Podcasts about brca

Dr. Neeraj Agarwal and Dr. Jeanny Aragon-Ching discuss important advances in the treatment of prostate, bladder, and kidney cancers that were presented at the 2025 ASCO Annual Meeting. TRANSCRIPT Dr. Neeraj Agarwal: Hello, and welcome to the ASCO Daily News Podcast. I am Dr. Neeraj Agarwal, your guest host of the ASCO Daily News Podcast today. I am the director of the Genitourinary Oncology Program and a professor of medicine at the University of Utah Huntsman Cancer Institute and editor-in-chief of the ASCO Daily News.  I am delighted to be joined by Dr. Jeanny Aragon-Ching, a GU medical oncologist and the clinical program director of the GU Center at the Inova Schar Cancer Institute in Virginia. Today, we will be discussing some key abstracts in GU oncology that were presented at the 2025 ASCO Annual Meeting.  Our full disclosures are available in the transcript of this episode.  Jeanny, it is great to have you on the podcast. Dr. Jeanny Aragon-Ching: Oh, thank you so much, Neeraj. Dr. Neeraj Agarwal: Jeanny, let's begin with some prostate cancer abstracts. Let's begin with Abstract 5017 titled, “Phase 1 study results of JNJ-78278343 (pasritamig) in metastatic castration-resistant prostate cancer.” Can you walk us through the design and the key findings of this first-in-human trial? Dr. Jeanny Aragon-Ching: Yeah, absolutely, Neeraj. So this study, presented by Dr. Capucine Baldini, introduces pasritamig, a first-in-class T-cell redirecting bispecific antibody that simultaneously binds KLK2 on prostate cancer cells and CD3 receptor complexes on T cells. KLK2 is also known as human kallikrein 2, which is selectively expressed in prostate tissue. And for reference, KLK3 is what we now know as the PSA, prostate-specific antigen, therefore making it an attractive and specific target for therapeutic engagement. Now, while this was an early, first-in-human, phase 1 study, it enrolled 174 heavily pretreated metastatic CRPC patients. So many were previously treated with ARPIs, taxanes, and radioligand therapy. So given the phase 1 nature of this study, the primary objective was to determine the safety and the RP2D, which is the recommended phase 2 dose. Secondary objectives included preliminary assessment of antitumor activity. So, pasritamig was generally well tolerated. There were no treatment-related deaths. Serious adverse events were rare. And in the RP2D safety cohort, where patients received the step-up dosing up to 300 mg of IV every 6 weeks, the most common treatment-related adverse events were low-grade infusion reactions. There was fatigue and grade 1 cytokine release syndrome, what we call CRS. And no cases of neurotoxicity, or what we call ICANS, the immune effector cell-associated neurotoxicity syndrome, reported. Importantly, the CRS occurred in just about 8.9% of patients. All were grade 1. No patients required tocilizumab or discontinued treatment due to adverse events. So, this suggests a favorable safety profile, allowing hopefully for outpatient administration without hospitalization, which will be very important when we're thinking about bispecifics moving forward. In terms of efficacy, pasritamig showed promising activity. About 42.4% of evaluable patients achieved a PSA50 response. Radiographic PFS was about 6.8 months. And among patients with measurable disease, the objective response rate was about 16.1% in those with lymph node or bone metastases, and about 3.7% in those with visceral disease, with a median duration of response of about 11.3 months. So, altogether, this data suggests that pasritamig may offer a well-tolerated and active new potential option for patients with metastatic CRPC.   Again, as a reminder, with the caveat that this is still an early phase 1 study. Dr. Neeraj Agarwal: Thank you, Jeanny. These are promising results for a bispecific T-cell engager, pasritamig, in prostate cancer. I agree, the safety and durability observed here stand out, and this opens the door for further development, possibly even in earlier disease settings.  So, shifting now from immunotherapy to the evolving role of genomics in prostate cancer. So let's discuss Abstract 5094, a real-world, retrospective analysis exploring the prognostic impact of homologous recombination repair gene mutations, especially BRCA1 and BRCA2 mutations, in metastatic hormone-sensitive prostate cancer. Can you tell us more about this abstract, Jeanny? Dr. Jeanny Aragon-Ching: Sure, Neeraj. So this study was presented by Dr. David Olmos, represents one of the largest real-world analyses we have evaluating the impact of homologous recombination repair, or what we would call HRR, alterations in metastatic hormone-sensitive prostate cancer. So, this cohort included 556 men who underwent paired germline and somatic testing. Now, about 30% of patients had HRR alterations, with about 12% harboring BRCA1 or BRCA2 mutations and 16% having alterations in other HRR genes. Importantly, patients were stratified via CHAARTED disease volume, and outcomes were examined across treatment approaches, including ADT alone, doublet therapy, and triplet therapy. The prevalence of BRCA and HRR alterations were about similar between the metastatic hormone-sensitive prostate cancer and the metastatic castrate-resistant prostate cancer, with no differences observed, actually, between the patients with high volume versus low volume disease.  So, the key finding was that BRCA and HRR alterations were associated with poor clinical outcomes in metastatic hormone-sensitive prostate cancer. And notably, the impact of these alterations may actually be even greater in metastatic hormone-sensitive prostate cancer than previously reported in metastatic CRPC. So, the data showed that when BRCA mutations are present, the impact of the volume of disease is actually limited. So, poor outcomes were observed across the board for both high-volume and low-volume groups. So, the analysis showed that patients with HRR alterations had significantly worse outcomes compared to patients without HRR alterations. Median radiographic progression-free survival was about 20.5 months for the HRR-altered patients versus 30.6 months for the non-HRR patients, with a hazard ratio of 1.6. Median overall survival was 39 months for HRR-altered patients compared to 55.7 months for the non-HRR patients, with a hazard ratio of 1.5. Similar significant differences were observed when BRCA-mutant patients were compared with patients harboring non-BRCA HRR mutations. Overall, poor outcomes were independent of treatment of ARPI or taxanes. Dr. Neeraj Agarwal: Thank you, Jeanny. So, these data reinforce homologous recombination repair mutations as both a predictive and prognostic biomarker, not only in the mCRPC, but also in the metastatic hormone-sensitive setting as well. It also makes a strong case for incorporating genomic testing early in the disease course and not waiting until our patients have castration-resistant disease. Dr. Jeanny Aragon-Ching: Absolutely, Neeraj. And I think this really brings home the point and the lead up to the AMPLITUDE trial, which is LBA5006, a phase 3 trial that builds on this very concept of testing with a PARP inhibitor, niraparib, in the hormone-sensitive space. Can you tell us a little bit more about this abstract, Neeraj? Dr. Neeraj Agarwal: Sure. So, the AMPLITUDE trial, a phase 3 trial presented by Dr. Gerhardt Attard, enrolled 696 patients with metastatic hormone-sensitive prostate cancer and HRR gene alterations. 