Podcasts about Cancer Care Ontario

In this episode, Ayesha spoke with Margaret Froh, President of the Métis Nation of Ontario (MNO). Margaret is also a lawyer by training.  The Métis are a distinct Indigenous people recognized in s.35 of Canada's Constitution. Métis communities have their own shared customs, traditions and collective identities that are rooted in kinship, their special aboriginal relationship to the land and a distinctive Indigenous culture and way of life that persists to the present day.  Cancer is a significant concern among Métis people in Ontario and across the Métis Nation Homeland, including women, as they experience higher cancer rates and lower cancer screening uptake than the non-Indigenous population.  Cancer Prevention Action Week, which took place during the third week of February, focuses on supporting and empowering people to make changes to their lifestyle and promoting routine cancer screening to reduce the risk of preventable cancers.  To help uncover and address cancer disparities among the Métis, Margaret has helped lead Métis-specific health research in collaboration with organizations like Ontario Health (formerly Cancer Care Ontario) and the Sunnybrook Research Institute.  Margaret is also a recent breast cancer survivor and by sharing her personal cancer story, is helping raise awareness about the importance of routine cancer screening among the Métis.  Tune into the episode to learn about the disproportionate impact of cancer on Métis communities and how Margaret's leadership at the MNO is helping to drive changes to help improve cancer screening rates and better health outcomes.  For more life science and medical device content, visit the Xtalks Vitals homepage. https://xtalks.com/vitals/  Follow Us on Social MediaTwitter: https://twitter.com/Xtalks Instagram: https://www.instagram.com/xtalks/ Facebook: https://www.facebook.com/Xtalks.Webinars/ LinkedIn: https://www.linkedin.com/company/xtalks-webconferences YouTube: https://www.youtube.com/c/XtalksWebinars/featured

On this episode of The DocTalks Podcast, host Ian Gillespie sits down with St. Joseph's Health Care London urologist Dr. Stephen Pautler to discuss a topic that is difficult for most men to talk about - prostate cancer. An associate professor of surgery and oncology at Western University, lead for Southwest Regional Surgical Oncology at Cancer Care Ontario and a Canadian pioneer in surgical robotics, Dr. Pautler is an internationally-acclaimed and highly respected leader in prostate care. He has been watching the changing tide of screening opinions over many years and wants men to know that screening is important to their health and a straightforward process. Prostate screening happens in two steps starting with a PSA test. “PSA is a simple blood test that looks for levels of a protein in the blood,” explains Dr. Pautler. “PSA is made by the prostate, and high levels mean a higher risk cancer is present. But this test isn't perfect, as it can sometimes come back with inconclusive results or false positives.” The second part of the screening is a rectal exam. “In my experience, men tend to build up this little exam in their heads. We are simply looking for lumps and bumps, which is a key indicator and an important thing to check. I've been in this field a long time, and the hype men give this is way worse than the exam. Men really need to move past the perceived awkwardness – because it's important.”  Want to learn more? Listen for free to the DocTalks Podcast episode with Dr. Pautler. For more information visit www.sjhc.london.on.ca/podcast or follow us on Twitter @stjosephslondon. Brought to you in partnership with St. Joseph's Health Care Foundation.Note: The content of St. Joseph's DocTalks Podcasts is for informational purposes only. The material is not intended for and should not be used as a substitute for direct medical advice from a licensed health care practitioner.Produced by The Pod Cabin and Kelsi Break Help a Patient Who Can't Go Home for the Holidays!Season of Celebration began with a single question from the care-giving team, "How can we make Christmas a little brighter for those in our care, who can't go home for the holidays?" What began as a single wish, has now become a beloved community campaign in support of St. Joseph's mission of care. Did you know there are more than 1,000 inpatient beds at St. Joseph's? We are a home for Veterans, residents in our long-term care facility, people in our mental health program and those requiring specialized care. Many of these people will not have the option of leaving our care to visit family over the holidays.Your gift to Season of Celebration will support the purchase of care and comfort items that make a hospital feel more like home — everything from accessible furniture and exercise equipment to blanket warmers and interactive technology that keeps those in hospital connected to the outside world.

Henry talks with Nancy Baxter, a Canadian surgeon and public health researcher. She is the Head of Melbourne University's School of Population and Global Health, while continues to maintain her appointment as Professor of Surgery in the Department of Surgery and the Institute of Health Policy, Management and Evaluation at the University of Toronto. [1] She is a scientist with the Li Ka Shing Knowledge Institute[2] and is a Senior Scientist in the Cancer Theme Group with the Institute for Clinical Evaluative Sciences (ICES). Baxter has achieved board certifications through the American Board of Surgery (2000) and the American Board of Colon and Rectal Surgery (2002). She is a Fellow of both the American College of Surgeons and the Royal College of Physicians and Surgeons of Canada. She served as the Associate Dean, Academic Affairs[3] at the Dalla Lana School of Public Health from 2016 to 2020. She was Provincial GI Endoscopy Lead[4] for Ontario at Cancer Care Ontario from 2013 to 2020. This conversation was originally broadcast on 3SER's 97.7FM Casey Radio in March 2022. It was produced by Rob Kelly.

This week's episode is featuring Elise Gasbarrino, Editor-in-Chief at Style Canada, and founder of Pink Pearl Canada.Elise has spent over a decade establishing herself in the world of fashion and lifestyle. Living in New York City for the majority of that time and working for iconic brands such as Oscar de la Renta and British luxury brand Burberry.Elise is passionate about her involvement in initiatives that support women. Her entrepreneurial spirit has led her to invest in female-founded start-up organizations. Her personal experience with cancer lead her to found Pink Pearl Canada, a registered Canadian charitable organization focused on bringing together young women affected by cancer through a network of peer support and innovative programs.Elise is a recipient of the Burberry Icon Award, has been recognized by Cancer Care Ontario with their Human Touch Award, and received the Community Leadership Award from her alma mater The Lazaridis School of Business and Economics at Wilfrid Laurier University.We talk about:- Taking risks as an entrepreneur   - Purchasing Style.ca and the growth of Style Canada- Starting her own charitable organization after her own personal experience with cancer- Balancing her time with running two businesses- Challenges she's overcome with her businessAnd more!Resourcesstyle.ca/pinkpearlcanada.org/

