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ASCOltaci: un podcast di OncoInfo in diretta da Chicago per ASCO2026 ASCOltaci è il podcast che ti aggiorna direttamente con la viva voce dei più autorevoli specialisti italiani dal congresso ASCO 2026 di Chicago. Le voci che contano… quando contano. Con uno sguardo tempestivo e critico, i nostri ospiti analizzano – a caldo – le novità che stanno ridisegnando le traiettorie della pratica clinica in oncologia. Strategie terapeutiche sempre più complesse, scelte che richiedono tempismo, visione e ascolto dei dati: dalla voce di chi quei dati li traduce in cura. Un podcast per chi vuole capire dove stiamo andando, mentre ci stiamo andando. Seguici sui nostri social Instagram (@drtalk_it) YouTube (DrTalk_it)
ASCOltaci: un podcast di OncoInfo in diretta da Chicago per ASCO2026 ASCOltaci è il podcast che ti aggiorna direttamente con la viva voce dei più autorevoli specialisti italiani dal congresso ASCO 2026 di Chicago. Le voci che contano… quando contano. Con uno sguardo tempestivo e critico, i nostri ospiti analizzano – a caldo – le novità che stanno ridisegnando le traiettorie della pratica clinica in oncologia. Strategie terapeutiche sempre più complesse, scelte che richiedono tempismo, visione e ascolto dei dati: dalla voce di chi quei dati li traduce in cura. Un podcast per chi vuole capire dove stiamo andando, mentre ci stiamo andando. Seguici sui nostri social Instagram (@drtalk_it) YouTube (DrTalk_it)
In this episode, we review the high-yield topic of Ductal Carcinoma In Situ (DCIS) from the Oncology section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
ASCOltaci: un podcast di OncoInfo in diretta da Chicago per ASCO2026 ASCOltaci è il podcast che ti aggiorna direttamente con la viva voce dei più autorevoli specialisti italiani dal congresso ASCO 2026 di Chicago. Le voci che contano… quando contano. Con uno sguardo tempestivo e critico, i nostri ospiti analizzano – a caldo – le novità che stanno ridisegnando le traiettorie della pratica clinica in oncologia. Strategie terapeutiche sempre più complesse, scelte che richiedono tempismo, visione e ascolto dei dati: dalla voce di chi quei dati li traduce in cura. Un podcast per chi vuole capire dove stiamo andando, mentre ci stiamo andando. Seguici sui nostri social Instagram (@drtalk_it) YouTube (DrTalk_it)
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PGK865. CME/AAPA/IPCE credit will be available until May 20, 2027.Propelling Modern Interventions in Neuroendocrine Carcinoma: Multidisciplinary Principles to Effectively Implement Emerging DLL3-Directed BiTE Therapy in Community Settings In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PGK865. CME/AAPA/IPCE credit will be available until May 20, 2027.Propelling Modern Interventions in Neuroendocrine Carcinoma: Multidisciplinary Principles to Effectively Implement Emerging DLL3-Directed BiTE Therapy in Community Settings In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PGK865. CME/AAPA/IPCE credit will be available until May 20, 2027.Propelling Modern Interventions in Neuroendocrine Carcinoma: Multidisciplinary Principles to Effectively Implement Emerging DLL3-Directed BiTE Therapy in Community Settings In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PGK865. CME/AAPA/IPCE credit will be available until May 20, 2027.Propelling Modern Interventions in Neuroendocrine Carcinoma: Multidisciplinary Principles to Effectively Implement Emerging DLL3-Directed BiTE Therapy in Community Settings In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PGK865. CME/AAPA/IPCE credit will be available until May 20, 2027.Propelling Modern Interventions in Neuroendocrine Carcinoma: Multidisciplinary Principles to Effectively Implement Emerging DLL3-Directed BiTE Therapy in Community Settings In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
This content has been developed for healthcare professionals only. Patients who seek health information should consult with their physician or relevant patient advocacy groups.For the full presentation, downloadable Practice Aids, slides, and complete CME/AAPA/IPCE information, and to apply for credit, please visit us at PeerView.com/PGK865. CME/AAPA/IPCE credit will be available until May 20, 2027.Propelling Modern Interventions in Neuroendocrine Carcinoma: Multidisciplinary Principles to Effectively Implement Emerging DLL3-Directed BiTE Therapy in Community Settings In support of improving patient care, PVI, PeerView Institute for Medical Education, is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.SupportThis activity is supported by an independent medical educational grant from Boehringer Ingelheim Pharmaceuticals, Inc.Disclosure information is available at the beginning of the video presentation.
Send us Fan MailBladder cancer treatment is entering a new era. From gene therapy and bladder preservation to AI-assisted diagnostics and the challenge of detecting “hidden” CIS, Dr. Ravi Chauhan, MD, FACS breaks down the technologies and clinical decisions reshaping urology in 2026.Dr. Ravi Chauhan, MD, FACS ( https://conradpearson.com/our-specialists/ravi-d-chauhan-m-d-facs/ ) is a board-certified urologist, fellowship-trained uro-oncology specialist, and one of the leading voices in advanced kidney and bladder cancer care in the Mid-South.Born and raised in Memphis, Tennessee, Dr. Chauhan graduated Cum Laude from Rhodes College with a degree in molecular biology before earning his M.D. and completing both his general surgery internship and urologic surgery residency at The University of Tennessee Health Science Center. He joined the Conrad Pearson Clinic in 2005 and has since become a recognized leader in the treatment of advanced bladder and kidney cancers, with numerous publications and presentations to his name.Dr. Chauhan's path into medicine was deeply personal. Inspired by watching his father practice medicine and witnessing the profound impact physicians can have on patients and families, he developed a philosophy centered on treating every patient with the same compassion, respect, and attention he would want for his own family.In addition to his expertise in surgical urology and uro-oncology, Dr. Chauhan has become increasingly focused on one of the biggest challenges in modern bladder cancer management: identifying and treating high-risk non–muscle invasive bladder cancer - or NMIBC, particularly carcinoma in situ - or CIS , which can often be difficult to detect in routine clinical practice.Today, we'll discuss the evolving diagnostic landscape for CIS, why missed or under-recognized disease can significantly impact treatment decisions, and the growing importance of collaboration between urologists and pathologists. We'll also explore how community urologists are navigating these rapidly evolving standards of care, the future of precision bladder cancer management, and what it means for patients facing this disease.We'll also discuss bladder-sparing approaches, including Adstiladrin® (nadofaragene firadenovec-vncg), an intravesical gene therapy for adults with high-risk Bacillus Calmette-Guerin (BCG)-unresponsive NMIBC with CIS, with or without papillary ( https://www.adstiladrin.com/ ).ADSTILADRIN should not be used in patients with hypersensitivity to interferon alfa or its components, and individuals who are immunosuppressed or immune-deficient should not handle or receive the therapy. Delaying cystectomy in patients with BCG-unresponsive CIS could lead to development of muscle invasive or metastatic bladder cancer, which can be lethal. If patients with CIS do not have a complete response to treatment after 3 months or if CIS recurs, consider cystectomy.The most common adverse reactions include urinary discharge, fatigue, bladder spasm, urgency to urinate, and blood in urine. Patients should consult their healthcare provider regarding all medications and report any side effects. Please see full Prescribing Information ( https://d2hu1op93domjx.cloudfront.net/wp-content/uploads/sites/12/2026/03/24101239/ADSTILADRIN-USPI-Mar.2026-CLEAN.pdf ) for additional details.#BladderCancer #Urology #CancerResearch #BladderCancerAwareness #NMIBC #CarcinomaInSitu #CIS #UroOncology #GeneTherapy #CancerTreatment #PrecisionMedicine #BCG #BladderPreservation #MedicalInnovation #Oncology #CancerCare #Immunotherapy #HealthcareInnovation #UrologistSupport the show
