Podcasts about Hodgkin

The lymphatic system, or lymphoid system, is one of the components of the circulatory system, and it serves a critical role in both immune function and surplus extracellular fluid drainage.  Components of the lymphatic system include lymph, lymphatic vessels and plexuses, lymph nodes, lymphatic cells, and a variety of lymphoid organs. The pattern and form of lymphatic channels are more variable and complex but generally parallel those of the peripheral vascular system. The lymphatic system partly functions to convey lymphatic fluid, or lymph, through a network of lymphatic channels, filter lymphatic fluid through lymph nodes and return lymphatic fluid to the bloodstream, where it is eventually eliminated. Nearly all body organs, regions, and systems have lymphatic channels to collect the various byproducts that require elimination . Liver and intestinal lymphatics produce about 80% of the volume of lymph in the body. Notable territories of the body that do not appear to contain lymphatics include the bone marrow, epidermis, as well as other tissues where blood vessels are absent. The central nervous system was long considered to be absent of lymphatic vessels until they were recently identified in the cranial meninges. Moreover, a vessel appearing to have lymphatic features was also discovered in the eye. The lymphatic system is critical in a clinical context, particularly given that it is a major route for cancer metastasis and that the inflammation of lymphatic vessels and lymph nodes is an indicator of pathology.  Structure The lymphatic system includes numerous structural components, including lymphatic capillaries, afferent lymphatic vessels, lymph nodes, efferent lymphatic vessels, and various lymphoid organs.  Lymphatic capillaries are tiny, thin-walled vessels that originate blindly within the extracellular space of various tissues. Lymphatic capillaries tend to be larger in diameter than blood capillaries and are interspersed among them to enhance their ability to collect interstitial fluid efficiently. They are critical in the drainage of extracellular fluid and allow this fluid to enter the closed capillaries but not exit due to their unique morphology. Lymphatic capillaries at their blind ends are composed of a thin endothelium without a basement membrane. The endothelial cells at the closed end of the capillary overlap but shift to open the capillary end when interstitial fluid pressure is greater than intra-capillary pressure. This process permits lymphocytes, interstitial fluid, bacteria, cellular debris, plasma proteins, and other cells to enter the lymphatic capillaries. Special lymphatic capillaries called lacteals exist in the small intestine to contribute to the absorption of dietary fats. Lymphatics in the liver contribute to a specialized role in transporting hepatic proteins into the bloodstream. The lymphatic capillaries of the body form large networks of channels called lymphatic plexuses and converge to form larger lymphatic vessels. Lymphatic vessels convey lymph, or lymphatic fluid, through their channels. Afferent (toward) lymphatic vessels convey unfiltered lymphatic fluid from the body tissues to the lymph nodes, and efferent (away) lymphatic vessels convey filtered lymphatic fluid from lymph nodes to subsequent lymph nodes or into the venous system. The various efferent lymphatic vessels in the body eventually converge to form two major lymphatic channels: the right lymphatic duct and the thoracic duct.  The right lymphatic duct drains most of the right upper quadrant of the body, including the right upper trunk, right upper extremity, and right head and neck. The right lymphatic trunk is a visible channel in the right cervical region just anterior to the anterior scalene muscle. Its origin and termination are variable in morphology, typically forming as the convergence of the right bronchomediastinal, jugular, and subclavian trunks, extending 1 to 2 centimeters in length before returning its contents to the systemic circulation at the junction of the right internal jugular, subclavian, and/or brachiocephalic veins.  The thoracic duct, also known as the left lymphatic duct or van Hoorne's canal, is the largest of the body's lymphatic channels. It drains most of the body except for the territory of the right superior thorax, head, neck, and upper extremity served by the right lymphatic duct. The thoracic duct is a thin-walled tubular vessel measuring 2 to 6 mm in diameter. The length of the duct ranges from 36 to 45 cm. The thoracic duct is highly variable in form but typically arises in the abdomen at the superior aspect of the cisterna chyli, around the level of the twelfth thoracic vertebra (T12). The cisterna chyli, from which it extends, is an expanded lymphatic sac that forms at the convergence of the intestinal and lumbar lymphatic trunks extending along the L1-L2 vertebral levels. The cisterna chyli is present in approximately 40-60% of the population, and in its absence, the intestinal and lumbar lymphatic trunks communicate directly with the thoracic duct at the T12 level. As a result, the thoracic duct receives lymphatic fluid from the lumbar lymphatic trunks and chyle, composed of lymphatic fluid and emulsified fats, from the intestinal lymphatic trunk. Initially, the thoracic duct is located just to the right of the midline and posterior to the aorta. It exits the abdomen and enters the thorax via the aortic hiatus formed by the right and left crura of the diaphragm, side by side with the aorta. The thoracic duct then ascends in the thoracic cavity just anterior and to the right of the vertebral column between the aorta and azygos vein. At about the level of the fifth thoracic vertebra (T5), the thoracic duct typically crosses to the left of the vertebral column and posterior to the esophagus. From here, it ascends vertically and usually empties its contents into the junction of the left subclavian and left internal jugular veins in the cervical region. To ensure that lymph does not flow backward, collecting lymphatic vessels and larger lymphatic vessels have one-way valves. These valves are not present in the lymphatic capillaries. These lymphatic valves permit the continued advancement of lymph through the lymphatic vessels aided by a pressure gradient created by vascular smooth muscle, skeletal muscle contraction, and respiratory movements. However, it is important to note that lymphatic vessels also communicate with the venous system through various anastomoses. Lymph nodes are small bean-shaped tissues situated along lymphatic vessels. Lymph nodes receive lymphatic fluid from afferent lymphatic vessels and convey lymph away through efferent lymphatic vessels. Lymph nodes serve as a filter and function to monitor lymphatic fluid/blood composition, drain excess tissue fluid and leaked plasma proteins, engulf pathogens, augment an immune response, and eradicate infection. Several organs in the body are considered to be lymphoid or lymphatic organs, given their role in the production of lymphocytes. These include the bone marrow, spleen, thymus, tonsils, lymph nodes, and other tissues. Lymphoid organs can be categorized as primary or secondary lymphoid organs. Primary lymphoid organs are those that produce lymphocytes, such as the bone marrow and thymus. Bone marrow is the primary site for the production of lymphocytes. The thymus is a glandular organ located anterior to the pericardium. It serves to mature and develop T cells, or thymus cell lymphocytes, in response to an inflammatory process or pathology. As individuals age, both their bone marrow and thymus reduce and accumulate fat. Secondary lymphoid organs serve as territories in which immune cells function and include the spleen, tonsils, lymph nodes, and various mucous membranes, such as in the intestines. The spleen is a purplish, fist-sized organ in the left upper abdominal quadrant that contributes to immune function by serving as a blood filter, storing lymphocytes within its white pulp, and being a site for an adaptive immune response to antigens. The lingual tonsils, palatine tonsils, and pharyngeal tonsils, or adenoids, work to prevent pathogens from entering the body. Mucous membranes in the gastrointestinal, respiratory, and genitourinary systems also function to prevent pathogens from entering the body. Lymph Lymphatic fluid, or lymph, is similar to blood plasma and tends to be watery, transparent, and yellowish in appearance. Extracellular fluid leaks out of the blood capillary walls because of pressure exerted by the heart or osmotic pressure at the cellular level. As the interstitial fluid accumulates, it is picked up by the tiny lymphatic capillaries along with other substances to form lymph. This fluid then passes through the lymphatic vessels and lymph nodes and finally enters the venous circulation. As the lymph passes through the lymph nodes, both monocytes and lymphocytes enter it.  Lymph is composed primarily of interstitial fluid with variable amounts of lymphocytes, bacteria, cellular debris, plasma proteins, and other cells. In the GI tract, lymphatic fluid is called chyle and has a milk-like appearance that is chiefly due to the presence of cholesterol, glycerol, fatty acids, and other fat products. The vessels that transport the lymphatic fluid from the GI tract are known as lacteals. Embryology The development of the lymphatic system is known from both human and animal, especially mouse studies. The lymphatic vessels form after the development of blood vessels, around six weeks post-fertilization. The endothelial cells that serve as precursors to the lymphatics arise from the embryonic cardinal veins. The process by which lymphatic vessels form is similar to that of the blood vessels and produces lymphatic-venous and intra-lymphatic anastomoses, but diverse origins exist for components of lymphatic vessel formation in different regions.  Six primary lymph sacs develop and are apparent about eight weeks post-fertilization. These include, from caudal to cranial, one cisterna chyli, one retroperitoneal lymph sac, two iliac lymph sacs, and two jugular lymph sacs. The jugular lymph sacs are the first to develop, initially appearing next to the jugular part of the cardinal vein. Lymphatic vessels then form adjacent to the blood vessels and connect the various lymph sacs. The lymphatic vessels primarily arise from the lymph sacs through the process of self-proliferation and polarized sprouting.  Stem/progenitor cells play a huge role in forming lymphatic tissues and vessels by contributing to sustained growth and postnatally differentiating into lymphatic endothelial cells. Lymphatic channels from the developing gut connect with the retroperitoneal lymph sac and the cisterna chyli, situated just posteriorly. The lymphatic channels of the lower extremities and inferior trunk communicate with the iliac lymph sacs. Finally, lymphatic channels in the head, neck and upper extremities drain to the jugular lymph sacs. Additionally, a right and left thoracic duct form and connect the cisterna chyli with the jugular lymph sacs and form anastomoses that eventually produce the typical adult form. The lymph sacs then produce groups of lymph nodes in the fetal period. Migrating mesenchyme enters the lymph sacs and produces lymphatic networks, connective tissue, and other layers of the lymph nodes. Function The lymphatic system's primary function is to balance the volume of interstitial fluid and convey it and excess protein molecules into the venous circulation. The lymphatic system is also important in immune surveillance, defending the body against foreign particles and microorganisms. It does so by conveying antigens and leukocytes to lymph nodes, where antigen-primed and targeted lymphocytes and other immune cells are conveyed into the lymphatic vessels and blood vessels. In addition, the system has a role in the absorption of fat-soluble vitamins and fatty substances in the gut via the gastrointestinal tract's lacteals within the villi and the transport of this material into the venous circulation.  Newly recognized lymphatic vessels are visible in the meninges relating to cerebrospinal fluid (CSF) outflow from the central nervous system. Finally, lymphatics may play a role in the clearance of ocular fluid via the lymphatic-like Schlemm canals. Clinical Significance Leaks of lymphatic fluid occur when the lymphatic vessels are damaged. In the abdomen, lymphatic vessel damage may occur during surgery, especially during retroperitoneal procedures such as repairing an abdominal aortic aneurysm. These leaks tend to be mild, and the vessels in the peritoneum and mesentery eventually absorb the lymphatic fluid or chyle. However, when the thoracic duct is injured in the chest, the chyle leak can be extensive. In most cases, conservative care with a no-fat diet (medium chain triglycerides) or total parenteral nutrition is unsuccessful. In most cases, if the injury to the thoracic duct was surgical, a surgical procedure is required to tie off the duct. If the thoracic duct is injured in the cervical region, then inserting a drainage tube and adopting a low-fat diet will help seal the leak. However, thoracic duct injury in the chest cavity usually requires drainage and surgery. It is rare for the thoracic segment of the thoracic duct to seal on its own. In terms of accumulation of chyle in the thorax (i.e., chylothorax), if a patient has an injury to the thoracic duct in the thorax below the T5 vertebral level, then fluid will collect in only the right pleural cavity. If the injury is to the thoracic duct in the thorax above the T5 vertebral level, then fluid will appear in both pleural cavities.   Other Issues The lymphatic system is prone to disorders like the venous and arterial circulatory systems. Developmental or functional defects of the lymphatic system cause lymphedema. When this occurs, the lymphatic system is unable to sufficiently drain lymphatic fluid resulting in its accumulation and swelling of the territory. Lymphedema, this swelling due to the accumulation of lymph, is classified as primary or secondary. Primary lymphedema is an inherited disorder where the lymphatic system development has been disrupted, causing absent or malformed lymphatic tissues. This condition often presents soon after birth, but some conditions may present later in life (e.g., at puberty or later adulthood). There are no effective treatments for primary lymphedema. Past surgical treatments were found to be mutilating and are no longer implemented. The present-day treatment revolves around compression stockings, pumps, and constrictive garments. Secondary lymphedema is an acquired disorder involving lymphatic system dysfunction that may result from many causes, including cancer, infection, trauma, or surgery. The treatment of secondary lymphedema depends on the cause. Oncological and other surgeries may result in secondary lymphedema due to the removal or biopsy of lymph nodes or lymphatic vessels. Non-surgical lymphedema may result from malignancies, obstruction within the lymphatic system, infection, or deep vein thrombosis. In most cases of obstructive secondary lymphedema, the drainage will resume if the inciting cause is removed, although some individuals may need to wear compressive stockings permanently. Also, physical therapy may help alleviate lymphedema when the extremities are involved. There is no absolute cure for lymphedema, but diagnosis and careful management can help to minimize complications. Lymphomas are cancers that arise from the cells of the lymphatic system. There are numerous types of lymphoma, but they are grouped into Hodgkin lymphoma and non-Hodgkin lymphoma. Lymphomas usually arise from the malignant transformation of specific lymphocytes in the lymphatic vessels or lymph nodes in the gastrointestinal tract, neck, axilla, or groin. Symptoms of lymphoma may include night sweats, fever, fatigue, itching, and weight loss. Cancers originating outside of the lymphatic system often spread via the lymphatic vessels and may involve regional lymph nodes serving the impacted organs or tissues. Lymphadenitis occurs when the lymph nodes become inflamed or enlarged. The cause is usually an adjacent bacterial infection but may also involve viruses or fungi. The lymph nodes usually enlarge and become tender. Lymphatic filariasis, or elephantiasis, is a very common mosquito-borne disorder caused by a parasite found in tropical and subtropical areas of the world, including Africa, Asia, the Pacific, the Caribbean, and South America. This condition involves parasitic microscopic nematodes (roundworms) that infect the lymphatic system and rapidly multiply and disrupt lymphatic function. Many infected individuals may have no outward symptoms, although the kidneys and lymphatic tissues may be damaged and dysfunctional. Symptomatic individuals may present with disfigurement caused by significant lymphedema and elephantiasis (thickening of the skin, particularly the extremities). The parasite may also cause hydrocele, an enlargement of the scrotum due to the accumulation of fluid, which may result from obstruction of the lymph nodes or vessels in the groin. Individuals presenting with symptoms have poorly draining lymphatics, often involving the extremities, resulting in huge extremities and marked disability. Lymphatic filariasis is the most common cause of disfigurement in the world, and it is the second most common cause of long-term disability.  (credits: NIH)

This epsiode is brought ot you by LMNT, Strong Coffee Company, Legion Athletics and Fatty15. After healing from Hodgkin's lymphoma in her 30s, Elissa Goodman turned her personal health crisis into a lifelong mission: helping others prevent and recover from cancer through holistic nutrition and mindful living. In this episode, she opens up about her journey from stress-driven corporate life to deep healing through green juicing, plant-based eating, and inner work like yoga, trauma release, and plant medicine. Elissa discusses how trauma, inflammation, and our toxic environment create the "cancer terrain"—and how we can reverse it with simple, nutrient-dense habits and radical self-love. Her story is not just about healing cancer but transforming one's entire way of living. Follow Elissa @elissagoodman Follow Chase @chase_chewning ----- 00:00 – The Current Cancer Epidemic 03:00 – Diagnosis at 32 & Discovering Juicing 07:00 – Taking Healing into Her Own Hands 11:00 – The Power of One Question: "Are You Happy?" 15:00 – Losing Her Husband & What Holistic Healing Taught Her 21:00 – Top Anti-Cancer Foods & The Inflammation Connection 28:00 - Cacao, Grief, and Plant Medicine as Emotional Healing Tools 33:00 - The Cancer Terrain: Internal Environment vs. Genetics 38:00 - Detoxification Basics: Sweat, Sleep, & Simplicity 43:00 - Myths About Juicing, Water Fasting, and Sugar ----- Episode resources: Get a FREE electrolyte variety mix with any purchase at https://www.DrinkLMNT.com/everforward Save 15% on organic coffee and lattes wiht code CHASE at https://www.StrongCoffeeCompany.com  Get an additional 15% off the 90-day starter kit of C15:0 essential fatty acids at https://www.Fatty15.com/everforward Get 20% off your entire first purhcase with code EVERFORWARD at https://www.LegionAthletics.com  Watch and subscribe on YouTube

