what we're really dealing with. In addition, this is where Dr. Tew mentioned getting the molecular profiling and genetic testing early in the course of disease. If that hasn't been done at this point in time, it's worth doing that in this setting so that that can also potentially help guide options for patients. And patients who are in those situations, really, the options are other chemotherapy regimens, clinical trials may be an option, or in some situations, if they have really rapidly progressing disease that isn't amenable to further therapy, then initiation of end-of-life care would be appropriate. Brittany Harvey: I appreciate you both for reviewing all of these recommendations and options for patients with advanced ovarian cancer. So then to wrap us up, in your view, what is both the importance of this guideline update and how will it impact clinicians and patients with advanced ovarian cancer? Dr. Bill Tew: Well, first off, I'm very proud of this guideline and the panel that I work with and Dr. Gaillard, my co-chair. The guideline really pulls together nicely all the evidence in a simple format for oncologists to generate a plan and determine what's the best step for patients. The treatment of ovarian cancer, newly diagnosed, is really a team approach - surgeons, medical oncologists, and sometimes even general gynecologists - and understanding the data is key, as well as the advances in maintenance therapy and HIPEC. Dr. Stéphanie Gaillard: For my part, I'd say we hope that the update really provides physicians with best practice recommendations as they navigate neoadjuvant chemotherapy decisions for their patients who are newly diagnosed with ovarian cancer. There is a lot of data out there and so we hope that we've synthesized it in a way that makes it easier to digest. And along that regard, I really wanted to give a special shout out to Christina Lacchetti, who just put in a tremendous effort in putting these guidelines together and in helping to coordinate the panel. And so we really owe a lot to her in this effort. Dr. Bill Tew: Indeed. And ASCO, as always, helps guide and build a great resource for the oncology community. Brittany Harvey: Absolutely. Yes, we hope this is a useful tool for clinicians. And I want to thank you both for the large amount of work you put in to update this evidence-based guideline. And thank you for your time today, Dr. Gaillard and Dr. Tew. Dr. Stéphanie Gaillard: Thank you. Dr. Bill Tew: Thank you for having us. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines Podcast. To read the full guideline, go to www.asco.org/gynecologic-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

Hearing the words, "You have cancer," had to be the biggest shock of my life. My oncologist advised me to go off of all hormone treatment immediately. So, within 48 hours, I had a cancer diagnosis, hot flashes, night sweats, brain fog, and painful sex. I'm a pretty happy and upbeat person, but the combination of this diagnosis, along with all of these other important things, was almost too much. Today's guest, Dr. Corinne Menn, believes that our treatment of women in menopause can be downright inhumane. She explained that there are better ways to move women off of hormones during cancer and that there rarely needs to be an immediate change. We also talked about the importance of having a positive and enjoyable sexual relationship. She was saying that so many of her patients have given up on sex due to pain. Dr. Menn explained the power of vaginal estrogen and how this one change can result in significant changes. Listen to the episode to learn how to Make Sex Great Again! Click here to listen to part one of my special menopause episode with Dr. Menn. About Dr Corinne Menn Dr. Corinne Menn is a board-certified OBGYN and Menopause Society Certified Practitioner. Dr. Menn is also an over 20 year survivor of breast cancer and premature menopause, a BRCA carrier, and uses her experience to help women navigate their own health challenges. She has dedicated her medical practice to menopause management, the unique healthcare needs of female cancer survivors, and those at high risk for breast cancer. Now practicing exclusively through telehealth, Dr. Menn provides women's health consultations and patient education via her private practice as well as at Alloy.  Connect with Dr Corinne Menn FaceBook: https://www.facebook.com/drcorinnemenn Instagram: https://www.instagram.com/drmennobgyn/ YouTube: https://www.youtube.com/@drmenn Linkedin: https://www.linkedin.com/in/drmenn/ Website: https://www.drmenn.com/ Amazon Store When I began detoxing my life after being diagnosed with cancer, I felt overwhelmed and confused. I thought I was already making good health choices, but the more I researched, the more I discovered that small changes could lead to significant improvements. For instance, switching from tea bags to loose-leaf tea can help prevent additional microplastics from accumulating in my body. These plastic particles can affect my hormones and contribute to inflammation. This was such a simple swap! I was so encouraged that I started to make more simple swaps. And now, I have an Amazon Store listing many of my favorite detox tips! Click here to check to see my simple swaps. Butcher Box I'm picky about fish. For years, I would only eat fish in restaurants because I had no clue how to prepare it. Then I discovered that when I buy fish at the supermarket, it is DOUBLE FROZEN. What?! Could that be why my fish texture would be a little off? Did you know that ButcherBox only freezes their salmon ONCE? I'm a huge fan of their wild Alaskan sockeye salmon. Right now, you can get a year of salmon for FREE. That's a $422 value, and you get $20 off of your first box. Click here to purchase

Drs. Isaacs and Traina share insights from the 2024 San Antonio Breast Symposium, covering the MARGOT trial, survival impacts of risk-reducing surgeries in young BRCA carriers, and outcomes of delaying surgery in operable breast cancer.

