Podcasts about john theurer cancer center

“Everyone's brain is extremely heterogenic, so it's different. You can put five of us in a room; we can all have the same diagnosis of a [glioblastoma multiforme], but all of ours can be different. They're highly aggressive biologically. It's a small area in a hard shell. So trying to get through the blood–brain barrier is different. There's a lot of areas of hypoxia in the brain. There's a lot of pressure there. The microbiology is very different—it's a cold environment versus a hot environment—and then the pathways are just different,” Lori Cappello, MSN, APN-C, CCRP, research advanced practice nurse at the John Theurer Cancer Center of Hackensack Meridian Health in New Jersey, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about brain malignancies and caring for patients with them. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by April 25, 2027. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to brain malignancies and their diagnosis and treatment. Episode Notes  Complete this evaluation for free NCPD.  ONS Podcast™ episodes: Episode 235: Self-Advocacy Skills for Patients Episode 166: Cognitive Behavioral Interventions Help Patients With a Spectrum of Cancer Symptoms ONS Voice articles: Glioblastoma Diagnosis, Treatment, Side Effect Management, and Survivorship Recommendations Blocking Fatty Acid Storage May Induce Glioblastoma Apoptosis Brain Tumor Navigator Role Bridges the Intersection of Cancer and Neuroscience Researchers Tie More Cancers, Mortality to NF1 Disorders Larotrectinib and Other Tumor-Agnostic Targeted Therapies Are Leading Cancer Care Into the Next Frontier McCain Announcement Sheds Light on Nurses' Role in Advance Care Planning ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition) Clinical Journal of Oncology Nursing articles: Implementing a Standardized Educational Tool for Patients With Brain Tumors Undergoing Concurrent Temozolomide and Radiation Therapy Exercise Intervention: A Pilot Study to Assess the Feasibility and Impact on Cancer-Related Fatigue and Quality of Life Among Patients With High-Grade Glioma Society for Neuro-Oncology Musella Foundation End Brain Cancer Initiative Brain Tumor Network American Brain Tumor Association Glioblastoma Research Organization Brain Tumor Funders' Collaborative Optune Gio® website Nurse.org article: Mysterious Brain Tumor Cluster Grows: Another Nurse Diagnosed at Newton-Wellesley Lori Cappello's contact information: lori.cappello@hmhn.org To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “A glioblastoma actually is the most predominant brain tumor that we do see. It is the most diagnosed of the brain tumors. And then I would say that an anaplastic astrocytoma is probably the second diagnosed. Historically a GBM, they used to say was probably an elderly patient for these. But we are definitely seeing it diagnosed at a much younger age now, definitely much more prevalent for people under 60.” TS 3:17 “Nine times out of ten, either a patient out of nowhere has a seizure, or they present with what they think are stroke-like symptoms. They noticed that they were slurring, or they were becoming more forgetful, or a family member noticed it and said, ‘Hey, what is going on with you?' But usually they present to the [emergency department], and a [computed tomography] scan is always done first. And lo and behold, something is seen.” TS 4:50 “The only other U.S. Food and Drug Administration-approved treatment that has come along in the last 20 years is a device called Optune Gio, which is an alternating electric field that stops cell division at the mitosis stage.” TS 7:45 “They lose so much of their independence, especially if they don't have a caregiver or help. That is huge. Medication management at home, to making sure that they're taking the medication properly, that they are actually taking their medication. Transportation is another huge problem. Getting to and from appointments is a challenge. Those are big issues—real, day-to-day, simple issues that people don't think about.” TS 17:11 “I think that having a brain tumor is very unique in the fact that you really need a dedicated neuro-oncologist. And depending on where you live, there are not a lot in the area. I actually had a patient that was moving out west, and the closest dedicated neuro-oncologist was four hours from them. … if you're not seeing dedicated neuro oncologists, you might not be getting the best treatment for yourself. So I think that having the resources and helping patients find the best care or the best brain tumor society—and there's a bunch of really good brain tumor groups to help patients find the best resources out there. I think that's really, really important for patients to know or for families to know.” TS 19:17 “So trying to help patients, there are always going to be challenges, and there are always going to be ups and downs. But finding that one person that they can go to, that they trust, that they have a great relationship with, whether at the doctor's office or whatever, and being available to them makes such a difference in their journey. I think that that is the most important for anybody in the journey.” TS 22:08 “With brain, there are going to be expectations. They are going to lose functionality at some point—and preparing them for that thing or preparing them for things that can help themselves. Like sometimes I say, ‘Go to the dollar store, get coloring books,' if they have weakness in one hand. Little tricks of the trade that can help them. About treatment options, going through the side effects, preparing them for whatever they can be prepared for.” TS 22:39 “It is not one of the better cancers to have, but it doesn't immediately mean it's a death sentence, and we shouldn't treat them like they're dying. We shouldn't take away their ability to live just because they were diagnosed with it. We shouldn't take away hope.” TS 25:35 “I think there's not enough discussed about [brain malignancies] and the lack of resources for this. These patients need a lot more resources and are available. There's just not enough available for it.” TS 26:59

In today's episode, we had the pleasure of speaking with Andre Goy, MD, about key updates from the 2024 ASH Annual Meeting. Dr Goy is physician in chief of Hackensack Meridian Health Oncology Care Transformation Services, as well as the chairman, chief physician officer, and chief of the Lymphoma Division at the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey. In our exclusive interview, Dr Goy discussed top hematologic oncology research conducted by his colleagues at the John Theurer Cancer Center and his predictions for the future of the field in 2025 and beyond.

Today we are bringing you a conversation between 3 experts on paroxysmal nocturnal hemoglobinuria (PNH). Ryan Haumschild, PharmD, MS, MBA, vice president of Pharmacy at Emory Healthcare and Winship Cancer Institute, spoke with Jamie Koprivnikar, MD, of John Theurer Cancer Center; David Dingli, MD, PhD, of Mayo Clinic; and Brian P. Mulherin, MD, of American Oncology Network. The topics of conversation for today's podcast include the pathophysiology of PNH, complement inhibitors, treatment strategies, and the challenges of managing this rare, life-threatening disorder.

In a discussion with CancerNetwork® at John Theurer Cancer Center, Gregory Charak, MD, highlighted advancements in surgical treatment strategies for patients with colorectal cancer (CRC) as well as other ongoing challenges in the field. Specifically, Charak, a board-certified colorectal surgeon at Palisades Medical Center and Hackensack University Medical Center of Hackensack Meridian Health, described how minimally invasive strategies such as laparoscopic and robotic surgery have become more prevalent in the field, which have appeared to confer improvements in pain and length of hospital stay for patients. Although these minimally invasive techniques are typically preferred in this population compared with open surgery, Charak stated that he would still employ the latter depending on factors such as tumor size. Charak also discussed the rise in CRC incidence among younger populations, which has impacted how practices conduct screening. He highlighted that patients who are in their late 20s or 30s receive recommendations to undergo colonoscopy in the event of weight changes or blood appearing in their stool, noting that he would not hesitate to perform screening even if there's a small but real possibility of disease. Regarding other treatment modalities in this population, Charak emphasized the potential benefits of neoadjuvant therapy. Administering neoadjuvant treatment with agents including cytotoxic chemotherapy and immunotherapy, for example, may help achieve negative-margin resections, thereby yielding less morbidity for patients. “It's a very exciting time to be a surgical oncologist. [There are] tremendous new treatment modalities coming down the pike. Immunotherapy, in particular, is extremely exciting because it's such an elegant way to treat cancer: to harness and augment the body's own defense system to eliminate a cancer rather than using cytotoxic chemicals or invasive surgery,” Charak said. “It's a beautiful thing. If we can get it to apply to more and more tumors and figure out how to make it work, it couldn't be more exciting.” 

In a conversation with CancerNetwork® at John Theurer Cancer Center, Timothy Chen, MD, highlighted various novel treatment strategies that have impacted his care of patients with brain tumors and other types of cancer.  Chen, a board-certified radiation oncologist and medical director of the Central Nervous System Program at Jersey Shore University Medical Center and the director of Proton Therapy in the Department of Radiation Oncology at Hackensack Meridian Health, first discussed his use of the novel stereotactic radiosurgery modality ZAP-X for patients with brain tumors. According to Chen, this tool may allow for practices to administer radiation at submillimeter precision, which can spare normal tissue from receiving excess radiation. Another technology that Chen highlighted included GammaTile, a radiation treatment that was developed for the management of brain tumors. He said that this collagen tile may help with administering strong radiation to precisely where the tumor is located, while also protecting healthy tissues to minimize the adverse effects from radiation therapy. Specifically, Chen stated that GammaTile may be beneficial for those with larger, difficult-to-treat tumors. Finally, Chen discussed the potential applications of proton therapy and how it may improve outcomes in patients compared with standard radiotherapy. According to Chen, proton therapy serves a “great purpose” with what he described as a precise depth charge that can minimize toxicity during treatment.  Additionally, Chen described how proton therapy may help reduce the probability of developing mutations or secondary cancers among pediatric patients. He highlighted the potential benefit of this modality based on a specific case in which a pediatric patient with myxopapillary ependymoma experienced improvements in pain and urinary control following proton therapy. Regarding these novel forms of therapy, Chen emphasized the notion of multidisciplinary care and said that practices should “work together as a team” when operating these technologies. “[With] all this technology, it's not just used as it is; the technology brings us to work together,” Chen said. “I think multidisciplinary care is the future. People are no longer siloed…. We all work together.” 

Drs Gutierrez and Leslie discuss common barriers that institutions face when implementing CAR T-cell therapy programs, the early success story of outpatient administration of this modality at John Theurer Cancer Center, and future considerations for using this treatment approach in solid tumors.

In this latest episode of ASTCT Talks, Christina Cho, MD, interviews Lori Muffly, MD, MS. During the conversation, Dr. Muffly emphasizes the need for more randomized data in ALL treatment and addresses the unique challenges of treating young adults, including fertility preservation. Dr. Muffly also emphasizes the significance of measurable residual disease (MRD) monitoring using the clonoSEQ® Assay, offering valuable insights into leukemia care. About Lori Muffly, MD, MS Lori Muffly, MD, MS, an Associate Professor of Medicine at Stanford University, specializes in adult acute leukemia research, clinical trials, and hematopoietic cell transplantation. Her work focuses on improving cancer care access and reducing disparities in young adults with acute lymphoblastic leukemia. Dr. Muffly leads multiple health outcomes studies and clinical trials, including research on measurable residual disease, CAR T-cell therapies, and real-world outcomes for adult acute lymphoblastic leukemia patients. She has a history of successful collaboration with fellow researchers and is a sought-after national speaker on adolescent and young adult leukemia and cancer care access. About Christina Cho, MD Christina Cho, MD is a hematologist/oncologist specializing in adult stem cell transplantation and cellular therapy at Hackensack University Medical Center's John Theurer Cancer Center. Dr. Cho conducts clinical research on stem cell transplantation, including therapies for leukemia and sickle cell disease. She is an active member of the American Society of Hematology and the American Society for Transplantation and Cellular Therapy and currently serves as editor for ASTCT Nucleus.

Dr Danish discusses barriers to using radiotherapy for the treatment of patients with metastatic lung and bone cancers; the novel capabilities of SCINTIX biology-guided technology; and how John Theurer Cancer Center plans to use this technology and help advance its role in the field of radiation oncology.

  “I think the take-home message here, though, is to have very specific guidelines at your institution to manage both CRS and ICANS. The protocols should be readily available to all practitioners who may participate in the care of these patients,” ONS member Phyllis McKiernan, MSN, APN, OCN®, advanced practice provider at the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS. McKiernan's and Taylor's conversation centered around the nurse's role in recognizing and managing toxicities related to CAR T-cell therapy for hematologic malignancies, specifically ICANS and CRS, which was an educational priority that ONS members identified during two ONS focus groups on the topic in March 2023. McKiernan was one of the content experts for those focus groups.  This podcast episode is produced by ONS and supported by funding from Janssen Oncology/Legend Biotech. ONS is solely responsible for the criteria, objectives, content, quality, and scientific integrity of its programs and publications.   Music Credit: “Fireflies and Stardust” by Kevin MacLeod   Licensed under Creative Commons by Attribution 3.0    Episode Notes  NCPD contact hours are not available for this episode.  Oncology Nursing Podcast episodes: Oncologic Emergencies 101 series Episode 261: CAR T-Cell Therapy for Hematologic Malignancies Requires Education and Navigation Episode 139: How CAR and Other T Cells Are Revolutionizing Cancer Treatment Episode 1: Experiences With CAR T-Cell Therapy ONS Clinical Practice Resources: Chimeric Antigen Receptor T-Cell Therapy: A Timeline of Events and Adverse Events Cytokine Release Syndrome ONS Clinical Update: Focus on Clinical Experiences With CAR T-Cell Therapy ONS course: Nursing Considerations for CAR T-Cell Therapy for Patients With Hematologic Malignancies: Patient Education and Symptom Management ONS Huddle Card™️: Cytokine Release Syndrome ONS Immuno-Oncology Learning Library ONS videos: CAR T-Cell Therapy Cytokine Release Syndrome American Cancer Society American Society for Transplantation and Cellular Therapy Grading Scale for CRS and ICANS Leukemia and Lymphoma Society  Multiple Myeloma Research Foundation  National Institutes of Health's National Cancer Institute Risk Evaluation and Mitigation Strategies   To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.   To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.   Highlights From Today's Episode  “All symptoms need to be investigated fully to determine their cause and thus the best management strategy and not just simply assume that they're related to CAR T.” Timestamp (TS) 9:21   “Accurate grading is really crucial to ensure that the toxicities are identified and managed consistently across the institution.” TS 10:52  “Once the patient shows signs and symptoms of neurotoxicity, they should have a comprehensive neurologic examine, and that should include, a neurology consult, maybe imaging, such as an MRI or CT, and perhaps even a lumbar puncture.” TS 14:12  “Letting patients and their families know what next steps are can alleviate anxiety and give the patients the confidence that the medical team is familiar with these toxicities. And let them know that these toxicities are expected and that there are protocols in place to manage these symptoms.” TS 22:56  “I think that some patients, and even healthcare professionals, who aren't familiar with CAR T believe that the toxicities are always severe and always irreversible. When, in reality, most of the toxicities are mild and managed with minimal intervention or even just supportive care.” TS 23:55   “Early detection, consistent grading, vigilant monitoring, and standardized care plans are crucial to the success of any CAR T program and can also help reduce the risk of the severe adverse effects and hopefully improve outcomes for our patients.” TS 30:26 

