Podcasts about jama oncology

This is the daily Tech and Business Report. Today, KCBS Radio anchor Eric Thomas spoke with Bloomberg's Robert Langreth. The cost of cancer drugs has been skyrocketing, but now questions are being raised about just how beneficial they are. A recent analysis in JAMA Oncology found that a drop in cancer deaths between 1975 and 2020 was due mostly to improved screening and preventative health measure, and not new treatments.

Interview with Shruti Gupta, MD, MPH, author of Intravenous Magnesium and Cisplatin-Associated Acute Kidney Injury. Hosted by Vivek Subbiah, MD. Related Content: Intravenous Magnesium and Cisplatin-Associated Acute Kidney Injury

Tens of millions of Americans smoke cigarettes regularly and something that has become clear in the last couple of decades is the direct correlation between smoking and cancer diagnoses. But is that message actually resonating enough with the general public? Nearly half of patients diagnosed with cancer in 2023 had a history of smoking, and 15% were smokers at the time of their diagnosis. That's according to new Yale Cancer Center-led research published in in JAMA Oncology. We spoke with Yale Cancer Center's Dr. Dan Boffa, the study's senior investigator. Image Credit: Getty Images

In this eye-opening episode of the Better Than Before Breast Cancer Podcast, host Laura Lummer dives into the powerful connection between your body's natural rhythms and the timing of your meals. Have you ever noticed how aligned you feel when you live in sync with nature's cycles? Drawing from Ayurveda—an ancient system of medicine from India—and contemporary scientific research, Laura reveals how understanding your body's internal clock, or circadian rhythm, can significantly enhance your health, especially after breast cancer.   What You'll Discover in This Episode: A gentle introduction to Ayurveda and how this 5,000-year-old wisdom emphasizes living in harmony with Earth's natural cycles. Clear, practical explanations of circadian rhythm, metabolism, hormonal balance, and their critical roles in breast cancer recovery. How Ayurvedic principles align surprisingly well with modern Western nutritional science. The profound health benefits of aligning meal timing with daylight hours, including improved sleep, reduced inflammation, and optimized metabolism. Easy strategies to shift your eating patterns gently, starting with simple steps like adjusting dinner times.   Key Studies Referenced: JAMA Oncology Study:Catherine R. Marinac, Dorothy D. Sears, Lok-Hei Lam, Shirley W. Flatt, Loki Natarajan, Ruth E. Patterson; "Prolonged Nightly Fasting and Breast Cancer Prognosis." JAMA Oncology, 2016; Read the full study here.   Cell Metabolism Study: Emily N.C. Manoogian, Satchidananda Panda et al.; "Time-restricted eating improves cardiometabolic health in overweight individuals." Cell Metabolism, 2019; Explore the study here.   Listen in to explore: How simple shifts in meal timing can powerfully support your body's natural detoxification pathways and hormonal balance. The Ayurvedic recommendations for ideal meal times and how they beautifully complement modern scientific guidelines. Ways to incorporate a loving, compassionate mindset toward food, meal timing, and your body's natural rhythm.   This episode encourages you to foster a nurturing, compassionate relationship with your body by syncing your daily habits with the earth's rhythms, creating lasting health and harmony after breast cancer.   Connect with Laura: Visit The Breast Cancer Recovery Coach for personalized metabolic health coaching, mindset transformation, and guidance specifically tailored for breast cancer survivors. Enjoyed the episode?  Subscribe, leave a review, and share with friends who could benefit from this healing wisdom!  

Interview with Jennifer M. Yeh, PhD, and Lisa R. Diller, MD, authors of Accelerated Aging in Survivors of Childhood Cancer—Early Onset and Excess Risk of Chronic Conditions. Hosted by Vivek Subbiah, MD. Related Content: Accelerated Aging in Survivors of Childhood Cancer—Early Onset and Excess Risk of Chronic Conditions On Accelerated Aging—A Phenomenon in Survivors of Childhood Cancer

Interview with Anand P. Jillella, MD, author of Academic-Community Partnership and Deaths in Promyelocytic Leukemia: The Nonrandomized ECOG-ACRIN EA9131 Trial. Hosted by Vivek Subbiah, MD. Related Content: Academic Community Partnership in Acute Promyelocytic Leukemia and Early Mortality

Episode 183: Colorectal Cancer in Young AdultsFuture Dr. Avila and Dr. Arreaza present evidence-based information about the screening and diagnosis of colorectal cancer and explain the increasing incidence among young adult and the importance to screen early in high risk groups.  Written by Jessica Avila, MS4, American University of the Caribbean School of Medicine. Edits and comments by Hector Arreaza, MD.You are listening to Rio Bravo qWeek Podcast, your weekly dose of knowledge brought to you by the Rio Bravo Family Medicine Residency Program from Bakersfield, California, a UCLA-affiliated program sponsored by Clinica Sierra Vista, Let Us Be Your Healthcare Home. This podcast was created for educational purposes only. Visit your primary care provider for additional medical advice.IntroductionJessica: Although traditionally considered a disease only affecting older adults, colorectal cancer (CRC) has increasingly impacted younger adults (defined as those under 50) at an alarming rate. According to the American Cancer Society, CRC is now the leading cause of cancer-related death in men under 50 and the second leading cause in women under 50 (American Cancer Society, 2024). Arreaza: Why were you motivated to talk about CRC in younger patients?Jessica: Because despite advancements in early detection and treatment, younger patients are often diagnosed at later stages, resulting in poorer outcomes. We will discuss possible causes, risk factors, common symptoms, and why early screening and prevention are important. Arreaza: This will be a good reminder for everyone to screen for colorectal cancer because 1 out of every 5 cases of colorectal cancer occur in adults between the ages of 20 and 54. The Case of Chadwick BosemanJessica: Many people know Chadwick Boseman from his role as T'Challa in Black Panther. His story highlights the worrying trend of increasing CRC in young adults. He was diagnosed with stage III colorectal cancer at age 39. This diagnosis was not widely known until he passed away at 43. His case shows how silent and aggressive young-onset CRC can be. Like many young adults with CRC, his symptoms may have been missed or thought to be less serious issues. His death drew widespread attention to the rising burden of CRC among young adults and emphasized the critical need for increased awareness and early screening efforts.Arreaza: Black Panther became a hero not only in the movie, but also in real life, because he raised awareness of the problem in young AND in Black adults. EpidemiologyJessica: While rates of CRC in older populations have decreased since the 1990s, adults under 50 have seen an increase in CRC rates of nearly 50%. (Siegel et al., 2023). Currently, one in five new CRC diagnoses occurs in individuals younger than 55 (American Cancer Society, 2024).Arreaza: What did you learn about the incidence by ethnic groups? Are there any trends? Jessica: Yes, certain ethnic groups are shown to have higher rates of CRC. Black Americans, Native Americans, and Alaskan Natives have the highest incidence and mortality rates from CRC (American Cancer Society, 2024). Black Americans have a 20% higher incidence and a 40% higher mortality rate from CRC compared to White Americans, primarily due to disparities in access to screening, healthcare resources, and early diagnosis. Hispanic and Asian American populations are also experiencing increasing CRC rates, though to a lesser extent.Arreaza: It is important to highlight that Black Americans have the highest rate of both diagnoses and deaths of all groups in the United States. Who gets colorectal cancer?Risk FactorsJessica: Anyone can get colorectal cancer, but some are at higher risk. In most cases, environmental and lifestyle factors are to blame, but early-onset CRC are linked to hereditary conditions. Arreaza: There is so much to learn about colorectal cancer risk factors. Tell us more.Jessica: The following are key risk factors:Modifiable risk factors:Diet and processed foods: A diet high in processed meats, red meat, refined sugars, and low fiber is strongly associated with an increased risk of CRC. Fiber is essential for gut health, and its deficiency has been linked to increased colorectal cancer risk (Dekker et al., 2023).Obesity and sedentary lifestyle: Obesity and physical inactivity contribute to CRC risk by promoting chronic inflammation, insulin resistance, and metabolic disturbances that promote tumor growth (Stoffel & Murphy, 2023).Gut microbiome imbalance: Disruptions in gut microbiota, especially an overgrowth of Fusobacterium nucleatum, have been noted in CRC pathogenesis, potentially causing tumor development and progression (Brennan & Garrett, 2023).Arreaza: As a recap, processed foods, obesity, sedentarism, and gut microbiome. We also have to mention smoking and high alcohol consumption as major risks factors, but the strongest risk factor is a family history of the disease.Non-modifiable risk factors:Genetic predisposition: Although only 20% of early-onset CRC cases are linked to hereditary syndromes such as Lynch syndrome and familial adenomatous polyposis (FAP), individuals with a first-degree relative with CRC are at a significantly higher risk and should undergo earlier and more frequent screening (Stoffel & Murphy, 2023).Arreaza: Also, there is a difference in incidence per gender assigned at birth, which is also not modifiable. The rate in the US was 33% higher in men (41.5 per 100,000) than in women (31.2 per 100,000) during 2015-2019. So, if you are a man, your risk for CRC is slightly higher. Protective factors, according to the ACS, are physical activity (no specification about how much and how often) and dairy consumption (400g/day). Jessica, let's talk about how colon cancer presents in our younger patients.Clinical Presentation and Challenges in DiagnosisJessica: Young-onset CRC is often diagnosed at advanced stages due to delayed recognition of symptoms. Common symptoms include:Rectal bleeding (often mistaken for hemorrhoids)Young individuals may ignore it, believe they do not have time to address it, or lack insurance to cover a comprehensive evaluation.Unexplained weight lossFatigue or weaknessChanges in bowel habits (persistent diarrhea or constipation)This may also be rationalized by dietary habits.Abdominal pain or bloatingIron deficiency anemia.Arreaza: All those symptoms can also be explained by benign conditions, and colorectal cancer can often be present without clear symptoms in its early stages. Jessica: Yes, in young adults, symptoms may be dismissed by healthcare providers as benign conditions such as irritable bowel syndrome (IBS), hemorrhoids, or dietary intolerance, leading to significant diagnostic delays. Arreaza: We must keep a low threshold for ordering a colonoscopy, especially in patients with the risks we mentioned previously. Jessica: We may also be concerned about the risk/benefit of colonoscopy or diagnostic methods in younger adults, given the traditional low likelihood of CRC. Approximately 58% of young CRC patients are diagnosed at stage III or IV, compared to 43% of older adults (American Gastroenterological Association, 2024). Early recognition and prompt evaluation of persistent symptoms are crucial for improving outcomes. Empowering and informing young adults about concerning symptoms is the first step in better recognition and better outcomes for these individuals.Arreaza: This is when the word “follow up” becomes relevant. I recommend you leave the door open for patients to return if their common symptoms worsen or persist. Let's talk about screening. Screening and PreventionJessica: Due to the trend of CRC being identified in younger populations, the U.S. Preventive Services Task Force (USPSTF) lowered the recommended screening age for CRC from 50 to 45 in 2021 (USPSTF, 2021). Off the record, some Gastroenterologists also foresee the USPSTF lowering the age to 40. Arreaza: That is correct, it seems like everyone agrees now that the age to start screening for average-risk adults is 45. It took a while until everyone came to an agreement, but since 2017, the US Multi-Society Task Force had recommended screening at age 45, the American Cancer Society recommended the same age (45) in 2018, and the USPSTF recommended the same age in 2021. This podcast is a reminder that the age of onset has been decreased from 50 to 45, for average-risk patients, according to major medical associations.Jessica: For individuals with additional risk factors, including a family history of CRC or chronic gastrointestinal symptoms, screening starts at age 40 or 10 years before the diagnosis of colon cancer in a first-degree relative. Dr. Arreaza, who has the lowest and the highest rate of screening for CRC in the US? Arreaza: The best rate is in Massachusetts (70%) and the lowest is California (53%). Let's review how to screen:Jessica: Recommended Screening Methods:Colonoscopy: Considered the gold standard for CRC detection and prevention, colonoscopy allows for identifying and removing precancerous polyps.Fecal Immunochemical Test (FIT): A non-invasive stool test that detects hidden blood, recommended annually.Stool DNA Testing (e.g., Cologuard): This test detects genetic mutations associated with CRC and is recommended every three years.Arreaza: Computed tomographic colonography (CTC) is another option, it is less common because it is not covered by all insurance plans, it examines the whole colon, it is quick, with no complications. Conclusion:Colorectal cancer is rapidly emerging as a serious health threat for young adults. The increase in cases over the past three decades highlights the urgent need for increased awareness, early symptom detection, and proactive screening. While healthcare providers must weigh the risk/benefit of testing for CRC in younger adults, patients must also be equipped with knowledge of concerning signs so that they may also advocate for themselves. Early detection remains the most effective tool in preventing and treating CRC, emphasizing the importance of screening and risk factor modification.Even without trying, every night you go to bed a little wiser. Thanks for listening to Rio Bravo qWeek Podcast. We want to hear from you, send us an email at RioBravoqWeek@clinicasierravista.org, or visit our website riobravofmrp.org/qweek. See you next week! _____________________References:American Cancer Society. (2024). Colorectal Cancer Statistics, 2024. Retrieved fromhttps://www.cancer.orgAmerican Gastroenterological Association. (2024). Delays in Diagnosis of Young-Onset Colorectal Cancer: A Systemic Issue. Gastroenterology Today.Brennan, C. A., & Garrett, W. S. (2023). Gut Microbiota and Colorectal Cancer: Advances and Future Directions. Gastroenterology.Dekker, E., et al. (2023). Colorectal Cancer in Adolescents and Young Adults: A Growing Concern. The Lancet Gastroenterology & Hepatology.Siegel, R. L., et al. (2023). Colorectal Cancer Statistics, 2023. CA: A Cancer Journal for Clinicians.Stoffel, E. M., & Murphy, C. C. (2023). Genetic and Environmental Risk Factors in Young-Onset Colorectal Cancer. JAMA Oncology.U.S. Preventive Services Task Force. (2021). Colorectal Cancer Screening Guidelines.Theme song, Works All The Time by Dominik Schwarzer, YouTube ID: CUBDNERZU8HXUHBS, purchased from https://www.premiumbeat.com/.