Drs. Isaacs and Traina share insights from the 2024 San Antonio Breast Symposium, covering the MARGOT trial, survival impacts of risk-reducing surgeries in young BRCA carriers, and outcomes of delaying surgery in operable breast cancer.

Let's talk about menopause.  When I was in my twenties, most of my nutrition clients were in their 50s. I would talk to them about hot flashes, low libido, and weight gain and "what they could do about it," exercise more, eat less, you know, the drill. I remember a few of my clients laughing at me and saying, "Oh, honey, in thirty years, give us a call and let us know what you think of the advice you're giving us!" Fast forward to 2020, when I was forced into INSTANT menopause after my breast cancer diagnosis, and oh goodness, I'm mortified by my lack of compassion and understanding of menopause in my twenties. Today's guest is Dr. Corinne Menn. She's a menopause expert, a world-renowned OB-GYN, and a twenty-four-year breast cancer survivor.  Dr. Menn explained that a recent study discovered that only 7% of ob/gyns were comfortable talking to their patients about menopause. WHAT?!? Who is supposed to help us? How about our quality of life, including sleep and weight gain? Not to mention the higher risk of heart disease. And should we talk about sex? I think we should. Sex can be incredibly painful during the menopause years. Dr. Menn is here to help! Her advice regarding tackling these menopause challenges was invaluable. I loved her tips on weight loss and sleep, and I will say it again: SEX! Click here to listen to part one of my special menopause episode with Dr. Menn. About Dr. Corinne Menn Dr. Corinne Menn is a board-certified OBGYN and Menopause Society Certified Practitioner. Dr. Menn is also an over 20 year survivor of breast cancer and premature menopause, a BRCA carrier, and uses her experience to help women navigate their own health challenges. She has dedicated her medical practice to menopause management, the unique healthcare needs of female cancer survivors, and those at high risk for breast cancer. Now practicing exclusively through telehealth, Dr. Menn provides women's health consultations and patient education via her private practice as well as at Alloy. Connect with Dr. Corinne Menn Facebook: https://www.facebook.com/drcorinnemenn Instagram: https://www.instagram.com/drmennobgyn/ YouTube: https://www.youtube.com/@drmenn Linkedin: https://www.linkedin.com/in/drmenn/ Website: https://www.drmenn.com/ _______ Amazon Store When I began detoxing my life after being diagnosed with cancer, I felt overwhelmed and confused. I thought I was already making good health choices, but the more I researched, the more I discovered that small changes could lead to significant improvements. For instance, switching from tea bags to loose-leaf tea can help prevent additional microplastics from accumulating in my body. These plastic particles can affect my hormones and contribute to inflammation. This was such a simple swap! I was so encouraged that I started to make more simple swaps. And now, I have an Amazon Store listing many of my favorite detox tips! Click here to check to see my simple swaps.   This podcast is for informational purposes only and none of the information should be construed as medical advice. Listeners should seek guidance from their own medical team before making any medical or lifestyle changes

We kick off 2025 on Raise the Line by sharing some good news for providers struggling to keep up with the growing number of applications for genomic testing: a new book from Elsevier Science Direct has been designed to arm you with the knowledge you need. Genomics in the Clinic: A Practical Guide to Genetic Testing, Evaluation, and Counselingdives into the use of this important tool in diagnosis and screening, indicating how individuals may respond to drug therapies, and more. “We really need to educate all healthcare providers about the practice of genetics because they're going to be involved directly or indirectly in genetic testing and conveying information about what the results mean to patients and their families,” explains co-author Dr. Ethylin Wang Jabs, enterprise chair of the Department of Clinical Genomics for Mayo Clinic. Jabs and her co-author, Dr. Antonie Kline, director of Clinical Genetics at the Harvey Institute for Human Genetics at Greater Baltimore Medical Center, chose a format that makes heavy use of case studies to help readers get a better grasp on this complicated field and they also include chapters on direct-to-consumer testing and the ethical and social implications in genomic medicine. “Any kind of potentially predictive testing can have ethical issues related to it, including insurance coverage, testing for family members, protections for minors, and more,” says Dr. Kline. Join host Caleb Furnas for an illuminating episode on an area of discussion in medicine that's growing in importance as the use of genetic testing rapidly increases.Mentioned in this episode: Genomics in the Clinic: A Practical Guide