56% of these patients had BRCA1 and BRCA2 mutations. Patients were randomized to receive abiraterone with or without niraparib, a PARP inhibitor. The majority of patients, 78% of these patients, had high-volume metastatic hormone-sensitive prostate cancer, and 87% of these patients had de novo metastatic HSPC. And 16% of these patients received prior docetaxel, which was allowed in the clinical trial. So, with a median follow-up of nearly 31 months, radiographic progression-free survival was significantly prolonged with the niraparib plus abiraterone combination, and median was not reached in this arm, compared to abiraterone alone, which was 29.5 months, with a hazard ratio of 0.63, translating to a 37% reduction in risk of progression or death. This benefit was even more pronounced in the BRCA1 and BRCA2 subgroup, with a 48% reduction in risk of progression, with a hazard ratio of 0.52. Time to symptomatic progression also improved significantly across all patients, including patients with BRCA1, BRCA2, and HRR mutations. Although overall survival data remain immature, early trends favored the niraparib plus abiraterone combination. The safety profile was consistent with prior PARP inhibitor studies, with grade 3 or higher anemia and hypertension were more common but manageable. Treatment discontinuation due to adverse events remained low at 11%, suggesting that timely dose modifications when our patients experience grade 3 side effects may allow our patients to continue treatment without discontinuation. These findings support niraparib plus abiraterone as a potential new standard of care in our patients with metastatic hormone-sensitive prostate cancer with HRR alterations, and especially in those who had BRCA1 and BRCA2 mutations. Dr. Jeanny Aragon-Ching: Thank you, Neeraj. This trial is especially exciting because it brings PARP inhibitors earlier into the treatment paradigm. Dr. Neeraj Agarwal: Exactly. And it is exciting to see the effect of PARP inhibitors in the earlier setting.  So Jeanny, now let's switch gears a bit to bladder cancer, which also saw several impactful studies. Could you tell us about Abstract 4502, an exploratory analysis from the EV-302 trial, which led to approval of enfortumab vedotin plus pembrolizumab for our patients with newly diagnosed metastatic bladder cancer? So here, the authors looked at the outcomes in patients who achieved a confirmed complete response with EV plus pembrolizumab. Dr. Jeanny Aragon-Ching: Sure, Neeraj. So, EV-302 demonstrated significant improvements in progression-free and overall survival for patients previously treated locally advanced or metastatic urothelial cancer, I'll just call it metastatic UC, as a frontline strategy, establishing EV, which is enfortumab vedotin, plus pembro, with pembrolizumab as standard of care in this setting.  So, this year at ASCO, Dr Shilpa Gupta presented this exploratory responder analysis from the phase 3 EV-302 trial. Among 886 randomized patients, about 30.4% of patients, this is about 133, in the EV+P arm, and 14.5% of the patients in the chemotherapy arm, achieved a confirmed complete response. They call it the CCR rates. So for patients who achieved this, median PFS was not reached with EV+P compared to 26.9 months with chemotherapy, with a hazard ratio of 0.36, translating to a 64% reduction in the risk of progression. Overall survival was also improved. So the median OS was not reached in either arm, but the hazard ratio favored the EV+P at 0.37, translating to a 63% reduction in the risk of death. The median duration of complete response was not reached with EV+P compared to 15.2 months with chemotherapy. And among those patients who had confirmed CRs at 24 months, 78% of patients with the EV+P arm remained progression-free, and around 95% of the patients were alive, compared to 54% of patients who were progression-free and 86% alive of the patients in the chemotherapy arm. Safety among responders were also consistent with prior reports. Grade 3 or higher treatment-related adverse events occurred in 62% of EV+P responders and 72% of chemotherapy responders. Most adverse events were managed with dose modifications, and importantly, no treatment-related deaths were reported among those who were able to achieve complete response.  So these findings further reinforce EV and pembro as the preferred first-line therapy for metastatic urothelial carcinoma, offering a higher likelihood of deep, durable responses with a fairly manageable safety profile. Dr. Neeraj Agarwal: Thank you for the great summary, Jeanny. These findings underscore the depth and durability of responses achievable with this combination and also suggest that achieving a response may be a surrogate for long-term benefit in patients with metastatic urothelial carcinoma.  So now, let's move to Abstract 4503, an exploratory ctDNA analysis from the NIAGARA trial, which evaluated perioperative durvalumab, an immune checkpoint inhibitor, in muscle-invasive bladder cancer. So what can you tell us about this abstract? Dr. Jeanny Aragon-Ching: Absolutely, Neeraj. So, in NIAGARA, presented by Dr. Tom Powles, the addition of perioperative durvalumab to neoadjuvant chemotherapy, gem/cis, significantly improved event-free survival, overall survival, and pathologic complete response in patients with cisplatin-eligible muscle-invasive bladder cancer. Recall that this led to the U.S. FDA approval of this treatment regimen on March 28, 2025.  So, a planned exploratory analysis evaluated the ctDNA dynamics and their association with clinical outcomes, which was the one presented recently at ASCO. So, the study found that the incidence of finding ctDNA positivity in these patients was about 57%. Following neoadjuvant treatment, this dropped to about 22%, with ctDNA clearance being more common in the durvalumab arm, about 41%, compared to the chemotherapy control arm of 31%. Notably, 97% of patients who remained ctDNA positive prior to surgery failed to achieve a pathologic CR. So, this indicates a strong association between ctDNA persistence and lack of tumor eradication. So, postoperatively, only about 9% of patients were ctDNA positive. So, importantly, durvalumab conferred an event-free survival benefit regardless of ctDNA status at both baseline and post-surgery. Among patients who were ctDNA positive at baseline, durvalumab led to a hazard ratio of 0.73 for EFS. So, this translates to a 27% reduction in the risk of disease recurrence, progression, or death compared to the control arm. In the post-surgical ctDNA-positive group, the disease-free survival was also improved with a hazard ratio of 0.49, translating to a 51% reduction in the risk of recurrence.  So, these findings underscore the prognostic value of ctDNA and suggest that durvalumab provides clinical benefit irrespective of molecular residual disease status. So, the data also supports that ctDNA is a promising biomarker for future personalized strategies in the perioperative treatment of muscle-invasive bladder cancer. Dr. Neeraj Agarwal: Thank you, Jeanny. It is great to see that durvalumab is improving outcomes in these patients regardless of ctDNA status. However, based on these data, presence of ctDNA in our patients warrants a closer follow-up with imaging studies, because these patients with positive ctDNA seem to have a higher risk of recurrence. Dr. Jeanny Aragon-Ching: I agree, Neeraj.  Let's round out the bladder cancer discussion with Abstract 4518, which reported the interim results of SURE-02, which is a phase 2 study evaluating neoadjuvant sacituzumab govitecan plus pembrolizumab in cisplatin-ineligible muscle-invasive bladder cancer. Can you tell us more about this abstract, Neeraj? Dr. Neeraj Agarwal: Sure, Jeanny. So, Dr Andrea Necchi presented interim results from the SURE-02 trial. This is a phase 2 study evaluating neoadjuvant sacituzumab govitecan plus pembrolizumab, followed by a response-adapted bladder-sparing treatment and adjuvant pembrolizumab in patients with muscle-invasive bladder cancer.  