Podcasts about Gynecologic oncology

I'm thrilled to sit down with Dr. Lorna Rodriguez, a medical doctor with a PhD in biochemistry and a true double doc!

Dr Kathleen Moore, Dr Ritu Salani, Dr Shannon Westin and moderator Dr Angeles Alvarez Secord share their perspectives and summarize recently presented data from the SGO 2025 annual meeting guiding the management of ovarian cancer. CME information and select publications here.

പല തരം ശാരീരികാവസ്ഥകളിലൂടെ തുടർച്ചയായി കടന്നുപോകുന്നവരാണ് സ്ത്രീകൾ. ഇത്തരത്തിൽ മാറ്റങ്ങൾ ഉണ്ടാവുമ്പോഴും ശരീരം പ്രകടമാക്കുന്ന ചില ലക്ഷണങ്ങൾ പലരും അവഗണിക്കാറുണ്ട്. എന്നാൽ ഇങ്ങനെ അവഗണിക്കേണ്ട ലക്ഷണങ്ങൾ അല്ല അവ.റീപ്രൊഡക്ടിവ് സിസ്റ്റത്തിനെ ബാധിക്കുന്ന രോഗങ്ങളുടെ മുന്നറിയിപ്പുകൾ വരെ ആവാം അവ .ഇത്തരത്തിൽ സ്ത്രീകളുടെ റീപ്രൊഡക്ടിവ് സിസ്റ്റത്തിനെ ബാധിക്കുന്ന ഗൈനക്കോളജിക്കൽ കാൻസറുകളും അവയുടെ ലക്ഷണങ്ങളും, ചികിത്സ രീതികളെയും കുറിച്ച് കൂടുതൽ അറിയാം ആരോഗ്യമംഗളത്തിലൂടെ. ആരോഗ്യമംഗളത്തിൽ ഇന്ന് ചേരുന്നു തെള്ളകം മിതേര ഹോസ്പിറ്റൽ  Consultant Gynaecologic Oncologist Dr Anu N Joseph

In today's episode, we sat down with Liliana Bustamante, MD, and Jessica Stine, MD, to discuss their experiences as women in oncology. Dr Bustamante is a medical oncologist and hematologist at Florida Cancer Specialists & Research Institute in Tampa. Dr Stine is the medical director of Gynecologic Oncology at Florida Cancer Specialists & Research Institute. In our exclusive interview, Drs Bustamante and Stine discussed their unique journeys toward choosing careers in oncology, the emotional fulfillment of treating patients with cancer, the importance of mentorship between colleagues, and the evolving nature of work-life balance. They also emphasize the importance of honesty, peer support, and self-grace in navigating oncology careers.

Drs Kathleen N Moore and Alessandro D Santin and moderator Dr David M O'Malley summarize and share their perspectives on data guiding the management of HER2-positive gynecologic cancers that were presented at the Society of Gynecologic Oncology 2025 annual meeting. CME information and select publications here.

Molecular differences in the profiles of low grade serous ovarian cancer (LGSOC) and high-grade SOC substantiate the need to find unique, differentiated treatment options for each epithelial ovarian cancer subtype, according to Kathleen N. Moore, MD, MS. CancerNetwork® spoke with Moore, Virginia Kerley Cade Endowed Chair of Cancer Development, associate director of Clinical Research at the Stephenson Cancer Center, director of the Oklahoma TSET Phase I Program and professor in the Section of Gynecologic Oncology the University of Oklahoma Health Sciences Center, about distinguishing low grade serous ovarian cancer from other types of ovarian cancer, current treatment options and clinical trials evaluating new regimens, as well as managing treatment in younger patients with or those seeking to preserve fertility. Moore began by differentiating LGSOC from high grade SOC, stating that this disease typically occurred in younger patients and was primarily characterized by MAP kinase alterations, specifically KRAS and BRAF mutations. She then discussed the emergence of endocrine therapies in this indication owing to the presence of estrogen receptors. Additionally, first line treatment was discussed, with the standard of care defined by primary cytoreduction followed by paclitaxel and carboplatin. She then highlighted multiple clinical trials assessing alternative treatment in this indication, particularly involving the use of letrozole (Femara). Other clinical trials evaluated the use of CDK4/6 inhibition plus fulvestrant or BRAF and MEK inhibition with letrozole, with Moore emphasizing the potential for these studies to shift the treatment paradigm in the frontline setting. Furthermore, she suggested that CDK4/6 inhibition may help enhance responses in patients with recurrent LGSOC. Moore then highlighted treatment concerns for younger patients and those seeking to preserve fertility, while expressing the importance of understanding a patient's goals, which may help optimize outcomes. She concluded by reiterating the importance of designing trials and tailoring treatment considering the molecular profile of LGSOC.

In a recent episode of Oncology on the Go, several oncologists discussed the impact of the COVID-19 pandemic on oncology care, 5 years later. Each doctor discussed a different aspect of multidisciplinary care, including medical oncology, radiation oncology, and epidemiology. CancerNetwork® spoke with leading clinicians including:  ·      Aditya Bardia, MD, MPH, FSCO, professor in the Department of Medicine, Division of Hematology/Oncology, and director of Translational Research Integration at the University of California Los Angeles Health Jonsson Comprehensive Cancer Center; ·      Ritu Salani, MD, director of Gynecologic Oncology at the University of California Los Angeles, and ONCOLOGY® editorial advisory board member; ·      Scarlett Lin Gomez, PhD, MPH, a professor in the Department of Epidemiology and Biostatistics at the University of California San Francisco (UCSF), and co-leader of the Cancer Control Program at UCSF Helen Diller Family Comprehensive Cancer Center ·      Marwan F. Fakih, MD, professor in the Department of Medical Oncology & Therapeutics Research, associate director for Clinical Sciences, medical director of the Briskin Center for Clinical Research, division chief of GI Medical Oncology, and co-director of the Gastrointestinal Cancer Program at City of Hope Comprehensive Cancer Center; ·      Elizabeth Zhang-Velten, MD, a radiation oncologist at Keck Medicine of University of Southern California;  ·      Frances Elain Chow, MD, neuro-oncologist at the University of Southern California (USC) Norris Comprehensive Cancer Center ·      James Yu, MD, MHS, FASTRO, assistant professor adjunct, Department of Radiation Oncology, Smilow Cancer Hospital at Saint Francis Hospital, and ONCOLOGY® editorial advisory board member.  The COVID-19 pandemic disrupted routine cancer care in a number of ways. Many patients were unable to receive timely screening, diagnosis, and treatment, Fakih noted. Additionally, Bardia stated that the pandemic led to a decrease in the number of patients participating in clinical trials. One of the most significant changes in oncology care, according to Salani, has been the increased use of telehealth. Telehealth has allowed patients to receive care from the comfort of their own homes, which has been especially beneficial for patients who live in rural areas or who have difficulty traveling. Telehealth has also made it easier for patients to connect with their doctors and to receive support from other members of their care team.  For Gomez, the COVID-19 pandemic also highlighted the importance of addressing the structural and social drivers of health. These are the conditions in which people are born, grow, live, work, and age that can affect their health. For example, people who live in poverty or who lack access to healthy food are more likely to develop cancer. The pandemic has led to a renewed focus on addressing these disparities. Overall, the COVID-19 pandemic has had a profound impact on oncology care. However, it has also led to a number of positive changes, such as the increased use of telehealth and the focus on addressing the structural and social drivers of health. In the years to come, it will be important to continue to build on these changes in order to improve the lives of patients with cancer.

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

In the second episode of A Deep Dive into HRD Testing in Ovarian Cancer, a three-part podcast series sponsored by AstraZeneca, we're speaking with Dr. Erin Crane who will highlight how HRD testing provides helpful information to ovarian cancer patients.   Erin K. Crane, MD, MPH, is a gynecologic oncologist with Atrium Health Levine Cancer in Charlotte, North Carolina. A graduate of the SUNY Upstate Medical University in Syracuse, NY, Dr. Crane completed her residency at the University of Virginia and a fellowship at The University of Texas MD Anderson Cancer Center in Gynecologic Oncology. She is board certified by the American Board of Obstetrics and Gynecology in Gynecologic Oncology and Obstetrics and Gynecology. Dr. Crane is a Clinical Associate Professor of Obstetrics and Gynecology at the Wake Forest University School of Medicine.   For more information, visit https://www.azprecisionmed.com/tumor-type/ovarian-cancer/hrd-testing.html For patient resources, please visit TestForHRD.com.   This podcast does not necessarily reflect the opinions of AstraZeneca and are the spokesperson's opinions and experience.

In the first episode of A Deep Dive into HRD Testing in Ovarian Cancer, a three-part podcast series sponsored by AstraZeneca, we're speaking with Dr. Kathleen Moore about HRD testing in ovarian cancer and its clinical significance in helping aid precision medicine approaches.   Dr. Kathleen Moore is a Professor of Gynecologic Oncology at the University of Oklahoma Health Sciences Center, Associate Director of Clinical Research and Director of the Oklahoma TSET Phase I Program at the Stephenson Cancer Center. A graduate of the University of Washington School of Medicine, WA, Dr. Moore completed her residency in gynecology at the University Health Center of Pittsburgh in Pittsburgh, PA and completed a fellowship in gynecologic oncology at the University of Oklahoma College of Medicine in Oklahoma City, OK. She is board certified in obstetrics and gynecology as well as gynecologic oncology and hospice and palliative care.   For more information, visit: https://www.azprecisionmed.com/tumor-type/ovarian-cancer/hrd-testing.html For patient resources, please visit TestForHRD.com.   This podcast does not necessarily reflect the opinions of AstraZeneca and are the spokeperson's opinions and experience.

In the first episode of A Deep Dive into HRD Testing in Ovarian Cancer, a three-part podcast series sponsored by AstraZeneca, we’re speaking with Dr. Kathleen Moore about HRD testing in ovarian cancer and its clinical significance in helping aid precision medicine approaches. Dr. Kathleen Moore is a Professor of Gynecologic Oncology at the University of Oklahoma Health Sciences Center, Associate Director of Clinical Research and Director of the Oklahoma TSET Phase I Program at the Stephenson Cancer Center. A graduate of the University of Washington School of Medicine, WA, Dr. Moore completed her residency in gynecology at the University Health Center of Pittsburgh in Pittsburgh, PA and completed a fellowship in gynecologic oncology at the University of Oklahoma College of Medicine in Oklahoma City, OK. She is board certified in obstetrics and gynecology as well as gynecologic oncology and hospice and palliative care. For more information, visit: https://www.azprecisionmed.com/tumor-type/ovarian-cancer/hrd-testing.html For patient resources, please visit TestForHRD.com. This podcast does not necessarily reflect the opinions of AstraZeneca and are the spokeperson's opinions and experience.