Welcome to another episode of the Oncology Brothers podcast! In this episode, hosts Drs. Rahul & Rohit Gosain are joined by Dr. Laura Huppert from UCSF to discuss key highlights from the San Antonio Breast Cancer Symposium 2024. We dive into three crucial studies: 1.⁠ ⁠INSEMA Study: Explore the findings on the potential omission of axillary surgery in early-stage hormone receptor-positive breast cancer and its implications for patient quality of life. 2.⁠ ⁠KEYNOTE-522 Update: Learn about the latest insights on the use of Pembrolizumab in triple-negative breast cancer, including the search for predictive biomarkers and the impact of achieving pathological complete response (PCR). 3.⁠ ⁠OlympiA Study Update: Discover the updated results on the use of Olaparib in BRCA-positive patients, highlighting its significant benefits in invasive disease-free survival and overall survival. Join us as we unpack these important studies and their implications for clinical practice. Don't forget to like, subscribe, and hit the notification bell for more updates from the Oncology Brothers! Website: http://www.oncbrothers.com/ X/Twitter: https://twitter.com/oncbrothers Contact us at info@oncbrothers.com

Dr. Evan Yu presents the new evidence-based guideline on genetic testing for metastatic prostate cancer. He discusses who should receive germline and somatic testing with next-generation sequencing technologies, what samples are preferred for testing, and the therapeutic & prognosistc impacts of genetic testing. Dr. Yu emphasizes the need for awareness and refers to areas of active investigation and future research to improve personalized therapies for patients with metastatic prostate cancer.  Read the full guideline, “Germline and Somatic Genomic Testing for Metastatic Prostate Cancer: ASCO Guideline” at www.asco.org/genitourinary-cancer-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/genitourinary-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO-24-02608 Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Evan Yu from the University of Washington and Fred Hutchinson Cancer Center, lead author on “Germline and Somatic Genomic Testing for Metastatic Prostate Cancer: ASCO Guideline”. Thank you for being here today, Dr. Yu. Dr. Evan Yu: Thanks for having me on. Brittany Harvey: Great. Then before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the entire guideline, including Dr. Yu, who has joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then, Dr. Yu, to start us off on the content of this guideline, could you first provide an overview of both the purpose and scope of this guideline? Dr. Evan Yu: Yeah, absolutely. So I think the one key thing to recognize is that prostate cancer is the highest incidence of all cancers in males. Additionally, it's the second highest cause of mortality in males, and that's about 35,000 deaths in 2024. So with that being said and done, it's a disease where we need to do better. And part of that is recognizing that we now have many targeted therapies, precision medicine type of therapies, but unlike a lot of other cancers out there, prostate cancer patients are not always getting sequencing, next generation DNA sequencing, let's say, to identify both inherited and also spontaneously develop what we call somatic mutations in their tumor. And I suspect that's partially because other cancers like breast cancer, we're so used to- in the first line, you present the patient, you throw out their estrogen receptor status, progesterone receptor status, HER2, ER/PR HER2; in lung cancer it's EGFR, ALK, ROS1, etc. In things like prostate cancer, things like BRCA2 have major important patient treatment implications and potentially family counseling and downstream cascade testing implications. But it hasn't made their way into that first-line presentation yet. And for that reason, there are some studies out there that show that testing in the community may be as low as 15% of patients with metastatic prostate cancer. We want to bring awareness to that and hopefully increase testing down the road so that we can better help our patients with metastatic prostate cancer. Brittany Harvey: Absolutely. It's important to get these targeted therapies to the patients who can benefit most. Using that context, I'd like to next review the key recommendations of this guideline across the six clinical questions that the panel addressed. So, starting with: Who should receive germline testing with next generation sequencing technologies? Dr. Evan Yu: Yeah. We think that it's common enough that everyone with metastatic prostate cancer should receive germline genetic testing. And the reason for that is there have been studies that have looked at this and have shown that 12% of men with metastatic prostate cancer have some sort of inherited germline mutation in a gene, mostly DNA repair genes. But 12% have something that is inherited and that loved ones, first degree relatives, siblings, offspring might have also inherited. Now, most of these are in the DNA repair genes, but that being said and done, there's not only treatment implications for the patient, where there are newer drugs that that patient could get treated with, but other loved ones that might have inherited these gene mutations, that these things can cause other cancers as well - not just prostate cancer, but breast cancer, endometrial cancer, ovarian cancer, pancreatic cancer. So, it's very important to test, with as high of an incidence as 12%, to test, and if you identify it in a patient, it's our job to talk to the patient about it and talk to them about the pros and cons of family counseling and talking to their loved ones and potentially having their loved ones get tested. Because if they test positive, then their doctors may want to know and may screen them very, very aggressively and differently for a whole host of other cancers. And the whole idea is you find the cancer very early and cure the patients before the cancer really takes hold and has the ability to spread so we can save a lot of lives down the road. Brittany Harvey: Absolutely. This germline testing is important not just for the patient, but has wider implications for their families as well, as you mentioned. So then, beyond those recommendations for germline testing, which patients should receive somatic testing with next-generation sequencing technologies? Dr. Evan Yu: So let's talk a little bit about somatic testing. So germline again, as we know, is inherited. The patient inherited it in every single cell in their body, then it becomes very easy, many of these are cancer predispositions for them to lose the other allele and then to have biallelic loss and then develop the cancer. Now, somatic just means it spontaneously occurred. Certainly, it's not going to occur in every cell in the body, but you can get one hit, lose one allele and then lose the other allele. And if that gene is truly carcinogenic and leading to that cancer, then that can have implications potentially for treatment as well. So we recommend that all patients with metastatic prostate cancer also undergo somatic next-generation sequencing testing. We recognize that at this point in time it's only those with metastatic castration-resistant prostate cancer or hormone-resistant prostate cancer, which is a later disease state where there are drugs that may target those mutations, for instance, like PARP inhibitors, but that early identification for a patient population that's fit and that can benefit from these therapies makes sense so that you know it's in place already and you have your treatments outlined and mapped out for the future. So we recommend it for everybody - somatic testing also for everyone with metastatic prostate cancer. Brittany Harvey: Understood. And then when patients are receiving that somatic testing, what is recommended for somatic testing? Primary tumor archival tissue? Fresh metastatic biopsy tissue? Or circulating tumor DNA testing? Dr. Evan Yu: We recommend that in the initial setting when you're first diagnosed, that archival tissue samples are fine and preferred. But circulating tumor DNA is good when there's no accessible archival tissue, or if the archival tissue, let's say, is very old and it's been sitting around for a long time, or you can't get it anymore because it's many years back when maybe a patient had a prostate needle biopsy. So if it's not accessible, then we recommend ctDNA. We believe that is preferred and also that ctDNA is recommended in a situation where you can't easily biopsy a metastatic site. Sometimes it's just not in a safe area to go after. Sometimes