Colorectal cancer (CRC) is the third most diagnosed cancer in Canada. About 26,900 Canadians will have been diagnosed with colorectal cancer in 2020. That's 1 in 14 men and 1 in 18 women who will be diagnosed with colorectal cancer in their lifetime. In this episode, we're  joined by Dr. Barry Lumb, professor of Department of Medicine and a Gastroenterologist and the Regional Endoscopy Lead for Cancer Care Ontario to discuss the importance of colorectal cancer screening, risk factors and how to reduce your risk.  The Cancer Assist Show is hosted by Dr. Bill Evans, MD, FRCP, Past President of the Juravinski Hospital and Cancer Centre at HHS. Brought to you by the Cancer Assistance Program – an organization lending support to cancer patients and families of those affected by cancer.---The Cancer Assist Show and its content represent the opinions of Dr. Bill Evans and guests to the podcast. Any views and opinions expressed by Dr. Bill Evans and guests are their own and do not represent those of their places of work. The content of The Cancer Assist Show is provided for informational, educational and entertainment purposes only, and is not intended as professional medical, legal or any other advice, or as a substitute or replacement for any such advice. The Cancer Assist Program, Dr. Bill Evans and guests make no representations or warranties with respect to the accuracy or validity of any information or content offered or provided by The Cancer Assist Show. For any medical needs or concerns, please consult a qualified medical professional. No part of The Cancer Assist Show or its content is intended to establish a doctor-patient or any other professional relationship. This podcast is owned and produced by the Cancer Assistance Program.

In the months since the pandemic hit, many parts of normal life have come to a stop. But while so much has been on hold or locked down to keep people safe and the health-care system functioning, oncologists fear that pause has contributed to another potential crisis. "What we're worried about, of course, is that there may be a tsunami of cancer out there that's going to suddenly show up," said Dr. Keith Stewart, director of the Princess Margaret Cancer Centre in Toronto.  Cancer specialists are worried about the significant drop in the number of cancer screening, referrals and diagnoses in Canada since the pandemic began in March. It doesn't mean that cancer rates are dropping — experts say it means that cases are being missed and people aren't getting the treatment they need. GUEST: Dr. Ralph Meyer, Vice President, Oncology and Palliative Care with Hamilton Health Sciences, Regional Vice President of Cancer Care Ontario and a Professor in the Department of Oncology at McMaster University See omnystudio.com/listener for privacy information.

In this episode, we were joined by surgical oncologist Dr. Carolyn Nessim (www.twitter.com/carolynnessim). Dr. Nessim works at the Ottawa General Hospital and gave us a masterclass on melanoma. We talk about an initial approach to melanoma, staging, immunotherapy, and a walk-through of how Dr. Nessim does her groin dissections. Links 1. http://carolynnessim.com/ 2. The eighth edition American Joint Committee on Cancer (AJCC) melanoma staging system: implications for melanoma treatment and care. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652033/ 3. Cordeiro et al. Sentinel Lymph Node Biopsy in Thin Cutaneous Melanoma: A Systematic Review and Meta-Analysis. https://pubmed.ncbi.nlm.nih.gov/26932710/ 4. Socioeconomic Status and Melanoma in Canada: A Systematic Review. https://pubmed.ncbi.nlm.nih.gov/32955341/ Brief Bio: Dr. Carolyn Nessim is a Surgical Oncologist at the Ottawa Hospital and Assistant Professor of Surgery at the University of Ottawa. She completed her MD, MSc (Biomedical Sciences) and General Surgery Residency at the University of Montreal. Her fellowship training was in Surgical Oncology at the University of Toronto and then at the Peter MacCallum Cancer Center in Melbourne Australia. She is currently also a Clinician Investigator in the Cancer Therapeutics Program at The Ottawa Hospital Research Institute (OHRI) as well as the Program Director for the Complex Surgical Oncology Subspecialty Fellowship training program. Her clinical practice focuses on the treatment of patients with Soft Tissue Sarcoma/GIST, Melanoma/Skin Cancers, Gastric cancer and Neuroendocrine Tumours. She is the Regional Co-Lead for Melanoma and Skin Cancers and Gastric Cancer in the Champlain LHIN. She has been invited as a speaker and moderator at several national and international conferences on the topics of Sarcoma and Melanoma. She is a member of Cancer Care Ontario's Skin Cancer Advisory Board as well as the American Society of Clinical Oncology's Technical Expert Group for Melanoma.

How has healthcare delivery changed as a result of COVID-19? What is being done at Juravinski Cancer Centre to keep patients and staff safe during this pandemic?Dr. Bill Evans is joined by Debbie Logel Butler Executive Director, Cancer Assistance Program, Dr. Ralph Meyers VP, Oncology & Palliative Care at Hamilton Health Sciences and Regional VP at Cancer Care Ontario, and Kristi MacKenzie, Director, Regional Cancer Program at Juravinski Cancer Centre for a discussion on cancer care during phase 2 of the province's reopening.The Cancer Assist Show is hosted by Dr. Bill Evans, MD, FRCP, Past President of the Juravinski Hospital and Cancer Centre at HHS. Brought to you by the Cancer Assistance Program – an organization lending support to cancer patients and families of those affected by cancer.---The Cancer Assist Show and its content represent the opinions of Dr. Bill Evans and guests to the podcast. Any views and opinions expressed by Dr. Bill Evans and guests are their own and do not represent those of their places of work. The content of The Cancer Assist Show is provided for informational, educational and entertainment purposes only, and is not intended as professional medical, legal or any other advice, or as a substitute or replacement for any such advice. The Cancer Assist Program, Dr. Bill Evans and guests make no representations or warranties with respect to the accuracy or validity of any information or content offered or provided by The Cancer Assist Show. For any medical needs or concerns, please consult a qualified medical professional. No part of The Cancer Assist Show or its content is intended to establish a doctor-patient or any other professional relationship. This podcast is owned and produced by the Cancer Assistance Program.