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

In the second episode of A Deep Dive into HRD Testing in Ovarian Cancer, a three-part podcast series sponsored by AstraZeneca, we’re speaking with Dr. Erin Crane who will highlight how HRD testing provides helpful information to ovarian cancer patients. Erin K. Crane, MD, MPH, is a gynecologic oncologist with Atrium Health Levine Cancer in Charlotte, North Carolina. A graduate of the SUNY Upstate Medical University in Syracuse, NY, Dr. Crane completed her residency at the University of Virginia and a fellowship at The University of Texas MD Anderson Cancer Center in Gynecologic Oncology. She is board certified by the American Board of Obstetrics and Gynecology in Gynecologic Oncology and Obstetrics and Gynecology. Dr. Crane is a Clinical Associate Professor of Obstetrics and Gynecology at the Wake Forest University School of Medicine. For more information, visit https://www.azprecisionmed.com/tumor-type/ovarian-cancer/hrd-testing.html For patient resources, please visit TestForHRD.com. This podcast does not necessarily reflect the opinions of AstraZeneca and are the spokesperson's opinions and experience.

In the first episode of A Deep Dive into HRD Testing in Ovarian Cancer, a three-part podcast series sponsored by AstraZeneca, we’re speaking with Dr. Kathleen Moore about HRD testing in ovarian cancer and its clinical significance in helping aid precision medicine approaches. Dr. Kathleen Moore is a Professor of Gynecologic Oncology at the University of Oklahoma Health Sciences Center, Associate Director of Clinical Research and Director of the Oklahoma TSET Phase I Program at the Stephenson Cancer Center. A graduate of the University of Washington School of Medicine, WA, Dr. Moore completed her residency in gynecology at the University Health Center of Pittsburgh in Pittsburgh, PA and completed a fellowship in gynecologic oncology at the University of Oklahoma College of Medicine in Oklahoma City, OK. She is board certified in obstetrics and gynecology as well as gynecologic oncology and hospice and palliative care. For more information, visit: https://www.azprecisionmed.com/tumor-type/ovarian-cancer/hrd-testing.html For patient resources, please visit TestForHRD.com. This podcast does not necessarily reflect the opinions of AstraZeneca and are the spokeperson's opinions and experience.

In the second episode of A Deep Dive into HRD Testing in Ovarian Cancer, a three-part podcast series sponsored by AstraZeneca, we’re speaking with Dr. Erin Crane who will highlight how HRD testing provides helpful information to ovarian cancer patients. Erin K. Crane, MD, MPH, is a gynecologic oncologist with Atrium Health Levine Cancer in Charlotte, North Carolina. A graduate of the SUNY Upstate Medical University in Syracuse, NY, Dr. Crane completed her residency at the University of Virginia and a fellowship at The University of Texas MD Anderson Cancer Center in Gynecologic Oncology. She is board certified by the American Board of Obstetrics and Gynecology in Gynecologic Oncology and Obstetrics and Gynecology. Dr. Crane is a Clinical Associate Professor of Obstetrics and Gynecology at the Wake Forest University School of Medicine. For more information, visit https://www.azprecisionmed.com/tumor-type/ovarian-cancer/hrd-testing.html For patient resources, please visit TestForHRD.com. This podcast does not necessarily reflect the opinions of AstraZeneca and are the spokesperson's opinions and experience.

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

On this episode of Health 411, host Dr. Jonathan Karp and student producer chat with Dr. Mona Saleh, Gynecologic Oncologist at Capital Health.

Dr. Crane is a distinguished leader in cancer control and is passionate about her commitment to the science of better outcomes for patients and community. Her work sits at the intersection of lifestyle medicine and digital health with a goal of developing targeted interventions, utilizing digital biomarkers to deliver the right intervention, at the right time to the right person. She received her Ph.D. from the University of Arizona and is an R25 Transdisciplinary Research on Energetics and Cancer (TREC) NCI Fellow.Dr. Crane was recruited to Sylvester Comprehensive Cancer Center to co-lead the Cancer Control Research Program and direct the Lifestyle Medicine, Prevention and Digital health initiative. She serves on the University of Miami IRB's consent to contact committee as the Sylvester representative for cancer-related studies and is an appointed cabinet member to the Executive Dean for Research of the Miller School of Medicine. As the population science representative, she serves on the Gynecologic Oncology and Lymphoma site disease groups and works with clinical and research faculty members. She was recently appointed the Vice-Chair for NRG Oncology NCORP Cancer Prevention and Control Committee.Dr. Crane joined Sylvester from the College of Nursing, Biobehavioral Health Sciences Division, at the University of Arizona in Tucson, where she served as co-lead of the Behavioral Measurement and Interventions Shared Resource at the University of Arizona Cancer Center. She also held joint appointments in the Department of Nutrition Sciences, Data Science Institute, and Mel and Enid Zuckerman College of Public Health.

About 61,000 cases of endometrial cancer are expected to be diagnosed in the U.S. this year. Our guest is Dr. Sharyn Lewin, Director of Gynecologic Oncology at the Holy Name Medical Regional Cancer Center in Teaneck, NJ to talk about diagnosis and treatment options, and the organization she founded to fight women's cancers, the Lewin Fund. For more, visit thelewinfund.org.

We welcome Dr. Benjamin Margolis of Albany Med. Dr. Margolis is a gynecologic oncologist who specializes in the medical and surgical management of ovarian, uterine, cervical and other gynecologic cancers. He also treats patients of all ages with pre-invasive conditions and complex gynecologic diseases that require surgery. Call at 2pm with your question. 800-348-2551. Ray Graf hosts.

According to 2024 data from the American Medical Association, around 40% of physicians surveyed indicated they were likely to reduce their clinical hours in the next year. One in 5 physicians say they intend to leave the profession entirely within the next two years, with nearly 28% of doctors surveyed reporting dissatisfaction with their current healthcare jobs. Our guest left direct patient care behind in 2022 after practicing as a Gynecologic Oncology surgeon for just four years. Dr. Wilbur then embarked on a project to conduct a series of one-on-one interviews with doctors like herself who had either recently left practice, or were strongly considering doing so, to shine light on this growing trend and what factors were driving it. We talk with her about her new book that came out of those conversations, “The Doctor is No Longer In: Conversations with U.S. physicians.”

Dr Kathleen N Moore shares her perspectives on the evolving therapeutic landscape for patients with gynecologic cancers, moderated by Dr Stephen "Fred" Divers. Produced by Research To Practice. CME information and select publications here (https://www.researchtopractice.com/AON24).

OncLive On Air is a podcast from OncLive®, which provides oncology professionals with the resources and information they need to provide the best patient care. In both digital and print formats, OncLive covers every angle of oncology practice, from new technology to treatment advances to important regulatory decisions. In today's episode, we had the pleasure of speaking with Susana M. Campos, MD, MPH, about the role of fam-trastuzumab deruxtecan-nxki (T-DXd; Enhertu) in patients with HER2-positive gynecologic cancers. Dr Campos is the clinical director and the director of Educational Initiatives in the Division of Gynecologic Oncology at Dana-Farber Cancer Institute, as well as an assistant professor of medicine at Harvard Medical School in Boston, Massachusetts. In our exclusive interview, Dr Campos discussed the clinical implications of findings from the gynecologic cancer cohorts of the phase 2 DESTINY-PanTumor02 trial (NCT04482309).

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Alessandro Santin to discuss Sacituzumab Govitecan (TROPiCS—03) in Advanced Endometrial Cancer. Dr. Alessandro D. Santin, a native of Italy, graduated with honors from the University of Brescia, Italy and received his postgraduate training in Obstetrics & Gynecology at the same University. He served a fellowship in Gynecologic Oncology at the University of California, Irvine and an International Fellowship in the Division of Gynecologic Oncology at the University of Arkansas for Medical Sciences, Little Rock, Arkansas. Dr. Santin joined the faculty in the Section of Gynecologic Oncology in the Department of Obstetrics, Gynecology & Reproductive Sciences at Yale University as Professor as of July 2008. Dr. Santin has more than 400 original research and peer-reviewed publications including multiple review articles and book chapters and he has written extensively on various topics, including cancer of the ovary, endometrium and cervix as well as on tumor immunology and immunotherapy. Dr. Santin's clinical interests include the use of immunotherapy in ovarian, cervical and endometrial carcinoma patients with disease resistant/refractory to standard treatment, therapeutic vaccines against Human Papillomavirus (HPV) infected genital tumors, and the development of personalized treatment modalities including monoclonal antibodies and antibody-drug-conjugates (ADC) against chemotherapy resistant gynecologic tumors. Highlights: In the TROPiCS-03 trial Sacituzumab Govitecan demonstrated encouraging clinical activity in recurrent endometrial cancer patients in progression after chemotherapy and immune check point inhibitors Sacituzumab Govitecan toxicity profile was manageable with only 5% of patients discontinuing treatment due to TRAEs TROP-2 protein was expressed in over 90% of endometrial cancer patients enrolled in the TROPiCS-03 trial and showed limited correlation with efficacy to Sacituzumab Govitecan

In today's episode, supported by Corcept Therapeutics, we had the pleasure of speaking with Premal Thaker, MD, MS, about the use of the selective glucocorticoid receptor modulator relacorilant (CORT125134) in patients with ovarian cancer. Dr Thaker is the David G. and Lynn Mutch Distinguished Professor of Obstetrics and Gynecology, as well as the director of Gynecologic Oncology Clinical Research and the interim chief of the Division of Gynecologic Oncology at the School of Medicine at the Washington University in St. Louis and the Siteman Cancer Center in Missouri. In our exclusive interview, Dr Thaker discussed the rationale for combining relacorilant with nab-paclitaxel (Abraxane) in patients with platinum-resistant ovarian cancer, striking phase 2 data (NCT03776812) with this combination in this population, and what the future has in store regarding the phase 3 ROSELLA trial (NCT05257408).