This week Mike sits down with entrepreneur Chuck Cuda—a man who transformed a life-altering setback into a multimillion-dollar comeback. Chuck's journey begins with a single decision that landed him in prison after he refused to testify against friends in an illegal sports-betting case. But it was in a prison cell on Thanksgiving Day where he experienced the wake-up call that reshaped his entire life. From that moment, accountability became his superpower. Chuck rebuilt everything from the ground up. He went on to close over $200 million in commercial real estate deals, mastering the fundamentals of discipline, prospecting, and relationship-driven success. His ambition then carried him into the fast-evolving cannabis industry, where he expanded an operation from 5 to 22 licenses across three states—turning major financial challenges into profitability. Driven by purpose, Chuck also shares his passion for philanthropy, inspired by his father's battle with non-Hodgkin's lymphoma. Through the OPES Charitable Foundation, he has helped raise more than $3 million for cancer research. His daily affirmations, leadership philosophy, and belief in limitless potential offer a blueprint for anyone looking to rebuild their life or elevate their mindset.   IN THIS EPISODE:

A Espanya, la incid

Broadcast from KSQD, Santa Cruz on 12-11-2025: Dr. Dawn presents colleague Dr. Paul Godin's essay on why US healthcare fails as a market system . She explains that healthcare violates every assumption of functional markets: patients can't compare options during emergencies, information asymmetry prevents informed decisions, demand is inelastic when one has an urgent medical issue, and trust is essential to medicine and in direct conflict with profit incentives. Since 1988's Knox-Keen Act allowed for-profit healthcare, private equity has acquired and stripped hospitals, while administrative costs consume enormous resources fighting over payments rather than providing care. She contrasts this with European models like Switzerland and Germany where everyone must participate, insurers must accept all patients, and profit on basic coverage is limited. She celebrates a vaccination success story: HPV vaccines have reduced cervical cancer by 50% over 30 years. The American Cancer Society now endorses self-collected vaginal samples for HPV screening, with an FDA-approved at-home kit from Teal Health allowing women to skip speculums and traditional Pap smears. Current guidelines recommend screening starting at age 25, with testing every five years after a negative result. Dr. Dawn issues a health alert about multiple hospitalizations in Santa Cruz County from foraged wild mushrooms identified incorrectly by phone apps. She describes cholinergic toxicity symptoms: sweating, excessive salivation, pinpoint pupils, and abdominal cramping—signs requiring immediate emergency care rather than waiting it out. She offers follow-up vaccine advice: "go in wet, then sweat." Hydrate before vaccination, then take a hot Epsom salt bath until sweat runs off your face. This helps eliminate adjuvants that cause post-vaccine fatigue and aches, which are often misinterpreted as catching illness from the vaccine itself. Dr. Dawn expresses alarm that Kennedy's reconstituted ACIP nearly voted to eliminate hepatitis B vaccination at birth. She notes infants exposed to infected mothers have 99% infection rates, with half becoming chronically infected and half of those developing terminal cirrhosis or cancer. Testing pregnant women misses infections acquired during pregnancy, and 12-16% of delivering women have no test records. Major insurers have committed to covering birth vaccination through 2026 despite the panel's actions. She offers holiday microbiome advice from researcher Karen Corbin: increase fiber intake through steel-cut oats, whole grain breads like Dave's Killer Bread, beans, apples, and alternative pastas made from lentils or garbanzo beans. Cooking potatoes ahead and reheating creates resistant starch that feeds beneficial gut bacteria, reduces inflammation, and even stimulates natural GLP-1 production. Dr. Dawn reviews research proving health insurance saves lives. When the ACA's Medicaid expansion became optional by state, researchers could compare outcomes, finding 8% lower mortality and 19,000 fewer deaths in expansion states over four years. An accidental IRS experiment—sending insurance enrollment letters to only 85% of penalty payers—showed significantly lower mortality among those who subsequently got insured. Studies of gunshot and auto accident victims found uninsured patients died more often despite receiving identical emergency treatment. She concludes with surprising cancer symptoms: chest pain specifically triggered by alcohol consumption may indicate Hodgkin's lymphoma, as vasodilation activates inflammatory chemicals in affected lymph nodes. Fractures from minimal trauma in people without osteoporosis warrant investigation, as 5% of cancers involve bone. Elevated calcium levels double cancer diagnosis risk in the following year and should prompt follow-up testing.

Dr Jeremy S Abramson from Massachusetts General Hospital in Boston and Dr Loretta J Nastoupil from CommonSpirit Mercy Hospital in Durango, Colorado, discuss the clinical applications of chimeric antigen receptor T-cell therapy for patients with non-Hodgkin lymphoma. CME information and select publications here.