So, in this interim analysis, 40 patients were treated and 31 patients were evaluable for efficacy. So, the clinical complete response rate was 38.7%. All patients achieving clinical complete response underwent bladder-sparing approach with a repeat TURBT instead of radical cystectomy. Additionally, 51.6% of patients achieved excellent pathologic response with a T stage of 1 or less after neoadjuvant therapy. The treatment was well tolerated, with only 12.9% of patients experiencing grade 3 or higher adverse events without needing dose reduction of sacituzumab. Molecular profiling, interestingly, showed that clinical complete response correlated with luminal and genomically unstable subtypes, while high stromal gene expression was associated with lack of response.  These results suggest that sacituzumab plus pembrolizumab combination has promising activity in this setting, and tolerability, and along with other factors may potentially allow a bladder preservation approach in a substantial number of patients down the line. Dr. Jeanny Aragon-Ching: Yeah, agree with you, Neeraj. And the findings are very provocative and support completing the full trial enrollment and further exploration of this strategy in muscle-invasive bladder cancer in order to improve and provide further bladder-sparing strategies. Dr. Neeraj Agarwal: Agree. So, let's now turn to the kidney cancer, starting with Abstract 4505, the final overall analysis from CheckMate-214 trial, which evaluated nivolumab plus ipilimumab, so dual checkpoint inhibition strategy, versus sunitinib in our patients with metastatic clear cell renal cell carcinoma. Dr. Jeanny Aragon-Ching: Yeah, absolutely, Neeraj. So, the final 9-year analysis of the phase 3 CheckMate-214 trial confirms the long-term superiority of nivolumab and ipilimumab over sunitinib for first-line treatment of advanced metastatic renal cell carcinoma. So, this has a median follow-up of 9 years. Overall survival remains significantly improved with the combination. So, in the ITT patient population, the intention-to-treat, the hazard ratio for overall survival was 0.71. So, this translates to a 29% reduction in the risk of death. 31% of patients were alive at this 108-month follow-up compared to 20% only in those who got sunitinib. So, similar benefits were observed in the intermediate- and poor-risk groups with a hazard ratio of 0.69, and 30% versus 19% survival at 108 months.  Importantly, a delayed benefit was also seen in those favorable-risk patients. So, the hazard ratio for overall survival improved from 1.45 in the initial report and now at 0.8 at 9 years follow-up, with 35% of patients alive at 108 months compared to 22% in those who got sunitinib. Progression-free survival also favored the nivo-ipi arm across all risk groups. At 96 months, the probability of remaining progression-free was about 23% compared to 9% in the sunitinib arm in the ITT patient population, 25% versus 9% in the intermediate- and poor-risk patients, and 13% compared to 11% in the favorable-risk patients. Importantly, at 96 months, 48% of patients in the nivo-ipi responders remained in response compared to just 19% in those who got sunitinib. And in the favorable-risk group, 36% of patients who responded remained in response, although data were not available for sunitinib in this subgroup.  So, this data reinforces the use of nivolumab and ipilimumab as a durable and effective first-line effective strategy for standard of care across all risk groups for advanced renal cell carcinoma. Dr. Neeraj Agarwal: Thank you, Jeanny. And of course, since ipi-nivo data were presented, several other novel ICI-TKI combinations have emerged. And I'm really hoping to see very similar data with TKI-ICI combinations down the line. It is really important to note that we are not seeing any new safety signals with the ICI combinations or ICI-based therapies, which is very reassuring given the extended exposure. Dr. Jeanny Aragon-Ching: Absolutely agree with you there, Neeraj.  Now, going on and moving on to Abstract 4514, which is the KEYNOTE-564 trial, and they reported on the 5-year outcomes of adjuvant pembrolizumab in clear cell RCC in patients who are at high risk for recurrence. Can you tell us a little bit more about this abstract, Neeraj? Dr. Neeraj Agarwal: Sure. So, the KEYNOTE-564 trial established pembrolizumab monotherapy as the first adjuvant regimen to significantly improve both disease-free survival and overall survival compared to placebo after surgery for patients with clear cell renal cell carcinoma. So, Dr Naomi Haas presented the 5-year update from this landmark trial.  A total of 994 patients were randomized to receive either pembrolizumab or placebo. The median follow-up at the time of this analysis was approximately 70 months. Disease-free survival remained significantly improved with pembrolizumab. The median DFS was not reached with pembrolizumab compared to 68.3 months with placebo, with a hazard ratio of 0.71, translating to a 29% reduction in risk of recurrence. At 5 years, 60.9% of patients receiving pembrolizumab remained disease-free compared to 52.2% with placebo. Overall survival also favored pembrolizumab. The hazard ratio for OS was 0.66, translating to a 34% reduction in risk of death, with an estimated 5-year overall survival rate of 87.7% with pembrolizumab compared to 82.3% for placebo. Importantly, these benefits were consistent across all key subgroups, including patients with sarcomatoid features. In addition, no new serious treatment-related adverse events have been reported in the 3 years since treatment completion.  So, these long-term data confirm pembrolizumab as a durable and effective standard adjuvant therapy for patients with resected, high-risk clear cell renal cell carcinoma. Dr. Jeanny Aragon-Ching: Thank you for that wonderful summary, Neeraj. Dr. Neeraj Agarwal: That wraps up our kidney cancer highlights. Any closing thoughts, Jeanny, before we conclude? Dr. Jeanny Aragon-Ching: It's been so wonderful reviewing these abstracts with you, Neeraj. So, the 2025 ASCO Annual Meeting showcased a lot of transformative data across GU cancers, from first-in-class bispecifics to long-term survival in RCC. And these findings are already shaping our clinical practices. Dr. Neeraj Agarwal: I agree. And we have covered a broad spectrum of innovations in GU cancers with strong clinical relevance.  So, thank you, Jeanny, for joining me today and sharing your insights.  And thank you to our listeners for joining us. You will find links to the abstracts discussed today in the transcript of this episode. If you find these conversations valuable, please take a moment to rate, review, and subscribe to the ASCO Daily News Podcast wherever you listen. Thank you so much. 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. Find out more about today's speakers:    Dr. Neeraj Agarwal     @neerajaiims     Dr. Jeanny Aragon-Ching   Follow ASCO on social media:       @ASCO on Twitter       ASCO on Bluesky   ASCO on Facebook       ASCO on LinkedIn       Disclosures:   Dr. Neeraj Agarwal:   Consulting or Advisory Role: Pfizer, Bristol-Myers Squibb, AstraZeneca, Nektar, Lilly, Bayer, Pharmacyclics, Foundation Medicine, Astellas Pharma, Lilly, Exelixis, AstraZeneca, Pfizer, Merck, Novartis, Eisai, Seattle Genetics, EMD Serono, Janssen Oncology, AVEO, Calithera Biosciences, MEI Pharma, Genentech, Astellas Pharma, Foundation Medicine, and Gilead Sciences  Research Funding (Institution): Bayer, Bristol-Myers Squibb, Takeda, Pfizer, Exelixis, Amgen, AstraZeneca, Calithera Biosciences, Celldex, Eisai, Genentech, Immunomedics, Janssen, Merck, Lilly, Nektar, ORIC Pharmaceuticals, Crispr Therapeutics, Arvinas  Dr. Jeanny Aragon-Ching:   Honoraria: Bristol-Myers Squibb, EMD Serono, Astellas Scientific and Medical Affairs Inc., Pfizer/EMD Serono   Consulting or Advisory Role: Algeta/Bayer, Dendreon, AstraZeneca, Janssen Biotech, Sanofi, EMD Serono, MedImmune, Bayer, Merck, Seattle Genetics, Pfizer, Immunomedics, Amgen, AVEO, Pfizer/Myovant, Exelixis,    Speakers' Bureau: Astellas Pharma, Janssen-Ortho, Bristol-Myers Squibb, Astellas/Seattle Genetics

