Podcasts about Gyn

Für Annekaren von Beckerath war es ein einschneidender Moment: Mitten in ihrer Facharztausbildung in der gynäkologischen Onkologie stellte sie fest, dass es einen Bereich gibt, der extrem unterversorgt ist. Die sexualmedizinische Komponente spielte in der Behandlung ihrer Patientinnen keine Rolle. Dabei wirkt die Diagnose Krebs schwer, sie ist nicht nur mit großen Ängsten und massiven körperlichen Beschwerden verbunden, sie berührt auch die Partnerschaft und reicht bis in die Sexualität, mitunter massiv. Das wollte Annekaren nicht so stehen lassen und absolvierte eine Zusatzausbildung zur Sexualmedizinerin. In ihrer Praxis behandelt die Fachärztin für Gynäkologie und Geburtshilfe nicht nur Patientinnen mit onkologischen Erkrankungen, auch die Autoimmunerkrankung Lichen Sclerosus, Vulvodynie, Probleme mit dem Beckenboden oder aber auch durch die Wechseljahre bedingte Beschwerden gehören zu ihrem Praxisalltag. Ihr ahnt es schon: Da wir heute längst nicht alles besprechen konnten, hat Annekaren versprochen, noch mal zu uns zu kommen. Es geht also weiter mit diesem wichtigen Thema, seid dabei! Ihr habt Fragen dazu, dann schreibt uns. (Alle Infos dazu in den Shownotes)

Ein plötzlich besseren Geruchssinn, Sprachfindungsstörungen über Nacht und die Erkenntnis, dass meine Gynäkologin gar nicht so viel über den Zyklus wusste, wie ich erwartet hätte. Hör unbedingt in die Folge rein, wenn du wissen willst, was mich am Beginn meiner eigenen Zyklus-Reise überrascht hat.

durée : 02:59:23 - Le 6/9 - Ce matin sur France Inter, À 7h50 : Vincent Doumeizel, conseiller pour les océans aux Nations Unies et auteur de “Le manifeste du plancton” (Les équateurs). À 8h20, Comment expliquer la baisse de la natalité ? Avec Hélène Périvier, présidente du HCFEA et Patrick Rozenberg, Gynécologue obstétricien. Vous aimez ce podcast ? Pour écouter tous les autres épisodes sans limite, rendez-vous sur Radio France.

Melanie Drewes erzählt in meiner Podcastfolge von ihren Erfahrungen als Gynäkologin in der Klinik. Sie setzt sich für gewaltfreie Geburten ein und informiert in der Folge ganz ausführlich darüber, worauf du bei einer Geburt achten kannst, um dich und dein Baby zu schützen. Für eine kraftvolle und selbstbestimmte Geburtserfahrung ist diese Podcastfolge GOLD wert.

Maladie du système reproducteur masculin ou féminin, l'infertilité se définit par une impossibilité à concevoir après 12 mois ou plus de rapports sexuels réguliers non protégés. Les causes sont multiples et peuvent concerner l'homme, autant que la femme. À partir de quand s'inquiéter ? Quels sont les examens pouvant aider à définir la cause de l'infertilité ? Quels sont les recours possibles ?   Pr Michael Grynberg, chef de service de Médecine de la Reproduction & Préservation de la Fertilité à l'Hôpital Antoine Béclère, à Clamart, en région parisienne  Pr Ahmed Abdi, gynécologue et chef du service de Gynécologie obstétrique à l'Hôpital mère enfant de Nouakchott, en Mauritanie. Président de la société mauritanienne de gynécologie obstétrique. Chef du département mère enfant à la Faculté de Médecine.      Programmation musicale :  ► Q twins, DJ Tira – Hamba  ► 15 15 – Afa 

Maladie du système reproducteur masculin ou féminin, l'infertilité se définit par une impossibilité à concevoir après 12 mois ou plus de rapports sexuels réguliers non protégés. Les causes sont multiples et peuvent concerner l'homme, autant que la femme. À partir de quand s'inquiéter ? Quels sont les examens pouvant aider à définir la cause de l'infertilité ? Quels sont les recours possibles ?   Pr Michael Grynberg, chef de service de Médecine de la Reproduction & Préservation de la Fertilité à l'Hôpital Antoine Béclère, à Clamart, en région parisienne  Pr Ahmed Abdi, gynécologue et chef du service de Gynécologie obstétrique à l'Hôpital mère enfant de Nouakchott, en Mauritanie. Président de la société mauritanienne de gynécologie obstétrique. Chef du département mère enfant à la Faculté de Médecine.      Programmation musicale :  ► Q twins, DJ Tira – Hamba  ► 15 15 – Afa 

Dr. Birgit Bergmeister – erfahrene und engagierte Gynäkologin – beantwortet Fragen, die viele Frauen rund um ihre Periode bewegen. Sie zeigt, wie vielfältig die Behandlungsmöglichkeiten sind und warum Schmerzmittel nicht immer die einzige Lösung sein müssen.

Wir haben es immer schon geahnt: Das Leben ist weder Ponyhof noch Kindergeburtstag. Sätze wie diese fallen ja immer dann, wenn etwas schief geht oder etwas Gravierendes passiert, Verlust, Trauer, Schmerz gehören für uns alle dazu, auch das ist bekannt. In diesen Momenten hoffen wir auf Beistand mit unserem ganz individuellen Leid, auf jemanden, der uns heilt und hilft. Wer aber schützt und stützt all die Menschen in den Regionen weltweit, in denen es zu Naturkatastrophen und Kriegen kommt? Wer fährt in die Krisengebiete und setzt dabei sein eigenes Leben auf das Spiel? Die ehrenamtlichen Mitarbeiter der medizinischen Hilfsorganisation "Ärzte ohne Grenzen" beispielsweise, deren Vorstandsvorsitzende Parnian Parvanta heute unser Gast ist. Sie kam 1982 in Kabul zur Welt, inmitten der Wirren des Afghanistankrieges, und hatte als 8jähriges Mädchen das Glück, mit ihrer Familie über Umwege nach Deutschland fliehen zu können. Immer schon wollte Parnian Parvanta Ärztin werden, sie wurde es, genauer: Fachärztin für Gynäkologie und Geburtshilfe. Nach Einsätzen z.B. in Indien, Nigeria und im Irak wurde sie 2023 zur Vorstandsvorsitzenden von "Ärzte ohne Grenzen" gewählt. Playlist: Shakira - Whenever wherever Grohe Baran - Kabul Jan Fettes Brot - Jein Freundeskreis - Mit Dir Ashiqi 2 - Tum Hi Ho Fairuz - Ya ana ya ana Shervin Hajipour - Barraye Rahat Fateh Ali Khan & Momina Mustehsan - Afareen Afareen Diese Podcast-Episode steht unter der Creative Commons Lizenz CC BY-NC-ND 4.0.

„Die meisten Medikamente wurden nie am weiblichen Körper getestet. Die Dosierungen, die Frauen täglich einnehmen, sind oft auf den männlichen Organismus abgestimmt – ohne zu wissen, ob sie für Frauen überhaupt geeignet sind.“ Dr. Judith Bildau ist Gynäkologin, Bestseller-Autorin und eine der führenden Stimmen für moderne Frauengesundheit. Ihr Ziel: Frauen endlich so zu behandeln, wie es ihrem Körper und ihren Bedürfnissen entspricht – wissenschaftlich fundiert, individuell und fernab veralteter Standards. Podcast-Host Jennifer Knäble spricht mit der engagierten Medizinerin über die häufig unterschätzten Unterschiede zwischen Frauen und Männern in der Medizin: Zwischen 35 und 45 Jahren, bereits weit vor der Menopause, können erhebliche Hormonveränderungen auftreten. Mit einem gravierenden Einfluss auf die Lebensqualität! Eine zentrale Rolle spielen dabei Hormone: "Es gibt für jede Frau einen Hormon-Kompass – vom ersten Zyklus bis in die Wechseljahre." Außerdem erklärt Dr. Judith Bildau, dass Frauen im medizinischen System häufig benachteiligt sind und z.B. in der Notaufnahme länger warten müssen. Auch wird die Menopause im Medizinstudium noch immer kaum thematisiert. Und was forderte sie in ihrer vielbeachteten Rede im Deutschen Bundestag? Ein leidenschaftliches Plädoyer für mehr Selbstbestimmung und moderne Frauengesundheit: Dr. Judith Bildau in BUNTE VIP GLOSS – Zuhören macht schön. -- Hier findet ihr alle Informationen zu unseren Podcast Partnern: https://www.wonderlink.de/@buntevipgloss-partner -- Ein BUNTE Original Podcast.

Faut-il avoir des douleurs ou des symptômes pour consulter un gynécologue ? Si un gynécologue n'est pas disponible, vers quel professionnel de santé peut-on se tourner ? Dans quelles circonstances faut-il rapprocher les consultations chez un spécialiste ? (Rediffusion) Dr Abdoulaye Diop, gynécologue obstétricien à la Clinique Bellevue à Dakar au Sénégal, auteur de Si l'on parlait de Gynécologie et d'Obstétrique, publié chez Lakalita. Retrouvez l'émission en entier ici :Questions de femmes à un gynécologue              

EinBlick – nachgefragt Podcast mit Interviews und Diskussionsrunden mit Expert:innen des Gesundheitswesens Zukunft der Versorgung: Wie regionale Gesundheitszentren den ländlichen Raum stärken Fachjournalist und EinBlick-Redakteur Christoph Nitz spricht mit Dr. Andreas Rühle, Geschäftsführer der Ärztegenossenschaft Niedersachsen-Bremen, und Ulrike Elsner, Vorstandsvorsitzende des Verbandes der Ersatzkassen vdek über innovative Versorgungsansätze im ländlichen Raum am Beispiel des Regionalen Versorgungszentrums Wurster Nordseeküste. Dieses Zentrum bündelt neben einer hausärztlichen Praxis auch spezialisierte Fachärzte wie Kinderärzte, Gynäkologen und Urologen sowie Angebote zur Physiotherapie, Psychotherapie und eine Tagespflege. Schwerpunkte liegen in der Integration von nichtärztlichem Fachpersonal, etwa durch den Einsatz von Telemedizin-Rucksäcken bei Hausbesuchen, sowie der Umsetzung eines umfassenden Care- und Case-Managements, das Patientinnen und Patienten insbesondere bei komplexen gesundheitlichen Problemlagen aktiv unterstützt. Dr. Andreas Rühle ist promovierter Wirtschaftswissenschaftler. Seit über zwanzig Jahren berät er Organisationen im Gesundheitswesen und verantwortet mehrere Tochterunternehmen der Ärztegenossenschaft Niedersachsen-Bremen, darunter das Regionale Versorgungszentrum Wurster Nordseeküste gGmbH. Er setzt auf interprofessionelle Zusammenarbeit: nichtärztliches Fachpersonal unterstützt das ärztliche Team durch Telemedizin, Care- und Case-Management sowie administrative Tätigkeiten. Ulrike Elsner studierte Rechtswissenschaften in Augsburg und Freiburg. Seit zweitausendzwölf ist sie Vorstandsvorsitzende des Verbandes der Ersatzkassen vdek, zuvor leitete sie dort die Abteilung Ambulante Versorgung. Elsner engagiert sich insbesondere für innovative Versorgungsmodelle, um Lücken in der ländlichen Gesundheitsversorgung zu schließen. Sie wirkt außerdem ehrenamtlich als Richterin am Bundessozialgericht. Digitale Innovationen wie der Telemedizin-Rucksack ermöglichen nichtärztlichem Fachpersonal eigenständig Kontrollbesuche durchzuführen. Direkt vor Ort können sie dann beispielsweise EKGs schreiben sowie Herzfrequenz- und Sauerstoffwerte messen. Bei Bedarf lässt sich über ein Tablet direkt eine Videosprechstunde mit Ärztinnen und Ärzten des Versorgungszentrums durchführen. Care- und Case-Management entlastet Arztpraxen, indem Patientinnen und Patienten direkt vor Ort individuell beraten werden – insbesondere bei der häuslichen Versorgung, Pflegefragen und Koordination medizinischer Folgetermine. Die Arbeit im Regionalen Versorgungszentrum Wurster Nordseeküste zeigt, wie sektorenübergreifende Kooperation und neue Berufsrollen Versorgung spürbar verbessern können. Die Patient:innen profitieren von kürzeren Wegen, schnellerer Hilfe und individueller Betreuung. Gleichzeitig wird das ärztliche Personal entlastet und Versorgungsengpässen im ländlichen Raum gezielt entgegengewirkt.

Warum menstruieren der Mensch und ein paar Tierarten, aber 97 Prozent der Säugetiere nicht? Es gibt überraschende Hinweise, warum sich die Menstruation im Laufe der Evolution entwickelt haben könnte. Die Forschung hofft dabei besonders auf Erkenntnisse von einem Tier: der Stachelmaus. Ein Podcast von Roana Brogsitter. Habt Ihr Feedback? Anregungen? Wir freuen uns, von Euch zu hören: WhatsApp (https://wa.me/491746744240) oder iq@br.de Credits Autorin: Roana Brogsitter SprecherInnen: Roana Brogsitter, Gudrun Skupin, Benjamin Stedler Produktion: Peter Riegel / mars13 Redaktion: Sarah Bioly Unsere Gesprächspartner: Dr. Christian Feregrino, Evolutionsbiologe Max-Planck-Institut für molekulare Genetik, Berlin https://www.molgen.mpg.de/person/131661

Dr. Lisa-Maria Wallwiener, Gynäkologin, und Hormonärztin, München
https://hormonaerztin.de/ Prof. Günther Wagner, Zoologe und Evolutionsbiologe Yale University, USA https://medicine.yale.edu/profile/gunter-wagner/ Zum Weiterschauen ARTE: Die Kraft des Zyklus https://www.youtube.com/watch?v=2Ipyp_7aI2Y Zum Weiterlesen Max Delbrück Center: Die Evolution der Menstruation erforschen https://www.mdc-berlin.de/de/news/news/die-evolution-der-menstruation-erforschen American Journal of Obstetrics & Gynecology: Menstruation: Wissenschaft und Gesellschaft https://www.ajog.org/article/S0002-9378(20)30619-0/fulltext IQ verpasst? Hier könnt ihr die letzten Folgen hören: https://www.ardaudiothek.de/sendung/iq-wissenschaft-und-forschung/5941402

Nina und Lotta nehmen so lang Podcasts auf, bis sie aus ihrem Redekäse ein großes Rad formen können. Bis dahin labern sie was das Zeug hält über Kuno den Killerwels, Gynäkologinnen auf Konzerten und Stand-Up-Paddler, die schon einmal in einem Wal waren.

Wir sollten über Abtreibungen so reden wie über Knie-OPs, findet der Gynäkologe Andreas Glasner. Im Podcast erklärt er, wie ein Schwangerschaftsabbruch typischerweise abläuft – und welche zwei medizinischen Methoden es gibt. Abtreibung, erklärt.

Die Humanen Papillomaviren sind eine der häufigsten, sexuell übertragbaren Krankheiten. Sie können alle möglichen Arten von Krebs auslösen, bei der Frau aber auch genauso beim Mann.Es gibt dafür eine Impfung, diese ist in Österreich sogar noch bis Ende des Jahres gratis, für alle bis 30. Wenn du dieses Angebot noch nutzen willst, dann musst du die erste Dosis noch im Juni abholen, damit die zweite im Dezember verabreicht werden kann.Gemeinsam mit Gynäkologin Dr. Katharina Liess kläre ich über die HPV Impfung auf und du stellst deine wichtigen Fragen.Hier auch die Website mit den Infos, wo du dich impfen lassen kannst.Magst du nachträglich noch Fragen stellen? Dann schreib Sandra jederzeit auf INSTAGRAM.

In dieser Folge sprechen ich mit Dr. Mirjam Wagner über PMS (Prämenstruelles Syndrom) und PMDS (Prämenstruelle Dysphorische Störung) – eine Erkrankung, die viele Menschen mit Menstruation betrifft, aber oft unterschätzt oder nicht ernst genommen wird. Wir klären, welche Symptome typisch für PMS und PMDS sind, worin der Unterschied liegt und warum PMDS weit mehr als „schlechte Laune vor der Periode“ ist. Außerdem sprechen wir über mögliche Ursachen, Behandlungsmöglichkeiten und Strategien, um den Alltag besser zu bewältigen.

In ihrem Podcast "Gyncast" und in ihrem aktuellen Buch will sie mit den Missverständnissen rund um die Gynäkologie aufräumen.