Dr. Alison Loren and Dr. Ann Partridge share the latest guideline from ASCO on the management of cancer during pregnancy. They highlight the importance of this multidisciplinary, evidence-based guideline and overarching principles for the management of cancer during pregnancy. Drs. Loren and Partridge discuss key recommendations from each section of the guideline, including diagnostic evaluation, oncologic management, obstetrical management, and psychological and social support. They also touch on the importance of this guideline and accompanying tools for clinicians and how this serves as a framework for pregnant patients with cancer. The conversation wraps up with a discussion on the unanswered questions and how future evidence will inform guideline updates.  Read the full guideline, "Management of Cancer During Pregnancy: ASCO Guideline" at www.asco.org/survivorship-guidelines TRANSCRIPT This guideline, clinical tools, and resources are available at www.asco.org/survivorship-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO-25-02115   Brittany Harvey: Hello and welcome to the ASCO Guidelines Podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one, at asco.org/podcasts. My name is Brittany Harvey, and today I am interviewing Dr. Alison Loren from the Perelman School of Medicine of the University of Pennsylvania and Dr. Ann Partridge from Dana-Farber Cancer Institute, co-chairs on "Management of Cancer During Pregnancy: ASCO Guideline." Thank you for being here today, Dr. Loren and Dr. Partridge. Dr. Alison Loren: Thanks for having us. Dr. Ann Partridge: It's a pleasure. Brittany Harvey: And then just before we discuss this guideline, I would like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO conflict of interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Partridge and Dr. Loren who have joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes. So then to dive into the meat of this guideline, to start us off, Dr. Loren, could you provide an overview of the scope and purpose of this new guideline on the optimal management of cancer during pregnancy? Dr. Alison Loren: Sure, thanks, Brittany. So this was really born out of I think a lot of passion and concern for this really vulnerable patient population. We have observed, and I am sure it is not any surprise to your audience, that the incidence of cancer in young people is increasing. And simultaneously, people are choosing to become pregnant at older ages, and so we are seeing more and more people with a cancer diagnosis during their pregnancy. And for probably obvious reasons, there is really no way to do randomized clinical trials in this population. And so really trying to assemble and articulate the best evidence for safely managing the diagnosis of cancer, the management of cancer once it is confirmed, being thoughtful about obviously the health of the mom, but also attending to potential risks to the developing fetus, and really just trying to be really comprehensive and balanced about all the choices for these patients when they are facing some really challenging decisions in a very emotionally fraught environment. And I think it is really emotionally fraught for the providers, too. You know, this is obviously an extremely intense, very emotional set of decisions, and so trying to provide a rudder essentially to sort of help people frame the questions and trying to make as evidence-based a set of recommendations as possible. Dr. Ann Partridge: And I would just add that "evidence-based" is a strong word here because typically our, as you just heard, our gold standard evidence is a randomized trial, but you can't do that in this setting, in general. And so, what we were able to do with the support of the phenomenal ASCO staff was to pull together kind of the world's literature on the safety and outcomes of treatments during pregnancy, as well as consensus opinion. And I think that is a really, really critical difference about this particular guideline compared to many of the other ones that ASCO does, where consensus and good judgment needed to kind of rule the day when evidence is not available. So, there is a lot of that in our recommendations. Dr. Alison Loren: That is such a good point. And I just, before we move forward, I just want to reflect that the composition of the panel was really broad and wide-ranging. We had maternal medicine specialists, we had legal and ethical experts, we had representatives who understand pharmaceutical industries' perspectives, and then medical oncologists representing the full spectrum of oncology diagnoses. And so it was a really diverse, in terms of expertise, panel, internationally composed to try to really get the best consensus that we could in the absence of gold standard evidence. Brittany Harvey: Absolutely. That multidisciplinary panel is really key to developing this guideline and, as you said, looking at the evidence and even though it does not reach the level of randomized trials, still critically evaluating it and reviewing that along with consensus to come up with optimal management for diagnosis and management of cancer during pregnancy. So then to follow that up, I would like to next review the key recommendations of the guideline across the main sections that the expert panel provided. First, I will throw this out to either of you, but what are the important general principles for the management of cancer during pregnancy? Dr. Ann Partridge: I think there were three major principles that we hammer home in the guidelines. One is that this is a team sport. It is multidisciplinary care that is necessary in order to optimize outcomes for the patient and potentially for the fetus. And that you really need to, from the beginning, bring in a coordinated team, including not just oncologists but obstetricians, maternal-fetal medicine specialists, neonatologists, ethics consultants, and obviously the patient and potentially her family. So that, I think, is one of the most important things. Second would be that obviously in a pregnancy, there are two potential patients and that the nuances of safety and risk from treatment is really wrapped up in where in the trimester of the pregnancy the patient is diagnosed, along with the kind of cancer that it is, both the urgency of treatment and the risk of the cancer, as well as the potential risks of any given intervention across the cancer continuum. It is a broad guideline in that regard. And then finally, and this is particularly timely given what is going on from a sociopolitical standpoint in the U.S., really thinking about informed consent and potential ethical as well as legal implications of some of the choices that patients might have when they are thinking about, in particular, continuing a pregnancy or potential termination. Dr. Alison Loren: And I will just add that I think that the key to all of this guidance is nuance and individualization and also making sure that patients and their care providers understand all the choices that are available to them and also the consequences of those choices. You know, nobody would choose to receive chemotherapy during pregnancy if that wasn't necessary. So there are risks to treatment, but there are also risks to not treatment. And making sure that in a suboptimal situation where you do not have a lot of evidence, trying to weigh, the best you can, the risks and benefits of all of the choices so that the patient can come to a decision about the treatment plan that is right for her. Brittany Harvey: Definitely. And those core concepts really set the stage for individualized care on what is necessary for appropriate multidisciplinary care, prioritizing both patient autonomy and informed decision making. With those core concepts and key principles in mind, I would like to move into the recommendations section of the guideline. So what are the key recommendations regarding diagnostic evaluation for pregnant patients with signs or symptoms of cancer? Dr. Alison Loren: I think the most important thing is to not delay, that there are very careful and well-thought-out recommendations for how to evaluate a potential cancer. And while there are certain things that we know can be harmful, particularly when certain dose thresholds are exceeded - for instance, abdominal imaging, there are certain radiographic thresholds that you don't want to exceed because of risk of harm to the embryo or fetus - there are still lots of options for diagnosing cancer during pregnancy. And again, thinking about the costs of not doing versus the cost of doing, right? It is really important to make the diagnosis of cancer if that is a consideration or a concern. And sometimes going directly to biopsies or getting definitive studies, even if there is a small risk to the developing fetus, is really essential because if the mom does not survive, of course, the fetus is also not going to survive. And so we need to be thinking first about the patient who is sitting in front of us, the woman who needs to know what is going on in her body so she can make good decisions about her health. So, I think that is a key principle in thinking about this. Brittany Harvey: Absolutely. So, following that diagnosis of a new or recurrent cancer, what is recommended for oncologic management of patients who are diagnosed with cancer during their pregnancy? Dr. Ann Partridge: So, I think the general principle is, again, cancer is such a wide number of diseases and even within diseases, a range of stages and risks and associated opportunities for risk reduction and/or treatment depending on the type of cancer. Just by example, in the work that I do, which is breast cancer, once someone has had a surgery in the early-stage setting, a lot of our treatment is about risk reduction. And that is very different than from what Alison does, which is treating people with leukemia, where it is kind of binary. If you do not treat, including with cytotoxic drugs, the patient and an unborn fetus will die, especially early in the pregnancy, obviously. So this is where cancers are very, very different. So I think taking the approach of what would you do if the patient were not pregnant? And what is the best treatment for that particular patient with that particular kind of cancer? And then applying the pregnancy and where the patient is in that pregnancy in terms of the trimester of the pregnancy, and what is safe and what is unsafe from the options that you would give her if she were not pregnant. And then if the patient is choosing to keep the pregnancy, which in my practice, many people come and they come to me because they want to hold onto their pregnancy and want to figure out how to make it work, coming up with a regimen that tries to give them kind of the best bang for the buck, the best possible breast cancer therapy with the least harm, when possible, to the fetus. It is a bit of a balance, right? And then we cannot always give people the best approach. And sometimes it comes down to making a decision to give up something that may improve their survival so as not to harm the fetus. And sometimes it goes the opposite direction where a patient will say, "Oh, that is going to improve my survival by 5% and you can't give it to me now? I am going to choose to terminate." Even though that is obviously a very, very difficult and challenging decision to make in this setting because they want to optimize their survival and ideally live on to potentially have another pregnancy in the future if that is something that is of interest to her. So these are really, really hard conversations as you can imagine, but that is kind of where we go. Dr. Alison Loren: Yeah, and I think this is where the need for more research and understanding is really key because sometimes questions come up. I guess I am thinking about like HER2-directed agents, which we know are contraindicated in pregnancy. But what about sequencing? Does it matter when you get it? Can you get it later? I think that is something that we don't really fully understand. And similarly, again, this is obviously like a breast cancer and blood cancer focused discussion because that is what we do, but thinking about managing blood cancers, certainly with acute lymphoblastic leukemia, there is actually a lot of options now that, you know, you could potentially use to temporize or sort of get somebody through a pregnancy relatively safely. I am focusing on the word "relatively" because we do not know what the long-term impact might be of potentially not optimal therapy in the long run. And then thinking about other things like timing of a bone marrow transplant relative to either delivery or termination. I mean, again, we really do not know what are the right sets of sort of timing considerations for those. So there are just a lot of unknowns. And I think trying to be sort of self-aware and humble and honest about those unknowns so that the patient can engage in the conversation in a way that is meaningful to her and make the decisions that make the most sense for her. I think the most important thing is to make sure that the patient feels supported and safe to make those decisions with as little regret as possible. Brittany Harvey: Yes, I think it is really important that you mentioned that there is a wide range of cancers here, and that means that care really needs to be individualized for each patient. I will also note, just in this section, that I found really informative while reading through the guideline the list of oncologic agents that may be offered in each individual trimester, whether it is contraindicated or it can be used with caution, or if there is relatively good safety data on it for prioritizing maternal treatment needs and balancing fetal safety at the same time. I think that is, that is really key. And I think readers will really like that section of the guideline to provide concrete information for them and their patients. Dr. Alison Loren: Thank you. We actually spent a lot of time on that table and just thinking about what it should look like, what the format ought to be, what the language ought to be. Because of course, at the end of the day, everything should be used with caution. So what does that actually mean? And we sort of tried to explicate that a little bit in like the footnotes. We really tried to leverage what we know from clinical experience, from package labels, from mechanism of action to try to be as clear and definitive as we could be without overstating or understating what we know. Dr. Ann Partridge: Yeah, and I think we are focusing on breast and leukemia because that is what we do. But the truth is much of the data comes from those two areas. Leukemia, not because it is so common, but because you do not really have choices to treat or not treat. And so for decades, they have been treating and saying, "We hope the progeny comes out okay." And for many agents it does. The babies are okay. And so, we have reasonable observational data. And then in breast cancer, there have been actually some prospective registry-type studies where people have been followed and treated when pregnant, and the progeny have been accounted for, and so we have some good experience in that way too. Again, not randomized trials, but at least data that suggests certain agents are safe. And increasingly, because of that, when we have had to treat patients, we have said, "Okay, let us do it on this registry so that we can at least learn from every patient that comes in in this situation." And so, I think we will have more and more data given the growing number of young adults with cancer and the delays in childbearing that are happening around the world, and particularly in Westernized countries. I wish we did not. We wish we did not see this problem, but of course, when we do, we have to make sure that we learn from it and try and get patients enrolled in these registries and any kinds of studies that are available. Dr. Alison Loren: Yeah, I will just underscore that to say that, you know, there is outcomes of pregnancy and then there is outcomes of pregnancy, right? So there is like, "Okay, the baby was born with 10 fingers and 10 toes, and they passed their Apgar, and they are doing all their developmental processes along the way." But what happens when they are 10 or 15 or 20? Are they maturing normally? Are they cognitively intact? And then, of course, it is really inseparable from what is the impact on a family of having the mom with cancer? And how does that impact childhood development and intellectual development? And so these are really, really important questions that are very difficult to answer given the longitudinal information that you need, but it is a really critical question that, you know, patients ask and we do not know the answer. Dr. Ann Partridge: Yeah, that actually leads me to one of the important principles in the guideline that is a little bit of a change from when I first started practicing, which is we have learned from the wider neonatology literature, as they have followed up on the children that were born prematurely, that it is actually better not to be premature and to keep the baby in utero as long as it is safe for the fetus and the mother as long as possible, ideally to term rather than delivering early and then giving the chemo after that or separating the chemo from before and after. We used to try and deliver early and then give agents, but now we typically will give agents that are safe to be given at the end of pregnancy, ideally close to term, a couple weeks out, to allow for the ability of count recovery, and you do not want to go into preterm labor with chemotherapy on board, but we used to go much earlier and have an argument with our maternal-fetal medicine doctors. "How early can you get them out?" And they would say, "How long can they stay in?" And increasingly, we have been able to try and compromise to go even later and allow the fetus to go to term because of the neonatal outcomes that in longer term there is a suggestion that the children are developing better in the long run if they are kept in utero for as long as possible. Dr. Alison Loren: Yeah, that is such a great point. I think that is probably the most important thing for people to take away. For anyone who sort of does this, I mean, no one does this regularly because it is a rare event, although I think it is increasing as I mentioned. But this idea that the third trimester is, most of us know, is primarily a time for growth. Most of the critical development has already occurred, and so administering most chemotherapy agents towards the end of the third trimester seems to be preferable long term than delivering them early. So that is a really big change. I think we used to try to sort of, "Oh, get them to 30 or 32 weeks and then deliver," but we really are trying to get them closer to term, 37 weeks or more, and then coordinating the treatment so that they are not nadiring, as Ann said, at the time of planned delivery. Brittany Harvey: Yes, and that is a really important point related to evidence-based care and why we have changed that practice. And so then that actually leads nicely into my next question. But as you both mentioned, this is an important collaboration between oncologists and obstetricians. So the next section of the guideline addresses obstetrical practice. And so beyond what is standard, what additional recommendations are there in obstetrical management for pregnant patients with cancer? Dr. Alison Loren: That is a great question. So I will say we were really struggling with like how much do we cover? Like this is an oncology guideline. We are not obstetricians. We certainly had great representation from our maternal-fetal medicine colleagues on the panel. But really trying to sort of give useful information without overstepping. And so I think that the main recommendations are to increase the frequency of fetal monitoring, make sure that there is close attention to blood counts in the patient. But I think there is really still a gap in terms of what we know about optimal management of a pregnant person who is receiving therapy and how to handle the pregnancy itself. The delivery should be a usual delivery. Our colleagues did not recommend a planned C-section. They recommended usual care in terms of planning for the delivery. Obviously, if a C-section is indicated, then it should be done, but it should not be planned this way because of the cancer diagnosis. And I guess the other thing that we mentioned in the guideline, although we were reluctant to push it too hard because of access to these specialized services, was evaluating the placenta after birth to ensure that there were no metastases in the placenta itself. Dr. Ann Partridge: Those are the main things, and judicious and prudent obstetrical care, as I think, you know, is trying to be practiced regularly with MFM. Typically these patients should be followed not by your average OB/GYN, but a maternal-fetal medicine specialist because these patients will have special concerns, especially if they are sick. So oftentimes, especially Alison's patients, are actually sick with leukemia. And so you are monitoring them a lot, whereas, you know, a breast cancer patient typically isn't sick, although they could get sick with their chemotherapy. And so we really want to hand-in-hand manage these patients with our MFM colleagues. Dr. Alison Loren: I think we also highlighted in the guideline just for the refresher purposes of the oncology community, generally which drugs that would be given in a normal oncology setting are safe to be given to a pregnant person. So we talked a little bit about what kinds of steroids are recommended, antiemetics, DVT prophylaxis, peripartum. These are things that we think about a lot in oncology, but just want to make sure that it sort of intersected appropriately with the care of a pregnant patient. Brittany Harvey: Definitely. That specialized care is really important for patients who are pregnant and have cancer. And then the last section of the recommendations addresses psychological and social support. As you both mentioned before, this is a highly emotional time and it can be difficult and challenging to make decisions. So what is recommended for the psychological and social support of pregnant patients with cancer? Dr. Ann Partridge: Well, as I said, it is really something that needs to be considered at the beginning, through the diagnostic period, all the way into survivorship. Ironically, even though it is a highly fraught, emotional situation, I find that my pregnant patients actually are extraordinarily resilient, and what they are really focused on often is the safety of the fetus, because again, many of the people that come to me, it is a highly wanted pregnancy. They are also focused on their own health, of course, and often you need to bring in social work, sometimes a psychologist, professionals who are there just to help manage their emotions while we are focusing on what do they need medically to be as healthy as possible, both for the again, the mother, the patient, and the fetus. It is very tricky, and I will say also bringing in sometimes people on the ethics team in the hospital to help, both from the "Are you recommending and giving something that is safe?" That is number one. And then number two, sometimes patients want to be treated with drugs that we do not have any safety data for in pregnancy. What are our obligations? I think most of us would say we would not treat someone if we do not have safety data and there is suspicion for concern. But where is that line in terms of the right thing to do by that patient? And so we are all beholden to our ethics colleagues to help us when we make decisions like that. You know, we all want to do right by the patient, but we have to uphold our oaths and legal obligations. I don't know if you have to add on that because it's very tricky. Dr. Alison Loren: It is, it is very hard. I mean, I think, you know, there is a lot of emotion, obviously any cancer diagnosis is extremely charged and people are already at sort of a heightened, you know, they are anticipating a new baby and planning around that. And so it is just an extremely disruptive is the smallest word I can think of to describe it. And I think that often there is a co-parent, there might be parents and in-laws and other siblings, and then there is care after delivery. And so it is just a very complex set of dynamics. And having both our ethics colleagues and our psychology and social work colleagues to sort of just pitch in and make sure that the patient is being supported. I think there are sometimes really difficult situations where maybe what the patient wants is different from what the father of the baby wants or what the rest of the family wants. And so that can be really challenging. And you never really know where those landmines are going to pop up. So it is good to have the team on board early and often. Dr. Ann Partridge: Yeah, I would add to that, the other thing here that I think is really important, like in all of medicine but especially in situations like this, this is where we have to be very careful as professionals not to impose our own ethical, moral, emotional, personal views on the patient and to try to reserve judgment as much as possible. We are their navigator with the most important evidence and information that we can provide in the current situation. And that is where this guideline is extraordinarily helpful, we hope, for clinicians in the years to come. And at the same time, we cannot necessarily impose our own views and what we would do on a patient or what we tell our daughters, sisters, friends, family members. It is very tricky in that way. And so sometimes not just support for the patient, but support for the care team may be warranted in some of these very fraught situations. Dr. Alison Loren: Yeah, that is such a great point. And I was sort of thinking that too. I mean, it is, of course, the patient is front and center, but these are really difficult situations to navigate. And I will just add also that a lot of times these patients end up in academic centers, which I think is that's where the expertise or even just the experience may be. But the downside of that is that, you know, the teams are constantly changing. You have a new resident, you have a new intern, you have a new attending, a new fellow. And so, you know, the patients may be subjected to lots of different ways of communicating and sometimes those perceived differences can be really challenging. So sort of team huddles to sort of make sure that everybody is reading from the same script and everyone is comfortable with how the information is being presented so that the patient does not feel more confused or more overwhelmed, that they are kind of getting a consistent message from the whole team that, "This is what we know, this is what we are recommending, here are your other choices, and here are the pros and cons of each of these options." Brittany Harvey: Yes, I think you have both touched on this and that bringing in appropriate experts to support both clinicians and patients and their decision-making and their mental health is really important for this section of the guideline. We have already discussed this a fair bit throughout our conversation, but in your view, what is the importance of this guideline and how will it impact both clinicians and pregnant patients diagnosed with cancer? Dr. Ann Partridge: I could start with that. We just talked about experts and having them all around, but the fact is most people do not have the experts all around when they are dealing with this. And I think this is, you know, an expert-based, evidence-based guideline where having this in one's back pocket, whether you are in rural Montana or at a major cancer center on either coast, you will be armed with the latest and the greatest in terms of what we know and what we do not know, and some very helpful algorithms for how to think through the process of dealing with a patient who is diagnosed during pregnancy, whichever type of cancer it is. We could not cover every single specific thing about every cancer, although it is a pretty long guideline and there is a lot of nuance in there. So you might find a lot about specific cancers. And I think that that will be very, very helpful for people who are faced with this situation in the clinics just to frame it out, think through. Sometimes there is no answer that is the perfect answer and then, you know, using this as kind of a scaffolding and phoning a friend who may have more experience to help guide you and guide the patient, most importantly. I think it will be very helpful in that regard. Dr. Alison Loren: Yeah, I think so too. And I have talked about that we are working on this guideline and the anecdotal feedback has been, "This is so helpful." Like there really has not been, I think, an all-in-one place, diagnostic considerations, radiographic considerations, staging, treatment, all the modalities, surgical, radiation, systemic chemotherapy. We tried to include, when we could, novel agents including targeted agents and monoclonal antibodies and bispecifics and cellular immunotherapies and non-cellular immunotherapies. We really, really tried to cover in 2025 what are people using to treat cancer and to try to give the most balanced view of what we think is is safe or reasonably safe and what we think is either unproven or known to be risky, really to have it be kind of a go-to, like all-in-one, as much information as we have about these really challenging cases. We tried to include, Ann mentioned, you know, specific cancers, and I think when there were specific things to shout out with specific cancers, we really tried to highlight that. Like, "Okay, lots of young patients with cancer have Hodgkin's lymphoma, so what is safe and what is not for that specific case?" Or, "What is safe or what is not when you are thinking about colon cancers?" And we have a shout-out in here about considering checking for DPD deficiencies in patients who are pregnant. And I know it is generally recommended nowadays, but certainly for people who are pregnant, you know, you really want to avoid excess toxicity. So I think just really trying to be attentive to specifics about certain cancers in young patients and what would be valuable for a practicing oncologist and obstetrician to know when you are faced with this situation. Dr. Ann Partridge: Yeah, and I think the other critical thing that is great about this guideline is it's a starting place. And I anticipate that we will be building on this guideline for many years to come. And remember that when first, I was not around then, but probably three or four decades ago, when chemotherapy was just coming out and patients were coming in pregnant, there was a feeling I am sure that was, "We cannot give this to this person because it is purposefully going to destroy cells. And when you destroy cells in a growing fetus, you are going to destroy or harm that fetus." And yet, people did not have great choices. It was get treated or die, especially with things like leukemia early on. And bold patients along with their oncologist said, "Bring it on." And that is how some of this literature has been born. And so moving forward, there will be either purposeful exposures or inadvertent exposures of some of our therapies where we will learn ultimately. And this is a place where we can update these guidelines. That is the beautiful thing about the ASCO guidelines is that they are constantly being thought about to be updated. And then when there is enough of a change in practice, they will be updated such that they will continue to inform how we do this in the years to come for patients who come in pregnant. Dr. Allison Loren: Yeah, and I will say I have been doing this long enough now, we were just talking about a different guideline, the fertility guideline earlier today, and over the 20 years that the fertility guidelines have been out, just the amount of research has really skyrocketed. And you can see as you look at each guideline how much we have learned, what we can say, "Yes, this is working," "No, this is not working." Like, it is stuff that we used to say, "Oh, we do not really know," and now we have answers.  I think I speak for both of us when I say that we are hopeful that this will serve as, as Ann said, as a starting off point and really inspire people to ask the questions and do the research so that we can give better guidance moving forward, really trying to think about, you know, mechanisms and leaning on our colleagues in pharma and in the government who sort of think about safety and efficacy, to sort of make sure that they are contemplating not just non-pregnant patients, but also pregnant patients or as they are thinking about marking the package inserts with safety guidelines around this. Brittany Harvey: Yes, this is a critically important first guideline on the management of cancer during pregnancy, and we will look forward to continuing to build on that. I think as you mentioned, this guideline is far-reaching and has a lot of recommendations in it. And so both the full text of the guideline and those at-a-glance algorithms, figures, and tables will be really useful for clinicians in their clinic. Finally, to wrap us up, we have just been discussing this a little bit, but specifically, what are the outstanding questions on the management of pregnant patients with cancer, and where is this further research needed? Dr. Alison Loren: There are lots and lots and lots of unanswered questions. And I think if you look at the table, most of what we say is, "We are pretty sure this is okay, we are not so sure about this." I am paraphrasing, but we really just are operating in a paucity of what we would normally consider gold-standard evidence. It is hard to imagine, of course, there would ever be, as we mentioned in the beginning, randomized trials. But I think that preclinical data, mechanistic data, trying to think about including as we go through animal data, making sure that we are looking at female animals and pregnant animals so that we can sort of fully understand what the impact may be. And then I think thinking about more localized therapies around sort of radiation, you know, we are now moving into really hyper-focused radiation treatments like protons. Is that better because there is less scatter? Like I think those are real considerations that we just do not know the answer to. What do you think? Dr. Ann Partridge: I think so many unanswered questions, and this is a call to action to continue to and increase the documentation of the experiences and outcomes for patients diagnosed during pregnancy. Dr. Alison Loren: Yeah, and I think the long-term outcomes too are really going to be critical. Brittany Harvey: Yes, we will look forward to learning about more evidence across the spectrum of care to inform future updates to this guideline. So I want to thank you both so much for your work to develop this guideline, to review the extensive amounts of literature that you did, and work to create this guideline. And thank you also for your time today, Dr. Loren and Dr. Partridge. Dr. Alison Loren: Thanks. It was fun. Dr. Ann Partridge: Yeah, thank you. Brittany Harvey: And finally, thank you to all of our listeners for tuning into the ASCO Guidelines Podcast. To read the full guideline, go to www.asco.org/survivorship-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app, which is available in the Apple App Store or the Google Play Store. If you have enjoyed what you have heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. 

L'Alberto Gadel i la Gal

Jiří Grossmann studoval stavební fakultu ČVUT. Díky hraní ve školním dixielandu se dostal do klubu Olympic. Stylem humoru si kápli do noty s Miloslavem Šimkem. Bavili diváky oblíbenými povídkami, které psali v kavárně Slávia. Jiří Grossmann byl také textař, pro Evu Olmerovou napsal hit Čekej tiše, pro Naďu Urbánkovou píseň Závidím, ve které se vyznal ze smutku ve chvíli, kdy mu lékaři oznámili, že trpí rakovinou mízních uzlin. Zemřel 5. prosince 1971 na Hodgkinův lymfom.Všechny díly podcastu Příběhy z kalendáře můžete pohodlně poslouchat v mobilní aplikaci mujRozhlas pro Android a iOS nebo na webu mujRozhlas.cz.