Julia Chiappetta was at the peak of her career, running a high-pressure consulting business, traveling the globe, when a diagnosis of stage 2B infiltrating ductal carcinoma and lupus stopped everything. Rather than follow the conventional path her oncologist demanded, Julia leaned into prayer, deep research, and a rigorous integrative protocol: a 30-day water fast, raw food veganism, juicing, the Gerson protocol, detoxing her home of every chemical and synthetic product, and rebuilding her sleep and stress habits from the ground up. A trip to MD Anderson, facilitated by a cousin on staff, became a turning point when Dr. Marek Ross told her that her bloodwork had nearly normalized in just 90 days. A lumpectomy with clean margins followed, and Julia has been thriving for 26 years. She now helps carry the legacy of the Annie Appleseed Project, the organization founded by her late friend Ann Fonfa, providing free education and advocacy to anyone navigating a cancer diagnosis.HealingStrong's mission is to educate, equip and empower our group leaders and group participants through their journey with cancer or other chronic illnesses, and know there is HOPE. We bring this hope through educational materials, webinars, guest speakers, conferences, community small group support and more.Please take advantage of our FREE resources below to help you along your health and healing journey:Support Group DirectoryHolistic Curriculum - Participant GuideSupport Our Mission - DonateAdditional Health ResourcesListen to Previous EpisodesWebsite: healingstrong.org
In this replay episode from 2 years ago, we delve into the world of adult congenital heart disease to review the topic of liver disease in the Fontan patient and specifically, hepatocellular carcinoma (HCC). What is the prevalence of this disease in the Fontan single ventricle adult patient? How effective are scores like the MELD-XI or Fibrosis-4 Index at identification of HCC in the Fontan patient? How should the Fontan adult patient be surveilled for this form of cancer? What evidence is there that earlier identification of HCC is associated with better outcomes? What may prove to be the most important factor in protection of the liver in the Fontan patient? Dr. Yuli Kim, Director of the ACHD program at The University of Pennsylvania shares her deep insights this week into this important topic.DOI: 10.1093/eurheartj/ehad788
In the landscape of childhood cancer, there are diseases so rare that even many physicians will never encounter a single case. Yet within these rare diagnoses lie some of the deepest biological insights and some of the most urgent clinical challenges. Choroid plexus carcinoma, often abbreviated as CPC, is one such disease. It is a malignant brain tumor that arises predominantly in very young children, most often under the age of four. Though rare, it is biologically revealing, clinically formidable, and, in recent years, the focus of a determined effort to change its outcome.
Interview with Trisha M. Wise-Draper, MD, PhD author of Amivantamab for Recurrent or Metastatic Adenoid Cystic Carcinoma: A Phase 2 Nonrandomized Clinical Trial. Hosted by Paul C. Bryson, MD MBA. Related Content: Amivantamab for Recurrent or Metastatic Adenoid Cystic Carcinoma
Interview with Trisha M. Wise-Draper, MD, PhD author of Amivantamab for Recurrent or Metastatic Adenoid Cystic Carcinoma: A Phase 2 Nonrandomized Clinical Trial. Hosted by Paul C. Bryson, MD MBA. Related Content: Amivantamab for Recurrent or Metastatic Adenoid Cystic Carcinoma
In this episode, we review the high-yield topic of Mucoepidermoid Carcinoma from the Oncology section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In this episode, we review the high-yield topic of Inflammatory Breast Carcinoma from the Oncology section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
In this podcast, experts Marwan Fakih, MD, Kristen Ciombor, MD, MSCI, and Van Karlyle Morris, MD, discuss the treatment of advanced squamous cell anal carcinoma in the immunotherapy era, with a focus on epidemiology, frontline treatment, and novel approaches to immunotherapy-refractory disease.
This DermSurgery Digest bonus content aptly named “At the Microscope” shares the latest research and techniques in dermatopathology. In this episode, contributors review Endocrine Mucin ProducingSweat Gland Carcinoma (EMPSGC). Contributors to this podcast include Naomi Lawrence, MD, Dermatologic Surgery Digital Content Editor; Ashley Elsensohn, MD, MPH, DermSurgery Digest at the Microscope co-host; Christine Ahn, MD; Jeff Gardner, MD; Marina K. Ibraheim, MD; and Michael P. Lee, MD. Articles featured in this episode include: · “TRPS1 Expression in Endocrine Mucin-Producing Sweat Gland Carcinoma: Diagnostic Utility and Pitfalls” The American Journal of Dermatopathology· “Utility of Insulinoma-Associated Protein 1 (INSM1) and Mucin 2 (MUC2) Immunohistochemistry in the Distinction of Endocrine Mucin-Producing Sweat Gland Carcinoma From Morphologic Mimics” The American Journal of Dermatopathology· “Endocrine Mucin-Producing Sweat Gland Carcinoma: Emerging Evidence of Multicentric Cutaneous Origin and Occasional Concurrence With Analogous Breast Tumors” The American Journal of Dermatopathology· “An Update on Endocrine Mucin-producing Sweat Gland Carcinoma” The American Journal of Surgical Pathology Your feedback is encouraged. Please contact communicationstaff@asds.net.
Beth Lehman went through a tumultuous year in 2020. Thanks to heavy drinking, she was diagnosed with cirrhosis, then basal cell carcinoma, a type of skin cancer, followed by hepatocellular carcinoma, a form of liver cancer. She underwent radioactive embolization in order to get a liver transplant. Beth said the two-hour operation wasn't so tough, but the after-effects were difficult, including nausea and vomiting. Then she experienced a procedure to get rid of the skin cancer on her right temple. She says between her physical and emotional recovery, she advocates for cancer patients and is happier than ever. Beth's alcohol consumption had soared to four or five bottles of wine a day. In 2020, she began to have a buildup of fluid in her stomach, known as ascites. For a long time, she avoided consulting a doctor, suspecting a doctor would tell her to quit drinking; but when ascites asserted itself, she sought medical attention. She was diagnosed with cirrhosis. Upon further examination, five tumors were discovered in her liver, which led to a diagnosis of hepatocellular carcinoma, a form of liver cancer. This diagnosis came after another diagnosis of basal cell carcinoma, but the skin cancer had to take back seat to the liver cancer. Beth said her care team first had to determine whether the cancer had spread beyond her liver. Thankfully, it hadn't. In order to complete a liver transplant, doctors wanted to execute radioactive embolization, in which radiation beads would be injected into her arteries through her wrist or groin and targeted at the tumors. However, for that to happen, the tumors had to be 2cm, but her largest tumor was 1.87cm. Incredibly, Beth's care team told her to go home and let the tumors grow so they would be large enough for it to go through with the radioactive embolization. Once the tumors grew, Beth went through the procedure, also known as Y-90. She had to go through the procedure a second time. Usually, a second procedure comes eight to twelve weeks after the first procedure. Beth's second procedure came just four weeks later. She said she was awake during each procedure, each lasted about two hours, but the toughest part was post-treatment, as she had a great amount of radiation in her body, so much that upon returning home, she had to be sequestered from her husband and her pet cats. Once she recovered from her liver transplant, she had her skin cancer treated. She said her doctors had to go seven layers deep to get all the cancer, but they did such an outstanding job that her incision is not visible. Beth Lehman once had a lucrative IT position, but these days she works as an advocate for cancer patients, especially liver cancer patients and says she is happier than ever. Additional Resources: Support Groups: The American Liver Foundation https://www.liverfoundation.org Beth's Nonprofit, The Liver Circle https://www.thelivercircle.org Beth's Personal Page with Her Story: https://www.bethlehmanliver.com