it's just a small lesion. So in general, we recommend tissue when available, and when we think that the tissue sample will yield clean results, if not, then we recommend doing ctDNA at that point in time. Brittany Harvey: So you have described who should get germline and somatic genomic testing. But what are the therapeutic impacts of this germline or somatic testing for single gene genetic variants? Dr. Evan Yu: We pulled this panel together and we met like every single month for like 12 months straight, and part of it was to review the literature. And as part of this literature review, we were able to pull a whole bunch of different trials. I think there was like 1713 papers we identified in the literature search. Eventually, we narrowed it down because with ASCO, we want to present the data with the highest level evidence, level 1 evidence, randomized controlled prospective data. And after reviewing 1713 papers, we narrowed it down to 14 papers. With those 14 papers, if you look at it, there are a lot of things that we think may have implications for treatment or prognosis, but we didn't feel was the highest level of evidence that we could support. So the things that have the highest level of evidence that we can support are certain DNA repair gene alterations, especially BRCA2, and treatment with PARP inhibitors because there are many PARP inhibitor prospective trials that show progression-free survival benefit and even overall survival benefit. And so that's the type of study that achieved the level of evidence that we could include. So I would say BRCA1 and BRCA2 highest level of evidence and PARP inhibitor use also is included in that. Brittany Harvey: Understood. I appreciate you reviewing those therapeutic options. So then, the last clinical question, which you just touched on briefly, but what are the prognostic impacts of germline and/or somatic testing? Dr. Evan Yu: Whenever you do testing, especially if you use panel testing, you find a lot of information. There's a lot of different mutations and some of which are VUSs (variants of unknown significance) where we don't quite know what it means yet, but we can track that, especially if it's germline. But with somatic, we find lots of things that have implications, but maybe just not treatment implications. A perfect example is p53. p53 is one of the most common tumor suppressor gene mutations on all cancers, but in prostate cancer they can occur and they can usually occur late, although there can even be germline inherited p53 alterations. There's no treatment that targets p53 right now, but we know that if you have a p53 mutation that those patients may have more aggressive disease and that prognostic information is important to give to the patient. And I think it's important for future clinical trial design and direction. So we do not recommend making treatment recommendations or changes based on these prognostic only biomarkers at this point in time. But we do recommend that, based on this, we can design intensification trials for those patients who have these poor risk biomarkers and de-intensification trials for patients who may have a good risk biomarker. So for instance, SPOP is a gene where we think these patients may have better outcomes, they might respond better to certain hormonal therapies like abiraterone. I say might because the level of evidence isn't quite there. But what I would say is that these prognostic only biomarkers, we just don't think they cut the mustard yet to be able to make treatment decisions. But we do think that they can drive counseling for the patient and potential selection and trial design for the future to say, “Okay. This is a patient population that has a more aggressive cancer. We need to be more aggressive in treating these patients.” “This patient population might have a less aggressive cancer. Maybe we can de-intensify and say side effects and quality of life may be better for the patients.” Brittany Harvey: Definitely. It's important for thinking through how to personalize care for these patients. So then you've talked about this a little bit in talking through the recommendations, but could you expand on what is the importance of this guideline and how it will impact both clinicians and patients with metastatic prostate cancer? Dr. Evan Yu: Yeah, I think the number one thing is awareness. I think the data's out there and people that are in my field, they know this. But by evidence of the fact that it's not first-line presentation lingo that everyone's talking about things like BRCA status, it means it hasn't necessarily disseminated all the way through. So it's increasing awareness of the fact that both germline and somatic alterations can occur and that these may have impacts on the patient for their treatment and their prognosis, and basically to increase testing for the future. I really think that in the future, there'll be other reasons that we may want to serially even retest and we may find that there may be mutations that develop as mechanisms of resistance that might guide therapy down the road. So we need to get people to start doing this for everyone with metastatic prostate cancer, because someday we might be doing it not just once, but over and over again. Brittany Harvey. Absolutely. We hope this guideline reaches a wide audience and that these recommendations can be put into practice. Finally, you've talked about how not all the data in the field has yet risen to the level of evidence that made it into the guidelines. So what are the outstanding questions in future research areas for both germline and somatic genomic testing for metastatic prostate cancer? Dr. Evan Yu: It was in our discussion, but it clearly- it's not common enough for there to be randomized prospective trials that would reach that level of evidence to make it in this guideline recommendation. But we all know that for any solid tumor, you can get mismatched repair deficiency, microsatellite instability leading to hypermutation or high tumor mutational burden. And that happens in maybe 3 to 5% of patients with metastatic prostate cancer as well. There is evidence and data that these patients can potentially benefit from immunotherapies like pembrolizumab. But again, it's just not common enough for there to be those randomized prospective controlled trials out there. But we mention it because we know it's FDA-approved across all the tumor types, so we felt like we have to mention it because that's something that has treatment implications for the patient. But also, I alluded to this earlier, I think an area of active investigation is the tried and true number one driver of prostate cancer, which is androgen receptor. Testosterone binds to androgen receptors, stimulates it. That's how androgen deprivation therapy works. That's how abiraterone and the amides like enzalutamide, apalutamide, darolutamide, that's how they all work. But even beyond that, we're starting to identify that maybe 15%, 20% of patients with metastatic castration resistant prostate cancer have androgen receptor mutations. And there are newer classes of therapies like androgen receptor degraders like CYP11A1 antagonist that lead to complete adrenal annihilation of other steroid hormones that might promiscuously stimulate these androgen receptor mutants. These things develop as mechanisms of resistance, and in the future, we might want to serially test- and that's an active area of investigation in the future, to say you've been treated, let's say, with androgen deprivation therapy and abiraterone for years. There are certain mutations that might develop as a resistance mechanism. We might need to serially test somebody because you didn't have that mutation earlier on, but later in the disease course you might. And then there might be a new drug X out there that we would want to use. Again, we need the data, we need the randomized prospective controlled trials, but they're happening out there. And somewhere down the road we may rewrite this guideline and have a lot more recommendations to add to it. Brittany Harvey: Yes, we'll look forward to more research in this field to better provide targeted therapies for patients with metastatic prostate cancer across the treatment paradigm. And we'll look forward to report outs from those trials that you mentioned. So I want to thank you so much for your work to develop this guideline and thank you for your time today, Dr. Yu. Dr. Evan Yu: Thank you so much. It's wonderful to be here today. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/genitourinary-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