Aus einer größenwahnsinnigen Wein-Idee ist vor 3 1/2 Jahren ein Podcast geworden. Und in dieser Folge feiern wir mit Euch, den üblichen 2 Dosen Energy-Drinks und einem Eimer voll Käseflips unseren runden Geburtstag: 100 Folgen Flexikon. Wir waren uns am Anfang nicht ganz sicher, was wir euch zumuten können und sind deshalb - die Älteren unter euch erinnern sich - mit Folge 1 erstmal niedrigschwellig und unverfänglich reingestartet: mit einem Besuch im Swingerclub. Wie schön (und entlarvend!), dass wir euch damit über die Jahre so an uns binden konnten. Seitdem haben wir zusammen wirklich viel Wissen gesammelt. Wir können jetzt lügen, ohne dass es jemand merkt, dirty talken ohne das Wort ‚Vulva‘ zu benutzen, in der Wildnis überleben ohne unseren eigenen Urin zu trinken, smalltalken ohne uns die Augen auszuschämen. Wir können bei dem/der Gynäkolo:in die Socken anlassen und auch mal Arschloch sein. Wir können Wein vinieren und Marathon laufen (in der Theorie!) Wir können aber vor allem festhalten: es gibt wahnsinnig viele herrlich dumme Fragen und die Antworten darauf interessieren euch zum Glück genauso sehr wie uns. In dieser Folge gucken wir nochmal auf unsere, vor allem aber auf eure, Highlights zurück. Danke an all diejenigen von euch, die in den letzten Wochen an unserer Umfrage teilgenommen haben. Beim Lesen der Antworten ist es uns teilweise das Herz geschmolzen, teilweise die Schamesröte ins Gesicht gestiegen. Wir haben einfach wirklich die reflektiertesten, lustigsten, offensten Hörer:innen der Podcast-Welt und es wär uns lieb, wenn das so bliebe. Wir hätten nämlich ziemlich Bock auf mindestens 100 weitere Folgen vom Flexikon. Also, hakt euch unter und schwelgt nostalgisch mit uns in Flexikon-Erinnerungen. We're not crying, YOU are! Und hier noch unsere Podcast Empfehlung: eat.READ.sleep. vom NDR - mit Katharina Mahrenholtz, Daniel Kaiser und Jan Ehlers https://www.ardaudiothek.de/sendung/eat-read-sleep-buecher-fuer-dich/10290671/https://www.ardaudiothek.de/sendung/eat-read-sleep-buecher-fuer-dich/10290671/

Avec Claire, Gynécologue à Lure & Luxeuil

Brustkrebs bei Männern ist selten – und wird oft zu spät erkannt. In dieser Folge von O-Ton Onkologie spricht Prof. Dr. Marion Kiechle über Symptome, genetische Risikofaktoren wie BRCA2, typische Fehldiagnosen und warum viele Männer unter der Stigmatisierung leiden. Die Professorin für Gynäkologie an der TU München plädiert für mehr Bewusstsein in Klinik und Praxis – und gibt Handlungsempfehlungen zu Diagnostik, Therapie und Nachsorge. Auch psychosoziale Aspekte kommen nicht zu kurz: Männer mit Brustkrebs erleben oft zusätzliche seelische Belastung, weil die Krankheit fälschlich als rein weiblich gilt. Jetzt reinhören und das Wissen auffrischen – für bessere Versorgung und frühere Diagnosen. Teilen Sie die Folge mit Kolleg:innen – gerade beim seltenen männlichen Brustkrebs zählt Wissen doppelt. Diese Podcast-Staffel wird ermöglicht durch Fortimel - medizinische Trinknahrung. Wir danken unserem Partner für die Unterstützung der Produktion dieses Audio-Formats. Unsere Sponsoring-Partner haben keinen Einfluss auf die Inhalte. Fortimel Trinknahrungen sind Lebensmittel für besondere medizinische Zwecke (bilanzierte Diät). Zum Diätmanagement bei krankheitsbedingter Mangelernährung. Nur unter ärztlicher Aufsicht verwenden. Zur Folgen-Übersicht: https://bit.ly/3NJPbAC Weiterführende Informationen: - https://www.frauenklinik.mri.tum.de/de/behandlungsschwerpunkte/allgemeine-gynaekologie - https://gu.de/products/66271-all-about-men?srsltid=AfmBOooYGjgV9izUB4bP-_KH-r7Uep67GYPgrX0gT9yh0IrFRJ2y4_bU - Medical-tribune.de - Journalonko.de

Im heutigen Zwei gegen Eins-Interview bei Patho aufs Ohr sprechen wir mit Martin Werner. Viele denken beim Thema Auswandern sofort an bessere Arbeitsbedingungen. Martin ist 2016 aus Deutschland in die Schweiz ausgewandert. Seine Frau kam später nach und beendete in der Schweiz ihre Weiterbildung zur Gynäkologin. Die Schweiz hat den Ruf, in vielen Belangen für ÄrztInnen attraktiver zu sein als Deutschland. Seit 2021 berät Martin ÄrztInnen beim Auswandern in die Schweiz und hilft bei der Stellensuche. Er ist Auswander-Architekt, Podcast-Host & ehrlicher Begleiter für ÄrztInnen in Veränderung. Ein besonderes Gespräch-viel Freude beim Zuhören! Hier der link zum Podcast DocsGoSwiss: https://www.youtube.com/@docsgoswiss   Wir freuen uns über euer feedback. Kontakt: sven.perner@pathopodcast.de   linkedin.com/in/prof-dr-med-sven-perner-6a771b48   christiane.kuempers@pathopodcast.de   linkedin.com/in/pd-dr-med-christiane-charlotte-kümpers-279a382b8

„Ich hätte gern mal ein bisschen mehr Zeit mit dir.“ Ein solcher Satz, wenn ein Jugendlicher wegen Halsschmerzen in die Praxis kommt, kann die Einladung zur J1 sein. Dr. Esther Maria Nitsche, Neonatologin, Endokrinologin und Diabetologin mit Praxis in Lübeck ist sich sicher, dass in der von weiblichen Bezugspersonen geprägten Welt viele Jungenfragen unbeantwortet bleiben. Körperlänge und -behaarung, Barrieremethoden, Gynäkomastie, Genitalgröße und form: Social media spielen dabei eine „ganz unglückliche Rolle“. Sie wirbt dafür, Jungen als unterversorgte Patientengruppe mehr in den wissenschaftlichen und präventiven Fokus zu nehmen. Das beginnt bei den frühen U-Untersuchungen schon mit dem Blick in die Windel – Kryptorchismus darf nicht unentdeckt bleiben. „Jungen sind keine Mädchen“, bringt es die Expertin auf den Punkt. Sie sind beispielsweise vulnerabler für endokrine Disruptoren. Gesundheitsvorsorge muss ein „männlicheres“ Thema werden. Für die erfolgreiche Gesprächsführung hat die erfahrene Niedergelassene hilfreiche Beispiele und Tipps, denn mit guter Kommunikation lässt sich selbst die HPV-Impfrate steigern. **Patienten-Ratgeber:** Unsere Patienten-Ratgeber finden Sie unter https://www.infectopharm.com/fuer-patienten/patienten-ratgeber/, darunter auch den Patientenratgeber „Kinder-Vorsorge-Untersuchungen (U1-J2)“ Fachkreise können die Patienten-Ratgeber im handlichen Din A 6-Format [hier](https://www.infectopharm.com/fuer-patienten/anforderung-patienten-ratgeber/) kostenlos bestellen. **Muster anfordern:** Eine Musteranforderung des genannten Produktes ist für Ärzte jeweils in einem Zeitraum von 8 Wochen ab dem ersten Erscheinungstag der Podcastfolge möglich: https://www.infectopharm.com/ma/VomiSaft/ Weitere Informationen zu VomiSaft Gebrauchsinformation VomiSaft Pflichtangaben VomiSaft **Link zum Transkript:** https://www.infectopharm.com/consilium/podcast/podcast-paediatrie/ **Kontakte:** Feedback zum Podcast? podcast@infectopharm.com Homepage zum Podcast: www.infectopharm.com/consilium/podcast/ Für Fachkreise: www.wissenwirkt.com und App „Wissen wirkt.“ für Android und iOS Homepage InfectoPharm: www.infectopharm.com **Disclaimer:** Der _consilium_ – Pädiatrie-Podcast dient der neutralen medizinischen Information und Fortbildung für Ärzte. Für die Inhalte sind der Moderator und die Gäste verantwortlich, sie unterliegen dem wissenschaftlichen Wandel des Faches. Änderungen sind vorbehalten. **Impressum:** _consilium_ ist eine Marke von InfectoPharm Arzneimittel und Consilium GmbH Von-Humboldt-Str. 1 64646 Heppenheim Tel.: 06252 957000 Fax: 06252 958844 E-Mail: kontakt@infectopharm.com Geschäftsführer: Philipp Zöller (Vors.), Michael Gilster, Dr. Markus Rudolph, Dr. Aldo Ammendola Registergericht: Darmstadt – HRB 24623 USt.-IdNr.: DE 172949642 Verantwortlich für den Inhalt: Dr. Markus Rudolph

Vitamin D spielt eine Schlüsselrolle in der Frauengesundheit – doch wie wichtig ist es wirklich für dich?

Ein Schwangerschaftsabbruch oder eine Fehlgeburt ist für viele Betroffene nicht nur eine körperliche Herausforderung, sondern vor allem auch eine seelische. Trotzdem wird kaum darüber gesprochen – und wenn, dann meist mit Scham, Unsicherheit oder Schuldgefühlen. In der neuen Folge von „Ist das noch normal?! Der kronehit Psychotalk“ sprechen unsere Moderatorin Meli Tüchler und Psychotherapeutin Mag.a Romana Gilli, BA offen und empathisch über ein Thema, das oft im Verborgenen bleibt.Zu Gast ist Dr.in Mirijam Hall, Gynäkologin und Aktivistin, die in ihrer Arbeit tagtäglich Frauen begleitet, die sich in extrem belastenden Situationen befinden – sei es nach einem medizinischen oder freiwilligen Schwangerschaftsabbruch oder nach dem plötzlichen Verlust durch eine Fehlgeburt.Wie geht man mit all den Gefühlen um, wenn eine Schwangerschaft nicht bleibt – oder bewusst beendet wird? Was sagen Betroffene selbst? Welche psychischen Reaktionen sind „normal“ – und wann braucht es Hilfe? Und warum ist es so wichtig, dass wir endlich anfangen, offener über diese Erfahrungen zu sprechen?Am Mittwoch, ab 22:00 Uhr auf kronehit. Ab Donnerstag ist die ganze Sendung, wie immer, auf allen gängigen Plattformen als Podcast verfügbar. Du möchtest mit unserer Moderatorin Meli Tüchler oder unseren psychotherapeutischen ExpertInnen, Mag.a Romana Gilli und Daniel Martos, eine Frage stellen? Schreib uns an psychotalk@kronehit.at oder auf unserem neuen Instagram-Kanal @psychotalk.at!Wichtige Kontakte & Links:· Österreichische Gesellschaft für Familienplanung: oegf.at/schwangerschaftsabbruch/· Abortion in Austria: mehrsprachig - abortion-in-austria.at/de/start/ Kontakte in Krisensituationen:· Polizei: 133o Gehörlose Frauen und Mädchen können per SMS rund um die Uhr unter 0800 133 133 polizeiliche Hilfe rufen (Angabe von Ort und Notsituation).· Rettung: 144· Telefonseelsorge (0-24 Uhr): 142· Psychiatrische Soforthilfe und mobiler Krisendienst: +43 1 31330 (0 - 24 Uhr), per Mail, Chat oder TelefonAlle psychosozialen Dienste für ganz Österreich findest du hier: https://www.gesundheit.gv.at/service/beratungsstellen/krankheiten/psyche/psychosozialer-dienst.html· Kriseninterventionszentrum: Du befindest dich in einer akuten Krise und brauchst Hilfe dann wende dich hierhin: https://kriseninterventionszentrum.at/ · "Rat auf Draht" für Kinder, Jugendliche und junge Erwachsene bis 24 Jahre: Hotline 24 Stunden - kostenlos und anonym aus ganz Österreich - 147 - https://www.rataufdraht.at/· "Rat auf Draht" für Eltern: Kostenlose Beratung von Eltern via Video, Audio oder Text-Chat rund um: Schule, Erziehung, Sexualität usw. - https://elternseite.at/ · Gesund aus der Krise: Ermöglicht bis zu 15 kostenlose Therapieeinheiten für Kinder, Jugendliche und junge Erwachsene! Anmeldung online oder unter 0800/800122 www.gesundausderkrise.atMental Health Days: Dieses österreichweite Projekt stärkt das Bewusstsein für psychische Gesundheit an Schulen. Bis Juni 2024 wurden über 75.000 Schüler erreicht. www.mentalhealthdays.eu