JCO PO author Dr. Foldi at UPMC Hillman Cancer Center and University of Pittsburgh School of Medicine shares insights into the JCO PO article, "Personalized Circulating Tumor DNA Testing for Detection of Progression and Treatment Response Monitoring in Patients With Metastatic Invasive Lobular Carcinoma of the Breast." Host Dr. Rafeh Naqash and Dr. Foldi discuss how serial ctDNA testing in patients with mILC is feasible and may enable personalized surveillance and real-time therapeutic monitoring. TRANSCRIPT Dr. Rafeh Naqash: Hello, and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I am your host, Dr. Rafeh Naqash, podcast editor for JCO Precision Oncology and Associate Professor at the OU Health Stephenson Cancer Center at the University of Oklahoma. Today, we are thrilled to be joined by Dr. Julia Foldi, Assistant Professor of Medicine in the Division of Hematology-Oncology at University of Pittsburgh School of Medicine and the Magee-Womens Hospital of the UPMC. She is also the lead and corresponding author of the JCO Precision Oncology article entitled "Personalized Circulating Tumor DNA Testing for Detection of Progression and Treatment Response Monitoring in Patients with Metastatic Invasive Lobular Carcinoma of the Breast." At the time of this recording, our guest's disclosures will be linked in the transcript. Julia, welcome to our podcast, and thank you for joining us today. Dr. Julia Foldi: Thank you so much for having me. It is a pleasure. Dr. Rafeh Naqash: Again, your manuscript and project address a few interesting things, so we will start with the basics, since we have a broad audience that comprises trainees, community oncologists, and obviously precision medicine experts as well. So, let us start with invasive lobular breast carcinoma. I have been out of fellowship for several years now, and I do not know much about invasive lobular carcinoma. Could you tell us what it is, what some of the genomic characteristics are, why it is different, and why it is important to have a different way to understand disease biology and track disease status with this type of breast cancer? Dr. Julia Foldi: Yes, thank you for that question. It is really important to frame this study. So, lobular breast cancers, which we shorten to ILC, are the second most common histologic subtype of breast cancer after ductal breast cancers. ILC makes up about 10 to 15 percent of all breast cancers, so it is relatively rare, but in the big scheme of things, because breast cancer is so common, this represents actually over 40,000 new diagnoses a year in the US of lobular breast cancers. What is unique about ILC is it is characterized by loss of an adhesion molecule, E-cadherin. It is encoded by the CDH1 gene. What it does is these tumors tend to form discohesive, single-file patterns and infiltrate into the tumor stroma, as opposed to ductal cancers, which generally form more cohesive masses. As we generally explain to patients, ductal cancers tend to form lumps, while lobular cancers often are not palpable because they infiltrate into the stroma. This creates several challenges, particularly when it comes to imaging. In the diagnostic setting, we know that mammograms and ultrasounds have less sensitivity to detect lobular versus ductal breast cancer. When it comes to the metastatic setting, conventional imaging techniques like CT scans have less sensitivity to detect lobular lesions often. One other unique characteristic of ILC is that these tumors tend to have lower proliferation rates. Because our glucose-based PET scans depend on glucose uptake of proliferating cells, often these tumors also are not avid on conventional FDG-PET scans. It is a challenge for us to monitor these patients as they go through treatment. If you think about the metastatic setting, we start a new treatment, we image people every three to four cycles, about every three months, and we combine the imaging results with clinical assessment and tumor markers to decide if the treatment is working. But if your imaging is not reliable, sometimes even at diagnosis, to really detect these tumors, then really, how are we following these patients? This is really the unique challenge in the metastatic setting in patients with lobular breast cancer: we cannot rely on the imaging to tell if patients are responding to treatment. This is where liquid biopsies are really, really important, and as the field is growing up and we have better and better technologies, lobular breast cancer is going to be a field where they are going to play an important role. Dr. Rafeh Naqash: Thank you for that easy-to-understand background. The second aspect that I would like to have some context on, to help the audience understand why you did what you did, is ctDNA, tumor informed and non-informed. Could you tell us what these subtypes of liquid biopsies are and why you chose a tumor informed assay for your study? Dr. Julia Foldi: Yes, it is really important to understand these differences. As you mentioned, there are two main platforms for liquid biopsy assays, circulating tumor DNA assays. I think what is more commonly used in the metastatic setting are non-tumor informed assays, or agnostic assays. These are generally next-generation sequencing-based assays that a lot of companies offer, like Guardant, Tempus, Caris, and FoundationOne. These do not require tumor tissue; they just require a blood sample, a plasma sample, essentially. The next-generation sequencing is done on cell-free DNA that is extracted from the plasma, and it is looking for any cell-free DNA and essentially, figuring out what part of the cell-free DNA comes from the tumor is done through a bioinformatics approach. Most of these assays are panel tests for cancer-associated mutations that we know either have therapeutic significance or biologic significance. So, the results we receive from these tests generally read out specific mutations in oncogenic genes, or sometimes things like fusions where we have specific targeted drugs. Some of the newer assays can also read out tumor fraction; for example, the newest generation Guardant assay that is methylation-based, they can also quantify tumor fraction. But the disadvantage of the tumor agnostic approach is that it is a little bit less sensitive. Opposed to that, we have our tumor informed tests, and these require tumor tissue. Essentially, the tumor is sequenced; this can either be whole exome or whole genome sequencing. The newer generation assays are now using whole genome sequencing of the tumor tissue, and a personalized, patient-specific panel of alterations is essentially barcoded on that tumor tissue. This can be either structural variants or it can be mutations, but generally, these are not driver mutations, but sort of things that are present in the tumor tissue that tend to stay unchanged over time. For each particular patient, a personalized assay, if you want to call it a fingerprint or barcode, is created, and then that is what then is used to test the plasma sample. Essentially, you are looking for that specific cancer in the blood, that barcode or fingerprint in the blood. Because of this, this is a much more sensitive way of looking for ctDNA, and obviously, this detects only that particular tumor that was sequenced originally. So, it is much more sensitive and specific to that tumor that was sequenced. You can argue for both approaches in different settings. We use them in different settings because they give us different information. The tumor agnostic approach gives us mutations, which can be used to determine what the next best therapy to use is, while the tumor informed assay is more sensitive, but it is not going to give us information on therapeutic targets. However, it is quantified, and we can follow it over time to see how it changes. We think that it is going to tell us how patients respond to treatment because we see our circulating tumor DNA levels rise and fall as the cancer burden increases or decreases. We decided to use the tumor informed approach in this particular study because we were really interested in how to determine if patients are having response to treatment versus if they are going to progress on their treatment, more so than looking for specific mutations. Dr. Rafeh Naqash: When you think about these tumor informed assays and you think about barcoding the mutations on the original tumor that you try to track or follow in subsequent blood samples, plasma samples, in your experience, if you have done it in non-lobular cancers, do you think shedding from the tumor has something to do with what you capture or how much you capture? Dr. Julia Foldi: Absolutely. I think there are multiple factors that go into whether someone has detectable ctDNA or not, and that has to do with the type of cancer, the location, right, where is the metastatic site? This is something that we do not fully understand yet: what are tumors that shed more versus not? There is also clearance of ctDNA, and so how fast that clearance occurs is also something that will affect what you can detect in the blood. ctDNA is very short-lived, only has a half-life of hours, and so you can imagine that if there is little shedding and a lot of excretion, then you are not going to be detecting a lot of it. In general, in the metastatic setting, we see that we can detect ctDNA in a lot of cases, especially when patients are progressing on treatment, because we imagine their tumor burden is higher at that point. Even with the non-tumor informed assays, we detect a lot of ctDNA. Part of this study was to actually assess: what is the proportion of patients where we can have this information? Because if we are only going to be able to detect ctDNA in less than 50 percent of patients, then it is not going to be a useful method to follow them with. Because this field is new and we have not been using a lot of tumor informed assays in the metastatic setting, we did not really know what to expect when we set out to look at this. We did not know