This episode is Research Review, a quarterly review of the research you may have missed. Today, we are covering the American Society of Hematology Annual Meeting highlights. First Up, results from the ECOG-ACRIN E1910 Randomized Phase III clinical trial showed that blinatumomab improved overall survival in newly diagnosed adult patients with b-lineage acute lymphoblastic leukemia. First author of this new research, Mark Litzow, MD, from the Mayo Clinic in Rochester, MN, talked with journalist Peter Goodwin at the ASH Annual Meeting. They discussed the use of blinatumomab in patients whose initial therapy for acute lymphoblastic leukemia had achieved minimum residual disease—MRD (Abstract LBA-1). Next, researchers explored the potential of using genomic DNA and RNA profiles in a machine-learning algorithm to predict which patients with acute myeloid leukemia or advanced myelodysplastic syndrome will respond to venetoclax-based therapy (Abstract 2789). Maher Albitar, MD, discussed the findings. Moving on, the downside of curative therapy for Hodgkin's lymphoma was under discussion at ASH. The conference heard about “epigenetic age” and neurocognitive function in young adults previously treated for Hodgkin's disease. OncTimes Talk correspondent Peter Goodwin asked first author of a report on this, Annalynn M. Williams, PhD, from the University of Rochester, in New York, about the impact of standard treatments on the subsequent lives of children (Abstract 902). Finally, we interviewed James McCloskey, MD, from the John Theurer Cancer Center at Hackensack University Medical Center, about the results of the V-Mast study showing the value of combining CPX-351 with midostaurin for high-risk acute myeloid leukemia. In this Phase III study in older adults with newly diagnosed, high-risk/secondary AML, CPX-351 significantly improved overall survival and remission rates versus conventional 7+3 chemotherapy, with a comparable safety profile (Abstract 1436).

The Healthcare Leadership Experience is hosted by Lisa Miller for health leaders who want to think differently and learn how to improve their performance. On this episode, Jim Cagliostro is joined by Walter ‘'Buddy'' Elliott, a nurse practitioner for the phase one cancer clinical research program for Hackensack Meridian Health, to explore the reality of life as a nurse practitioner.       Episode Introduction    The role of a nurse practitioner has changed in recent years. In this episode, Jim Cagliostro, VIE's Clinical Operations Performance Improvement Expert, interviewed Walter ‘'Buddy'' Elliott to discuss the benefits of previous ‘'hands-on'' nursing experience for nurse practitioners, the critical role they play in enhancing the patient experience, and the support they offer physicians.    Show Topics    ‘'Bedside nursing'' experience is essential for nurse practitioners Identifying prospective patients for clinical trials The indepth knowledge required of cancer studies From cost savings to better patient care  Drawing on the expertise of more experienced nurses Nurse practitioners enhance the patient experience Achieving formal qualifications through multiple routes     Show Links   04:35 ‘'Bedside nursing'' experience is essential for nurse practitioners Based on his personal experience, Walter said hands-on nursing care provides vital experience for nurse practitioners.    ‘'I definitely feel it is essential as a nurse practitioner to have had experience in nursing because as a floor nurse, you have increased access to being able to see how care is carried out. From the orders that are placed and the management of the patients' care, being able to watch a patient's vitals and how a patient is reacting to a certain treatment and being that first line of being able to counter anything that would be negatively impacting the patient. Being able to have the access of seeing multiple different types of disease processes and modalities of care, I think definitely increases the experience for a nurse practitioner to be able to draw off of. So I definitely feel it is important to have had a couple of years or more of nursing, hands-on nursing care, before pursuing nurse practitioner roles just because it allows you to have that experience.''     06:21 Identifying prospective patients for clinical trials   Walter outlined his involvement as a nurse practitioner in identifying patients for clinical trials.    ‘'Well speaking for myself personally, in research, my role as the nurse practitioner whenever a prospective patient is identified or referred to our program, my job is to help identify the appropriate enrolling study for their disease process and then to help evaluate their eligibility based off the criteria of the prospective trial. We work primarily in solid tumors so anything such as non-small cell lung cancer, colorectal cancer, those being examples of disease processes that we see, I help look at what's available for them because trials open and close based off of how many they've been able to enroll in a cohort and then I can say, "We have these three open trials that would be available for you. We would like you to review the consent, the process, of what you would be undertaking in this clinical trial." And then meet back up with the patient in the screening process to determine whether they would like to sign and then go on from there.''     08:18 The indepth knowledge required of cancer studies Walter outlined the complex nature of working as a nurse practitioner on cancer treatment trials.    ‘'I definitely feel now that there are a number of different roles that a nurse practitioner is able to help fill. The research role is in and of itself a different avenue that beforehand I wasn't aware of but intrigued me as I became more aware of what the position entailed, mainly because of the in-depth knowledge that's required of the available studies. What the study is comprised of, what the treatment modality is, what's being investigated, what criteria has been set up to find a patient. Sometimes there can be a criteria that's very restrictive and it's only a very small subset of people with a particular disease process that would be eligible for. Sometimes they're any and all solid tumors that come in and so just being able to know what each study entails is essential for my role. And then being able to understand how that study would impact the patient and identify any issues that could arise during their care.''     12:11 From cost savings to better patient care Jim said that the role of nurse practitioner leads to fewer emergency room visits and more cost effective treatment.    ‘'In recent research that I've done and I've been talking with some of our clients, the studies have shown that nurse practitioners, and it's pretty obvious most people would know this, that nurse practitioners cost healthcare systems less. They're less expensive to see for the patient and for the healthcare system, so that overall helps to decrease the cost of healthcare services.   And then I know you don't want to toot your own horn but I'll brag on nurse practitioners in this way, another study showed that patients who saw nurse practitioners had fewer emergency room visits, had shorter hospital stays, and overall lowered the treatment of their cost. So there's a number of things. And that could be a whole other podcast about the benefits of having nurse practitioners as part of a health system.''     15:40 Drawing on the expertise of more experienced nurses Walter said continued access to a mentor can help nurse practitioners to grow in their role.    ‘'I'm working closely with a nurse practitioner that has been with the John Theurer Cancer Center phase one clinical trial department for a number of years. And phenomenal amount of knowledge and experience that I reap from her. And with my previous position as well, I have worked with senior nurse practitioners that are just incredible assets to their practice because of their wealth of experience and knowledge. I do think it's important that newer nurse practitioners be able to have that access. And I know that with the John Theurer Cancer Center, I've seen that at play with precessing opportunities and just newer individuals in the field being able to work with established nurse practitioners. I definitely feel like it helps us grow in the position to be able to draw from somebody who's in the field themselves, doing well in it, and providing safe care for patients. So I definitely think it's important for continued access to be a part of the curriculum. And then also, just as getting a mentor especially as you move into the field to be able to reach out to and say, "Hey, this is something new that I'm dealing with." Or, "How would you troubleshoot this situation."      18:53 Nurse practitioners enhance the patient experience Walter said the ability to expand access to patient care and offer solutions influenced his decision to become a nurse practitioner.    ‘'I was intrigued at the additional level of care that these individuals brought to the patients' experience. I noticed that they had more of an ability to connect with the patients, be able to meet their needs. And their ease of contact as a provider, they were able to work more closely with the nursing staff. Which in my own experience, I was grateful for, because I could easily call someone and know that they would be able to help me in a particular situation. They would be able to provide a solution more quickly due to their designated role, and spend more time educating which I felt was exceptionally important in the role. Especially, for instance, after an individual had gone through say a life-changing situation such as a stroke, this new debilitating issue that they had. Recent cancer diagnosis, after having gone through major surgery, the nurse practitioner was there to be able to reiterate and reinforce the education that would help the patient succeed. But then also reassure them as they were going through this process.''     21:49 Achieving formal qualifications through multiple routes Walter said the diverse options available are helpful for people who are already in a full-time role.  ‘'I would say more nowadays, you have multiple options which is helpful for a full-time working adult. In the proximity of where I live, there is a university that offers nurse practitioner programs. So not only did I myself went to an online program but some of my coworkers went to the brick and mortar school. And I would say while they did have the advantage of being able to have more of a personal interaction with their professors, it seemed like some of our outcomes were similar. We were all in charge of putting together our own clinical experience. I felt like a lot of my education came from being in the clinical experience, being able to utilize what I was not only learning but also being able to draw off the experiences of those that I was having my clinicals with who were there in the local community working. So there are multiple avenues that an individual can pursue.''     You'll Also Hear:   Walter's career path, from management degree to nurse practitioner, via positions as a floor and unit nurse, to nurse practitioner for a neurology group.    The critical role of a nurse practitioner in the management of clinical trials for cancer, ‘'I evaluate patients on their treatment visits to help address any needs that they may have, manage any symptoms, as well as identify any adverse events that could be associated with treatment. ‘'   Giving hope to cancer patients - how new technologies benefit the nurse practitioner's role ‘'Being on the forefront of new technologies that are coming out and seeing how they progress from phase one where they're first in humans to something that you're watching on television as being a new breakthrough treatment modality for a cancer that's bringing hope to people who are currently going through that process.''   How nursing practitioners can help to expand access to care for all. ‘'It's a benefit for the patient because now they don't have to necessarily wait until the physician is available to be able to call them back, answer their email, or see them in person.''   Why finding a mentor before pursuing a career as a nurse practitioner role brings clarity. ‘'There are multiple higher education roles that a nurse can pursue. Nursing education, like you said, nurse anesthetist. I would say try to find something that you feel more inclined to succeed in or love what you're doing….''     What To Do Next:   Subscribe to The Cost Advantage for Healthcare Leaders and receive a special report on 15 Effective Cost Savings Strategies. Learn more about the simple 3 step process to work with us. If you are interested in learning more, the quickest way to get your questions answered is to speak with one of our margin improvement experts. Schedule a call with our team here.

Today, Peg is joined by Heather Younker, RDN, CSO, a dietician at the John Theurer Cancer Center at Hackensack University Medical Center.  We cover all things related to Graft vs. Host Disease and diet. Nutrition is important for everyone, but especially those with GVHD, in order to prevent malnutrition and other issues.  Registered dieticians and nutritionists can be key in a multidisciplinary approach. It's important to keep your entire health care team in the loop so they can be aware of all issues. GVHD can present in many different ways and at any time.Symptom management is key for Heather and her coworkers.  This can be gastrointestinal issues related to GVHD, or side effects from various medications. Sometimes, this can cause a fear of eating, which can result in unhealthy weight loss and muscle mass. Sometimes food sensitivities can develop, such as one to lactose.  Maybe digestive enzymes are needed, or a change in diet.Oral care is also important, as GVHD can affect the mouth, teeth and throat.  Maybe softer foods are needed.  Maybe you'll need to stay away from acidic, citrus-ey foods.  Maybe pureeing foods can be helpful.   Heather even mentions a patient who pureed his whole breakfast of sausages, eggs and rice!Sometimes nutritional supplements like Ensure, Boost, or Orgain can be used to add calories and nutrients to the diet. And when it comes to smoothies, Heather prefers homemade to store-bought so that you can have more control over the ingredients.Hydration is important for everyone, but especially GVHD patients.   You need to moisturize your system inside and out, and there are many ways to do this besides just water.  Antioxidants found in fruits and vegetables are also key.Sometimes patients struggle with loss of appetite and other symptoms.  One way to ensure you're getting your needed calories, protein, vitamins, and other nutrients can be to eat smaller meals throughout the day instead of three large ones.  When your GVHD is active, you actually need more calories and nutrients.  And of course, exercise is key.Resources:Hackensack John Theurer Cancer Center: https://www.hackensackmeridianhealth.org/en/Services/Cancer-Care?fbclid=IwAR0ANqlbRxjJs_yJVG8YxzS9LW2YefeSBNzmmeJG85UyPZeVMM9KUbepY3QNational Institutes of Health (NIH) website: https://www.nih.gov/American Institute for Cancer Research: https://www.aicr.org/National Bone Marrow Transplant Link - (800) LINK-BMT, or (800) 546-5268.nbmtLINK Website: https://www.nbmtlink.org/nbmtLINK Facebook Page:  https://www.facebook.com/nbmtLINKnbmtLINK YouTube Page can be found by clicking here.Thank you to this season's sponsors:Pharmacylics: https://www.pharmacyclics.com/Janssen: https://www.janssen.com/Kadmon: https://kadmon.com/Sanofi: https://www.sanofi.com/

As part of its OncView™ video series, CancerNetwork® spoke with David H. Aggen, MD, PhD, of the Memorial Sloan Kettering Cancer Center, Robert S. Alter, MD, of the John Theurer Cancer Center, Arnab Basu, MD, MPH, of the O'Neal Comprehensive Cancer Center, Mehmet Asim Bilen, MD, of Winship Cancer Institute, and Chung-Han Lee, MD, MPH, of Memorial Sloan Kettering Cancer Center, who shared their thoughts on recent advances in treatment options for metastatic renal cell carcinoma (RCC) and commented on emerging data in the field. To watch more videos in the CancerNetwork® OncView™ series, visit cancernetwork.com/oncview.  Don't forget to subscribe to the “Oncology Peer Review On-The-Go” podcast on Apple Podcasts, Spotify, or anywhere podcasts are available. 