Interview with Michael A. Postow, MD, author of Intracranial Outcomes of Ipilimumab and Nivolumab in Melanoma Brain Metastases After Progression on Anti–PD-1 Therapy. Hosted by Vivek Subbiah, MD. Related Content: Intracranial Outcomes of Ipilimumab and Nivolumab in Melanoma Brain Metastases After Progression on Anti–PD-1 Therapy

In this enlightening episode of the Patient From Hell, host Samira Daswani interviews Dr. Sara Tolaney, a leading oncologist specializing in breast cancer. They delve into the evolving landscape of triple-negative breast cancer (TNBC), exploring advancements in treatment, from targeted therapies to immunotherapy, and the challenges faced by patients in both early-stage and metastatic settings. With her characteristic warmth and expertise, Dr. Tolaney provides actionable insights for patients and caregivers, offering hope and understanding in navigating this complex diagnosis. Key Highlights: 1. A New Paradigm in Early-Stage TNBC Treatment: Dr. Tolaney explains how neoadjuvant chemotherapy combined with immunotherapy has revolutionized outcomes, achieving pathologic complete response rates above 60%. 2. Metastatic TNBC Advances: The discussion highlights the critical role of biomarker testing and the introduction of innovative therapies like antibody-drug conjugates, providing extended survival for many patients. 3. Empowering Patient Symptom Management: The episode underscores the importance of patient-reported outcomes and emerging tools like health apps to enhance self-management and real-time support for side effects. About our guest: Sara Tolaney, MD, MPH is the Chief of the Division of Breast Oncology at Dana-Farber Cancer Institute, and is internationally recognized for her research and education leadership in breast cancer. She also serves as Associate Director of the Susan F. Smith Center for Women's Cancers and is a Senior Physician at Dana-Farber Cancer Institute and Associate Professor of Medicine at Harvard Medical School. Dr. Tolaney received her undergraduate degree from Princeton University and her medical degree from UC San Francisco. She subsequently completed her residency in Internal Medicine at Johns Hopkins University, and fellowships in hematology and medical oncology at Dana-Farber Cancer Institute. She obtained her Masters in Public Health from Harvard School of Public Health. Her research focuses on the development of novel therapies in the treatment of breast cancer and developing more effective and less toxic treatment approaches. Her work has demonstrated that a relatively low risk regimen is beneficial in women with early stage node-negative HER2-positive cancers, and this works has been incorporated into national and international guidelines. She has developed several follow-up studies looking at novel approaches to early stage HER2-positive disease and has also played a significant role in development of cdk 4/6 inhibitors, antibody drug conjugates, and immunotherapy in breast cancer. She is the author of over 150 peer-reviewed publications with manuscripts included in many prestigious journals such as the New England Journal, Lancet Oncology, Journal of Clinical Oncology, and JAMA Oncology. Key Moments: At 8 minutes: "It used to be that if someone had a triple negative breast cancer, we would often take someone to surgery and then after surgery give them some chemotherapy to kill any stray cells that might've gotten into the bloodstream and integrate radiation as needed. But we've really changed our approach very dramatically over the last few years where we've learned that if someone has an early stage, stage two or three triple negative breast cancer, it is actually very critical that they not go to upfront surgery, but in fact get chemotherapy with immunotherapy prior to surgery." Disclaimer: All content and information provided in connection with Manta Cares is solely intended for informational and educational purposes only. This content and information is not intended to be a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Interview with Katrina A. B. Goddard, PhD, author of Estimation of Cancer Deaths Averted From Prevention, Screening, and Treatment Efforts, 1975-2020. Hosted by Vivek Subbiah, MD. Related Content: Estimation of Cancer Deaths Averted From Prevention, Screening, and Treatment Efforts, 1975-2020

Les relations entre cancer et maladie d'Alzheimer intriguent les scientifiques depuis plusieurs années. Des études épidémiologiques ont observé un phénomène contre-intuitif : les patients atteints de certains cancers semblent moins susceptibles de développer la maladie d'Alzheimer, et vice versa. Ce paradoxe a suscité de nombreuses recherches pour comprendre les mécanismes sous-jacents. En 2013, une étude publiée dans Neurology a analysé les dossiers de 3,5 millions de patients sur une période de 50 ans. Elle a révélé que les personnes ayant un diagnostic de cancer présentaient un risque réduit de 35 % de développer la maladie d'Alzheimer. Ce résultat a été confirmé par d'autres travaux, comme une méta-analyse publiée en 2021 dans Frontiers in Neuroscience, qui a examiné plusieurs cohortes et établi un lien inverse significatif entre les deux pathologies. Les mécanismes biologiques expliquant ce phénomène restent hypothétiques, mais plusieurs pistes sont explorées. La première concerne les voies de régulation cellulaire. Le cancer résulte d'une prolifération incontrôlée des cellules, tandis que la maladie d'Alzheimer est liée à une dégénérescence neuronale et à une mort cellulaire excessive. Ces pathologies opposées pourraient impliquer des mécanismes biologiques inverses. Par exemple, la protéine p53, connue pour son rôle dans la prévention des cancers en éliminant les cellules endommagées, semble sous-active dans les cancers et suractive dans l'Alzheimer. Une autre hypothèse concerne le système immunitaire. Dans le cancer, une inflammation chronique et une réponse immunitaire altérée sont fréquentes. Certaines de ces altérations pourraient paradoxalement limiter les processus inflammatoires caractéristiques d'Alzheimer. Cependant, ce lien protecteur n'est pas universel. Il varie selon les types de cancer. Par exemple, une étude de 2017 dans JAMA Oncology a montré que les cancers hématologiques, comme la leucémie, n'offrent pas la même protection. Malgré ces corrélations intrigantes, il est important de souligner qu'aucun lien de causalité direct n'a été établi. Les facteurs de confusion, comme le biais lié à une espérance de vie différente chez les patients atteints de cancer, pourraient expliquer en partie cette association. En conclusion, bien que le cancer puisse, dans certains cas, sembler offrir une protection contre la maladie d'Alzheimer, cette observation reflète probablement une interaction complexe entre biologie cellulaire, génétique et immunologie. Ces découvertes ouvrent toutefois des perspectives intéressantes pour comprendre les mécanismes fondamentaux de ces deux pathologies et développer des traitements innovants. Hébergé par Acast. Visitez acast.com/privacy pour plus d'informations.