what was going to be the baseline detection rate in this patient population, so that was one of the first things that we wanted to answer. Dr. Rafeh Naqash: Excellent. Now going to this manuscript in particular, what was the research question, what was the patient population, and what was the strategy that you used to investigate some of these questions? Dr. Julia Foldi: So, we partnered with Natera, and the reason was that their Signatera tumor-informed assay was the first personalized, tumor-informed, really an MRD assay, minimal residual disease detection assay. It has been around the longest and has been pretty widely used commercially already, even though some of our data is still lacking. but we know that people are using this in the real world. We wanted to gather some real-world data specifically in lobular patients. So, we asked Natera to look at their database of commercial Signatera testing and look for patients with stage 4 lobular breast cancer. The information all comes from the submitting physicians sending in pathologic reports and clinical notes, and so they have that information from the requisitions essentially that are sent in by the ordering physician. We found 66 patients who were on first-line or close to first-line endocrine-based therapies for their metastatic lobular breast cancer and had serial collections of Signatera tests. The way we defined baseline was that the first Signatera had to be sent within three months of starting treatment. So, it is not truly baseline, but again, this is a limitation of looking at real-world data is that you are not always going to get the best time point that you need. We had over 350 samples from those 66 patients, again longitudinal ctDNA samples, and our first question was what is the baseline detection rate using this tumor informed assay? Then, most importantly, what is the concordance between changes in ctDNA and clinical response to treatment? That is defined by essentially radiologic response to treatment. Dr. Rafeh Naqash: Interesting. So, what were some of your observations in terms of ctDNA dynamics, whether baseline levels made a difference, whether subsequent levels at different time points made a difference, or subsequent levels at, let us say, cycle three made a difference? Were there any specific trends that you saw? Dr. Julia Foldi: So, first, at baseline, 95 percent of patients had detectable ctDNA, which is, I think, a really important data point because it tells us that this can be a really useful test. If we can detect it in almost all patients before they start treatment, we are going to be able to follow this longitudinally. And again, these were not true baseline samples. So, I think if we look really at baseline before starting treatment, almost all patients will have detectable ctDNA in the metastatic setting. The second important thing we saw was that disease progression correlated very well with increase in ctDNA. So, in most patients who had disease progression by imaging, we saw increase in ctDNA. Conversely, in most patients who had clinical benefit from their treatment, so they had a response or stable disease, we saw decrease in ctDNA levels. It seems that what we call molecular response based on ctDNA is tracking very nicely along with the radiographic response. So, those were really the two main observations. Again, this is a small cohort, limited by its real-world nature and the time points that ctDNA assay was sent was obviously not mandated. This is a real-world data set, and so we could not really look at specific time points like you asked about, let us say, cycle three of therapy, right? We did not have all of the right time points for all of the patients. But what we were able to do was to graph out some specific patient scenarios to illustrate how changes in ctDNA correlate with imaging response. I can talk a little bit about that. Dr. Rafeh Naqash: That was going to be my question. Did you see patients who had serial monitoring using the tumor informed ctDNA assay where the assay became positive a few months before the imaging? Did you have any of those kinds of observations? Dr. Julia Foldi: Yes, so I think this is where the field is going: are we able to use this technology to maybe detect progression before it becomes clinically apparent? Of course, there are lots of questions about: does that really matter? But it seems like, based on some of the patient scenarios that we present in the paper, that this testing can do that. So, we had a specific scenario, and this is illustrated in a figure in the paper, really showing the treatment as well as the changes in ctDNA, tumor markers, and also radiographic response. So, this particular patient was on first-line endocrine therapy and CDK4/6 inhibitor with palbociclib. Initially, she had a low-level detectable ctDNA. It became undetectable during treatment, and the patient had a couple of serial ctDNA assays that were negative, so undetectable. And then we started, after about seven months on this combination therapy, the ctDNA levels started rising. She actually had three serial ctDNA assays with increasing level of ctDNA before she even had any imaging tests. And then around the time that the ctDNA peaked, this patient had radiographic evidence of progression. There was also an NGS-based assay sent to look for specific mutations at that point. The patient was found to have an ESR1 mutation, which is very common in this patient population. She was switched to a novel oral SERD, elacestrant, and the ctDNA fell again to undetectable within the first couple months of being on elacestrant. And then a very similar thing happened: while she was on this second-line therapy, she had three serial negative ctDNA assays, and then the fourth one was positive. This was two months before the patient had a scan that showed progression again. Dr. Rafeh Naqash: And Julia, like you mentioned, this is a small sample size, limited number of patients, in this case, one patient case scenario, but provides insights into other important aspects around escalation or de-escalation of therapy where perhaps ctDNA could be used as an integral biomarker rather than an exploratory biomarker. What are some of your thoughts around that and how is the breast cancer space? I know like in GI and bladder cancer, there has been a significant uptrend in MRD assessments for therapeutic decision making. What is happening in the breast cancer space? Dr. Julia Foldi: So, super interesting. I think this is where a lot of our different fields are going. In the breast cancer space, so far, I have seen a lot of escalation attempts. It is not even necessarily in this particular setting where we are looking at dynamics of ctDNA, but in the breast cancer world, of course, we have a lot of data on resistance mutations. I mentioned ESR1 mutation in a particular patient in our study. ESR1 mutations are very common in patients with ER-positive breast cancer who are on long-term endocrine therapy, and ESR1 mutations confer resistance to aromatase inhibitors. So, that is an area that there has been a lot of interest in trying to detect ESR1 mutations earlier and switching therapy early. So, this was the basis of the SERENA-6 trial, which was presented last year at ASCO and created a lot of excitement. This was a trial where patients had non-tumor-informed NGS-based Guardant assay sent every three to six months while they were on first-line endocrine therapy with a CDK4/6 inhibitor. If they had an ESR1 mutation detected, they were randomized to either continue the same endocrine therapy or switch to an oral SERD. The trial showed that the population of patients who switched to the oral SERD did better in terms of progression-free survival than those who stayed on their original endocrine therapy. There are a lot of questions about how to use this in routine practice. Of course, it is not trivial to be sending a ctDNA assay every three to six months. The rate of detection of these mutations was relatively low in that study; again, the incidence increases in later lines of therapy. So, there are a lot of questions about whether we should be doing this in all of our first-line patients. The other question is, even the patients who stayed on their original endocrine therapy were able to stay on that for another nine months. So, there is this question of: are we switching patients too early to a new line of therapy by having this escalation approach? So, there are a lot of questions about this. As far as I know, at least in our practice, we are not using this approach just yet to escalate therapy. Time will tell how this all pans out. But I think what is even more interesting is the de-escalation question, and I think that is where tumor informed assays like Signatera and the data that our study generated can be applied. Actually, our plan is to generate some prospective data in the lobular breast cancer population, and