De'Ann Richter is a renowned coach at Breast Cancer Conqueror who works closely with Veronique Desaulniers. Their mission is to provide women and men with a variety of options when it comes to cancer, specifically breast cancer. Learn the many options available to combat breast cancer, both conventional medicine and alternative approaches to empower you to live your best life through healing body, mind, and soul. Look for special supplements marked with an asterisk* New episodes of Welcome to Wellness released every Friday! Not listening on Spotify? Show notes at: https://www.ashleydeeley.com/w2w/breastcancerconqueror Episode brought to you by: Dry Farm Wines Episode brought to you by: ⁠⁠⁠⁠⁠Thyroid Fixxr⁠⁠⁠⁠⁠ (Code: WELCOMEWELLNESS) Episode brought to you by: ⁠⁠VieLight⁠⁠ (Code: DEELEY10) Episode brought to you by: ⁠⁠⁠⁠⁠Methylene Blue⁠⁠⁠⁠⁠ (Code: ASHLEY15) 3:23: Has been a coach for over 10 years 4:23: The Seven Essentials Let Food Be Your Medicine Reduce Your Toxic Exposure Balance Your Energy Heal Your Emotional Wounds Embrace Biological Dentistry Repair Your Body with Therapeutic Plants Adopt Very Early Detection 8:15: Dr Veronique Desaulniers, two-time breast cancer survivor 10:29: How to heal 12:16: * Broccoli Sprouts * Sulforaphane supplement 12:42: * Vitamin D 12:54: *Curcumin 13:05: *Modified Citrus Pectin / or, Econugenics brand of Modified Citrus Pectin powder 13:35: Modified citrus pectin can up regulate the P53 gene which helps kill tumors 14:40: Exposing your breasts to sunlight 15:19: Stop wearing underwire bras 16:33: Reduce your EMF exposure (Visit Tech Wellness to learn more!) 17:40: Gia for EMF protection (or BluShield is one of my favorites!) 18:48: My free Clean Beauty Guide 21:35: Thermography 22:37: Inflammatory markers (ask for these on your blood test): CRP LDH ESR Homocysteine 23:58: BRCA gene 25:19: Difference between mammography and thermography 28:04: Ultrasounds 29:00: Diagnostic sample 31:48: Coffee enemas (MUST use organic coffee) (blog post) 34:03: You don't get glutathione from food 36:46: Wine during cancer (low alcohol is OK! Dry Farm wine ONLY makes low alcohol wine!) 38:26: Anatomy of an Illness 38:44: Stimulating the vagal nerve 42:31: How to mitigate damage from chemo 42:41: Dr. Valter Longo: Fasting Cancer 43:39: Mistletoe & breast cancer 44:19: Sex, Lies, & Menopause 45:27:* Morning Glory tincture 45:44: *Dandelion tincture 46:12: Bioidentical Hormone Replacement Therapy (hormone solutions) 50:23: * DIM 50:52: Soy & breast cancer (YES to Haelen, fermented soy beverage) 56:05: Top book recommendations: Heal Breast Cancer Naturally The Metabolic Approach to Cancer How to Starve Cancer You Are the Placebo Getting Well Again The Success Principles Limitless by Jim Kwik Where to find De'Ann: Website Instagram Where to find Ashley Deeley: ⁠⁠⁠Website⁠⁠⁠ ⁠⁠⁠Instagram⁠⁠⁠ hello@ashleydeeley.com