218: In this episode, I'm covering one of the most requested and controversial topics in women's health—whether breast cancer survivors can safely use hormone replacement therapy (HRT). To help answer this complex question, I'm joined by Dr. Corinne Menn, a board-certified OB-GYN, Menopause Society certified practitioner, and Fellow of the American College of Obstetrics and Gynecology. Dr. Menn brings a powerful blend of clinical expertise and lived experience. She's a 23-year breast cancer survivor, BRCA gene carrier, and went through premature menopause herself. We cover what the research really says about HRT after breast cancer, risks versus benefits, the reality of estrogen deprivation, and why “it depends” is the only honest answer. Topics Discussed: → Can breast cancer survivors safely use HRT? → Is hormone therapy after breast cancer risky? → What are the benefits of estrogen for cancer survivors? → Does HRT increase breast cancer recurrence? → Are there safe hormone options for BRCA carriers? Sponsored By: → Timeline | Head to timeline.com/DRTYNA and get 20% off with code DRTYNA  → Nutrisense | Head over to nutrisense.io/drtyna to get 30% off your Nutrisense plan. Code TYNA at checkout → LVLUP | Head over to LVLUPHealth.com and use code DRTYNA at checkout to get 20% off your order sitewide.  → Manukora | Head to manukora.com/DRTYNA to save up to 31% & $25 worth of free gifts in Starter Kit, which comes with an MGO 850+ Manuka Honey jar. → BIOptimizers | Go to bioptimizers.com/tyna and use promo code TYNA10 to order Masszymes now and get 10% off any order → Dr Tyna's Brain spark | Go to store.drtyna.com/products/brainspark and use code BRAINSPARK10 for 10%  On This Episode We Cover:  → 00:00:00 - Introduction  → 00:04:51 - Dr. Menn's cancer story → 00:07:09 - Estrogen loss effects → 00:11:45 - Surgical menopause → 00:15:05 - Estrogen and cancer risk → 00:25:32 - Pregnancy after cancer → 00:31:40 - Estrogen in midlife → 00:34:45 - HRT after breast cancer → 00:37:56 - Recurrence risk → 00:44:06 - Dangers of low estrogen → 00:50:34 - New HRT options → 00:58:05 - Sexual health & dryness → 01:04:02 - You don't need to suffer → 01:08:16 - Estrogen and surgery → 01:13:04 - Estrogen for tissue health Show Links: → Estrogen Matters (book) Further Listening:  → EP. 199 | Hot Flashes Are a Warning Sign: The Truth About Metabolic Dysfunction | Quick + Dirty → Hormones Playlist Check Out Dr. Menn: → Instagram  → Website  → More Dr. Menn Disclaimer: Information provided in this podcast is for informational purposes only. This information is NOT intended as a substitute for the advice provided by your physician or other healthcare professional, or any information contained on or in any product. Do not use the information provided in this podcast for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or other supplement, or using any treatment for a health problem. Information provided in this blog/podcast and the use of any products or services related to this podcast by you does not create a doctor-patient relationship between you and Dr. Tyna Moore. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent ANY disease.