I have an ongoing study to do that, to really be able to tease out the early ctDNA dynamics as patients first start on endocrine therapy. So, this is patients who are newly diagnosed, they are just starting on their first-line endocrine therapy, and measure, with sensitive assays, measure ctDNA dynamics in the first few months of therapy. In those patients who have a really robust response, that is where I think we can really think about de-escalation. In the patients whose ctDNA goes to undetectable after just a few weeks of therapy with just an endocrine agent, they might not even need a CDK4/6 inhibitor in their first-line treatment. So, that is an area where we are very interested in our group, and I know that other groups are looking at this too, to try to de-escalate therapy in patients who clear their ctDNA early on. Dr. Rafeh Naqash: Thank you so much. Well, lots of questions, but at the same time, progress comes through questions asked, and your project is one of those which is asking an interesting question in a rarer cancer and perhaps will lead to subsequent improvement in how we monitor these individuals and how we escalate or de-escalate therapy. Hopefully, we will get to see more of what you are working on in subsequent submissions to JCO Precision Oncology and perhaps talk more about it in a couple of years and see how the space and field is moving. Thanks again for sharing your insights. I do want to take one to two quick minutes talking about you as an investigator, Julia. If you could speak to your career pathway, your journey, the pathway to mentorship, the pathway to being a mentor, and how things have shaped for you in your personal professional growth. Dr. Julia Foldi: Sure, yeah, that is great. Thank you. So, I had a little bit of an unconventional path to clinical medicine. I actually thought I was going to be a basic scientist when I first started out. I got a PhD in Immunology right out of college and was studying not even anything cancer-related. I was studying macrophage signaling in inflammatory diseases, but I was in New York City. This was right around the time that the first checkpoint inhibitors were approved. Actually, some of my friends from my PhD program worked in Jim Allison's lab, who was the basic scientist responsible for ipilimumab. So, I got to kind of first-hand experience the excitement around bringing something from the lab into the clinic that actually changed really the course of oncology. And so, I got very excited about oncology and clinical medicine. So, I decided to kind of switch gears from there and I went back to medical school after finishing my PhD and got my MD at NYU. I knew I wanted to do oncology, so I did a research track residency and fellowship combined at Yale. I started working early on with the breast cancer team there. At the time, Lajos Pusztai was the head of translational research there at Yale, and I started working with him early in my residency and then through my fellowship. I worked on several trials with him, including a neoadjuvant checkpoint inhibitor trial in triple-negative breast cancer patients. During my last year in fellowship, I received a Conquer Cancer Young Investigator Award to study estrogen receptor heterogeneity using spatial transcriptomics in this subset of breast cancers that have intermediate estrogen receptor expression. From there, I joined the faculty at the University of Pittsburgh in 2022. So, I have been there about almost four years at this point. My interests really shifted slowly from triple-negative breast cancers towards ER-positive breast cancers. When I arrived in Pittsburgh, I started working very closely with some basic and translational researchers here who are very interested in estrogen signaling and mechanisms of resistance to endocrine therapy, and there is a large group here interested in lobular breast cancers. During my training, I was not super aware even that lobular breast cancer was a unique subtype of breast cancers, and that is, I think, changing a little bit. There is a lot more awareness in the breast cancer clinical and research community about ILC being a unique subtype, but it is not even really part of our training in fellowship, which we are trying to change. But I have become a lot more aware of this because of the research team here and through that, I have become really interested also on the clinical side. And so, we do have a Lobular Breast Cancer Research Center of Excellence here at the University of Pittsburgh and UPMC, and I am the leader on the clinical side. We have a really great team of basic and translational researchers looking at different aspects of lobular breast cancers, and some of the work that I am doing is related to this particular manuscript we discussed and the next steps, as I mentioned, a prospective study of early ctDNA dynamics in lobular patients. I also did some more clinical research work in collaboration with the NSABP looking at long-term outcomes of patients with lobular versus ductal breast cancers in some of their older trials. And so, that is, in a nutshell, a little bit about how I got here and how I became interested in ILC. Dr. Rafeh Naqash: Well, thank you for sharing those personal insights and personal journey. I am sure it will inspire other trainees, fellows, and perhaps junior faculty in trying to find their niche. The path, as you mentioned, is not always straight; it often tends to be convoluted. And then finding an area that you are interested in, taking things forward, and being persistent is often what matters. Dr. Julia Foldi: Thank you so much for having me. It was great. Dr. Rafeh Naqash: It was great chatting with you. And thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review, and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcasts. 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.
What do you do when metastatic urothelial cancer responds dramatically to systemic therapy? In this episode of BackTable Urology, Dr. Abhinav Khanna (Mayo Clinic) speaks with host Dr. Daniel Roberson about the growing question of consolidative surgery after enfortumab vedotin plus pembrolizumab. They discuss how EV-pembro has reshaped treatment expectations, why unexpected complete or near-complete responses are prompting tumor board debates about cystectomy, and how careful multidisciplinary decision-making guides which patients may be considered for surgery. --- SYNPOSIS The conversation reviews early outcomes showing high rates of pathologic downstaging and the possibility that many patients may avoid additional systemic therapy after surgery, while emphasizing this approach is not yet standard of care. Dr. Khanna highlights coordination with medical oncology, radiology, and pathology, postoperative considerations, and the potential future role of biomarkers such as ctDNA. Ultimately, the episode underscores the need for clinical trials and thoughtful patient selection as clinicians navigate integrating surgery into an evolving systemic therapy landscape. --- TIMESTAMPS 00:00 - Introduction02:19 - The Evolution of Urothelial Carcinoma Treatment05:23 - Rationale for Consolidative Surgery12:32 - Patient Selection Criteria15:23 - Surgical Approach and Considerations23:58 - Pathologic Findings31:34 - The Role of Radiation39:38 - Biomarkers44:10 - Prospective Trials and Future Directions53:06 - Guidance for Urologists --- RESOURCES Consolidative Surgery for Advanced Urothelial Carcinoma Following Induction Enfortumab Vedotin and/or Immune Checkpoint Inhibitor Therapy: A Multicenter Analysishttps://pubmed.ncbi.nlm.nih.gov/40425390/ Enfortumab Vedotin and Pembrolizumab in Untreated Advanced Urothelial Cancerhttps://www.nejm.org/doi/full/10.1056/NEJMoa2312117 Standard or Extended Lymphadenectomy for Muscle-Invasive Bladder Cancerhttps://www.nejm.org/doi/abs/10.1056/NEJMoa2401497
In today's OncClub episode, we spoke with Ramy Sedhom, MD; Ryan Chow, MD; and Ronac Mamtani, MD, MSCE, about a pragmatic real-world question in advanced urothelial carcinoma: Can upfront dose reduction of enfortumab vedotin-ejfv (Padcev) improve tolerability, particularly neuropathy and treatment interruption, without compromising clinical outcomes in patients with bladder cancer? Dr Sedhom is co-lead of Geriatric Oncology at the Penn Cancer Service Line; associate director of the Penn Center for Cancer Care Innovation; and clinical director of Medical Oncology, co-lead of Psychosocial Oncology Services, division chief of the Palliative Care Division, and a clinical assistant professor of medicine (hematology-oncology) at Penn Medicine Princeton Health in Plainsboro, New Jersey. Dr Chow is an internal medicine resident at Penn Medicine in Philadelphia, Pennsylvania. Dr Mamtani is section chief of Genitourinary Cancers at Penn Medicine and an associate professor of medicine (hematology-oncology) at the Hospital of the University of Pennsylvania.