Interview with Hagop Kantarjian, MD, author of Olverembatinib After Failure of Tyrosine Kinase Inhibitors, Including Ponatinib or Asciminib: A Phase 1b Randomized Clinical Trial. Hosted by Vivek Subbiah, MD. Related Content: Olverembatinib After Failure of Tyrosine Kinase Inhibitors, Including Ponatinib or Asciminib

Interview with Maria E. Cabanillas, MD, author of Anti–Programmed Death Ligand 1 Plus Targeted Therapy in Anaplastic Thyroid Carcinoma: A Nonrandomized Clinical Trial. Hosted by Vivek Subbiah, MD. Related Content: Anti–Programmed Death Ligand 1 Plus Targeted Therapy in Anaplastic Thyroid Carcinoma

A study published by JAMA Oncology shows that spouses of cancer patients are at a heightened risk of suicide attempts and death by suicide. A cancer diagnosis can reshape relationships for better or worse, whether they're family, partners, or friends. How can breast cancer survivors make sure they're getting the support they need and that their loved ones feel supported, as well? Racquel Williams talks with a panel of survivors and supporters, along with a social worker from The Penn Medicine | Virtua Health Cancer Program, about these crucial relationships through the breast cancer journey. Learn more about these survivors' missions with The Chrysalis Initiative and Create Urgency. Then, on Shara in the City, Shara Dae Howard visits Unite for HER, a non-profit that provides free integrative care for breast cancer and ovarian cancer patients - from acupuncture to nutrition counseling and much more - and has built a community of support. To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

Interview with Eileen M. O'Reilly, MD, author of Lynch Syndrome and Somatic Mismatch Repair Variants in Pancreas Cancer. Hosted by Vivek Subbiah, MD. Related Content: Lynch Syndrome and Somatic Mismatch Repair Variants in Pancreas Cancer

Interview with Michelle Rengarajan, MD, PhD, author of Identification of Immune Checkpoint Inhibitor–Induced Diabetes. Hosted by Vivek Subbiah, MD. Related Content: Identification of Immune Checkpoint Inhibitor–Induced Diabetes

We'd love to hear your thoughts on the podcast. Take the survey at wbur.org/survey. Here & Now's Chris Bentley joins us to talk about what he's hearing at the Democratic National Convention ahead of Vice President Kamala Harris' acceptance speech. And, a study published in JAMA Oncology found that spouses of cancer patients were at a significantly higher risk of suicide and death compared to those married to people without cancer. Angus Chen, cancer reporter at STAT, joins us. Then, Netflix's "The Decameron" follows a group of aristocrats escaping to an Italian villa in the countryside to avoid the Black Plague in the mid-1300s. Creator and executive producer Kathleen Jordan joins us.Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

THE ZOOMER SQUAD: A ‘LONGEVITY-OPTIMIZED' DIET COULD INCREASE LIFE EXPECTANCY UP TO 10 YEARS, STUDY SUGGESTS Libby Znaimer is joined by Bob Richardson, Public Affairs Consultant, Rudy Buttignol, President of CARP and John Wright, Executive Vice President of Maru Public Opinion. The Zoomer Squad panel discusses a new study that suggests a ‘longevity-optimized' diet could add 10 years to your life. Then, we move to the ever-relevant topic of terrible Toronto traffic. And it's been a year since vehicles were banned from entering High Park, has it been beneficial? UNLESS YOU HAVE A GENE VARIANT, DOUBLE MASTECTOMY HAS NO SURVIVAL ADVANTAGE Libby Znaimer is now joined by Dr. Ellen Warner, Professor of Medicine at the University of Toronto and a staff medical oncologist at the Odette Cancer Centre at Sunnybrook, and Dr. Eileen Rakovitch, Professor in the Department of Radiation Oncology at UofT and the Cancer Program Director of Research at Sunnybrook. A study in JAMA Oncology finds that removing the unaffected breast does not improve survival rates for breast cancer patients. Researchers analyzed data from more than 661,000 women and found that those who underwent a lumpectomy or single mastectomy had similar survival outcomes to those who opted for a double mastectomy.  CANADIAN OLYMPIC COMMITTEE APPEALS SIX-POINT OLYMPIC SOCCER DEDUCTION  Libby Znaimer is now joined by Sean Fitzgerald, Senior National Writer at The Athletic and Wally (Walter) Rigobon, Host of the Naz and Wally Sports hour on Zoomer Radio. The plot thickens in the drone spying scandal which led to a six point deduction for the Canadian women's Olympic soccer team and the banning of three coaches for one year each after a staffer was caught using a drone to spy on the New Zealand team's practices. Now Canada is appealing the scoring penalty on the grounds that it unfairly punishes the athletes for actions they had no part in. Meantime, the women's soccer team has pulled off two victories that put it back to zero. 

Interview with Lee W. Jones, PhD, author of Neoadjuvant Exercise Therapy in Prostate Cancer: A Phase 1, Decentralized Nonrandomized Controlled Trial. Hosted by Vivek Subbiah, MD. Related Content: Neoadjuvant Exercise Therapy in Prostate Cancer

Nora Disis, MD, editor in chief of JAMA Oncology and a JAMA deputy editor, and guests share JAMA Network highlights from the American Society of Clinical Oncology's annual meeting, including new research on colorectal cancer screening, an antibody therapy for non–small cell lung cancer, access to oncology clinical trials, and a new model of palliative care for patients with cancer. Related Content: Refining Colon Cancer Screening, Antibody Therapy for Lung Cancer, and More—Highlights From ASCO 2024

Interview with Kemi M. Doll, MD, MSCR, author of Endometrial Thickness as Diagnostic Triage for Endometrial Cancer Among Black Individuals. Hosted by Vivek Subbiah, MD. Related Content: Endometrial Thickness as Diagnostic Triage for Endometrial Cancer Among Black Individuals

Interview with Roni Shouval, MD, PhD, author of T-Cell Malignant Neoplasms After Chimeric Antigen Receptor T-Cell Therapy. Hosted by Vivek Subbiah, MD. Related Content: T-Cell Malignant Neoplasms After Chimeric Antigen Receptor T-Cell Therapy

Interview with Tobias Janowitz, MD, PhD, and Karen Winkfield, MD, PhD, authors of Analysis and Optimization of Equitable US Cancer Clinical Trial Center Access by Travel Time. Hosted by Vivek Subbiah, MD. Related Content: Analysis and Optimization of Equitable US Cancer Clinical Trial Center Access by Travel Time

Interview with José P. Leone, MD, author of Mortality Risks Over 20 Years in Men With Stage I to III Hormone Receptor–Positive Breast Cancer. Hosted by Nora L. (Mary) Disis, MD. Related Content: Mortality Risks Over 20 Years in Men With Stage I to III Hormone Receptor–Positive Breast Cancer

The CDC's Guideline for Prescribing Opioids for Chronic Pain excludes those undergoing cancer treatment, palliative care, and end-of-life care. In doing so, it seems to give the impression that pain seen in cancer is inherently different than pain seen in other conditions and that those with cancer may not have the same risk for opioid use disorder as compared to other conditions. Today's podcast tackles these issues and more with three amazing guests: Katie Jones, Jessica Merlin, and Devon Check.   We start off the conversation by talking about whether patients with cancer and cancer pain are really that different, and their paper that was just published on January 11th in JAMA Oncology showing that substance use disorder is not uncommon in individuals with cancer. After discussing screening options for substance use disorder, we go on to talk about both the treatments for it and the issues that arise.  In particular, we talk about Katie's and Jesica's paper in NEJM titled “Juggling Two Full-Time Jobs — Methadone Clinic Engagement and Cancer Care,” which described the difficulty in managing cancer pain and methadone for opioid use disorder. Lastly, we discuss Katie's paper on substance use disorder in an aging population and how one can incorporate the 5 Ms (ie, matters most, medications, mind, mobility, and multicomplexity) into a framework for age-friendly care for older adults with substance use disorder. If you want to do a deeper dive, here are some other references we talk about in the podcast: Previous podcasts on substance use disorder Buprenorphine Use in Serious Illness: A Podcast with Katie Fitzgerald Jones, Zachary Sager and Janet Ho  Substance Use in Older Adults: A Podcast with Ben Han  Palliative Care, Chronic Pain, and the Opioid Epidemic: GeriPal Podcast with Jessie Merlin    Expert consensus-based guidance Expert consensus-based guidance on approaches to opioid management in individuals with advanced cancer-related pain and nonmedical stimulant use Consensus-Based Guidance on Opioid Management in Individuals With Advanced Cancer-Related Pain and Opioid Misuse or Use Disorder Expert Panel Consensus on Management of Advanced Cancer-Related Pain in Individuals With Opioid Use Disorder  

Interview with Sajid A. Khan, MD, author of Immunotherapy Initiation at the End of Life in Patients With Metastatic Cancer in the US. Hosted by Mary L. (Nora) Disis, MD. Related Content: Immunotherapy Initiation at the End of Life in Patients With Metastatic Cancer in the US