Born and raised in Canada, Victoria Watson is a health policy specialist driven to close equity gaps in sexual and reproductive health and rights. Before joining the International Youth Alliance for Family Planning, Victoria worked in Washington, D.C. at the Center for Health and Gender Equity as an SRHR research analyst exploring the impact of foreign policy and legislation on reproductive justice, health, and human rights fulfillment. In Canada, she has worked as a policy coordinator at Cancer Care Ontario facilitating patient engagement and cancer screening program design, wherein she honed a passion for generating patient-centered policies and programming. Her personal experience as a cancer survivor motivated a life-long commitment to non-communicable disease (NCD) advocacy and community engagement, and for this reason, Victoria also sits on the Governing Council of NCD Child, a global advocacy coalition championing youth health rights in global NCD control. As a teenager, Victoria was an ambassador for Canada’s Children’s Wish Foundation, being a public speaker and sharing her story as a survivor to emphasize the need for integrated social support for cancer patients. Following her undergraduate in public policy and MSc. in Global Health, she applied her research and work experiences to better understand the social determinants to health that put youth at greater risk of preventable chronic diseases, and what health systems can do to make care more accessible, affordable, and meaningful for diverse populations. This led her to work at high-level global health organizations such as the Clinton Foundation, to working within hospitals in southern India. What you’ll learn about in this episode: How Victoria’s organization operates in more than 80 countries, advancing sexual and reproductive health rights, and justice for young people and adolescents globally How the International Youth Alliance for Family Planning was founded in 2013 as a movement of young people pressing to be included in the discussion around global health policy-making and discourse What organizational, cultural and financial challenges the IYAFP faced as a young, global organization How the IYAFP maneuvered and scaled up from being a grassroots organization to a formalized INGO What advice Victoria has for nonprofits just starting out and for nonprofits that have reached a plateau and are having trouble progressing What common problems organizations face when reaching a growth plateau, and why refocusing your organization on its mission can often help correct these issues Why utilizing communication best practices can help strengthen your team and reorient your team around the organization’s vision What practical, actionable advice Victoria has for nonprofit organizations attempting to navigate the global pandemic crisis Why taking the time to do a strategic refresh can help you identify ways to adapt to crisis and your changing environment Why data, communication with stakeholders, and a focus on the community you serve and its needs can help you navigate challenging times Additional resources: Website: https://iyafp.org/ LinkedIn: www.linkedin.com/in/victoria-watson-aba9a752/ Additional resources from Wild Apricot: Website: www.wildapricot.com Episode Host, Alexandra Morgan’s LinkedIn: www.linkedin.com/in/alexandramorganca/ Facebook: www.facebook.com/wildapricot Twitter: @WildApricot

With 25 years of experience leading change in the health care and non-profit sectors and an MBA from the Smith School of Business, Laura now turns her passion to setting fellow women leaders on fire for the next phase of their careers. She sees a vast untapped resource in senior women leaders and has created the Feeling On Fire coaching program and the Flourishing Business Collective for entrepreneurs as tools in her mission to rouse fellow leaders to even greater contribution and purpose. In her own career within the health sector, Laura and her team set the standard for patient-centred care in Ontario and beyond. She was an expert panel member for Accreditation Canada, advising on the first national standards for client-centred care. Laura has also held senior roles at leading organizations such as Cancer Care Ontario, Mount Sinai Hospital, Patheon Inc. and Baxter, where she has been recognized with awards for excellence including a Rising Star award amongst others. Frequently called on as a speaker and moderator at conferences across Canada, England and the United States, Laura presents on a broad range of topics from the patient experience to resilience. A life-long volunteer, she is passionate about supporting youth at risk and in 2015 developed a resilience program for youth living in a shelter. Contact Laura Macdougall: LauraMacdougall.com Do you want to live an incredible life? Get started now by reading my book: "Visualizing Happiness in Every Area of Your Life" https://amzn.to/2kvAuXU What is your biggest obstacle to creating an incredible life? You can book a free 15-minute mentoring session with Dr. Kimberley Linert. Click on this booking link: https://calendly.com/drkimberley/15min Please subscribe to the podcast and take a few minute to review on iTunes, Thank you If you have an amazing story to tell about your life and how you are sharing your gifts and talents with the world, then I would love to have you as a guest on my podcast. Contact me via email: incrediblelifepodcast@gmail.com or private message me on Facebook: www.facebook.com/incrediblelifecreator Contact Dr. Kimberley Linert: DrKimberleyLinert.com