On this episode of The Wholesome Fertility Podcast, I am joined by Dr. Nirali Jain (eggspert_md), a board-certified OB/GYN and reproductive endocrinologist at Reproductive Medical Associates (RMA). Dr. Jain shares her expert insights on fertility preservation for individuals undergoing cancer treatment, a crucial yet often overlooked aspect of reproductive care. We explore what options are available for fertility preservation, including egg and sperm freezing, and why it's so important to initiate these discussions before starting chemotherapy or radiation. Dr. Jain also explains the difference between Letrozole and Clomid, the impact of estrogen-sensitive cancers on IVF treatments, and innovative approaches like random-start cycles and DuoStim protocols. Whether you're facing a cancer diagnosis or simply thinking proactively about your reproductive future, this conversation is filled with knowledge and reassurance. Key Takeaways: Why it's essential to discuss fertility before starting cancer treatment. The role of Letrozole in estrogen-sensitive cancers and fertility preservation. Differences between Letrozole and Clomid, and why Letrozole is often preferred. How new protocols like DuoStim and random-start cycles are improving outcomes. Why fertility preservation is important even for those without a cancer diagnosis. Guest Bio: Dr. Nirali Jain (@eggspert_md) is a board-certified OB/GYN and fertility specialist at Reproductive Medicine Associates (RMA) in Basking Ridge, New Jersey. She earned both her undergraduate degree in neurobiology (with a minor in dance!) and her medical degree from Northwestern University, before completing her residency at Weill Cornell/NYP, where she served as co-Chief Resident, and her fellowship in reproductive endocrinology and infertility at NYU Langone. Deeply passionate about women's health and fertility preservation, Dr. Jain blends the latest research and cutting-edge treatments with compassionate, patient-centered care. Her interests include third-party reproduction and oncofertility, and she is especially passionate about supporting patients navigating fertility preservation through a cancer diagnosis. Outside of the clinic, Dr. Jain is a trained dancer, a dedicated global traveler, and an adventurer working toward hiking all seven continents with her husband. Her diverse experiences, from international medical rotations to personal connections with friends and family navigating infertility, have shaped her into a warm, resourceful, and determined advocate for her patients. Links and Resources: Visit RMA websiteFollow Dr. Nirali Jain on Instagram For more information about Michelle, visit www.michelleoravitz.com To learn more about ancient wisdom and fertility, you can get Michelle's book at: https://www.michelleoravitz.com/thewayoffertility The Wholesome Fertility facebook group is where you can find free resources and support: https://www.facebook.com/groups/2149554308396504/ Instagram: @thewholesomelotusfertility Facebook: https://www.facebook.com/thewholesomelotus/ Disclaimer: The information shared on this podcast is for educational and informational purposes only and is not intended as medical advice. Please consult with your healthcare provider before making any changes to your health or fertility care. --  Transcript:   # TWF-Jain-Nirali (Video) ​[00:00:00]  **Michelle Oravitz:** Welcome to the podcast Jain.  **Dr. Nirali Jain:** Thanks so much for having me **Michelle Oravitz:** Yeah, so. **Michelle Oravitz:** I'm very excited to talk about this topic, which, um, actually you don't really hear a lot of people talking about, which is how to preserve your fertility if you're going through a cancer diagnosis and if you have to go through treatments. 'cause obviously that can impact a lot on fertility. **Michelle Oravitz:** I have, um, seen actually like a colleague of mine go through. And she also preserved her fertility and, and now she has a baby boy. so it's really nice. **Michelle Oravitz:** to **riverside_nirali_jain_raw-video-cfr_michelle_oravitz's _0181:** so nice. **Michelle Oravitz:** So I'd love for you first to introduce yourself and kind Of give us a background on how you got into this work. **Dr. Nirali Jain:** Of course. Um, so I am Dr. Narly Jane. I am, um, an OB GYN by training, and then I did an additional, after completing four years of residency in OB GYN and getting board certified in that, I did an additional training in reproductive endocrinology and [00:01:00] infertility or otherwise known as REI. So now I'm a fertility specialist. **Dr. Nirali Jain:** Um, I trained at Northwestern in Chicago, so I went to undergrad and medical school there. And then, um, home has always been New Jersey for me, so I moved back out east to New Jersey. Um, I did all my training actually in New York City at Cornell for residency and NYU for fellowship. Um, and then moved to the suburbs. **Dr. Nirali Jain:** Um, and now I'm a fertility specialist in, in Basking Ridge at Reproductive Medical Associates.  **Michelle Oravitz:** Very impressive background. That's awesome.  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** I'd love to hear just really. About what your process is. If a person has been diagnosed with cancer, like what is the process? What are some of the things that you address if they are trying to preserve fertility, and what are some of the concerns going  **Dr. Nirali Jain:** yeah, yeah. All great questions. So, you know, there's a lot of us, uh, the Reis. Are a very small, [00:02:00] there's a very small number of us. So in terms of specializing in fertility preservation, technically we all are certified to treat patients with cancer and kind of move them through fertility preservation before starting chemotherapy. **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** Um, luckily we've been working closely with oncologists in the past several years just to establish some type of streamlined system because having a diagnosis of cancer and hearing all that information. Especially when you're young is so hard. So I think that's, that's where my interest started in terms of being able to speak to and counsel cancer patients. **Dr. Nirali Jain:** I think it is a very specific niche that you really have to be comfortable with in our field. Um, I. So I'll kind of walk you through, you know, what it, what does it look like, right? Um, you go into your oncologist's office suspecting that you have this, this lump. I'll take breast cancer, for example. It could really be any kind of cancer. **Dr. Nirali Jain:** Um, but breast cancer in a reproductive age patient or someone that's in those years where you're starting [00:03:00] to think about building a family, planning a family, um, or if you have kids at home, that's usually the type of patient that we see come in with a breast cancer diagnosis. So. Kinda just taking that, for example, um, the minute that you're diagnosed, it's really your oncologist's responsibility to counsel you on what treatment options are going to be offered to you. **Dr. Nirali Jain:** And then based off of the treatment options, it's important to know how that affects your reproduction. So how does it affect your ovaries in the short term, in the long term, um, in any way possible. So. Once a patient is initially referred from their oncologist to myself or any other fertility specialist, they come into my office and we just have a 30 minute conversation really talking about family planning goals. **Dr. Nirali Jain:** Any kids that they've had in the past either naturally conceived or through um, IVF, and then we talk about where they're at in their relationship. Are they married, are they not? Are they with a partner, [00:04:00] a male partner, a female partner, whatever it might be. It's important to know the social standpoint, um, especially in this sensitive phase of life. **Dr. Nirali Jain:** So patient patients usually spend anywhere from 30 minutes to an hour. Um, just kind of talking through where they're at, how they're feeling, what their ultimate childbearing goals are. And then from there we do an ultrasound and that's when I'm really able to see, you know, the, the reproductive status. **Dr. Nirali Jain:** So what do the ovaries look like? What does the uterus look like? Is there something that I need to be concerned about from a baseline GYN standpoint? Um, and all of those conversations are happening in real time. So. I think one of the things is patients come in and they're like, I'm already so overwhelmed with all this information from my oncologist, and now my fertility specialist is throwing all this information at me. **Dr. Nirali Jain:** Luckily, the way I like to frame it is you come in and you just let go. Like you let us do the work because in the background we're the ones talking to your oncologist. We're the [00:05:00] ones giving that feedback and creating a timeline with your oncologist. Um, and really I think just getting in the door is the hardest part. **Dr. Nirali Jain:** So once patients are here to see us, we go through the whole workup. We do anything that we would do for a normal patient that came in for fertility preservation. And then based off of where they're at in their journey, we talk about what makes sense for them, whether that means freezing embryos, freezing eggs, they're very similar in terms of the, the few weeks leading up to the egg retrievals. **Dr. Nirali Jain:** So I have that whole conversation just at the initial visit. And then from there we talk about the timeline behind the scenes and make sure that it works with their lives before moving forward. **Michelle Oravitz:** So for people listening to this, why, and this might be an obvious question, but to some it might not be,  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** why would somebody want to preserve. eggs or sperm. 'cause I've had actually some couples  **Dr. Nirali Jain:** Yep. **Michelle Oravitz:** come to me where the husband preserved the sperm and they had to go through IVF just because he was going [00:06:00] through cancer treatments. So he had to preserve the sperm ahead of time.  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** people need to consider doing that before doing cancer treatments?  **Dr. Nirali Jain:** So there are certain cancer treatments that do affect the ovaries and the sperm health, and you know, for men and women, it affects your reproductive organs. In a similar way, um, depending on the type of chemotherapeutic agent, there are some that are more dangerous in terms of, um, being toxic to your ovaries or toxic to your sperm. **Dr. Nirali Jain:** And those are the instances where we are really thinking about what's the long-term impact because there's medications that oncologists do give patients, and our oncologists are amazing, the ones that we work with, Memorial Sloan Kettering from Reproductive Medical Associates through RMA, um, and. **Dr. Nirali Jain:** They're just so good at what they do and are so well-trained, so they know in the back of their mind, is this going to impact your ovaries or your sperm health or not? Um, and I [00:07:00] think that any chemotherapy, you know, your ovaries are these, these small organs that are constantly turning over follicles every month. **Dr. Nirali Jain:** So every month we're losing those eggs, and if they don't become. If an egg isn't ovulated, it doesn't become a baby, it's just gonna die off. So I counsel even patients that don't have cancer, I counsel them on fertility preservation as young as possible. You know, between the ages of 28 and 35, that's like the best time to preserve your fertility. **Dr. Nirali Jain:** So in cancer patients, there's an extra level added to that where even if they are a little bit younger, a little bit older. Your eggs are not gonna be the same quality. There's gonna be higher level of chromosomal errors, more DNA breakage, um, and, and bigger issues that lead to issues with conceiving naturally afterwards. **Dr. Nirali Jain:** So I think that it's important to consider how that chemotherapy is going to affect them or how surgery would affect them if it was, for example, a GYN cancer where [00:08:00] we're removing a whole ovary, you know, what, what do we have to do to preserve your fertility in that case? And those are important conversations to have. **Michelle Oravitz:** Yeah. for sure. I know that a lot of people are also concerned, you know, with going through the IVF process, you're taking in a lot of estrogen, a lot of hormones, and many cancers are actually estrogen sensitive. So I wanted to talk to you about that. 'cause I know that the data shows that it's. It's been fine, which some people might find surprising, but I wanted you to address that and just kind of **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** from your perspective.  **Dr. Nirali Jain:** That's so interesting that you asked that question because I actually, my whole I I graduated fellowship last year and my entire, like passion project in fellowship was looking at one of the drugs that we use to suppress the estrogen levels specifically in cancer patients. Um, and I had presented this at a few of our reproductive meetings. **Dr. Nirali Jain:** Um, A SRM is one of our annual meetings where all of the reiss get together. A lot of male fertility [00:09:00] specialists come and we kinda just talk about. Specific things and fertility preservation for cancer patients is, has been an ongoing topic of interest for all of us. Um, and it's important to know that there are different medications that we can offer. **Dr. Nirali Jain:** Letrozole is the one that I, um, have a particular love for and I, uh, you know, I use all the time for my patients, um, for different reasons, but it suppresses the exposure that your body has to estrogen. And there's mixed data, um, out there in terms of, you know, does Letrozole suppression actually impact, you know, does it help or. **Dr. Nirali Jain:** Or does it have no impact on your future risk of cancer after treatment? Um, and that honestly is still up for debate. But what we do know is that there's no increased risk of cancer recurrence in patients that have undergone fertility preservation with or without Letrozole. Um, Letrozole is one of those things that we can give, and the way it works is basically. **Dr. Nirali Jain:** It masks that [00:10:00] conversion. It, it doesn't allow for conversion from those androgens in the male hormones over to estrogen. Um, and so your body doesn't really see that estrogen exposure. It stays nice and low throughout your cycle, and it does help with actually ovarian maturation and getting mature eggs harvested and, um, helps a little bit with, with quality too. **Dr. Nirali Jain:** So I think that it's really nice in terms of having that available to us, but know that. It's not, it's not essential that you have it, really, the data showing plus minus. Um, but there are certain things that we can do to protect the ovaries, protect your exposure to estrogen. Um, and so that shouldn't be top of mind of concern when we're going through fertility preservation, even with an estrogen sensitive cancer. **Michelle Oravitz:** Actually, so, uh, on a different topic, kind of going back to that, so Letrozole versus Clomid, I, it's like a, the questions I personally feel just based on what I've heard and like my own research that Letrozole would be kind of like the more. [00:11:00] Um, the, it's, it's a little better, but I know that it really depends on the person as well.  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** they might do better with Clom, but I'd love to hear your perspective and kind of pick your brain on this.  **Dr. Nirali Jain:** totally. You're choosing all the, all the right questions because these are all of my, my specific interests and niches. So  **Michelle Oravitz:** Oh,  **Dr. Nirali Jain:** Letrozole is basically, you know, we use Letrozole and Clomid in. Patients that don't have cancer and patients that come in for an intrauterine insemination, that's kind of the most common scenario where we're thinking about, you know, which medication is better? **Dr. Nirali Jain:** Letrozole or Clomid and Clomid used to be the, the most common medication that we use, we dose patients, you know, have 50 milligrams of Clomid, give them five days of the medication. It's an oral pill. Feels really easy and. The way it works is really, it recruits more than one follicle, so it really helps with the release of, um, more than one follicle growing more than one follicle in the ovary. **Dr. Nirali Jain:** Um, but it has a little bit [00:12:00] higher of a risk of twins because that's exactly what it's good at. Um, Clomid, not so much in the cancer. In the cancer front, it's not really used there because it's considered, from a scientific perspective, it's considered like a selective estrogen receptor modulator. So it doesn't necessarily suppress your estrogen levels in the same way that Letrozole does versus. **Dr. Nirali Jain:** Letrozole is an aromatase inhibitor, so it really blocks the chemical conversion of one drug or one hormone to the other hormone. Um, the reason we love Letrozole so much, and I don't mean to like gush over Letrozole, but um, it's a mono follicular agent, so it works really well at recruiting one follicle  **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** you know, every OB-GYN's nightmare in a way is having multiples when you didn't intend on having multiples at all. **Michelle Oravitz:** so  **Dr. Nirali Jain:** Um. **Michelle Oravitz:** were saying that, um, there's more of a chance of twins, it's Clomid, not letrozole.  **Dr. Nirali Jain:** Yes, there's a higher chance with Clomid versus Letrozole. And I mean, don't get me wrong, there's a chance of twins with [00:13:00] any type of assisted reproductive technology. Even when we're doing single embryo transfers, there's a chance that it's gonna split. So, um, the chance is always there just like it is in the natural world. **Dr. Nirali Jain:** But we know for a fact that. CLO is really good at recruiting many follicles. It's good for certain patients that don't respond well to Letrozole. Um, but Letrozole is kind of our, our go-to drug these days just because of all the benefits that we've seen.  **Michelle Oravitz:** Awesome.  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** These are all fun things to ask because I, I love talking to our eis 'cause there's so much information that I'm always  **Dr. Nirali Jain:** totally. **Michelle Oravitz:** learn a lot from my patients in my own research, but it's really cool. Picking your guys' brains. So another question I have, and I have actually talked to Dr. Andrea Elli, he's been on,  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** and he does a lot of endometriosis and, and immune related work as well,  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** so. I'd love to know just from your perspective. One thing that I do know from, based on what I've heard is that the, [00:14:00] guess like you were just saying, that breast cancer or estrogen sensitive breast cancer doesn't seem to be affected by IVF cycles, however, and endometriosis lesions do get affected.  **Dr. Nirali Jain:** Yeah. **Dr. Nirali Jain:** that's a great question. So, you know, every, there are so many complex G mind diagnoses that the, that our patients come in with. Um, and endometriosis is a big one because there is clear data that endometriosis is linked to infertility. So we think about, you know, when a patient comes in with endometriosis, we really do think about the different treatment options and what are the short-term and long-term impacts of the hormones that we're giving 'em. **Dr. Nirali Jain:** Um, these days, again, kind of going back to Letrozole, we, letrozole is something that I give all of my endometriosis patients because it helps suppress their estrogen because we know.  **Michelle Oravitz:** interesting.  **Dr. Nirali Jain:** is very responsive to estrogen and leads to this dysfunctional regulation of all the endometrial tissue that can really flare in a, [00:15:00] in a cycle, or shortly after a cycle. **Dr. Nirali Jain:** I. So we really, for endometriosis patients, the, the best treatment is being on birth control because we don't see that hormonal fluctuation. The up and down of the estrogen and the progesterone, that's what leads to those flares. Um, so I really, I watch patients closely after their cycles too, because you definitely can have an endometriosis flare and we say the best treatment for endometriosis is pregnancy, right? **Dr. Nirali Jain:** That's when you're suppressed, that's when you're at your lowest. Um, and patients, my endo patients feel so good in pregnancy because they have. Hormones that are nice in that baseline, they're not getting periods of course. Um, and that's truly, truly the best treatment.  **Michelle Oravitz:** That's interesting.  **Dr. Nirali Jain:** But it is important to consider when you're going through infertility treatments. **Dr. Nirali Jain:** How does my endometriosis affect the short and long-term effects of the fertility medications? And really not to, not to say that they're bad in any way. I think a lot of endometriosis patients go through IVF and have success and do really, really well, and that's kind of the push that they need. [00:16:00] Um, but it's important to be mindful of the bigger picture here. **Dr. Nirali Jain:** It's not just, you're not just a number of. A patient with endo coming in, getting the same protocol. It's really individualized to the extent of your lesions, what symptoms you're having, what grade of endometriosis, where your lesions are. So we're the RAs are thinking about everything before we actually start your protocol. **Michelle Oravitz:** It's crazy how in depth it is, and it's, it, there's just so, it's so multifaceted,  **Dr. Nirali Jain:** Yeah,  **Michelle Oravitz:** when it's females  **Dr. Nirali Jain:** totally. **Michelle Oravitz:** are a little, I mean, they can, you know, there, there's definitely a number of things, but it's not as complicated and interconnected  **Dr. Nirali Jain:** Exactly. Exactly. That's so true. **Michelle Oravitz:** And so one question I actually have, this is kind of really off topic, but something that I was curious about. **Michelle Oravitz:** 'cause I heard about a while  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** a, a type of cancer treatment that was used. I'm not sure exactly what it was, but for some reason it actually caused follicles to grow, [00:17:00] or to multiply. And they were **Dr. Nirali Jain:** Interesting. **Michelle Oravitz:** this definitely. Puts, um, the whole idea of like a woman being born with all the follicles she'll ever have on its head, I thought that was really Interesting. **Michelle Oravitz:** Now I learned a little bit about it. I don't think it really went further than that,  **Dr. Nirali Jain:** Mm-hmm. **Michelle Oravitz:** one of those things that they're like, Hmm, this is interesting. I don't know, it was kind of a random side effect of this chemo drug. I dunno if it was a chemo drug or a cancer drug.  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** ever heard of that. **Michelle Oravitz:** So I was just **Dr. Nirali Jain:** I haven't, I mean, that's interesting. I feel like I'd have to look into that because that would be definitely a point of interest for a lot of Reis. But it kind of does go back to the point of, you know, women are really born with all the eggs we're ever gonna have. So it's about a million, and then it just goes down from there. **Dr. Nirali Jain:** And the, by the time you start having periods, I like to kind of show my patients a chart, but you have a couple hundred thousand eggs and you ovulate one egg a month. That's, you know. Able to [00:18:00] progress into a fertilized egg and then into a, an embryo into a baby, um, if that's your goal. But otherwise, patients that are having periods and not trying to actually get pregnant, we're losing hundreds of eggs a month. **Dr. Nirali Jain:** So.  **Michelle Oravitz:** Mm.  **Dr. Nirali Jain:** It's important to kind of think about that decline, and it's important to know that that rate can be faster in patients with cancer, patients with low ovarian reserve. And sometimes when you have the two compounded, that's when a fertility specialist is definitely, you know, in the queue to, to have a discussion with you in terms of what that means and how you can reach your family building goals despite being faced with that, with that challenge. **Michelle Oravitz:** Yeah. **Michelle Oravitz:** I mean, 'cause we know oxidative stress is one of the things that can cause, uh,  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** quality eggs, but it's also can cause cancer. **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** um, similar, you know, like things that really deplete the body could definitely impact. Um, and then what are your thoughts? I know I'm asking you all kinds of random questions, **Dr. Nirali Jain:** I love it. **Michelle Oravitz:** are your thoughts about doing low simulation in certain [00:19:00] circumstances versus high stem? **Michelle Oravitz:** Sometimes people don't respond as well to higher stems.  **Dr. Nirali Jain:** Yeah, that's a great point. I think that it kind of all goes back to creating an individualized protocol. If. A patient's going to a practice and basically just getting a protocol saying, this is our standard. We start with our standard of, you know, I, I think about the standard, which is 300 of the FSH or that pen that you dial up, and then 150 units of that powder vial. **Dr. Nirali Jain:** And we have patients mixing powders all the time, and that's kind of our blanket protocol that we give patients. But that's not really what's happening behind the scenes. And if you're given a protocol that's, and being told, you know, this is kind of what we give to everyone, it's probably not the right fit for you. **Michelle Oravitz:** Yeah, I  **Dr. Nirali Jain:** Um, there are certain patients that respond to a much lower dose and do really, really well, and then some patients that need a much higher dose. Um, and I think it's, that's kind of like the fun part of being an REI of being able to individualize the [00:20:00] protocol to the patient. Um, and I know for a fact there are so many, luckily, you know, we have so many leaders in REI that have been. **Dr. Nirali Jain:** Have dedicated their entire careers to researching these different protocols and how they can help different patients. Um, patients with lower a MH, you know, might benefit from a duo stim protocol, for example. That's kind of the first one that comes to mind, but a protocol where we're using those follicles from the second half of a cycle. **Dr. Nirali Jain:** I would've never thought that those were the follicles that  **Michelle Oravitz:** Oh,  **Dr. Nirali Jain:** would be better than the first half of the cycle,  **Michelle Oravitz:** Wait,  **Dr. Nirali Jain:** but, **Michelle Oravitz:** that. Explain that. Um, because I think that that's kind of a unique  **Dr. Nirali Jain:** mm-hmm.  **Michelle Oravitz:** that I haven't heard of.  **Dr. Nirali Jain:** Yeah, so there's this new day. It's still kind of developing, but um, kind of going back to, you know, what's an individualized protocol? Duo STEM is one of the newer protocols that we've started using. I, I've used it once or twice in patients. Um, but it goes back to the research that shows that you might actually have two different periods of time in a menstrual cycle where you could potentially recruit [00:21:00] follicles. **Dr. Nirali Jain:** You could have a follicular phase where there's a certain cohort of follicles recruited, and then you have a follicle that forms creates a corpus glut.  **Michelle Oravitz:** um, protocols  **Dr. Nirali Jain:** Yep. And then you basically go through the follicular protocol and then a few days after a retrieval, instead of waiting for a new follicular cohort or follicular recruitment from the first half of your menstrual cycle, you actually use the luteal phase and you recruit those follicles that would've actually died off or have been prematurely recruited in a prior cycle. **Dr. Nirali Jain:** So **Michelle Oravitz:** that's So  **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** you just do a similar, I guess, um, medicine,  **Dr. Nirali Jain:** go right back into it.  **Michelle Oravitz:** do the same exact thing, but right after ovulation.  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** Fascinating. That's really interesting.  **Dr. Nirali Jain:** Yeah,  **Michelle Oravitz:** has been your experience with that?  **Dr. Nirali Jain:** I think it's, honestly, it's mixed. Um, so far, you know, our data from fertility and sterility and A SRM, it, it shows support for these DUO STEM [00:22:00] protocols, saying that if patients don't have that great quality of eggs or if they have a very low number, maybe they'd benefit from starting the meds earlier and recruiting follicles. **Dr. Nirali Jain:** A little bit earlier. Um, so we've seen positive results so far. A lot of work to be done in terms of really understanding it. Um, and of course, as a new attending, I have a lot more experience to kind of build on. Um, but I, I have seen success from it. **Michelle Oravitz:** That's fascinating. Are there any other new technologies, like new add-ons, um, that you've seen, that you've found to be really cool or interesting?  **Dr. Nirali Jain:** I think the biggest thing, actually, kind of going back to our whole topic for today is fertility preservation cancer patients. One of the biggest things that I've learned recently is that we used to start fertility, um, patients. You know, only in the beginning of the cycle days, two or three is technically like when most. **Dr. Nirali Jain:** Most clinics, um, start patients, but for our cancer patients, sometimes you don't have that time. You don't wanna wait a full month to [00:23:00] restart, um, your, you know, your menstrual cycle and then do the fertility preservation and then delay chemotherapy a full month. So we started doing what we call random starts. **Dr. Nirali Jain:** So you basically start a patient whenever they come in. You know, it could be the day after your consultation, the day of your consultation. I've kind of seen all of the above. Um, and we've seen really good success with random starts, per se. Um, and we've been doing a lot more of that, where it's not as dependent on where you're at in your cycle. **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** Um, obviously there's a difference in outcomes. You might not be a great candidate for it, so definitely it's worth talking to your doctor about it. But it kind of gives relief to our cancer patients where if you have a new cancer diagnosis and you're like, oh, I just finished my period, like, I can't even start a cycle until next month. **Dr. Nirali Jain:** That's not always true. Um, so it's always worth it to go into see a fertility specialist and just get, you know, get the data that you need right away, and then you can make a decision later on. **Michelle Oravitz:** For sure. Um, Yeah. **Michelle Oravitz:** and I wanted to kind of cover a lot of different topics 'cause I know that [00:24:00] some people are gonna wanna hear what you have to say that don't necessarily, or, uh, have cancer. But it is important. I, I think that, you know, if you get to thirties and you haven't gotten married or you don't have a partner, I think it's really important to preserve your fertility in general.  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** important thing. And then if you were going through a cancer diagnosis and you decided to preserve your fertility, um, guess more for women because they're eventually going to be thinking about transfers after they go through treatment. So what are some of the things that they would need to consider as far as that goes? **Michelle Oravitz:** Like after the  **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** then they go through the cancer treatments. Um, and then what, how long should they  **Dr. Nirali Jain:** yeah. Like what does it look like? So I've had patients that come back, you know, in my fellowship training I did a, a couple research projects on patients that came back to pursue an embryo transfer, um, after chemotherapy agent. And basically compared them to how they did, um, [00:25:00] compared to patients that didn't have cancer and just froze their embryos or froze their eggs and then came back to pursue a transfer and. **Dr. Nirali Jain:** I think the, the most reassuring thing from the preliminary data that we have is saying that there's no difference in pregnancy rates and no difference in life birth,  **Michelle Oravitz:** Awesome.  **Dr. Nirali Jain:** of whether they had chemotherapy or not. After freezing those eggs and going through fertility preservation.  **Michelle Oravitz:** Amazing.  **Dr. Nirali Jain:** Um, in terms of where your body needs to be, I think the oncologist, we, we wait for their green light. **Dr. Nirali Jain:** We wait for their signal to say, you know, she's safe to carry a pregnancy.  **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** And then once we do that, we basically treat you like any other patient. So if you're coming in for a cycle, if you're having periods, then it's reasonable to try a natural cycle protocol, wait for your body to naturally ovulate an egg. **Dr. Nirali Jain:** And instead of obviously hoping that egg will fertilize, we, um, use a corpus luteum. We use the progesterone from the corpus luteum to really support this embryo being implanted into the uterus. Um. Yeah. [00:26:00] And then there's also another side. I mean, some patients don't get their periods back and they always ask like, what if I never get my period back? **Dr. Nirali Jain:** What if I'm just like in menopause because of the chemotherapy agents? And for that, we can start you on a synthetic protocol or basically an estrogen dependent protocol where you take an estrogen pill for a certain number of days. We monitor your lining, then we start progesterone, um, to support your hormones from that perspective instead of relying on your ovaries to release the progesterone that they need, um, and then doing the embryo transfer a few, few days after progesterone starts. **Dr. Nirali Jain:** So there's definitely different protocols depending on where your menstrual health is at after the chemotherapy or after the cancer treatment. Um, but it's important to kind of just know that. That there's options. It doesn't mean that it's the end of the road if you all of a sudden stop getting your period. **Michelle Oravitz:** Yeah, for sure. I mean, 'cause you, technically speaking, you can really control a lot of that. More so for transfers  **Dr. Nirali Jain:** Yep. **Michelle Oravitz:** Retrievals really is kind of like what [00:27:00] eggs you have, what the quality is. But people can be in complete menopause and you guys can still control their cycles for transfer, which is kind of. A huge difference  **Dr. Nirali Jain:** Yeah,  **Michelle Oravitz:** in the  **Dr. Nirali Jain:** exactly. That's exactly right. Yeah. **Michelle Oravitz:** interesting. Any other, um, new, new things that you're, you guys are excited about? I always like to hear about like the new and upcoming things  **Dr. Nirali Jain:** Of course.  **Michelle Oravitz:** actually before, which I thought was fascinating. Yeah.  **Dr. Nirali Jain:** I feel like there's always like updates and, and new data and things like that coming out, but just know, I think it's important for patients to know, like we're constantly, we're, the reason I chose to even pursue this field was because it's new. Right. There's something that we are discovering every day, every year, and that's what makes our, our conferences so important to attend, um, to really just stay up to date. **Dr. Nirali Jain:** Um, but we are, uh, constantly updating our embryology standards, the way we thaw our eggs, and the success rate associated with a thaw and [00:28:00] how we treat our embryos and the media that we use, right? Like, so we're really thinking about the basic science perspective every single day, and that's what makes this field so unique. **Michelle Oravitz:** It is really awesome. And so do you guys specialize specifically on, um. Egg freezing and, and I mean specific fertility preservation in patients that do that have cancer that are going through treatments, do you guys specialize specifically in that? I mean, I know you do range  **Dr. Nirali Jain:** Yeah. Yeah, because it's such a small community, we all have our own niches and we all kind of have our own interests and  **Michelle Oravitz:** Yeah.  **Dr. Nirali Jain:** no like specific training. There are a couple courses that you take that I took in in training as well, just to kind of understand what it sounds like to, I. Council of fertility preservation, patient with and without cancer. **Dr. Nirali Jain:** Um, and then, you know, you kind of just learn by experience and you form a niche for something that you're passionate about. 'cause that's what makes you, you know, really thorough in, in your treatment. [00:29:00] So that's one of my interests. Um, and, but I would say,  **Michelle Oravitz:** training for that. It's just like  **Dr. Nirali Jain:** yeah, **Michelle Oravitz:** just know how to treat that in  **Dr. Nirali Jain:** exactly.  **Michelle Oravitz:** especially if you're interested in doing that.  **Dr. Nirali Jain:** Exactly. That's exactly right. It's kind of, it just comes with the experience comes with your mentors and who you're surrounded by, and everyone kind of helps each other get to that point. But there are several specialists in our practice at RMA that specialize specifically in fertility preservation in cancer patients. **Dr. Nirali Jain:** So we have a close communication with our oncologist and they know who to refer to within the practice because everyone has their own little interests.  **Michelle Oravitz:** Amazing.  **Dr. Nirali Jain:** Yeah. **Michelle Oravitz:** Um, definitely. I, like I said, I really enjoy picking your brain because it's a lot of fun for me. I, I do  **Dr. Nirali Jain:** Totally.  **Michelle Oravitz:** acupuncture, so  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** and I, I think that it's just so crazy that our fields don't work together. I mean, we kind of do, but I think, I just feel like it would be so great  **Dr. Nirali Jain:** exactly.[00:30:00]  **Michelle Oravitz:** the expertise because you guys have immense. Benefits like in, in, uh, technology and incredible innovations and, and then the natural aspect of really understanding the, the body. And I, I just think that it would work so amazing together if it was more of like a thing. 'cause it, I know in China they actually combine the two  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** eastern.  **Dr. Nirali Jain:** Yeah, I mean I think that that's so important and there is data that shows, you know, there's actually a recent study that came out just a few weeks ago on the benefits of acupuncture for fertility patients. And we know that, I mean, I recommend it to all of my patients, specifically the day of the embryo transfer. **Dr. Nirali Jain:** We, luckily, we offer it on site at RMA and we have acupuncturists that come in and, and do a session before and after the embryo transfer, and I think. A lot of that is targeted towards stress relief. But I also think that holistically it's important to feel at your best when we're doing something that's so crucial to your, to your health. **Dr. Nirali Jain:** So to really focus on the diet, focus on stress relief, [00:31:00] focus on meditation, yoga, whatever it takes to get to your best wellbeing when you're going through fertility treatments, um, is so important. So I appreciate  **Michelle Oravitz:** Mm-hmm.  **Dr. Nirali Jain:** like you that really specialize in the other side of. Of this, because I do consider it still part of the holistic medicine that we need to really maximize success for our patients. **Michelle Oravitz:** Awesome. Well,  **Dr. Nirali Jain:** Yeah, **Michelle Oravitz:** Jane, this is such a pleasure Of talking to you. You've given us some, so much great information and we've definitely dived into a, do a topic that I don't typically, I haven't yet spoken about. But, um, that being said, it's such an important topic to talk about. And thank you so much for coming on today. **Michelle Oravitz:** Oh,  **Dr. Nirali Jain:** course. **Michelle Oravitz:** I get off, how can people find you?  **Dr. Nirali Jain:** That's a great question. So I have, um, a social media page. I, it's called Expert nc. So like EGG,  **Michelle Oravitz:** I  **Dr. Nirali Jain:** um, expert nc. Try, tried to make it a little bit humorous. Um, but I'm all over social [00:32:00] media and would love to hear from anyone that is listening. I, you know, every, every day I get different, um, dms and I'm happy to respond. **Dr. Nirali Jain:** I love hearing about everyone else's. Stories and things like that. Um, so that is kind of my main, main social media platform. Um, and then through like RMA and Reproductive Medical Associates, we also have a YouTube channel. We have an Instagram page, um, of our office available, um, as well that is public. **Dr. Nirali Jain:** So you can find us pretty easily if you just kind of hit Google. But um, yeah, I'm kind of developing my social media platform as the expert and I hope it grows.  **Michelle Oravitz:** Love it. Great.  **Dr. Nirali Jain:** Yeah.  **Michelle Oravitz:** was such a pleasure talking to you. Thank you. so much **Dr. Nirali Jain:** Thank you. **Michelle Oravitz:** today.  **Dr. Nirali Jain:** Of course. Thank you so much for having me.  [00:33:00]   