Cervical cancer is preventable and treatable when diagnosed early, but you must be proactive. The most important things you can do to prevent cervical cancer are to get the HPV vaccine if you are eligible and to undergo regular screenings, including Pap Tests and HPV tests. Dr. Mira Hellman-Ostrov, a board- certified obstetrics, gynecology and gynecological oncology specialist at John Theurer Cancer Center, Hackensack, NJ. discusses risk reduction, screenings and why the HPV vaccine matters.Fearless Fabulous You Radio Show is broadcast live at 12noon ET Wednesdays on W4WN Radio – The Women 4 Women Network (www.w4wn.com) part of Talk 4 Radio (www.talk4radio.com) on the Talk 4 Media Network (www.talk4media.com). This podcast is also available on Talk 4 Podcasting (www.talk4podcasting.com).

To claim CME credit, visit https://i3health.com/oda-itp Immune thrombocytopenia is an acquired immune-mediated disorder with no known cause. Effective management is limited by lack of specific diagnostic criteria and other current gaps in knowledge. This episode of Oncology Data Advisor will focus on advances in the treatment of relapsed or refractory immune thrombocytopenia. It features perspectives from two noted experts in the field: Dr. Keith McCrae, Director of Benign Hematology at the Cleveland Clinic Taussig Cancer Center; and Ms. Phyllis McKiernan, Advanced Practice Nurse in Blood & Marrow Stem Cell Transplantation at the John Theurer Cancer Center, Hackensack Meridian Health.

Steve Adubato and Mary Gamba are joined by John Devin, President, Fedway Associates, about the importance of innovation in challenging times, as well as fostering a culture of team building and mentoring with an organization. Then, Steve and Mary talk with Andre Goy, MD, Chairman & Chief Physician Officer, John Theurer Cancer Center, Physician in … Continue reading Lessons in Leadership: John Devin and Andre Goy

In this special series on careers in oncology, guest host Dr. Miriam Knoll, radiation oncologist at the John Theurer Cancer Center at Hackensack Meridian Health, interviews a wide range of oncologists who discuss their greatest challenges and the decisions that have shaped their careers. In this episode, we hear from Dr. Vinay Prasad, hematologist-oncologist, author, and associate professor of medicine at the University of California San Francisco, and host of the podcast, Plenary Session.  (This podcast was recorded while Dr. Prasad was at the Oregon Health & Science University School of Medicine).    TRANSCRIPT   Dr. Miriam Knoll: Welcome to the ASCO Daily News podcast. I'm Dr. Miriam Knoll, and I'm delighted to be the Daily News guest host for a special podcast series that explores the full spectrum of oncology careers.   Dr. Miriam Knoll: I'm an early career radiation oncologist. And in this series, I will bring you interviews with a wide range of oncologists to hear about their diverse experiences, their greatest challenges, and the unforgettable moments that have shaped and continue to shape their careers. In today's episode, I'm so excited to welcome my friend and colleague, Dr. Vinay Prasad, a medical oncologist and associate professor of medicine at the Oregon Health and Science University School of Medicine.   Dr. Miriam Knoll: He's also an author and host of the podcast, Plenary Session. Dr. Prasad and I report no conflicts of interest relevant to this podcast. Full disclosures relating to all Daily News podcasts can be found in our Episode pages. Dr. Prasad, welcome.   Dr. Vinay Prasad: Thank you so much, Miriam, for having me. It's a pleasure to be here with you.   Dr. Miriam Knoll: Amazing. So my first question is, I wanted to ask you when you first started off as an early career oncologists. And actually, you still are an early career oncologist. Would that be fair to say?   Dr. Vinay Prasad: I guess. I hope so. But I'm five years in the job. So take it for what it is.   Dr. Miriam Knoll: I guess it depends on the exact definition.   Dr. Vinay Prasad: Yes.   Dr. Miriam Knoll: But when you actually started in your first year, you already had a large following on social media. And you were very vocal then, and now, about how we should improve cancer care and cancer research. And you're the host of the very popular podcast, Plenary Session, which I was actually interviewing on about a year ago.   Dr. Vinay Prasad: Yes, you were a lovely guest. Yes.   Dr. Miriam Knoll: Thank you. And so my question is, did you ever consider then, and now, how social media could impact your early career?   Dr. Vinay Prasad: That's a great question. I guess I would say I didn't consider then. It has been a total surprise.   Dr. Vinay Prasad: And just to give you a little bit of background, I started on faculty in 2015. So it's my fifth year as a faculty member, and it's my first job out of fellowship. So listeners will decide if that's early or mid-career.   Dr. Vinay Prasad: But I went back and I looked at it. One of the first things I did as a faculty member was we did a paper that came out in JAMA Internal Medicine about financial conflicts of interest for doctors on Twitter, medical oncologists on Twitter. And in doing that project, we kind of based it off my Twitter account at the time. And it might surprise you to know that, at that time when I started, I had about 1,000 followers.   Dr. Vinay Prasad: So I think that's some following, but I don't know if that would be considered a large following. And from there to five years later, it really has kind of grown. And it surprised me that people are interested in the kinds of issues that I want to discuss, which are very technical issues about drug development, clinical trials, and medical evidence.   Dr. Vinay Prasad: And it kind of led me to think about doing something else, reaching out to people. And that led to the podcast, Plenary Session. And I guess I would say, the honest reason why I started making a podcast was, because I, myself, really enjoy listening to podcasts. I have a lengthy commute, and I listen to all sorts of shows. And I really do like shows that are done by technical experts, which also try to reach a broad audience.   Dr. Vinay Prasad: So shows that you know don't dumb things down, but also try to be accessible and engaging. And I thought that there will be some opportunity to do that in oncology. And we've been doing the show now for over a year, and it's been great.   Dr. Miriam Knoll: So would it be fair to say that you got involved in social media and continued to do it, because you were excited about it, and found it really interesting, and enjoyed it?   Dr. Vinay Prasad: I guess, I would say, yes. It's a mix of emotions, as you'll know from being on it. When I started, I think being-- the reason I opened a Twitter account-- and I'm not a social media type, and I don't have a Facebook page, and I'm not on Instagram.   Dr. Vinay Prasad: The reason I created a Twitter account was because somebody assigned it to me in a class. I was taking my MPH degree. And I think I spent a year or two years just kind of being a lurker, just kind of seeing what people are saying, and not even checking it all that frequently.   Dr. Vinay Prasad: But I kind of got pulled out of my shell, drawn into it a little bit, when one day a paper we had published, I noticed a bunch of academics were discussing it. And they were a little bit critical about some things, which I thought were an unfair criticism. And that's kind of what pulled me out, out of the shadows, and into the arena of the discussion on social media.   Dr. Miriam Knoll: Wow, that's a great story. Would you say that social media has helped your career?   Dr. Vinay Prasad: That's a good question. I think it is a double-edged sword. It has certainly helped in many ways, which is that you're invited to give a lecture, or go talk to somebody.   Dr. Vinay Prasad: It's led to a collaboration with people with whom I never would have worked with. We published papers. So there are all these ways in which it connects you to this community of oncologists. So that's all the plus side of it.   Dr. Vinay Prasad: I think the minus side of it is people think of me as a social media person, and maybe for better or worse, they think of me as somebody who does that kind of stuff. But that may mean that they're likely to ignore that I do a lot of academic work too, and published a few hundred papers, and have two peer review books in the academic literature. And so I think it can be used as a tool to disparage or trivialize something you're doing. And so I think that's why it kind of cuts both ways.   Dr. Miriam Knoll:  That's very interesting. I hadn't thought about it that way. But I wonder if that's an impression that someone who is not involved in social media would have, and not something that someone who is involved would think.   Because I can't imagine anyone thinking that about you. But then again, maybe that person who would think that has never been on Twitter before, so doesn't actually know what it's about. You know?   Dr. Vinay Prasad: I agree. I think there a lot of people who aren't on Twitter who have misconceptions about it. But I'll just give you one good example, which is Bob Califf, who is the former Commissioner of the FDA, a senior cardiologist; he just wrote an editorial in a cardiology journal critical of the Kardashians, he calls it, which are people who have far more Twitter followers than they have cumulative career citations.   Dr. Vinay Prasad: And I guess even though I've published a lot of papers, I'm in that camp. Because cumulative career citations only accrue on the order of decades, and Twitter followers come much more rapidly. And so the whole Kardashian index, I think, is a term that people have created to disparage and criticize the changing power dynamics that have happened through social media. It's a fictitious invented scale that accomplishes that goal.   Dr. Miriam Knoll: Yeah. Well, I think this is a discussion that we should definitely continue. But I just have so many other questions to ask you about jobs. But before we go to the next question, I just want to make sure that you and I clarify that we don't think that's the case, right?   Dr. Vinay Prasad: Yeah. And I think the benefits certainly outweigh any negative ideas that someone who has no idea about anything about social media may think about it.   Dr. Vinay Prasad: Social media, it's-- what all scientists want, what all you know academics want, is for their ideas and the work they're doing to reach the broadest and most receptive audience. And this is just a tool, perhaps the most powerful tool we have, that accomplishes that goal. And so anyone who's sort of anti-social media I think is missing the printing press of the modern age. And in retrospect, they're not going to do so well in the history books.   Dr. Miriam Knoll:  I could not agree more. And I think also that some of the hesitation that people have to using it is because their only exposure to social media is the Kardashians. So they haven't met people like you who are sharing real data and thought-provoking information that they can't find anywhere else. So it's even beyond the typical printing press, because you can share information that there's really no other platform for.   Dr. Vinay Prasad: That's a great point, yeah.   Dr. Miriam Knoll:  Tell me about the process of changing jobs and academic centers. Because, congratulations, I heard that you're going to be switching over to UCSF. So I'd love to hear about that transition for you.   Dr. Vinay Prasad: Oh, thank you. Yeah, I guess I'm still in the midst of it, because I haven't finished packing my desk here, but it's imminent. It's going to be happening in the next eight weeks or so.   Dr. Vinay Prasad: I guess I would say that the biggest question that faces a researcher is-- actually, let me pause. Let me actually start by something that somebody told me. When I took my first academic job, I had a very senior faculty member at the NCI, where I did my fellowship, pulled me aside and say, congratulations on your job. That's a great five-year job.   Dr. Vinay Prasad: And I said, excuse me? What do you mean, a five-year job? And he said, think about the first academic job as-- not in everybody, but in many people-- people work in that job four or five years, and they end up making a switch. And it won't surprise me if you're one of those people.   Dr. Vinay Prasad: And I thought it wouldn't happen to me-- absolutely not the case. It's not going to happen to me. I didn't see that in my future.   Dr. Vinay Prasad: But nevertheless, five years later, this person's words rang really true. And I guess I would say that the process of switching jobs or thinking about that has to do with you really want-- you really reach a point where you have a clear sense of what you want to do, what you aspire to do, and what you hope to do in the future, what you're good at doing, and you also know what you're not good at doing. I think that comes out in the first few years of a job.   Dr. Vinay Prasad: And that's a time where you might think to yourself, you want to be at a place where your goals and the central goal of the organization or the institution are really aligned. And you see opportunity for growth, opportunity for collaboration, you see that what you do is going to be really valued and respected. And so at the end of the day, what I want to do is oncology policy work, work that aligns cancer medicine with I think patients' best interests. I also enjoy teaching and working with trainees. And I really felt like UCSF is a place with just such a strong, strong history of doing all those things-- a huge policy group, a really strong program of education, and really strong training in epidemiology and bio statistics, which is the department that I'm joining.   Dr. Miriam Knoll: So you shared with us what the mindset would be for switching jobs. What about the nitty-gritty? Is it generally someone reaches out to you, you reach out to someone else? What advice would you have to other early career or even at any point in someone's career? And how does that work?   Dr. Vinay Prasad: I think that's a great question. I guess I'd say, the nitty-gritty is when you in your mind start to open your mind up to the possibility of looking for another job. So for me, I don't even-- my mind was not even open to that for the first 3 and 1/2, four years even.   Dr. Vinay Prasad: Then I think you start taking a look at job post websites. You start looking on institutional websites. You start listening to word of mouth, what different divisions or groups are looking for. And you get wind of jobs here or there.   