An interview with Dr. Nasser Hanna from Indiana University Simon Cancer Center and Dr. Gregory Masters from Helen F. Graham Cancer Center and Research Institute on "Therapy for Stage IV Non-Small-Cell Lung Cancer Without Driver Alterations: ASCO and OH (CCO) Joint Guideline Update." This guideline provides recommendations on systemic therapy treatment options for patients with stage IV non-small-cell lung cancer (NSCLC) without driver alterations in epidermal growth factor receptor or ALK, based on histology, PD-L1 status, and/or the presence or absence of contraindications. Read the full guideline at www.asco.org/thoracic-cancer-guidelines.  Transcript [MUSIC PLAYING] 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. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. [MUSIC PLAYING] Hello, and welcome to the ASCO Guidelines Podcast series brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all the shows including this one at podcasts.asco.org. My name is Brittany Harvey. And today, I'm interviewing Dr. Nasser Hanna from Indiana University's Simon Cancer Center and Dr. Gregory Masters from Helen F. Graham Cancer Center and Research Institute, co-chairs on therapy for stage IV, non-small cell lung cancer without driver alterations, ASCO and CCO Joint Guideline Update. Thank you for being here today Dr. Hanna and Dr. Masters. Thank you. Glad to be with you. My pleasure. Thanks. First, Dr. Hanna, can you give us a general overview of what this guideline covers? Sure. So the ASCO guidelines for the treatment of patients with stage IV, non-small cell lung cancer were last updated in 2017. And since that time, there has been a tremendous amount of change that has taken place. The 2017 guidelines included recommendations for basically three subgroups-- those patients with non-small cell lung cancer who have certain targetable DNA mutations and those who do not have those mutations but have a PD-L1 score of 50% or higher and then everyone else. But because of the rapid and vast changes that have taken place, we decided to make a separate guideline for those with targetable DNA mutations and to focus this current guideline on those without the targetable mutations. So within that context, this guideline categorizes patients by whether their tumors have a PD-L1 score of 0% to 49% or those who have a PD-L1 score or 50% or greater. And within those categories, recommendations are characterized based upon whether the patient has squamous cell histology or non-squamous cell histology. And we also consider whether patients are candidates for chemotherapy or perhaps even those that decline chemotherapy and whether they have any contraindications for immunotherapy. So what distinguishes these guidelines from other guidelines is our attempt to adhere to the strongest available evidence-based medicine. And while not every iteration of clinical management can be covered, these guidelines provide oncologists with a strong, evidence-based roadmap to treat the vast majority of patients with non-small cell lung cancer. So as a result of this collective effort by ASCO staff and the guideline writing committee, this report offers a substantial amount of change to the recommendations from the clinical practices guidelines provided in 2017. In 2017, the only recommendations for the use of immunotherapy were in the first line setting for patients who had a PD-L1 score of greater than 50% and in the second line setting of patients progressing after first line chemo. But these updated guidelines include the incorporation of immunotherapy in all subgroups of patients regardless of histology and PD-L1 score. So as a result, there are about three times the number of options to consider in the first line setting with these new guidelines compared to the 2017 guidelines. However, the 2020 guidelines provides a preferred treatment regimen for each situation to simplify the decision making process for most patients. And what are those key recommendations of this guideline update for patients without driver alterations? So the key changes for 2020 is the incorporation of immunotherapy into nearly all settings in the first line setting, regardless of tumor histology and regardless of PD-L1 score. For those patients who have a PD-L1 score of 50% or higher, single agent pembrolizumab remains the preferred treatment for most patients. But new evidence does provide a rationale for giving select patients chemotherapy, either carbo and pemetrexed if they have non-squamous, or carbo plus paclitaxel or nab-paclitaxel for squamous plus the addition of pembrolizumab in this subgroup of patients. For those patients with PD-L1 scores of 0% to 49% who are eligible and willing to take chemotherapy, these new guidelines recommend chemotherapy plus pembrolizumab. For those who have a PD-L1 score of 1% to 49% are not appropriate for chemo or decline chemotherapy, these guidelines suggest single agent pembrolizumab as a reasonable option. The guidelines also provide the option of alternative chemo immunotherapy regimens to be used in patients with non-squamous, non small-cell that were not included in the prior guidelines. And while these are not necessarily preferred for most patients, select patients can be considered for these regimens, which include the immunotherapy drug, atezolizumab, and combination chemo with atezolizumab and bevacizumab. And the guidelines provide some commentary on potential scenarios in which these options should be considered. Dr. Masters, why is this guideline important, and how will it change practice? Well, the new ASCO CCO joint non-small cell lung cancer guideline update is important in that it clarifies recommendations for an international audience and is co-sponsored by the American Society for Clinical Oncology and Cancer Care Ontario. These guidelines were developed through a rigorous, evidence-based process with a broad range of experts, including a multidisciplinary team of clinicians, researchers, data specialists, and patient representatives. The new guideline update provides a comprehensive review and analysis of the current literature on the treatment of advanced non-small cell lung cancer. The current update also includes a data supplement with evidence tables, slide sets, and links to patient information through cancer.net, ASCO's patient information website. In an increasingly complicated environment for oncologists, managing patients with advanced cancer, we're learning how to incorporate molecular testing and other biomarkers. And this guideline will help change day-to-day practice for clinicians as they implement these recommendations. This guideline will help clarify the optimal treatment strategies for non-small cell lung cancer patients without driver gene mutations and allow individualization based on tumor histology and immunotherapy biomarkers, such as PD-L1 testing. At the same time, the update allows clinicians to use their individual judgment and experience to incorporate unique, intangible characteristics of patients. It also emphasizes the importance of patient preferences in deciding the optimal care for an individual affected by advanced non-small cell lung cancer. And finally, how will these guideline recommendations impact patients? The broad range of experts who've contributed to these guidelines includes a multidisciplinary team, including clinicians, researchers, data specialists, and patient representatives. This assures patients of a consensus opinion based on the available clinical research on treating advanced non-small cell lung cancer. It provides clinicians with the best up-to-date distillation of the many complicated trials of chemotherapy and immune checkpoint inhibitor therapy in an area where patient-centered, precision medicine dictates the optimal treatment strategies. We incorporate molecular testing in these guidelines, although this particular guideline is directed at patients without driver gene mutations. We include recommendations on implementation of chemotherapy and immunotherapy based on the best available data on biomarker testing for PD-L1. We recognize, however, that new research continues into treatment strategies and molecular analysis to help guide incorporation of targeted therapy and immunotherapy. We recognize that new treatment options and combinations will become available, and new testing techniques will help guide the decision process in the future. We plan to continue to analyze the available research and update these guidelines as clinically indicated to provide the best options for our patients. Most of our patients will still be treated with palliative intent. But a growing number of patients have sustained control of their cancer with recent studies and updates suggesting that up to 25% of patients may have control of their disease for five years or longer. Now that more patients can maintain their quality of life with prolonged survival, with the current therapy, it is also critical that we continue to look to patient reported outcomes as an important way of defining the best options for our patients. Thank you both for your work on this ASCO CCO guideline update for therapy for stage IV, non-small cell lung cancer without driver alterations and for coming on the podcast today to provide an interview, Dr. Hanna and Dr. Masters. Thanks for having us on the program. And we have enjoyed being part of the process. Thank you. And thank you to all our listeners for tuning into the ASCO Guidelines Podcast series. To read the full guideline, go to www.asco.org/thoracic-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available and iTunes or the Google Play Store. If you've enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. [MUSIC PLAYING]