Dies ist der 2. Teil unseres spannenden Gesprächs mit Gynäkologin und Kinderwunsch-Coach Dr. Katharina Osten. Wir knüpfen in dieser Folge an Katharinas eigenen Kinderwunsch-Weg an und erfahren, wie sie dazu gekommen ist, sich selbst mit Energiearbeit auseinander zu setzen. Bitte hört erst den 1. Teil unseres Gesprächs an, falls ihr das noch nicht getan habt. In ihrer Arbeit geht es heutzutage viel darum, wie man tief verankerte hinderliche Glaubenssätze im Bezug auf die eigene Möglichkeit, schwanger zu werden, erkennen und auflösen kann. Dazu gibt uns Katharina spannende Einblicke und am Ende hat sie noch ein wunderbares Geschenk für alle Hörer und Hörerinnen. Hast du auch ein Thema, was wir hier im Podcast besprechen sollen? Schreib uns sehr gerne per Mail an kontakt@zukunftsglueck.de Shownotes: Hole dir direkte Unterstützung bei Romy in ihrem Holistic Health Coaching: Kontakt zu Dr. Katharina Osten aufnehmen per E-Mail an oder über Facebook hier: Hier geht es zum Download der 8-minütigen Audio-Übung, die euch dabei unterstützt, euren Körper optimal auf eine Schwangerschaft vorzubereiten: Katharinas Gruppe „Als Frau mit unerfülltem Kinderwunsch endlich entspannt zum Wunschkind“: Kinderwunsch & Paarbeziehung: Unsere Akuthilfe nur für Frauen - das Leben wieder spüren im KiWu:

In this episode, Catherine Fahey, MD, PhD; Alexandra Leary, MD, PhD; Funda Meric-Bernstam, MD; and Zev A. Wainberg, MD, discuss the evolving safety considerations and future directions of HER2-targeted antibody–drug conjugates (ADCs) across genitourinary, gastrointestinal, and gynecologic cancers.Toxicity Profiles of HER2-Targeted ADCs: Common and serious adverse events such as ILD/pneumonitis, neuropathy, and cytopenia across ADCsOn-Target vs Off-Target Effects: How linker design, payload type, and drug-to-antibody ratio (DAR) contribute to toxicityCombination Therapy Considerations: Challenges in combining ADCs with immunotherapy or chemotherapy due to overlapping toxicities and tolerability concerns Presenters:Catherine Fahey, MD, PhDAssistant ProfessorDivision of OncologyUniversity of North Carolina at Chapel HillChapel Hill, North CarolinaAlexandra Leary, MD, PhDPresident, GINECO GroupCo-Director, Department of Medical OncologyMedical Oncologist GynecologyTeam Leader, Gynecologic Translational Research Lab, INSERM u981Institut Gustave RoussyVillejuif, FranceFunda Meric-Bernstam, MDChair, Department of Investigational Cancer TherapeuticsMedical Director, Institute for Personalized Cancer TherapyNellie B. Connally Chair in Breast CancerThe University of Texas MD Anderson Cancer CenterHouston, TexasZev A. Wainberg, MDProfessor of Medicine and SurgeryCo-Director of GI OncologyDirector, Early Phase Clinical Research ProgramJonsson Comprehensive Cancer CenterUCLA School of MedicineLos Angeles, CaliforniaLink to full program: https://bit.ly/42iEDjVTo claim credit for listening to this episode, please visit the podcast online at the link above. 