In the third episode of Tit Talk, Rosalina guides us through a study featured in JAMA Oncology in November 2023. Examining data from nearly 50,000 women in the UK, the study investigates the potential link between vaginal estrogen therapy and breast cancer-related mortality. The study's findings reveal no evidence of an elevated risk. As always, Rosalina encourages listeners to stay informed, seek advice from healthcare professionals, and feel empowered to make decisions that align with their well-being.In this third season of the podcast, we had a dedicated episode on sexual health, where we spoke to medical oncologist and sexual health expert Dr. Laila Agrawal on a misconception about hormone-positive breast cancer and the use of vaginal estrogen. It's an episode worth catching up on, especially since discussions about women's sexual health are often overlooked.Resources: Main study: https://jamanetwork.com/journals/jamaoncology/article-abstract/2811413Dr. Agrawal analysis of the main study: https://www.instagram.com/reel/C0HTzb2Ad9k/More info on the model used in the study: https://sphweb.bumc.bu.edu/otlt/mph-modules/bs/bs704_survival/BS704_Survival6.htmlASCO 2018 recommendation: https://ascopubs.org/doi/full/10.1200/JCO.2017.75.8995Medical study general analysis: https://www.youtube.com/watch?v=BHsdpg1OOf0North American Menopause Society recommendation: https://www.menopause.org/docs/default-source/professional/nams-2022-hormone-therapy-position-statement.pdfRecurrence study: https://pubmed.ncbi.nlm.nih.gov/37535961/Dr. Agrawal's post re: recurrence study: https://www.instagram.com/p/C0P9wdsg1nf/

Interview with Jennifer A. Pietenpol, PhD, Brian D. Lehmann, PhD, and Vandana G. Abramson, MD, authors of Atezolizumab in Combination With Carboplatin and Survival Outcomes in Patients With Metastatic Triple-Negative Breast Cancer: The TBCRC 043 Phase 2 Randomized Clinical Trial. Hosted by Mary L. (Nora) Disis, MD. Related Content: Atezolizumab in Combination With Carboplatin and Survival Outcomes in Patients With Metastatic Triple-Negative Breast Cancer

GDP Script/ Top Stories for Dec 10th   Publish Date:  Dec 8th   HENSSLER 15 From the Henssler Financial Studio Welcome to the Gwinnett Daily Post Podcast. Today is Sunday, December 10th and Happy 48th Birthday to Seven Nation Army drummer Meg White ***12.10.23 - BIRTHDAY - MED WHITE (SEVEN NATION ARMY)*** I'm Bruce Jenkins and here are your top stories presented by Peggy Slappy Properties. Aurora Theatre's 'Christmas Canteen' is a community tradition Diabetes drugs may reduce colon cancer risk: study Central Gwinnett's Jenna Cloninger named Gwinnett County Public Schools' Teacher of the Year All of this and more is coming up on the Gwinnett Daily Post podcast, and if you are looking for community news, we encourage you to listen daily and subscribe! Break 1: Peggy Slappy STORY 1: Aurora Theatre's 'Christmas Canteen' is a community tradition The Aurora Theatre's annual production of "Christmas Canteen" in Lawrenceville, Georgia, is celebrating its 28th year. Conceived as a tribute to the USO shows entertaining military personnel during past decades, the show has evolved into a lively revue-type production reminiscent of Christmas variety shows from the 1960s and 1970s. The 10-person cast, including members of Aurora's apprentice program, performs a mix of old and modern tunes, incorporating skits for comedy and poignant songs for emotional moments. The show, running until December 23, has become a holiday tradition for many patrons, blending nostalgia with new experiences. STORY 2: Diabetes drugs may reduce colon cancer risk: study A groundbreaking study suggests that diabetes drugs, specifically glucagon-like peptide-1 receptor agonists (GLP-1 RAs), may significantly reduce the risk of colon cancer (colorectal cancer or CRC). Researchers at Case Western Reserve University found that GLP-1 RAs were more effective than other anti-diabetic drugs in preventing CRC. The study, published in JAMA Oncology, emphasizes the potential of GLP-1 RAs in preventing deadly forms of cancer associated with obesity and diabetes. The drugs, commonly used to treat type 2 diabetes, have been shown to lower blood sugar, improve insulin sensitivity, manage weight, and reduce rates of major cardiovascular ailments. STORY 3: Central Gwinnett's Jenna Cloninger named Gwinnett County Public Schools' Teacher of the Year Jenna Cloninger, who teaches oceanography at Central Gwinnett High School, has been named Gwinnett County Public Schools' overall Teacher of the Year. Cloninger emphasized the recognition as an achievement for the entire oceanography team in Gwinnett schools, shedding light on elective subjects often overshadowed by high-stakes testing and core subjects. The course is offered as a fourth-year science elective for high school seniors and plays a vital role in enriching students' lives and helping them discover their passions. Cloninger will compete for statewide Teacher of the Year honors. We have opportunities for sponsors to get great engagement on these shows. Call 770.874.3200 for more info. We'll be right back Break 2: MOG  – TOM WAGES – Glow Light Show STORY 4: Consumer Health: Flu vaccination and cancer It is crucial for individuals with cancer to receive a yearly flu vaccination, as recommended by the Centers for Disease Control and Prevention and Mayo Clinic. The flu can lead to severe complications, especially for those with weakened immune systems, chronic illnesses, or cancer. Flu complications for high-risk individuals may include pneumonia, heart problems, and acute respiratory distress syndrome. While the flu vaccine may not be 100% effective, it significantly reduces the risk of infection, lessens severity, and lowers the chance of hospitalization. Additional preventive measures include frequent handwashing, avoiding face-touching, covering coughs and sneezes, cleaning surfaces, and avoiding crowded places during peak flu season. STORY 5: Editorial: Voters are right to complain about inflation The Federal Reserve's efforts to guide the U.S. economy toward a soft landing, reducing inflation without causing a recession, appear to be working against the odds. Recent data show continued economic growth, a gradually cooling job market, and a slower pace of service price increases. However, despite these positive signs, voters remain persistently unhappy with the economy, possibly due to the significant inflation surge following the pandemic. The Biden administration's attempts to declare victory over inflation have been met with skepticism, as many households experience increased costs of living, particularly in groceries, housing, and credit. The lesson for policymakers is to recognize that people are the best judges of their own financial circumstances, and inflation disproportionately affects financially stressed households, making it a critical concern for both economics and politics. We'll be back in a moment Break 3:  JACKSON – ESOG - INGLES 3 STORY 6: Commentary: What's it like to be an average American? On an average day in the United States, people drive 32 miles (about an hour daily), with over 14,000 car accidents occurring daily. The average American spends almost three hours watching TV and over three hours on smartphones, checking their phones 58 times daily. Americans consume around 5.5 pounds of food daily and approximately two alcoholic beverages per day. On average, 10,000 babies are born, 9,500 people die, and around 4,000 people immigrate to the U.S. daily. The federal government spends over $17 billion daily, leading to unsustainable fiscal imbalances. The daily average of 123 firearm-related deaths includes about 13 from mass shootings, while drug overdose deaths average 294 per day, emphasizing the need for effective policies. The data highlights the diverse and unique experiences within a population of 335 million people. STORY 7: Liam Denning: Musk's Cyberbeast has a weight problem The weight and acceleration of electric vehicles (EVs), exemplified by Tesla's Cybertruck, pose safety concerns in collisions with traditional vehicles. EVs, heavier due to batteries, accelerate faster and can overpower lighter vehicles, causing more severe accidents. The Insurance Institute for Highway Safety (IIHS) warns about the dangers in mismatched collisions. The popularity of heavier EVs contributes to a longstanding trend of increasing vehicle weights in the auto industry. As EVs become more prevalent, the potential for such mismatched collisions grows. The key to addressing safety concerns involves improving charging infrastructure to reduce the need for large, heavy batteries and promote lighter EV models. We'll have final thoughts after this. Break 4:  DTL- Henssler 60 Signoff – Thanks again for hanging out with us on today's Gwinnett Daily Post podcast. If you enjoy these shows, we encourage you to check out our other offerings, like the Cherokee Tribune Ledger Podcast, the Marietta Daily Journal, the Community Podcast for Rockdale Newton and Morgan Counties, or the Paulding County News Podcast. Read more about all our stories, and get other great content at Gwinnettdailypost.com. Did you know over 50% of Americans listen to podcasts weekly? Giving you important news about our community and telling great stories are what we do. Make sure you join us for our next episode and be sure to share this podcast on social media with your friends and family. Add us to your Alexa Flash Briefing or your Google Home Briefing and be sure to like, follow, and subscribe wherever you get your podcasts. www.wagesfuneralhome.com  www.psponline.com  www.mallofgeorgiachryslerdodgejeep.com  www.esogrepair.com www.henssler.com  www.ingles-markets.com  www.downtownlawrencevillega.com  www.gcpsk12.org  www.downtownlawrencevillega.com #NewsPodcast #CurrentEvents #TopHeadlines #BreakingNews #PodcastDiscussion #PodcastNews #InDepthAnalysis #NewsAnalysis #PodcastTrending #WorldNews #LocalNews #GlobalNews #PodcastInsights #NewsBrief #PodcastUpdate #NewsRoundup #WeeklyNews #DailyNews #PodcastInterviews #HotTopics #PodcastOpinions #InvestigativeJournalism #BehindTheHeadlines #PodcastMedia #NewsStories #PodcastReports #JournalismMatters #PodcastPerspectives #NewsCommentary #PodcastListeners #NewsPodcastCommunity #NewsSource #PodcastCuration #WorldAffairs #PodcastUpdates #AudioNews #PodcastJournalism #EmergingStories #NewsFlash #PodcastConversationsSee omnystudio.com/listener for privacy information.