Featuring an interview with Dr Matthew Lunning, including the following topics: Reflection on the advances made in chimeric antigen receptor (CAR) T-cell therapy (0:00) Overview of the CAR T-cell therapy administration process (4:40) Opportunities for referral for CAR T-cell therapy (10:05) Selection of a CAR T-cell therapy based on patient characteristics (16:09) Sequencing of CAR T-cell therapy for various non-Hodgkin lymphomas (23:23) Safety regulations and mitigation strategies for adverse events (30:36) Case: A woman in her early 80s with relapsed/refractory (R/R) diffuse large B-cell lymphoma receives lisocabtagene maraleucel (36:16) Case: A man in his early 60s with R/R mantle cell lymphoma receives brexucabtagene autoleucel (43:09) Case: A man in his early 60s with R/R multiple myeloma receives ciltacabtagene autoleucel (49:09) CME information and select publications

In this first half of a two-part conversation, I sit down with Jenny Leavitt — pastor's wife, author of GodPrints, and bereaved mom — to hear the story of her son, Jacob, and the unmistakable “GodPrints” woven throughout her family's journey.Jenny begins by describing her earlier battle with stage four non-Hodgkin's lymphoma while raising two very young boys, and how God used that season to prepare her heart in ways she wouldn't fully understand until years later. She then introduces us to Jacob — a friendly, artistic, big-hearted high school senior — and recounts the tragic accident caused by a drunk driver that took Jacob's life and left his older brother, Caleb, critically injured.Throughout the episode, Jenny speaks honestly about the physical, emotional, and spiritual shock of those early days, the challenge of grieving one child while caring for another, and the surprising places where God's fingerprints began to appear. She shares about a profound “GodPrint” uncovered just days after Jacob's death — a handwritten piece Jacob created months earlier that offered their family deep assurance of his salvation and his walk with the Lord.Jenny also offers compassionate, practical wisdom for newly bereaved parents: the importance of connection, the value of grace for yourself and others, and the reminder that you don't have to walk this path alone.Links Mentioned:GodPrints: Finding Evidence of God in the Shattered Pieces of Life by Jenny LeavittJenny's websiteResilient Hope resourcesBe sure to join us next week for Part Two, where Jenny reflects on how her grief has evolved over the last ten years, how she and her husband navigate grieving differently, and the GodPrints they continue to see in their story.I would love to hear your thoughts on the show. Click here to send me a message! (Though I read every message, I am unable to respond through this format.) ** IMPORTANT** - All views expressed by guests on this podcast are theirs alone, and may not represent the Statement of Faith and Statement of Beliefs of the While We're Waiting ministry. We'd love for you to connect with us here at While We're Waiting! Click HERE to visit our website and learn about our free While We're Waiting Weekends for bereaved parentsClick HERE to learn more about our network of While We're Waiting support groups all across the country. Click HERE to subscribe to our YouTube channelClick HERE to follow our public Facebook pageClick HERE to follow us on Instagram Click HERE to follow us on Twitter Click HERE to make a tax-deductible donation to the While We're Waiting ministryContact Jill by email at: jill@whilewerewaiting.org

Today's guest is Erin Cummings, co-founder and executive director of Hodgkin's International, a non-profit dedicated to supporting, educating, and advocating for long-term survivors of Hodgkin's Lymphoma Worldwide. She herself is an over 50 year survivor of Hodgkin's Lymphoma. Erin believes that survivorship is not the end of the cancer journey, but a lifelong chapter that deserves understanding, resources and hope.We talk all about Hodgkin's Lymphoma, treatments that are thankfully no longer in practice, what are called "late effects" of those treatments, the importance of survivorship care and community, pro-active health management, and so much more!!Resources:Erin's Website: https://www.hodgkinsinternational.com/Erin's Facebook:  https://www.facebook.com/hodgkinsurvivorsErin's Linkedin: https://www.linkedin.com/company/hodgkins-internationalErin's Instagram: https://www.instagram.com/hodgkinsinternational/Erin's Email: erincummings@hodgkinsinternational.orgFollow:Follow me: https://www.instagram.com/melissagrosboll/My website: https://melissagrosboll.comEmail me: drmelissagrosboll@gmail.com

On this episode of Kankakee Podcast, host Drew Raisor sits down once again with Jeff Cross to talk about Ordinary Dads, a local group of about 15 fathers who come together each holiday season to sing Christmas music and raise money for families in need.Jeff shares the humble beginnings of the group, why “ordinary” is the point, and how a handful of dads with varying levels of musical ability create something meaningful through just eight practices a year. Drew and Jeff discuss the group's upcoming 2025 performances, the family-friendly atmosphere, and the joy — and humor — that comes from watching everyday dads step onstage in ugly sweaters to sing their hearts out.This year, Ordinary Dads is supporting two local families:• The Ericksons, whose young son Bedford has a rare neurological condition and needs accessible playground accommodations• The Dalton family, as their daughter Megan finishes treatment for non-Hodgkin's leukemiaJeff also talks about group growth, the challenges of scheduling dads, the thought behind not overcommitting the group, and how the community's support has led to standing-room-only shows.If you've ever wondered what can happen when everyday people come together with simple intentions and big hearts, this episode is for youSend us a textSupport the show

In this episode, we review the high-yield topic of⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠Hodgkin vs. Non-Hodgkin Lymphoma⁠⁠⁠⁠⁠ from the Oncology section.Follow⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Medbullets⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠ on social media:Facebook: www.facebook.com/medbulletsInstagram: www.instagram.com/medbulletsofficialTwitter: www.twitter.com/medbullets

Sometimes we don’t get to choose when life asks us to begin again. One moment you’re following a dream, and the next you’re rebuilding from the pieces of what used to be. It’s a strange kind of starting over – the kind you never asked for but somehow learn to live inside. Ava Jones knows that space well. At seventeen, she survived a devastating car accident that took her father’s life and changed everything she knew about herself. Two years later, she was diagnosed with stage four cancer. Through it all, she’s learning what it means to keep moving, to ask for help, and to find gratitude even in the hardest chapters. This conversation isn’t about silver linings. It’s about choosing to live when the story doesn’t go the way you planned. Ava’s honesty reminds us that starting over doesn’t mean you’ve failed – it means you’re still here. What You’ll Hear The day Ava’s life changed forever Learning to walk, talk, and feel again after trauma Grieving her father while navigating recovery Letting go of the basketball dream that once defined her Facing cancer with honesty and faith in her support system Rediscovering joy in small, ordinary moments Listen to the full episode and more conversations like this at:

Support the show to get full episodes, full archive, and join the Discord community. The Transmitter is an online publication that aims to deliver useful information, insights and tools to build bridges across neuroscience and advance research. Visit thetransmitter.org to explore the latest neuroscience news and perspectives, written by journalists and scientists. Read more about our partnership. Sign up for Brain Inspired email alerts to be notified every time a new Brain Inspired episode is released. To explore more neuroscience news and perspectives, visit thetransmitter.org. Henk de Regt is a professor of Philosophy of Science and the director of the Institute for Science in Society at Radboud University. Henk wrote the book on Understanding. Literally, he wrote what has become a classic in philosophy of science, Understanding Scientific Understanding. Henks' account of understanding goes roughly like this, but you can learn more in his book and other writings. To claim you understand something in science requires that you can produce a theory-based explanation of whatever you claim to understand, and it depends on you having the right scientific skills to be able to work productively with that theory - for example, making qualitative predictions about it without performing calculations. So understanding is contextual and depends on the skills of the understander. There's more nuance to it, so like I said you should read the book, but this account of understanding distinguishes it from explanation itself, and distinguishes it from other accounts of understanding, which take understanding to be either a personal subjective sense - that feeling of something clicking in your mind - or simply the addition of more facts about something. In this conversation, we revisit Henk's work on understanding, and how it touches on many other topics, like realism, the use of metaphors, how public understanding differs from expert understanding, idealization and abstraction in science, and so on. And, because Henk's kind of understanding doesn't depend on subjective awareness or things being true, he and his cohorts have begun working on whether there could be a benchmark for degrees of understanding, to possibly asses whether AI demonstrates understanding, and to use as a common benchmark for humans and machines. Google Scholar page Social: @henkderegt.bsky.social;   Book: Understanding Scientific Understanding. Related papers Towards a benchmark for scientific understanding in humans and machines Metaphors as tools for understanding in science communication among experts and to the public Two scientific perspectives on nerve signal propagation: how incompatible approaches jointly promote progress in explanatory understanding 0:00 - Intro 10:13 - Philosophy of explanation vs understanding 14:32 - Different accounts of understanding 20:29 - Henk's account of understanding 26:47 - What counts as intelligible? 34:09 - Hodgkin and Huxley alternative 37:54 - Familiarity vs understanding 44:42 - Measuring understanding 1:02:53 - Machine understanding 1:16:39 - Non-factive understanding 1:23:34 - Abstraction vs understanding 1:31:07 - Public understanding of science 1:41:35 - Reflections on the book

Lucinda speaks with data protection expert Sarah Hodgkin-Bates about the critical overlap between HR and compliance, specifically regarding the handling of employee personal data.  They examine the importance of setting a company culture of transparency and cooperation by properly managing data protection, and discuss the legal frameworks governing data (GDPR/Data Protection Act 2018), how to manage access to different types of employee records (e.g., payroll vs. disciplinary), and the challenges organisations face with complex areas like Subject Access Requests (SARs) and the proper retention of sensitive data. KEY TAKEAWAYS Being transparent about how employee data is used, often via separate employee privacy notices, builds a positive, co-operative company culture and a better employee brand. A core principle of data protection is to minimise access. Access should only be given to individuals who strictly need it for their job or role (e.g., payroll staff, but not the whole accounts team). Subject Access Requests (SARs) are often raised during complaints to create stress. Organisations must have a clear procedure and recognise that a SAR must be fulfilled within one month, as failure to comply could lead to regulatory body involvement. Data protection classifies certain types of personal data (like protected characteristics under the Equality Act 2010 or biometric data from CCTV) as 'special category data,' requiring elevated security measures like encryption and limited access. BEST MOMENTS "If you get your data protection right, you are creating a spirit of transparency and cooperation." "A basic principle of data protection is to minimise access. So you would only give access to people that strictly need it for their job or role." "Subject Access Requests... are usually raised because someone has a complaint or a grievance and they're looking to gather evidence or to create stress and hassle." "If you are challenged by an employee, you must be able to give them an open and honest answer about how you're using your data and why you're using it." VALUABLE RESOURCES The HR Uprising Podcast | ⁠Apple⁠ | ⁠Spotify⁠ | ⁠Stitcher⁠   ⁠The HR Uprising LinkedIn Group⁠ ⁠How to Prioritise Self-Care (The HR Uprising)⁠ ⁠How To Be A Change Superhero - by Lucinda Carney⁠ HR Uprising Mastermind - ⁠https://hruprising.com/mastermind/⁠   ⁠www.changesuperhero.com⁠ ⁠www.hruprising.com⁠            Get your copy of How To Be A Change Superhero by emailing at ⁠info@actus.co.uk⁠ CONTACT SARAH LinkedIn - https://www.linkedin.com/in/sarah-hodgkin-bates-35a035177/ ABOUT THE HOST Lucinda Carney is a Business Psychologist with 15 years in Senior Corporate L&D roles and a further 10 as CEO of Actus Software where she worked closely with HR colleagues helping them to solve the same challenges across a huge range of industries. It was this breadth of experience that inspired Lucinda to set up the HR Uprising community to facilitate greater collaboration across HR professionals in different sectors, helping them to ‘rise up' together. “If you look up, you rise up” CONTACT METHOD Join the LinkedIn community - ⁠https://www.linkedin.com/groups/13714397/⁠ Email: ⁠Lucinda@advancechange.co.uk⁠ Linked In: ⁠https://www.linkedin.com/in/lucindacarney/⁠ Twitter: @lucindacarney Instagram: @hruprising Facebook: @hruprising This Podcast has been brought to you by Disruptive Media. ⁠https://disruptivemedia.co.uk/

Luke Carson bridges basketball courts and design studios, carrying forward a creative legacy while carving his own path. As the son of legendary designer David Carson, Luke spent his early years shooting hoops rather than studying typography—until a Hodgkin's lymphoma diagnosis at 18 forced him to confront life, death, and purpose. During chemotherapy on his 19th birthday, he improved his college test scores by 400 points to reach his dream film school at Chapman University.Now at 27, Luke represents his father's work, curating brand partnerships that honor authentic creative expression over commercial convenience. From Stüssy collections that sold out in two hours to intricate Rapha cycling collaborations featuring custom Factor bikes, Luke's curatorial eye reflects his New York upbringing—where street culture, film photography, and raw documentary storytelling shaped his aesthetic sensibilities.His approach to life mirrors his father's design philosophy: trust your intuition, embrace imperfection, and never stop moving. His mantra combines hope with action, curiosity with discipline, and creative passion with business savvy—proving that the Carson legacy isn't just about breaking design rules, but about living authentically and fearlessly.Key TakeawaysAdversity reveals your priorities: Luke's cancer diagnosis at 18 taught him that small daily wins matter more than distant goals when you're struggling to surviveTrust your creative intuition: Growing up around David Carson's work instilled the belief that gut instinct matters more than formal rules or external validationExperiences outweigh possessions: Luke consistently chooses travel, basketball games, and cultural immersion over material purchases—a philosophy born from understanding life's fragilityAuthentic partnerships beat forced collaborations: Successful brand work requires genuine connection and cultural fit, not just big names partnering with big names for visibilityDocument your journey relentlessly: From iPhone photos to film photography, Luke creates an endless archive that informs his creative direction and preserves meaningful momentsBalance heritage with originality: Working with his father taught Luke how to honor a creative legacy while bringing his own perspective and contemporary cultural awarenessHope requires action: The most important lesson from cancer—and from climate activism—is that hope alone isn't enough without consistent follow-throughStay levelheaded through extremes: Learning not to ride highs too high or lows too low creates sustainable momentum through both success and setbackCuriosity opens unexpected doors: Luke's diverse interests in film, basketball, furniture, and street culture create unique intersection points that fuel creative opportunitiesNew York confidence comes from community: Growing up surrounded by artists, designers, and passionate people in NYC Daring Creativity. Daring Forever. Podcast with Radim Malinic Show questions or suggestions to desk@daringcreativity.com Latest books by Radim MalinicMindful Creative: How to understand and deal with the highs and lows of creative life, career and business Paperback and Kindle > https://amzn.to/4biTwFcFree audiobook (with Audible trial) > https://geni.us/free-audiobookSigned books https://novemberuniverse.co.ukLux Coffee Co. https://luxcoffee.co.uk/ (Use: PODCAST for 15% off)November Universe https://novemberuniverse.co.uk (Use: PODCAST for 10% off)

Broadcast from KSQD, Santa Cruz on 11-13-2025: Dr. Dawn discusses a New England Journal of Medicine study examining radiation exposure from medical imaging in over 4 million children showing increased hematological cancer risk. Head and brain CTs deliver highest bone marrow doses, with under-1-year-olds receiving 20 milligrays compared to background radiation of 1 milligray yearly. The study found 3,000 cancers in 4 million children over roughly 10 years, with relative risk increasing 1.6-fold per CT scan. However, methodological flaws include combining US and Canadian cohorts with different data quality, potential reverse causation where imaging detected pre-existing cancers, and arbitrary 6-month latency assumptions are significant flaws in this study.. Despite small absolute risk increases given low baseline cancer rates, she encourages parents to question necessity of repeat scans and request alternatives like MRI when appropriate. She reports on cutting-edge CRISPR therapy using lipid nanoparticles to deliver molecular scissors targeting the ANGPTL3 gene controlling LDL cholesterol production. Recent setbacks in several other CRISPR trials raise issues for unexplained liver toxicity. Concerns include off-target gene editing effects and partially repaired DNA creating mutated proteins triggering autoimmune reactions. Dr. Dawn emphasizes restricting gene therapy to life-threatening genetic diseases with no alternatives until safety improves. Stanford scientists used AI model Evo trained on 9 trillion gene samples to design 300 new bacteriophages from scratch, with 16 phages successfully killing E. coli bacteria. AI tools now predict protein structures, design custom drugs, create antivenoms, invent antibiotics, and break down PFAS forever chemicals. The research represents evolution through computation and requires guardrails on AI's ability to manipulate biological structures. An emailer shares the Rosencare model where hotel chain owner Harris Rosen created self-insured health coverage featuring direct provider contracting, imaging facilities charging one-third to one-half traditional costs, transparent pharmacy benefit management, and zero or $5 primary care copays. Employees receive proactive screening for colonoscopies, mammograms, cholesterol, diabetes, and hypertension during clinic visits. Ninety percent of medicines including insulin cost nothing, with remaining drugs $0-25, and hospital admissions cost flat $750. The model saved $600 million while providing superior preventive care by eliminating insurance middlemen and focusing on early chronic disease detection when 75-85% of costs originate. Dr. Dawn explains abdominophrenic dyssynergia causing bloating unrelated to gas or food. The diaphragm descends and abdominal wall muscles relax, pushing organs forward after meals. CT scans showed lettuce-related bloating involved no intestinal gas changes but demonstrated this abnormal muscle reflex. Randomized trials showed biofeedback training with chest-lifting and abdominal wall contracting exercises before and after eating for four weeks improved symptoms 66%. She warns that constant bloating in postmenopausal women unrelated to eating requires ovarian cancer screening. She discusses how genes drive personality using dopamine receptor gene DRD4 polymorphisms as an example. The 7-repeat variant present in 48% of Americans creates receptors binding dopamine poorly, associating with ADHD, pathological gambling, alcoholism, drug dependence, and bulimia, plus personality traits of novelty-seeking, impulsiveness, and optimism. The 2-repeat DRD4 variant common in Asia correlates with lower anger and higher forgiveness. DRD2 variations enhance the memory of negative outcomes, creating pessimistic bias and avoidance behavior. She presents the KETO trial showing "lean mass hyper-responder phenotype" where very low-carbohydrate dieters averaging age 55 maintained LDL cholesterol of 272 for five years but showed identical coronary artery calcium scores and plaque burden as matched controls with LDL under 150. Despite extreme LDL elevation, the very low insulin levels from carbohydrate restriction prevent LDL oxidation, the inflammatory "loading" process enabling arterial damage. She concludes with unusual cancer symptom where recurrent pain in specific body locations after alcohol consumption, lasting 1-2 days, occurs in 5% of Hodgkin lymphoma patients and in other cancers when alcohol induced blood vessel dilation and inflammatory chemical release in cancer-containing lymph nodes causes pain after drinking.