An interview with Dr. Philip Saylor from Massachusetts General Hospital on "Bone Health and Bone-Targeted Therapies for Prostate Cancer: ASCO Endorsement of a Cancer Care Ontario Guideline." This guideline includes recommendations for management of osteoporotic fracture risk in nonmetastatic disease and interventions for men with castration-resistant prostate cancer metastatic to bone. Read the full guideline at www.asco.org/genitourinary-cancer-guidelines.  Transcript [MUSIC PLAYING] 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. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. [MUSIC PLAYING] Hello, and welcome to the ASCO Guidelines Podcast series brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all the shows, including this one, at podcast.ASCO.org. My name is Brittany Harvey, and today I'm interviewing Dr. Philip Saylor from Massachusetts General Hospital, lead author on "Bone Health and Bone-Targeted Therapies for Prostate Cancer: ASCO Endorsement of a Cancer Care Ontario Guideline." Thank you for being here today, Dr. Saylor. Oh, it's my pleasure. First, can you give us a general overview of what this guideline covers and about the endorsement process? Yes. So the Cancer Care Ontario has a program in evidence-based medicine, and they periodically put out clinical practice guidelines for management of a whole variety of topics. And they relatively recently put out a publication on bone health and bone-targeted therapies in prostate cancer. And so that's a really big topic because bone health is such a big part of prostate cancer care across the entire range of scenarios that patients can face. And their guideline addresses topics all the way from osteoporosis and fragility fractures and that risk as it relates to GnRH agonist, androgen deprivation therapy that men can get for really any prostate cancer scenario, goes all the way from that to improving quality of life in patients who have bone metastases that have progressed despite systemic therapy. So it's really a very broad series of topics that they addressed. And so when they put out that guideline, ASCO identifies it as something that's very relevant to the ASCO community and goes through, then, a formal process of reviewing the methodology of those guidelines and then having an expert panel discuss the quality and evidence of the guidelines and really provide, if appropriate, an endorsement and some additional discussion of those topics. So what are the key recommendations of this guideline? They really have four sort of subtopics within this bone-themed guideline that are addressed and discussed in a fair amount of detail. And each one of those four topics deserves some of its own discussion. The first topic is osteoporosis and risk for just fragility fractures, like hip fracture and vertebral body compression fractures. That's one. The second is potential prevention of bone metastases in a patient that does not yet have bone metastases. The third one is management of castration-resistant prostate cancer metastatic to bone. And the fourth one is symptomatic management of men with CRPC metastatic to bone. So it is probably worth discussing each one of those, in some detail, one by one. So for the osteoporosis fracture risk question, Cancer Care Ontario, their recommendation really is that men with non-metastatic prostate cancer at high risk for fracture who are receiving ADT should be considered for the osteoporosis dosing of denosumab. And in situations or places where denosumab is not available, then patients can consider a bisphosphonate as an alternative. So we had a fair amount of discussion of that recommendation. We endorsed that recommendation. And I guess my personal emphasis would be that osteoporotic fracture risk is really the biggest challenge to that is not forgetting about it. So you can often have men who are in a good prostate cancer scenario, likely to be cured by their therapy. They're going to get some duration of ADT. And they look healthy as they sit there in clinic with you. They're likely to do well from a prostate cancer standpoint. And it just would be so easy not to adequately screen for osteoporotic fracture risk, and just not to remember that because so many of our discussions together in clinic are focused on the prostate cancer more than the broader health questions. And so, I mean, to me, I think not forgetting about this issue is really one of the most important things to emphasize in any discussion of osteoporosis. And so really, it's a fairly simple problem to screen for and manage. Most men should be, if they're going to be on any duration of ADT, should be tested with a bone density test, a DEXA scan. It's really a fairly inexpensive and easy test for getting a sense for where their bone health is as they begin. And I usually tell my patients in clinic that most men don't need any new prescription medicines to manage that risk, but we'll never figure out the ones who need it unless we go through the very disciplined systematic work of doing that screening. And then among those who really do deserve treatment, it's really denosumab at the osteoporosis dosing or a bisphosphonate. Really, any of those choices really works well for improving bone mineral density. One of the big ASCO discussion points is that denosumab is the only medicine that's been shown definitively to improve fracture risk in this setting. But that's really a product of denosumab being studied in a really large prospective randomized controlled trial. And so that's one where they required more than 1,000 patients in order to assess that fracture endpoint. So the reason, perhaps-- probably the most important reason that bisphosphonates have not been shown to improve fractures is that none of them have been studied in such a big study. The bone mineral density trials that have studied bisphosphonates are all on the order of maybe 30 to 100 patients rather than 1,000. So really, in many clinical settings, cost and convenience are important considerations. And when those are factored in, it's often very reasonable to use a bisphosphonate rather than denosumab, though either one really could be considered a gold standard. So that's point number one from the guidelines. Number two really discusses the issue of prevention of bone metastases. And so there are a couple of sub-recommendations from Cancer Care Ontario. But really, the most important point from that is that there is no bone-targeted drug that has been shown to prevent or delay the development of the first bone metastasis. So a number of different studies have tried to address this question in slightly different clinical scenarios. But the bottom line is, we don't use bone-targeted medicines to prevent the first bone metastasis. And so there's always been sort of an attractive potential effectiveness there because you think if your bone-targeted therapy changes the bone microenvironment, could the natural history of prostate cancer play out differently? But the answer is that we really don't have any convincing evidence of effectiveness on that front using any drug, in any situation. So that's a pretty easy one to summarize. For the third category of situation that's addressed in the guideline really relates to castration-resistant prostate cancer metastatic to bone. And so there are three sub-recommendations there. In that situation, either zoledronic acid or denosumab in monthly dosing at the skeletal event preventing dosing is a gold standard and reasonable to pursue. So that's one thing. In men with symptomatic disease, radium-223 can be considered, both to prevent skeletal events and to improve health-related quality of life. And then, finally, all radiopharmaceuticals can be considered in that situation for palliation of bone pain. And so we endorsed those recommendations as well. And we added a fair amount of discussion about how to optimally support men's health in those situations. For one thing, it's important to note that monthly zoledronic acid or monthly denosumab, whichever is pursued, is a fairly intensive osteoclast-targeted therapy. And so the studies that formally establish those as gold standards in that setting, they really only treated for about two years, plus or minus. So we don't know a lot about the safety of that intensity of therapy beyond two years. And so that's an important consideration, because there are many men who do well, thankfully, for a lot longer than two years in the castration-resistant setting with bone metastases. And so we really do, as clinicians, need to respect the possibility of toxicities, especially osteonecrosis of the jaw seems to be a much, much more common phenomenon with longer durations of treatment and with these more intensive regimens. So that's one thing that deserves a lot of attention by clinicians. The other thing is that dental evaluation and proactive dental care before and during any of these bone-targeted therapies is really an important issue not to miss. So the highest risk for having osteonecrosis of the jaw is in patients who are on one of these intensive regimens and then need to have invasive dental work when they're already been started on one of those regimens. Those are the jaws and mandibles that seem not to heal as well. And so ideally, every patient that is going to go on intensive osteoclast-targeted therapy really should be evaluated by a dentist with the question of whether there's any dental work that really needs to be done proactively before the start of one of those medicines. And so I always say I have to be humble as a medical oncologist to say I really know little to nothing about teeth. And so I have to reach out to my colleagues in the dental field to tell me which are the patients that need to do something ahead of time and heal before they start one of these medicines. So those are a couple of important points. And then the other thing that's really not a new piece of information but is important to emphasize is that it's really monthly therapy with denosumab or zoledronic acid should really be used only for patients with castration-resistant prostate cancer metastatic to bone. So the patients who are responding to their systemic therapy really seem not to benefit from the bone-targeted therapy. And that's likely because any systemic therapy that's controlling the prostate cancer, in general, that's active against the cancer, in general, is going to prevent skeletal complications. We just have a lot fewer of those events, thankfully, when the disease is under control. And then, finally, the fourth category of recommendation addresses symptomatic castration-resistant prostate cancer metastatic to bone. And that's a situation where the radium-223 given in the typical once per month times six series of treatments is a gold standard, improves health-related quality of life and overall survival. I think one of the important discussion points on that front relates to recent clinical trial data that examines the use of other secondary systemic therapies in addition to the radium. So we have a prospective randomized study that looked at abiraterone with or without radium. And what it really showed was that the combination of abiraterone and prednisone with radium resulted at a very high rate of fractures and worsened overall survival. So that's really a combination that should absolutely not be pursued outside of a clinical trial. And so that's an important thing to know, but it's also sort of a cautionary tale that if we're tempted to combine other secondary medicines with our radium treatment, we really don't have a lot of evidence for the safety or efficacy of doing that. So that's the sort of thing that really should be reserved for clinical trials. And those are probably the most important-- those are the four main topics addressed by the guidelines. As you can tell, it really includes situations that are relevant to just about every man who receives systemic therapy for prostate cancer. Absolutely. And thank you for that comprehensive overview and those considerations of the guideline endorsement panel. Why if this guideline important? And how will it impact practice? So I think there's really sort of two main ways that it's important to the reader in 2020. I'd say, first of all, as a reminder and sort of educational promotion of awareness of the things that we already know but are easy to overlook. And I think the things that are really there are that it is easy to focus on the cancer therapy and easy to overlook the bone-targeted therapy. So as we have an increasing number of systemic therapies that are active against the cancer itself, and as we have sort of, in the best possible way, more options and more molecular considerations for our prostate cancer patients, we really can't forget to do the fundamentals, like doing monthly zoledronic acid or monthly denosumab in men with castration-resistant disease that's metastatic to bone. So I think that's the kind of thing that would be easy to forget, but that we shouldn't. And the second subtopic there would be screening for osteoporosis in any man who receives ADT. And again, that's something that-- osteoporosis or someone at high risk for fragility fracture, that's an asymptomatic situation until the fracture occurs. And then at that moment, you're really thinking back and saying, man, I wish I'd done something three years ago, or five years ago, or 10 years ago to improve bone health so that this wouldn't have happened in the first place. So it really is up to us as the clinicians caring for these prostate cancer patients to advocate for their general health in a way that includes their bone health. We just have to really not forget to screen for osteoporotic fracture risk. So I think those reminders of things that we already know but are really easy to miss, I think that's one aspect of this. And I think the other is just discussion of the data. It really adds some richness to the topics. And we do have these updates in an emerging field, particularly when it relates to radium-223. It seems like a drug really on, like, a drug strategy that could easily be paired with other drug strategies because it's reasonably well-tolerated. But we learned, really especially from that clinical trial experience of radium with abiraterone, we really learned that freewheeling combinations are not necessarily safe and not necessarily effective. And so we have to just be mindful of recently emerging data and have an ear to the ground about ongoing clinical trials, sort of how to best combine and sequence all the different medicines that are sort of in our back pocket. And finally, how will these guideline recommendations affect patients? Yeah. I mean, I think bone health is really just so important to every patient with prostate cancer. And it's almost, for clinicians, it's almost an educational issue where we have to help our patients understand how important bone health is. When we talk in clinic about a DEXA scan to look at bone density, a lot of men really look at me a little bit blankly. They think of osteoporosis more as this sort of issue that women deal with more so than men. But I always talk about, if you imagine having a hip fracture and needing hip surgery, or if you think about the pain and the postural changes that happen with vertebral body compression fractures, we really have to do something before any of those things occur. And most men agree with me if you put it in those practical terms. It's just the kind of thing that you have to take a couple of minutes out of your clinic visit to make sure that you address. And the other thing really is, in men who have more challenging prostate cancer metastatic to bone, even life-threatening prostate cancer, all the complications that can happen later in the course of disease, we really need to do the best possible job not only to keep men living longer, but also to make sure their quality of life is the best it can possibly be. And that's really-- and most of the time when prostate cancer starts to become a physical burden as it progresses, it's really a physical burden that's centered on bones and skeletal health. And that can have an effect on comfort. That can have an effect on mobility. And these things are hugely central to quality of life. So the impact on patients, all the way from osteoporosis to bone metastases, really, it's just such a central theme within the management of everybody who has to face prostate cancer. Thank you for your work on this important guideline, and thank you for your time today Dr. Saylor. Oh, it's my pleasure. We got to keep working to get the word out there and have the optimal management for all of our patients. And thank you to all of our listeners for tuning into the ASCO Guidelines Podcast Series. 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 available in iTunes 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. [MUSIC PLAYING]  