In this episode, Dr. Supriya Mohile discusses the need for geriatric oncology and the underrepresentation of older adults in clinical trials. She highlights the challenges of decision-making in oncology and the discrepancy between guidelines and patient goals. She also discusses the significance of patient-reported outcomes in treatment decisions. Finally, Dr. Mohile explores the role of social networks in supporting patients during the decision-making process, cancer prevention strategies and the acceptance of the unknown. This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features this study by Dr. Mohile. Key Highlights: There are an increasing number of older adults with cancer, yet older adults are often underrepresented in clinical trials. Social networks play a significant role in decision-making, and it is important to consider the influence of family and friends on patients' choices. Patient input is valuable in developing interventions and improving care delivery. About our guest: Dr. Supriya Gupta Mohile, a distinguished figure in the field of geriatric oncology, is a Professor of Medicine and Surgery at the James Wilmot Cancer Institute, University of Rochester. Her research focuses on assessing patterns of care, health outcomes, and quality of life in older patients undergoing systemic cancer treatment. With nearly 300 publications in geriatric oncology, she serves as the Editor-in-Chief of the Journal of Geriatric Oncology and chairs the ASCO Geriatric Oncology Clinical Guideline panel. You can find her research in the following journals: Lancet, Journal of Clinical Oncology, and JAMA Oncology. In addition to her research focus, Dr. Mohile works closely with such patients in the Cancer and Aging Research Group, providing administrative support to a community of older adults with cancer and their caregivers.  Key Moments: 10 minutes: On the challenge of treating older cancer patients using clinical trial data. “But the problem is, we're getting clinical trial data in very fit patients, either younger or even older patients who are very healthy. And then we don't know when we have the drugs come on market, what is the safety and efficacy for the patient that's sitting in front of me in the clinic who has a disability, has heart disease, has real insufficiency, lives alone, is having trouble taking their medicines, and may not be as fit as the people that are in the trials.” 40 minutes: On the way people often make decisions based on anecdotal evidence from their friends and not science. “Even my mother does this too, for example, about knee injections. She said ‘All my friends told me not to do this one. They told me to do that one instead.' I'm like, ‘mom, I'm a physician. This doesn't matter. This is what the data shows. I appreciate that this bad thing happened to your friend, but it's not necessarily going to happen to you.' But people will use anecdotal information to drive decisions more than evidence.” 50 minutes: Despite preventative measures, people still get cancer. “ So when patients come to me and say ‘why me'? They want to know why. I can say sometimes we just don't know why and it's not up to us. Something happens, the universe exists. So we have to move forward and help with what we can help.”  Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support

Interview with Daniel E. Spratt, MD, author of Increasing Use of Shorter-Course Radiotherapy for Prostate Cancer. Hosted by Jack West, MD. Related Content: Increasing Use of Shorter-Course Radiotherapy for Prostate Cancer

Medical communication is tough, although fundamentally at its most basic unit of delivery, it includes really only three steps. First, a clinician's thoughts must be encoded into words, then transmitted often via sounds, and finally decoded back to thoughts by a patient or family member. Simple, right? Not so much, as each one of these steps is fraught with miscommunication. For example, a surgeon may want to convey that all visible tumors were removed during surgery, but transmits that message to the patient by saying “we got it all” only to have the patient hear an entirely different message that the cancer is gone and they are now cancer free. On today's podcast we talk with three communication experts, Abby Rosenberg, Don Sullivan, and Shunichi Nakagawa about the concept of miscommunication, including examples of it and ways we can mitigate this issue.  This podcast was inspired by Abby and Don's recent JAMA Oncology paper titled Miscommunication in Cancer Care—Do You Hear What I Hear?  We also ask Shunichi Nakagawa about some of the amazing communication pearls he posts on his Twitter account (don't tell me to call it X). Lastly, we also plan to have two more podcasts coming up on communication, one on the language of life sustaining treatments and one on surgical communication, so stay tuned! Eric   Note: For more reading on this subject, check out these links: Shunichi Nakagawa's Twitter account Miscommunication in Cancer Care—Do You Hear What I Hear? Patient Values: Three Important Questions-Tell me more? Why? What else? A "Three-Stage Protocol" for Serious Illness Conversations: Reframing Communication in Real Time  

Interview with Oreste Davide Gentilini, MD, author of Sentinel Lymph Node Biopsy vs No Axillary Surgery in Patients With Small Breast Cancer and Negative Results on Ultrasonography of Axillary Lymph Nodes: The SOUND Randomized Clinical Trial. Hosted by Jack West, MD. Related Content: Sentinel Lymph Node Biopsy vs No Axillary Surgery in Patients With Small Breast Cancer and Negative Results on Ultrasonography of Axillary Lymph Nodes

The comprehensive geriatric assessment is one of the cornerstones of geriatrics.  But does the geriatric assessment do anything?  Does it improve outcomes that patients, caregivers, and clinicians care about? Evidence has been mounting about the importance of the geriatric assessment for older adults with cancer, the subject of today's podcast.  The geriatric assessment has been shown in two landmark studies (Lancet and JAMA Oncology) to reduce high grade toxicity, improve patient and caregiver satisfaction, and improve completion of advance directives (can listen to our prior podcast on this issue here).  Based on this surge in evidence, the American Society of Clinical Oncologists recently updated their guidelines for care of older adults to state that all older adults receiving systemic therapy (including chemo, immuno, targeted, hormonal therapy) should receive geriatric assessment guided care.  We talk about these new guidelines today with William Dale, a geriatrician at City of Hope and lead author of the guideline update in the Journal of Clinical Oncology, Mazie Tsang, palliative care/heme/onc physician-researcher at Mayo Clinic Arizona who authored a study of geriatric and palliative conditions in older adults with poor prognosis cancers published in JAGS, and John Simmons, a retired heme/onc doctor, cancer survivor, and patient advocate.  We talk about: What is a practical geriatric assessment and how can busy oncologists actually do one? (hint: 80% can be done in advance by patients or caregivers) Why is it that some oncologists are resistant to conducting a geriatric assessment, yet have no problem ordering tests that cost thousands of dollars? What can you do with the results of a geriatric assessment? How does the geriatric assessment lead to improved completion of advance directives, when the assessment doesn't address advance care planning/directives at all? How does palliative care fit into all this?  Precision medicine? What groups are being left out of trials? What are the incentives to get oncologists and health systems to adopt the geriatric assessment?   And Mazie, who is from Hawaii, requested the song Hawaii Aloha in honor of the victims of the wildfire disaster on Maui.  You can donate to the Hawaii Red Cross here. Aloha, -@AlexSmithMD   Additional Links: Brief ASCO Video of how to conduct a practical geriatrics assessment Brief ASCO Video of how to use the results of a practical geriatrics assessment Time to stop saying the geriatric assessment is too time consuming    

In this latest episode of Investigating Breast Cancer, Dr. Nora Disis talks about prevention, treatment, breast cancer vaccine research, and more. Her research focuses on identifying ways to boost the immune response in breast cancer patients to improve chemotherapy outcomes. She is working on discovering new molecular immunologic targets in solid tumors to develop vaccines and cellular therapy for treating and preventing breast cancer. Dr. Disis, a BCRF investigator since 2016, is the Athena Distinguished Professor of Breast Cancer Research and the associate dean for Translational Health Sciences at the University of Washington School of Medicine. She is also the editor-in-chief of JAMA Oncology.

Interview with Kara N. Goldman, MD, author of A Geospatial Analysis of Disparities in Access to Oncofertility Services. Hosted by Jack West, MD. Related Content: A Geospatial Analysis of Disparities in Access to Oncofertility Services

Interview with Sean P. Pitroda, MD, author of Integrated Clinical-Molecular Classification of Colorectal Liver Metastases: A Biomarker Analysis of the Phase 3 New EPOC Randomized Clinical Trial. Hosted by Jack West, MD. Related Content: Integrated Clinical-Molecular Classification of Colorectal Liver Metastases