Dr Jeremy S Abramson from Massachusetts General Hospital in Boston and Dr Manali Kamdar from the University of Colorado Cancer Center in Aurora discuss patient questions and experiences with CAR T-cell therapy for non-Hodgkin lymphoma. Educational information and select publications here.

Fear thrives on vague labels; clarity starts with biology. We open by replacing the word “cancer” with “chronically fermenting cells,” so the focus shifts from doom to mechanism: cells favoring fermentation rather than oxidative phosphorylation. That reframe lets us explain PET scans and SUVs in plain language, showing how to distinguish metabolic activity from leftover anatomy, and why a smaller, quiet lesion can mean success even if it's still visible.From there, we build a full map of health that goes beyond any single protocol. Oral health emerges as a major, overlooked driver of systemic inflammation, making a visit to a true biological dentist a foundational step. We unpack environmental stressors—EMFs, persistent chemicals, ultra-processed food, and chronic sympathetic overdrive—that blunt immunity and confuse test results. On nutrition, we cut through the noise of diet wars and food myths, grounding choices in form-and-function design: eat to nourish and energize while reducing toxic load. Metabolic approaches make sense not as a fad but as measurable physiology, especially when tracked against baseline and follow-up imaging.We also tackle practical questions listeners ask every week. Parasites aren't just folklore; eggs, larvae, and adults respond to different agents, and the real goal is restoring balance so the body stops hosting trouble. For severe back pain, we highlight prolotherapy and prolozone as underused options that can stabilize and heal without the losses of fusion surgery. We walk through cases—Hodgkin's with lingering hot spots, pediatric brain tumors with urgent decisions, skin lesions mislabeled into aggressive plans—and show how to sequence actions, reduce fear, and choose comprehensively rather than experiment piecemeal.If you value honest guidance that puts mechanisms over buzzwords and measSend us a text Join Dr. Lodi's Inner Circle membership and unlock exclusive access to webinars, healthy recipes, e-books, educational videos, live Zoom Q&A sessions with Dr. Lodi, plus fresh content every month. Elevate your healing journey today by visiting drlodi.com and use the coupon code podcast (all lowercase: P-O-D-C-A-S-T) for 30% off your first month on any membership option. Support the showThis episode features answers to health and cancer-related questions from Dr. Lodi's social media livestream on Jan. 19th, 2025Join Dr. Lodi's FREE Q&A livestreams every Sunday on Facebook, Instagram, and Tiktok (@drthomaslodi) and listen to the replays here.Submit your question for next Sunday's Q&A Livestream here:https://drlodi.com/live/Facebookhttps://www.facebook.com/DrThomasLodi/Instagramhttps://www.instagram.com/drthomaslodi/ Join Dr. Lodi's Inner Circle membership and unlock exclusive access to webinars, healthy recipes, e-books, educational videos, live Zoom Q&A sessions with Dr. Lodi, plus fresh content every month. Elevate your healing journey today by visiting drlodi.com and use the coupon code podcast (all lowercase: P-O-D-C-A-S-T) for 30% off your first month on any membership option. Learn to Thrive with ADHD Podcast Welcome to the Learn to Thrive with ADHD Podcast. This is the show for you if you're... Listen on: Apple Podcasts Spotify Join Dr. Lodi's informative FREE Livestreams...

Receberemos Padre Lucas Gonçalves, da Paróquia Jesus de Nazaré (DF) — um testemunho vivo de fé, esperança e superação.

Small businesses funded through the SBIR program have developed drugs generating $36 billion in annual sales; treating everything from Hodgkin's lymphoma to breast cancer. Now, nearly two months into the program's lapse, those cash-strapped innovators face mounting uncertainty as solicitations freeze and funding disappears. Jere Glover of the Small Business Technology Council joins us with an update. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Episode: 00292 Released on November 10, 2025 Description: In this episode of Analyst Talk with Jason Elder, Jennifer Corum shares her remarkable 19 year journey with the Louisville Metro Police Department, including eight years as a crime analyst and her rise to Director of the Real Time Crime Center. From the early days of manually creating compstat maps to leading a 24/7 civilian staffed RTCC, Jennifer discusses how the field has evolved, the lessons she learned building a team from scratch, and how data and critical thinking drive modern policing. Jennifer also opens up about leading through 2020's social unrest, balancing motherhood, and surviving non Hodgkin's lymphoma, a battle that reshaped her perspective on leadership, gratitude, and the unseen strength of caretakers. She highlights the vital role her husband played throughout her recovery, emphasizing how support systems at home and work make resilience possible. This conversation is as much about courage and community as it is about crime analysis, and a must listen for anyone who believes in the people behind the data.

On this episode of Bringin' It Backwards, host Adam Lisicky reconnects with Caroline Grace Vein (Blondestandard) for an honest, inspiring conversation about resilience, creativity, and the journey of an artist. Nearly three years after her breakthrough debut "Blue Eyes," Caroline opens up about navigating health challenges—including a diagnosis of Hodgkin's lymphoma just after graduating college—and how they shaped her music and perspective. She shares how those experiences led to a deeper, more authentic songwriting process, the evolution of her sound from bubblegum pop to alternative rock, and the impact of community and collaboration in her work. Caroline dives into the stories behind new singles like "California Dreams," "Freaking Out," "Ruin My Day," and her latest release, "Arms of Another," offering insight into the themes of vulnerability, strength, and connection that drive her artistry. Plus, Caroline reveals she's working on a new podcast to share her story even further, and gives advice to fellow aspiring musicians: stay true to yourself, focus on what you love, and let your art resonate authentically. Whether you're an indie musician, a fan of genuine artist stories, or looking for inspiration to overcome obstacles and pursue your passion, this episode is full of raw, empowering moments you won't want to miss. Listen to the full interview and be sure to subscribe to Bringin' It Backwards for more stories from legendary and rising artists!

Elissa Goodman, Holistic Nutritionist & Cleanse Expert, shares her transformative journey through cancer, her holistic healing approach, and insights on detoxing and emotional health. She discusses her personal experiences with plant medicine, the importance of emotional health, and her upcoming book on healthy aging.TakeawaysElissa Goodman overcame cancer with a holistic approach.Emotional health is crucial for overall wellness.Detoxing is a natural body process, not a trend.Plant medicine can aid emotional healing.Nutrition plays a key role in health recovery.Stress management is vital for health.Hydration and fiber are essential for detoxing.Elissa's journey inspired her career in nutrition.Her upcoming book focuses on healthy aging.Community and support are important for healing.Chapters00:21 Introduction to Elissa Goodman03:00 Cancer Diagnosis and Holistic Healing09:00 Detoxing and Nutrition15:00 Emotional Health and Plant Medicine21:00 Insights on Healthy AgingFind out more about Erin:Elissa Goodman shares her healing wisdom through her signature programs and bestselling book, Cancer Hacks: A Holistic Guide to Overcoming Your Fears and Healing Cancer. Drawing from her personal journey of healing from Hodgkin's lymphoma, Elissa has guided thousands through holistic approaches to detox, nourish, and reclaim their health—emotionally, mentally, and physically.Her book invites readers to rethink the cancer journey with a powerful blend of nutrition, emotional healing, and spiritual insight. Elissa also offers structured cleanses and programs designed to support the immune system, reduce inflammation, and restore balance in the body.You can explore her work, book a session, or access free wellness tools at elissagoodman.com.KeywordsElissa Goodman, cancer journey, holistic healing, detoxing, emotional health, plant medicine, healthy aging, nutrition, wellness

Toxic Exposure: The Monsanto Roundup Trials, and the Search for Justice," reveals the dark side of the world's most widely used herbicide. Jessica Aldridge interviewed Dr. Chadi Nabhan in 2023, who offered his expert insights on the link between glyphosate and cancer, the landmark legal battles against Monsanto, and the ongoing struggle for environmental justice. Tune in for a compelling narrative that exposes the failures of regulatory agencies and the courage of individuals standing up to agrochemical giants. For years, Monsanto declared that their product Roundup, the world's most widely used weed killer, was safe. But in 2015, scientific studies concluded that glyphosate, the active ingredient in Roundup, is probably carcinogenic. The Environmental Protection Agency (EPA) and Monsanto disagreed with the findings, as scientists worked to understand the link between glyphosate and cancer. Dr. Chadi Nabhan's book, Toxic Exposure [https://chadinabhan.com/mybooks/], tells the true story of his role as an expert physician witness who testified in multiple state and federal trials against Monsanto. His book recounts the heartbreaking stories of numerous patients who developed the cancer non-Hodgkin lymphoma, after regularly using Roundup on yards and school grounds. Monsanto is now owned by Bayer, one of the largest agrochemical companies in the world. These companies and the EPA downplayed the health dangers of Roundup and the active ingredient glyphosate even after Monsanto lost numerous court cases (owing billions in judgements) and settled out of court for more than $11 Billion for more than 100K patients. In this interview we discuss the history of Roundup, the dangers of glyphosate, the trial stories and verdicts, and what the everyday person can do to fight for justice against this agricultural behemoth. Dr. Chadi Nabhan is an expert in lymphoid malignancies and treating and diagnosing cancers. He is author of Toxic Exposure: The True Story behind the Monsanto Trials and the Search for Justice [http://www.chadinabhan.com]. He received his medical degree from Damascus University in Syria. After performing basic science research at Massachusetts General Hospital/Harvard Medical School, he completed his internal medicine residency as well as an MBA in Healthcare Management at Loyola University in Chicago. Dr. Nabhan maintains active medical licenses in five states, and has over 300 peer-reviewed articles and abstracts. He is also a sought-after speaker, moderator, facilitator, and the creator and host of his own podcast, "Healthcare Unfiltered" [https://www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA]. Jessica Aldridge, Co-Host and Producer of EcoJustice Radio, is an environmental educator, community organizer, and 15-year waste industry leader. She is a co-founder of SoCal 350, organizer for ReusableLA, and founded Adventures in Waste. She is a former professor of Recycling and Resource Management at Santa Monica College, and an award recipient of the international 2021 Women in Sustainability Leadership and the 2016 inaugural Waste360, 40 Under 40. More Info/Resources: Buy the book, Toxic Exposure: https://chadinabhan.com/mybooks/ Salon Article: https://www.salon.com/2023/02/25/glyphosate-roundup-chadi-nabhan-interview/ Related Show: Kelly Ryerson - Glyphosate Girl - https://wilderutopia.com/ecojustice-radio/glyphosate-an-herbicide-that-kills-more-than-weeds/ Podcast Website: http://ecojusticeradio.org/ Podcast Blog: https://www.wilderutopia.com/category/ecojustice-radio/ Support the Podcast: Patreon https://www.patreon.com/ecojusticeradio PayPal https://www.paypal.com/donate/?hosted_button_id=LBGXTRM292TFC&source=url Executive Producer: Jack Eidt Host and Producer: Jessica Aldridge Engineer and Original Music: Blake Quake Beats

Dr Carla Casulo from Wilmot Cancer Institute in Rochester, New York, and Dr Brad S Kahl from Siteman Cancer Center in St Louis, Missouri, review recent datasets and their significance for the management of various forms of non-Hodgkin lymphoma. CME information and select publications here.

Matt and Allie are back to discuss this month's clinical corner article! In this case presentation- you'll hear about a patient who experienced consistent gluteal pain even after seeing his PCP, PA and PT. With more and more time passing and worsening symptoms, and a palpable mass finding by the PT, the patient was urged to get an MRI. This uncovered that the mass was identified as advanced-stage non-Hodgkin's lymphoma. Luckily, after treatment and a couple months of PT, the patient resumed walking, golfing, etc with no pain and in complete remission! This article highlights the importance of hands-on PT, self advocacy, and early intervention.Read the article here: https://www.jospt.org/doi/10.2519/josptcases.2025.0126https://www.jospt.org/doi/10.2519/josptcases.2025.0126Did you know that you don't need a doctor's prescription to receive physical therapy? The laws of Direct Access allow you to receive physical therapy without a referral and still use your insurance benefits! Learn more on how Direct Access can help YOU! Our website: https://www.oxfordphysicaltherapy.com/

Chuck Scheper, Board Chair at Bexion Pharmaceuticals, shares how a stage IV non-Hodgkin lymphoma diagnosis at age 39 and a life-saving clinical trial led to his lifelong commitment to cancer research. He joins Tim Schroeder, CEO and Chairman of CTI, to discuss the founding of VaxCella, the evolution of cancer therapies, the importance of patient-centered research, and the role of collaboration in advancing drug development, highlighting resilience, innovation, and the impact of clinical trials. 

In this week's episode we'll learn more about a study comparing busulfan-melphalan with melphalan alone as the conditioning protocol for newly diagnosed, transplant-eligible multiple myeloma; then we will discuss data on how three-dimensional transcriptomics can reveal complex interactions between plasma cells and bone marrow microenvironments.Featured ArticlesHigh-dose busulfan-melphalan vs melphalan and reinforced VRD for newly diagnosed multiple myeloma: a phase 3 GEM trialProfiling the spatial architecture of multiple myeloma in human bone marrow trephine biopsy specimens with spatial transcriptomicsPreclinical advances in glofitamab combinations: a new frontier for non-Hodgkin lymphoma

Dr. Hope Rugo and Dr. Giuseppe Curigliano discuss recent developments in the field of bispecific antibodies for hematologic and solid tumors, including strategies to optimize the design and delivery of the immunotherapy. TRANSCRIPT Dr. Hope Rugo: Hello and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I am your host, Dr. Hope Rugo. I am the director of the Women's Cancers Program and division chief of breast medical oncology at the City of Hope Cancer Center. I am also the editor-in-chief of the Educational Book. Bispecific antibodies represent an innovative and advanced therapeutic platform in hematologic and solid tumors. And today, I am delighted to be joined by Dr. Giuseppe Curigliano to discuss the current landscape of bispecific antibodies and their potential to reshape the future of precision oncology. Dr. Curigliano was the last author of an ASCO Educational Book piece for 2025 titled, "Bispecific Antibodies in Hematologic and Solid Tumors: Current Landscape and Therapeutic Advances." Dr. Curigliano is a breast medical oncologist and the director of the Early Drug Development Division and chair of the Experimental Therapeutics Program at the European Institute of Oncology in Milan. He is also a full professor of medical oncology at the University of Milan. You can find our disclosures in the transcript of this episode. Dr. Curigliano, Giuseppe, welcome and thanks for being here. Dr. Giuseppe Curigliano: Thanks a lot for the invitation. Dr. Hope Rugo: Giuseppe, I would like to first ask you to provide some context for our listeners on how these novel therapeutics work. And then perhaps you could tell us about recent developments in the field of bispecific antibodies for oncology. We are at a time when antibody-drug conjugates (ADCs) are all the rage and, trying to improve on the targeting of specific antigens, proteins, receptors in the field of oncology is certainly a hot and emerging topic. Dr. Giuseppe Curigliano: So, thanks a lot. I believe really it was very challenging to try to summarize all the bispecific antibodies that are under development in multiple solid tumors. So, the first thing that I would like to highlight is the context and the mechanism of action of bispecific antibodies. Bispecific antibodies represent a groundbreaking advancement in cancer immunotherapy, because these engineered molecules have the unique ability to target and simultaneously bind to two distinct antigens. That is why we call them bispecific. So typically, one antigen is expressed on the tumor cell and the other one is expressed on the immune effectors, like T-cell or natural killer cells. So this dual targeting mechanism offers several key advantages over conventional monoclonal antibodies because you can target at the same time the tumor antigen, downregulating the pathway of proliferation, and you can activate the immune system. So the primary mechanism through which bispecific antibodies exert their therapeutic effects are: First, T-cell redirecting. I mean, many bispecific antibodies are designed to engage tumor-associated antigens like epidermal growth factor receptor, HER2, on the cancer cell and a costimulatory molecule on the surface of T-cell. A typical target antigen on T-cell is CD3. So what does it mean? That you activate the immune system, immune cells will reach the tumor bed, and you have a dual effect. One is downregulating cell proliferation, the other one is activation of the immune system. This is really important in hematological malignancies, where we have a lot of bispecifics already approved, like acute lymphoblastic leukemia or non-Hodgkin lymphoma.  The second, in fact, is the engagement of the tumor microenvironment. So, if you engage immune effector cells like NK cells or macrophages, usually the bispecific antibodies can exploit the immune system's ability to recognize and kill the immune cells, even if there is a lack of optimal antigen presentation.  And finally, the last mechanism of action, this may have a role in the future, maybe in the early cancer setting, is overcoming immune evasion. So bispecific antibodies can overcome some of the immune evasion mechanisms that we see in cancer. For example, bispecific antibodies can target immune checkpoint receptors, like PD-L1 and CTLA-4. Actually, there is a bispecific under development in breast cancer that has a dual targeting on vascular endothelial growth factor receptor and on PD-L1. So you have a dual effect at the same time. So, what is really important, as a comment, is we need to focus first on the optimal format of the bispecific, the optimal half-life, the stability, because of course even if they are very efficient in inducing a response, they may give also a lot of toxicities. So in clinical trials already, we have several bispecifics approved. In solid tumors, very few, specifically amivantamab for non-small cell lung cancer, but we have a pipeline of almost 40 to 50 bispecifics under development in multiple solid tumors, and some of them are in the context of prospective randomized trials. Dr. Hope Rugo: So this is really a fascinating area and it's really exciting to see the expansion of the different targets for bispecific antibodies. One area that has intrigued me also is that some of the bispecifics actually will target different parts of the same receptor or the same protein, but presumably those will be used as a different strategy. It's interesting because we have seen that, for example, in targeting HER2. Dr. Giuseppe Curigliano: Oh, yes, of course. You may consider some bispecifics like margetuximab, I suppose, in which you can target specifically two different epitopes of the same antigen. This is really an example of how a bispecific can potentially be more active and downregulating, let us say, a pathway, by targeting two different domains of a specific target antigen. This is an important point.  Of course, not all the bispecifics work this way, because some of the target antigen may dimerize, and so you have a family of target antigen; an example is epidermal growth factor receptor, in which you have HER1, HER2, HER3, and HER4. So some of them can inhibit the dimerization between one target antigen and the other one, in order to exert a more antiproliferative effect. But to be honest, the new generation of them are more targeting two different antigens, one on the tumor and one on the microenvironment, because according to the clinical data, this is a more efficient way to reduce proliferation and to activate the immune system. Dr. Hope Rugo: Really interesting, and I think it brings us to the next topic, which is really where bispecific antibodies have already shown success, and that is in hematologic malignancies where we have seen very interesting efficacy and these are being used in the clinic already. But the expansion of bispecific antibodies into solid tumors faces some key challenges. It's interesting because the challenges come in different shapes and forms. Tell us about some of those challenges and strategies to optimize bispecific antibody design, delivery, patient selection, and how we are going to use these agents in the right kind of clinical trials. Dr. Giuseppe Curigliano: This is really an excellent question because despite bispecific antibodies having shown a remarkable efficacy in hematological malignancies, their application in solid tumors may have some challenges. The first one is tumor heterogeneity. In hematological malignancy, you have a clear oncogene addiction. Let us say that 90% of the cells may express the same antigen. In solid tumors, it is not the same. Tumor heterogeneity is a typical characteristic of solid tumors, and you have high heterogeneity at the genetic, molecular, and phenotypic levels. So tumor cells can differ significantly from one another, even if within the same tumor. And this heterogeneity sometimes makes it difficult to identify a single target antigen that is universally expressed in an hematological malignancy. So furthermore, sometimes the antigen expressed on a tumor cell can be also present on the normal tissue. And so you may have a cross-targeting. So let's say, if you have a bispecific against epidermal growth factor receptor, this will target the tumor but will target also the skin with a lot of toxicity. The second challenge is the tumor microenvironment. The solid tumor microenvironment is really complex and often immunosuppressive. It is characterized by the presence of immunosuppressor cells like the T regulators, myeloid derived suppressor cells, and of course the extracellular matrix. All these factors hinder immune cell infiltration and also may reduce dramatically the effectiveness of bispecific antibodies. And as you know, there is also an hypoxic condition in the tumor. The other challenge is related to the poor tumor penetration. As you know also with antibody-drug conjugate, only 1 to 3% of the drug will arrive in the tumor bed. Unlike hematological malignancies where tumor cells are dispersed in the blood and easily accessible, the solid tumors have a lot of barriers, and so it means that tumor penetration can be very low. Finally, the vascularity also of the tumor can be different across solid tumors. That is why some bispecifics have a vascular endothelial growth factor receptor or vascular endothelial growth factor as a target. Of course, what do we have to do to overcome these challenges? First, we have to select the optimal antigen. So knowing very well the biology of cancer and the tumor-associated antigens can really select a subgroup of epitopes that are specifically overexpressed in cancer cells. And so we need to design bispecifics according to the tumor type. Second, optimize the antibody format. So there are numerous bispecific antibody formats. We can consider the dual variable domain immunoglobulin, we specified this in our paper. The single chain variable fragments, so FC variable fragments, and the diabodies that can enhance both binding affinity and stability. And finally, the last point, combination therapies. Because bispecific antibodies targeting immune checkpoint, we have many targeting PD-1 or PD-L1 or CTLA-4, combined eventually with other immune checkpoint inhibitors. And so you may have more immunostimulating effect. Dr. Hope Rugo: This is a fascinating field and it is certainly going to go far in the treatment of solid tumors. You know, I think there is some competition with what we have now for antibody-drug conjugates. Do you see that bispecifics will eventually become bispecific ADCs? Are we going to combine these bispecific antibodies with ADCs, with chemotherapy? What is the best combination strategy do you think looking forward? Dr. Giuseppe Curigliano: So, yes, we have a bispecific ADC. We have actually some bispecifics that are conjugated with a payload of chemotherapy. Some others are conjugated with immunoactivation agents like IL-2. One of the most effective strategies for enhancing bispecific activity is the combination therapy. So which type of combination can we do? First, bispecific antibodies plus checkpoint inhibitors. If you combine a bispecific with an immune checkpoint, like anti-PD-1, anti-PD-L1, or anti-CTLA-4, you have more activity because you have activation of T-cells, reduction of immunosuppressive effect, and of course, the capability of this bispecific to potentiate the activity of the immune checkpoint inhibitor. So, in my opinion, in a non-small cell lung cancer with an expression of PD-L1 more than 50%, if you give pembrolizumab plus a bispecific targeting PD-L1, you can really improve both response rate and median progression-free survival.  Another combination is chemotherapy plus bispecific antibodies. Combining chemotherapy with bispecific can enhance the cytotoxic effect because chemotherapy induces immunogenic cell death, and then you boost with a bispecific in order to activate the immune system. Bispecific and CAR T-cells, until now, we believe that these are in competition, but this is not correct. Because CAR T-cells are designed to deliver an activation of the immune system with the same lymphocytes engineered of the patients, with a long-term effect. So I really do not believe that bispecifics are in competition with CAR T-cells because when you have a complete remission induced by CAR T-cell, the effect of this complete remission can last for years. The activity of a bispecific is a little bit different. So there are some studies actually combining CAR T-cells with bispecifics. For example, bispecific antibodies can direct CAR T-cells in the tumor microenvironment, improving their specificity and enhancing their therapeutic effect.  And finally, monoclonal antibody plus bispecific is another next generation activity. Because if you use bispecific antibodies in combination with existing monoclonal antibodies like anti-HER2, you can potentially increase the immune response and enhance tumor cell targeting. In hematological malignancies, this has been already demonstrated and this approach has been particularly effective. Dr. Hope Rugo: That's just so fascinating, the whole idea that we have these monoclonal antibodies and now we are going to add them to bispecifics that we could maybe attach on different toxins to try and improve this, or even give them with different approaches. I suppose giving an ADC with a bispecific would sort of be similar to that idea of giving a monoclonal antibody with the bispecific. So it is certainly intriguing. We also will need to understand the toxicity and cost overall and how we are going to use these, the duration of treatment, the assessment of biomarkers. There are just so many different aspects that still need to be explored.  And then with that idea, can you look ahead five or ten years from now, and tell us how you think bispecific antibodies will shape our next generation cancer therapies, how they will be incorporated into precision oncology, and the new combinations and approaches as we move forward that will help us tailor treatment for patients both with solid tumors and hematologic malignancies? Are we going to be giving these in early-stage disease in solid tumors? So far, the studies are primarily focusing on the metastatic setting, but obviously one of the goals when we have successful treatments is to move them into the early stage setting as quickly as possible. Dr. Giuseppe Curigliano: Let us try to look ahead five years rather than ten years, to be more realistic. So, personally I believe some bispecifics can potentially replace current approaches in specifically T-cell selected population. As we gather more data from ongoing clinical trials and we adopt a deeper understanding of the tumor immuno microenvironment, of course we may have potentially new achievement. A few days ago, we heard that bispecifics in triple negative breast cancer targeting VEGF and PD-L1 demonstrated an improvement in median progression-free survival.  So, how to improve and to impact on clinical practice both in the metastatic and in the early breast cancer setting or solid tumor setting? First, personalized antigen selection. So we need to have the ability to tailor bispecific antibody therapy to the unique tumor profile of individual patients. So the more we understand the biology of cancers, the more we will be able to better target. Second, bispecific antibodies should be combined. I can see in the future a potential trial in which you combine a bispecific anti-PD-L1 and VEGF with immune checkpoint inhibitor selected also to the level of expression of PD-L1, because integration of antibody bispecific with a range of immunotherapies, and this cannot be only immune checkpoint inhibitors, but can be CAR T-cells, oncolytic viruses, also targeted therapy, will likely be a dominant theme in the coming years. This combination will be based on the specific molecular and immuno feature of the cancer of the patient.  Then we need an enhanced delivery system. This is really important because you know now we have a next generation antibody. An example are the bicyclic. So you use FC fragment that are very short, with a low molecular weight, and this short fragment can be bispecific, so can target at the same time a target antigen and improving the immune system. And so the development of this novel delivery system, including also nanoparticles or engineered viral vectors, can enhance the penetration in the tumor bed and the bioavailability of bispecific antibodies. Importantly, we need to reduce toxicity. Until now, bispecifics are very toxic. So the more we are efficient in delivering in the tumor bed, the more we will reduce the risk of toxicity. So it will be mandatory to reduce off-target effects and to minimize toxicity.  And finally, the expansion in new indication. So I really believe you raised an excellent point. We need to design studies in the neoadjuvant setting in order to better understand with multiple biopsies which is the effect on the tumor microenvironment and the tumor itself, and to generate hypotheses for potential trials or in the neoadjuvant setting or in those patients with residual disease.  So, in my opinion, as we refine design, optimize patient selection, and explore new combination, in the future we will have more opportunity to integrate bispecifics in the standard of care. Dr. Hope Rugo: I think it is particularly helpful to hear what we are going to be looking for as we move forward to try and improve efficacy and reduce toxicity. And the ability to engineer these new antibodies and to more specifically target the right proteins and immune effectors is going to be critical, of course, moving forward, as well as individualizing therapy based on a specific tumor biology.  Hearing your insights has been great, and it really has opened up a whole area of insight into the field of bispecifics, together with your excellent contribution to the ASCO Educational Book. Thank you so much for sharing your thoughts and background, as well as what we might see in the future on this podcast today. Dr. Giuseppe Curigliano: Thank you very much for the invitation and for this excellent interview. Dr. Hope Rugo: And thanks to our listeners for joining us today. You will find a link to the Ed Book article we discussed today in the transcript of this episode. It is also, of course, on the ASCO website, as well as on PubMed. Please join us again next month on By the Book for more insightful views on the key issues and innovations that are shaping modern oncology. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement. Follow today's speakers:       Dr. Hope Rugo  @hope.rugo  Dr. Giuseppe Curigliano @curijoey Follow ASCO on social media:       @ASCO on X (formerly Twitter)       ASCO on Bluesky      ASCO on Facebook       ASCO on LinkedIn       Disclosures:      Dr. Hope Rugo:   Honoraria: Mylan/Viatris, Chugai Pharma  Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer  Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx  Dr. Giuseppe Curigliano: Leadership: European Society for Medical Oncology, European Society of Breast Cancer Specialists, ESMO Open, European Society for Medical Oncology Honoraria: Ellipses Pharma Consulting or Advisory Role: Roche/Genentech, Pfizer, Novartis, Lilly, Foundation Medicine, Bristol-Myers Squibb, Samsung, AstraZeneca, Daiichi-Sankyo, Boerigher, GSK, Seattle Genetics, Guardant Health, Veracyte, Celcuity, Hengrui Therapeutics, Menarini, Merck, Exact Sciences, Blueprint Medicines, Gilead Sciences Speakers' Bureau: Roche/Genentech, Novartis, Pfizer, Lilly, Foundation Medicine, Samsung, Daiichi Sankyo, Seagen, Menarini, Gilead Sciences, Exact Sciences Research Funding: Merck Travel, Accommodations, Expenses: Roche/Genentech, Pfizer, Daiichi Sankyo, AstraZeneca      