GET MY FREE INSTANT POT COOKBOOK: https://www.chefaj.com/instant-pot-download MY BEST SELLING WEIGHT LOSS BOOK: https://www.amazon.com/dp/1570674086?tag=onamzchefajsh-20&linkCode=ssc&creativeASIN=1570674086&asc_item-id=amzn1.ideas.1GNPDCAG4A86S Disclaimer: This podcast does not provide medical advice. The content of this podcast is provided for informational or educational purposes only. It is not intended to be a substitute for informed medical advice or care. You should not use this information to diagnose or treat any health issue without consulting your doctor. Always seek medical advice before making any lifestyle changes. To learn more about MBSR(Mindfulness Based Stress Reduction program) https://www.ethosprimarycare.com/mbsr-course To register for the course https://ethos-health.myshopify.com/products/minfulness-based-stress-reduction-mbsr-course Dr. Weiss is speaking at the NHA Virtual Conference (June 27-30,2024). Use this link to get your tickets now: https://events.ringcentral.com/events/nha-conference-2024/registration?utm_campaign=Chef+AJ&utm_source=Affiliate Dr. Weiss, founder of Ethos Primary Care, embodies what it means to be a true primary care doctor. He listens deeply and compassionately, fully aware that your health is a direct result of how you eat, sleep, move, stress, and your connection to nature. He is the kind of doctor who will help you trade your prescriptions for plants. Deeply committed to helping people obtain their optimal health through living a mindful, whole plant food-based lifestyle for more than 30 years, Dr. Weiss has been helping people reverse and prevent disease and illness to live a more energized, fulfilled life. Dr. Weiss is also the founder of Ethos Farm Project, a nonprofit organization and semifinalist in the Rockefeller Foundation 2050 Food System Vision Prize competition. He has been featured in top media, including The New York Times, The New York Post, The Today Show, New Jersey Monthly, and the feature-length documentary, "Eating You Alive." The mission of Ethos Farm Project is to address the interconnected nature of how agriculture affects human health, planetary health, and our relationship with animals. To achieve this, his 388-acre historic farm in Long Valley NJ where he operates Ethos Primary Care from, produces truly nourishing food to feed the community, restoring the land, all while cultivating and empowering a new generation of farmers, doctors, and nurses through hands-on educational programming. Dr Weiss feels that he is fulfilling his purpose in life through the work he does as a Board Certified, Lifestyle Medicine physician and the work he does through his nonprofit, Ethos Farm Project. Connecting his life's passion for medicine and the environment, Dr. Weiss believes we need "all hands on deck" to combat the healthcare and environmental crises we now face as a species, in order to ensure a habitable planet for our children. Dr. Weiss is here monthly, on Chef AJ, to answer any and all medical questions you may have. An experienced primary care doctor, there is no question too simple or too complex for him to handle. To learn more about Dr. Weiss and all he is involved with, visit the following: https://www.ethosprimarycare.com/ https://www.ethosfarmproject.org/

Liz & Becca tackle the controversial topic of breast cancer and BRCA gene mutations. They break down the science behind BRCA1 and BRCA2, the truth about genetic predisposition, and why these genes don't have to define your future. From lifestyle changes and diet to safer testing methods and informed consent, this episode equips you with the knowledge to make empowered decisions. Whether you're navigating genetic testing, considering preventive measures, or just curious about breast cancer risk, this episode provides practical insights and a dose of much-needed hope.