CancerNetwork® spoke with John Paul Diaz, MD, about uterine transposition, a surgical technique aiming to preserve fertility in women undergoing radiotherapy for pelvic tumors. Diaz is the chief of gynecologic oncology, director of robotic surgery, director of the Center of Excellence in Minimally Invasive Gynecologic Surgery at Baptist Health, and lead physician for Clinical Trials in Gynecologic Oncology at Miami Cancer Institute.  Of note, Diaz discussed the outcomes associated with 2 procedures conducted at his practice, as well as challenges associated with the development and implementation of the procedure. Additionally, he spoke about the next steps in developing and raising awareness of the procedure. Diaz foregrounded the discussion by highlighting the simplicity of the procedure, which he stated was similar to a hysterectomy. Unlike a hysterectomy, uterine transposition entails a temporary relocation of the uterus to the anterior abdominal wall, which preserves it for fertility while removing it from the radiation field. Furthermore, Diaz described the collaboration between Baptist Health and Memorial Sloan Kettering Cancer Center, including a partnership with Mario M. Leitao, Jr., MD, FACOG, FACS, who holds the largest series in the United States in performing uterine transpositions. He explained that the collaboration was conducive for expanding patient populations that may benefit from this surgery. Diaz then underlined outcomes related to 2 uterine transposition procedures he conducted at Baptist Health. He described a favorable outcome with one patient who had completed the procedure 3 months prior who may be able to become pregnant in the future. The second patient was undergoing radiotherapy, with plans to undergo the second stage of the surgery in following months. Diaz then highlighted a distinction between uterine transposition and other fertility preservation measures in that it preserves the entire uterus so patients can still carry a child, whereas other radiation therapy techniques do not. He then highlighted patients who are eligible for this procedure, particularly among women who want to preserve their fertility with pelvic tumors requiring radiation that might otherwise sterilize the uterus. Challenges related to the development and implementation of the procedure were discussed, with particular emphasis placed upon quality of life following treatment. Additionally, he emphasized the idea of patient-driven improvements in treatment outcomes, which he hoped could be applied to help more women preserve their fertility. Diaz continued by emphasizing the novelty of the procedure, explaining that experiences with it are growing while surgery success rates increase with global collaboration and technique sharing. He followed by underscoring the primary goal of cancer eradication, stressing that treatment for progressing disease takes precedence over fertility, and in those situations, fertility may be compromised. He further outlined key short-term outcomes in patients undergoing uterine transposition, particularly as they related to maintaining uterine perfusion and mitigating post-operative complications. For long-term outcomes, he highlighted the goal for patients to be disease-free and capable of carrying a live birth. Additionally, Diaz underscored a challenge related to raising awareness for this procedure, highlighting efforts he has undertaken to inform surgeons in the colorectal cancer field about the availability of this procedure as an option for this patient population. He suggested that colleague identification of eligible patients, effective referral, and increased proliferation of procedure knowledge may be effective in overcoming this challenge. Diaz concluded by highlighting next steps for the procedure as they relate to expanding access for patients, increasing knowledge of the procedure among physicians, and developing novel techniques for uterine preservation during radiotherapy. He highlighted the “exciting” development of this procedure, which he suggested might have been inconceivable a few years ago, in achieving better outcomes for young women diagnosed with pelvic tumors.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Rongyu Zang and Yulian Chen to discuss the SOC-1 trial. Dr. Rongyu Zang is the Director of the Department of Gynecologic Oncology, Fudan University Zhongshan Hospital, & Institute for Ovarian Cancer, Fudan University and is the Principal investigator of the SOC-1 and SUNNY trials. Dr. Yulian Chen is an Attending Physician at the Department of Gynecologic Oncology, Fudan University Zhongshan Hospital.   Highlights: The SOC-1 trial concluded that in patients with platinum-sensitive, relapsed ovarian cancer, surgery did not increase overall survival in the intention-to-treat population, but resulted in a prolongation of survival after adjustment of crossover. Surgery may provide an obviously higher proportion of long-term relapse-free survivors than chemotherapy alone. An active preoperative evaluation for all patients with platinum-sensitive first relapsed ovarian cancer is suggested in specialized centers.

On tomorrow night's show, we'll be highlighting endometrial cancer with Kristen Foreman, an endometrial cancer survivor and Dr. Sharyn Lewin, Director of Gynecologic Oncology at the Holy Name Medical Regional Cancer Center in Teaneck, NJ. After that, I'll have a generic interview focused on allergies related to Halloween candy with Dr. S. Shahzad Mustafa and Margaret, the mother of a 16-year-old who is severely allergic to peanuts and tree nuts.

Editor’s Choice: Implementation of a financial navigation program in gynecologic oncology Editorial: Financial toxicity: moving from describing the problem toward developing interventions Hosted by:Diane Yamada, MDFeaturing: Katharine M. Esselen, MDMargaret Liang, MD