Dr. Vinay Prasad: And I think it's reasonable that, even if you're not super serious about leaving, to go on some interviews. You don't know what's out there unless you go look. And it's a long process.   Dr. Vinay Prasad: In my case, it was like over, I don't know, maybe about a year from-- maybe over a year-- from my first toe in the water to actually committing to make the move. And so I think it is kind of a slow process. But in my mind, the mental attitude to consider it is the first step.   Dr. Vinay Prasad: And then the logistics of it is just to keep an eye open. But nobody approached me in this particular situation. Although, I'm aware, and I've heard, that there are people who get approached with job offers, but that wasn't my case.   Dr. Miriam Knoll: That's really, really great advice. So thank you for that. Can you tell us about your second book, which I've already preordered on Amazon?   Dr. Vinay Prasad: Thanks.   Dr. Miriam Knoll:  What advice can you give our listeners about the process of writing a book and becoming a published author?   Dr. Vinay Prasad: So you're referring to the book, called Malignant.   Dr. Miriam Knoll: Yes, Malignant.   Dr. Vinay Prasad: And I learned a lesson from the first book, Ending Medical Reversal, which needs a punchier title. So Malignant is really everything I know about cancer policy in one book. I guess, let me separate the two again-- so the process of doing the book and the reason why you might want to write a book. So I guess, let me take the process one.   Dr. Vinay Prasad: The process is, it's a long process to write a book. And you'll see when you read this book, and you'll read something in the chapter that I've written, and it says, "at the time of this writing, 2017," and you're going to say, boy, it's 2020 now. But that's really how long the process takes. It takes several years.   Dr. Vinay Prasad: The process of writing a book is you have to, I think, first, have a clear idea of what you want to talk about, what you want to write. Second, you've got to draft a proposal, which is very different than a book itself. It's kind of a succinct summary of what you hope to do.   Dr. Vinay Prasad: Third, you have to find an agent, which can take on the order of years. And then the fourth thing is you have to sell the book to a publisher, which can take on the order of years again. And then you've got to write it, which is the most important, but often the shortest period of time. And then you got to edit it, and proof it, and all those sorts of steps.   Dr. Vinay Prasad: And in my case, I have a publisher that is a peer review publisher. So this book is peer reviewed in triplicate, which adds, just like an academic article, all that back and forth peer review. So it's time-consuming. So that's the process of how to do it, and it takes, I think, a long time.   Dr. Vinay Prasad: But let me talk about the reason why to do it. I think you write a book when you have something to say that you just can't say more succinctly. And in my case, for years we've been working on so many different spaces that seem like they're not interconnected.   Dr. Vinay Prasad: So we then work on financial conflict of interest. We'd done work on how the FDA approves drugs with the use of surrogate endpoints, the control arms of clinical trials, crossover. We have done work on the cost of cancer drugs, and how Medicare reimburses for it.   Dr. Vinay Prasad: And so it seems like these are projects all across cancer medicine, but they're like intertwined braids, and they tie together. And when you twist them all together, I think you start to see the full story of why the system is set up the way it is, and how so much cancer policy fails, I think, people with cancer. And so me writing the book was a recognition that I was never going to persuade people. I was never going to get people to see this whole tapestry until I got all the strands and tried to weave them together in front of you.   Dr. Vinay Prasad: And so that was why I wrote the book. And I guess I would say, when you want to talk about writing a book, I think you have to realize that a book is an intermediary endpoint. It's a surrogate endpoint of itself.   Dr. Vinay Prasad: The goal of the book is so that there are people out there who will read this, and I think it'll change the way they see cancer medicine. That's the goal. And the book is just a vehicle to do it.   Dr. Miriam Knoll: I cannot wait to read it. And I'm hearing you speak, and it's echoing a conversation that you had on Plenary Session. It was a few weeks ago. I forget which episode it was.   Dr. Miriam Knoll: But it was about careerism, and the idea that you write papers because you have something that you want to say, not because you want to write papers.   Dr. Vinay Prasad: Right, that's an important thing, yeah. I'm a vocal critic of this careerism movement that I see all around me. Dr. Miriam Knoll:  Do you think that it's a new movement?   Dr. Vinay Prasad: I think it's been-- I guess I'm so new myself. I don't know if it's always been there. But I think it's been amplified in a way that is unprecedented. And it's amplified, I think, in part-- social media, of course, a double-edged sword. It also amplifies careerism.   Dr. Vinay Prasad: And just for your listeners' sake, let me separate the two things. So there are the things you want to do in life, and there is the things you do for your career. And to me, careerism is advice about careers.   Dr. Vinay Prasad: That is, how can I give more lectures? How can I have more followers? How can I sit on panels? How can I be a consultant for pharmaceutical companies? How can I network? How can I be successful?   Dr. Vinay Prasad: Those are all sort of the arbitrary brass rings that people chase. And I think that they're all misguided. Because the more and more you talk about how to achieve those goals, you miss the entire purpose of the whole enterprise, which is, what do you want to accomplish? What issues matter to you? What topics interests you? What skills do you uniquely bring to them? Is your work accurate or truthful? Does your work matter? Is this what you want to do with your life? Those are the real questions, I think, that define our career. You have to think, what are you passionate about, and what can you do that others can't do? And then you just do it. Dr. Vinay Prasad: And if along the way you get these rewards of you give lectures, you get the invited consultancies, you get all that stuff, so be it. But if you don't get it, you shouldn't feel bad at all if what you're doing is what you really want to do. And if what you're wanting to do is challenging, I think, the status quo, then don't be surprised if you don't get it, you get some pushback. But I think that's something worth taking on, that's worth fighting for, if what you're doing is what you believe you ought to do with your career and your life.   Dr. Miriam Knoll:  I totally agree with you. And I think that people who really understand that are less likely to separate their life into their work life, and their life life, and their personal life. Because it's all one thing. Dr. Miriam Knoll: You do it all, all of it-- family, hobbies, career. You do it all, because you feel strongly about it, because that's what you want to do. So there's no reason to separate them.   Dr. Vinay Prasad: I love the way you put that, because that's what I'm trying to say, yeah. You feel strongly about it, and that's why you do it. And that's what you want in a career.   Dr. Vinay Prasad: You and I, we pursued the career of medicine, and we're really lucky to do it. Because we're some of the few people, I think, who get to do something day in and day out that doesn't feel like work. It feels like a joy. It feels like the thing that you want to do, you want to get out of bed and do, and that's a tremendous privilege in this world.   Dr. Vinay Prasad: And the more you chase the brass rings, and the less you forget about what you want to do with the brief time we have on this planet, I think the more you're prone to burn out, the more you'll want to separate things. And I think recognizing that, if you chase what you really want to do, those things will naturally fall into place.   Dr. Miriam Knoll: And that was one of the goals of my doing this podcast series, was to allow people that have-- people like yourself-- who are excelling in many different ways of being an oncologist and are passionate about it, and being able to share the ways that being an oncologist can be fulfilling in many different ways from each other. And it's very personal. So I want to ask you another more personal career question, which is, what is the best career advice that you remember that you've been given?   Dr. Vinay Prasad: I guess I would say that the best career advice came to me from a wise man, who is a professor at University of Chicago, Adam Cifu. And he's a kind guy, because I think he's tweeted out a slide he calls "Career Advice," and he's put this out on the internet for all people to see. And here's his career advice.   Dr. Vinay Prasad: Choose the job that promises the best set of colleagues. Choose the better job over the higher paying one. Be honest with yourself about whether you'll be happy with the demands of the job and the level of acuity of the patients.   Dr. Vinay Prasad: Don't trust that your new employers will change the job they offer you to fit your desires. Early in your career, say yes to everything. Later in your career, say no to everything except the things you really want to do. And beware of promotions that take you away from doing what you love. And he has a few others.   Dr. Vinay Prasad: But the reason that really speaks to me is that the theme of everything he's saying is that it's not about the money. It's not about-- it's not about the title. It's not about the promotion. It's about making sure that what you want to do and the job you're signing up for are a good fit.   Dr. Vinay Prasad: And a lot of fit and a lot of job satisfaction is who you surround yourself with, and what are the sort of tasks you are facing. And I think that's the core of his career advice. And I think it's very wise.   Dr. Miriam Knoll: What was the worst career advice you've ever been given?   Dr. Vinay Prasad: Well, I guess I would say the worst career advice I've been given is-- I guess it wasn't to me. It was directed broadly. But I saw it on Twitter recently, and I ended up writing a column in Medscape about it. And it was something like, oncology is a small world. Don't make enemies, is the advice.   Dr. Vinay Prasad: And I guess the reason it's stuck with me was, at first glance, I see that that is incredibly reasonable. It's a small world. There are so few of us in oncology. We all know each other after a period of time.   Dr. Vinay Prasad: Don't make enemies. Try to avoid conflict. But I think the reason it really started to trouble me, the more I thought about it, was that we are in the midst of a crisis in our profession.   Dr. Vinay Prasad: We have more drug approvals than ever, but more of the drugs we have that come to market are drugs that we don't know if they make people live longer or live better. The prices of our drugs are the most they've ever been. The dollar amounts that expert oncologists are taking home from consulting fees from pharmaceutical companies is the highest it's ever been.   Dr. Vinay Prasad: The experts who are conflicted are the ones who write the guidelines. The guidelines often recommend drugs based on weak evidence. Those weak evidence guidelines are tied to CMS and mandate Medicare reimburse for drugs without negotiation.   Dr. Vinay Prasad: Many of the academic papers have flaws. Many are ghost written. Many have medical writers. So what I want to say is that we live in a time where the entire cancer system, in so many ways, is misaligned towards corporate profits over the best interests of patients. And if you really, as a junior person, enter the field with this mantra, that above all else don't make enemies, you're never going to do what it takes to fix this ship, to realign the ship, to correct the serious deficiencies that plague our patients. You're never going to be able to do what we need you to do if you enter this thinking, I don't want to ever have anyone dislike me. You're going to be a part of the problem, not the solution. And so I think that's the worst advice.   Dr. Vinay Prasad: The right advice is, you're not in this business to make friends. You're in this business to do what's best for people. And 30 years sounds like a long time when you start your career. But five years goes by like a flash, and 25 years will go by like a flash too. And before it all ends, the system will just be as entrenched and flawed as it was when you started.   Dr. Vinay Prasad: So if you don't do everything you can every day you can, you're squandering your opportunity. And that's an opportunity that I think when we swore that oath to be a doctor, we swore an oath to do what's best for patients. And so I think that that's bad advice. The right advice is, do what needs to be done, and let people feel how they feel about it.   Dr. Miriam Knoll:  And I know that we could continue talking about this for hours and hours. And I know you have amazing advice to give, and I really appreciate your time. So my last question for today is, what advice do you have for trainees and early career oncologists?   Dr. Vinay Prasad: I guess my advice would echo those last comments, which is, you're entering oncology at one of the most exciting times. There's a lot going on. You need to do your best to stay up with oncology in an independent and thoughtful way.   Dr. Vinay Prasad: You've got to read papers yourself. You've got to critically appraise them yourself. You've got to see what the discussions are, the debates are. You've going to make your own decisions.   Dr. Vinay Prasad: And when you see the system fail your patients, you've got to be an advocate. You've got to speak out. And I think we need your voice more than ever. So that's the advice I'd leave them with, which is, it's OK to make enemies, if what you're doing is the right thing.   Dr. Miriam Knoll: Dr. Prasad, thank you so much for this insightful discussion. And thanks so much to our listeners, for you guys, for joining us for this episode of the ASCO Daily News podcast. We'd love to have your feedback, as always. So please, drop us a line at DailyNews@ASCO.org. And of course, don't forget to rate and review us on Apple Podcast.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.    