פרופ' אליזבט הלף, מנהלת היחידה לאיתור ומניעת ממאירות במערכת העיכול, מכון גסטרואנטרולוגיה, מנהלת המרכז הרב תחומי לגילוי מוקדם ומניעת סרטן, מנהלת מרפאת מעקב BRCA במרכז הרפואי רמב''ם עם כל מה שרציתם לדעת על תסמונת לינץ' לאור החשיפה של פרשה שהסעירה את הציבור שבמרכזה תורם זרע שמת שהפיץ מוטציה מחוללת סרטן

The Rose’s Roxann Hayford sits down with Amy Byer Shainman, also known as BRCA Responder, to discuss her passion for patient advocacy and her award-winning work as the author of “Resurrection Lily” and film producer of “Pink & Blue Colors of Hereditary Cancer” and the soon to be released film, “Love, Danielle.” She opens up about her sister’s cancer diagnosis, the missed opportunities for genetic counseling, and the ripple effects of discovering a BRCA mutation. Amy shares the emotional weight of learning you’re at higher risk, the confusion over what to do next, and the importance of certified genetic counselors. With her latest film, “Love, Danielle,” she and the entire production team, cast, and crew aim to break the silence around hereditary cancer risk with honesty and humor. Connect with Amy Byer Shainman: Website: lovedaniellefilm.com Social: @BRCAResponder Book: "Resurrection Lily" Support The Rose HERE. Subscribe to Let’s Talk About Your Breasts on Apple Podcasts, Spotify, iHeart, and wherever you get your podcasts. Key Questions Answered What are BRCA1 and BRCA2 genes, and why do mutations in them matter? Which cancers are linked to BRCA mutations for both women and men? How are BRCA mutations inherited within families? Does having a BRCA mutation mean you will definitely get cancer? When should someone consider genetic testing for hereditary cancer risk? What is the role of a certified genetic counselor in this process? Are direct-to-consumer genetic tests reliable for assessing cancer risk? What are the main barriers people face when considering genetic testing? How can someone prepare emotionally for the possibility of life-changing test results? Why was the film "Love, Danielle" made, and what conversations does it hope to spark? Timestamped Overview 01:35 – Roxann welcomes Amy and sets the stage for a conversation about genetic risk and advocacy. 02:15 – Amy shares her personal journey: her sister’s diagnosis, frustration with missed genetic counseling, and the start of her advocacy. 03:37 – What are BRCA genes? Amy explains how these genes work and why mutations increase cancer risk. 04:50 – The conversation shifts to the specific cancers linked to BRCA mutations, for both women and men. 05:25 – Confusion about screening and testing: When should you get a mammogram? What guidelines exist for genetic testing? 06:42 – The importance of certified genetic counselors and why primary care doctors might not be enough. 08:14 – Direct-to-consumer tests versus medical-grade testing. How to find a qualified genetic counselor. 10:26 – The pitfalls of relying solely on your regular doctor for genetic risk assessment. 11:30 – Preparing for genetic testing: managing anxiety, seeking support, and understanding your choices. 13:57 – Barriers to testing: cost, access, and the hidden fears that keep people from seeking answers. 16:17 – The power of support groups like BRCA Sisterhood and the importance of safe, private spaces. 17:34 – Amy introduces "Love, Danielle," a film about hereditary cancer risk, family, and tough decisions. 19:37 – The challenge of making a movie about cancer that’s both honest and watchable. 21:06 – How the cast and crew’s personal cancer stories shaped the film. 22:18 – Amy reflects on separating her own experience from the film’s narrative. 25:04 – The differences between Amy’s real-life choices and those faced by the film’s lead character. 26:01 – The emotional reality: fear, family, and the weight of life-changing decisions. 27:34 – The unique risks of ovarian cancer for BRCA1 carriers and the lack of reliable screening. 28:25 – Amy’s children, their awareness of her advocacy, and their contributions to the film. 29:41 – Plans for the film’s release and how listeners can follow updates. 30:27 – The risks BRCA mutations pose for men, and which populations are most affected.See omnystudio.com/listener for privacy information.

In this episode, we continue with a special series close to my heart: Decoding Destiny: Navigating Breast Cancer with Genetic Insight. I'm joined by Kathy Baker, patient advocate and founder of My Faulty Gene to explore the power of genetic testing—particularly cascade testing—and how it can help both you and your family take control of your breast cancer risk. Kathy shares her compelling personal story and how it inspired her to launch My Faulty Gene, a nonprofit organization that provides education, emotional support, and financial assistance for genetic testing. You'll learn all about the importance of cascade testing for families, how genetic knowledge can lead to proactive screenings and preventive health measures, and how advocacy is truly paving the way for more accessible care. Whether you're facing a BRCA-positive diagnosis, considering genetic testing, or looking for support navigating hereditary cancer risk, this is one conversation that you'll want to listen to - and share with your entire family.  Thank you to Merck and AstraZeneca for making this episode possible!

What do you do when cancer is always present in your family? David Mauk lost his mother, his sister, and other loved ones to breast cancer. He knows what it's like to grow up surrounded by the reality of cancer and to carry the BRCA gene. In today’s episode, you’ll hear: How genetic testing changed the choices his family made What it feels like to be a cancer advocate in Washington, D.C. Why sharing your family history can help save lives Support The Rose HERE. Subscribe to Let’s Talk About Your Breasts on Apple Podcasts, Spotify, iHeart, and wherever you get your podcasts. Key Questions Answered What impact did breast cancer have on David Mauk's family? What is the significance of the BRCA gene in David’s family? How did David’s family talk about breast cancer while he was growing up? How did David cope with losing his mother at such a young age? Did David himself undergo genetic testing and what were the results? How does David’s family approach genetic testing and health surveillance today? What has David done as an advocate for cancer research and awareness? Why does David believe early detection and knowing your family history is so crucial? What advice does David have for those with a family history of cancer? How has cancer research and treatment changed since previous generations? Timestamped Overview 00:00 Family, Cancer, Advocacy, Gene Awareness 04:31 Air Force Headsets Linked to Tumors 07:36 "Air Force Brat’s Journey" 11:07 Cancer Society Fundraising Champions 14:11 "Make Cancer Conversations Personal" 15:41 "Missing Maternal Memories" 22:00 Family Migration Journey 22:57 Living Positively Amidst Fear 25:57 Discovering Family Through DNA Insights 29:37 Empowering Young Women Against Breast CancerSee omnystudio.com/listener for privacy information.