Dr. Shannon Westin and her guest, Dr. Brian  Slomovitz discuss the article “Pembrolizumab or Placebo Plus Adjuvant Chemotherapy With or Without Radiotherapy For Newly Diagnosed, High-Risk Endometrial Cancer: Results in Mismatch Repair-Deficient Tumors” recently published in the JCO and presented at the 2024 International Gynecologic Cancer Society. TRANSCRIPT The guest's disclosures can be found in the transcript.  Dr. Shannon Westin: Hello, and welcome to another episode of JCO After Hours, the podcast where we get in depth on manuscripts and literature published in the Journal of Clinical Oncology. I'm your host, Shannon Westin, gynecologic oncologist and JCO Social Media Editor by trade. I am thrilled because we are going to be talking about gynecologic cancer today. So, this is my jam. And specifically, we're going to be talking about a manuscript that's a simultaneous publication in the Journal of Clinical Oncology and presented at the Annual Meeting of the International Gynecologic Cancer Society on October 16, 2024. And this is “Pembrolizumab or Placebo, Plus Adjuvant Chemotherapy, With or Without Radiotherapy for Newly Diagnosed High Risk Endometrial Cancer: Results in Mismatch Repair Deficient Tumors.” This is affectionately the KEYNOTE-B21 trial, also known as the GOG-3053 trial and the ENGOT-en11 trial. And we are joined today by the primary author in this manuscript, Dr. Brian Slomovitz, who is the Director of Gynecologic Oncology at Mount Sinai Medical Center in Miami Beach, Florida, and the clinical trial advisor in uterine cancer for the Gynecologic Oncology Group foundation. Welcome, Brian. Dr. Brian Slomovitz: Hey, thanks, Shannon, so much. It's a pleasure to be here. And thanks for giving us the opportunity to discuss this trial. Dr. Shannon Westin: Yes, it's a great trial and I'm so excited to talk about it. And I think we'll start just because this is a broad group that listens to this podcast, they're not all GYN oncologists, experts like yourself, so can you just level set a little bit and speak a bit about the incidence and mortality of endometrial cancer overall and the recent trends in this disease? Dr. Brian Slomovitz: Yeah, sure. So, and it is nice to speak about gynecologic cancers, as we know, endometrial cancer was and still is the most common of all gynecologic cancers. The numbers are going up. Right now, there's about 65,000 to 70,000 cases each year in the US diagnosed with endometrial cancer. The numbers are going up. A lot of its obesity related, some other factors, but as the population gets less healthy, those are some of the risk factors for the disease. The thing that, however, is quite surprising is that we're seeing the deaths due to endometrial cancer going up as well, while for other diseases, we're making slow, steady steps to try to decrease the mortality we're actually seeing an increase in mortality. And the most discouraging point, Shannon, as you know is the number of deaths from endometrial cancer is going to outnumber the number of deaths from ovarian cancer if it hasn't done it already. I mean, now's the time. So, we really need to come up with better treatment strategies to everything to decrease the incidence of disease, to help with prevention, but for those poor women who are diagnosed, to come up with better treatment options so we don't have to keep this increasing trend in mortality. Dr. Shannon Westin: Absolutely. And I think some of that is related and we don't need to get on a soapbox here, but the amount of funding that goes towards research in endometrial cancer, and of course you, you have been leading the way and really trying to get a ton of trials in this space and getting our industry partners and our government partners to really support this. So really just commending you on how much you've worked on, on this area. And to that end, we've had a huge renaissance with immunotherapy and endometrial cancer, a lot of really big trials. Why don't you give the audience a rundown of where, so far, this seems to be best utilized for people with endometrial cancer? Dr. Brian Slomovitz: Thanks for that. And as you sort of alluded to, it's been a revolution, really, with immunotherapy. We started off at immunotherapy looking at microsatellite instability or the dMMR patients. What we found is similar to other disease sites in the second and third line setting that we saw good activity with the single agent checkpoints, pembrolizumab dostarlimab, that's based on the earlier KEYNOTE data and the GARNET trial. Really, a landmark study in the second line was Vicki Makker and her colleagues put pembrolizumab and lenvatinib combination for those patients with the cold tumors. Not the dMMRs or MSI Highs, but the proficient mismatch repair. And that study in a second line setting found that it was better than chemotherapy for an overall survival advantage. So right there, we know that it works in the second line setting in the dMMR population, and we got an indication in the PMR population saying that immunotherapy works in all women with endometrial cancer at some point, then we really had the groundbreaking trials. And Shannon, thank you. You are the leader on one of the four trials that happened, to DUO-E, AtTEnd, GY018 and RUBY trial, all very similar studies showing that the combination of immunotherapy with chemotherapy in the first line, metastatic or recurrent setting had a better outcome for patients than if given chemotherapy alone. That actually led to amazing things. We had three of those drugs have FDA approvals, pembrolizumab for all comers, dMMR and PMMR in the first line metastatic setting with chemotherapy; Dostarlimab, PMR, dMMR in the first line or metastatic with chemotherapy. And Shannon, in your study, I think we still have to learn a lot from your study. DUO-E, chemotherapy plus minus dostarlimab. And you also added a PARP inhib, and those patients with a PARP did better. So I'm really looking forward to your data, to the subgroup analysis to figure out which of those patients, depending on the biomarker, do better with PARP therapy. And right now, you have a dMMR FDA indication. But who knows? The future is really exciting to see- to be splitters, not lumpers. And I really want to see how that data pans out. And so that's how it came into the first and second line setting and that led us really to come up with the idea for this trial to put it into the adjuvant setting. Dr. Shannon Westin: Right. And so, I think this would be really important because we're so ingrained in this. We see this on the day to day. Can you kind of tease out a little bit what's different about those patients that would be treated in that advanced recurrent setting versus the patients that would be potentially treated in this B21 study? Dr. Brian Slomovitz: Yeah, so the first step, we demonstrated the efficacy in patients that really the treatment options were an unmet need. In the second line setting, we didn't have good treatment options. Those are the patients with measurable disease, with symptomatic disease giving immunotherapy. And not only did we see the efficacy, which was better, but we also were able to give it with limiting the side effects as seen with chemotherapy, which is nice. And then we know that the first line therapy, traditionally for endometrial cancer with carboplatin paclitaxel, response rates about 50%, progression free survival about a year, really something that we needed to improve upon. So, adding immunotherapy to the platinum backbone therapy really demonstrated an advantage. But now what we want to do is we want to see if we could prevent, in the high-risk patients, those without disease, what can we do to help prevent the disease from recurring and help patients live longer without really the need for really lifesaving types of treatments? We want to prevent it from recurring. Dr. Shannon Westin: Yeah, I think that's essential. We know that if we can sit on that prevention side and kind of invest all the time and effort that we need to upfront, that really does yield the longer survival. So why don't you just walk through the overall design of this trial, please? Dr. Brian Slomovitz: Yeah. So, this was an all-comers trial, meaning in individuals that had high risk endometrial cancer, high risk for recurrence, that included, in endometrial cancer, we have aggressive histologic subtypes, serous histologies, clear cell histologies, any stage, as long as there was some myometrial invasion. We also, for the first time, included patients looking at the molecular subclassifications. So, if there was a P53 mutation and they were stage 1 with myometrial invasion, they were included. And then in all comers, any patients with stage 3 or up to 4a disease, as long as the surgery was for a curative intent, and they had no residual disease after surgery, then they were allowed to enroll into this trial. One of the things is that this is the first time we've done an adjuvant trial this large. I think one of the reasons that helped us succeed in doing a trial like this is that we left radiation as investigator's choice, because a lot of times going into a trial like this, people feel strongly, we know our radiation oncology colleagues, rightfully so, feel that radiation could help prevent disease from coming back. And we also have the camp that says they don't need radiation. We took that question out of this study. We let investigators decide whether or not they're going to get radiation. It was for patients to get chemotherapy, who are going to normally get chemotherapy for their high-risk disease and randomize them to chemotherapy plus placebo or chemotherapy plus pembrolizumab, a PD-1 inhibitor, in order to see if we could prevent the disease from coming back. Dr. Shannon Westin: And the primary results of this study were just presented at ESMO and published in the Annals of Oncology. Can you give us just a quick overview of what that was, what they found? Dr. Brian Slomovitz: Yep. So, we enrolled 1100 patients. The primary objective of the study was to look at the ITT population, progression free survival and overall survival. And the overall study was negative. Okay, so the hazard ratio in the ITT population was 1.02, not demonstrating a benefit of adding pembrolizumab in this population. I would say disappointing, but at the same point, something that we could really learn a lot from and somewhere that we know that in the whole population, we need to come up with better strategies to help prevent recurrence of disease, better adjuvant treatment strategies. But there's also information that we learned from this trial and that we're reporting on that we're actually super excited about and we feel may be game changing. Dr. Shannon Westin: Yeah. So, let's go to that. This is the good news. Your manuscript in the JCO, thank goodness you published it here, was focused on that subset of mismatch repair deficient. So, tell us what you found. Dr. Brian Slomovitz: So, in this study, we found that the first stratification factor was dMMR versus pMMR. Now, in the pMMR group, those patients had further stratification factors, but dMMR by itself was a stratification factor. Amongst those patients that had dMMR tumors, we found the hazard ratio to be 0.31 benefiting those patients who received pembrolizumab in the adjuvant setting. Really something that when we look at the treatment studies, the GY018s, the RUBYs, the atTEnds, the DUO-Es, in a dMMR setting, we see a similar hazard ratio of 0.3, 0.4. But to get that hazard ratio, which was statistically significant, obviously, is something that we were quite pleased with and something that we felt was worthy of reporting further. I will say it was a pre-specified endpoint. We didn't allocate alpha to it. So, at the beginning, it was a pre-specified endpoint, but at the same time even though we didn't specify alpha towards that outcome, it still, we feel is clinically meaningful and can definitely add to affect the standard of care and the management of these patients. Dr. Shannon Westin: Yeah. I'm very intrigued to see what kind of people do with this. It makes sense, mechanistically, it makes sense if there was a population that was going to benefit, if not everybody does, this is the group that will. I mean, do you feel like there's enough data? What are you going to do? FDA approval aside, obviously, those kinds of things. But how do you feel about this? Is this something you're going to offer to your patients? Dr. Brian Slomovitz: The first answer is yes. I think it's something that I would like to offer my patients. As you know, we need one of two things: we either need an FDA approval or for a lot of our payers required to be in the NCCN listings. I don't serve on the committee. I have no influence on NCCN. I'm excited to see how they'll respond to not only the Annals article, but obviously in today's release of the JCO article, I hope that they'll look upon it favorably. It's a drug that we're used to giving. Pembrolizumab, we have a lot of experience with it. It's interesting. We didn't see any new safety signals, Shannon. Dr. Shannon Westin: Yeah, I was going to ask - that's great. Dr. Brian Slomovitz: There was nothing, nothing additional that we found in this trial. So, I feel that it can definitely improve the outcome of those patients, in my view, with high risk for recurrence, treating pembrolizumab in this setting. Dr. Shannon Westin: Yeah, I think it's important, of course, to look at the safety. What about quality of life? Any new findings there? Dr. Brian Slomovitz: Yeah, we did that quality of life as part of the phase 3 trial. No difference between the two arms. No difference between the two arms. When we looked at a couple of the other analyses, we found that the benefit is the same on stage 3, 4 tumors. We saw that the benefit was there as well. So, there were less patients in the stage 1, 2 group. But I think really, for all comers, for the patient population, I would definitely consider giving pembrolizumab, again, for those patients with a deficient mismatch repair. Dr. Shannon Westin: It's really exciting, and I think you mentioned some of the statistical limitations. Anything else that gives you pause about the study or things you wish you did better? I know we always like to armchair quarterback ourselves after we do these kinds of studies. Dr. Brian Slomovitz: Yeah, it's interesting. When we designed the study years ago, we used the best information we had at that time to come up with the study design, and we're happy with it, and we really don't think that we could have done it much better. I should say, this was a great partnership that we had here between the GOG, ENGOT and with sponsor Merck, Toon Van Gorp was the lead PI of the global trial. When he gave me the good opportunity to present it at the IGCS and to be the lead author on this, it was really a great partnership. And when we came up with a trial years ago, it was the best trial that we thought at that time. And based on the information now, I think it's really something that we're excited about these results, even though the overall trial was negative. Dr. Shannon Westin: Yeah, I agree with you. I think it's interesting, it's informative to think about, “Well, what would we do now or then if we knew what we knew now?” But still, you design the trial the best way you can. I think the results are super intriguing. I'm hopeful at the way they'll be reviewed. I agree I don't have any inside information about the NCCN committee, but I do hope that they'll consider the overarching data to support immunotherapy and mismatch repair deficiency and the findings of this study. And then I guess the last question I would just ask, as you're an expert here, what are you looking forward to seeing coming next in this space? What's the stuff you're intrigued about in endometrial cancer? Dr. Brian Slomovitz: I think, Shannon, you and I have talked about this for a while. I think we're getting really close to eliminating chemotherapy for some of the patients who suffer from this disease. So, I'm not sure if we'll do a follow up to this trial, but I think a logical type of follow up would be to see: what if we just took away chemotherapy altogether and we did pembro in the adjuvant setting, pembrolizumab versus chemotherapy? We don't have that trial in the adjuvant setting, but actually, we completed accrual of that trial in the recurrent setting and we're anxiously awaiting those results. That's KEYNOTE-C93, where in the dMMR population we studied pembrolizumab versus carboplatin paclitaxel. How those results may translate into this setting, I'm not sure. Right now, it's exciting what we have, but yeah. And I think future is bright for this. Just to highlight, in the two arms, there's 140 patients approximately in each arm; there were 25 recurrences in those patients who received placebo. Only eight recurrences in those that received pembrolizumab. Really, when we talk about numbers, it's really remarkable and it shows you the benefit it really had on the patients. Dr. Shannon Westin: Well, this was great. It flew by, as it always does when I'm having conversations with you. I just really want to thank you again for taking the time to share your knowledge with our listeners. Dr. Brian Slomovitz: Thanks, Shannon. Dr. Shannon Westin: And listeners. Thank you all for taking the time to hear about endometrial cancer. Again, this was “Pembrolizumab or Placebo, Plus Adjuvant Chemotherapy, With or Without Radiotherapy for Newly Diagnosed High Risk Endometrial Cancer Results in Mismatch Repair Deficient Tumors.” And this was the JCO After Hours. If you loved what you heard, please check out wherever you get your podcast to see what else we have to offer. 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.        

Details of the expanding range of cell therapies beyond hematologic malignancy were reported at the 2024 Annual Meeting of the Chinese Society of Clinical Oncology (CSCO) by Oliver Dorigo, MD, PhD, Director of the Division of Gynecologic Oncology at the Stanford Women's Cancer Center in Stanford University. After his talk at CSCO, Dorigo told Oncology Times reporter Peter Goodwin about the promise cell therapies held for improving outcomes in ovarian cancer and other solid tumors, as well as the benefit of the exchange of ideas flowing between China, U.S., and other global players in this young science.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Luis Chiva to discuss the Elikia project in the Democratic Republic of the Congo. Dr. Luis Chiva is the Head of Gynecology and Obstetrics and Director of Gynecologic Oncology at at Clínica Universidad de Navarra.   Highlights: Inspiration: Dr. Luis Chiva began the Elikia project in the DRC in 2016 after seeing the urgent need for cervical cancer screening and maternal health. Screening Approach: The project uses visual inspection with acetic acid, inspired by a successful model from India, to reduce cervical cancer mortality. Team and Challenges: A team of volunteers faces challenges like limited healthcare infrastructure and promoting preventive care. Sustainability: The project relies on donations and grants  to remain sustainable. Personal Impact: The work has profoundly influenced Dr. Chiva, renewing his commitment to humanitarian efforts.