Guest host Dr. Miriam Knoll, radiation oncologist at the John Theurer Cancer Center at Hackensack Meridian Health, interviews oncologists about the decisions and extraordinary moments that have shaped their careers in this special podcast series. In this episode, Dr. Knoll speaks with Dr. Suzanne Cole, director at University Hospital Simmons Cancer Clinic at UT Southwestern Medical Center, about her early-career leap of faith to move from academia to a remote community oncology practice.   TRANSCRIPT: Dr. Miriam Knoll: Welcome to the ASCO Daily News Podcast. I'm Dr. Miriam Knoll and I'm delighted to be the Daily News guest host for a special podcast series that explores a full spectrum of oncology careers. I am an early career radiation oncologist. And in this series, I'll bring you interviews with a wide range of oncologists to hear about their diverse experiences, greatest challenges, and the unforgettable moments that shaped their careers.   Dr. Miriam Knoll: In today's episode, I'm thrilled to welcome Dr. Suzanne Cole, a medical oncologist at UT Southwestern Medical Center. She serves as a director of the University Hospital Simmons Cancer Clinic at the UT Southwestern Medical Center at Richardson/Plano. Dr. Cole and myself report no conflicts of interest relevant to this podcast. Full disclosures relating to all Daily News Podcast can be found on our episode pages. Dr. Cole, welcome to the podcast.   Dr. Suzanne Cole: Thank you so much for inviting me.   Dr. Miriam Knoll: So I'm so excited to have you here. You and I met on social media, which is becoming way more common nowadays. Would you agree?   Dr. Suzanne Cole: I totally agree.   Dr. Miriam Knoll: So I'm going to ask you about the HEME/ONC women's Facebook group a little bit later. But right now I first wanted to ask you about your career trajectory. Because I know that you first started off after you completed your training working in the community and more recently joined UT Southwestern.   Dr. Suzanne Cole: That's true.   Dr. Miriam Knoll: How did that come about for you?   Dr. Suzanne Cole: So I think that my story is not unlike other women who may be considering, you know, various options coming out of fellowship as far as what do they want to do or where do they see themselves. But I think I also had some kind of just normal life family pressures that pushed me in a certain direction. So I did my fellowship at MD Anderson.   Dr. Suzanne Cole: And when I went there, I thought I might be a stem cell transplant doctor. And I spent my first year in clinic kind of embedded in a transplant clinic and doing a lot of inpatient. And, you know, I kind of learned during that time that transplant probably wasn't the right fit for me. And I really didn't love any particular other tumor type enough to kind of then switch gears and dedicate my life to like one specific type of cancer.   Dr. Suzanne Cole: And so I told my program that I thought I was probably going to end up being a generalist and go back into the community. Most of my family is in Dallas. And that's where I was kind of hoping to land eventually. And I focused the last couple years of my fellowship on just really getting a very broad education in all of the tumor types.   Dr. Suzanne Cole: And then also, I think that this is important for women and men, but I'm the breadwinner of my family. I have four children. My husband is a musician. And when I was coming out of fellowship, I was probably about $250,000 in debt. And my oldest son was kind of getting close to needing to go to college.   Dr. Suzanne Cole: And, of course, like, I'd been in training and med school and residency for most of his growing up. And I had nothing set aside for his college. So I really needed to be in a place where I could be in a situation where I could pay off my loans and also save money for college. And, to be quite frank, a lot of the entry level academic positions just would not allow me to financially get my loans out of the way and also prepare for college, which was coming in a very short period of time for my oldest son.   Dr. Suzanne Cole: So I ended up taking a job in Charleston, West Virginia, where I was able to kind of get a loan payment situation taken care of. And I worked in this underserved area and was able to, basically, get financially straightened out within the first four years of my career. And it was a really fantastic place to cut my teeth as an oncologist.   Dr. Suzanne Cole: Because I was working for a very large hospital system called CAMC. And they have this network of hospitals in Charleston that basically serves the entire southern half of West Virginia. It's a huge patient population that filters into this kind of safety net hospital.   Dr. Suzanne Cole: And when I joined that practice, I was one of nine oncologists. So I had a lot of great partners to just help me and mentor me. But we took care of anything that walks through the door from acute leukemia to rare sarcomas to bread and butter breast cancer, prostate cancer, colon cancer. And also benign hematology, we had the hemophilia center for the state. And it was a really fascinating, busy, very robust and varied type of first practice.   Dr. Suzanne Cole: And I also was very fortunate that they had a pretty well-developed community oncology research program. And I was able to put patients on clinical trial, which was very gratifying. Because coming out of fellowship at MD Anderson, everybody was on trial. And I was very comfortable with having that access to research and giving options to patients that was beyond the standard of care. And so that was my first four years in practice.   Dr. Miriam Knoll: Wow, so can you tell us more, you know, logistically, you mentioned that you were looking for a certain type of, you know, let's say loan repayment or job security and compensation and that you were comparing your opportunities. You know, did you, you know, work with a recruiter or did people reach out to you? You know, what was that process like for you?   Dr. Miriam Knoll:  Because I think a lot of our listeners would be interested in hearing more about, you know, how does one look for different types of job opportunities if they're considering more than one type of practice? And I think that's something that a lot of people don't really admit when they're looking for a job. Because a lot of people say, "Oh, I'm only looking for academics" or "I'm only looking for private practice." And, you know, that isn't the case for all of us.   Dr. Suzanne Cole: Yeah, and I'll tell you, I felt like pretty on my own because I was in an incredibly academic environment. I was kind of the only fellow that I was aware of at that time that was saying, "I'm planning on going back into the community and not into academia." And so, you know, everyone around me as far as faculty members like really couldn't mentor me or help me navigate how to do that well.   Dr. Suzanne Cole: And so in my second year of fellowship, I actually started looking for jobs at that time. And my husband and I were kind of looking possibly to go back to Dallas. But at that time, this was in like the 2008 economic crash that was going on. And because I had done my residency at UT Southwestern, I had a lot of friends who were in practice in Dallas and in that community. And the jobs were just drying up.   Dr. Suzanne Cole: Like a lot of the private practice or community oncology programs were just not sure financially what was happening nationally. And so they weren't putting out new jobs because they weren't sure that they would be able to support bringing on another partner. And so when I realized that the Dallas market was not looking like a feasible option, I kind of thought, "Well, look, you know, I don't really have any ties to anywhere else. I'm going to cast a very wide net and I'll look, you know, from California to Maine and just see what's the best opportunity for me to get my loans taken care of and to get into a good group where I have like a feeling of mentorship from colleagues and a good vibe from the team."   Dr. Suzanne Cole: And I started looking at just kind of all kinds of random opportunities across the United States. And, you know, to be quite honest, when the West Virginia job came onto my radar, I thought, "Mm, you know, it's West Virginia. I don't have any connection to that place. You know, I'm not sure that this is going to be, like, Option A, B, C, or E, but it might be Option F."   Dr. Suzanne Cole: And then I went out to interview and I just, I really loved the people. I was actually quite impressed by the scale of their operation. I had trained at Parkland in Dallas for my residency. And so I was used to this kind of hospital system that was caring for underserved populations.   Dr. Suzanne Cole: And what I found very attractive about it was that in that hospital system, if you needed a cardiothoracic surgeon, if you needed interventional radiology, if you needed a GI endoscopist who could do stents or interventional things, those things were all in place. And so it was kind of the size of the system that was attractive to me, but then also the partners that I interviewed that lured me to kind of think about that job. And then I went for a second interview.   Dr. Suzanne Cole: And it came to the top of the list just because of the whole package. But it was a real leap of faith to pack up my family and move across the country by ourselves to, you know, a very remote part of the country where we didn't have a lot of support either from friends or family. And we were just kind of loners showing up in this city together.   Dr. Suzanne Cole: But it worked out. And it was I think it was one of the best decisions that I've ever made because I was able to like become very independent as a practitioner and really feel confident that I could handle anything that came through the door. And then it also just kind of launched my research career in community practice, which is not something that's easy to find or carve out for yourself. And so I just felt like it was a very fortuitous way everything came together.   Dr. Miriam Knoll: Can you tell us about your transition to UT Southwestern?   Dr. Suzanne Cole: So there was a little bit of a break in the middle of that. As my younger children were approaching elementary school, we started looking to try and get closer to Texas where both my husband and my family are in Texas. And so about four years after I had been in West Virginia, we started looking back in Dallas again.   Dr. Suzanne Cole: And, again, kind of the job market was still not where I was-- there was nothing there that was kind of interesting to me as far as having the clinical research component, but also general community practice. And so I kind of widened my scope again and found a job in Oklahoma City at Mercy Hospital where they also have this very robust community practice, I had multiple partners, and a very strong community-based clinical research program. And Oklahoma City is about three hours from Dallas.   Dr. Suzanne Cole: And so it was not that far from my family. So we decided to take that position. And we settled in Oklahoma and stayed there for four years. And I thought I would probably never leave. I was, you know, very happy. My job was really good.   Dr. Suzanne Cole: And then I got this flyer in the mail. It was like a super random thing where I get home from work one day and I'm kind of going through the junk mail. And there is this flier advertising UT Southwestern Community Oncology Practice in North Dallas, have access to over 300 clinical trials, you know, be connected to the university, but be embedded in your community.   Dr. Suzanne Cole: And, you know, I have like this huge allegiance and great love and respect for you UT Southwestern, which is where I did my medical school and residency. And it's a job in Dallas that is kind of-- if I could dream up on paper exactly what I would see myself doing for the rest of my life in a kind of hybrid setting, that was kind of what was on this flyer. And I told my husband, I was like, "I'm just going to like send them my CV and see what happens. I'm sure nothing will come of it."   Dr. Suzanne Cole: But they called me the next day. And I came to interview like maybe a week or two later. And it was just this kind of perfect fit. Because they really needed somebody who could do all of the cancers, benign hematology, you know, would be able to see anything that walks through the door in the community. But they also were looking for somebody that had kind of an academic mind as far as thinking about how to get clinical trials available to the patients, collaborating with the main campus, being part of tumor boards and presenting patients, and, you know, kind of leveraging the strengths of a University within the community practice. And I think like if I had written down my dream job, every kind of point that I wanted, you know, on paper, that is what has come to pass in the last year and a half that I've been here.   Dr. Miriam Knoll: Wow, that's really an amazing story. And thanks so much for sharing it with us. Dr. Cole, I wanted to ask you about your story about founding the hematology and oncology women's Facebook group, renamed the HEME/ONC Wolf Pack group after Abby Wambach's Barnard commencement address in 2018. So, of course, I'm a member of the group. And can you tell us, what were you thinking when you started the group? And were you thinking about it from a social perspective, from a career perspective? And what would you tell other oncologists who are thinking about potentially getting involved in social media?   Dr. Suzanne Cole: So I think that the social media stuff happened to me by accident. I mean, I was kind of like a partaker of social media. I used Facebook to stay in touch with family and friends. And I would say it was probably five years ago now that-- it might have been six-- the physician mother's group came about. And I don't know why, but for some reason I got added to that group when it was very young and very small. Dr. Suzanne Cole: And I remember kind of seeing posts on the physician mother's group, which is now-- I don't how many people are on it. But it's probably close to 100,000 women physicians across the world. When I was first part of that, it was maybe 5,000 people were on the site. And I remember seeing a colleague of mine in Oklahoma City, who was an ER doctor, make a comment that, you know, on the physician mothers group ER subgroup, they had discussed this issue about emergency medicine.   Dr. Suzanne Cole: And I thought, wow, is there like a HEME/ONC group that I could join? Because I would love to talk with other women about issues that are specific to hematology and oncology. And the response that I got from the masses was that, you know, nobody was aware that there was any kind of physician mothers' group that had a HEME/ONC subset. And so I just decided to start one that day.   Dr. Suzanne Cole: And when I reached out to Hala who runs PMG she said, you know, we don't sanction any official physician mother group subgroups. And so if you want to make a HEME/ONC group, that's fine. But it'll be kind of separate from the PMG platform.   Dr. Suzanne Cole: And so I just basically went through my friend list and added every woman physician that I could think of that was on Facebook with me. And we probably started with like 25 people. And it has grown into this really amazing network, support, resource. You know, I'd say that the thing that people use it the most for is for advice on de-identified cases.   Dr. Suzanne Cole: You know, somebody posts a case about, "I have a lady with breast cancer and she's been through these three lines of therapy and, you know, she's progressing in this way, what would you say would be the next step?" And what I also find very cool about our group is that we have multiple experts in particular fields who will kind of weigh in and point out clinical trials that may be available or say, you know, in that situation, I would kind of reach for this drug next. And it's been also just very supportive from, like, a human being perspective.   Dr. Suzanne Cole: Just because, you know, we have patients that are critically ill. And we're constantly dealing with sad things happening to patients that we really care about. And it's become a little bit of a safe space for physicians to kind of say, "Hey, you know, one of my favorite patients died and today and I'm just feeling really torn up about that" and get a whole lot of support from people all across the world that identify with that. And just you don't have to explain it. Everybody understands where you're coming from.   Dr. Miriam Knoll: Yeah, I've personally seen both those things firsthand and been a beneficiary of that. So and I think there is even more support that people can find, both in terms of job opportunities, job advice, you know, how to set up your clinic, you know, the electronic medical record, negotiating salary, right? Have you seen posts like that too?   Dr. Suzanne Cole: I feel like very recently there was a post about a woman who found out that her junior colleague was being paid, like, twice as much as she was. He was taking less call. You know, he had constructed his contract in a way that was very beneficial to him.   Dr. Suzanne Cole: And when she brought it to the attention of her employers, they kind of were like, "So, you know, what are you going to do about it?" And by her just kind of putting that situation out there to us, she got so much feedback from the group about like, "This is not acceptable. You know, there are all these other opportunities. You can be paid fairly. You can be valued."   Dr. Suzanne Cole: And within, I want to say, like two months, she had a different job. You know, she was like, "I don't have to put up with this because I'm not alone." and it was really cool to see that happen for somebody.   Dr. Miriam Knoll: That rallying around, right?   Dr. Suzanne Cole: Yeah, yeah.   Dr. Miriam Knoll: Even though it's virtual.   Dr. Suzanne Cole: It's virtual, but it's real, you know? And it's I think also the networking that goes on. Like I just, I know so many people who have given talks at different institutions who have had opportunities, you know, just kind of presented on our Facebook group. And they've snatched up the opportunity to be part of that. And it has helped them grow their network and their academic credentials. There's just a lot of things that could happen out of this if you are engaged and you take advantage of it.   Dr. Miriam Knoll: So how can somebody join the group if they're not in it yet?   Dr. Suzanne Cole: So because we are a private group, you have to know somebody who's already a member. And they need to kind nominate you to join the group. And then we verify that you are a physician in some type of hematology, oncology field. And we take HEME/ONC doctors, palliative care, surgeons, there's some dermatologists that specialize in skin cancers.   Dr. Suzanne Cole: And so anybody who takes care of cancer patients or does hematology is welcome to join. And the requirements are, you have to be a physician, you have to be a woman. And we vet everybody to make sure that they are who they say they are. And then they are added in.   Dr. Miriam Knoll: And radiation oncologists, right?   Dr. Suzanne Cole: Oh, yes, radiation, definitely.   Dr. Miriam Knoll: Don't forget about us. And actually now there is a separate radiation oncology women's Facebook group too. So if any listeners want to join that group, that's actually a group that grew out of the HEME/ONC group.   Dr. Suzanne Cole: Yes, and there's also a pediatric hematology oncology subgroup that has kind of split off. And we still have all of those members as part of the bigger group, but I love that there's an opportunity for people to network with each other and discuss things that are particular to their subspecialties.   Dr. Miriam Knoll: So what's the worst career advice you've ever gotten?   Dr. Suzanne Cole: I think the worst career advice is to do what your-- what everyone around you is doing. I think there's like an incredible pressure when you're in training to conform to what is expected and to sometimes ignore those inner voices that are telling you, you know, "Hey, maybe this is not the right fit for me." I personally have always really struggled with writing. Like I don't enjoy it.   Dr. Suzanne Cole: I love clinical medicine. I love seeing patients. I love participating in clinical trials. But I don't totally love writing them. So I think being browbeaten into pushing down a pathway that doesn't feel inspiring to you could be very, very detrimental to your long-term career.   Dr. Miriam Knoll: What's the best career advice you've gotten?   Dr. Suzanne Cole: So the best career advice I've gotten is know yourself and even if you're scared, go for it if you are excited and feel a passionate interest in something that may be a little off the beaten path.   Dr. Miriam Knoll: And last question for you this morning, what advice would you give to trainees and early career oncologists?   Dr. Suzanne Cole: So I would say really take time during your training and in the first one to two years that you're out of training to figure out who you are as a physician and what makes you happy. Because if you can find something that is setting you on fire, you're so passionate about this particular thing, it can carry you through the harder stuff that we all have to deal with throughout our careers.   Dr. Suzanne Cole: So also to seek out different options. If you have, you know, an interest in community practice but you're not really exposed to it as is usual in a fellowship-type program, network and connect and try to speak with other people who are practicing in a place that you think, "I might be happy in this place." And you really need to talk to people who are doing it.   Dr. Miriam Knoll: Dr. Cole, thank you so much for joining me this morning and for this amazing discussion. And thank you to our listeners for joining us for this episode of the ASCO Daily News Podcast. We'd love to have your feedback so please drop us a note at dailynews@asco.org. And rate and review us on Apple Podcasts.   The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

In this special podcast series, guest host Dr. Miriam Knoll, radiation oncologist at the John Theurer Cancer Center at Hackensack Meridian Health, interviews a wide range of oncologists who reflect on their diverse experience, greatest challenges, and the unforgettable moments that have shaped their careers. In this episode, Dr. Knoll speaks with Dr. Gilberto D. Lopes of the Sylvester Comprehensive Cancer Center about his inspiring career that has taken him across the globe. TRANSCRIPT Dr. Miriam Knoll: Welcome to the ASCO Daily News Podcast. I'm Dr. Miriam Knoll, and I'm delighted to be the Daily News guest host for this special podcast series that will explore the spectrum of oncology careers. I'm a radiation oncologist, and I'm an early career oncologist, and I'm really interested in interviewing oncologists from a variety of oncology careers. In this series, you'll hear from a wide range of guests about their diverse experience, greatest challenges, and the unforgettable moments that shaped their careers. In today's episode, I'm thrilled to welcome Dr. Gilberto Lopes, a medical oncologist and the Medical Director for International Programs and Associate Director for Global Oncology at the Sylvester Comprehensive Cancer Center. He's also an associate professor of clinical medicine at the University of Miami Miller School of Medicine. Dr. Lopes and myself report no conflicts of interest relevant to this podcast. Full disclosures relating to all Daily News Podcast can be found on the episode page. Dr. Lopes, welcome to the podcast. Dr. Gilberto Lopes: Hi, Miriam. It's great to hear from you. How are you? Dr. Miriam Knoll: Good. So of course, you and I met for the first time on Twitter. Dr. Gilberto Lopes: We did. And then we met in real life. Dr. Miriam Knoll: Yep. Yep, which is always amazing. I always find, I don't know if you agree with this or not, but I'm always surprised when I meet someone that I first met through Twitter that you really feel like you know them, like you really know them, like, it actually is a real relationship. Isn't that amazing? Dr. Gilberto Lopes: It is. It is amazing, and it is true, because we tend to share so much similar medical Twitter accounts that it is like you actually have been part of our lives. Dr. Miriam Knoll: Exactly. Exactly. I find the only thing that surprises me always is I'm always surprised by someone's height. No matter what, I thought they're either taller or shorter in real life. Dr. Gilberto Lopes: I love that. I really love that. Dr. Miriam Knoll: Right? And it's not like I remember thinking, like, hmm, I thought that person was tall or short. It's always taller or shorter than whatever it is I had in my head. Dr. Gilberto Lopes: And I was going to say that's not the type of social media we actually disclose that type of information. Dr. Miriam Knoll: Exactly. Exactly. So today, I wanted to talk to you about your career and what advice you have for really, anyone that's listening, all of our ASCO members, but also specifically for trainees and early career oncologists. So, my first question is, what advice would you have for someone who's interested in getting involved in global oncology? And maybe you could also give us a short intro into what global oncology is. Dr. Gilberto Lopes: Absolutely. And this is something that a few years ago we wouldn't have anybody asking us about. And we are extremely happy that it is becoming an area of academic interest, and it is becoming an area where not just ASCO, but also the NCI and a number of academic institutions have actually been putting a lot of effort and also money in so that we can continue to develop global oncology. So global oncology is actually a very broad term. We had the challenge of actually trying to define exactly what global oncology is for ASCO. We were part of a task force that was called the Academic Global Oncology Task Force, which actually tried to make sense of what it is. And I'm going to quote, and I'm going to actually get the formal definition that we came up with so that I do not deviate from what the group actually came up with. And Julie Gralow was the chair for that task force, and we actually do have those coming out in a forthcoming issue of the Journal of Global Oncology. And we do have some of it already out in ASCO Connection if people want to check it out. And the gist of it is that global oncology is the discipline that actually studies all worldwide aspects of cancer care. And here we, of course, always mention delivery of care implementation science related to being able to deliver the best cancer care possible in resource-constrained settings. But we also like to remember particularly that global oncology is also about learning the biological differences in between cancers that we see in developed countries and developing countries. So why is it that yes, cancer patients do better in certain parts of the world and worse in others? Why it is that we have so many gall bladder cancers in the Andes region, in the Americas, and also in Asia. So, these are all the important and interesting questions. Of course, it does intersect with policy, with health economics, pretty much with anything that has to do with delivering cancer care around the world. Dr. Miriam Knoll: And what advice would you have for someone who's interested in getting involved, who hears about what you're sharing with us and thinks, wow, that's fascinating, I want to do that, I want to be a part of that? Dr. Gilberto Lopes: It absolutely helps to find a mentor. And we had a survey of NIH-funded institutions in NCI-designated Cancer Centers, and more than half of the centers actually had somebody working in international projects and works in projects that we would classify as having to do with global oncology. So, reaching out to somebody in your institution would be a great way to start. And if you don't, as I mentioned, it's very easy to find many of us on the Twitter, of course, and on other social media. I have always been surprised in my career, especially when I started more than 20 years ago, how the people who tend to be the most active are also the nicest. And it was extremely rare that I would reach out to someone by email—when I started there was no such thing as a Twitter or Facebook, and we reached out to people by email. And actually, I even had a period in my career where you reached out to people by letter or phone. And I just dated myself, no? But it is something that you can do. So, reaching out to somebody that works on it always helps. But one big piece of advice—whenever you reach out to somebody, come in with an idea. If you just reach out to people and say, I want to do work in global oncology, it really doesn't get you to move much because people are busy. And even though most of us would love to help, it's extremely hard to just come up with some project out of nothing. So always think about those things that your strengths are, where you're from, where you have contacts, where you have worked, and what is it that you can do in that environment, what is that you can do with the specific strengths that your institution has? So always try to think about the issue a little bit before you actually move forward. So, for instance, in Miami, we do have a large population that has migrated from the Caribbean, from Latin America. And that has helped us actually ask a number of interesting questions. What are the differences in epigenetics, for instance, of Haitian patients were diagnosed in Miami versus patients in Caribbean? So, we have a number of projects that have come out of the curiosity that we had for seeing things that we're seeing on a daily basis. So always think about the strengths you have in your center and what it is that you're curious about that you would like to try to do. Dr. Miriam Knoll: Yeah, I absolutely agree, and I think that's great advice. I don't know if you read Sheryl Sandberg's book Lean In. Dr. Gilberto Lopes: I did. Dr. Miriam Knoll: Yeah, so you know how she says there the way that you get a mentor is not by asking someone, can you be my mentor, right? So, mentorship is an organic process. It's something that happens over time. It's a relationship that you develop with someone. Let's say someone says they are interested in global oncology - and I -  Dr. Gilberto Lopes: That's right. Dr. Miriam Knoll : —don't know anything about that person, and it's really easy to sort of forget to write back because you don't even know where to start. That's very, very different than an email from someone that says, hi. I'm a third-year medical student. I'm really interested in this and this, and I'd like to do a review of this topic. Do you have time to talk? That's an email that's— Dr. Gilberto Lopes: Absolutely. Dr. Miriam Knoll:  —a whole lot easier to respond to. Dr. Gilberto Lopes: It's very hard to say no to an email that actually comes with an idea. Dr. Miriam Knoll: Right. Amazing. So, such great advice, thanks so much. And I also wanted to ask you about your MBA. When and why did you get an MBA? And do you feel that that's a degree that has helped you in your career? Dr. Gilberto Lopes: I get that question a lot, and it definitely has. So, I was in my second year of post-fellowship when I got my MBA. I was in Singapore, and I did my MBA at a British school that actually had a overseas campus in Southeast Asia. And the reason I thought I needed to do it is because in medicine we learn nothing about the world. We pretty much just learn about medicine as we train. And we learn nothing about how things are run. We learn nothing about how to manage people. We learn nothing about finance, how to do budgets, how to invest. So, we pretty much see not at all from all those aspects that are extremely important when you start actually having a career in academic medicine. As you move from just being a physician, which is extremely important and many of my brightest colleagues just want to do that, they just want to be physicians with patients, but if you do intend to have a career in any institution that is larger than just a small physician group, it is extremely interesting and important if you want to be in a leadership position to consider doing an MBA or any other types of programs that will give you a little bit of the background, the vocabulary. And it helps you learn about the language of management and business. So, I realized that for me to continue growing in academic medicine, I wanted to become a director for clinical trials first and then a medical director for a cancer center. Eventually, I actually became chief medical and scientific officer for the largest practice in Brazil. So, I was in Singapore after finishing fellowship for about seven years. And I actually thought, at some point, that I would never come back to the West. And I got this invitation from a growing group in Brazil that eventually became one of the largest practices not just in Latin America, but also around the world. Today, there's more than 450 oncologists in the group. And they invited me to come in and be their chief medical and scientific officer because I had a background in both being a clinician, doing research, and also in management. So, it has been invaluable for me to learn a number of things that I had no idea about to actually get the MBA. And people do MBAs for different reasons. So, one of the main reasons people do MBAs are for the networking, for the people that you meet that can then help you in consulting ventures, and business ventures, and so on. For me that was never the most important thing. For me it was really learning about how to manage people, how to make sure that your budgets make sense, how investments work, how you actually get people to put money in different endeavors, and things of that sort. So, it is absolutely a must if you intend to be in leadership positions in any institutions that has thousands of people. Dr. Miriam Knoll: Great. That's really a very interesting perspective. And I love how what you're saying is that you want to continue working with patients and being an oncologist, and that the MBA— Dr. Gilberto Lopes: Absolutely. Dr. Miriam Knoll: —really helped with that. Dr. Gilberto Lopes: It did. And I can't imagine myself not seeing patients. Actually, that was one of the main reasons I moved back to the US from Brazil because here at the University of Miami, I have actually what I see as the perfect balance in my activities. I see patients about 45% to 50% of my time, and the other 50% I'm now dividing between global oncology and clinical research as well as the fellowship program. I became the director for our fellowship program on January 2. And everything that I learned in the MBA has been extremely useful helping develop careers of young oncologists and hematologists as well. Dr. Miriam Knoll: Well, congratulations on becoming the program director. That's amazing. Can you tell us about—actually, a different position that I wanted to ask you about— Dr. Gilberto Lopes: Sure. Dr. Miriam Knoll: —is that you're editor-in-chief of the Journal of Global Oncology. So how does one become an editor-in-chief? I think that's something that a lot of trainees and early career oncologists look at and say, wow, I want to be an editor. How do I do that? So, was it something that you always wanted to do? And what was the path for you? And what could the path be for someone else? Dr. Gilberto Lopes: I don't think anybody finishes medical school or high school thinking, someday I'm going to be editor-in-chief of a medical journal. But it is something that does come with the career, and it is something that is fascinating. We actually all get involved in things that eventually are basically to become an editor-in-chief. So as soon as we start in academic medicine, we start reviewing works of our colleagues. So, whenever we actually publish an article anywhere, you start getting invitations from that journal, usually, to become a reviewer. And that's actually the first step for you to have a career in editorial boards and as editor of medical journals. And that becomes a very interesting endeavor as well. It's a great way of actually seeing what your colleagues are working on, sometimes months before they come to the forum. And there's different ways of preparing. So, at ASCO, and especially at the Journal of Global Oncology, we created a new program called the Editorial Fellowships. And this is a very competitive process. We get hundreds of applications for between one and five positions every year. We started that as a pilot at the Journal of Global Oncology. We got something called a PROSE award for innovation based on having the program, and the idea of the program was to train people to become better reviewers so that they could actually start that process of eventually becoming a member of an editorial board, and hopefully in the future also editors in chief for not just ASCO, but different international oncology journals as well. The program has been going on for a few years, and we now actually have five fellows, one for General of Global Oncology and four that are shared work from one of the other ASCO journals. Also, good moment to remind everybody that ASCO journals now have a common name. They're all Journal of Clinical Oncology. Of course, we have the original JCO. And we now have JCO Global Oncology, JCO Precision, and JCO Clinical Informatics, as well as Practice, which used to be the JOP. So, this is a path that a number of colleagues have taken in the past. What used to happen is that your mentors actually get you to meet people, and then you did more reviews. And if you do actually generate quality reviews, often you get involved in more reviews, and then you get invited to be part of an editorial board. And for the JGO, JCO GO in particular, this was a global process. ASCO created a search. I was one of the original associate editors, so I was relatively young. I wasn't out of fellowship that long when I became associate editor. And then when Dr. Kerr, who was the original editor-in-chief for the JCO GO had to leave, there was a search. And ASCO selected me as the second editor-in-chief for what was then JGO, and is now JCO Global Oncology. And I have just started the beginning of my second term. The second term is a five-year term, so I should continue being the editor-in-chief for five more years. And then it's time to pass the ball to the next generation. Dr. Miriam Knoll: Great. So, what's the worst career advice that you've ever gotten? Dr. Gilberto Lopes: Don't go to Singapore. That was the worst—that was the worst career advice I ever got. When I decided to move to Asia, it was such an easy decision to me. So, I had come from Brazil to the U.S. as a sixth-year medical student. Then I went back home, graduated, studied, worked a little bit so I could actually make enough money to take the steps. Then I took the similar steps one and two. At the time, we didn't have the clinical skills assessment part of it. And then I applied to one place for residency because that's what I had money to travel to—I had money to travel from Brazil to Miami. And as I had spent time here as a student, I knew that this was the place I had the best chance of getting an internship in the U.S. Dr. Miriam Knoll: Wow. Dr. Gilberto Lopes: And I came to Miami as an intern, did my residency here. I was the chief resident. And then for fellowship, I did have a number of different options. My wife's job was here and was not quite portable, so we decided to stay in Miami for fellowship as well. And when I finished, I actually had a J-1 visa, so I either had to go back home for a few years, 2 years to be exact, or I needed to go to some area that would be considered underserved and through which I could get a waiver to stay in the U.S. And I did have a few options, and I got an offer from Penn. I had a potential offer from UT at Southwest here in Dallas. But the potential to go to Singapore was actually the most interesting one. So, Hopkins had had a cancer center in Singapore and research labs for a few years, and they were looking for somebody to help develop their clinical trials program. And my wife is of Chinese origin, so she always had the curiosity to live in Asia for a while. Then we decided to apply for it, and we went for an interview in Singapore. Loved the place, and then just decided, well, it was just such an easy decision to make that even though more than one person actually told me, don't go to Singapore, stay in the U.S. somewhere, it was definitely a very, very easy decision, and it's certainly a decision that I see today as being the beginning of my academic career. And it was certainly a great beginning. I have a lot to thank Singapore and Hopkins for. Dr. Miriam Knoll: So, was that unsolicited advice that you got? Dr. Gilberto Lopes: In a way, it was. But when I discussed plans in general with colleagues who were graduating fellowship or with mentors, there was actually only one who clearly saw that that was easy, very easy to decide and that was the best option for my career then. This was one of our breast cancer oncologists, Dr. Stefan Gluck. He was the one who actually was the only one who said, I have no doubt that this is the best option for you right now, and you should go and not think twice. And now— Dr. Miriam Knoll: Was it hard to reject everyone else's, quote, "advice?" Dr. Gilberto Lopes: Actually, it wasn't because in my mind, it was such an easy decision to make that I pretty much ignored everybody who was a naysayer about going to Singapore. Dr. Miriam Knoll:  Great. Well, it definitely sounds like you're—at that time and now, that it was the right decision. Dr. Gilberto Lopes: Mm-hmm Absolutely. Dr. Miriam Knoll:  What was the best career advice that you've ever gotten? Dr. Gilberto Lopes: Oh, there's a lot. So, there is something that everybody should read if you haven't read, and I think this was published back in 1999, and they're now known as the "Simone Maxims" for anybody working in academic centers. Joe Simone was and is an oncologist who has had a very big role in managing and developing people as well, and he came up with his maxims that everybody should try and read. And I think it came out in Clinical Cancer Research more than 20 years ago or so. And these were things like the first one is the one that I always remember the most, and its institutions don't love you back. And that is something that is a little bit cynical, but it makes a lot of sense. Any place you work for, even though sometimes you think that that's your whole life, it has a different time horizon. They are going to be there when you leave, so you always have to think on what's best for yourself. So, I grew up in medicine in a time when Brazil was coming out and was living its transition from dictatorship to democracy. And we were infused with a sense of public service and an ethos of serving the collective rather than the individual. And to me, it was always hard to realize that we have to be well, and we have to take care of ourselves so that we can actually serve. And that was one of the maxims that helped me realize that as I was becoming a little bit older. But to finish just in terms of what the best career advice is, is that oncology is a team sport. You do not accomplish anything alone. So, you need to make friends. You need to collaborate. You need to help other people's projects so that you can actually further your own. And that is the single most important advice I've gotten in terms of becoming an academic oncologist. And that advice I got from Caio [Max Sao Pedro] Rocha Lima, who used to be a GI oncologist in Miami when I was a fellow and who now works at Wake Forest. Dr. Miriam Knoll: And you mean working with other oncologists and colleagues with their projects? Dr. Gilberto Lopes: With colleagues in every arena, so not just oncologists, not just medical oncologists, with radiation oncologists. Collaboration is the only way we actually do anything that is worthwhile. Dr. Miriam Knoll: Wow. That's great advice. So, what advice would you give to trainees and early career oncologists? Dr. Gilberto Lopes: Get out there. Do everything that you can. Go to meetings. Get to see people. Get to know your fellow colleagues. They often will be partners for projects for your whole life. Get to meet people in different institutions. Just get yourself out there. It's amazing how people will help you if you have an interest and if you show that you can actually get things done. Dr. Miriam Knoll: Well, Dr. Lopes, thank you so much for this insightful and candid discussion. And thanks so much to our listeners for joining us for this special episode of the ASCO Daily News Podcast. We'd really love to have your feedback, so feel free to email us at DailyNews@asco.org. And of course, don't forget to rate and review us on Apple podcasts. Dr. Lopes, of course, can be found on Twitter @glopesmd. And I can be found on Twitter, too, @MKnoll_MD. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

Guest host Dr. Miriam Knoll, radiation oncologist at the John Theurer Cancer Center at Hackensack Meridian Health, interviews a wide range of oncologists who reflect on their diverse experience, greatest challenges, and the unforgettable moments that have shaped their careers in this special podcast series exploring early-career oncology and more.  In this episode, Dr. Knoll speaks with Dr. Howard Burris, ASCO President (2019-2020).  TRANSCRIPT ASCO Daily News: Welcome to the ASCO Daily News Podcast. I'm Dr. Miriam Knoll. I'm delighted to be the Daily News guest host for a special podcast series that will explore the full spectrum of oncology careers. I am a radiation oncologist in New Jersey at the John Theurer Cancer Center. In this series, you'll hear from a wide range of guests about their diverse experiences, greatest challenges, and unforgettable moments that shaped their careers. In our first episode today, it's an honor to welcome Dr. Skip Burris, President of ASCO during the 2019 to 2020 term. Dr. Burris is President of Clinical Operations and Chief Medical Officer for Sarah Cannon, a cancer institute of HCA health care. He is also an associate of Tennessee Oncology PLLC, where he practices medical oncology. Dr. Burris reports no conflicts of interest relevant to this podcast. And I also report no conflicts of interest relevant to this podcast. Full disclosures related to all Daily News podcasts can be found on the Episode page. Dr. Burris, welcome to the podcast. Dr. Skip Burris: Thank you very much, Dr. Knoll. I appreciate you having me as your guest. ASCO Daily News: So, Dr. Burris, I'm going to jump right into it. You've almost completed your 1-year term as ASCO president, and this undoubtedly has been a major highlight of your career. So, I really want to ask you something that I think a lot of ASCO members, when they see the ASCO president such as yourself, they're wondering. How does one become the ASCO president? And was this something that you always wanted to do? And did you think about it and plan for it? Dr. Skip Burris: Great question, and you're exactly right. It's been an exciting year. It is such an honor to work with not only the membership, but the superb staff, the full-time staff that runs ASCO that's headquartered in Washington. I have always—had always hoped to have the opportunity to run for ASCO president, and it is something that—it was always on the list of things that I would like to have had the opportunity to do. And the fact that it came to fruition has been a joy and been exciting. Hard to plan for it because, each year, there's two candidates that run. The pool is actually fairly small of potential candidates, because one of the requirements is that you have to have been on the ASCO board previously. So, serving on the ASCO board is the first step in the process. And then, obviously, having been on the nominating committee, it sort of narrows down to those people that are placed in their career or have the sort of perspective where it might be appropriate for them to run for ASCO president. But it absolutely is an honor. And the past presidents that you work with and the incoming presidents really make the office of the president a team sport. And I've been fortunate to have Dr. Bertagnolli and Dr. Johnson before me and Dr. Pierce and Dr. Vose coming afterwards. And there is a nice team spirit to how we've all approached—the year goes by fast, and it's important to have some overlap and synergies as we think about objectives that we're trying to achieve. ASCO Daily News: Wow, so that's really interesting. I actually did not know that, that in order to be nominated to run for ASCO president, one first has to have sat on the ASCO board. Dr. Skip Burris: Yes, that is true. And ASCO board nominations come from a lot of different places. But in general, the ASCO board for the majority of the seats is really loose. Folks were nominated for the elections from their experience serving on ASCO committees. So, for our listeners, participating in the various committees and task force and opportunities to engage with ASCO both locally and nationally is certainly something to pursue. My journey with ASCO began in 1990. I was fortunate to have our cancer center director, Chuck Coleman, Dr. Coleman elected as president of ASCO back then. Through the years, [I] served on a number of committees in the '90s and then served on the board in the 2006 to 2009 timeframe. So, it's been a lifelong journey to become the ASCO president, serving on a number of committees and such. But it really—it put me in a good place to actually know the staff and know the system, so it's been a productive year and looking forward to the Annual Meeting that's approaching quickly. ASCO Daily News: Yeah, we're all really excited about that. So, it sounds like you're saying that it's a long process. It's a lot of time spent volunteering and getting to know people. And you actually had a 10-year lapse from when you sat on the board to when you were nominated and became president? Dr. Skip Burris: Yes. And during that time, stayed engaged and participated in government advocacy projects and served on committees and participated in some of the task force. So, it is something where I urge folks to be members of ASCO. We're continuing to look at how we expand and enhance and serve our membership. But it doesn't need to be something where folks enjoy coming to serve the society. It isn't about that 1 year. It really is the culmination of many, many years invested in the society. ASCO Daily News: Yeah, and that makes sense. So, I wanted to shift gears just for a moment and ask you more about your practice as an oncologist. And some questions that we've gotten when thinking about this podcast was people wanted to know if they're interested in being involved in clinical trials and running clinical trials and they're currently not, what would you recommend for that? How would someone get involved in clinical trials? Dr. Skip Burris: So, I always encourage physicians to participate in clinical trials. I firmly believe that we're still in a place in the development of new oncology therapies that we need clinical trials to decide what our best course of action and treatment plan should be. It's not a cliche to say that the best management of a cancer patient is usually participation in the clinical trial. Not everybody has to participate in clinical trials at the earliest investigational drug level. We still have important questions to answer in the arena of Phase II and Phase III trials. Actually, important question as we sort through all the new drugs that are available to us, which ones should be given in the neoadjuvant or adjuvant setting? And which might be best saved for the metastatic setting? I do caution folks that the most important element of the clinical trial process after the physician leader is the infrastructure. And Sarah Cannon, we have a fabulous administrative staff. I think our key to success at Sarah Cannon has really been the investment that we have made in the data managers and the regulators and the financial staff and the like. And so, one should not take that with any sort of casualness that that's something that can be done as a hobby, but I don't mean that to scare someone away. I think that if you're in a smaller practice or you're new to research, my best advice would be to look at who your partner should be. Is there a network for you to join? Is that affiliating with the network or is that affiliating with an NCore site, part of the NIH NCI program? Is there an alliance that can be formed with a university in your region or some other practice setting? But having that partner to help with the early stages of getting some trials up and running is something that every oncologist should take advantage of that opportunity. And I know most networks and alliances and universities are, in fact, welcoming getting community colleges involved. I mean, that is where the vast majority, 80% plus of patients are seen. So, one, positive on folks doing it. Two, really think about how you're going to have your infrastructure, maybe at your local hospital, that's willing to help you with that infrastructure. And then third, think about who your partner is, and that's so you're not going alone. ASCO Daily News: Wow, so that's great advice. And I appreciate that you mentioned private practice doctors. I'm technically private practice myself, and I think that's really important for us to be thinking about. Because sometimes it seems like that hurdle is really just too large. And it sounds like what you're saying is think about what opportunities that do exist and how we can foster that connection, that, really, every community hospital should want to have or be thinking about with that cancer center that increasingly are being part of these network, really large conglomerates. So what you're saying is you can use that to your advantage and get involved that way, instead of thinking about building everything yourself in your own center. Dr. Skip Burris: Absolutely. And you know your situation there, and you have a premier practice with a very academic, community-based practice at Hackensack University Medical Center and akin to but different than what we have at Sarah Cannon where we've got several of those types of locations. But both the institutions proving that someone can be in what is basically community oncology practice—not employed by a medical school or academic medical Center—and yet really participate in high level care with clinical trials. And that's what we've got to do to better serve the country and actually serve the world. We cannot expect that every patient is going to be able to make that trek into a tertiary medical center. And as we walk this out, we have got to bring the trials to the patients, and we've got to bring the therapies to the patients. And that's where an effort at embracing these community oncologists is something that we always hold dear to our heart. Yeah, so I can tell you from my own experience, when I first started off at Hackensack, I was actually medical director of one of the network sites, which even though-- you know New Jersey. There's a hospital in every corner. So, this hospital was in my clear. It was called Hackensack Mountainside. And even though it was only 20 minutes from the cancer center that it was affiliated with, patients really wanted to stay in their hospital. ASCO Daily News: And it's important to bring that perspective because it's not always the case that you can just tell a patient, no, you should go here. They really want to be treated in their community hospital. So being able to offer them what they need is really important. Or even sometimes what I would do is I would bring them over to the cancer center, give them something unique and special that we couldn't do such as a gamma knife radiosurgery, and then bring them back to the main hospital and continuing their care there with their regular oncologist and primary care doctor—everything else that they wanted to continue at their main hospital. Dr. Skip Burris: Yes, well said. I couldn't agree more. And being that liaison and making that connection is going to be a key next step as we try to get more patients and volunteers, physicians involved in research. ASCO Daily News: Yeah. So, I want to ask you another question, which is what is the worst career advice you've gotten? Dr. Skip Burris: So the worst career advice that I received, and it was early in my career—and I want to make sure I call out that I have some great mentors and my career has been focused on early drug development, Phase I clinical trials, and I'm fortunate to have had Dr. Daniel Von Hoff as my first mentor in that regard. But along the way, various other professors and various other leaders there in San Antonio would offer up the advice, which wasn't helpful, which was if you don't do this, you'll never be successful. And on the list of "If you don't do this, you'll never be successful" were if I didn't pick a tumor type—I mean, just—early in my career, make a decision. You're 30 plus years old, new to oncology. And great if a tumor resonates with you, but I wasn't ready to make that commitment. I really liked patients, and I really liked working with oncologists. Second thing was you'll never have credibility if you don't have lab experience. I mean, you've got to have a lab, even if it's a small lab, if it's a one-day-a-week lab, but you'll never have credibility if you don't have a lab. And I did the minimal amount of laboratory work. And, again, I liked being with people. I liked the oncologists I practiced with, and I liked the patients, and so the lab career wasn't for me. And then thirdly and maybe more that era was if you don't take a tenure track at a university, you'll never be a respected thought leader. And so those have to, have to, have to’s we're actually bad advice. And, luckily, I ignored those as I pursued my passion. And my passion was really, during the '90s, the exciting new drugs that were coming along, just how grateful cancer patients were, and what an honor it was to take care of cancer patients. And then actually, as you and I both know the optimistic spirit of most of our colleagues, I actually liked coming to work and being with oncologists. So, setting up and having a community-based practice that did clinical research and ignoring those early have-to’s turned out to be a great selection for me. ASCO Daily News: Wow. I love how you have three worst career advice examples and that you remember them so vividly. I think that's amazing. And like you said, you can think that someone's wrong without having bad feelings towards them, right? But the fact is, they were clearly wrong. Dr. Skip Burris: Correct. And that—you get that perspective. I mean, there are—if I had loved a lab, it probably would've worked out. If I had decided I liked this particular cancer and I threw my heart and soul into it, that probably would've worked out. But the fact is I think you've just got to take a few minutes and know what gets you out of bed and what gets you excited every day and then try to stay true to that. ASCO Daily News: Yeah, that's amazing. So, what would you say is the best career advice you've ever gotten? Dr. Skip Burris: I've had several folks give me really excellent career advice along the way. And my background's a little bit unique because I went to the United States Military Academy at West Point for my undergraduate. So along the way and in my training and through connections, many, many great military leaders of the country I had the opportunity to interact with. And there were little things that were said to me along the way. One of my first connections in the military was with General Maxwell Thurman, who was a be-all-you-can-be person. And that was his motto with the Army at those times. And then I had the good fortune to interact with General Norman Schwarzkopf, whose very simple advice was always when placed in charge, take charge. And those sort of things always stuck with me through the years, but I received some great advice from a mentor and colleague, Dr. Stan Winokur, who, early on in my career, he told me, "While you're busy trying to be famous and you're trying to be a thought leader, when you go into a patient's room, that's their time. And do three things. We sit down for every visit. Always ask them an open-ended question and listen until they answer. And third, make sure that you examine every patient. Have that personal touch. Put your stethoscope on them, feel their belly, do that examination, and create that human connection." And I have kept that in mind. And to this day, when I go in an exam room, I do those three things. And I think just making sure that that patient, whether it's 5 minutes or 15 minutes or whatever, you're in the room with them. Between the nurse practitioners and the hustling for treatment and all the paperwork that has to be done, that has enabled me to have that connection with my patients. And I just think back. That's very simple advice, and it really was something that I've kept near and dear to my heart. And it's worked out for me through the years. ASCO Daily News: Well, thanks for sharing that with us. That's really amazing advice. So, my last question is, what advice would you give to trainees and early career oncologists? Dr. Skip Burris: Today, in the field of cancer, boy, just all the opportunities and the excitement with the many new therapies and just the flood of information. It can be overwhelming. I think that can contribute to our concerns about burnout and our concern about doctors being overwhelmed. So, a couple thoughts that I would say to somebody early in their career. One is that you can do absolutely anything, but you also absolutely cannot do everything. And so hard to say no and hard to pick and choose, but really, really eyes open, listen to your heart, take a broad perspective, but resist the temptation to try to be all things to all people all the time. And then secondly, I think it's important as you're deciding where to spend your time and your career, I looked at two elements of that. You've got to love what you're doing, be that patient care, clinical research, laboratory, or some combination of those or lecturing or the others. But also, you're going to spend a lot of time at work. And so, make sure that you're choosing an area where you like being with those people. That's something that I got that advice early on not only loving what you do, but love being with the people that you're doing it with. And I think that's something that folks early in their career will really need to think about as they choose what particular path they're going to take. ASCO Daily News: Thanks so much for the candid advice and spending this time with us today. And I wanted to thank all of our listeners for joining us for this episode of the ASCO Daily News Podcast. We absolutely love, love to have your feedback, so please drop us a note at DailyNews@ASCO.org. And rate and review us on Apple Podcasts. Have a great day. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.    

Although genomic testing is recognized in national oncology guidelines as key to determining the right therapy for metastatic colorectal cancer (MCC), overall biomarker testing rates remain poor. On this episode of Managed Care Cast, we speak with one of the authors of a recent study about this issue published in JCO Precision Oncology. Stuart Goldberg, MD, a hematologist oncologist at the John Theurer Cancer Center at Hackensack University Medical Center, discusses real-world testing of biomarkers in MCC by mining electronic health records. Goldberg is also the hospital’s first chief of the Division of Outcomes and Value Research, and the episode also discusses the relationship between value-based medicine and precision medicine and the promise of delivering improved outcomes at lower costs by avoiding ineffective therapies through the use of specialized testing and diagnostics.

Welcome to the Third Annual Cancer Conference - Beyond Rest: A Rehabilitative Approach to Managing Cancer-Related Fatigue sponsored by Kessler Institute Rehabilitation and Kessler Foundation. In this session, nurse clinician Linda Schmidt from the John Theurer Cancer Center at Hackensack University Medical Center presented “Screening for Cancer-Related Fatigue”. View the transcript at https://kesslerfoundation.org/sites/default/files/2019-09/Cancer-Related%20Fatigue%20Part%202%20of%205%20Screening-FINAL-Transcript.pdf Cancer-related fatigue is an issue that often develops during treatment and can last for months or even years. This live course will focus on the impact, screening and management of the physical, psychological, emotional and cognitive sequelae. Participants will gain understanding of various evidence-based therapeutic interventions and the overall benefits of a multi-professional approach. Topics to be discussed will include current research and practice guidelines, as well as the unique role that rehabilitation can play in managing and reducing signs of cancer-related fatigue. This presentation was recorded, produced, and edited by Joan Banks-Smith, Creative Producer for Kessler Foundation on Thursday, August 8, 2019 at the Kessler Institute for Rehabilitation, West Orange Campus, New Jersey. To listen to more conference podcasts, go to https://soundcloud.com/kesslerfoundation/sets/cancer-research For more information about Kessler Institute for Rehabilitation, go to kessler-rehab.com (www.kessler-rehab.com) For more information about Kessler Foundation and our researchers, go to KesslerFoundation.org (www.KesslerFoundation.org). Follow us on Facebook, Twitter, and Instagram. Listen to us on Apple Podcasts, Spotify, SoundCloud, or wherever you get your podcasts.

Dr. Miriam A. Knoll, MD DABR is a board-certified radiation oncologist at the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey. Dr Knoll is an Associate Senior Editor for the American Society of Radiation Oncology (ASTRO)'s journal Advances in Radiation Oncology. She is an international invited lecturer speaking about social media in medicine, women in medicine, and medical education. Dr. Knoll has published in many high-impact factor peer reviewed journals. Her writing has been featured in the Huffington Post, ASCO Connection, Mishpacha, Jewish Press, KevinMD.com, among others. She is a Forbes contributor. Dr. Knoll lives with her physician husband and four sons in Woodmere, New York. You can follow her on Twitter @MKnoll_MD  and on Instagram @Dr.Mimi.K   In this Episode, Dr.  Miriam "Mimi" Knoll shares her advice on living a courageous, whole life. We discuss the idea that we all have choices in just about everything we do. We often are afraid to take a scary leap, try something new or get out of our comfort zone and that is truly what is stoping us from living our most vibrant, happy life. Mimi discusses how she views all her numerous roles (doctor, wife, mother etc.) as one cohesive element and that when a mother is fulfilled and passionate about what she is doing the whole family thrives. I could have chatted with Mimi for hours. She is truly remarkable in all that she has accomplished and continues to do.  (In this episode, we talk about Brooke Castillo and her podcast: The Life Coach School Podcast   Favorites: Book: Daring Greatly by Brene Brown Role Model: her mother  Dr. Chana Gelbfish Easy Dinner:Tacos Way to unwind: manicure or massage

Patients with Parkinson disease can suffer complications in the hospital if the individualized, highly structured care plans that manage their disease are not followed. We interviewed neurologist Hooman Azmi, MD, the co-author of Parkinson's Disease for the Hospitalist: Managing the Complex Care of a Vulnerable Population, about what it takes to improve patient care for this population. He is the director of the Division of Movement Disorders at Hackensack University Medical Center and is also a member of the neuro-oncology team at the John Theurer Cancer Center at Hackensack UMC.

CAR T therapy is becoming a hot area of early clinical trials for multiple myeloma patients, but most are personally customized for each patient. A company called Cellectis has developed an off-the-shelf CAR T that every patient can use. Instead of being an "autologous" CAR T treatment (where you use your own cells), this is also called an "allogeneic" CAR T, or a "donor"CAR T. Many of the current CAR T therapies are going after a target called b-cell maturation antigen (BCMA). This It is going after a different target called CS1/SLAMF7. Learn more about this new treatment (called UCARTCS1) from David Siegel, MD, PhD of Hackensack University / John Theurer Cancer Center and how it will be used in early myeloma clinical trials.  Thanks to our episode sponsor: Celgene Corporation

What are the biggest challenges in healthcare currently? How does a human-centric health system look like? How will digital technologies, big data and precision medicine change the way we are diagnosed and treated in the future? In this weeks episode of "A Glimpse into the Future", we talk to the internationally renowned clinician and researcher, Dr Andre Goy, Chairman and Executive Director of the John Theurer Cancer Center at Hackensack University Medical Center. Dr Goy is also the co-chair of the World Economic Forum's Council on the Future of Health and Healthcare.

This interview is part of our HIMSS18 coverage and was recorded live in the exhibit hall. On this episode we talk with Stuart Goldberg, MD, Chief Scientific Officer at Cota. Dr. Goldberg tells us all about Cota's physician-led journey to organize and classify real-world evidence about every type of cancer. This effort led to something they call the Cota Nodal Address (CNA), and it's enabling health systems to get very specific about the types of patients they're treating, the costs associated with them, and the outcomes being achieved. This apples-to-apples comparison allows Cota to identify variation and address it in ways that are beneficial to the provider, payer and patient. It enables a concept Dr. Goldberg calls "Precision Payment", which in turn enables proper bundled payment design, and precision medicine.  And Cota is not only physician led, but the payers are on board too. Literally. Horizon Blue Cross Blue Shield lead their Series A funding round. Plus, they just closed a $40 Million Series C funding round in February. Cota is clearly a company to watch. This was one of the most intriguing conversations I had at HIMSS '18 and one that I'll be exploring some more. I'm very excited to share it with you... ~ Don Lee About Cota Cota is a healthcare data and analytics company that enables providers, payers and life science companies involved in diagnosing and treating complex diseases to optimize the outcomes of individual patients and lower the overall cost of the patient population served. It is powered by the patented Cota Nodal Address™ (CNA) system, a unique digital classification methodology built by leading physicians and data scientists. The CNA is the first and only system that precisely categorizes patient factors, their diseases and intended therapies, enabling precision medicine at scale. Cota's technology enriches medical records to create research-grade data and joins it with a suite of analysis, visualization and management tools. This enables providers, payers and life science companies to analyze, report on and research outcomes, costs, treatments and quality at any granularity and stage of the patient journey. The result is a constantly improving system that merges technology and medicine to improve the lives of patients everywhere. For more information, go to www.cotahealthcare.com  About Stuart Goldberg, MD Stuart Goldberg, MD is Chief Scientific Officer at Cota, Inc. and Associate Clinical Professor of Medicine at Rutgers: The New Jersey Medical School. He also maintains an active clinical practice in the Division of Leukemia at the John Theurer Cancer Center. Dr. Goldberg obtained his medical degree at the Milton Hershey Medical Center of Pennsylvania State University. After completing internal medical residency and hematology-oncology fellowships at George Washington University Medical Center, he served as a BMT fellow at the Mayo Clinic and Associate Director of the BMT Program at Temple University. Dr. Goldberg's clinical research has focused on new treatment strategies for patients with chronic myelogenous leukemia and myelodysplastic syndromes. Recognizing the wealth of information contained in electronic health record data, he and his partners at JTCC founded Cota, a data and analytics company that seeks to optimize patient outcomes while reducing population healthcare costs. In the field of “big data” analysis he has used databases to redefine the incidence and complications related with myelodysplastic syndromes (published in JCO and Transfusion) and has reviewed observational databases (including SIMPLICITY) to foster adherence with evidence based CML monitoring guidelines (published in JOP, CRMO and CLML). Most recently he has used the Cota database to explore rates and implications of EGFR mutational testing among community oncologists (published in Clin Lung), patterns of care in T-cell lymphoma (published in CLML), end-of-life care decisions (published in Palliative Med) and cost-effectiveness of genomic profiling in lower risk breast cancer (published in AJMC). This research earned him the 2015 David King Clinical Scientist Award from the Association of Community Cancer Centers (ACCC). He is listed as a Castle Connolly Top Doctor for Medical Oncology in the NY Metro and NJ areas. You can find the rest of our HIMSS '18 Interviews here. Subscribe to Weekly Updates If you like what we're doing here, then please consider signing up for our weekly newsletter. You'll get one email from me each week detailing: New podcast episodes and blog posts. Content or ideas that I've found valuable in the past week. Insider info about the show like stats, upcoming episodes and future plans that I won't put anywhere else.   Plain text and straight from the heart :) No SPAM or fancy graphics and you can unsubscribe with a single click anytime. The #HCBiz Show! is produced by Glide Health IT, LLC in partnership with Netspective Media. Music by StudioEtar

What are the biggest challenges in healthcare currently? How does a human-centric health system look like? How will digital technologies, big data and precision medicine change the way we are diagnosed and treated in the future? In this weeks episode of "A Glimpse into the Future", we talk to the internationally renowned clinician and researcher, Dr Andre Goy, Chairman and Executive Director of the John Theurer Cancer Center at Hackensack University Medical Center. Dr Goy is also the co-chair of the World Economic Forum's Council on the Future of Health and Healthcare.

The multiple myeloma aresenal is growing, giving myeloma experts more tools to combat the complex blood cancer, multiple myeloma. Learn how investigators like Dr. David Siegel, MD, PhD of the John Theurer Cancer Center are vetting treatment combinations using clinical trials to identify optimal treatment paths, especially for patients who are facing relapses or who have become refractory to existing medications.  Thanks to our episode sponsor, Takeda Oncology.