Is the era of cisplatin over, or are we simply becoming more precise about who benefits from it? As perioperative strategies in bladder cancer continue to evolve, emerging tools like circulating tumor DNA (ctDNA) are playing a bigger role in how clinicians assess recurrence risk and tailor treatment. In this episode of BackTable Tumor Board, host Alan Tan, medical oncologist at Vanderbilt-Ingram Cancer Center, is joined by bladder cancer experts Dr. Amanda Nizam and Dr. Brad McGregor to discuss recent advances in the diagnosis and treatment of urothelial carcinoma. --- SYNPOSIS The doctors examine the evolving management of muscle-invasive bladder cancer (MIBC), including the role of neoadjuvant and adjuvant therapies, the integration of immunotherapy, and the recent approval of enfortumab vedotin plus pembrolizumab. The discussion explores the rapidly changing perioperative landscape, the prognostic utility of ctDNA, and how biomarkers such as HER2 and FGFR are influencing treatment selection across disease states. They also address bladder preservation strategies, management of treatment-related toxicities, and the importance of multidisciplinary coordination. The episode concludes with a forward-looking discussion on emerging therapies and the potential to improve cure rates in bladder cancer. --- TIMESTAMPS 00:00 - Introduction01:44 - Overview of Bladder Cancer Treatment04:54 - Patient Staging and Treatment Goals10:12 - Bladder Preservation vs. Radical Cystectomy16:39 - Emerging Trials and Future Directions22:40 - ctDNA and Precision Medicine33:50 - Metastatic Disease and Biomarker Strategies42:16 - Managing Neuropathy in Metastatic Treatment48:44 - HER2 and FGFR in Bladder Cancer54:15 - Future Directions in Bladder Cancer Treatment --- RESOURCES EV-302/303 Trialhttps://newsroom.astellas.com/2023-12-15-PADCEV-R-enfortumab-vedotin-ejfv-with-KEYTRUDA-R-pembrolizumab-Approved-by-FDA-as-the-First-and-Only-ADC-Plus-PD-1-to-Treat-Advanced-Bladder-Cancer NIAGARA Regimenhttps://www.nejm.org/doi/full/10.1056/NEJMoa2408154 KEYNOTE-905 Studyhttps://www.annalsofoncology.org/article/S0923-7534(25)04894-X/fulltext
Rare diseases like renal medullary carcinoma demand earlier awareness, stronger advocacy, and faster specialist-driven care because delays can be deadly.In this episode, Tanisha Washington, the mother of Jelani Washington and a family advocate, shares her son's sudden diagnosis and passing from renal medullary carcinoma (RMC), a rare and highly aggressive kidney cancer strongly linked to sickle cell trait. She recounts his first symptoms, abdominal pain and severe blood in the urine, and how imaging revealed a kidney mass that set off a rapid and overwhelming medical journey.Tanisha describes the urgency of Jelani's treatment, which included kidney removal and intensive chemotherapy, and reflects on how little clinical familiarity exists with RMC. She highlights the critical role played by MD Anderson specialists and explains how limited research, scarce awareness, and delayed recognition worsen outcomes, particularly in Black communities.She also discusses warning signs families may dismiss, the importance of second opinions and self-advocacy, and the need for greater education about sickle cell trait–related risks. The episode closes with the family's creation of the Jelani Washington Seeds of Hope Foundation, which offers grief support and promotes healing initiatives centered on hope, remembrance, and growth.Tune in and learn how awareness, early detection, and insistence on care can save lives.ResourcesConnect with Tanisha Washington on LinkedIn here.Visit the Jelani Washington Seeds of Hope Foundation website.Learn more about Jelani's story in the news here.Watch Jelani's testimony video here.
In this episode of the Pediatric and Developmental Pathology, our hosts Dr. Mike Arnold (@MArnold_PedPath) and Dr. Jason Wang speak with Dr. Lauren Miller (@LJMiller_MD), a 4th year AP/CP Pathology Resident at the University of Michigan; Dr. Amer Heider (@amerheider), Pediatric and Perinatal Pathologist at the University of Michigan; and Dr. Lina Shao, Cytogeneticist and Clinical Professor at the University of Michigan. Hear about Pathology at the University of Michigan (https://www.pathology.med.umich.edu/) and training in Pediatric Pathology (https://www.pathology.med.umich.edu/index.php?t=page&id=1396). Find out how they triage tissue from pediatric cancers, and how that approach led to their article in Pediatric and Developmental Pathology: A Novel GLCCI1::BRAF Fusion With Independent MYC and MYCN Amplifications in Pediatric Pancreatic Acinar Cell Carcinoma Learn more about Pathology at the University of Michigan on social media: X: @UMichPath Insta: umichpath Facebook: University of Michigan Department of Pathology Featured public domain music: Summer Pride by Loyalty Freak
Mind Webs || (001) Carcinoma Angels (Norman Spinrad) || 1970s-1990sBroadcast from WHA Radio in Madison, Wisconsin: : : : :You can donate to show your support for my podcast and the time I put into creating and posting every week. Donations are through my duane.media PayPal account:https://www.paypal.com/donate/?hosted_button_id=MSL7S8FKCSL94My other podcast channels include: MYSTERY x SUSPENSE -- DRAMA X THEATER -- COMEDY x FUNNY HA HA -- VARIETY X ARMED FORCES -- THE COMPLETE ORSON WELLES.Subscribing is free and you'll receive new post notifications. Thank you for your support.https://otr.duane.media | Instagram @duane.otr#scifiradio #oldtimeradio #otr #radiotheater #radioclassics #bbcradio #raybradbury #twilightzone #horror #oldtimeradioclassics #classicradio #horrorclassics #xminusone #sciencefiction #duaneotr:::: :
Please visit answersincme.com/KEC860 to participate, download slides and supporting materials, complete the post test, and get a certificate. Presented by Jonathan E. Rosenberg, MD and Dayna A. Leis, NP. In this activity, experts in genitourinary oncology management discuss evidence-based first-line approaches for advanced urothelial carcinoma (UC) and share practical strategies to recognize and manage adverse events (AEs) through coordinated, multidisciplinary care. Upon completion of this activity, participants should be better able to: Review guideline-recommended first-line systemic treatments for patients with advanced UC; Identify AEs among patients receiving preferred first-line systemic treatment for advanced UC; and Outline multidisciplinary strategies to optimize care for patients receiving preferred first-line systemic treatment for advanced UC.
In this episode of the Pediatric and Developmental Pathology, our hosts Dr. Mike Arnold (@MArnold_PedPath) and Dr. Jason Wang speak with Professor Matthew J. Murray of the Department of Pathology and the Department of Paediatric Haematology and Oncology at the University of Cambridge, Cambridge, UK; Consultant Pediatric Pathologist Claire Trayers of the Department of Histopathology at Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; and Consultant Pediatric Oncologist Charlotte Burns of the Department of Paediatric Haematology and Oncology at Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK. Hear about how persistence and a serum biomarker for a miRNA helped identify a NUT carcinoma as we talk about their work and their article in Pediatric and Developmental Pathology: Mediastinal NUT Carcinoma With Raised Serum Alpha-Fetoprotein Mimicking a Malignant Germ Cell Tumor: Suspicion Raised Due to Negative Serum miR-371a-3p Levels Featured public domain music: Summer Pride by Loyalty Freak
Does having darker skin really protect you from skin cancer? Can you imagine getting a Pap smear every single day for 21 years just to help your husband’s research? And, what do you do if your vagina involuntarily “clenches” during sex. In this episode, we speak to Professor Georgina Long, Medical Director of Melanoma Institute Australia (MIA) and 2024 Australian of the Year, to decode Australia’s complicated relationship with the sun. We talk about the "ABCDE" rule for checking your moles, whether darker skin tones are at less risk of melanoma and why you should be taking photos of your skin spots.Plus, in Med School, Claire and Dr Mariam pay tribute to the unsung heroines of medical history - from the wife of Dr. Papanicolaou (who underwent daily pap smears for 21 years ) to Anarcha Westcott, the enslaved woman known as the 'mother of modern gynecology', who endured 30 experimental surgeries without anaesthesia.And, in our Quick Consult, Dr Mariam helps a listener named Sarah who is struggling with Vaginismus. We break down exactly what this condition is, why it is a physical reflex rather than "just in your head" and the multidisciplinary team you need to help reclaim your sex life.THE END BITS All your health information is in the Well Hub. If you've been putting off a skin check, this is your sign to book it. For more information on sun safety, visit the Cancer Council. We understand that conversations about cancer can be difficult, whether you're navigating your own diagnosis, supporting a loved one, or remembering someone you've lost. If today's episode has brought up difficult feelings, please reach out. The Cancer Council offers a confidential support line staffed by specialist nurses, and you can call them on 13 11 20. For more specific information on the topics we discussed today, organisations like the Cancer Council, the Australian Skin Cancer Foundation, and the Melanoma & Skin Cancer Advocacy Network (MSCAN) provide dedicated advocacy, education and community support for patients impacted by all forms of skin cancer. And if you just need to talk to someone immediately, you can always call Lifeline on 13 11 14. Remember to be kind to yourself, and please don't hesitate to seek support. GET IN TOUCH Sign up to the Well Newsletter to receive your weekly dose of trusted health expertise without the medical jargon. Ask a question of our experts or share your story, feedback, or dilemma - you can send it anonymously here, email here or leave us a voice note here. Ask The Doc: Ask us a question in The Waiting Room. Follow us on Instagram and Tiktok. Support independent women’s media by becoming a Mamamia subscriber CREDITS Hosts: Claire Murphy and Dr Mariam Guest: Professor Georgina Long Senior Producers: Claire Murphy and Sally Best Audio Producer: Scott Stronach Video Producer: Julian Rosario Social Producer: Elly Moore Mamamia acknowledges the Traditional Owners of the Land we have recorded this podcast on, the Gadigal people of the Eora Nation. We pay our respects to their Elders past and present, and extend that respect to all Aboriginal and Torres Strait Islander cultures.Information discussed in Well. is for education purposes only and is not intended to provide professional medical advice. Listeners should seek their own medical advice, specific to their circumstances, from their treating doctor or health care professional. +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++Support the show: https://www.mamamia.com.au/mplus/See omnystudio.com/listener for privacy information.
Beyond the Pearls: Cases for Med School, Residency and Beyond (An InsideTheBoards Podcast)
Today's Case A 37-year-old female presents to her primary care physician with a palpable breast mass. She says she felt the mass about 2 weeks ago while taking a shower. She did not note any pain or change in the size of the mass during her last menstruation. She is married and without children and has no significant medical or surgical history. Today's Reader Kada Fehlman is an Internal Medicine Resident at Huntington Health Cedars-Sinai. About Dr. Raj Dr Raj is a quadruple board certified physician and associate professor at the University of Southern California. He was a co-host on the TNT series Chasing the Cure with Ann Curry, a regular on the TV Show The Doctors for the past 7 seasons and has a weekly medical segment on ABC news Los Angeles. More from Dr. Raj The Dr. Raj Podcast Dr. Raj on Twitter Dr. Raj on Instagram Want more board review content? USMLE Step 1 Ad-Free Bundle Crush Step 1 Step 2 Secrets Beyond the Pearls The Dr. Raj Podcast Beyond the Pearls Premium USMLE Step 3 Review MedPrepTGo Step 1 Questions MedPrepTGo Step 2 Questions Learn more about your ad choices. Visit megaphone.fm/adchoices
Editor in Chief Cecelia E. Schmalbach, MD, MSc, is joined by senior author John P. Dahl, MD, PhD, MBA, and Associate Editor Marissa Ryan, MD, to discuss their findings in "TI-RADS and Bethesda Classification System Correlate With Predicting Pediatric Papillary Thyroid Carcinoma," which was published in the October 2025 issue of Otolaryngology–Head and Neck Surgery. Click here to read the full article.
When Abby Fish, who was still under the age of 2 in the summer of 2025 was diagnosed with the Pediatric Brain Cancer Choroid Plexus Carcinoma, her mom Amelia and her dad Joel were told how rare and difficult this cancer was. When they then found out that Abby also had the genetic condition Li Fraumeni to go along with her Brain cancer, they were told that the chances of her surviving until she was at least 5 years old were less than 12 percent. After hearing that, they found the Burzynski Clinic in Houston Texas, and that Dr. Burzynski had treated a young woman named Kaityln who is now 25 years old, and had suffered from both the same cancer and same genetic condition that Abby has. Abby is now following the same treatment path that Kaitlyn did.
Our host, Dr. Celina Nahyun Jo, explores how identifying middle neck lymph node involvement can reshape clinical decision-making for nasopharyngeal carcinoma. Joined by Dr. Heejun Kang, they breaks down how this imaging finding could refine risk groups and potentially shift treatment intensity for certain patients. MRI-based Middle Neck Involvement in Stage N1–N2 Nasopharyngeal Carcinoma: A Marker for Risk Stratification. Qin and Jiang et al. Radiology 2025; 316(2):e243399. Middle Neck Involvement: New Layer of Risk Stratification in Nasopharyngeal Carcinoma. Jabehdar Maralani and Kang. Radiology 2025; 316(2):e252512.
Keratinocyte carcinomas, which include basal cell carcinoma and squamous cell carcinoma, are common forms of skin cancer. Approximately 5.4 million keratinocyte carcinomas are diagnosed in the US annually. Author Mackenzie R. Wehner, MD, MPhil, of the University of Texas MD Anderson Cancer Center joins JAMA Associate Editor David Simel, MD, MHS, to discuss treatment of these types of nonmelanoma skin cancer. Related Content: Keratinocyte Carcinoma ----------------------------------- JAMA Editors' Summary
This week, Riff Worship celebrates 25 years of Electric Wizard's nihilistic masterpiece, Dopethrone! We're joined by special guests John Hoffman (STOMACH, Weekend Nachos) and David Stepanavicius (Atræ Bilis, Fulci Rots) to explore the band's rural Dorset roots as well as the tumultuous events and hazy recording sessions that forged tracks like “Barbarian” and “Funeralopolis.” Please join us as we discuss the album that redefined doom metal for the 21st century!Recommendations:STOMACH - LOW DEMONAtræ Bilis - AumicideEyehategod - Take as Needed for PainHenry: Portrait of a Serial Killer (1986)Carcinoma (2014)Brainscan (1994)Luciferion - The ApostateUsipian - Dead Corner of the EyeWith the Dead - With the DeadRamesses - We Will Lead You To Glorious TimesPsychomania (1973)Follow STOMACHInstagram: https://www.instagram.com/stomachdoom/Follow Weekend NachosFacebook: https://www.facebook.com/weekendxnachosInstagram: https://www.instagram.com/weekendnachos2004/Follow Atræ BilisFacebook: https://www.facebook.com/atraebilisInstagram: https://www.instagram.com/atraebilis/Follow Fulci RotsInstagram: https://www.instagram.com/fulcirots/Follow Riff WorshipInstagram: https://www.instagram.com/riffworshippod/Twitter: https://x.com/RiffWorshipPodYouTube: https://www.youtube.com/@RiffWorshipPodCheck out our Official Playlists:Riffs on Repeat (Spotify)Riffs on Repeat (YouTube Music)Hits from the Crypt (Apple)
Elevate your nasopharyngeal cancer (NPC) care. Top experts deliver 10 clinical pearls on new standards in immunotherapy, radiation, and surveillance. Credit available for this activity expires: 9/30/26 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/top-10-clinical-pearls-outlining-optimal-care-nasopharyngeal-2025a1000pwu?ecd=bdc_podcast_libsyn_mscpedu
How has nasopharyngeal carcinoma (NPC) care evolved? Explore pivotal immunotherapy data, new treatment guidelines, and community care strategies to optimize patient outcomes. Credit available for this activity expires: 09/29/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/coming-together-community-discussing-nasopharyngeal-2025a1000pm8?ecd=bdc_podcast_libsyn_mscpedu
In this new episode of Speaking of SurgOnc, Dr. Rick Greene discusses with Dr. Faina Nakhlis the upgrade rate to ductal carcinoma in situ or invasive cancer following excision for patients diagnosed with flat epithelial atypia on core biopsy, as reported in the article, "Incidence of Adjacent Synchronous Ipsilateral Infiltrating Carcinoma and/or Ductal Carcinoma In Situ in Patients Diagnosed with Flat Epithelial Atypia by Core Needle Biopsy (TBCRC 034).”