Listen to JCO Global Oncology's Art of Global Oncology article, "Whispers After the Cure: Reflections on Marriage and Malignancy in India” by Dr. Vangipuram Harshil Sai, who is a fourth semester medical student at All India Institute of Medical Sciences. The article is followed by an interview with Harshil Sai and host Dr. Mikkael Sekeres. Sai shares his personal reflection of a visit which transformed into an education in silence, stigma, and the unseen aftermath of survivorship for young women in India. TRANSCRIPT Narrator: Whispers After the Cure: Reflections on Marriage and Malignancy in India, Vangipuram, Harshil Sai   A Summer Afternoon and A Story That Stayed The summer break of my fourth semester of medical school offered a fleeting reprieve from the relentless immersion in textbooks and caffeine-fueled study sessions. I had envisioned a few weeks of rest—a pause from the algorithms of diagnosis and the grind of multiple-choice questions that had become my daily rhythm. But one humid afternoon altered that plan. I accompanied my mother—a senior medical oncologist—to her clinic in a Tier 2 city in Southern India. Over the years, I had seen her not just as a clinician but as a quiet force of empathy. She was one of those remarkable physicians who listened not just to symptoms but also to stories. Her practice was rooted in presence, and her calm resilience often made my academic anxieties seem trivial. I settled into a corner chair in the waiting area, where the air was tinged with antiseptic and that uncomfortable waiting room stillness—an alert hush between uncertainty and news. Patients waited in quiet constellations: a man turning the same page of a newspaper, a teenage girl watching her intravenous drip as if it held answers, and a couple clasping hands without meeting eyes. It was in this atmosphere of suspended quiet that Aarthi entered. She was a young woman whose presence was composed yet tentative. Her story would become a quiet inflection point in my understanding of medicine. She was 24 years old, embodying the aspirations tied to a recent engagement. A postgraduate in English literature and a practicing psychologist; she carried herself with a rare blend of intellect, poise, and cultural grace that, in the eyes of many families, made her a deeply desirable bride. Her sari was immaculately draped, her posture measured and calm, yet in the way her fingers intertwined and her eyes briefly lowered, there was a trace of vulnerability—a shadow of the turmoil she carried within. She came alone that day, stepping into the waiting room with a composed demeanor that only hinted at the weight she bore in silence. What began as a day to observe became the beginning of something far more enduring: a glimpse into how healing extends beyond treatment—and how survival, though silent, often speaks the loudest. The Diagnosis That Changed the Wedding The consultation was precipitated by a clinical presentation of persistent neck fullness, low-grade fevers, and drenching night sweats, which had prompted a fine-needle aspiration before her visit. The atmosphere in the room held an implicit gravity, suggesting a moment of significant change. My mother, with her characteristic composure, initiated a diagnostic process with a positron emission tomography-computed tomography and biopsy. As usual, her steady presence provided reassurance amid the uncertainty. A week later, the diagnosis of classic Hodgkin lymphoma, stage IIB, was confirmed. Rapid initiation of ABVD chemotherapy would provide an almost certain pathway to remission and an excellent prognosis. Yet, this clinical assurance did not extend to personal tranquility. Aarthi made a deliberate choice to share the diagnosis with her fiancé—a considerate and empathetic individual from a well-regarded family. Their wedding preparations were already underway with gold reserves secured and a vibrant WhatsApp group of 83 members chronicling the countdown to their big day. Shortly thereafter, a prolonged silence settled, eventually broken by a call from a family member—not the fiancé—indicating that the family had decided to terminate the engagement because of apprehensions about future stability. The union dissolved without public discord, leaving Aarthi to navigate the subsequent journey independently. As expected, 6 months of chemotherapy culminated in a clean scan. Her physical health was restored, but an emotional chasm remained, unrecorded by clinical metrics. Yet beneath that silence was a quiet resilience—a strength that carried her through each cycle of treatment with a resolve as steady as any celebrated elsewhere. The regrowth of her hair prompted a conscious decision to trim it shorter, seemingly an assertion of autonomy. Her discourse on the illness shifted to the third person, suggesting a psychological distancing. Her reactions to inquiries about the terminated engagement were guarded. She would yield only a restrained smile, which intimated a multifaceted emotional response. Her remission was certain, yet the world she stepped back into was layered with quiet hurdles—social, cultural, and unseen—barriers far more intricate than the disease itself. Survivorship Without A Map In the weeks that followed Aarthi's diagnosis, I began to notice a quiet but consistent pattern in the oncology clinic—one that extended beyond medical recovery into the unspoken social aftermath. Among young, unmarried women in India, survivorship often came with a parallel challenge of navigating shifts in how they were perceived, particularly as marriage prospects. In Indian families where marital status is closely tied to stability and future security, a woman with a cancer history, even after complete remission, somehow came to be quietly perceived as less suitable. Proposals that had once moved forward with confidence were paused or reconsidered after disclosure. In some cases, financial discussions came with requests for additional support framed as reassurance rather than rejection. These changes were seldom explicit. Yet, across time, they pointed to a deeper uncertainty—about how survivorship fits into the expectations of traditional life scripts. For women like Aarthi, the narrative shifted toward caution. There were subtle inquiries about reproductive potential or disease recurrence and private deliberations over disclosure during matrimonial discussions, even within educated circles. Meanwhile, my observation of the disparity in how survivorship was interpreted across genders in our country left a profound mark on me. A 31-year-old male investment banker who had recovered from testicular cancer was hailed in local media as a testament to fortitude. Male patients seemed to gain social capital from their cancer journeys. This suggested a cultural framework where female value was quietly reassessed, influencing their post-treatment identity through unstated societal perceptions. Digital Ghosting and the New Untouchability Within the digital landscape of curated profiles and algorithmic matchmaking, the reassessment of female survivorship acquired a new dimension. In one instance, a sustained exchange of text messages ended abruptly following the mention of cancer remission. The final message remained unanswered. This form of silent disengagement—subtle, unspoken, and devoid of confrontation—highlighted how virtual spaces can compound post-treatment vulnerability. Designed to foster connection, these platforms sometimes amplified social distance, introducing a modern form of invisibility. Similar to employment status or religion, a cancer history has become another addition to a checklist used to evaluate compatibility. When Medicine Ends, but Society Does Not Begin As a medical student, I felt a growing discomfort. Our curriculum equips us to manage treatment protocols and survival metrics but rarely prepares us for the intangible burdens that persist after cure. What captures the weight of a canceled engagement? What framework supports the quiet reconstruction of identity after remission? Aarthi's path, echoed by many others, revealed a dissonance that medicine alone could not resolve. The challenge was not solely the illness but the reality that she was now unqualified to return to her normal life. Medicine delivers clean scans and structured follow-up, but social reintegration is less defined. In that space between biological recovery and social acceptance, cancer survivors often stand at the edge of wholeness—clinically well but navigating a quieter uncertainty. A Different Ending Two years later, Aarthi's journey took a quiet turn. At a spiritual retreat in Bengaluru, she met an ear, nose, and throat resident who had lost his father to lung cancer. Their connection, shaped by shared experiences, evolved into a partnership grounded in empathy and mutual respect. They married the following year. Their invitation carried a brief but powerful line: “Cancer Survivor. Love Thriver. Come celebrate both.” Today, they comanage a private hospital in Hyderabad. Aarthi leads psycho-oncology services, whereas her partner performs surgeries. He often notes that her presence brings a calm to the clinic that no medication can replicate. Aarthi's journey continues to guide me as I progress through my medical training, reminding me that cure and closure often follow separate paths. Healing, I have come to understand, extends beyond the clinic. It often unfolds in quieter spaces where scans no longer guide us. The real curriculum in oncology lies not only in staging and response rates but in recognizing the many transitions—social, emotional, and cultural—that survivors must navigate long after treatment has concluded. Social stigma is often a second metastasis—undetectable by imaging but present in tone, hesitation, and traditions that quietly redefine survivorship. For many women of marriageable age, treatment marks not the end of struggle but the start of another kind of uncertainty. These survivors carry wounds that do not bleed. Yet, they persist, navigate, and redefine strength on their own terms. Aarthi's quiet resilience became a point of reckoning for me, not as a medical case, but as a guide. Her story is not one of illness alone, but of dignity quietly reclaimed. “Out of suffering have emerged the strongest souls; the most massive characters are seared with scars.”—Khalil Gibran.   Mikkael Sekeres: Welcome back to JCO's Cancer Stories: The Art of Oncology. This ASCO podcast features intimate narratives and perspectives from authors exploring their experiences in oncology. I'm your host, Mikkael Sekeres. I'm professor of medicine and chief of the Division of Hematology at the Sylvester Comprehensive Cancer Center, University of Miami. In oncology, we often focus on treatment and a way to find a cure. But what about the expectations and challenges a patient may face from their diagnosis, and even discrimination, especially in different cultures? Today, we're going to examine that space with Harshil Vangipuram, a medical student from India whose JCO Global Oncology article, "Whispers After the Cure: Reflections on Marriage and Malignancy in India," touches on this complexity after treatment. Harshil, thank you for contributing to JCO Global Oncology and for joining us to discuss your article. Harshil Vangipuram: Thank you for having me, Dr. Sekeres. I was raised by a family of oncologists, my mother being a senior medical oncologist and father a senior radiation oncologist. I had exposure to contrasting worlds, which were resource constrained and a cutting edge technology world. And I have unfulfilled curiosity, and I'm still learning, forming ideals. I also see patients as my teachers, so I think that might be helpful. Mikkael Sekeres: Thank you so much for a little bit of that background. So, tell us a little bit about your journey through life so far. Where were you born and where did you do your education? Harshil Vangipuram: I was born in a state called Gujarat in the western part of India. My father got transferred to the southern part of India, so I did my education there. That's it, yeah. Mikkael Sekeres: Okay. That's enough. You're not that old. You haven't had the sort of training and final job that a lot of us have gone through. So, what about your story as a writer? How did you first get interested in writing, and how long have you been writing reflective or narrative pieces? Harshil Vangipuram: I read some books from Indian authors and from foreign, too. And they actually inspired me how patient care was being seen around globally. I always used to carry a hand note. I used to write what I used to see in the clinical postings here at AIIMS. And actually, journaling started as a stress relief for me, and slowly, after hearing patients' stories, it almost became an obligation to write about them. Mikkael Sekeres: Obligation, you use that word, which is such an interesting one. How did writing become an obligation? What did you feel obliged to do when writing about some of the patients you were seeing for the first time? Harshil Vangipuram: Many of them were having struggles which were not seen by everybody. And I got astonished by their confidence and resilience in those situations. So, I thought that I should write about them so that everybody knows about it. And these social stigmas were never talked by anyone around them. So, I felt that if I could voice them, others might eventually know about them. So, that's pretty much the reason I wrote. Mikkael Sekeres: It's so interesting. The people we meet every single day, particularly in hematology oncology, bring such fascinating backgrounds to us, and they're backgrounds that may be unfamiliar to us. And I think that as doctors and writers, we do often feel obliged to tell their stories from the mountaintops, to let other people in on some of the aspects of life and medical care that they're going through and just how inspiring some of these patients can be. Harshil Vangipuram: Yeah, yeah, very true. Very true. Mikkael Sekeres: You mentioned that your mom is a medical oncologist. What kind of influence did she have on your decision to enter medicine and perhaps your own specialty one day? Harshil Vangipuram: Observing my mother practice influenced a lot, and she taught me that medicine is not only about treating a patient, but also listening to their problems. It may be more present in the room. The textbooks I read didn't capture live experiences. I always thought that stories will stay with people longer than actual survival curves. Writing filled that gap between what I studied and what I felt in the OPD. Mikkael Sekeres: It's a great phrase you just whipped out. Patients' stories will stay with us longer than survival curves. Can you tell us a little bit about where her clinic is located? You said in southern India. Can you describe the types of patients she sees? Harshil Vangipuram: It's a small town called Nellore in Andhra Pradesh state. The patients are, most of the time, from a rural population where decisions are mostly family-driven and there's a tight community surveillance and the stigmas are more overt, too. A few of them can be from urban population also, but they have subtler discriminations towards stigmas. Mikkael Sekeres: Can you explain a little further what you mean by decisions are often family-driven? Harshil Vangipuram: If we take marriage, it is often seen as an alliance between two families that are trying to increase their social value, their economic status, and respect in the society. In arranged marriages, for suppose, it's basically driven between these concepts. Mikkael Sekeres: I don't know if it's too personal to ask, but are your parents in an arranged marriage? Harshil Vangipuram: No, not at all. Mikkael Sekeres: So not all the marriages in the clinic are arranged marriages. Harshil Vangipuram: Yeah. Mikkael Sekeres: You know, when you said that decisions are family-driven, you mentioned that people are in arranged marriages. And I wanted to talk a little bit about the stigma you highlight in your essay. I'll talk about that in a second. I thought you were going to go down a route about medical decisions being family-driven, meaning people have to support their families, and getting medical care is costly and takes time away from work, and that sometimes influences decisions about treating cancer. What examples have you seen of that in shadowing your mom? Harshil Vangipuram: I have seen patients who have Hodgkin's lymphoma, breast cancer, and ovarian cancer, who were in the age of 25 to 35, who were getting married. Many of them actually got their engagements broken. And many of them got rejected at matrimonial apps. Many of them also had been told to increase the dowry that is given actually in the form of financial security. Mikkael Sekeres: In your essay, you describe a woman who is engaged and who has a new diagnosis of Hodgkin lymphoma. Can you talk a little bit about the process of getting engaged and marrying in southern India? Harshil Vangipuram: We have the arranged marriage, love marriage, and hybrid, which is kind of arranged and kind of in love. Mostly, these problems really occur in arranged marriages. In love marriages, we don't see that that often because both are understanding about themselves and their families. And both families actually accept them both. Mikkael Sekeres: What's the process of going through an arranged marriage? What happens? Harshil Vangipuram: It can be through parents, relatives, or any known ones or through peers. We just find a man or woman who has a similar caste, who has a good financial income, and people who are respected by the society. And obviously, both the families should have aligned interests for them to accept the marriage. Mikkael Sekeres: About how often are marriages arranged and how often are they love marriages in southern India where you live? Harshil Vangipuram: Almost 90% of the marriages are arranged here. Mikkael Sekeres: Wow. So, your parents were unusual then for having a love marriage. Harshil Vangipuram: Yeah. Mikkael Sekeres: In your essay, you write, and I'm going to quote you now, "Among young, unmarried women in India, survivorship often came with a parallel challenge of navigating shifts in how they were perceived, particularly as marriage prospects. In Indian families where marital status is closely tied to stability and future security, a woman with a cancer history, even after complete remission, somehow came to be quietly perceived as less suitable." Wow, that's a really moving statement. I'm curious, what stories have you seen where, in your words, women became less suitable as a marriage prospect? Harshil Vangipuram: For women, the most important thing in a marriage is, what do you call, a family honor, fertility, and economic status in the community. So, after a long dose of chemo, many people think that people become infertile. In India, basically, we have many misconceptions and stigmas. So, people obviously think that people who have got cancer can spread it to their children or are infertile and are often excluded out of the society as a marriage prospect. Mikkael Sekeres: Gosh, that must be devastating. Harshil Vangipuram: Yeah. Mikkael Sekeres: Does the same occur for men? So, is it also true that if a man has cancer, that he is perceived as less fertile, or it may be perceived that he can pass the cancer on to children? Harshil Vangipuram: Here, after a man beats cancer, they start to celebrate it, like they have achieved something, and it's not like that for a woman. Mikkael Sekeres: In your essay, you do write about a happy ending for one woman. Can you tell us about that? Harshil Vangipuram: Yeah, a cancer survivor obviously met her true love of life in Bengaluru, who was an ENT resident then. And his father died from lung cancer. So obviously, he knew what it felt to beat cancer. Mikkael Sekeres: Yeah, he'd been through it himself. And the irony, of course, is that most cancer treatments that we give do not lead to infertility, so it's a complete misperception. Harshil Vangipuram: Yeah. Mikkael Sekeres: Tell us about your future. What are the next steps for you in your training and what do you hope to specialize in and practice? Harshil Vangipuram: Actually, I'm working on another paper which involves financial toxicity after treatment and post treatment depression. I think it would be completed in another year. And after that, after my med school is completed, I think I'm going to pursue oncology or hematology as my branch of interest. Mikkael Sekeres: Wonderful. It's thrilling to hear that somebody who is as sensitive to his patients and both their medical needs and their needs outside of medicine will be entering our field. It'll be great to know that you'll be taking care of our future patients. Harshil Vangipuram: The pleasure is all mine, sir. Mikkael Sekeres: Harshil Vangipuram, I want to thank you for choosing JCO Cancer Stories: The Art of Oncology and for submitting your great piece, "Whispers After the Cure: Reflections on Marriage and Malignancy in India" to JCO Global Oncology. To our listeners, if you've enjoyed this episode, consider sharing it with a friend or colleague or leave us a review. Your feedback and support helps us continue to have these important conversations. If you're looking for more episodes, follow our show on Apple, Spotify, or wherever you listen, and explore more from ASCO at asco.org/podcasts. Until next time, this has been Mikkael Sekeres from the Sylvester Cancer Center, University of Miami. Have a good 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. Show notes:Like, share and subscribe so you never miss an episode and leave a rating or review. Guest Bio:Dr Vangipuram Harshil Sai is a fourth semester medical student at All India Institute of Medical Sciences. Additional Reading Impact of Gender of the Child on Health Care–Seeking Behavior of Caregivers of Childhood Patients With Cancer: A Mixed-Methods Study | JCO Global Oncology

Cortney Campbell was diagnosed with a rare form of Hodgkin's lymphoma in 2008 at age 26. After a PET scan and other testing she learned it was in her neck, opposite armpit, and small amounts in her rib cage. She had a lymph node biopsied and found that the cancer was slow growing but needed to be addressed because of how much it had spread.  Since the suggested conventional treatment threatened her fertility amongst other permanent side effects, she and her husband opted to pursue non-toxic strategies as a Plan A.  After 8 months of specific anti-cancer diet and lifestyle changes, Cortney was NED and has been ever since. She now has 6 children and leads a community of like-minded cancer thrivers Connect with Cortney@anticancermom on IG and Facebook. You can learn more about her story at AnticCancerMom.com. Resources: Healing Strong Bill Henderson Budwig Protocol Anne Wigmore ___________ To learn more about the 10 Radical Remission Healing Factors, connect with a certified RR coach or join a virtual or in-person workshop visit www.radicalremission.com.   To watch Episode 1 of the Radical Remission Docuseries for free, visit our YouTube channel here.  To purchase the full 10-episode Radical Remission Docuseries visit Hay House Online Learning. To learn more about Radical Remission health coaching with Liz or Karla, Click Here Follow us on Social Media: Facebook  Instagram YouTube ____________ Why does Dr. Linda Isaacs, M.D., a board-certified internist, offer an enzyme-based nutritional program for cancer patients? Decades of seeing people have much better outcomes than expected. The approach she uses is not an easy answer and it's not a guarantee. It involves a lot of capsules and big lifestyle changes. But for the right patient, it can be transforming. For more information about her work, please visit her website at www.drlindai.com/radical You can also listen to her interview on the Radical Remission podcast: https://www.podbean.com/ew/pb-7v5kr-1546ad9