The words “hormones” and “hot flashes” have been synonymous with menopause for decades. Now, more and more women have been speaking up and bringing this unique phase in a woman's life to the spotlight. And the medical community is paying attention.   Host:Johanna Gomez Guests:Alejandra Angel, M.D., OB/GYN at Baptist Health Baptist Hospital John P. Diaz, M.D., Chief of Gynecologic Oncology at Baptist Health Miami Cancer Institute 

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Gregg Nelson to discuss ERAS Guidelines and Outcomes Meta-analysis. Dr. Gregg Nelson is Professor and Chair of Gynecologic Oncology at the University of Calgary, in Calgary, Canada. He is the Physician Lead for ERAS Alberta and is Co-Chair of Enhanced Recovery Canada.  Highlights: Largest meta-analysis of ERAS randomized clinical trials finds hospital length of stay decreased by 1.9 days overall and risk of complications decreased by 29%, in favor of ERAS ERAS can be applied to both open and minimally invasive surgery ERAS benefits multiple surgery types

Listen to ASCO's Journal of Clinical Oncology Art of Oncology article, "Humor Me” by Dr. Stacey Hubay, who is a Medical Oncologist at the Grand River Regional Cancer Center. The essay is followed by an interview with Hubay and host Dr. Lidia Schapira. Dr Hubay share how even though cancer isn't funny, a cancer clinic can sometimes be a surprisingly funny place. TRANSCRIPT Narrator: Just Humor Me, by Stacey A. Hubay, MD, MHSc   Most of the people who read this journal will know the feeling. You are lurking at the back of a school function or perhaps you are making small talk with your dental hygienist when the dreaded question comes up—“So what kind of work do you do?” I usually give a vague answer along the lines of “I work at the hospital” to avoid the more specific response, which is that I am an oncologist. I have found this information to be a surefire conversational grenade, which typically elicits some sort of variation on “wow, that must be so depressing” although one time I did get the response “Great! I'm a lawyer and a hypochondriac, mind if I ask you some questions?” After I recently dodged the question yet again, I found myself wondering why I am so reticent about telling people what I do. While discussing work with strangers in our hard earned free time is something many people wish to avoid, I think for me a significant motive for this urge to hide is that I do not actually find the cancer clinic to be an overwhelmingly depressing place. Admitting this to others who are not engaged in this work can lead to at the very least bafflement and at worst offense to those who believe that laughing while looking after cancer patients is a sign of callousness. I am an oncologist who laughs in my clinic every day. Of course, the oncology clinic is sometimes a bleak place to work. Cancer has earned its reputation as a fearsome foe, and the patients I see in my clinic are often paying a heavy toll, both physically and emotionally. Many are grappling with their own mortality, and even those with potentially curable cancers face months of challenging treatment and the torture of uncertainty. Yet somehow, perhaps inevitably, the cancer clinic is not just a place of sadness and tears but also a place of hope and laughter. Although most of us recognize humor and use it to varying degrees, few of us consider it as an academic subject. A few lucky souls in academia have taken on the task of developing theories of humor, which attempt to explain what humor is, what purpose it has, and what social function it serves. Although there are almost as many theories of humor as there are aspiring comedians, most explanations fall into one of three categories: relief theory, superiority theory, and incongruous juxtaposition theory.1 Relief theory holds that people laugh to relieve psychological tension caused by fear or nervousness. I suspect this is the most common type of humor seen in a cancer clinic given the weight of fear and nervousness in such a fraught environment. The second category, people being what we are, asserts that sometimes we laugh out of a feeling of superiority to others. It goes without saying that this sort of humor has no place in the clinician patient interaction. Finally, we laugh at absurdity, or as Kant put it, at “the sudden transformation of a strained expectation into nothing.”2 This last category is also surprisingly fruitful in the oncology setting. Laughter in the cancer clinic is still to some extent considered taboo. Near the start of my oncology training, I remember laughing until my stomach hurt with my attending staff in the clinic workspace between seeing patients. What we were laughing about escapes me now, but what I do clearly recall is an administrator in a buttoned-up suit striding over to us in high dudgeon. “Don't you people realize this is a cancer clinic?” she admonished us. “This is not a place for laughter!,” she added before striding off, no doubt to a management meeting or some other place where the policy on laughter is more liberal. At this point, my attending and I looked at each other for a beat and then burst into helpless gales of laughter. We do not tend to think all that much about why we are laughing at something, but looking back now, I think at least part of the reason was the absurdity of a person so unfamiliar with the culture of the cancer clinic presuming that physicians and nurses somehow park their sense of humor when they arrive at work and turn into a herd of gloomy Eeyores.  We oncologists are starting to come clean about the fact that we laugh in the clinic and there is now a modest amount of work in the medical literature addressing the use of humor in oncology. One survey of patients undergoing radiotherapy in Ottawa found that a stunning 86% of patients felt that laughter was somewhat or very important to their care, whereas 79% felt that humor decreased their level of anxiety about their diagnosis.3 If we had a drug that decreased anxiety levels in 79% of patients, had minimal to no side effects when used correctly, and cost the health care system zero dollars, should not we be using it?  Sometimes, it is the patient or their family member who introduces an element of humor into an interaction as on one occasion when my patient was filling out a pain survey which included a diagram of the body on which he was asked to circle any areas where he was having pain. As his wife ran through a detailed list of his bowel habits over the past few days, the patient circled the gluteal area on the diagram he was holding, pointed to his wife and said “I've been suffering from a pain in my ass doctor.” His wife looked at him pointedly for a moment before the two of them started laughing and I joined in.  Sometimes, a patient's use of humor serves to level the playing field. Patients with Cancer are vulnerable, and the physician is an authority figure, meting out judgments from on high. My patient from a few years ago was having none of that. I met him when he was referred to me with widely metastatic lung cancer, a diagnosis typically associated with a dismal prognosis. The patient, however, was not buying into any of the usual gloom and doom that is customary for these interactions. As his daughter translated the information I was providing, he tilted his chin down, fixed his gaze on me, and proceeded to smile at me in a disarmingly friendly way while simultaneously waggling his generous eyebrows up and down throughout the interview. Over the course of 45 min, I became increasingly disconcerted by his behavior until eventually, I was unable to finish a sentence without sputtering with laughter. If you think you would have done better, then you have clearly never been on the losing end of a staring contest. By the end of the interview, all three of us had happily abandoned any hope of behaving with more decorum. Laughter and the use of humor require a certain letting down of one's guard, and the fact that all three of us were able to laugh together in this interview took me down from any pedestal onto which I might have inadvertently clambered. One study from the Netherlands noted that patients used humor to broach difficult topics and downplay challenges they faced and concluded that “Hierarchy as usually experienced between healthcare professionals and patients/relatives seemed to disappear when using laughter.  If applied appropriately, adding shared laughter may help optimize shared decision-making.”4 Although it could be a coincidence, it is worth noting that several years after meeting this patient, I discharged him from my practice because he had somehow been cured of lung cancer. Perhaps laughter really is the best medicine.  On other occasions, it might be the physician who takes the plunge and uses humor during a clinical encounter. The same Dutch study by Buiting et al noted that 97% of all specialists used humor in their interactions and all reported laughing during consultations at least occasionally. One of my colleagues, a generally serious sort whose smiles in clinic are as rare as a total eclipse albeit not as predictable, managed to win over his patient with a rare outburst of humor. During their first meeting, the patient listed off the numerous ailments he had experienced in the past including his fourth bout with cancer which had prompted this appointment. As he finished reciting his epic medical history, my colleague looked at him somberly over the rim of his glasses for a moment and asked “Sir, I must ask—who on earth did you piss off?” The patient was so tickled by this interaction that he recounted it to me when I saw him a few weeks later while filling in for my colleague. Although humor is a powerful tool in the clinic, it is of course not something that comes naturally to all of us. Attempts at humor by a clinician at the wrong time or with the wrong patient do not just fall flat but can even be damaging to the physician-patient relationship. Even if a physician uses humor with the best of intentions, there is always the possibility that they will be perceived by the patient as making light of their situation. As Proyer and Rodden5 point out, tact is essential and humor and laughter are not always enjoyable to all people, or to borrow a phrase frequently used by one of my patients, “about as welcome as a fart in a spacesuit.” Socalled gelotophobes have a heightened fear of being laughed at, and with them, humor and especially laughter must be wielded with great care if at all. All I can say in response to the legitimate concern about the use of humor being misconstrued is that as with any other powerful tool physicians learn to use, one improves with time. As far as PubMed knows, there are no courses in medical faculties devoted to the fine art of the pun or the knock-knock joke. But even if we physicians cannot all reliably be funny on command, perhaps there is something to be said for occasionally being a little less self-serious. One must also be mindful of patients with whom one is not directly interacting—to a patient who has just received bad news, overhearing the sound of laughter in the clinic corridor has the potential to come across as insensitive. Moments of levity are therefore best confined to a private space such as the examination room in which physicians and patients can indulge in anything from a giggle to a guffaw without running the risk of distressing others. The final reason I submit in support of laughing in a cancer clinic is admittedly a selfish one. While humor has been shown to have the potential to reduce burnout,6 the real reason I laugh with patients in my clinic is because it brings me joy. The people at parties who think my job must be depressing are not entirely wrong. I have noticed that when I have a positive interaction with a patient based on humor or laugh with a colleague about something during a meeting, I feel better. Surprise! As it turns out, this is not just an anecdotal observation. In 2022, a study was published whose title was “Adaptive and maladaptive humor styles are closely associated with burnout and professional fulfillment in members of the Society of Gynecologic Oncology.”7 The SGO has not to my knowledge been widely recognized up to this point for their sense of humor, but I have a feeling that might change. Humor is an essential part of the way I approach many situations, and given that I spend the majority of my waking hours at work, it is neither possible nor I would argue desirable for me to leave that part of myself at the entrance to the cancer center. So to the administrator who admonished my mentor and me to cease and desist laughing in the cancer clinic, I respectfully decline. My patients, my colleagues, and I will continue to laugh together at any opportunity we get. Joy in one's work is the ultimate defense against burnout, and I for one intend to take full advantage of it.  Dr. Lidia Schapira: Hello, and welcome to JCO's Cancer Stories: The Art of Oncology, which features essays and personal reflections from authors exploring their experience in the field of oncology. I'm your host, Dr. Lidia Schapira, Professor of Medicine at Stanford University. Today we're joined by Dr. Stacey Hubay, Medical Oncologist at the Grand River Regional Cancer Center. In this episode, we will be discussing her Art of Oncology article, “Just Humor Me.”  Our guest disclosures will be linked in the transcript.   Stacey, welcome to our podcast, and thank you for joining us. Dr. Stacey Hubay: Thank you for having me. It's a pleasure to be here.  Dr. Lidia Schapira: It is our pleasure. So let's start by chatting a little bit about what humor means to you and what led you to write this piece and share it with your colleagues.  Dr. Stacey Hubay: I didn't realize how important humor was to me until recently. I just finished a Masters in Bioethics, which was 20 years in the making, and this was the first time I'd been writing anything that wasn't a case report for many, many years. And there was actually specifically a course called “Writing in Bioethics,” and this was the first thing that came to my mind. And I realized sort of how much humor there is in my day to day work life, which, because none of the other people in this bioethics class of 10 or 14 people were working in oncology, they were surprised. So I thought it would be interesting to write about that. And then when I started thinking about it, I realized how integral it is to most of, I guess not just my practice life, but the way I deal with life. And then I could see a thread going back all the way to the beginning of my practice in oncology, and I'm like, “I should write about this.” And I don't think it's unique to me either. I think it's probably many of us in this field. Dr. Lidia Schapira: It is. So let's talk a little bit about humor in the practice of such a serious specialty as we tend to think, or people tend to think of, as in oncology. You talk about humor also connecting you with joy and practice, can you tell us a little bit more about that? Dr. Stacey Hubay: I'm just as surprised, probably as anybody, at least when I first went into this field, which is now more than 20 years ago, how much happiness I found in the field. I meant what I said in the beginning of this essay. When I run into people or strangers, you're getting your hair cut or you're at your kid's volleyball practice, and people always say, “Oh, so what do you do?” And I always say, “I'm in healthcare.” And if they start drilling down, eventually I have to admit what I do. And I say, “I'm an oncologist.” And immediately the long faces and people say, “That must be so terrible.” And I'm like, “Well, it can be, but it's not as bad as you might think.” And they're like, “Oh, it must be very difficult.” And I know that avenue of conversation is closed once or twice. I think I did try saying, “You know what? I have a surprising amount of fun in my clinic with my patients.” And they were aghast, I think is the word I would use. And it made me realize sort of what a taboo it is for many people, including maybe some of us in the field, to admit that we sometimes enjoy ourselves with our patients in our clinics. Dr. Lidia Schapira: So let's talk about that. Let's talk about joy, and then from there to laugh. I think the reason why laughter seems sort of stranger than joy is laughter assumes that we see some levity, humor. And some people would say, there's really nothing funny about having humor. And yet you seem to see it and find it and share it with your patients. So take us into your exam rooms and tell us a little bit more about your process. Dr. Stacey Hubay: It's funny, when I think about the humor in my clinics, I don't see myself as the one who's necessarily sort of starting it, although maybe sometimes I do. I think perhaps it's just that I'm more open to it. And I think it's frequently the patients who bring it in with them. Obviously, we know patients in the oncology clinic, they're often very nervous. It's a very anxious time for them. And we are in a position of power compared to our patients, they're very vulnerable. And so sometimes the patient makes a joke, sometimes I wonder if it's a way of testing if that kind of relationship will work with you. They're kind of testing you to see if you will respond to that. And it's also a way of them relieving their own anxiety, because one of the theories about humor is just a way of alleviating tension. It makes sense that oncology is a place where humor would be welcome, because it's one of the most tense places, I think, in medical practice, although I'm not sure it's present in other places like at the ICU.  