Dr. Supriya Mohile , Dr. William Dale, and Dr. Heidi Klepin discuss the updated guideline on the practical assessment and management of age-associated vulnerabilities in older patients undergoing systemic cancer therapy. They highlight recent evidence that prompted the guideline update, and share the updated evidence-based recommendations from the panel, focusing on geriatric assessment-guided management. Dr. Mohile also reviews what the expert panel recommends should be included within a geriatric assessment, and Dr. Dale highlights the Practical Geriatric Assessment tool, aimed at helping clinicians implement a geriatric assessment. Dr. Klepin comments on the impact for both older adults with cancer and their clinicians, and reviews outstanding questions and challenges in the field. Read the full guideline, "Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Systemic Cancer Therapy: ASCO Guideline Update" at www.asco.org/supportive-care-guidelines TRANSCRIPT This guideline, clinical tools, and resources are available at www.asco.org/supportive-care-guidelines. Read the full text of the update and review authors' disclosures of potential conflicts of interest disclosures in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO.23.00933. See also the Practical Geriatric Assessment tool and associated videos (How to do a Geriatric Assessment, What to do with the Results of a Geriatric Assessment) mentioned in the podcast episode. Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all the shows, including this one at asco.org/podcasts.  My name is Brittany Harvey, and today I'm interviewing Dr. William Dale from City of Hope National Medical Center, Dr. Heidi Klepin from Wake Forest Baptist Comprehensive Cancer Center, and Dr. Supriya Mohile from University of Rochester Medical Center—co-chairs on “Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Systemic Cancer Therapy: ASCO Guideline Update.”  Thank you for being here, Dr. Dale, Dr. Klepin, and Dr. Mohile. Dr. William Dale: Nice to see you. Thanks for having us. Brittany Harvey: Then, before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensures that the ASCO conflict of interest policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including our guests joining us on this podcast episode today, are available online with the publication of the guideline in the Journal of Clinical Oncology linked in the show notes.  Diving into the content of this guideline first, Dr. Dale and Dr. Mohile, can you speak to what prompted an update of this ASCO guideline on the practical assessment and management of age-associated vulnerabilities in older patients undergoing systemic cancer therapy, which was previously published in 2018? Dr. William Dale: Sure. Yes. In 2018, that was the very first guideline for older adults that ASCO had created, and that was based on work that had been done up to that time, focused on chemotherapy toxicities. And to summarize what was put out at that time, the evidence was thought to be strong enough for doing geriatric assessments. And these are specialized assessments across a number of domains, including functional impairments, cognitive losses, social impairments, etc. But to do these kinds of geriatric assessments with validated tools; that a certain selection of these domains to cover everything that was relevant; to conduct non-cancer prognostication so that for decision-making purposes, if someone were to have their cancer cured, what would be their prognosis, and help make decisions about giving chemotherapy and what doses; and then to enact geriatric assessment-guided target interventions was the fourth recommendation. And so that's where we were in 2018.  In 2020 at ASCO, there was an oral session that had four randomized controlled trials that enrolled older adults. And in that was kind of the signal that there was more coming. And in 2021, two big trials that are practice-changing were published. One led by Dr. Mohile in Lancet that we call the GAP70+ study, and another one was published in JAMA Oncology. And they essentially showed the same thing, which was that GA-guided interventions could change the primary outcome, which was to reduce chemotherapy toxicity up to 20%, and also to affect a number of other outcomes. That, along with a number of other trials that have since come out and are included in the upcoming guidelines, and made it a high priority to update these guidelines. So that's where we got from there to here. And I think it's worth saying a few words about these new trials, particularly the GAP and GAIN studies. So the GAIN study included patients who were 65 and older who were starting systemic chemotherapy and looked at the likelihood of having chemotherapy toxicity as described and looked at a number of other outcomes. Most importantly, it showed that chemotherapy toxicity could be reduced with these interventions based on the geriatric assessment from about 60% to about 50%. It also showed that the likelihood of completing advanced directives would go up by around 25%. And importantly, there was no impact after all of the use of the geriatric assessments on mortality. So patients were living just as long, but they were having less toxicity and they were having more goal-concordant care. And at almost the same time, the GAP study came out, which I would hand over to Dr. Mohile to describe. Dr. Supriya Mohile: Thank you, Dr. Dale. I agree that it was time for an update, and I'm glad ASCO partnered with us to do this. I'll also just mention that Dr. Dale, Dr. Klepin, and I lead the Cancer and Aging Research Group, and many of the original predictive models that showed that geriatric assessment could help us identify patients at highest risk for toxicity were designed by Cancer and Aging Research Group investigators. And that's what informed the first guideline. I'll mention Dr. Arti Hurria, who unfortunately passed away a few years ago, and she led some of the first large studies that developed these predictive models. We built on that data in both GAP and GAIN studies to show that the geriatric assessment—when you assess and provide management—can reduce chemotherapy toxicity.   Like GAIN, GAP70+ implemented a geriatric assessment intervention that both assessed and provided management to older adults. There were some key differences. In GAP70+, the patients had advanced cancer, whereas, in the GAIN study, it was a more generalizable population of patients with both curative intent and advanced cancer. And in the GAP70+ study, we enrolled patients who already had geriatric assessment domain impairments, meaning that these patients were more vulnerable because of those aging-related conditions. We were trying to enroll patients who are traditionally excluded from therapeutic clinical trials. The GAP70+ study was done in oncology offices by Community Oncology practices.  So this was what I think was really interesting, in that geriatricians were not involved in implementing the geriatric assessment in this study. Oncologists received the assessment information from their team, and they're the ones that implemented the recommendations. We found in GAP70+ that not only chemotherapy toxicity was reduced, that we were able to reduce the prevalence of falls and reduce the incidence of polypharmacy, which are important geriatric outcomes for older adults. We included patients who were receiving chemotherapy, but also patients who are receiving high-risk targeted agents in GAP70+, which also leads us to believe that these interventions are important for patients who are receiving treatments other than chemotherapy.  So we believe these two trials, plus others, really inspired the ASCO guidelines. Brittany Harvey: Absolutely. I appreciate you both for providing that context and background and some of the new evidence that's informed this latest update. So then I'd like to move into some of the updated recommendations of the guideline. So, Dr. Mohile, what is the updated recommendation from the panel regarding the role of geriatric assessment in older adults with cancer? Dr. Supriya Mohile: So the first guideline really focused on the assessment piece, what should be assessed, and why, which we still incorporate in this new guideline. This guideline extends now because of the randomized controlled trials into management. And when we think about geriatric assessment, we think about two pillars of management. One is how geriatric assessment influences cancer decisions, that includes what treatments to provide, what dose to provide. And then the second is how geriatric assessment can influence management recommendations that are supportive care based that address some of the geriatric assessment domain impairments.  I'll just give you an example of both. So when we see patients with advanced cancer who have geriatric assessment domain impairments who are presenting for treatment, often the doses of chemotherapy may be overtreatment because those doses were developed in therapeutic clinical trials in younger, more fit patients. And in our geriatrics world, we often think about going slow and starting low, and we may do a first cycle that's dose reduced a touch, to kind of see how the patient does physiologically with that first cycle. There are therapeutic clinical trials like FOCUS2 in patients with metastatic colon cancer that show the benefits of being careful with dosing in the first cycle.  So, in GAP70+, the oncologists who received information from the assessment were more likely to reduce the dose of the treatment in the first cycle which led to less toxicity but did not lead to a difference in survival, so do not compromise survival. And I think this is because we don't know the right doses for patients who have significant aging-related impairments. So that's one example of decision-making.  As examples for geriatric management recommendations that are supportive care, this can be done in almost like an algorithmic approach. So, if a patient has an impairment on a physical function test, then through the geriatrics literature we know of management recommendations that can improve outcomes like physical therapy, home safety evaluations, balance, training, fall prevention information. And if we implement those supportive care recommendations through that patient who's at risk for falls, we may prevent falls and we were able to show that in addition in GAP70+ as well as other trials showed benefits in some of those outcomes.  And so those are the two pieces that I think are newer with this guideline than with the previous guideline. We know more about how those management recommendations can improve outcomes.    Brittany Harvey: Understood. Yes. It's helpful to understand those examples of how integrating this geriatric assessment can help improve the management of care for these patients. So then you've mentioned some of the geriatric assessment domain impairments. So, Dr. Mohile, what does the guideline recommend should be included within a geriatric assessment? Dr. Supriya Mohile: This was a really great question for us to rise and think about, as part of this guideline and as a panel, we went back and forth with all of the authors to try to think about what is the most streamlined number of domains that should be assessed? What are the highest priority domains that, if you could only do a few things in a busy oncology clinic, which are the ones that oncologists should have to do because without doing them, they won't have relevant information to inform treatment decisions or to improve the outcomes of their patients?  And so when we think about geriatric assessment, there has been literature to show that almost all of the domains we do are important in identifying patients who are at risk of poor outcomes. These include physical function, cognitive function, emotional health, comorbidities, polypharmacy, nutritional status, and social support. That sounds like a lot, but we do many of those assessments sort of naturally in oncology clinics. There are just a few that are not done as standard. For example, it is not standard for oncologists to assess cognition using a validated screening test for cognition. And we know that recognizing patients who may have cognitive impairment is really important in identifying vulnerabilities and providing support systems in place so patients who are receiving treatment can go through treatment safely.   Other things, like just doing a formalized nutritional assessment, really bringing in the caregiver, are done not in a standard way. And so what the geriatric assessment allows is for us to assess each of those domains in a standard way. When we're communicating to our colleagues and tumor boards, we can describe vulnerabilities in a standard way. And we're moving now past the eyeball test, which is different for different clinicians, and having more objective ways of describing health status to be able to have a common language across studies and in clinical care. Brittany Harvey: That's helpful to understand moving past the less formal approach to geriatric assessment and making it more standardized.  So then, Dr. Dale, this guideline offers a specific tool, the Practical Geriatric Assessment, as an option for clinicians conducting a geriatric assessment. What is this tool and where can clinicians access it? Dr. William Dale: Very good question. Just to set the context a bit, after hearing about all the evidence that we've just described. We did do some work as a task force through ASCO and through some work that Dr. Klepin and her colleague have done to understand now that the guidelines in 2018 had come out, they weren't really being used. So when we asked, about 25% of people would say they were using them very much, even though we saw in these large studies that we did, that those who were using the guidelines were changing their practice significantly in the ways that Dr. Mohile mentioned. And this was among a large group of community oncologists.  So we have been breaking down the geriatric assessment into the most concise, most straightforward, and easiest-to-use version of the geriatric assessment, maintaining its validity and maintaining the number of domains. We really tried to make it simple. So the Practical Geriatric Assessment is not the only tool, but it is a tool that accomplishes this practical charge to make it accessible to community oncologists while also being valid. So those domains that Dr. Mohile mentioned physical function, functional status, nutrition, social support, psychological considerations, comorbidities are all in the Practical Geriatric Assessment.   But what we've done is boil it down to here's a very specific tool that we think is valid but easily applied. Here are the very specific thresholds that tell you when a deficit has been identified and then gives recommended actions to be taken, whether it's in decision-making or in other interventions like a referral to somebody, perhaps physical therapy, or a cognitive specialist, all of which come from the GAP. So this tool is designed to be very straightforward and practical, but still cover all the relevant domains. And it will be made available through both the ASCO website and through the Cancer and Aging Research Group website so that people can access it easily. Brittany Harvey: That sounds like a real challenge that the ASCO working group took on to create a comprehensive yet practical tool for clinicians to use. We'll also provide some links for people to access this in the show notes of this podcast episode.   So then I want to move on. Dr. Klepin, in your view, how will this guideline update impact both clinicians and older adults with cancer?  Dr. Heidi Klepin: Yes. Thank you. As was mentioned, for clinicians, the guidelines provide an overview of new evidence and concrete recommendations to address the challenge experienced every day in practice, that of providing personalized care in the context of age-related conditions to maximize benefits and minimize the risk for older adults with cancer. The evidence summary will educate clinicians on key outcomes that can be positively impacted by use of geriatric assessment, including decreasing treatment toxicity, enhancing decision-making, and improving communication and patient-caregiver satisfaction.  And this information on outcomes is really critical to informing the use of geriatric assessment in practice. We hope that the evidence-based recommendations with the provision of the practical geriatric assessment and the associated trigger table to guide management strategies will empower clinicians to incorporate geriatric assessment into their workflow by helping them overcome some of those known barriers that Dr. Dale mentioned, such as lack of time and uncertainty about which measures to use and what to do with the information once you have it. So, we anticipate that providing clear recommendations and accompanying readily available materials to support the implementation that clinicians in both community and academic practices will be able to use the geriatric assessment and incorporate it into routine care. For patients, we anticipate that the guideline recommendations would translate into increased use and access to this type of assessment as part of their routine oncology care. So, we hope that our patients will actually be able to access this regardless of whether they're receiving care at a specialized academic center versus a community oncology clinic. So, by doing this, we would extend the proven benefits of geriatric assessment, including lower rates of side effects, experiencing fewer hospitalizations, and improving satisfaction to older adults regardless of where they receive treatment.   And we feel like this is critically important, since currently, most older adults receive cancer care in community oncology clinics without access, as was mentioned, to any geriatric specialty care. So, as more older adults have the opportunity to participate in this type of assessment as part of routine care in their oncology clinics, they'll be able to discuss the results of the assessment with their healthcare providers, which can help them make better-informed decisions and engage, I think, more completely in what we would consider patient-centered decision making. And ultimately, we would hope that the guidelines would provide an evidence-based and practical strategy for improving the quality of care received by older adults with cancer.   Dr. Dale, would you be interested in commenting a little bit more on the patient perspective informed by our patient partners on the guideline panel? Dr. William Dale: Yeah. Thank you, Dr. Klepin. Very well said. Yeah, our guideline panel, just to fill out the picture of that, included our patient partners, along with a wide diversity of perspectives. We had experts in geriatric oncology, but we had community oncologists who take care of cancer patients. We have people from across the country. We had different backgrounds and different levels of experience. But to focus on the patients for a group that we've worked with for some time called SCOREboard, and they were some of the strongest voices on this.  Whenever people said, “Well, do we really need to require this?” The patient partners were insistent that this be included as a requirement as much as possible for what happens. I think one of the most important roles they've played is as advocates for this. If I can, when the community oncologists are having some concerns about how hard this would be or how difficult it might be, the patient partners have been the first to say, we need to find a way to do it and insist that we empower the patients to ask for it. So, one of the hopes for all of these guidelines is also that it get disseminated to patients who can self-advocate as they go forward and have tools that will be made available for them to use in this self-advocacy. Brittany Harvey: Definitely, that self-advocacy is important and the geriatric assessment is critical for optimal care for older adults.  So, then we've talked a lot about the new evidence regarding geriatric assessment and also making it easier for clinicians to implement the geriatric assessment, but Dr. Klepin, what are the outstanding questions and challenges regarding geriatric assessment in older adults with cancer?  Dr. Heidi Klepin: Thanks. So, while there's strong evidence and clear rationale to incorporate geriatric assessment into routine clinical care, there are outstanding questions and challenges that we have to consider. First and foremost, still remains a challenge of implementation. As mentioned, we hope that the Practical Geriatric Assessment, the detailed recommendations, and the associated educational materials on what to do with the geriatric assessment information will help overcome implementation barriers for many. But we recognize that more work needs to be done to both train providers to facilitate behavior change as well as to tackle clinic and healthcare system barriers to routine use.  And along these lines, we also recognize that it's important to educate patients and caregivers about the role of geriatric assessment and its value in order to optimize uptake in community clinics. We want all of our patients to be as enthused and recognize the importance of the geriatric assessment, as our colleagues on the recommendation panel did. Another consideration is the challenge of tailoring use of geriatric assessment to specific disease and treatment settings. And more research is underway testing geriatric assessment and management strategies in varied disease settings, as well as with varied treatment types and intensities.  And finally, I would suggest that another challenge is the lack of routine incorporation of geriatric assessment measures into cancer clinical trials. And this will really be necessary to interpret clinical trial data for older adults optimally and to reinforce the value of routine geriatric assessment in clinical care. Brittany Harvey: Absolutely. These are key points for moving forward and looking forward to additional research in this area and maybe future guideline updates down the line.  So, I want to thank you all so much for your work on updating this guideline and for your time today. Dr. Dale, Dr. Klepin, and Dr. Mohile.  Dr. Heidi Klepin: Thank you for having us.  Dr. William Dale: Yeah, thanks for having us here. We're delighted to be talking about this.  Dr. Supriya Mohile: Thank you.  And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/supportive-care-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store.  If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode.  The purpose of this podcast is to educate and 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.    