Host: Mindy McCulley, MS Family and Consumer Sciences Extension Specialist for Instructional Support, University of Kentucky  Guest: Susan Yacksan, PhD, APRN, AOCN Enterprise Director of Service Line Performance Management, UK HealthCare Cancer Conversations Episode 64 Join us on Cancer Conversations for an insightful discussion with Dr. Susan Yacksan, the Enterprise Director for Service Line Performance Management with Markey Cancer Center, as we take a look at the multifaceted world of oncology nursing. Discover the different pathways to becoming an oncology nurse, the various subspecialties such as medical, surgical, and GYN oncology, and the certification processes involved. Dr. Yacksan shares her extensive career experiences, from academic medical centers to community hospitals, emphasizing her passion for patient relationships and the scientific approach needed in cancer care. If you are considering a nursing career or want to explore oncology, learn about the impact of this specialty and the opportunities available through the Oncology Nursing Society. Yacksan Article on UKNOW Connect with the UK Markey Center Online Markey Cancer Center On Facebook @UKMarkey On X @UKMarkey

Headlines for May 07, 2025; “A Dangerous Escalation”: India Bombs Pakistan in Intensification of “Forever War” over Kashmir; “Columbia Knew”: Survivors Win Historic $750M from Univ. & Hospital in OB-GYN Sex Abuse Settlement; Rodney Scott, Trump’s CBP Nominee, Accused of Covering Up Death of Mexican Father in CBP Custody

In this episode, Catherine Fahey, MD, PhD; Alexandra Leary, MD, PhD; Funda Meric-Bernstam, MD; and Zev A. Wainberg, MD, explore the mechanisms of HER2-targeted antibody–drug conjugates (ADCs) and emerging clinical data with these agents across genitourinary, gastrointestinal, and gynecologic cancers.Mechanisms of action of ADCs: how ADCs selectively deliver potent chemotherapy to tumor cellsClinical data across tumor types: highlights from recent trials with trastuzumab deruxtecan and exploration of emerging data on agents such as disitamab vedotinChallenges and future directions:key considerations for combining HER2-targeted ADCs with immunotherapy or chemotherapy, and sequencing ADC therapiesPresenters:Catherine Fahey, MD, PhDAssistant ProfessorDivision of OncologyUniversity of North Carolina at Chapel HillChapel Hill, North CarolinaAlexandra Leary, MD, PhDPresident, GINECO GroupCo-Director, Department of Medical OncologyMedical Oncologist GynecologyTeam Leader, Gynecologic Translational Research Lab, INSERM u981Institut Gustave RoussyVillejuif, FranceFunda Meric-Bernstam, MDChair, Department of Investigational Cancer TherapeuticsMedical Director, Institute for Personalized Cancer TherapyNellie B. Connally Chair in Breast CancerThe University of Texas MD Anderson Cancer CenterHouston, TexasZev A. Wainberg, MDProfessor of Medicine and SurgeryCo-Director of GI OncologyDirector, Early Phase Clinical Research ProgramJonsson Comprehensive Cancer CenterUCLA School of MedicineLos Angeles, CaliforniaLink to full program:https://bit.ly/42iEDjVTo claim credit for listening to this episode, please visit the podcast online at the link above. 

Check out this week's QuadCast as we highlight the predictive abilities of AI for ADT duration in prostate cancer, how consolidative chemoRT benefits patients with unresectable gallbladder cancer, the benefits of immunotherapy in clear cell GYN cancer, and more. Check out the website and subscribe to the newsletter! www.quadshotnews.com Founders & Lead Authors: Laura Dover & Caleb Dulaney Podcast Host: Sam Marcrom

+++ Alle Rabattcodes und Infos zu unseren Werbepartnern findet ihr hier: https://linktr.ee/wunschkind +++Danielle und Katja sprechen in dieser Folge mit Prof. Dr. Mandy Mangler über Frauengesundheit und die Wechseljahre. Mandy ist Chefärztin für Gynäkologie und Geburtshilfe und lehrt im Studiengang „Hebammenwissenschaft“ an der Evangelischen Hochschule in Berlin. Sie hat außerdem „Das große Gyn-Buch“ geschrieben. Shownotes:Mandys Buch "Das große Gyn-Buch": https://amzn.to/3EkowJ9, Mandy bei Instagram: https://www.instagram.com/mandy_mangler, Mandys Podcast "Gyncast": https://www.tagesspiegel.de/podcasts/gyncast/, Online-Termine in Gyn-Praxen: https://www.doctolib.de+++ Unsere allgemeinen Datenschutzrichtlinien finden Sie unter https://datenschutz.ad-alliance.de/podcast.html +++ Wir verarbeiten im Zusammenhang mit dem Angebot unserer Podcasts Daten. Wenn Sie der automatischen Übermittlung der Daten widersprechen wollen, klicken Sie hier: https://datenschutz.ad-alliance.de/podcast.htmlUnsere allgemeinen Datenschutzrichtlinien finden Sie unter https://art19.com/privacy. Die Datenschutzrichtlinien für Kalifornien sind unter https://art19.com/privacy#do-not-sell-my-info abrufbar.

Linda Kreter welcomes Nurse Practitioner Lorinda Fontaine-Faris to respond to listener questions - when time is limited at the annual GYN visit... Here's your way to find out answers without a co-pay! This is the first of two episodes, and we help women thrive!

Emily is a surgical physician assistant who has worked in women's health for 10 years. She started her career in a hospital as a labor and delivery PA and for the last 6 years she has worked in minimally invasive GYN surgery. Emily's surgical practice specializes in the treatment of endometriosis, fibroids, adenomyosis, ovarian cysts and other GYN issues. Emily strives to never stop learning and is always seeking out new ways she can help her patients. You can follow her on Instagram @holisticgyn or on her surgical practice's page @innovativegyn.  In this episode we chat about:  Why you need to check your vitamin d Homelessness and c**vid outcomes Theories about fibroid causes Fibroids linked to infertility How to look for adenomyosis or endometriosis What endometriosis looks like What is causing endo? Is it estrogen? What is indoor air polution and is it killing you? Eye lash extensions in surgery WTF is talc powder Mouth breathing in babies isn't normal My first myofunctional therapy appointment Tips and trips after pelvic surgery Do plants grow when you talk nice to them? Learn more about working with me  Shop my masterclasses (learn more in 60-90 minutes than years of dr appointments) Follow me on IG Follow Empowered Mind + Body on IG   

In this episode, Zev A. Wainberg, MD; Funda Meric-Bernstam, MD; Alexandra Leary, MD, PhD; and Catherine Fahey, MD, PhD, explore testing for HER2 alterations and the incidence of HER2-positive disease in the treatment of genitourinary, gastrointestinal, and gynecologic malignancies. HER2 Testing in Advanced Cancers: Recommendations for when and how to test for HER2 in advanced cancers and how these tests guide therapy selectionVariability in HER2 Expression Across Tumor Types: Insights into the heterogeneity of HER2 expression and amplification in different cancersChallenges in Standardizing HER2 Testing: The complexities of scoring and testing HER2 in different cancers and institutions, and the need for better harmonization of guidelines and approachesPresenters:Zev A. Wainberg, MDProfessor of Medicine and SurgeryCo-Director of GI OncologyDirector, Early Phase Clinical Research ProgramJonsson Comprehensive Cancer CenterUCLA School of MedicineLos Angeles, CaliforniaFunda Meric-Bernstam, MDChair, Department of Investigational Cancer TherapeuticsMedical Director, Institute for Personalized Cancer TherapyNellie B. Connally Chair in Breast CancerThe University of Texas MD Anderson Cancer CenterHouston, TexasAlexandra Leary, MD, PhDPresident, GINECO GroupCo-Director, Department of Medical OncologyMedical Oncologist GynecologyTeam Leader, Gynecologic Translational Research Lab, INSERM u981Institut Gustave RoussyVillejuif, FranceCatherine Fahey, MD, PhDAssistant ProfessorDivision of OncologyUniversity of North Carolina at Chapel HillChapel Hill, North CarolinaLink to full program:https://bit.ly/42iEDjVTo claim credit for listening to this episode, please visit the podcast online at the link above. 

Send us a textGet answers to some of the most common women's health questions, answered by Marissa Walker, a registered nurse from the Cleveland Clinic's Center for Specialized Women's Health. Together, Host Dr. Holly Thacker and Nurse Marissa uncover the critical differences between a GYN annual exam and a pap smear, and discuss the essential role of maintaining personal health records.They explore the world of women's health screenings and the truth behind common misconceptions. Dr. Thacker and Nurse Marissa guide you through the importance of regular HPV checks and mammograms, shedding light on Ohio's new mammogram reporting laws and what they mean for you. The conversation doesn't stop there—find out why annual GYN exams remain crucial even post-hysterectomy, as we emphasize comprehensive health monitoring.Join them as they tackle hormone therapy and the complexities of managing prescriptions. They delve into why continuous monitoring of hormone levels is vital, especially for women with specific health backgrounds. Plus, they address the anxiety surrounding test results and the importance of medical guidance over online misinformation. This episode is packed with invaluable advice to empower you to take charge of your health with confidence.Fit, Healthy & Happy Podcast Welcome to the Fit, Healthy and Happy Podcast hosted by Josh and Kyle from Colossus...Listen on: Apple Podcasts SpotifySupport the show

Warum reden wir immer noch nicht offen über Inkontinenz, brennende Vulven und Schmerzen beim Sex? In dieser Folge räumen wir auf mit Tabus rund um den weiblichen Körper – gemeinsam mit Dr. med. Rebekka Westphal, Oberärztin für Gynäkologie und Urogynäkologie aus Hamburg. Es geht um das stille Leiden vieler Frauen – nach der Geburt, im Zyklus, in der Menopause. Dr. med. Rebekka Westphal, Gynäkologin und Urogynäkologin in Hamburg, spricht über Themen, für die selbst in der Frauenarztpraxis oft kein Raum ist.

Vitamin D spielt eine Schlüsselrolle in der Frauengesundheit – doch wie wichtig ist es wirklich für dich?

Es ist peinlich, und es macht vielen Angst: Wenn einem plötzlich Wörter nicht mehr einfallen oder sogar der Name der Kollegin, mit der man seit zehn Jahren das Büro teilt. Oder wenn man sich dieselbe Bluse noch einmal kauft, weil man vergessen hat, dass genau so eine im Schrank hängt. Und man genau weiß: Früher wäre Verlass gewesen auf den eigenen Kopf. Diana im Gespräch mit Gynäkologin Prof. Dr. Petra Stute vom Menopausenzentrum der Universitätsklinik Bern über Brainfog in den Wechseljahren, was Östrogene für Gehirn und Gedächtnis tun und die große Frage: Geht das wieder weg?INFOS ZUR FOLGE:Der Vortrag von Prof. Stute zum Thema Brainfog aus der Reihe "Wissen macht cool" der Deutschen Menopause Gesellschaft:https://www.menopause-gesellschaft.de/videosProf. Dr. Petra Stute im Netz:https://www.menoqueens.com https://frauenheilkunde.insel.ch/de/ueber-uns/team/details/person/detail/petra-stute… und auf Instagram: https://www.instagram.com/menoqueens.official/ Die Bücher von Lisa Mosconi:„Das weibliche Gehirn“: https://www.rowohlt.de/autor/dr-lisa-mosconi-25876 „Das Gehirn in den Wechseljahren“ (erscheint am 17. April 2025): https://www.dtv.de/buch/das-gehirn-in-der-menopause-40039Diana auf Instagram: https://www.instagram.com/apothekerin_ihres_vertrauens/Julia auf Instagram: https://www.instagram.com/julia_jortzig/Hier geht es zum Newsletter "Saisonwechsel" von der BRIGITTE: https://brigitte.guj-medien.de/newsletter-anmeldung-saisonwechselHier zum neuen meno_brigitte-Insta-Account: https://www.instagram.com/meno_brigitte/In unserer Eigenwerbung geht es um die BRIGITTE Masterclass Finanzen Premium: https://academy.brigitte.de/masterclass?utm_source=menoanmich&utm_medium=podcast&utm_campaign=mcf-premium-kh10Es gibt auch einen MENO AN MICH-Rabattcode, MENO15 (gilt für viele BRIGITTE-Angebote).WEITERE ANGEBOTE aus der BRIGITTE Redaktion:Masterclass Finanzen Basic: https://academy.brigitte.de/course/masterclass-finanzen-basic?utm_source=menoanmich&utm_medium=podcast&utm_campaign=mcf-basicKostenloses Webinar Rentenlücke berechnen: https://academy.brigitte.de/webinar-aufzeichnung-rentenluecke-berechnenETF Kurs: https://academy.brigitte.de/course/etf-kurs?utm_source=menoanmich&utm_medium=podcast&utm_campaign=etf-kurs-mOn Demand Video-Kurs "Wechseljahre: Wissen, was hiilft": https://academy.brigitte.de/course/wechseljahre?utm_source=podcast&utm_medium=meno&utm_campaign=wechseljahreDossier "Wechseljahre": https://produkte.brigitte.de/products/brigitte-dossier-wechseljahre?utm_campaign=briwebsite&utm_medium=link&utm_source=podcastmenoanmichDossier "Stoffwechsel anregen": https://produkte.brigitte.de/products/stoffwechsel-anregen?utm_source=podcast&utm_medium=menoanmich&utm_campaign=stoffwechselDossier "Gehen oder blieben?": https://produkte.brigitte.de/products/gehen-oder-bleiben?utm_source=podcast&utm_medium=menoanmich&utm_campaign=gobIhr habt Anregungen, wollt uns Eure Geschichte erzählen oder selbst bei uns zu Gast im Podcast sein? Dann schreibt uns beiden persönlich, worüber Ihr gern mehr wissen würdet, was Euch bewegt, rührt, entsetzt und Freude macht an podcast@brigitte.de. Wir freuen uns auf Euch! Und bewertet und abonniert unseren Podcast gerne auch auf Spotify, iTunes, Amazon Music oder Audio Now. Noch mehr spannende Beiträge findet Ihr zudem auf Brigitte.de sowie dem Instagram- oder Facebook-Account von BRIGITTE –schaut vorbei! +++ Weitere Infos zu unseren Werbepartnern finden Sie hier: https://linktr.ee/menoanmich ++++++ Unsere allgemeinen Datenschutzrichtlinien finden Sie unter https://datenschutz.ad-alliance.de/podcast.html ++++++ Wir verarbeiten im Zusammenhang mit dem Angebot unserer Podcasts Daten. Wenn Sie der automatischen Übermittlung der Daten widersprechen wollen, klicken Sie hier: https://datenschutz.ad-alliance.de/podcast.html +++Unsere allgemeinen Datenschutzrichtlinien finden Sie unter https://art19.com/privacy. Die Datenschutzrichtlinien für Kalifornien sind unter https://art19.com/privacy#do-not-sell-my-info abrufbar.