"We need to get the law changed so that developers, so that people running these kinds of wallets are protected so that we can have access to these things in the U.S." In this episode of THE Bitcoin Podcast, Walker America talks with Bitcoin developer Matt Corallo about the Blockchain Regulatory Certainty Act (BRCA), why BRCA matters for wallet development and access in America, non-custodial wallets, Spiral, Vibe coding wallets, Bitcoin mining and mining pool centralization, the Lightning Network and other Layer 2s, Sats vs Bits vs Bitcoin, other ongoing debates in the Bitcoin community. CALL YOUR REPS: https://saveourwallets.org/ Follow Matt: X: https://x.com/TheBlueMatt Nostr: https://primal.net/mattcorallo THE Bitcoin Podcast Partners: > GET FOLD: https://use.foldapp.com/r/WALKER > SIGN UP FOR THE FOLD BITCOIN REWARDS CREDIT CARD: https://foldapp.com/credit-card?r=UZoiP > Get the BITKIT mobile wallet: https://get.bitkit.to/walker > http://bitbox.swiss/walker -- use promo code WALKER for 5% off the Bitcoin-only Bitbox02 hardware wallet. Summary: Matt from Spiral discusses the importance of the Blockchain Regulatory Certainty Act, which aims to clarify regulations around non-custodial wallets and protect developers from being classified as money transmitters. The act, introduced by Representatives Emmer and Torres, seeks to amend the law so that developers of non-custodial platforms are not subject to KYC and AML requirements. Matt emphasizes the need for the Bitcoin community to pressure Congress to pass the act to prevent potential restrictions on access to innovative wallet technologies in the US. ***** If you enjoy THE Bitcoin Podcast you can help support the show by doing the following: FOLLOW ME (Walker) on @WalkerAmerica on X | @TitcoinPodcast on X | Nostr Personal (walker) | Nostr Podcast (Titcoin) | Instagram

This is a follow up of my interview with Margaret Tueller Proffitt who I spoke to after her phase one DIEP flap surgery at PRMA in San Antonio in January of 2024. I invited her back to the DiepCJourney podcast to share  details of the completion of her breast reconstruction after phase two. She traveled back to San Antonio seven months after phase one for her phase two surgery. We talk about the following: ·       Communication and discussion with Dr. Whipple about your phase via a ZOOM call. ·       What did she pack for phase 2. ·       Who she traveled with for this phase of her surgery. ·       The details of what Dr. Whipple did for phase 2. ·       Compression garments, medical dressings, and showering. ·       Pain medication, bruising, and change in clothing size after fat grafting. ·       Flying home after surgery. Margaret is a strong advocate and voice for the BRCA and breast reconstruction community. She is a mother, wife, loves to read, travel, has pets and she is a rock star on our Foundation YouTube channel with over a thousand views of video interview of phase one surgery. She is living life, enjoying activities, travel, and family celebrations. I love success stories so I asked Margaret what she wanted to share with those listening to the interview who might be considering DIEP flap surgery. “This was a short period of hard. Go forth with confidence. I love the body I have now.” Connect with Margaret on the following platforms: Instagram: https://www.instagram.com/cmproffitt/ LinkedIn: https://www.linkedin.com/in/margaret-proffitt/ Facebook: https://www.facebook.com/margaret.t.proffitt

Sara Aranda is a trail runner and outdoor adventurer who has developed a strong interest in going after FKTs, fastest known times. But her outdoor passions are about much more than setting records: Aranda's motivations are spurred by processing life and death, grief and hope, fear and joy. Aranda's passion for trail running began while she was in college. It was a space where she could process the death of her mother, who'd died after many years of fighting breast cancer. Aranda herself then had to face some tough decisions. She first decided to learn whether or not she carried the same genetic abnormality her mother and other family members had, a BRCA mutation, which puts the carrier at high risk for breast and ovarian cancer. She did. Aranda then had a decade to decide if she wanted to take the preventative steps that would lower her chances of getting cancer, beginning with a double mastectomy. This episode traces how running and moving through wild spaces have become intertwined with how Aranda has navigated big life questions and experiences that clarify how short this life can be. The meaningful experiences found out on the trail are integral to how she chooses to live. How to Keep Up with Sara Aranda Instagram: @oyesaranda Website: bivytales.com Mentioned in this Episode FKT Website: fastestknowntime.com Becky Croft on WRS: womensrunningstories.com/becky-croft-running-endometriosis-and-post-hysterectomy-menopause To support WRS, please rate and review the show iTunes/Apple:⁠⁠⁠⁠ https://podcasts.apple.com/us/podcast/womens-running-stories/id1495427631⁠⁠⁠⁠ Spotify:⁠⁠⁠⁠ https://open.spotify.com/show/4F8Hr2RysbV4fdwNhiMAXc?si=1c5e18155b4b44fa⁠⁠⁠⁠ Music Credits Cormac O'Regan, of⁠⁠⁠⁠ Playtoh⁠⁠⁠⁠ ⁠⁠⁠⁠Coma-Media⁠⁠⁠⁠, via⁠⁠⁠⁠ Pixabay⁠⁠⁠⁠ ⁠⁠Lidérc Bell⁠⁠, via ⁠⁠Pixabay⁠ ⁠⁠⁠⁠aidanpinsent⁠⁠⁠⁠, via ⁠⁠⁠⁠Pixabay⁠⁠⁠ ⁠⁠⁠⁠penguinmusic⁠⁠⁠⁠, via⁠⁠⁠⁠ Pixabay⁠⁠⁠⁠ ⁠⁠⁠RomanBelov⁠⁠⁠, via⁠⁠⁠ Pixabay⁠⁠ ⁠⁠⁠⁠⁠Rockot⁠⁠, via⁠⁠ Pixabay⁠ SergePavkinMusic⁠⁠, via⁠⁠ Pixabay⁠⁠ PaulYudin, via⁠⁠⁠ Pixabay⁠⁠⁠ Ways to Connect and Engage with Women's Running Stories WRS Instagram: ⁠⁠@womensrunningstories⁠⁠⁠⁠ Facebook:⁠⁠⁠⁠ facebook.com/WomensRunningStories⁠⁠⁠⁠ Website:⁠⁠⁠⁠ womensrunningstories.com⁠⁠⁠⁠ Women's Running Stories is a proud member of the Evergreen network:⁠⁠⁠⁠ https://evergreenpodcasts.com/⁠ Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. John Sweetenham shares highlights from Day 5 of the 2025 ASCO Annual Meeting, including data from large trials in advanced malignant melanoma and mCSPC plus a new approach to first-line treatment for patients with multiple myeloma who are not transplant eligible. Transcript Hello, I'm Dr. John Sweetenham, the host of the ASCO Daily News Podcast, with my takeaways on selected abstracts from Day 5 of the 2025 ASCO Annual Meeting. My disclosures are available in the transcript of this episode. The selected abstracts from this final day of ASCO25 include important new data from large, randomized trials in patients with advanced malignant melanoma and patients with metastatic castration-sensitive prostate cancer, as well as a new approach to the first-line treatment of patients with multiple myeloma who are not transplant eligible.  Starting with LBA9500, this study was conducted in patients with completely resected stage III or IV malignant melanoma and compared the combination of relatlimab plus nivolumab versus nivolumab alone in this population. The study, named the RELATIVITY-098 trial, was presented by Dr. Georgina Long from the University of Sydney, Australia. In her introduction to the study, Dr. Long explained that the current standard of care for adjuvant therapy of resected stage III/IV melanoma is with PD-1 monotherapy with nivolumab, but that about 50% of patients will suffer from a subsequent relapse. In the first-line setting in patients with advanced or unresectable melanoma, the combination of nivolumab with the LAG-3 inhibitor, relatlimab, has been previously shown to improve progression-free survival in the RELATIVITY-047 trial. The current study evaluated this same combination in the adjuvant setting. More than 1,000 patients from 24 countries were randomized to receive either nivolumab alone (546 patients) or the combination of nivolumab with relatlimab (547 patients). Both treatments were given for a maximum of 1 year or until progression of disease, unacceptable toxicity, withdrawal, or death. Various biomarker studies were also undertaken including LAG-3 and PD-1 expression on CD8-positive T cells. The primary endpoint of the study was relapse-free survival, and Dr. Long reported that this was the same in both arms of the study. For example, at 24 months, the relapse-free survival was 64% in the monotherapy arm compared with 62% in the combination arm. The hazard ratio was 1.01 and the P value was 0.928. Metastasis-free survival was also identical in both arms. No benefit was observed for the combination in any of the prespecified subgroups. No new toxicity signals emerged compared with the RELATIVITY-047 trial. Interestingly, the baseline surface expression of LAG-3 and co-expression of LAG-3 and PD-1 on CD8 T cells in the 098 adjuvant trial were lower than in the 047 advanced disease trial, perhaps explaining why the combination did not confer benefit over nivo alone in the adjuvant setting. This is an important result, demonstrating that results from one clinical setting cannot always be extrapolated to another. Although the combination has gained some use in the adjuvant setting, this study clearly demonstrates that more drug in this situation is no better and that monotherapy remains the current standard of care. Results from the AMPLITUDE trial for patients with metastatic castration-sensitive prostate cancer with alterations in homologous recombination repair (HRR) genes, in LBA5006, were presented today by Dr. Gerhardt Attard from University College London, UK. This international, multicenter study evaluated the combination of the selective PARP inhibitor, niraparib, in combination with abiraterone acetate and prednisone. The same combination has been previously shown to improve outcomes in castration-resistant metastatic prostate cancer harboring BRCA mutations in the MAGNITUDE study. The current trial included patients with castration-sensitive disease with HRR mutations including BRCA1/2. Six hundred and ninety-six patients were randomized between niraparib, abiraterone, and prednisone plus androgen deprivation therapy, or the same combination with placebo instead of niraparib. Permitted prior therapies included no more than 6 months of prior androgen deprivation therapy and the use of docetaxel, or prior palliative radiation therapy. The primary endpoint of the study was radiographic relapse-free survival. Dr. Attard reported that the risk for radiographic progression-free survival in the whole population was significantly reduced by 37% with niraparib and abiraterone acetate plus prednisone compared with the placebo arm. The radiographic progression-free survival risk reduction with niraparib in the prespecified BRCA1/2 subgroup was 48% and reached statistical significance compared with the placebo arm. The secondary endpoint of time to symptomatic progression was also improved with niraparib in the HRR population and the BRCA1/2 subgroup. There was a trend for overall survival favoring the niraparib combination. However, the overall survival data were immature at this first interim analysis and did not yet reach statistical significance. No new safety concerns emerged with the toxicity data consistent with the MAGNITUDE study. Less than 5% more of the patients on the experimental arm discontinued treatment in comparison to the control arm. The authors conclude that the AMPLITUDE study results support the use of niraparib, abiraterone, and prednisone as a new treatment option for patients with metastatic castration- sensitive prostate cancer and BRCA and homologous recombination repair gene alterations. The results certainly support this conclusion and are potentially practice-changing. Turning to hematologic malignancies, my final selection from today's presentations is Abstract 7504, presented by Dr. Hang Quach from St Vincent's Hospital, Melbourne, Australia, and describes a novel combination of elranatamab, daratumumab, and lenalidomide in patients with newly diagnosed multiple myeloma who are not transplant-eligible – the so-called MagnetisMM-6 trial part 1. Elranatamab is a novel bispecific T-cell engaging antibody directed against BCMA and CD3, which has previously been approved for certain patients with relapsed and refractory multiple myeloma. In the present study, this was combined with lenalidomide and daratumumab in newly diagnosed patients. The report today describes the dose-finding phase of this study, which was part 1, specifically addressing so-called dose level ‘G', comprising elranatamab 76mg subcutaneously every 4 weeks plus daratumumab 1800mg subcutaneously and lenalidomide 25mg given orally. Thirty-seven patients were entered at this dose level, of whom 32 were on treatment at the time of analysis. Early response data show an overall response rate of 97.3%. With median follow up of 7.9 months, the current CR rate is 27% with a VGPR rate of almost 68%. The most frequent toxicities were hematologic, with neutropenia observed in 75%. Some cytokine release syndrome was observed in about 60% of patients, but none was greater than grade 2. The authors conclude that this combination is active in untreated multiple myeloma, with manageable toxicity and evidence of responses which appear to deepen over time. The dose-finding component of this trial is continuing and will subsequently progress into a phase 3 trial based on the data from the current study. This will compare daratumumab plus lenalidomide with the same combination plus elranatamab in previously untreated patients. That concludes our special coverage from the 2025 ASCO Annual Meeting. Thanks for listening and we hope you have enjoyed listening to our top takeaways from ASCO25. If you value the insights that you hear on the ASCO Daily News Podcast, please remember to rate, review, and subscribe wherever you get your podcasts. 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.  Find out more about today's speaker:    Dr. John Sweetenham    Follow ASCO on social media:     @ASCO on Twitter    @ASCO on Bluesky    ASCO on Facebook    ASCO on LinkedIn     Disclosures:   Dr. John Sweetenham:    No relationships to disclose