So the patient often brings it in, and then you respond to it, and if you're on the same wavelength, it sort of immediately establishes this kind of trust between you and the patient. It's not something you can do with everybody. Sometimes some people will not be open to that at any time. And some patients, you have to get to know them quite a bit before that starts to come into the mix. But I find with most people, if you follow them for long enough and you have a good working, therapeutic relationship with them, just like you would the people you like, your friends, your family, that comes into a relationship almost unavoidably. And I used to think, “Oh, I'm not supposed to do that,” when I first came into practice. I'm a serious oncologist, which I am, and I can be a serious oncologist. And I also just didn't have the bandwidth for it. I think I was so kind of focused on, I have to know what I'm doing. Early in my practice, I didn't have the mental energy to devote to that. And then as that part became easier, I became kind of more open, I think, to that, coming into the interactions with my patients. And over time, I started realizing that was probably what I enjoyed the most about my working day. At the end of the day, I'd come home and tell stories, and my kids would be like, “It sounds like you have fun at work.” And I go, “You know? I really do. Surprisingly I do.” Dr. Lidia Schapira: That's so very cool. I think there's so much wisdom in what you just told us, which is that at the beginning, especially when in the first few years of your practice, you really are so focused on being clinically competent that you may be just very nervous about trying anything. And then as you relax, you actually say in your essay that for some people, this may bring relief and may level the playing field. So if there is an opportunity and you're loose enough to find it, you may be able to keep that conversation going. It made me wonder, I don't know if you've had any experience yourself as a patient or accompanying a family member as a caregiver to a medical visit. Have you used humor when you are the patient or when you're accompanying the patient?  Dr. Stacey Hubay: That's an interesting question. I haven't been a patient apart from my routine family medicine visits for quite a long time. But when I was much younger, I was a teenager, I did have that experience. I was maybe 15 or 16. I had some parathyroid issues. And I remember seeing these specialists in Toronto, and they were very serious people. I remember thinking, if I want to become a physician, because it was at the back of my mind at that time, I'm going to be a lot more fun than these people. I'm going to enjoy myself a lot more. And little did I realize how difficult that actually was at the time. But I found them kind of very serious and a little bit intimidating as a 15-year-old kid. I hadn't reflected on that before. I'm not sure if that's something that I'm deliberately pushing back against. I think now if I see a physician as a patient, I probably am much more willing to bring that in if the physician is open to it. But you can usually tell many physicians, you meet them and you're like, “You're not going to even try that kind of thing.” But if they're open to it, I think it would bring me much more fun as a patient as well.  Dr. Lidia Schapira: Yeah. Do you teach your students or trainees or members of your team to use humor? Dr. Stacey Hubay: That's a very interesting question. How do you do that? So I mentioned, I just finished this Masters of Bioethics, and one of the excellent courses in it was how to teach bioethics, which really was a course about how to teach anything. And most of us who are in medicine, we've spent a lot of time teaching without being taught how to teach. In my own practice of teaching, we mostly use one on one with people coming into our clinics and seeing patients with us. And I think mostly some of it's through observation. I will say to people who work with me that we all have to find our own style. It's important, no matter what your style is, to try and connect with patients, because you're trying to create a therapeutic alliance. You're on the same side. The way that works for me is you don't laugh with people you don't trust. When you're trying to make a plan with people in these difficult situations, I think if you've already formed this alliance where they realize you're with them, they're more likely to believe you and trust your recommendations. I tell trainees, I'd say, “This is my way of doing it. And if it works for you, that's wonderful.” But I can see that for some people it's difficult.  Although even the most serious clinicians, one of my very good friends and colleagues who I mentioned in my essay and I talked about, he doesn't make a lot of jokes with his patients, which is perfectly reasonable, but the occasional time he does, the patients were so struck by it because they knew him as such a serious person. They bring it up, “Remember that time my doctor said this,” and they thought it was a wonderful thing. So it's difficult to teach. It's just how would the Marx Brothers teach someone else to be the Marx Brothers? It can't be done. Only the Marx Brothers are the Marx Brothers. Not that I'm comparing myself to the Marx Brothers by any means, but I think you find your own style. Maybe what I'd like to show trainees who come through with me is that it's okay to enjoy the patients, even in a very serious discussion. Dr. Lidia Schapira: Yeah, I would almost say that it speaks to the fact that you're very comfortable with your clinical persona in that you can allow yourself to be totally human with them. And if human means that you can both sort of align around seeing some humor or cracking a joke, that is perfectly fine. I have a question for you, and that is that a lot of my patients in my practice, and maybe some of our other listeners come from completely different cultural backgrounds, and many don't speak the same language as I do. So for me, thinking about humor in those situations is impossible just because I just don't even know what we can both accept as funny. And I don't want to be misunderstood. Tell me a little bit about how to think of humor in those situations. Dr. Stacey Hubay: That's a good point you make. It makes me think about how when I read Shakespeare's plays, we all think his tragedies are fantastic. And when I read his comedies, I'm like, “This isn't very funny.” Or if even when you watch sort of silent movies from the 1920s, I'm like, “Did people really laugh at this?” So you're right. Humor is very much of its time and place and its culture. And even people from the same time and place might not share the same sense of humor. That being said, somehow it still works with the people who are open to it. Somehow it's not necessary, because you've made a very witty joke, or vice versa, that we all understood all its complexities. It's more the sense that we're laughing together.   And I talk about a gentleman that I met in my practice in this essay, and he didn't speak English, so his daughter was translating for us. And nobody was making any kind of verbal jokes or humor. And this was the first time I was meeting him in consultation, and he just kept making funny faces at me the whole time I was talking, and I didn't know what to do. I was completely bamboozled by this interaction. And it actually ended up being sort of one of the funniest visits I'd had with a patient. By the end of it, I could barely get a sentence out. And I thought, this is absurd. This is a very serious situation. This poor gentleman has stage 4 lung cancer, brain metastasis, but he just wouldn't let me be serious. So I think that humor can transcend cultural, linguistic boundaries amazingly enough. Again, if the person was open to it, this person was almost determined that he was going to make me laugh. It was like he'd set out that by the end of his visit, he was going to make sure that we were having a good time. And I was just, “I'm helpless against this. We're going to have a good time.” I remember coming out of the room, the nurses I was working with, they're like, “What was going on in that room? Is he doing well?”I'm like, “Well, in a way, yes, he is doing well.”   At the end of this visit, we were all in a very good mood. But I'll sometimes use sign language, or I'll make some stab at French or whatever it is that the patient speaks, and then they just laugh at me, which is also fine, because they can kind of see that you've made yourself vulnerable by saying, “You know, it's okay if I can't speak your language.” And they just smile and laugh with me. So it's not that it's a joke so much, it's more that they just feel comfortable with you. But you're right, it is more challenging. It's something I wouldn't usually do in such a situation unless I had gotten to know the patient, their family, reasonably well.  Dr. Lidia Schapira: Let's talk for a moment about wellness and joy in practice. What gives you the greatest joy in practice?  Dr. Stacey Hubay: Undoubtedly the people that I see and I work with. When you go into medicine and you train, we all train in academic settings. And I had excellent mentors and academic mentors, and the expectation, because you're trained by people who are good at that kind of work and succeeded, is that you might want to pursue that, too. And it took me a while to realize that that's not where I get most of my joy. I like being involved with research and I appreciate that people are doing that work and I love applying that knowledge to my practice. But I get my joy out of actually seeing patients. That wasn't modeled a lot necessarily to us in the academic setting. It's taken me quite a long time to realize that it's okay to lean into that. If that's what I like about my practice and that's what I can bring to the interaction, then that's what I'm going to do. And I started looking back, it would have been nice to realize, it's okay. It's okay to be a clinician who really enjoys seeing patients and wants to do a lot of that. Again, different kinds of people become physicians, but a lot of the people we had as mentors, they had chosen academic careers because, not that they didn't like patients, they often did, but they really wanted to pursue the research aspect of it. And they would try to cut down on their clinical work and say, “It's nice if you don't have two clinics, you can focus on the research.” And I think to myself, but I like doing the clinics and I like seeing the patients, and it would be a shame to me if I didn't have that.  It's not just the patients, but my colleagues as well, who are also great fun to have around, the nurses we work with. Really, it's the interactions with people. Of course, we get joy from all kinds of other things. In oncology, it's good to see patients do well. It's wonderful to apply new knowledge and you have a breakthrough coming from immunotherapy to lung cancer, melanoma. That sort of thing is fantastic, and it gives me joy, too. But I have the feeling that when I retire at the end of my career, I'm going to look back and go, “Remember that interaction with that patient?” Even now, when I think of when I started in clinical settings as a medical student, I remember, I think it was my first or second patient, I was assigned to look after an elderly woman. She had a history of cirrhosis, and she was admitted with hepatic encephalopathy and a fractured humerus after a fall. I didn't know what I was doing at all, but I was rounding every day. And I went to see her on the third day, she was usually confused, and I said, “How are you doing?” She looked at her arm and she said, “Well, they call this bone the humerus, but I don't see anything particularly funny about it.” I thought, “Oh, she's better.” That's actually one of the earliest things I remember about seeing patients.   Or the next year when I didn't realize I was going to pursue oncology. And I was rotating through with an excellent oncologist, Dr. Ellen Warner at Sunnybrook, who does breast cancer. We were debriefing after the clinic, and she said, “Someday, Stacey, I'm going to publish a big book of breast cancer humor.” And I thought, “I wonder what would be in that book.” And that's when I got this inkling that maybe oncology had just as much humor in as every other part of medicine. And that proved to be true.  Dr. Lidia Schapira: What was it, Stacey, that led you to bioethics? Tell us what you learned from your bioethics work. Dr. Stacey Hubay: I think it's because basically I'm a person who leads towards the humanities, and for me, bioethics is the application of philosophy and moral ethics to a clinical situation. And I think medicine, thankfully, has room for all kinds of people. Of course, you have to be good at different things to be a physician. But I always imagined myself, when I went to school, that after a class, you'd sit around a pub drinking beer and discuss the great meaning of life. And I thought, this is my chance to pursue that. And I was hoping to kind of– I didn't think of it as that I was going to this because I was interested in humor and joy in oncology, although I obviously am. I was thinking that I would be able to make a difference in terms of resource allocation and priority setting, and I still want to pursue those things. Things often lead you down a side road. And bioethics, for me, has sort of reminded me of what I like about this work. And because I was surrounded by many people who are not doing that kind of work, who were surprised how much I liked it, it made me think very carefully about what is it that I like about this. So the bioethics degree, it's finally allowed me to be that person who sits around in pubs drinking beer, discussing Immanual Kant and Utilitarianism and whatever moral theory is of flavor that particular day. Dr. Lidia Schapira: What led you to write this particular story and put it in front of your medical oncology colleagues? Is it your wish to sort of let people sort of loosen up and be their authentic selves and find more joy in the clinic? Dr. Stacey Hubay: That's a good question! The most immediate impetus was I had an assignment for my degree, and I thought, I have to write something. But I'd been writing down these sort of snippets of things I found funny. Occasionally, I just write them down because they were interesting to me. And because we often relate stories to people, “What did you do today? What was your day like?” And because you tell these stories over and over, they develop some kind of oral, mythical quality. You're like, “Here's what I remember that was funny that happened, and it might have been many years ago now.” And I think I'd been thinking a long time about writing it down and sort of organizing it that way. And I guess having to produce something as part of this degree program was an impetus for me. But I'd always wanted to do it. And I think the main thing was I wanted to make it clear to myself what it is I like about it. It's actually made it, for me, much more clear. It was sort of a nebulous thing that I like my work and what is it like about it. And this is what I like. I like the joy I get from patient interactions. And then a secondary goal is I hope that other people, if they were to read this, they realize it's okay for us to have joy in our work as oncologists. And there is a lot of doom and gloom in the world and in our practices, but there's always, always a chink that lets the light in, there's always some humor in what we do. And so I hope that if other people can find that, too, that they enjoy their practice and they last a long time and ultimately help patients through this difficult journey. Dr. Lidia Schapira: Are you somebody who likes to read stories? And if so, what stories have you read recently that you want to recommend to our listeners? Dr. Stacey Hubay: Oh, I am reading The Master and Margarita because three different people recommended this novel to me over the last three years. When a third person did, I thought, “That's it. Got to read it.” It's a Russian novel from the 1930s that was banned until, I think, the ‘60s or ‘70s. It's like a satire of Russian society in the ‘30s. And actually, what I like about it, I haven't finished it. I'm a third of the way through, as I think it's one of the so-called classic novels, people tell me, but that's funny. A lot of the classic novels are kind of tragedies or romances, and this one is sort of absurd black humor in the face of a difficult situation, which I guess is related to oncology, again. So this sort of oppressive, difficult society, the 1930s and Soviet Union, how do you deal with that? With humor. So I'm quite enjoying it, actually. So I recommend that one.  Dr. Lidia Schapira: Well, you're an amazing storyteller, and I really enjoyed our conversation. Is there any final message that you want to convey to our listeners? Dr. Stacey Hubay: If you have a chance to become an oncologist, you should do it. It's just the best career I can imagine. Dr. Lidia Schapira: Well, with your laughter and with that wonderful wisdom, let me say, until next time, to our listeners, thank you for listening to JCO's Cancer Stories: The Art of Oncology. Don't forget to give us a rating or review, and be sure to subscribe so you never miss an episode. You can find all of the ASCO shows at asco.org/podcast. 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.   Show Notes: Like, share and subscribe so you never miss an episode and leave a rating or review.   Guest Bio: Dr. Stacey Hubay is a Medical Oncologist at the Grand River Regional Cancer Center.

According to 2024 data from the American Medical Association, around 40% of physicians surveyed indicated they were likely to reduce their clinical hours in the next year. One in 5 physicians say they intend to leave the profession entirely within the next two years, with nearly 28% of doctors surveyed reporting dissatisfaction with their current healthcare jobs. Our guest left direct patient care behind in 2022 after practicing as a Gynecologic Oncology surgeon for just four years. Dr. Wilbur then embarked on a project to conduct a series of one-on-one interviews with doctors like herself who had either recently left practice, or were strongly considering doing so, to shine light on this growing trend and what factors were driving it. We talk with her about her new book that came out of those conversations, “The Doctor is No Longer In: Conversations with U.S. physicians.”

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Timo Westermann and Philipp Harter to discuss fertility-sparing surgery in borderline ovarian tumors. Dr. Timo Westermann is a gynecologist and fellow at the Department of Gynecologic Oncology at Kliniken Essen-Mitte. Dr. Philipp Harter is a gynecologic oncologist, working at Kliniken Essen Mitte and Chair of the AGO Study Group.   Highlights:   Fertility-Sparing Surgery in Borderline-Tumors does not negatively impact overall survival. Higher recurrence rates are observed after fertility-sparing surgery, particularly in higher FIGO stages. Long-term follow up is crucial due to potential risk of late recurrences.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Enrique Chacón to discuss the SENECA Study: Molecular profiling and SLN. Dr. Chacón works in the Gynecologic Oncology Unit of the Clínica Universidad de Navarra. Dr. Chacón is an active member of the European Society of Gynecologic Oncology where he is the co-chair of the ENYGO Online Education Committee and the national representative of Spain. In 2021 he completed his editorial fellowship in the IJGC, where today he is serving on the Editorial Board of the journal.   Highlights:   This study, for the first time, reveals significant differences in SLN involvement among more than 2000 patients with early-stage endometrial cancer based on their molecular subtypes, with the p53 abn and MMRd groups having the greatest lymph node involvement. The study defined the risk of SLN involvement for each of the ESGO risk groups. In this sense, the study notes that molecular profiling does not improve the prediction of nodal status with respect to the classical risk factors (FIGO stage and histology). Lymph node staging should not yet be adopted based on molecular profiling as prospective studies are needed to validate whether these differences impact survival (DFS/OS)

Dr Angeles Alvarez Secord from the Duke Cancer Institute in Durham, North Carolina, provides her perspectives on recent datasets from ASCO 2024 on the management of ovarian and endometrial cancers, moderated by Dr Neil Love. Produced by Research To Practice. CME information and select publications here (https://www.researchtopractice.com/OncologyTodayASCOOvarianEndo24).

Join us on this poignant episode of Cervivor, where Dulcely Tavarez bravely shares her journey through cervical cancer, shedding light on the profound impact it had on her fertility. Alongside Dulcely, Dr. Terri Lynn Woodard delves into the intricate link between cancer and infertility, offering insights into fertility preservation options and navigating post-treatment infertility challenges. Tune in to gain invaluable knowledge and support for those facing similar journeys. Did you connect with this episode? Share your thoughts with us on social media using #CervivorPodcast or by ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠emailing us.⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠   For more Cervivor-related content, check out: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Cervivor.org⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠. Follow Cervivor on all social media platforms. If you would like to be interviewed as a potential guest for an upcoming episode or would like to request a speaker or topic for a future podcast episode, email us at info@cervivor.org. More About The Guests: Dulcely Tavarez, 31, is a native New Yorker from a Hispanic Latino background, her parents having migrated from the Dominican Republic over 30 years ago. Growing up in a tight-knit family in upper Manhattan, she found solace and strength in their support when diagnosed with Cervical Cancer. Today, she proudly declares herself cancer-free. Motivated by her journey, Dulcely pursued a career in health services, holding a Bachelor's in Health Services Administration and a Master's in Organizational Leadership. Currently serving as an Intake Director at a Home Care Agency, she remains committed to helping others and embracing life's challenges with unwavering resilience. Dr. Terri L. Woodard is an Associate Professor in the Department of Gynecologic Oncology and Reproductive Medicine at MD Anderson Cancer Center. She holds a joint appointment in the Division of Reproductive Endocrinology and Infertility at Baylor... College of Medicine and Texas Children's Hospital Pavilion for Women. As a reproductive endocrinologist and infertility specialist, she has a specific interest in fertility preservation and family building for people diagnosed with cancer. Dr. Woodard established the MD Anderson Oncofertility Program in 2012. Provided through the Department of Gynecologic Oncology and Reproductive Medicine and Baylor College of Medicine, the program includes a clinical service that offers fertility counseling prior to cancer treatment, as well as comprehensive fertility preservation and family-building services for men, women and children whose reproductive potential may or may have been impacted by cancer or its treatment. --- Support this podcast: https://podcasters.spotify.com/pod/show/cervivor/support

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Andrea Rosati. Mr. Rosati is a consultant at the Department of Gynecologic Oncology at Fondazione Policlinico Universitario Agostino Gemelli in Rome (Italy). He is currently attending a second level master "Gynecologic Oncology International Master" at the Catholic University of the Sacred Heart (Rome, Italy) accredited as a Subspecialty Fellowship by the European Society of Gynaecological Oncology. His main interest areas are gynecological cancer, surgical anatomy, and gynecologic oncology surgery.   Highlights: This study evaluated the prevalence of concurrent endometrial cancer in patients with pre-operative diagnoses of atypical endometrial hyperplasia undergoing hysterectomy.  Among 460 patients, 47.2% were found to have concurrent endometrial cancer. Sentinel lymph node biopsy provided prognostic and therapeutic information in 60.8% of cases.  It also allowed for the adjustment of adjuvant therapy in 12.3% of high to intermediate-risk patients without increasing operative time or complication rates.  The study suggests sentinel lymph node biopsy can provide valuable prognostic and therapeutic insights in managing atypical endometrial hyperplasia.

In this episode, listen to Floor J. Backes, MD, and Angeles Alvarez Secord, MD, MHSc, share their clinical insights and takeaways on new data presented for endometrial, ovarian, and cervical cancers presented at the 2024 annual meetings of the Society of Gynecologic Oncology and American Society of Clinical Oncology including:RUBY Part 1 Subgroup Analyses by MRR Status: Addition of dostarlimab to platinum-based therapy followed by dostarlimab maintenance in advanced endometrial cancerRUBY Part 2: Survival outcomes with addition of dostarlimab to platinum-based therapy followed by dostarlimab plus niraparib maintenance in advanced endometrial cancerSurvival Analyses From Phase III NRG GY018: Carboplatin plus paclitaxel with or without pembrolizumab as frontline treatment for patients with advanced endometrial cancerDUO-E: First-line therapy with carboplatin plus paclitaxel plus bevacizumab and durvalumab followed by maintenance with bevacizumab, durvalumab, and olaparib in newly diagnosed endometrial cancerLong-term Follow-up From SIENDO: PFS in TP53 wild-type and preliminary survival by molecular subgroups in patients with endometrial cancer and complete or partial response after ≥12 weeks of first line taxane/carboplatinSubgroup Analyses From the Randomized Phase III MIRASOL: Mirvetuximab soravtansine vs investigator's choice of chemotherapy in FR

Featuring perspectives from Dr Dana M Chase, including the following topics: Introduction: ASCO 2024 Review (0:00) Ovarian Cancer (14:29) HER2 as a Therapeutic Target (29:18) Endometrial Cancer (38:55) Cervical Cancer (51:11) CME information and select publications

Dr Dana M Chase from the David Geffen School of Medicine at UCLA in Los Angeles, California, discusses select 2023 data sets on the management of ovarian, endometrial and cervical cancers, moderated by Dr Neil Love. Produced by Research To Practice. CME information and select publications here (https://www.researchtopractice.com/YiR2023/Gyn).

Dr Dana M Chase from the David Geffen School of Medicine at UCLA in Los Angeles, California, discusses select 2023 data sets on the management of ovarian, endometrial and cervical cancers.

Gynecologic oncology experts Dr. Matthew Powell from Washington University School of Medicine and Dr. Amanda Fader from Johns Hopkins Hospital discuss the increasing rates of endometrial cancer along with future directions of treatments and screenings. --- SYNPOSIS First, the physicians discuss trends in endometrial cancer rates and delve into the factors driving these trends, such as the obesity epidemic and aging population. They explore the differences between endometrioid and non-endometrioid cancers, along with the impact of racial and geographic disparities. The conversation also covers advances in diagnostics and treatments—including immunotherapy and targeted therapies—and the critical need for better awareness, screening practices, and research funding to combat this public health threat. --- TIMESTAMPS 00:00 - Introduction 03:11 - Types of Endometrial Cancer 04:44 - Rising Rates and Risk Factors 08:03 - Disparities in Endometrial Cancer Care 10:37 - Symptoms and Diagnosis 13:52 - Ultrasound vs. Biopsy 16:17 - Challenges in Biopsies 20:58 - Management/Treatment Approaches 23:03 - Geographic Disparities/Access to Care 26:07 - Vaginal Brachytherapy 32:11 - Innovations in Treatment and Research 40:34 - Future Directions: Endometrial Screening 43:54 - AI in Gynecologic Oncology --- RESOURCES Beavis, A. L., Blechter, B., Najjar, O., Fader, A. N., Katebi Kashi, P., & Rositch, A. F. (2023). Identifying women 45 years and younger at elevated risk for endometrial hyperplasia or cancer. Gynecologic Oncology, 174, 98–105. https://doi.org/10.1016/j.ygyno.2023.04.019 Mirza, M. R., Sharma, S., Roed, H., Landrum, L. M., Gilbert, L., Gold, M. A., Novák, Z., Edelson, M., Meirovitz, M., Diaz, J. P., Huygh, G., Buscema, J., Pothuri, B., Eshed, H. D., Coleman, R. L., Slomovitz, B. M., Kostadinov, R., Stevens, S., Ronzino, G., & Powell, M. A. (2024). Post hoc analysis of progression-free survival (PFS) and overall survival (OS) by mechanism of mismatch repair (MMR) protein loss in patients with endometrial cancer (EC) treated with Dostarlimab plus chemotherapy in the ruby trial. Journal of Clinical Oncology, 42(16_suppl), 5606–5606. https://doi.org/10.1200/jco.2024.42.16_suppl.5606 Society of Gynecologic Oncology (SGO): https://www.sgo.org/

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Gabriel Levin and Behrouz Zand to discuss ChatGPT-fabricated abstracts in gynecologic oncology. Dr. Gabriel Levin is a gynecologic oncology Fellow at McGill University, and an assistant professor at the Hebrew University of Jerusalem. His research encompasses population database studies with clinical implication and innovations in medical education and health care. Dr. Behrouz Zand is a gynecologic oncologist at Houston Methodist Hospital's Neal Cancer Center and Department of Obstetrics and Gynecology, and an assistant professor at Weill Cornell College at Houston Methodist Academic Institute. Specializing in innovative cancer care and clinical trials, he is passionate about integrating AI in medicine, a recent alumnus of the physician program at MIT for AI integration in healthcare. Dr. Zand combines cutting-edge research with compassionate patient care to advance the field.   Highlights:   Reviewers had difficulty in discriminating ChatGPT-written abstracts. Reviewers correctly identified only 46.3% of ChatGPT-generated abstracts, with human-written abstracts slightly higher at 53.7%.  Senior reviewers and those familiar with AI had higher correct identification rates, with senior reviewers at 60% and juniors/residents at 45%. Experience and familiarity with AI were independently associated with higher correct identification rates. ChatGPT assists researchers by generating reviews, summaries, and enhancing writing clarity, but it raises ethical concerns and could diminish human expertise. For non-English speaking authors, it improves writing quality and clarity. In scientific writing, it enhances clarity, summarizes concisely, brainstorms ideas, assists with terminology, and offers data interpretation, augmenting human expertise. ChatGPT and AI in scientific writing can lead to ethical issues, factual inaccuracies, and may eventually diminish human expertise and critical thinking.

Podcast Description: In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Mueller and Manning-Geist to discuss molecular classification in ovarian preservation for uterine cancer. Jenny Mueller MD is a gynecologic oncologist and an associate attending in the department of surgery at Memorial Sloan Kettering Cancer Center.  She leads the endometrial cancer research team at MSKCC with an emphasis on prospective, translational and collaborative efforts within and across institutions. Beryl Manning-Geist is a Gynecologic surgery fellow at Memorial Sloan Kettering Cancer Center and will be joining Emory University Division of Gynecologic Oncology in 2024 as an assistant professor. Her research focuses on how to leverage the molecular underpinnings of gynecologic cancers for tailored treatment. Highlights: -Patients with microsatellite instability-high/mismatch repair-deficient or copy number-high/TP53abnormal endometrial cancer were at increased risk of concurrent ovarian disease. -The presence of lymphovascular space invasion and positive cytology were also associated with an increased risk of concurrent ovarian disease. -Integrating molecular tumor profiling with pathologic characteristics of disease may help to better risk stratify pre-menopausal patients with endometrial cancer for ovarian preservation.

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Dr. Shitanshu Uppal to discuss the impact of closure of small fascial bites on incisional hernia rates in gynecologic oncology patients. Dr. Uppal is the George W. Morley Collegiate Professor of Obstetrics and Gynecology and the Division Chief of Gynecologic Oncology at the University of Michigan. Dr. Uppal is recognized for his research in surgical outcomes and quality improvement, alongside his pivotal role in leading educational initiatives for Gynecologic Oncology.   Highlights:   - This quality improvement study validates prior RCT data in gynecologic oncology population - Adoption of Small-Bite Fascial Closure Reduced Hernia rates by 50% - Obesity and adjuvant chemotherapy are independent risk factors for hernia development

In this episode of the IJGC podcast, Editor-in-Chief Dr. Pedro Ramirez is joined by Drs. Arina Onoprienko and Thomas Bartl to discuss ARID1A in NSMP uterine cancers. Dr. Onoprienko is undergoing residency training in OB/GYN and pursuing a PhD in experimental cancer research at the Medical University of Vienna, Austria. Her clinical research primarily focuses on modeling therapeutic outcomes in patients with gynecological cancers and assessing cognitive dysfunction in patients undergoing therapy for disease recurrence. Dr. Bartl completed his residency training in OB/GYN at the Medical University of Vienna, Austria, and is about to commence an ESGO-Fellowship in Gynecologic Oncology. Having completed a PhD program in experimental cancer research, he developed a strong interest in translational cancer research with a focus on precision medicine and definition of new therapeutic targets in rare gynecologic tumors.   Highlights: Approximately one-third of endometrial cancers classified as "no specific molecular profile" (NSMP) harbors _ARID1A_-mutations. As ARID1A has previously been hypothesized to be associated with higher risks of recurrence and more pro-immunogenic tumor phenotypes, _ARID1A_ could qualify as a promising future biomarker for NSMPs. Consistent with previous research, _ARID1A_-mutations are associated with a significantly higher risk of recurrence within the NSMP subgroup, which translates into impaired progression-free survival. _ARID1A_ mutations appear not to be associated with impaired disease-specific survival. Based on a small subgroup analysis of patients experiencing disease recurrence, it could be hypothesized that this effect might be partly attributed to a better response to recurrence therapy.