TRANSCRIPT 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. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Hello, and welcome to the ASCO Guidelines Podcast series. My name is Shannon McKernin, and I'm interviewing Dr. Joe Mikhael from the City of Hope Cancer Center and International Myeloma Foundation, lead author on "Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline." Thank you for being here today, Dr. Mikhael. It's a pleasure to be with you. So first, can you give us some context as to why this guideline was developed? Well, we had a lot of ideas when we put together this guideline, but most importantly, multiple myeloma continues to be a rare disease in the cancer world. It really only accounts for about 1% to 2% of cancers. So for the practicing oncologist, they spend perhaps 3-ish percent of their time doing multiple myeloma. And when you add to that there has been really a revolution in myeloma with new drugs approved, new treatments, new approaches, it really leaves the general oncologist with a complexity of how to treat this disease. And so we wanted to create a very practical guideline that would give very precise advice to walk through how one would care for a multiple myeloma patient, right from their diagnosis to indeed relapse disease. We felt this approach was so important now, more than ever, because of the fact that myeloma has really changed so much, and now, thankfully, we're seeing our patients live so much longer that the treatment options can become a little bit more complicated over time. Furthermore, we partnered with Cancer Care Ontario, because this was really felt to be not just an American phenomenon, but really a full North American phenomenon of how we could work together to really give practical advice as to how to treat this disease. So what are the key recommendations of this guideline? In this guideline, we focused really on the treatment of the disease itself. There have been other guidelines that have focused on supportive care and bone disease and multiple myeloma, but we really focused on the treatment of patients really from induction therapy through to relapse. So we spend time helping guide the decision around whether or not a patient is transplant eligible or ineligible, because that's really the first dividing marker in myeloma, because we know that transplant still has a role in myeloma, and eligible patients should have a transplant, or at least have access to a transplant. And historically, this was really done on the basis of age. But the guidelines helps the clinician see that it's really not just an age phenomena. It's really a decision based on comorbidities and really what's best for the patient. So we spend time helping making that decision, and then provide very practical advice as to how to treat a patient who's going to transplant versus a patient who's not going to transplant. We also, then, after the transplant, or in lieu of a transplant, we discuss the importance of continuous therapy, or sometimes called, maintenance therapy in myeloma. Again, we've seen maintenance therapy, now, have an impact on both progression free and overall survival. And so we felt it was really important to be very practical in giving advice as to what maintenance therapy agents to use and how to use them. And then lastly, the guideline provides a lot of practical advice as to a patient who has relapsed with multiple myeloma. We have so many choices now with three major classes of drugs of proteasome inhibitors, immuno-modulatory drugs, and now newer monoclonal antibodies, it can be difficult sometimes to know which combination to use. We know that triplet combinations tend to be preferred. So we walk through a number of those triplets and provide advice as how to explicitly use them. We do emphasize the importance of supportive care and of risk factor analysis throughout the guideline, so that we can understand the difference between high risk and low risk myeloma, so that we can understand how important a patient's comorbidities, especially in a disease that primarily affects older patients, can be managed. And so we try to do so in a comprehensive way, but one that really distills down to the critical pieces to allow the practicing clinician some real advice. So why is this guideline so important, and how will it change practice? There are several kinds of guidelines for multiple myeloma, but I really think this is a critical guideline because it is so clinical and practical in its essence. It's really designed to not just give the utopian view or the clinical trial view of a disease, but practically in the trenches, how do we use the drugs that we know are going to benefit our patients. Myeloma is one of the few cancers where we have seen a doubling, if not a tripling of survival in the last decade, because of so many of these new agents. And so making sure that our patients are treated optimally really is important. And we want to be able to ensure that they receive the best therapy possible, so they can live a longer life, but also live it with a greater quality of life. And so finally, how will these guideline recommendations affect patients? Well, we really hope that this is going to help patients all across North America and the whole world, because it will give very concrete advice to the practicing clinician in how to approach the disease. And one of the things I think will directly impact patients, if you will, right away is one of the themes of these guidelines, which is that you don't treat a patient simply based on the biopsy or simply based on their age, but that it is really a complex network of comorbidities, risk factors from the disease itself, the potential side effects of certain drugs, and a patient's own very personal history. It really fits in with the ASCO modality that we have of ensuring that we bring personalized medicine to our patients. And so this will allow the person who's reading it and who's applying it to their patient to recognize the importance of general guidelines, but also of applying it to the specific patient they care for. Because as I like to say, we don't treat multiple myeloma, we treat people. And so hopefully, this will allow the clinician to have that precision to care for their patient in the best way possible. Great. Thank you for that overview of this guideline, and thank you for your time today Dr. Mikhael. It's been a real pleasure. Thank you very much. And thank you to all of our listeners for tuning into the ASCO Guidelines Podcast series. To read the full guideline, go to www.asco.org/hematologic-malignancies-guidelines. And if you've enjoyed what you've heard today, please rate and review the podcast, and refer the show to a colleague.

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. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Hello, and welcome to the ASCO Guidelines Podcast series. My name is Shannon McKernin, and I'm interviewing Dr. Joe Mikhael from the City of Hope Cancer Center and International Myeloma Foundation, lead author on "Treatment of Multiple Myeloma: ASCO and CCO Joint Clinical Practice Guideline." Thank you for being here today, Dr. Mikhael. It's a pleasure to be with you. So first, can you give us some context as to why this guideline was developed? Well, we had a lot of ideas when we put together this guideline, but most importantly, multiple myeloma continues to be a rare disease in the cancer world. It really only accounts for about 1% to 2% of cancers. So for the practicing oncologist, they spend perhaps 3-ish percent of their time doing multiple myeloma. And when you add to that there has been really a revolution in myeloma with new drugs approved, new treatments, new approaches, it really leaves the general oncologist with a complexity of how to treat this disease. And so we wanted to create a very practical guideline that would give very precise advice to walk through how one would care for a multiple myeloma patient, right from their diagnosis to indeed relapse disease. We felt this approach was so important now, more than ever, because of the fact that myeloma has really changed so much, and now, thankfully, we're seeing our patients live so much longer that the treatment options can become a little bit more complicated over time. Furthermore, we partnered with Cancer Care Ontario, because this was really felt to be not just an American phenomenon, but really a full North American phenomenon of how we could work together to really give practical advice as to how to treat this disease. So what are the key recommendations of this guideline? In this guideline, we focused really on the treatment of the disease itself. There have been other guidelines that have focused on supportive care and bone disease and multiple myeloma, but we really focused on the treatment of patients really from induction therapy through to relapse. So we spend time helping guide the decision around whether or not a patient is transplant eligible or ineligible, because that's really the first dividing marker in myeloma, because we know that transplant still has a role in myeloma, and eligible patients should have a transplant, or at least have access to a transplant. And historically, this was really done on the basis of age. But the guidelines helps the clinician see that it's really not just an age phenomena. It's really a decision based on comorbidities and really what's best for the patient. So we spend time helping making that decision, and then provide very practical advice as to how to treat a patient who's going to transplant versus a patient who's not going to transplant. We also, then, after the transplant, or in lieu of a transplant, we discuss the importance of continuous therapy, or sometimes called, maintenance therapy in myeloma. Again, we've seen maintenance therapy, now, have an impact on both progression free and overall survival. And so we felt it was really important to be very practical in giving advice as to what maintenance therapy agents to use and how to use them. And then lastly, the guideline provides a lot of practical advice as to a patient who has relapsed with multiple myeloma. We have so many choices now with three major classes of drugs of proteasome inhibitors, immuno-modulatory drugs, and now newer monoclonal antibodies, it can be difficult sometimes to know which combination to use. We know that triplet combinations tend to be preferred. So we walk through a number of those triplets and provide advice as how to explicitly use them. We do emphasize the importance of supportive care and of risk factor analysis throughout the guideline, so that we can understand the difference between high risk and low risk myeloma, so that we can understand how important a patient's comorbidities, especially in a disease that primarily affects older patients, can be managed. And so we try to do so in a comprehensive way, but one that really distills down to the critical pieces to allow the practicing clinician some real advice. So why is this guideline so important, and how will it change practice? There are several kinds of guidelines for multiple myeloma, but I really think this is a critical guideline because it is so clinical and practical in its essence. It's really designed to not just give the utopian view or the clinical trial view of a disease, but practically in the trenches, how do we use the drugs that we know are going to benefit our patients. Myeloma is one of the few cancers where we have seen a doubling, if not a tripling of survival in the last decade, because of so many of these new agents. And so making sure that our patients are treated optimally really is important. And we want to be able to ensure that they receive the best therapy possible, so they can live a longer life, but also live it with a greater quality of life. And so finally, how will these guideline recommendations affect patients? Well, we really hope that this is going to help patients all across North America and the whole world, because it will give very concrete advice to the practicing clinician in how to approach the disease. And one of the things I think will directly impact patients, if you will, right away is one of the themes of these guidelines, which is that you don't treat a patient simply based on the biopsy or simply based on their age, but that it is really a complex network of comorbidities, risk factors from the disease itself, the potential side effects of certain drugs, and a patient's own very personal history. It really fits in with the ASCO modality that we have of ensuring that we bring personalized medicine to our patients. And so this will allow the person who's reading it and who's applying it to their patient to recognize the importance of general guidelines, but also of applying it to the specific patient they care for. Because as I like to say, we don't treat multiple myeloma, we treat people. And so hopefully, this will allow the clinician to have that precision to care for their patient in the best way possible. Great. Thank you for that overview of this guideline, and thank you for your time today Dr. Mikhael. It's been a real pleasure. Thank you very much. And thank you to all of our listeners for tuning into the ASCO Guidelines Podcast series. To read the full guideline, go to www.asco.org/hematologic-malignancies-guidelines. And if you've enjoyed what you've heard today, please rate and review the podcast, and refer the show to a colleague.