In this episode, Dr. Vonda Wright sits down with Dr. Corinne Menn, a board-certified OBGYN, Menopause Society Certified Practitioner, and 23-year breast cancer survivor who brings both clinical expertise and lived experience to the menopause conversation. A BRCA carrier and surgical menopause patient, Dr. Menn is a fierce advocate for women navigating cancer risk, premature menopause, and hormone health.   Together, they unpack the major gaps in menopause care—from the underuse of hormone therapy (only 4–5% of women use it) to the widespread misinformation among healthcare providers. Dr. Menn sheds light on how women with conditions like endometriosis, PCOS, or hereditary cancer risk are often excluded from mainstream menopause discussions and left without support. She explains why many cancer survivors can safely use hormone therapy under updated guidelines and why progesterone is still needed even after hysterectomy if endometriosis was present.   This powerful conversation is a must-listen for anyone impacted by surgical or early menopause, and those advocating for more compassionate, informed, and personalized care. ••• Connect with Dr. Corinne Menn: Instagram: @drmennobgyn TikTok: @drmennobgyn Website: www.drmenn.com Alloy Website: www.myalloy.com ••• Make sure to follow Dr. Vonda Wright: Instagram: @drvondawright Youtube: https://www.youtube.com/@vondawright Tiktok: https://www.tiktok.com/@drvondawright LinkedIn: https://www.linkedin.com/in/vonda-wright-md-ms-2803374 Website: http://www.DrVondaWright.com ••• If you enjoyed this episode, Subscribe to “HOT For Your Health” for more inspiring episodes. Apple Podcast: https://podcasts.apple.com/us/podcast/hot-for-your-health/id1055206993 Spotify: https://open.spotify.com/show/1Q2Al27D79jCLAyzp4hKBv?si=b62b374994884eed We'd love to hear your thoughts on this episode! Share your comments or join the discussion on social media using #HotForYourHealthPodcast.

In this episode of Death Clock, host Brant Franson speaks with Dr. Anne Marie McCarthy, a cancer epidemiologist from the University of Pennsylvania, to unravel the complexities of breast cancer prevention and screening. They explore the role of genetics, particularly BRCA mutations, and how family history can influence screening strategies. Dr. McCarthy shares insights into the nuanced decisions around genetic counseling, the limitations of over-the-counter tests, and why population-wide genetic screening is still a topic of ongoing debate. They also discuss broader issues like the psychological and economic costs of false positives, overdiagnosis, and overtreatment. From lifestyle factors to systemic constraints in healthcare access, this episode offers a comprehensive look at what it means to be proactive when it comes to breast cancer risk. Hope you enjoy.

In this episode, host Shikha Jain, MD, speaks with Sadie Dobrozsi, MD, about the power of information in personalized oncology care, understanding the impacts of genetic testing and more. •    Welcome to another exciting episode of Oncology Overdrive 1:34 •    About Dobrozsi 1:39 •    The interview 2:03 •    What was your path to this field of pediatric oncology, and how did you decide to focus on genetic testing?  2:33 •    Can you talk about what it means to use genomics to optimize therapy and tailor precision medicine, and how you implement that in your work? 7:58 •    Why is it so important to continue focusing on funding precision medicine as an advancement in cancer care? 10:34 •    Can you talk about your work with BRCA research and how treatment and surgeries have evolved with our understanding of it?  14:30 •    Jain and Dobrozsi on the importance of shared decision-making in oncology, and how genomics plays a role in that ongoing conversation. 20:18 •    How do we navigate difficult conversations with increasingly younger patient populations, and why are we having these conversations more now than ever before? 23:55 •    When it comes to genetic testing, how much knowledge is “good knowledge”? 27:05 •    If someone could only listen to the last few minutes of this episode, what would you want listeners to take away? 34:31 •    How to contact Dobrozsi 35:12 •    Thanks for listening 35:39 Sadie Dobrozsi, MD, is a board-certified pediatric oncologist, a nationally recognized leader in complex care delivery, and the medical director of genetic testing and oncology imaging at Evolent, a leading specialty and primary care management company.  We'd love to hear from you! Send your comments/questions to Dr. Jain at oncologyoverdrive@healio.com. Follow Healio on X and LinkedIn: @HemOncToday and https://www.linkedin.com/company/hemonctoday/. Follow Dr. Jain on X: @ShikhaJainMD. Dobrozsi can be reached on LinkedIn or via email sdobrozsi@evolent.com. Disclosures: Jain and Dobrozsi report no relevant financial disclosures. 

In this episode, Bahar Etminan speaks with Krystal Barter, a leading advocate for women's health, to discuss her remarkable journey and the broader challenges surrounding BRCA1, breast cancer, and medically induced menopause. Krystal shares her personal experience of being diagnosed with the BRCA gene mutation, her proactive approach to managing her health, including surgeries and hormone replacement therapy, and her mission to empower women through education and support. The conversation delves into Krystal’s advocacy work with Pink Hope, her role in creating awareness around genetic testing, and her upcoming event, So Hot Right Now, which addresses menopause in a holistic and empowering way. Together, they explore the future of genomics in healthcare, legislative changes concerning genetic rights, and how women can take control of their health through knowledge and community. With insights from leading experts, this episode shines a light on the importance of open dialogue about women's health, genetic predispositions, and proactive steps towards longevity and wellness. Watch the full episode here: https://youtu.be/S_9ZnsiC4gsSee omnystudio.com/listener for privacy information.

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

Love the episode? Send us a text!Genetic tests like 23andMe are perceived as a fun and engaging way to explore family history,  However, the implications of genetic testing extend beyond mere curiosity about ancestry; they touch on the very fabric of our lives and the lives of our loved ones. For those who discover they carry genes associated with increased cancer risk, like Lesser, the stakes are high. It raises questions about proactive measures, such as screenings or preventive surgeries, and how these decisions affect not only the individual but also their family members. Lesser's narrative illustrates the emotional complexity of being a previvor—someone who has not yet developed cancer but carries a genetic predisposition. The conversations around such decisions often involve family dynamics, as loved ones grapple with the implications of their own genetic risks and the potential need for testing.SURVIVINGBREASTCANCER.ORGAttend a free virtual yoga class:https://www.survivingbreastcancer.org/movement-mondaysAttend a free virtual SurvivingBreastCancer.org event:https://www.survivingbreastcancer.org/eventsFollow us on InstagramSurvivingBreastCancer.org: https://www.survivingbreastcancer.org/Breast Cancer Conversations: https://www.instagram.com/breastcancerconversations/About SurvivingBreastCancer.org: SurvivingBreastCancer.org, Inc. (SBC) is a federally recognized 501(c)(3) non-profit virtual platform headquartered in Boston with a national and global reach. Through education, community, and resources, SurvivingBreastCancer.org supports women and men going through breast cancer. We provide a sanctuary of strength, compassion, and empowerment, where those diagnosed with cancer unite to share their stories, learn invaluable coping strategies to manage wellness and mental health, and find solace in the unbreakable bond that fuels hope, resilience, and the courage to conquer adversity.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.

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

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)  

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

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.

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.

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.

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.