In this two-part episode of the Precision Medicine Podcast, host Karan Cushman continues her deep dive into prostate cancer care with expert guest Dr. William Oh, a leading genitourinary oncologist, Director of Precision Medicine at Yale Cancer Center and Chair of the American Cancer Society National Prostate Cancer Roundtable. Building on part one (episode 63), they explore the transformative role of precision medicine, advanced diagnostics, and targeted therapies—emphasizing the urgent need for greater awareness, understanding, and advocacy as prostate cancer continues to rise steadily. Karan opens the conversation by emphasizing the growing complexity of prostate cancer diagnostics and treatment. Dr. Oh discusses the wide array of diagnostic tools, from PSA tests and MRIs to the cutting-edge PSMA PET scan, which has revolutionized staging and treatment planning by providing detailed insights into cancer spread. He highlights how these tools are helping oncologists tailor treatment plans with unprecedented precision. The discussion shifts to molecular diagnostics, a burgeoning field that provides critical information about the aggressiveness of cancer. Dr. Oh explains how molecular tests, such as genomic profiling, are enabling personalized treatment decisions for prostate cancer patients, particularly those on the fence about options like surgery, radiation, or active surveillance. Karan and Dr. Oh also address disparities in access to these advanced diagnostics, underlining the need for wider implementation. Karan steers the conversation toward advancements in targeted therapies. Dr. Oh outlines breakthroughs in precision treatments, including PARP inhibitors for patients with BRCA mutations and the innovative LU-177-PSMA therapy, a “smart bomb” approach that targets cancer cells with remarkable specificity. He also explores the promise of immunotherapy, though he acknowledges its limited applicability for prostate cancer due to the disease's low mutational burden. The role of artificial intelligence in precision oncology is another key topic. Dr. Oh and Karan discuss how AI and machine learning are helping clinicians process complex data, from imaging to genomic profiles, to guide more informed treatment decisions. Dr. Oh envisions AI as an essential tool for streamlining oncology workflows while preserving the human connection between doctors and patients. Karan highlights the importance of effective communication in prostate cancer care, referencing a recent editorial co-authored by Dr. Oh. Together, they explore the need for more patient-centered terminology, such as replacing the term “castration-resistant prostate cancer” with “androgen deprivation-resistant prostate cancer,” to foster better understanding and improve patient experience. The episode concludes with a forward-looking discussion on clinical trials, the integration of new technologies like liquid biopsies, and the ongoing efforts to expand insurance coverage for biomarker testing. Dr. Oh emphasizes the critical role of collaboration, awareness, and education in advancing precision medicine and ensuring that patients benefit from the latest innovations. With Karan's thoughtful questions and Dr. Oh's expertise, this episode offers a comprehensive and accessible exploration of how precision medicine is reshaping the future of prostate cancer care. We hope you'll tune in to the series and share this important episode with others!

One of my dream guests is on the podcast TODAY! Jill Martin, Today Show Contributor, opens up about her BRCA gene mutation that ultimately led to her diagnosis of aggressive breast cancer. Jill reflects on the past year of treatment and survivorship, how her breast cancer diagnosis made her a better person, and tells us why she calls her chemotherapy her "best friend pills." She shares her best holiday gifts including our favorite sherpas, and I share a super secret project I've been working on! I hope you enjoy this conversation as much as I loved recording it! (ps Jill, did we just become breast friends?)xo Robynfollow me at @theboobiedocs for more of the BREAST information

TED Health's very own Dr. Shoshana Ungerleider has a new podcast Before We Go. You heard the first episode earlier this year so we wanted to share the second episode in the series -- if you'd like more from Before We Go, check it out wherever you are listening to this.Before We Go follows Shoshana's personal and emotionally charged journey after her father was diagnosed with terminal cancer in the summer of 2022. His doctors were encouraged when testing showed that the cancer was related to a BRCA genetic mutation, which meant that it might respond to new, targeted therapies. But that also meant that Shoshana and her sister were also at risk for developing life-threatening cancers. With the help of renowned experts and some of the professionals who helped her along the way, Shoshana tells her story of love, loss, family, mortality, and the unexpected paths we take to find meaning and purpose in the face of life's greatest challenges.In this episode, Shoshana reflects on the death of her paternal grandmother, Joy Ungerleider, who died of the same cancer Steven now faces. The family learns that Steven's cancer is BRCA-related, and hope rises with the possibility that targeted therapy may offer him many months, if not years, of quality life. But he would first need to endure several months of harsh chemotherapy. See behind the scenes and join the conversation on Instagram @beforewegopodcast.