Dr Jonathan Strosberg from Moffitt Cancer Center in Tampa, Florida, discusses recent updates on available and novel treatment strategies for extrapulmonary neuroendocrine carcinoma. CME information and select publications here.
Featuring an interview with Dr Jonathan Strosberg, including the following topics: Overview of extrapulmonary neuroendocrine carcinoma (NEC) (0:00) Treatment strategies for extrapulmonary NEC (10:26) Targeting DLL3 in extrapulmonary NEC (18:49) Early clinical data with obrixtamig for extrapulmonary NEC (21:56) Additional investigational agents for extrapulmonary NEC (25:44) Case: A woman in her mid 50s with poorly differentiated metastatic NEC of unknown primary (27:20) Case: A man in his early 60s with poorly differentiated metastatic esophageal NEC (32:30) Clinical management of well-differentiated NEC (36:58) CME information and select publications
Dr Jonathan Strosberg from Moffitt Cancer Center in Tampa, Florida, discusses recent updates on available and novel treatment strategies for extrapulmonary neuroendocrine carcinoma. CME information and select publications here.
Featuring a slide presentation and related discussion from Dr Jonathan Strosberg, including the following topics: Overview of the classification, grading and incidence of neuroendocrine carcinoma (NEC) (0:00) Overview of mutational profile, biomarker assessments and prognosis of NEC (3:45) Current treatment paradigm for extrapulmonary NEC (8:59) DLL3 as an emerging target biomarker in extrapulmonary NEC (17:46) Novel therapeutic agents under investigation for extrapulmonary NEC (23:05) CME information and select publications
En este episodio de NETWise, continuamos centrándonos en el carcinoma neuroendocrino, una forma rara y agresiva de cáncer neuroendocrino. Si bien en el episodio anterior exploramos el diagnóstico y el tratamiento, este debate se centra en los desafíos únicos que enfrentan los cuidadores. Cuidar a una persona con carcinoma neuroendocrino puede ser increíblemente intenso debido […] The post Episodio 3: Cuidando al Cuidador del Carcinoma Neuroendocrino appeared first on NETRF.
Ductal carcinoma in situ (DCIS) represents a clinical crossroads in breast surgery—balancing the risks of over-treatment with the need to prevent invasive cancer. With new data from active monitoring trials, the pressure is on for surgeons to personalize care. Tune in to this essential episode to stay ahead of the curve on DCIS management and to hear expert insights from two leading breast surgical oncologists. Hosts: - Rashmi Kumar, MD, PhD Resident, University of Michigan General Surgery Residency Program Twitter/X: @RashmiJKumar - Melissa Pilewskie, MD Attending Breast Surgical Oncologist, Co-Director of the Weiser Family Center for Breast Cancer, Michigan Medicine Twitter/X: @MPilewskie - Stephanie Downs-Canner, MD Attending Breast Surgical Oncologist & Physician-Scientist, Memorial Sloan Kettering Cancer Center, Program Director of the Breast Surgical Oncology Fellowship Training Program Twitter/X: @SDownsCanner Learning Objectives: - Define DCIS and explain its significance as a precursor to invasive breast cancer. - Discuss challenges in diagnosing and risk-stratifying DCIS. - Review current standards for surgical and adjuvant management of DCIS. - Understand the implications of new research, including the COMET trial, for low-risk DCIS. - Evaluate patient-centered strategies for managing DCIS and preventing over-treatment. References: - Worni M, Akushevich I, Greenup R, et al. Trends in Treatment Patterns and Outcomes for Ductal Carcinoma In Situ. J Natl Cancer Inst. 2015;107(12):djv263. PubMed - Francis A, Thomas J, Fallowfield L, et al. Addressing overtreatment of screen detected DCIS; the LORIS trial. Eur J Cancer. 2015 Jan;51(16):2296-303. PubMed - Elshof LE, Tryfonidis K, Slaets L, et al. Feasibility of a non-surgical management strategy for low-grade DCIS: The LORD study. Eur J Cancer. 2015;51(12):1497–1510. PubMed - Toss MS, et al. Ductal carcinoma in situ (DCIS): current management and future directions. Cancer Treat Rev. 2020;90:102091. PubMed - Comparative Effectiveness of Surgery versus Active Monitoring for Low-Risk DCIS (COMET) Trial Results. Early COMET Results: King TA, et al. Surgical excision versus active monitoring for low-risk ductal carcinoma in situ (DCIS): 2-year results of the COMET randomized trial. J Clin Oncol. 2024; e2400110. PubMed Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://behindtheknife.org/listen Behind the Knife Premium: General Surgery Oral Board Review Course: https://behindtheknife.org/premium/general-surgery-oral-board-review Trauma Surgery Video Atlas: https://behindtheknife.org/premium/trauma-surgery-video-atlas Dominate Surgery: A High-Yield Guide to Your Surgery Clerkship: https://behindtheknife.org/premium/dominate-surgery-a-high-yield-guide-to-your-surgery-clerkship Dominate Surgery for APPs: A High-Yield Guide to Your Surgery Rotation: https://behindtheknife.org/premium/dominate-surgery-for-apps-a-high-yield-guide-to-your-surgery-rotation Vascular Surgery Oral Board Review Course: https://behindtheknife.org/premium/vascular-surgery-oral-board-audio-review Colorectal Surgery Oral Board Review Course: https://behindtheknife.org/premium/colorectal-surgery-oral-board-audio-review Surgical Oncology Oral Board Review Course: https://behindtheknife.org/premium/surgical-oncology-oral-board-audio-review Cardiothoracic Oral Board Review Course: https://behindtheknife.org/premium/cardiothoracic-surgery-oral-board-audio-review Download our App: Apple App Store: https://apps.apple.com/us/app/behind-the-knife/id1672420049 Android/Google Play: https://play.google.com/store/apps/details?id=com.btk.app&hl=en_US
Editor's Summary by Kirsten Bibbins-Domingo, PhD, MD, MAS, Editor in Chief, and Preeti Malani, MD, MSJ, Deputy Editor of JAMA, the Journal of the American Medical Association, for articles published from August 16-22 2025.
En este episodio de NETWise, profundizamos en uno de los tipos más agresivos de cáncer neuroendocrino: el carcinoma neuroendocrino. Si bien muchos tumores neuroendocrinos son de crecimiento lento y controlables con el tiempo, el carcinoma neuroendocrino es diferente: se desarrolla rápidamente y requiere atención especializada inmediata. Le guiaremos a través de la información esencial sobre […] The post Episodio 2: Carcinoma Neuroendócrino 101 appeared first on NETRF.
In this episode, we review the high-yield topic Esophageal Carcinoma from the Oncology section at Medbullets.comFollow Medbullets on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbulletsLinkedin: https://www.linkedin.com/company/medbullets
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