Send us a textWhat happens when life's greatest challenge becomes your greatest stepping stone? In this powerful conversation, Darren Warren, President and CEO of Stor-Mor Portable Buildings, shares his remarkable journey from a 16-year-old cancer patient with a 40% survival rate to becoming an innovative leader in the shed industry.Darren's story begins in 1998 when his non-Hodgkin's lymphoma diagnosis led his father to start building portable sheds—allowing young Darren to participate in the family business while undergoing 120 chemotherapy treatments at St. Jude Children's Research Hospital. What started as a solution to a family crisis evolved into a passion and eventually, industry leadership with a people-first approach."It's our people, it's our people, it's our people," Darren emphasizes as the true secret to Stor-Mor's success. This isn't just a catchphrase but a deeply held belief that has shaped their business decisions—including the surprising choice to dismantle their in-house online sales department to funnel leads to their dealers instead, resulting in a $1 million sales increase in just one month.The conversation dives into the shed industry's evolution beyond "just building boxes," exploring vertical integration, product diversification into post-frame buildings and carports, and the crucial balance between online and brick-and-mortar sales. Darren warns against the "race to the bottom" pricing strategies while advocating for quality, service, and innovation as the path forward.Perhaps most compelling is Darren's unwavering commitment to purpose beyond profit. "Between God and St. Jude, I'm here," he states, explaining why charitable initiatives remain central to Stor-Mor's identity. This commitment extends to his vision for the industry—calling for greater collaboration among competitors to establish ethical practices and combat growing fraud concerns.Whether you're in the shed industry or simply appreciate stories of resilience and purpose-driven leadership, this episode offers valuable insights on transforming personal challenges into stepping stones for helping others. As Darren poignantly asks, "What's the glory in making all the money and seeing no one else's life be better around you?"For more information or to know more about the Shed Geek Podcast visit us at our website.Would you like to receive our weekly newsletter?  Sign up here.Follow us on Twitter, Instagram, Facebook, or YouTube at the handle @shedgeekpodcast.To be a guest on the Shed Geek Podcast visit our website and fill out the "Contact Us" form.To suggest show topics or ask questions you want answered email us at info@shedgeek.com.This episodes Sponsors:Studio Sponsor: Shed ProShed HubShed ChallengerNewFound SolutionsShed SuiteCAL

Staci Kirk, a six-time cancer survivor, shares her remarkable journey of resilience and advocacy in this episode of Integrative Cancer Solutions with Dr. Michael Karlfeldt. Diagnosed with follicular lymphoma at just 14, and later facing Hodgkin's lymphoma twice and breast cancer twice by the age of 31, Staci's story is one of perseverance through repeated adversity. She recounts the emotional and physical challenges of each diagnosis, emphasizing the importance of self-advocacy, clear communication with medical teams, and the value of having a strong support system throughout treatment and recovery. Throughout the conversation, Staci highlights the lessons she learned from navigating multiple cancer diagnoses. She stresses the need for patients to educate themselves about their conditions, ask questions, and bring someone to appointments for support and to help remember important information. Staci also discusses the evolution of chemotherapy and radiation treatments, sharing her experiences with side effects such as nausea, hair loss, neuropathy, and bone pain, and underscores the importance of self-care and managing expectations during treatment. A significant portion of the episode is dedicated to the power of community and support. Staci describes her efforts to connect with other patients and provide encouragement through her organization, Warrior Boxes, and her involvement with Black Girls Fighting Cancer. She advocates for mentorship programs, networking, and education, particularly for women and young girls of color who may face additional health disparities. Her authenticity and transparency in sharing her journey have inspired many, as reflected in her memoir, "Hold On, Sis." Staci also opens up about navigating personal trauma, including childhood molestation, sexual abuse, and dealing with addiction in her marriage. She explains how these experiences have shaped her advocacy work and highlights the importance of addressing mental health and trauma in cancer patients. Staci encourages the use of tools like meditation, deep breathing, and journaling to manage stress, find clarity, and maintain a sense of purpose and joy even in the face of significant challenges. In conclusion, Staci provides information about her organizations, including the Letter Foundation and Black Girls Fighting Cancer, and offers resources for support and information through her website, social media, and coaching services. She urges listeners to reach out for help, build community, and embrace authenticity on their own journeys. Staci's story is a testament to the power of resilience, the importance of advocacy, and the transformative impact of community support for those facing cancer and other life challenges.Staci Kirk recounts her journey as a six-time cancer survivor, emphasizing the importance of self-advocacy and communication with medical teams.She discusses the physical and emotional impacts of chemotherapy and radiation, including long-term effects like neuropathy and bone pain.Staci highlights the value of community, mentorship, and support networks, especially for women and young girls of color facing health disparities.She openly addresses personal trauma and mental health, advocating for tools like meditation and journaling to manage stress and find purpose.Through her organizations and memoir, Staci provides resources and encouragement, inspiring others to seek support and embrace authenticity on their healing journeys.Grab my book A Better Way to Treat Cancer: A Comprehensive Guide to Understanding, Preventing and Most Effectively Treating Our Biggest Health Threat - https://www.amazon.com/dp/B0CM1KKD9X?ref_=pe_3052080_397514860 Unleashing 10X Power: A Revolutionary Approach to Conquering Cancerhttps://store.thekarlfeldtcenter.com/products/unleashing-10x-power-Price: $24.99-100% Off Discount Code: CANCERPODCAST1Healing Within: Unraveling the Emotional Roots of Cancerhttps://store.thekarlfeldtcenter.com/products/healing-within-Price: $24.99-100% Off Discount Code: CANCERPODCAST2----Integrative Cancer Solutions was created to instill hope and empowerment. Other people have been where you are right now and have already done the research for you. Listen to their stories and journeys and apply what they learned to achieve similar outcomes as they have, cancer remission and an even more fullness of life than before the diagnosis. Guests will discuss what therapies, supplements, and practitioners they relied on to beat cancer. Once diagnosed, time is of the essence. This podcast will dramatically reduce your learning curve as you search for your own solution to cancer. To learn more about the cutting-edge integrative cancer therapies Dr. Karlfeldt offer at his center, please visit www.TheKarlfeldtCenter.com

Born with sickle cell anemia, Cary-Grove senior football player Elias Berthelsen was diagnosed with Hodgkin's lymphoma earlier this year. It never stopped him from playing the sport he loves.Become a supporter of this podcast: https://www.spreaker.com/podcast/friday-night-drive--3534096/support.

Born with sickle cell anemia, Cary-Grove senior football player Elias Berthelsen was diagnosed with Hodgkin's lymphoma earlier this year. It never stopped him from playing the sport he loves.Become a supporter of this podcast: https://www.spreaker.com/podcast/friday-night-drive--3534096/support.

Born with sickle cell anemia, Cary-Grove senior football player Elias Berthelsen was diagnosed with Hodgkin's lymphoma earlier this year. It never stopped him from playing the sport he loves.Become a supporter of this podcast: https://www.spreaker.com/podcast/friday-night-drive--3534096/support.

Born with sickle cell anemia, Cary-Grove senior football player Elias Berthelsen was diagnosed with Hodgkin's lymphoma earlier this year. It never stopped him from playing the sport he loves.Become a supporter of this podcast: https://www.spreaker.com/podcast/friday-night-drive--3534096/support.

Born with sickle cell anemia, Cary-Grove senior football player Elias Berthelsen was diagnosed with Hodgkin's lymphoma earlier this year. It never stopped him from playing the sport he loves.Become a supporter of this podcast: https://www.spreaker.com/podcast/friday-night-drive--3534096/support.

Born with sickle cell anemia, Cary-Grove senior football player Elias Berthelsen was diagnosed with Hodgkin's lymphoma earlier this year. It never stopped him from playing the sport he loves.Become a supporter of this podcast: https://www.spreaker.com/podcast/friday-night-drive--3534096/support.

Born with sickle cell anemia, Cary-Grove senior football player Elias Berthelsen was diagnosed with Hodgkin's lymphoma earlier this year. It never stopped him from playing the sport he loves.Become a supporter of this podcast: https://www.spreaker.com/podcast/friday-night-drive--3534096/support.

The future of workplace learning is changing. Instead of focusing on "what" to learn, the focus is now on "how" to learn. Jayney Howson, SVP of global learning and development at ServiceNow, says effective learning should be predictive, personalized, and available exactly when you need it — just like what happens when you watch Netflix. This is all possible thanks to AI. Howson talks about personalized learning powered by AI, equal opportunities for growth, psychologically safe environments for taking risks, and how AI helps create equal opportunities for all. She also opens up about her personal journey with stage two Hodgkin's lymphoma and how it has shaped her leadership style, emphasizing the importance of wellness and being comfortable with being uncomfortable. Tune in to learn how to create a high-trust workplace where employees can thrive, innovate, and grow. Don't miss the company culture event of the year! Enter the code "Better" and save 20% off registration for the Great Place To Work For All Summit: For All Summit 2026 | Great Place To Work® Subscribe to our LinkedIn newsletter: Culture Edge Want to join our Great Place To Work community? Learn more about Certification. For a transcript of this episode, visit Service Now's Jayney Howson on the Power of AI in Workplace Learning | Great Place To Work®

Dr. Morse Q&A - Spirituality - Hodgkin lymphoma - Candida - Paranoia and More #797 00:00:00 - Intro  00:03:17 - Candida - Diarrhea - Dehydration - Thinning Hair - Prostate Pain - Anxiety - Paranoia  00:41:23 - Angels - Golden Light - True Master - Spirituality  01:21:59 - Hodgkin lymphoma Stage 1 00:03:17 - Candida - Diarrhea - Dehydration - Thinning Hair - Prostate Pain - Anxiety - Paranoia I've been 100% raw on fruits for 6 months and counting, fully committed to healing.  00:41:23 - Angels - Golden Light - True Master - Spirituality What does it mean if you see the golden light? 01:21:59 - Hodgkin lymphoma Stage 1 My naturopath told me to go back to eating meat.

In this episode of Everyday Oral Surgery, we continue our Heme Series on all things blood-related by discussing lymphomas and multiple myeloma. Joining Dr. Stucki on the podcast again, to share a wealth of knowledge, are Drs. Andrew Jenzer and Maxwell Lloyd. They delve into a discussion on the basics of lymphomas, dissecting the two categories of Hodgkin's and non-Hodgkin lymphoma, and get into the diagnosis and presenting symptoms, stages, risk stratification, and treatments of each category. Next, they touch on what Tumor Lysis Syndrome (TLS) is and dive into a broad discussion on multiple myeloma. Dr. Lloyd breaks down the spectrum of this disease, including the signs and symptoms, testing and diagnostics, and explains that there is no cure for the disease. He also expands on the various treatments and management regimens available. To hear more, including thoughts on how to improve communication between collaborating teams, be sure not to miss out on today's episode. Thanks for tuning in!Key Points From This Episode:Introduction to today's topic as we continue our Heme Series.Dr. Lloyd talks us through lymphoma basics.Dr. Jenzer unpacks the presenting symptoms of the Hodgkin lymphoma category.Stages and risk stratification that constantly evolve: Ann Arbor Staging System. Treatment of lymphoma: thinking broadly, as regimens seem to be changing quickly.  We discuss the same aspects, but of the non-Hodgkin lymphoma category.Dr. Lloyd dives broadly into the chemotherapy regimen options for non-Hodgkin lymphoma.He explains a double-hit lymphoma and the associated treatment.We discuss Tumor Lysis Syndrome (TLS).Dr. Jenzer explains what multiple myelomas are. Dr. Lloyd further unpacks the spectrum of this disease (multiple myeloma).Signs and symptoms of multiple myeloma.An explanation for the lack of a cure for multiple myeloma.Testing and diagnostics of multiple myelomaDr. Lloyd broadly delves into the different types of medications and treatments used in managing multiple myeloma.He touches on some of the side effects of the medications.Big takeaway points from today's discussion.Dr. Lloyd's thoughts on how we can improve communication between collaborating teams.Final thoughts and recommendations to listeners.Links Mentioned in Today's Episode:Dr. Andrew Jenzer Email — andrew.jenzer@duke.edu Dr. Maxwell Lloyd — https://connects.catalyst.harvard.edu/Profiles/display/Person/192727 AAOMS — https://aaoms.org/education-meetings/meetings/ NCCN Guidelines — https://www.nccn.org/guidelines/category_1 Ann Arbor Staging System — https://www.ncbi.nlm.nih.gov/books/NBK65726.23/table/CDR0000062933__557/?report=objectonly St. Louis Course — https://stlomfsreview.com/ Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/ Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/ Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

From cancer survivor to pioneering fertility attorney, Rijon Charne has turned personal adversity into advocacy and entrepreneurship. In this episode of She Leads, she shares how battling Hodgkin's lymphoma led her to challenge insurance denials, lobby for fertility preservation rights, and ultimately build one of the nation's leading reproductive law firms.Rijon shares how her battle with Hodgkin's lymphoma shortly after law school shifted her path from litigation to advocating for fertility preservation. Through her firm, Sunray Fertility Law, Rijon guides clients through surrogacy, egg and sperm donation, embryo agreements, and cross-border fertility matters.Rijon's journey was shaped by critical turning points, from confronting potential infertility at 26 to challenging insurance denials that threatened her own fertility. These experiences inspired her to ensure others wouldn't face the same obstacles, turning personal setbacks into a purpose-driven venture that serves an important purpose. Her logical approach, strong support system, and determination were central to this transformation.She offers practical guidance on navigating fertility law, emphasizing clear contracts, understanding insurance benefits, and advocating for parental rights in diverse family structures. Rijon also shares lessons in entrepreneurship, including hiring the right team, seeking mentorship, and balancing resilience with growth while running a law firm.This conversation highlights broader themes of leadership, perseverance, and advocacy. Listeners will find inspiration in Rijon's dedication to educating others, empowering informed reproductive choices, and creating smoother pathways for families.Tune in to hear Rijon Charne's story, gain actionable insights on reproductive law, and discover how one attorney is making a meaningful impact for families worldwide.Chapters

Are you tired of feeling sick and run-down? Do you suspect your diet is harming your health? Is stress quietly destroying your immune system? In this episode of A Really Good Cry, Radhi sits down with integrative holistic nutritionist Elissa Goodman for a deep and heartfelt conversation about healing chronic illness through food, gut health, emotional wellness, and daily detox practices. After being diagnosed with Hodgkin’s lymphoma at 32, Elissa rejected full chemotherapy and followed a holistic path—one that helped her heal and has since transformed the lives of thousands of others. From overcoming autoimmunity to supporting her husband through cancer, Elissa’s story is one of deep intuition, resilience, and radical self-care. She breaks down the exact foods that help lower inflammation and tumor markers, the importance of fiber and hydration, and the overlooked link between stress and disease. This episode is filled with accessible tools and honest truths—especially for anyone feeling overwhelmed by conflicting wellness advice. In this episode, you’ll learn: What foods, oils, and additives may be damaging your immune system. Why your gut health is the foundation of your healing. The truth about sugar, fiber, and plant-based eating. How to reset your body with a 5-day food-based cleanse. Why your water quality could be affecting your hormones and energy. The most underrated practices for detoxing your mind and body. How trauma, stress, and self-love are directly linked to physical health. Simple daily rituals that support deep healing—without restriction or burnout. Whether you’re living with a chronic condition or just trying to feel more energized and alive, this episode reminds you that healing doesn’t have to be extreme—it just has to be aligned with you. Follow Elissa: https://www.instagram.com/elissagoodman https://share.google/2AZYOunoDkkfksOUG https://www.linkedin.com/in/elissa-goodman-04212b11 https://www.facebook.com/share/16xAY9XNHy/?mibextid=wwXIfr Follow Radhi: https://www.instagram.com/radhidevlukia/ https://www.youtube.com/channel/UCxWe9A4kMf9V_AHOXkGhCzQ https://www.facebook.com/radhidevlukia1/ https://www.tiktok.com/@radhidevlukiaSee omnystudio.com/listener for privacy information.

Alpha Dad Nation, this episode of the Ben Barker Fitness Podcast is powerful. I sit down in the garage gym with my friend Matt Ferrell—real estate agent, CrossFit coach, husband, and father. At just 29 years old, Matt was diagnosed with stage 4 non-Hodgkin's lymphoma only three weeks after his son was born.In this raw conversation, Matt shares:How his faith anchored him through nine months of chemoThe role of his wife, men's group, and community in the fightWhy men can't afford to live like “lone wolves”The importance of surrounding yourself with men who sharpen you in faith, family, and fitnessMatt's story is about resilience, faith in the fire, and fighting for your family. If you're a dad, this is one you don't want to miss.

What do you do when everything comes crashing down? When your dreams stall, your health fails, and you're left staring into the unknown? This week's episode isn't just another conversation—it's a raw, emotional, and deeply inspiring story of survival, grit, and unshakable faith.Jacob Conrad, shares his extraordinary journey from event producer and music lover in Quincy, IL, to battling an aggressive form of non-Hodgkin's lymphoma that nearly took his life. What began as a story of community-building and creativity through concerts and networking turned into a fight for survival—and a deeper look at what truly matters.In this first part of our two-part conversation, Jacob walks us through:His background in media and music, and how that shaped his mission to bring people together.The events he helped produce in Quincy that sparked connection in a post-COVID world.The shocking moment he was diagnosed with cancer—and the symptoms he ignored leading up to it.The mental, emotional, and spiritual battle he faced in the hospital room.How slowing down, finding inner peace, and holding onto faith became his true healing.