Dr. Ebony Hoskins and Dr. Andreas Obermair discuss the surgical management of gynecologic cancers, including the role of minimally invasive surgery, approaches in fertility preservation, and the nuances of surgical debulking. TRANSCRIPT Dr. Ebony Hoskins: Hello and welcome to the ASCO Daily News Podcast, I'm Dr. Ebony Hoskins. I'm a gynecologic oncologist at MedStar Washington Hospital Center in Washington, DC, and your guest host of the ASCO Daily News Podcast. Today we'll be discussing the surgical management of gynecologic cancer, including the role of minimally invasive surgery (MIS), approaches in fertility preservation, and the nuances of surgical debulking, timing, and its impact on outcomes. I am delighted to welcome Dr. Andreas Obermair for today's discussion. Dr. Obermair is an internationally renowned gynecologic oncologist, a professor of gynecologic oncology at the University of Queensland, and the head of the Queensland Center for Gynecologic Cancer Research. Our full disclosures are available in the transcript of this episode. Dr. Obermair, it's great speaking with you today. Dr. Andreas Obermair: Thank you so much for inviting me to this podcast. Dr. Ebony Hoskins: I am very excited.  I looked at your paper and I thought, gosh, is everything surgical? This is everything that I deal with daily in terms of cancer in counseling patients. What prompted this review regarding GYN cancer management? Dr. Andreas Obermair: Yes, our article was published in the ASCO Educational Book; it is volume 44 in 2024. And this article covers some key aspects of targeted precision surgical management principles in endometrial cancer, cervical cancer, and ovarian cancer. While surgery is considered the cornerstone of gynecologic cancer treatment, sometimes research doesn't necessarily reflect that. And so I think ASCO asked us to; so it was not just me, there was a team of colleagues from different parts of the United States and Australia to reflect on surgical aspects of gynecologic cancer care and I feel super passionate about that because I do believe that surgery has a lot to offer. Surgical interventions need to be defined and overall, I see the research that I'm doing as part of my daily job to go towards precision surgery. And I think that is, well, that is something that I'm increasingly passionate for. Dr. Ebony Hoskins: Well, I think we should get into it. One thing that comes to mind is the innovation of minimally invasive surgery in endometrial cancer. I always reflect on when I started my fellowship, I guess it's been about 15 years ago, all of our endometrial cancer patients had a midline vertical incision, increased risk of abscess, infections and a long hospital stay. Do you mind commenting on how you see management of endometrial cancer today? Dr. Andreas Obermair: Thank you very much for giving the historical perspective because the generation of gynecologic oncologists today, they may not even know what we dealt with, what problems we had to solve. So like you, when I was a fellow in gynecologic oncology, we did midline or lower crosswise incisions, the length of stay was, five days, seven days, but we had patients in hospital because of complications for 28 days. We took them back to the operating theaters because those are patients with a BMI of 40 plus, 45, 50 and so forth. So we really needed to solve problems. And then I was exposed to a mentor who taught minimal invasive surgery. And in Australia he was one of the first ones who embarked on that. And I can remember, I was mesmerized by this operation, like not only how logical this procedure was, but also we did rounds afterwards. And I saw these women after surgery and I saw them sitting upright, lipstick on, having had a full meal at the end of the day. And I thought, wow, this is the most rewarding experience that I have to round these patients after surgery. And so I was thinking, how could I help to establish this operation as standard? Like a standard that other people would accept this is better. And so I thought we needed to do a trial on this. And then it took a long time. It took a long time to get the support for the [LACE - Laparoscopic Approach to Cancer of the Endometrium] trial. And in this context, I just also wanted to remind us all that there were concerns about minimal invasive surgery in endometrial cancer at the time. So for example, one of the concerns was when I submitted my grant funding applications, people said, “Well, even if we fund you, wouldn't be able to do this trial because there are actually no surgeons who actually do minimally invasive surgery.” And at the time, for example, in Australia, there were maybe five people, a handful of people who were able to do this operation, right? This was about 20 years ago. The other concern people had was they were saying, could minimally invasive surgery for endometrial cancer, could that cause port side metastasis because there were case reports. So there were a lot of things that we didn't know anyway. We did this trial and I'm super happy we did this trial. We started in 2005, and it took five years to enroll. At the same time, GOG LAP2 was ramping up and the LACE trial and GOG LAP2 then got published and provided the foundations for minimally invasive surgery in endometrial cancer. I'm super happy that we have randomized data about that because now when we go back and now when people have concerns about this, should we do minimally invasive surgery in P53 mutant tumors, I'm saying, well, we actually have data on that. We could go back, we could actually do more research on that if we wanted to, but our treatment recommendations are standing on solid feet. Dr. Ebony Hoskins: Well, my patients are thankful. I see patients all the time and they have high risk and morbidly obese, lots of medical issues and actually I send them home most the same day. And I think, you know, I'm very appreciative of that research, because we obviously practice evidence-based and it's certainly a game changer. Let's go along the lines of MIS and cervical cancer. And this is going back to the LACC [Laparoscopic Approach to Cervical Cancer] trial.  I remember, again, one of these early adopters of use of robotic surgery and laparoscopic surgery for radical hysterectomy and thought it was so cool. You know, we can see all the anatomy well and then have the data to show that we actually had a decreased survival. And I even see that most recent updated data just showing it still continued. Can you talk a little bit about why you think there is a difference? I know there's ongoing trials, but still interested in kind of why do you think there's a survival difference? Dr. Andreas Obermair:  So Ebony, I hope you don't mind me going back a step. So the LACC study was developed from the LACE trial. So we thought we wanted to reproduce the LACE data/LAP2 data. We wanted to reproduce that in cervix cancer. And people were saying, why do you do that? Like, why would that be different in any way? We recognize that minimally invasive radical hysterectomy is not a standard. We're not going to enroll patients in a randomized trial where we open and do a laparotomy on half the patients. So I think the lesson that really needs to be learned here is that any surgical intervention that we do, we should put on good evidence footing because otherwise we're really running the risk of jeopardizing patients' outcomes. So, that was number one and LACC started two years after LACE started. So LACC started in 2007, and I just wanted to acknowledge the LACC principal investigator, Dr. Pedro Ramirez, who at the time worked at MD Anderson. And we incidentally realized that we had a common interest. The findings came totally unexpected and came as an utter shock to both of us. We did not expect this. We expected to see very similar disease-free and overall survival data as we saw in the endometrial cancer cohort. Now LACC was not designed to check why there was a difference in disease-free survival. So this is very important to understand. We did not expect it. Like, so there was no point checking why that is the case. My personal idea, and I think it is fair enough if we share personal ideas, and this is not even a hypothesis I want to say, this is just a personal idea is that in endometrial cancer, we're dealing with a tumor where most of the time the cancer is surrounded by a myometrial shell. And most of the time the cancer would not get into outside contact with the peritoneal cavity. Whereas in cervix cancer, this is very different because in cervix cancer, we need to manipulate the cervix and the tumor is right at the outside there. So I personally don't use a uterine manipulator. I believe in the United States, uterine manipulators are used all the time. My experience is not in this area, so I can't comment on that. But I would think that the manipulation of the cervix and the contact of the cervix to the free peritoneal cavity could be one of the reasons. But again, this is simply a personal opinion. Dr. Ebony Hoskins: Well, I appreciate it. Dr. Andreas Obermair: Ebony at the end of the day, right, medicine is empirical science, and empirical science means that we just make observations, we make observations, we measure them, and we pass them on. And we made an observation. And, and while we're saying that, and yes, you're absolutely right, the final [LACC] reports were published in JCO recently. And I'm very grateful to the JCO editorial team that they accepted the paper, and they communicated the results because this is obviously very important. At the same time, I would like to say that there are now three or four RCTs that challenge the LACC data. These RCTs are ongoing, and a lot of people will be looking forward to having these results available. Dr. Ebony Hoskins: Very good. In early-stage cervical cancer, the SHAPE trial looked at simple versus radical hysterectomy in low-risk cervical cancer patients. And as well all know, simple hysterectomy was not inferior to radical hysterectomy with respect to the pelvic recurrence rate and any complications related to surgery such as urinary incontinence and retention. My question for you is have you changed your practice in early-stage cervical cancer, say a patient with stage 1B1 adenocarcinoma with a positive margin on conization, would you still offer this patient a radical hysterectomy or would you consider a simple hysterectomy? Dr. Andreas Obermair:  I think this is a very important topic, right? Because I think the challenge of SHAPE is to understand the inclusion criteria. That's the main challenge. And most people simplify it to 2 cm, which is one of the inclusion criteria but there are two others and that includes the depth of invasion. Dr. Marie Plante has been very clear. Marie Plante is the first author of the SHAPE trial that's been published in the New England Journal of Medicine only recently and Marie has been very clear upfront that we need to consider all three inclusion criteria and only then the inclusion criteria of SHAPE apply. So at the end of the day, I think what the SHAPE trial is telling us that small tumors that would strictly fulfill the criteria of a 1B or 1B1 cancer of the cervix can be considered for a standard type 1 or PIVA type 1 or whatever classification we're trying to use will be eligible. And that makes a lot of sense. I personally not only look at the size, I also look at the location of the tumor. I would be very keen that I avoid going through tumor tissue because for example, if you have a tumor that is, you know, located very much in one corner of the cervix and then you do a standard hysterectomy and then you have a positive tumor margin that would be obviously, most people would agree it would be an unwanted outcome. So I'd be very keen checking the location, the size of the tumor, the depths of invasion and maybe then if the tumor for example is on one side of the cervix you can do a standard approach on the contralateral side but maybe do a little bit more of a margin, a parametrial margin on the other side. Or if a tumor is maybe on the posterior cervical lip, then you don't need to worry so much about the anterior cervical margin, maybe take the rectum down and maybe try to get a little bit of a vaginal margin and the margin on the uterus saccals. Just really to make sure that you do have margins because typically if we get it right, survival outcomes of clinical stage 1 early cervix cancer 1B1 1B 2 are actually really good. It is a very important thing that we get the treatment right. In my practice, I use a software to record my treatment outcomes and my margins. And I would encourage all colleagues to be cognizant and to be responsible and accountable to introduce accountable clinical practice, to check on the margins and check on the number on the percentage of patients who require postoperative radiation treatment or chemo radiation. Dr. Ebony Hoskins: Very good. I have so many questions for you. I don't know the statistics in Australia, but here, there's increased rising of endometrial cancer and certainly we're seeing it in younger women. And fertility always comes up in terms of kind of what to do. And I look at the guidelines and, see if I can help some of the women if they have early-stage endometrial cancer. Your thoughts on what your practice is on use of someone who may meet criteria, if you will. The criteria I use is grade 1 endometrioid adenocarcinoma. No myometria invasion. I try to get MRI'd and make sure that there's no disease outside the endometrium. And then if they make criteria, I typically would do an IUD. Can you tell me what your practice is and where you've had success? Dr. Andreas Obermair: So, we initiated the feMMe clinical trial that was published in 2021 and it was presented in a Plenary at one of the SGO meetings. I think it was in 2021, and we've shown complete pathological response rates after levonorgestrel intrauterine device treatment. And so in brief, we enrolled patients with endometrial hyperplasia with atypia, but also patients with grade 1 endometrial adenocarcinoma. Patients with endometrial hyperplasia with atypia had, in our series, had an 85 % chance of developing a complete pathological response. And that was defined as the complete absence of any atypia or cancer. So endometrial hyperplasia with atypia responded in about 85%. In endometrial cancer, it was about half, it was about 45, 50%. In my clinical practice, like as you, I see patients, you know, five days a week. So I'm looking after many patients who are now five years down from conservative treatment of endometrial cancer. There are a lot of young women who want to get pregnant, and we had babies, and we celebrate the babies obviously because as gynecologist obstetricians it couldn't get better than that, right, if our cancer patients have babies afterwards. But we're also treating women who are really unfit for surgery and who are frail and where a laparoscopic hysterectomy would be unsafe. So this phase is concluded, and I think that was very successful. At least we're looking to validate our data. So we're having collaborations, we're having collaborations in the United States and outside the United States to validate these data. And the next phase is obviously to identify predictive factors, to identify predictors of response. Because as you can imagine, there is no point treating patients with a levonorgestrel intrauterine joint device where we know in advance that she's not going to respond. So this is a very, very fascinating story and we got our first set of data already, but now we just really need to validate this data. And then once the validation is done, my unit is keen to do a prospective validation trial. And that also needs to involve international collaborators. Dr. Ebony Hoskins: Very good. Moving on to ovarian cancer, we see patients with ovarian cancer with, say, at least stage 3C or higher who started neoadjuvant chemotherapy. Now, some of these patients are hearing different things from their medical oncologist versus their gynecologic oncologist regarding the number of cycles of neoadjuvant chemotherapy after getting diagnosed with ovarian cancer. I know that this can be confusing for our patients coming from a medical oncologist versus a gynecologic oncologist. What do you say to a patient who is asking about the ideal number of chemotherapy cycles prior to surgery? Dr. Andreas Obermair: So this is obviously a very, very important topic to talk about. We won't be able to provide a simple off the shelf answer for that, but I think data are emerging.  The ASCO guidelines should also be worthwhile considering because there are actually new ASCO Guidelines [on neoadjuvant chemotherapy for newly diagnosed, advanced ovarian cancer] that just came out a few weeks ago and they would suggest that we should be aiming for R0 in surgery. If we can maybe take that as the pivot point and then go back and say, okay, so what do need to do to get the patient to zero?  I'm not an ovarian cancer researcher; I'm obviously a practicing gynecologic oncologist. I think about things a lot and things like that. In my practice, I would want a patient to develop a response after neoadjuvant chemotherapy. So, if a patient doesn't have a response after two or three cycles, then I don't see the point for me to offer her an operation. In my circle with the medical oncologists that I work with, I have a very, very good understanding. So, they send the patient to me, I take them to the theater. I take a good chunk of tissue from the peritoneum. We have a histopathologic diagnosis, we have a genomic diagnosis, they go home the same day. So obviously there is no hospital stay involved with that. They can start the chemotherapy after a few days. There is no hold up because the chances of surgical complication in a setting like this is very, very low. So I use laparoscopy to determine whether the patient responds or not. And for many of my patients, it seems to work. It's obviously a bit of an effort and it takes operating time. But I think I'm increasing my chances to make the right decision. So, coming back to your question about whether we should give three or six cycles, I think the current recommendations are three cycles pending the patient's response to neoadjuvant chemotherapy because my aim is to get a patient to R0 or at least minimal residual disease. Surgery is really, in this case, I think surgery is the adjunct to systemic treatment. Dr. Ebony Hoskins: Definitely. I think you make a great point, and I think the guideline just came out, like you mentioned, regarding neoadjuvant. And I think the biggest thing that we need to come across is the involvement of a gynecologic oncologist in patients with ovarian cancer. And we know that that survival increases with that involvement. And I think the involvement is the surgery, right? So, maybe we've gotten away from the primary tumor debulking and now using more neoadjuvant, but surgery is still needed. And so, I definitely want to have a take home that GYN oncology is involved in the care of these patients upfront. Dr. Andreas Obermair: I totally support that. This is a very important statement. So when I'm saying surgery is the adjunct to medical treatment, I don't mean that surgery is not important. Surgery is very important. And the timing is important. And that means that the surgeons and the med oncs need to be pulling on the same string. The med oncs just want to get the cytotoxic into the patients, but that's not the point, right? We want to get the cytotoxic into the patients at the right time because if we are working under this precision surgery, precision treatment mantra, it's not only important what we do, but also doing it at the right time. And ideally, I I would like to give surgery after three cycles of neoadjuvant chemotherapy, if that makes sense. But sometimes for me as a surgeon, I talk to my med onc colleagues and I say, “Look, she doesn't have a good enough response to her treatment and I want her to receive six cycles and then we re-evaluate or change medical treatment,” because that's an alternative that we can swap out drugs and treat upfront with a different drug and then sometimes they do respond. Dr. Ebony Hoskins:  I have maybe one more topic. In the area I'm in, in the Washington D.C. area, we see lots of endometrial cancer and they're not grade 1, right? They're high-risk endometrial cancer and advanced. So a number of patients with stage 3 disease, some just kind of based off staging and then some who come in with disease based off of the CT scan, sometimes omental caking, ascites. And the real question is we have extrapolated the use of neoadjuvant chemotherapy to endometrial cancer. It's similar, but not the same. So my question is in an advanced endometrial cancer, do you think there's still a role, when I say advanced, I mean, maybe stage 4, a role for surgery? Dr. Andreas Obermair: Most definitely. But the question is when do you want to give this surgery? Similar to ovarian cancer, in my experience, I want to get to R0. What am I trying to achieve here? So, I reckon we should do a trial on this. And I reckon we have, as you say, the number of patients in this setting is increasing, we could do a trial. I think if we collaborate, we would have enough patients to do a proper trial. Obviously, we would start maybe with a feasibility trial and things like that. But I reckon a trial would be needed in this setting because I find that the incidence that you described, that other people would come across, they're becoming more and more common. I totally agree with you, and we have very little data on that. Dr. Ebony Hoskins: Very little and we're doing what we can. Dr. Obermair, thank you for sharing your fantastic insights with us today on the ASCO Daily News Podcast and for all the work you do to advance care for patients with gynecologic cancer. Dr. Andreas Obermair: Thank you, Dr. Hoskins, for hosting this and it's been an absolute pleasure speaking with you today. Dr. Ebony Hoskins: Definitely a pleasure and thank you to our listeners for your time today. Again, Dr. Obermair's article is titled, “Controversies in the Surgical Management of Gynecologic Cancer: Balancing the Decision to Operate or Hesitate,” and was published in the 2024 ASCO Educational Book. And you'll find a link to the article in the transcript of this episode. Finally, if you value the insights that you hear on the ASCO Daily News Podcast, please take a moment to rate, review and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers: Dr. Ebony Hoskins @drebonyhoskins Dr. Andreas Obermair @andreasobermair Follow ASCO on social media:       @ASCO on Twitter       ASCO on Bluesky   ASCO on Facebook       ASCO on LinkedIn       Disclosures:   Dr. Ebony Hoskins: No relationships to disclose. Dr. Andreas Obermair: Leadership: SurgicalPerformance Pty Ltd. Stock and Ownership Interests: SurgicalPerformance Pty Ltd. Honoraria: Baxter Healthcare Consulting or Advisory Role: Stryker/Novadaq Patents, Royalties, and Other Intellectual Property: Shares in SurgicalPerformance Pty Ltd. Travel, Accommodation, Expenses: Stryker    

Dr. Shannon Westin and her guest, Dr. Breelyn Wilky, discuss the JCO article, "“Botensilimab (Fc-enhanced anti-cytotoxic lymphocyte-association protein-4 antibody) Plus Balstilimab (anti-PD-1 antibody) in Patients With Relapsed/Refractory Metastatic Sarcomas." TRANSCRIPT  Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast where we get in depth on research that has been published in the Journal of Clinical Oncology. I am your host, Gynecologic Oncologist and Social Media Consultant Editor of the JCO, Shannon Westin. I serve here from the University of Texas MD Anderson Cancer Center. And I am so excited to welcome Dr. Breelyn Wilky. She's an Associate Professor and the Director of Sarcoma Medical Oncology in the Department of Medicine Division of Medical Oncology, and the Cheryl Bennett & McNeilly family endowed chair in Sarcoma Research, the Deputy Associate Director of Clinical research at the University of Colorado Cancer Center. Welcome. Dr. Breelyn Wilky: Thank you so much. I'm delighted to be here. Shannon Westin: And with all those titles, I'm super impressed that she was able to complete the manuscript that we're going to discuss today, which is “Botensilimab (Fc-enhanced anti-cytotoxic lymphocyte-association protein-4 antibody) Plus Balstilimab (anti-PD-1 antibody) in Patients With Relapsed/Refractory Metastatic Sarcomas.” And this was published in the JCO on January 27, 2025. And please note, our participants do not have any conflicts of interest. So this is exciting. Let's first level set. Can you review with us just the current state of sarcoma incidents, survival outcomes, that kind of thing so we all know where we're starting? Dr. Breelyn Wilky: Yes. So, you know, sarcomas are really, I like to call them the black box cancer type. And the big thing is that there's really more than a hundred different kinds of sarcomas, which collectively altogether make up only 1% of adult cancers. And so we talk about these as being bone and soft tissue tumors, but really, the heterogeneity is just incredible. You're talking maybe 10,000 to 12,000 new cases of soft tissue sarcoma per year, which is pretty rare in the grand scheme of things. And the trouble with these is that while you can cure sarcomas if you find them early and they're localized, when they metastasize and spread and are not resectable, we're looking at median overall survivals of really only 12 to 18 months, even, you know, with our best therapies that we have. So, really there's just a dire need for new treatments for this really tough group of diseases. Shannon Westin: Yeah, I agree. I'm a gynecologic oncologist, and we have our little subset of sarcomas that I know there's a little bit out of every one. So I'm really excited to pull this manuscript as one of our podcasts offerings because I think we're all seeing these patients in the clinic and certainly our listeners that have sarcoma or have family members with sarcoma, this is so good to have a real focus on a rare group of tumors that have been a little bit lumped together. Now, with that being said, I know this is such a heterogeneous population, but can you briefly overview a little bit around the standard of care for treatment of recurrent sarcomas? Dr. Breelyn Wilky: We have actually been using the same drugs really since about the 1970s, and up until very recently, nothing had really challenged doxorubicin, the old ‘red devil', like we used to call it. And this has been the mainstay of treatment for metastatic sarcomas and really used across the board. In the GYN literature, for uterine leiomyosarcoma, we did see some promising activity with the combination of doxorubicin and trabectedin coming out of the French group. But, except for that study, no combination therapy or new drug has been proven better in terms of overall survival compared to doxorubicin monotherapy, really over 40, 50 years. So it's definitely a tough situation. Now, we do have other drugs that we use, so most patients will wind up getting doxorubicin-based therapy. There's a couple of other regimens that we'll reach to, like gemcitabine docetaxel. And once you get into the specific subtypes, we have some approvals in liposarcomas and leiomyosarcomas for some other drugs. But really the median progression for survival for most of these regimens is somewhere four to six months. And response rates typically are somewhere like 10%, 15% for most of these. So it's really just a very tough field and a tough group of patients to try to make an impact for. Shannon Westin: So let's talk a little bit more kind of getting focused on what you've studied here. What's been the role of immunotherapy thus far in the treatment of sarcomas maybe prior to this particular study? Dr. Breelyn Wilky: Clearly, we all know that immune therapy has just changed cancer care forever over the last few years for so many different types of cancers and diseases like melanoma and renal cell and lung cancer have just been transformed by checkpoint inhibitors specifically directed against PD-1 or CTLA-4 or both. And so, of course, you know, sarcoma docs we're super excited to try to see if these might potentially have activity in our tumors as well. I never had seen myself in my career getting into immunotherapy until I was able to run an investigator-initiated study during my role in Miami, where we combined pembrolizumab, so PD-1 inhibitor, with axitinib which was a pan-VEGF inhibitor. And lo and behold, like I had patients that I was seeing responses when other treatments, all those chemotherapies I was just talking about had failed. And one of my first patients I treated was about a 60-year-old lady with something called cutaneous angiosarcoma. So this is a blood vessel sarcoma all over her face. And we had treated her with 10 different therapies, all the chemotherapy regimens, targeted therapies, clinical trials, and nothing was working. But I put her on a phase 1 trial with a baby dose of CTLA-4 and this woman had a complete response. And so for me, once I saw it work in even just those couple of patients, like that was nothing that we'd ever seen with our chemotherapy regimens. And so that sort of shifted my career towards really focusing on this, and this is about the time where some of the studies started to come out for sarcomas. And the take home with sarcoma is about 20% of sarcomas have this sort of immune hot physiology. So what that basically means is if you look at gene expression of immune related gene signatures, or you look for infiltrating T-cells, sort of the SWAT team of our immune system, like you can find those in the tumors. And it's sort of evidence that the immune system had some clue for that 20% of patients that this was a foreign tumor and that it should be attacking it and maybe just needed a little help. But globally, about 80% of sarcomas are these immune cold tumors, which means the immune system has no clue that these things are even a threat. And there's almost no immune activation, very, very few antigens. In other cancer types, high neoantigens or tumor antigens help the immune system work better. And so that basically goes with what we've seen with trials of PD-1 or CTLA-4 blockade. About 20% of sarcomas, with some exceptions, can respond. But really 80% across the board, you're stuck, you just can't get them to be recognized. And so that's where I think this data is so interesting is there's some signals of activity in these immune cold tumors which, at least historically with the trials we've done so far, we really haven't seen that with sort of the traditional checkpoints. Shannon Westin: So I think now this is a great time to maybe talk about the study design in general, the eligibility and just give us kind of a run through of that. Dr. Breelyn Wilky: So this trial was a phase 1 trial of a drug called botensilimab, which is a next generation CTLA-4 directed immune modulator. So what makes botensilimab different is that the CTLA-4 end is very similar to other CTLA-4 inhibitors that are out there, but it's been engineered on the back end of the molecule that binds to Fc gamma receptors to basically bind tighter with higher affinity. And what this translates to in laboratory models and increasingly now in patients is it does a better job of priming, of educating our T cells, our, again, these highly intelligent antigen specific cells, but also natural killer cells. It does a better job of sort of educating those. It helps to activate macrophages and other supporting actors in the immune response. And so the idea here is that there's evidence that botensilimab may do a better job at creating new responses in immune cold tumors. The study combined either botensilimab as monotherapy or in combination with a PD-1 inhibitor called balstilimab. And this was all comers, really a variety of tumor types. And to date I think we're close to about 500 patients with a variety of solid tumors that have been accrued to this study, this C-800-01 phase 1 trial. This paper reports on the sarcoma patients that were enrolled as part of this study. And so, again, given what I've told you about sarcomas being really immune cold, we were just so excited to have the opportunity to enroll on a next generation immune therapy for these tumors that really we were running into roadblocks trying to use immunotherapy previously. Shannon Westin: It's a very compelling idea and I'm so excited for you to tell people what you found. I think first things first, it was an early phase trial. So why don't we talk a little bit about the safety of the regimen. Was there anything that you didn't expect? Dr. Breelyn Wilky: Right. So similar to other checkpoint inhibitors, you know, the idea is that these drugs can cause immune mediated toxicities, right? So essentially you're revving up the immune system and it can sometimes get a bit confused and start attacking our normal cells, our normal organs, leading to essentially any number of toxicities of basically head to toe, something can get inflamed and you can develop a toxicity from that. So the key take homes with this particular drug with, botensilimab with balstilimab, we saw colitis was sort of the primary immune mediated toxicity and it was about a third of patients, give or take. It happens and it can be aggressive and needs to be managed aggressively. And you know, one of the things that we learned very quickly taking part in this study is how important it is that as soon as patients start to get diarrhea, immunosuppression gets on board. So steroids, early use of TNF alpha blockade, so infliximab for example, if we jumped on it quickly and we recognized it and we got the patients treated, it would resolve fairly quickly and even some patients could remain on treatment. So I think that was sort of the first take home is “Okay if you get colitis, you treat it fast, you treat it early and you can still have patients not only recover, which essentially everybody recovered from this colitis and then being able to continue on treatment and still have their anti-tumor responses.” So that's the first point. The second thing that was really interesting is part of the engineering of botensilimab on the back end of the molecule, it's been designed to decrease complement binding and it's thought that that triggers some of these other toxicities that we've seen with prior CTLA-4 inhibitors like pneumonitis or hypophysitis. We actually don't see that with botensilimab. So there's sort of this selective toxicity that may reflect the design of the molecule. But overall the treatment was, we didn't see any new safety signals that were outside of what we would expect in class. And colitis was sort of the dominant thing that we had to be ready for and ready to manage. Shannon Westin: We've been doing it for a while now, so we kind of know what to do and we can act quickly and really try to mitigate and avoid some of the major toxicities. So that's great that that was what was reflected in what you found. And then of course I think: What about the efficacy?” Right. This is what we care about as practitioners, as patients. Does it work and are there any subtypes that seem to benefit the most from this combination? Dr. Breelyn Wilky: Right. So for the sarcoma patients, we treated 64 patients and 52 of those patients were evaluable for efficacy. So a decent size group of patients in sarcomas, where, you know, typically our trials are pretty small, they're very rare, but we had 52 evaluable with at least one post baseline scan. So that was our criteria. And basically we saw across all of the patients, and keep in mind, these are heavily pre-treated patients, as you mentioned, so a median of 3 prior lines of therapy, so most of these patients had had chemotherapies and then about 20% had also had prior immunotherapy as well. So PD-1 treatments or so on. The overall response rate by RECIST was 19.2% for all of the evaluable patients. And then with iRECIST, which is sort of that immune adapted response criteria that allows for early pseudo progression, we actually had another patient who did have that. And so that response rate was 21.2%. Overall, we were really excited to see this in a heavily pre-treated group of patients. But what was really exciting to me was when we looked at the subset of patients that had angiosarcoma, that blood vessel tumor I was talking about earlier with my other patient. So angios come in two flavors. One is this sort of cutaneous type, or meaning involving the skin that has a UV signature, a UV damage signature, very similar to melanoma. So these tumors tend to have a high mutation burden. And oftentimes there is a track record that we've seen responses with immunotherapy in cutaneous angiosarcomas. But the other group that we deal with is called visceral angiosarcomas. And so these are totally different biologically. These are often driven by mutations in MYC or KDR amplification, and they arise in organs, so primary breast angiosarcoma, not associated with radiation, or they can arise in the liver or the spleen or an extremity. So these are very, very different tumors, and the visceral ones almost never historically have responded to checkpoint inhibitors. So we had 18 patients with angio split - 9 with cutaneous, 9 with visceral. And we were just blown away because the response rate for that group was 27.8%. And if you looked at the responses between the hot ones and the cold ones, it was almost equal and a little bit better in the visceral. So we had a 33% response rate in visceral angiosarcoma, which is crazy, historically speaking, and about 20% again in the cutaneous angios. So for a disease where visceral angio gets treated with chemotherapy, might respond initially, but then rapidly progresses - like these people go through multiple lines of therapy - to have a third of patients responding, and then some of those responses were durable. Our median duration of response for the study was 21.7 months, which is just nuts for sarcomas where we just don't see those sorts of long term benefits with the drugs that we have. So I think those are kind of the two main things. There were other subtypes that had clinical benefit and responses as well in d-diff liposarcoma, soft tissue leiomyosarcoma, which are again thought to be fairly cold immune subtypes. So just really exciting to kind of see responses we hadn't expected in a very challenging group of tumors. Shannon Westin: We see all these patients and we have patients that respond so well to immunotherapy with other histotypes. And so it's so exciting to see an option for these really hard to treat tumors that our patients struggle with. So this is so, so very exciting. I wanted to make mention, you know, I was really impressed with the amount of translational work you were able to do in this early phase study. So do you want to review just maybe a few of the key findings that you guys discovered? Dr. Breelyn Wilky: It's always great. I'm a translational researcher at heart and we do a lot of immune correlative work. And I think the reason I got so excited about this field to begin with was trying to learn why it works for some patients and why it doesn't work for other patients. So I'm a huge believer in learning from every patient that we can. So it's such a testament to the company, Agenus, who sponsored this trial to invest their time and resources into correlative studies at this phase. It's huge. So we learned a couple of things. IL-6 or interleukin 6 is a cytokine that basically has, in other tumor types, been associated with worse outcomes. And what we were interested in this group is we saw the same thing. And again, sarcomas have very, very little correlative biology that's done. We're really in infancy and understanding the microenvironment and how that milieu balances out in our tumors. So we were really excited to see again that lower peripheral interleukin 6 associated with improved overall survival. So again, kind of sorting out a group of patients that might be immunologically favorable when it comes to this type of therapy. The other thing that's important to know about sarcoma is so the other tumor types are lucky and have PD-L1 expression and the tumor is a biomarker, but we never have PD-L1 expression. We can find it in sarcomas and it can be loosely correlated with a chance of benefit with immunotherapy. But I've had patients respond that were PD-L1 negative, and I've had patients that were loaded with PD-L1 that didn't seem to make a difference. And that's not just in this study. So we saw in this trial a trend towards improved overall survival with PD-L1 expression that wasn't significant, but there was like this trend. And it's really interesting because, again, this is largely a CTLA-4 directed therapy. And so what we wondered is if PD-L1 expression is an index of sort of this underlying potential immunogenicity. And actually PD-1 works very late in the whole immune process. That's really at the very end where you've got the T cell that's facing the tumor cell and it's just activating that T cell that's already grown up and already educated and ready to go. Whereas CTLA-4 is really educating in early immune responses and expanding the T cells that have potential to kill. So I'm interested to look into this in more depth in the future to see if this is actually the biomarker for CTLA-4 directed therapy that we've been looking for, because we really don't have a great sense about that. And then the last piece just to note is that in this trial, like most others, very, very few sarcomas had high mutational burden. Everybody was very low, which reflects the population. And it's just really more encouragement than an immune cold tumor with very crappy neoantigens can still respond to immunotherapy if we get them the right agents. Shannon Westin: Yeah, I mean, I'm taking notes because we have such a struggle with this across the gynecologic tumors. I'm like, “Okay, maybe this is finally it.” So hopefully your work will go on to really inspire us across a number of solid tumors that have been traditionally cold. So, so very exciting. And I would just say for my last question, obviously, congratulations on this successful study. What do you think are the next steps for this combination in sarcomas? Dr. Breelyn Wilky: So, again, just to your point, this trial enrolled a bunch of different subtypes, and sarcomas are not the only immune cold tumor that this combo has looked really promising for, microsatellite stable colorectal cancer, ovarian cancer that was platinum refractory, non-small cell lungs. So I think the future is really bright for immune cold tumors kind of across the board. So, yes, lots of hope for not just sarcomas but in terms of our patients, I just have to be so grateful to Agenus for their interest in a rare disease. Sometimes it's hard to get that interest for a very challenging group of patients that are all heterogeneous, they are not all the same and our big clinical trials are a few hundred patients. It's just a very different environment. But they have been so supportive and involved in making sure that sarcomas are represented in their priorities. So there are ongoing discussions about what the optimal way to explore this further in sarcomas is going to be and I cannot wait to have the official plans in place. But my hope is this will not be the last that we see of these drugs for our patients. Shannon Westin: Well, I support that and my vote is on your side. So, thank you so much again, Dr. Wilky. This time just flew by. This was such a great discussion and I mean, I think it's, again, a testament to your exciting data. And thank you to all of our listeners. This has been JCO After Hours' discussion of “Botensilimab (Fc-enhanced anti-cytotoxic lymphocyte-association protein-4 antibody) Plus Balstilimab (anti-PD-1 antibody) in Patients With Relapsed/Refractory Metastatic Sarcomas,” published in the JCO on January 27, 2025. So be sure to check out the full manuscript. And we hope that you enjoyed this podcast. And if you want to hear more about research published in the JCO, check this out on our ASCO JCO website or wherever you get your podcasts. Have an awesome day.   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. Dr. Wilky Disclosures  Consulting or Advisory Role: SpringWorks Therapeutics, Deciphera, Epizyme, Adcendo, Polaris, Boehringer Ingelheim, AADi, InhibRx Research Funding: Exelixis Travel, Accommodations, Expenses: Agenus    

What surgical techniques and safety measures are important to consider when operating in a pregnant patient? In this episode of the BackTable OBGYN podcast, Dr. Craig Sobolewski, a minimally invasive GYN surgeon at Duke, speaks with host Dr. Mark Hoffman about the intricacies of laparoscopic surgery in pregnant patients. --- SYNPOSIS The surgeons delve into the critical importance of understanding anatomy and ensuring proper exposure during surgeries, particularly the challenges and techniques for operating during pregnancy. Key discussions include the use of liver retractors, the management of symptomatic ovarian cysts, and the methods for performing and evaluating abdominal cerclages. They also explore the physiological changes in pregnant patients and the adjustments needed for anesthesia, laparoscopic entry, pressures during surgery, and pre/post-operative care. --- TIMESTAMPS 00:00 - Introduction 07:20 - Laparoscopy in Pregnant Patients 11:23 - Common Surgeries During Pregnancy 15:56 - Laparoscopic Surgery Techniques 24:04 - Physiologic Changes in Pregnancy 27:33 - Access Methods and Pressure Considerations 28:53 - Managing Torsion and Cysts in Pregnancy 30:21 - Energy Use and Safety in Pregnant Patients 31:38 - Preoperative and Postoperative Care 34:15 - Cerclage Procedures and Counseling 47:46 - Professional Reflections and Conclusions

-REPLAY-De plus en plus au fil des épisodes du podcast, je vous distille ci-et-là des informations, des sujets autour de mon métier de naturopathe spécialisée dans la santé des femmes. Il me semble important de vous partager des clefs au fil de mes découvertes pour vivre au mieux votre bien-être.Cet épisode en fait partie, et je suis ravie d'y accueillir Maud Renard pour évoquer le quotient émotionnel qu'il se joue au creux de nos ventres, dans nos organes de femmes, ainsi que de sa méthode : la Gyn'Émotion !J'espère que cet épisode plein de douceur et de jolis symboles vous plaira et vous éclairera !À vos casques !—Si mon échange avec Maud a piqué votre curiosité, je vous invite chaudement à découvrir le travail de Maud sur son site internet, son compte instagram, et à dévorer son livre “Habiter son utérus” aux Editions Tana !Découvrez HEALTHY CYCLES, mon programme en ligne et en autonomie pour vous aider à reconnecter avec votre cycle menstruel, équilibrer vos hormones et soulager vos maux ! Rendez-vous juste ici pour embarquer dans l'aventure !Vous préférez un suivi individuel et main dans la main ? Je vous propose mon ACCOMPAGNEMENT HOLISTIQUE, individuel ou en couple, mêlant naturopathie, phytothérapie, aromatologie, symptothermie et bien d'autres techniques pour vous reconnecter à votre corps et atteindre enfin votre objectif santé ! Par ici pour découvrir toutes les informations et par là pour réserver un appel découverte gratuit !Je vous propose également de vous former à la symptothermie avec mon programme HEALTHY SYMPTOTHERMIE, pour vous permettre d'adopter une contraception 100 naturelle et fiable à 98,2% après formation (contre 97,6% de fiabilité pour la pilule, chiffres de l'OMS) ! Par ici pour en savoir plus et rejoindre l'aventure !Et enfin, n'hésitez pas à découvrir mes ebooks : HEALTHY FOOD, le guide de l'alimentation hormonale et HEALTHY PUBERTÉ, pour accompagner les jeunes filles vers leur vie de femmes.Si vous aimez Healthy Living et souhaitez m'aider à faire connaître le podcast, n'hésitez pas à le partager autour de vous auprès de personnes que cela pourrait aider ou intéresser. N'hésitez pas également à laisser des appréciations et commentaires sur votre application d'écoute préférée. It means the world to me!Pour ne rien manquer des actualités du podcast, pensez à vous abonner sur votre plateforme d'écoute préférée, à me rejoindre sur insta et à vous inscrire à la newsletter dans laquelle je partage chaque mois une avalanche de good vibes et astuces healthy ! Je vous retrouve également sur youtube avec du contenu vidéo inédit ainsi que certains de mes épisodes préférés en versions sous-titrée, accessible aux sourds et malentendants ! Création originale : Marion PezardRéalisation & production : Marion PezardMontage & mixage : Marion PezardMusique : Alice, Hicham Chahidi

Die Fristenlösung wird 50 Jahre alt – innerhalb einer dreimonatigen Frist können Frauen in Österreich eine Schwangerschaft abbrechen. Harte politische Auseinandersetzungen um das Recht auf den weiblichen Körper und seine Gebärfähigkeit führten in Österreich dazu, dass der Schwangerschaftsabbruch am 1. Jänner 1975 straffrei wurde. Legal ist er bis heute nicht.In diesem zweiten Teil der Sendung hören Sie die Historikerin Maria Mesner im Gespräch mit der Gynäkologin Mirijam Hall und der Journalistin Marlene Nowotny im Rahmen einer Wiener Vorlesung. In Teil 1 der Sendung hören Sie einen Vortrag der Historikerin Maria Mesner zur Geschichte der Abtreibung. Hosted on Acast. See acast.com/privacy for more information.

Die Fristenlösung wird 50 Jahre alt – innerhalb einer dreimonatigen Frist können Frauen in Österreich eine Schwangerschaft abbrechen. Harte politische Auseinandersetzungen um das Recht auf den weiblichen Körper und seine Gebärfähigkeit führten in Österreich dazu, dass der Schwangerschaftsabbruch am 1. Jänner 1975 straffrei wurde. Legal ist er bis heute nicht.In diesem ersten Teil der Sendung hören Sie einen Vortrag der Historikerin Maria Mesner zur Geschichte der Abtreibung, der im Rahmen einer Wiener Vorlesung stattgefunden hat. Eine anschließende Diskussion mit der Gynäkologin Mirijam Hall und der Journalistin Marlene Nowotny finden in Teil zwei dieser Sendung. Hosted on Acast. See acast.com/privacy for more information.

Ein Schwangerschaftsabbruch ist in Deutschland eine Straftat – sie bleibt nur unter bestimmten Bedingungen straffrei. Das hat direkte Folgen: Betroffene müssen weite Wege auf sich nehmen, kämpfen mit fehlenden Informationen, Vorurteilen und Stigmatisierung. Während fast 80 % der Deutschen für ein Recht auf Abtreibung sind, bleibt der Zugang schwierig.     Wie fühlt sich eine Abtreibung an? Welche Hürden gibt es? Und wie beeinflusst die Kriminalisierung die medizinische Versorgung?     Y-Kollektiv-Reporterin Sophie Rebmann begleitet Frauen, die abgetrieben haben – und ist mit dem Mikrofon live bei einer Abtreibung im OP dabei.  Sie spricht mit Frauen, die erleben mussten, wie Ärzt*innen ihr die Abtreibung ausreden wollten. Und sie spricht mit einem Gynäkologen, der über 70 ist und trotzdem weiterhin Abbrüche durchführt – weil es sonst niemand in seiner Region macht.     Ein Podcast über eine Erfahrung, über die kaum jemand spricht. Über ein System, das Frauen alleinlässt. Und über die Frage: Warum ist Abtreibung in Deutschland immer noch Tabu? Unser aktueller Podcast Tipp: Berlin Code - aus dem ARD-Hauptstadtstudio mit Linda Zervakis https://kurz.ard.de/BerlinCode Habt ihr Feedback oder Kritik? Schreibt uns gerne an y-podcast@ard.de oder https://www.instagram.com/y_kollektiv/    Reporterin: Sophie Rebmann    Redaktion: Linda Achtermann    Technische Produktion: Martin Seelig       "Y-Kollektiv – Der Podcast" wird verantwortet von Radio Bremen und dem rbb. Diese Episode ist eine Produktion vom rbb 2025.

Angst, Scham oder Sorge vor dem Besuch in der gynäkologischen Praxis? Viele Patientinnen werden nicht ernst genommen, bekommen beiläufig die Pille verschrieben oder machen rassistische Erfahrungen. Dr. Mertcan Usluer, besser bekannt als der [Gynäkollege](https://www.instagram.com/gynaekollege/?hl=de) ist der ideale Gast, um über strukturelle Probleme und Tabuthemen, aber auch die schönen Dinge in seinem Berufsfeld zu sprechen. **Buchempfehlungen:
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Wie kann es sein, dass in den allermeisten Darstellungen des weiblichen Beckens einfach ein Organ fehlt? Und ist die Gynäkologie besonders konservativ und männlich geprägt, oder fällt es hier nur mehr auf als in anderen Fachrichtungen? Diana im Gespräch mit Frauenärztin Prof. Dr. Mandy Mangler über Gynäkologie als gesellschaftspolitisches Fach, warum die Wechseljahre längst nicht der einzige blinde Fleck auf der frauenärztlichen Landkarte sind und wie jede von uns sich ermächtigen kann, bessere Entscheidungen für sich und ihren Körper zu fällen.INFOS ZUR FOLGE:Hier geht es zum Interview mit Mandy in der BRIGITTE woman.Hier geht es zur Dokumentation "Frauen in Führungspositionen" auf der Homepage des Deutschen Ärztinnenbundes.Hier geht es zu Mandys Instagram, und hier direkt zu ihren #womeninmalefiels-Storys.Hier geht es zum Newsletter "Saisonwechsel" von der BRIGITTE.Hier geht es zum neuen meno_brigitte-Insta-Account.Hier geht es zu Dianas Instagram.Hier geht es zur BRIGITTE Masterclass Finanzen Premium, um die es in unserer Eigenwerbung geht. Und es gibt auch einen MENO AN MICH-Rabattcode, MENO15, der für viele BRIGITTE-Angebote gilt.Falls obige Links nicht funktionieren hier noch mal in voller Länge!Masterclass Finanzen Premiumhttps://academy.brigitte.de/masterclass?utm_source=menoanmich&utm_medium=podcast&utm_campaign=mcf-premium-kh10Masterclass Finanzen Basic: https://academy.brigitte.de/course/masterclass-finanzen-basic?utm_source=menoanmich&utm_medium=podcast&utm_campaign=mcf-basicRentenlücke berechnen (kostenlos!)https://academy.brigitte.de/webinar-aufzeichnung-rentenluecke-berechnenETF Kurshttps://academy.brigitte.de/course/etf-kurs?utm_source=menoanmich&utm_medium=podcast&utm_campaign=etf-kurs-mUND ES GIBT WEITERE TOLLE ANGEBOTE aus der BRIGITTE Redaktion:On Demand Video-Kurs zum Thema Wechseljahre Dossiers zu den ThemenWECHSELJAHRESTOFFWECHSELPARTNERSCHAFT Ihr habt Anregungen, wollt uns Eure Geschichte erzählen oder selbst bei uns zu Gast im Podcast sein? Dann schreibt uns beiden persönlich, worüber Ihr gern mehr wissen würdet, was Euch bewegt, rührt, entsetzt und Freude macht an podcast@brigitte.de. Wir freuen uns auf Euch! Und bewertet und abonniert unseren Podcast gerne auch auf Spotify, iTunes, Amazon Music oder Audio Now. Noch mehr spannende Beiträge findet Ihr zudem auf Brigitte.de sowie dem Instagram- oder Facebook-Account von BRIGITTE –schaut vorbei! +++ Weitere Infos zu unseren Werbepartnern finden Sie hier: https://linktr.ee/menoanmich +++Unsere allgemeinen Datenschutzrichtlinien findet Ihr unter https://datenschutz.ad-alliance.de/podcast.htmlUnsere allgemeinen Datenschutzrichtlinien finden Sie unter https://art19.com/privacy. Die Datenschutzrichtlinien für Kalifornien sind unter https://art19.com/privacy#do-not-sell-my-info abrufbar.

Triggerwarnung: In dieser Folge geht es um Ableismus. Als die kleine Rosemary 1918 zur Welt kommt, ist schnell klar, dass sie anders ist als ihre Geschwister. Sie ist entwicklungsverzögert, hat Schwierigkeiten mit dem Lesen, Schreiben und ihrer Koordination. Ein Zustand, der vor allem ihrem Vater Joseph P. Senior ein Dorn im Auge ist. Schließlich ist Rosemary eine Kennedy. Und wer diesen Namen trägt, hat seiner Ansicht nach nicht weniger als perfekt zu sein. Als sich zu Rosemarys Defiziten auch noch Wutausbrüche gesellen, sieht sich ihr Vater zum Handeln gezwungen. Und so landet Rosemary schließlich auf dem OP-Tisch eines Mannes, der für Ruhm und Erfolg bereit ist, sämtliche moralische und ethische Grenzen zu überschreiten… In dieser Folge von „Mordlust - Verbrechen und ihre Hintergründe“ beleuchten wir das Verfahren der Lobotomie, das vor allem in den 1940er und 50er Jahren als Heilung für psychische Krankheiten galt, aber oft fatale Folgen hatte. Wir sprechen über Stigmatisierung und Ausgrenzung und erklären, wie ein vermeintlicher Meilenstein zu einem der dunkelsten Kapitel in der Medizingeschichte wurde. Experten in dieser Folge: Dr. med. Richard Krüger, Arzt in Weiterbildung für Gynäkologie und Geburtshilfe, Prof. Dr. Heiner Fangerau, Medizinhistoriker und -ethiker sowie Neurochirurg Prof. Dr. med. Jürgen Schlaier **Credit** Produzentinnen/ Hosts: Paulina Krasa, Laura Wohlers Redaktion: Paulina Krasa, Laura Wohlers, Jennifer Fahrenholz Schnitt: Pauline Korb Rechtliche Abnahme: Abel und Kollegen **Quellen (Auswahl)** aerzteblatt.de: “Die Lobotomie - Wie ein Relikt aus finsterer Zeit”: https://www.aerzteblatt.de/archiv/60000/Die-Lobotomie-Wie-ein-Relikt-aus-finsterer-Zeit Larson, Kate: “The Hidden Kennedy Daughter “ GEO: “Lobotomie: Tiefe Schnitte ins Gehirn”: https://t1p.de/sok49 Doku “Der Lobotomist”: https://t1p.de/85i7q Howard Dully: “Howard's Journey”: https://t1p.de/ogrkw **Partner der Episode** Du möchtest mehr über unsere Werbepartner erfahren? Hier findest du alle Infos & Rabatte: https://linktr.ee/Mordlust Du möchtest Werbung in diesem Podcast schalten? Dann erfahre hier mehr über die Werbemöglichkeiten bei Seven.One Audio: https://www.seven.one/portfolio/sevenone-audio

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