Interview with Sophia C. Kamran, MD, author of US Cancer Mortality Trends Among Hispanic Populations From 1999 to 2020. Hosted by Jack West, MD. Related Content: US Cancer Mortality Trends Among Hispanic Populations From 1999 to 2020

Interview with Robert W. Holloway, MD, and Sarfraz Ahmad, PhD, authors of Clinical Activity of Olvimulogene Nanivacirepvec–Primed Immunochemotherapy in Heavily Pretreated Patients With Platinum-Resistant or Platinum-Refractory Ovarian Cancer: The Nonrandomized Phase 2 VIRO-15 Clinical Trial. Hosted by Jack West, MD. Related Content: Clinical Activity of Olvimulogene Nanivacirepvec–Primed Immunochemotherapy in Heavily Pretreated Patients With Platinum-Resistant or Platinum-Refractory Ovarian Cancer

Interview with Samuel Ryu, MD, author of Stereotactic Radiosurgery vs Conventional Radiotherapy for Localized Vertebral Metastases of the Spine: Phase 3 Results of NRG Oncology/RTOG 0631 Randomized Clinical Trial. Hosted by Jack West, MD. Related Content: Stereotactic Radiosurgery vs Conventional Radiotherapy for Localized Vertebral Metastases of the Spine

In a paper published in JAMA Oncology, Dr. Erik Eckert, of Stanford, and his colleagues found that LGBTQ people with breast cancer faces delays in diagnosis and have a three times higher risk of recurrence than heterosexual cisgender people. Listen to the episode to hear Dr. Eckhert discuss: the discrimination LGBTQ+ people face when going to doctor's appointments and other healthcare visits why he decided to do the study and what the results were the next steps for this research how LGBTQ+ people can make sure they're getting the best and most appropriate care, whether it's for breast cancer or another issue

Interview with Dian Wang, MD, author of Pathologic Complete Response and Clinical Outcomes in Patients With Localized Soft Tissue Sarcoma Treated With Neoadjuvant Chemoradiotherapy or Radiotherapy: The NRG/RTOG 9514 and 0630 Nonrandomized Clinical Trials. Hosted by Jack West, MD. Related Content: Pathologic Complete Response and Clinical Outcomes in Patients With Localized Soft Tissue Sarcoma Treated With Neoadjuvant Chemoradiotherapy or Radiotherapy

Although Black women are less like to be diagnosed with breast cancer than white women, they are more likely to die if they do develop the disease. Much of Dr. Kent Hoskins' research focuses on trying to figure out the factors behind this difference in survival. He was the lead author of a paper in the journal JAMA Oncology that found that both the characteristics of a breast cancer, as well the environment in which women live, contribute equally to this survival disparity. Listen to the podcast to hear Dr. Hoskins explain: when survival differences were first noticed what social determinants of health are how he and his colleagues developed their study what the results mean for Black women who develop breast cancer what the next steps are for his research

Dr. Kathryn Nevel talks with Dr. Linda Liau about the use of autologous tumor lysate-loaded dendritic cell vaccination for the treatment of newly diagnosed and recurrent glioblastoma. Read the related article in JAMA Oncology.

Interview with Laura A. Bolte, MSc, Geke A. P. Hospers, MD, PhD, and Rinse K. Weersma, MD, PhD, authors of Association of a Mediterranean Diet With Outcomes for Patients Treated With Immune Checkpoint Blockade for Advanced Melanoma. Hosted by Jack West, MD. Related Content: Association of a Mediterranean Diet With Outcomes for Patients Treated With Immune Checkpoint Blockade for Advanced Melanoma

What do we know about various diets and their association with cancer? Have you ever wondered what the evidence shows? To answer this important question, Chadi hosts two specialists from Memorial Sloan Kettering Cancer Center: Urvi Shah, MD, hematologist oncologist (myeloma expert and a cancer survivor herself), and Neil Lyengar, MD, medical oncologist (breast cancer expert). They discuss whether there's a direct cause-and-effect relationship between lack of exercise and cancer diagnoses and alcohol/food consumption and cancer diagnoses, methodologies of studying these relationships in the breast and myeloma spaces, lifestyle and dietary interventions they are studying, how Keto and plant-based diets factor into the discussion, and a whole lot more. Read their publication in JAMA Oncology. https://jamanetwork.com/journals/jamaoncology/fullarticle/2794147 Check out Chadi's website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on Youtube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Interview with Nancy L. Keating, MD, MPH, author of Adoption of Innovative Therapies Across Oncology Practices—Evidence From Immunotherapy. Hosted by Jack West, MD. Related Content: Adoption of Innovative Therapies Across Oncology Practices—Evidence From Immunotherapy