On today’s show: President Biden pardons his son. President-elect Trump picks a new FBI director. The Washington Post details how an urgently needed global agreement on plastic fell apart. Health experts say more men should get tested for the BRCA cancer gene. The Atlantic’s Kristen Brown explains why. Plus, the Bills “mafia” grabs their shovels again, the L.A. Times breaks down how much food Americans waste at Thanksgiving, and what to know about online shopping this Cyber Monday. Today’s episode was hosted by Shumita Basu.

Dr. Shoshana Ungerleider shares her personal and professional experiences with end-of-life care. Diagnosed in 2022, her father's pancreatic cancer journey becomes a central topic, shedding light on the BRCA mutation and its impact. She discusses her preventative surgeries and the emotional turmoil of being both a daughter and a caregiver. Highlighted are her views on the U.S. healthcare system's shortcomings in supporting terminally ill patients and her work with End Well to improve end-of-life experiences. The episode also touches on the importance of mental health and the power of belief in shaping our health outcomes. Dr. Shoshana is the host of podcast ⁠"Before We Go"⁠ Her foundation "End Well": ⁠www.endwellproject.org⁠ Join the ⁠⁠DEAD Talk Patreon⁠⁠ for only $5/mo to support our mission & and gain access to exclusive content and features.    "Dead Dad Club" & "Dead Mom Club" hats and shirts: ⁠⁠Shop Here⁠⁠   Purchase “Not Dead Yet” or DEAD Talk trucker hats here with free domestic shipping:

Technology is transforming genetic testing and bringing hope to families facing rare diseases. In this episode, GeneDx (Nasdaq: WGS) CEO Katherine Stuhlin sits down with Steve Kraus to share how AI is being used to crack life's most complex code and speed up diagnosis from years to days.We cover:

BRCA mutations are inextricably linked with breast cancer in women, but they can also lead to cancer in the pancreas, prostate and more in men. Kristen V. Brown, staff writer at The Atlantic covering health and science, explains the link and why more men should get tested for the BRCA gene.

In this episode of the Realfoodology podcast, I sit down with the incredible Grace Price, an 18-year-old changemaker who is already making waves in the world of cancer prevention and food activism. Grace, who you may recognize from her powerful testimony at the Senate, shares her inspiring journey—from losing her grandfather to cancer to creating a free documentary that explores the link between processed foods and cancer. We discuss the corrupt influence of big food and the dangers of ultra-processed foods. We also talk about regenerative farming, tackling food deserts, and empowering Gen Z to challenge the status quo when it comes to public health. Don't miss this eye-opening conversation on how we can flatten the cancer curve and improve our food system for future generations! Timestamps: 00:00:00 - Introduction   00:05:51 - Grace's Documentary   00:07:55 - Cancer Research   00:09:59 - Genetics and Cancer   00:13:31 - The Food Pyramid and Other Big Food Corruption   00:19:18 - Ultra-Processed Foods Are the New Cigarettes   00:22:22 - Dietitian Curriculum and the Importance of Whole Foods   00:25:41 - Bottom-Up Change   00:27:28 - Big Tabasco and Big Food   00:33:40 - Kellogg Campaign and Senate Roundtable 00:35:53 - Coca-Cola Donating to the American Cancer Society   00:40:16 - How Bad Is Processed Food & Worst Processed Foods   00:44:38 - Carb Loading and Blood Sugar Spikes   00:45:31 - Cigarettes and French Fries   00:48:14 - Clorox and Twinkies   00:50:07 - Getting Gen Z Involved   00:54:53 - Harnessing the Power of Rebellious Teens   00:56:08 - Climate Change and Agriculture   00:58:06 - What's Next for Grace   01:01:56 - CGMs and Learning the Long-Term Impacts of Processed Foods   01:03:38 - Flattening the Cancer Curve   01:06:48 - Grace's Health Non-Negotiables   Show Links:  211: BRCA, Modernizing Cancer Treatment, + Medical Ketosis | Dr. Thomas Seyfried  No Such Thing As Vegan Food | Chef Mollie of Sage Cancer: A Food-Borne Illness Good Energy (Book) Health Roundtable (Senate Hearing) Kiss The Ground (Documentary)  Common Ground (Documentary)  The Ends (Restaurant)  Sponsored By:  Organifi Go to www.organifi.com/realfoodology and use code REALFOODOLOGY for 20% Off and from 11/12 - 11/13 enjoy Fall savings

For years, TODAY Contributor Jill Martin has been lighting up our TV screens with her optimism, her joy and her open heart. In June 2023, Jill's life changed when she was diagnosed with stage 2 breast cancer, after she learned she had a BRCA gene mutation. Now, with a clean bill of health, Jill has a new perspective on life. She's living her life with more intention than ever before, and realigning with her purpose. Jill sat down with Hoda Kotb to talk about her journey, and her mission to spread awareness, encourage genetic testing and help others.