This week, the provincial government announced sweeping changes to modernize Ontario's 60 billion dollar health care system. It's creating a new super-agency by consolidating local and provincial health networks like Cancer Care Ontario, to create a central agency. Libby speaks with Christine Elliott, Minister of Health for Ontario, on what the changes mean for Zoomers. And – As the federal government prepares to pardon Canadians for simple pot possession….Chris James, the owner of a former Toronto pot dispensary, is suing the province for damages, after the Ford Tories capped the number of retail pot licenses at just 25. Chris James joins Libby to talk about it.

Alex is joined by Francesca Grosso, Co-author of Navigating Canada's Healthcare - A User Guide to Getting the Care You Need, to discuss the Ford government's plan to consolidate Ontario's local and provincial health networks, in order to create a central agency as part of a system overhaul. Legislation introduced Tuesday would create a new agency, called Ontario Health, to consolidate the 14 local health integration networks, Cancer Care Ontario, eHealth Ontario and several other agencies.

Ontario's Health Minister Christine Elliott has announced that local and provincial health networks will be merged into one super agency as part of the government's plan to overhaul the health care system.

Alex Goel of Cancer Care Ontario joins the team to talk about Integrated Synoptic Reporting, a structured reporting effort out of Ontario. The discussion covers their experience in SR over the past few years, including the design, advantages and challenges in adoption. SIIM 2018 Annual Meeting abstract: https://siim.org/resource/resmgr/siim2018/abstracts/18quality-Goel.pdf  

Everyone has their own perspective through which they view the world. But an integral part of science is questioning – questioning our assumptions and reflecting on how they may be impacted by the academic and medical systems within which we find ourselves. With this episode, we aim to do just that by learning about a different approach to health and wellness, one rooted in Indigenous knowledge. We spoke with Lee Maracle, Traditional Teacher at First Nations House about Indigenous perspectives on health. Next, Julie Bull, Research Methods Specialist at the Centre for Addictions and Mental Health, Dr. Michael Anderson, physician and researcher at the Waakebiness-Bryce Institute for Indigenous Health, and Dr. Raglan Maddox, post-doctoral fellow and researcher at the Well Living House, all shared their experiences in conducting research in partnership with Indigenous communities. Finally, Drs. Lisa Richardson and Jason Pennington talk about their efforts as curricular co-leads of Indigenous Health Education in the Faculty of Medicine to improve Indigenous health education for the next generation of clinicians. We hope this episode prompts you to appreciate the multitude of ways of knowing the world and inspires you to disrupt cultures that do not allow for these ways to co-exist. Until next time, keep it raw! Links and Resources: - Indigenous Cultural Safety Training Program by the Provincial Health Services Authority in BC - The Truth and Reconciliation Commission of Canada Report - Workshops and Courses through the Ontario Federation of Indigenous Friendship Centres - First Nations House (University of Toronto) - Cancer Care Ontario Cultural Safety Courses - Julie Bull's full spoken word poem, Collective Responsibility

An interview with Dr. Neelima Denduluri from US Oncology, Virginia Cancer Specialists, on the key recommendations of the ASCO guideline adaptation of the Cancer Care Ontario guideline on the selection of optimal adjuvant chemotherapy regimens for early breast cancer and adjuvant targeted therapy for breast cancer. Read the full guideline on www.asco.org/breast-cancer-guidelines    

Cars and Cancer Podcast 1: Aboriginal Cancer Journey   Listen to episode 1 of Cars and Cancer. This podcast includes conversations with: Thunder Bear, a Cherokee woman, taught in Ojibwe, shares her Indigenous background Dr. Hugh Langley, Regional Aboriginal Lead and Primary Care Lead, discusses Cancer Care Ontario’s Aboriginal Cancer Strategy Dionne Nolan, South East Regional Cancer Program Aboriginal Patient Navigator, shares a cup of cedar tea and her Algonquin and Ojibwe background First Nations woman sharing her cancer screening experience Teenagers making cancer prevention wampums To access the podcast either download the file by clicking on the link or use Google drive player. 

New statistics released today by Cancer Care Ontario say the number of new cancer cases have nearly tripled over the last three and a half decades. But the statistics also show survival rates have also increased. We discussed

This podcast discusses a decision aid tool developed by ASCO and Cancer Care Ontario to help people who have had surgery for non-small cell lung cancer talk with their doctor about whether to have chemotherapy after surgery. Treatments, Tests, and Procedures