Videos: Did Julian Assange's lawyers just EXPOSE this CIA scheme? Redacted with Natali and Clayton Morris (3:23 to 6:46) EXCLUSIVE: UNDERTAKER EXPLAINS “MYSTERIOUS” CLOTTING PHENOMENON! | Louder with Crowder (8:17 – 26:00)   Green tea and resveratrol reduce Alzheimer's plaques in lab tests Tufts University, November 2, 2022 Tufts researchers are working to understand what might slow progression of Alzheimer's disease. They have tested 21 different compounds in Alzheimer's-afflicted neural cells in the lab, measuring the compounds' effect on the growth of sticky beta amyloid plaques. These plaques develop in the brains of people with Alzheimer's. The researchers found that two common compounds—green tea catechins and resveratrol, found in red wine and other foods—reduced the formation of plaques in those neural cells. And they did so with few or no side effects. The researchers reported their findings in the journal Free Radical Biology and Medicine. Some of the 21 compounds tested reduced the disease progression by acting as anti-viral agents—slowing Alzheimer's induced by the herpes virus. But finding a compound “that could diminish the plaques regardless of the virus component would be ideal, because that would show that regardless of the cause of Alzheimer's, you might still see some kind of improvement,” says Dana Cairns, GBS12. Cairns is a research associate in the Kaplan Lab in the School of Engineering and led the research. The initial screen found five compounds had “really robust prevention of these plaques,” she says. In addition to the green tea compounds and resveratrol, they found curcumin from turmeric, the diabetic medication Metformin, and a compound called citicoline prevented plaques from forming and did not have anti-viral effects. “We hoped to find compounds that would be harmless and show some level of efficacy,” she said. Green tea compounds and resveratrol met that standard. “We got lucky that some of these showed some pretty strong efficacy,” Cairns said. “In the case of these compounds that passed the screening, they had virtually no plaques visible after about a week.” The discovery is significant because there is no cure for Alzheimer's or a way to prevent its progression, aside from several potential drugs developed by pharmaceutical companies that are still in trials, Cairns says. Compounds like these two that show some efficacy and are known to be safe and easily accessible could be taken as a supplement or consumed as part of one's diet, she adds. High fiber, yogurt diet associated with lower lung cancer risk Vanderbilt University Medical School, October 28, 2022 A diet high in fiber and yogurt is associated with a reduced risk for lung cancer, according to a study by Vanderbilt University Medical Center researchers published in JAMA Oncology. The benefits of a diet high in fiber and yogurt have already been established for cardiovascular disease and gastrointestinal cancer. The new findings based on an analysis of data from studies involving 1.4 million adults in the United States, Europe and Asia suggest this diet may also protect against lung cancer. Participants were divided into five groups, according to the amount of fiber and yogurt they consumed. Those with the highest yogurt and fiber consumption had a 33% reduced lung cancer risk as compared to the group who did not consume yogurt and consumed the least amount of fiber. “This inverse association was robust, consistently seen across current, past and never smokers, as well as men, women and individuals with different backgrounds,” she added. Shu said the health benefits may be rooted in their prebiotic (nondigestible food that promotes growth of beneficial microorganisms in the intestines) and probiotic properties. The properties may independently or synergistically modulate gut microbiota in a beneficial way. Yoga Practice Beneficial to Patients With COPD All India Institute of Medical Sciences Oct. 28, 2022 Patients with COPD who practice yoga can improve their lung function, according to a study by researchers at the All India Institute of Medical Sciences, Department of Pulmonary Medicine and Sleep Disorders. The study found that lung function, shortness of breath, and inflammation all showed significant improvement after patients completed 12 weeks of training. An estimated 24 million Americans may have COPD, which includes chronic bronchitis, emphysema, or both. Patients with COPD have trouble pushing used air out of their lungs, making it difficult to take in healthy new air. Although there is no cure for COPD, a patient's quality of life can be improved by controlling symptoms, such as shortness of breath. The study included 29 stable patients with COPD who received yoga training in a format that included the use of physical postures (asanas), breathing techniques (pranayama), cleansing techniques, (kriyas), meditation, and a relaxation technique (shavasan) for 1 hour, twice a week, for 4 weeks. Following the 4-week period, patients were trained for 1 hour every 2 weeks, with the remaining sessions completed at home. Patients were evaluated on assessment of lung function, breathing, quality of life, and inflammation status. A repeat assessment was done at the end of the 12-week training session. All parameters showed significant improvement at the end of the 12-week period. “We found that yoga can be a simple, cost-effective method that can help improve quality of life in patients with COPD,” stated Dr. Guleria. Iron proposed as cause of heart failure in many heart attack patients Indiana University School of Medicine, November 2 2022. A study published in Nature Communications revealed the discovery of a cause for chronic heart failure that occurs in approximately half of the people who experience a heart attack. “For the first time, we have identified a root cause of chronic heart failure following a heart attack,” lead researcher Rohan Dharmakumar of Indiana University School of Medicine's Cardiovascular Institute announced. Using large animal models, the research team found that in heart attacks in which bleeding within the heart muscle occurs upon restoration of circulation, scar tissue is gradually replaced by fat. The inability of fat to effectively propel blood from the heart can lead to heart failure in survivors of this type of heart attack. “Using noninvasive imaging, histology and molecular biology techniques, and various other technologies, we have shown that iron from red blood cells is what drives this process,” Dr Dharmakumar reported. “When we removed the iron, we reduced the amount of fat in the heart muscle. This finding establishes a pathway for clinical investigations to remedy or mitigate the effects associated with iron in hemorrhagic myocardial infarction patients.” The finding led to a clinical trial to determine the effect of iron chelation therapy to remove excess iron in patients with hemorrhagic heart attack. “While advances across populations have made survival after a heart attack possible for most, too many survivors suffer long-term complications like heart failure,” Indiana University's Cardiovascular Institute physician director Subha Raman, MD noted. “Dr Dharmakumar's breakthrough science illuminates who is at risk and why and points to an effective way to prevent these complications.” DHEA supplementation associated with improved sexual function in women Center for Human Reproduction (New York), October 6, 2022 A report published in the journal Endocrine revealed improvements in sexual function among older premenopausal women who supplemented with the hormone dehydroepiandrosterone (DHEA). In their introduction to the article, authors Vitaly A. Kushnir of the Center for Human Reproduction in New York and colleagues describe their use of DHEA in the treatment of infertile women who had low levels of androgen hormones. “In the process of treating thousands of so-affected infertile women, we noticed that many spontaneously reported improvements in libido, sexual desire and, sometimes, even pain status, leading to the paradoxical situation of women refusing to discontinue DHEA supplementation once they conceived,” they remarked. “When we, in a review of the literature, were unable to find a study that investigated the effectiveness of DHEA on female sexuality in older premenopausal women, this study was developed.” The study included 50 infertile premenopausal women whose age averaged 41 years. The participants supplemented with oral DHEA for a minimum of six weeks prior to starting any other fertility treatments. Serum androgen hormone levels, including DHEA and testosterone, were shown to increase following DHEA supplementation. In comparison with pretreatment scores, FSFI index scores improved by 7%, including a 17% increase in desire, a 12% increase in arousal, and an 8% increase in lubrication. However, among women whose scores were among the lowest 25% of the group, total FSFI scores increased by 34%, which included a 40% increase in desire, a 46% increase in arousal, and a 33% increase in lubrication. Women in this group also experienced a 54% increase in orgasm, greater satisfaction, and less pain in comparison with pretreatment values. Trauma during childhood triples the risk of suffering a serious mental disorder in adulthood, study finds Hospital del Mar Medical Research Institute (Spain), November 2, 2022 A study led by researchers at the Hospital del Mar Medical Research Institute links psychological trauma in childhood with an increased risk of developing some kind of mental disorder years later. Suffering psychological trauma during childhood significantly increases the risk of developing a mental disorder in adulthood. Specifically, as much as three times, according to a recent study, published in the journal European Archives of Psychiatry and Clinical Neuroscience. The study analyses the fourteen reviews and meta-analyses published to date in specialized journals on this issue, and is the first to take into account the full range of existing mental disorders. In total, the studies analyzed incorporate more than 93,000 cases, revealing a direct link between suffering psychological trauma at a pediatric age and the risk of developing a mental pathology later in life. “It is the strongest evidence to date that psychological trauma really is a risk factor for suffering a mental disorder later on,” says Dr. Benedikt Amann, lead author of the study The most common childhood traumas are emotional, physical and sexual abuse, as well as emotional or physical neglect and bullying, although there are many others. Suffering one of these situations damages the brain, causing physical as well as psychological consequences in the form of various disorders. In the case of emotional abuse, the most frequent trauma is associated with the most prevalent disorder in the population, that of anxiety. But there is also a relationship between childhood trauma and other pathologies, such as psychosis, which is linked to all traumas, obsessive-compulsive disorder or bipolar disorder. The risk of suffering from borderline personality disorder increases up to fifteen times in the case of having experienced trauma during childhood. Trauma in adulthood is also associated with a four-fold increase in the risk of a later mental disorder. The researchers point out, however, that there is less evidence for this type of pathology.

Chadi hosts Dr. Neal Shore, a urologic oncologist who became heavily involved in GU oncology research – including trials that incorporate systemic chemotherapy. Dr. Shore has a unique practice where he and his staff deliver chemotherapy when appropriate. Chadi was intrigued by this setting as medical oncologists are the ones customarily delivering chemotherapy, and invited him to the show to share how this all started, its pros and cons, and the impact on patients. Dr. Shore explains how the field has seen drastic changes since the early 1990's, why he decided to spearhead bringing clinical research into his community clinic, and how his clinic is staffed and structured to support a functioning and successful research hub. Then, the discussion pivots to his recently published clinical trial, ENACT, and the controversy surrounding use of enzalutamide monotherapy in low- or intermediate-risk prostate cancer. There's been so much controversy and backlash about the ENACT trial that Chadi had to ask him about it and his reaction to what happened when the article was published. View Dr. Shore's recently published ENACT study in JAMA Oncology. https://jamanetwork.com/journals/jamaoncology/fullarticle/2793567 Check out Chadi's website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on Youtube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA