Podcasts about Oncology

This episode is sponsored by Invivyd, Inc.Marc Elia is a biotech investor, the Chairman of the Board at Invivyd, and a Long COVID patient who decided to challenge the system while still stuck inside it. He's not here for corporate platitudes, regulatory shoulder shrugs, or vaccine-era gaslighting. This is not a conversation about politics, but it's about power and choice and the right to receive care and treatment no matter your condition.In this episode, we cover everything from broken clinical pathways to meme coins and the eternal shame of being old enough to remember Eastern Airlines. Marc talks about what it means to build tools instead of just complaining, what Long COVID has done to his body and his patience, and why the illusion of “choice” in healthcare is a luxury most patients don't have.This conversation doesn't ask for empathy. It demands it.RELATED LINKSMarc Elia on LinkedInInvivyd Company SiteMarc's Bio at InvivydFEEDBACKLike this episode? Rate and review Out of Patients on your favorite podcast platform. For guest suggestions or sponsorship inquiries, email podcast@matthewzachary.comSee Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Doctors often use euphemisms to dance around the 'C' word. But for oncologist Dr Ranjana Srivastava, how you talk to someone with cancer goes beyond "shadows, lumps and lesions". It's all about compassion and clarity, even when honesty is difficult.Ranjana Srivastava was a young doctor in regional Australia, accompanying her consultant on his late night rounds when she heard a patient say something that stopped Ranjana in her tracks.It was in that moment that she finally knew what her speciality was going to be: oncology. Ranjana now works in Melbourne as an oncologist and an author.She often writes about the need for clarity and compassion in doctor-patient conversations, to deliver good news, bad news and everything that falls between.Ranjana had her own experience of being at the receiving end of devastating news when she was pregnant with twins.Ranjana has carried the lesson she received from her own doctor forward, into her work as an oncologist, where bearing witness to the attitudes of her patients has changed the way she sees the world and has helped put her own life in perspective.Further informationRanjana's latest book, Every Word Matters, is published by Simon & Schuster.She has published seven books about cancer and end of life care, including A Better Death, Tell Me the Truth, Dying for a Chat, So It's Cancer: Now What, and After Cancer: A Guide to Living Well.Ranjana also writes a regular column for The Guardian.In 2017, Ranjana was awarded an Order of Australia medal for her work as an oncologist and in improving doctor-patient communication.This episode of Conversations was produced by Meggie Morris. Executive producer is Nicola Harrison.It explores cancer, oncology, the big C, cancerland, breast cancer, bowel cancer, how to survive cancer, incurable cancer, end of life care, palliative care, honest doctors, refusing treatment, chemotherapy, radiation, how to be honest with patients, doctor patient relationship, geriatric oncology, India, migration, motherhood, late term miscarriage, pregnancy, writing, books, origin story, journalism.To binge even more great episodes of the Conversations podcast with Richard Fidler and Sarah Kanowski go the ABC listen app (Australia) or wherever you get your podcasts. There you'll find hundreds of the best thought-provoking interviews with authors, writers, artists, politicians, psychologists, musicians, and celebrities.

Did you know that in some families with a history of prostate cancer, the women may have an increased risk of breast cancer? People with one or more first-degree relatives (father or brother) who have had prostate cancer may have an increased risk of breast cancer, especially if the prostate cancer was diagnosed at a young age. This also works in reverse with a family history of breast cancer. This increased risk is likely due to inherited gene mutations. We are lucky to be joined today by genetic testing expert, Dr. Tuya Pal. Dr. Pal is here to discuss the importance of early detection and to decode some common questions surrounding genetic testing.

Send us a textCristina Durán is President of Evinova ( https://evinova.com/ ), a healthtech company empowering global life sciences organizations to accelerate better health outcomes with a suite of globally scaled digital health solutions, empowering sites, sponsors and contract research organizations to optimize the entire clinical development lifecycle.Prior to launching Evinova in November 2023, Cristina led AstraZeneca's Digital Health function in Research & Development (R&D) across key therapy areas: Oncology; Cardiovascular, Renal and Metabolism; and Respiratory and Immunology.Cristina previously held senior leadership roles at AstraZeneca across global commercial, in-country commercial, finance and R&D, and led a global transformation in clinical development across R&D functions, focusing on patients' experiences and outcomes with benefits delivered globally.Before joining AstraZeneca, Cristina was a senior management consultant at Accenture, leading large transformation programs, including the set up, from scratch, of a new joint venture between two technology companies, which is now a major business for a top retailer, as well as guiding business transformation strategy reviews and implementing global change initiatives for large telecoms.Cristina is passionate about innovation and increasing enterprise value by inspiring organizations to change for the future and has spoken about using innovative technologies to transform patients' lives at conferences, including the Digital Health World Congress, HLTH EU, BiotechX EU, and the Financial Times Global Pharmaceutical and Biotechnology Conference. Cristina is a chartered accountant (CIMA) and has completed the Massachusetts Institute of Technology Leading Enterprise Transformation program.#CristinaDuran #Evinova #AstraZeneca #DigitalHealth #ClinicalTrials #PatientExperience #RemoteMonitoring #DecentralizedClinicalTrials #MachineLearning #ArtificialIntelligence #Innovation #Science #Technology #Research #ProgressPotentialAndPossibilities #IraPastor #Podcast #Podcaster #Podcasting #ViralPodcastSupport the show

Ms Charise Gleason from Emory Healthcare in Atlanta, Georgia, discusses the evolution of first-line therapy for patients with multiple myeloma. NCPD information and select publications here.

Prof Xavier Leleu from Poitiers University Hospital in Poitiers, France, discusses nursing considerations in the treatment of newly diagnosed multiple myeloma. NCPD information and select publications here.

Dr. Sumanta (Monty) Pal and Dr. Petros Grivas discuss innovative new intravesical therapies and other recent advances in the treatment of non-muscle invasive bladder cancer. TRANSCRIPT Dr. Sumanta (Monty) Pal: Hello and welcome. I'm Dr. Monty Pal here at the ASCO Daily News Podcast. I'm a medical oncologist and professor and vice chair of academic affairs at the City of Hope Comprehensive Cancer Center in Los Angeles. And I'm really delighted to be your new host here. Today's episode is going to really sort of focus on an area near and dear to my heart, something I actually see in the clinics, and that's bladder cancer. We're specifically going to be discussing non-muscle invasive bladder cancer, which actually comprises about 75% of new cases. Now, in recent years, there's been a huge shift towards personalized bladder-preserving strategies, including innovative therapies and new agents that really are reducing reliance on more primitive techniques like radical cystectomy and radiation therapy. And I'm really excited about this new trend. And really at the forefront of this is one of my dear friends and colleagues, Dr. Petros Grivas. He's a professor in the Department of Medicine and Division of Hematology Oncology at the University of Washington. It's going to take a while to get through all these titles. He's taken on a bunch of new roles. He is medical director of the International Program, medical director of the Local and Regional Outreach Program, and also professor in the Clinical Research Division at the Fred Hutch Cancer Center. Petros, welcome to the program. Dr. Petros Grivas: Thank you so much, Monty. It's exciting for me to be here. Dr. Sumanta (Monty) Pal: Just FYI for our audience, our disclosures are available in the transcript of this episode.  We're going to get right into it, Petros. Non-muscle invasive bladder cancer, this is a really, really challenging space. We see a lot of recurrence and progression of the disease over time, about 50% to 70% of patients do have some recurrence after initial treatment, and about 30% are ultimately going to progress on to muscle-invasive or metastatic disease. Now, I will say that when you and I were in training, non-muscle invasive bladder cancer was something that was almost relegated to the domain of the urologist, right? They would use treatments such as BCG (Bacillus Calmette-Guérin) in a serial fashion. It was rare, I think, for you and I to really enter into this clinical space, but that's all changing, isn't it? I mean, can you maybe tell us about some of the new therapies, two or three that you're really excited about in this space? Dr. Petros Grivas: Monty, you're correct. Traditionally and conventionally, our dear friends and colleagues in urology have been managing patients with non-muscle invasive bladder cancer. The previous term was superficial bladder cancer. Now, it has changed, to your point, to non-muscle invasive bladder cancer. And this has to do with the staging of this entity. These tumors in superficial layers of bladder cancer, not invading the muscularis propria, the muscle layer, which makes the bladder contract for urine to be expelled. As you said, these patients have been treated traditionally with intravesical BCG, one of the oldest forms of immunotherapy that was developed back in the 1970s, and this is a big milestone of immunotherapy development. However, over the years, in the last 50 years, there were not many options for patients in whom the cancers had progression or recurrence, came back after this intravesical BCG. Many of those patients were undergoing, and many of them still may be undergoing, what we call radical cystectomy, meaning removal of the bladder and the lymph nodes around the bladder. The development of newer agents over the last several years has given the patients the option of having other intravesical therapies, intravesical meaning the delivery of drugs, medications inside the bladder, aiming to preserve the bladder, keep the bladder in place. And there are many examples of those agents. Just to give you some examples, intravesical chemotherapy, chemotherapy drugs that you and me may be giving intravenously, some of them can be given inside the bladder, intravesical installation. One example of that is a combination of gemcitabine and docetaxel. These drugs are given in sequence one after the other inside the bladder, and they have seen significant efficacy, good results, again, helping patients keeping the bladder when they can for patients with what we call BCG unresponsive non-muscle invasive bladder cancer. And again, there's criteria that the International Bladder Cancer Group and the FDA developed, how to define when BCG fails, when we have BCG unresponsive non-muscle invasive bladder cancer. Dr. Sumanta (Monty) Pal: And we're actually going to get into some of the FDA requirements and development pathways and so forth. What I'm really interested in hearing, and I'm sure our audience is too, are maybe some of the new intravesical treatments that are coming around. I do think it's exciting that the gemcitabine and docetaxel go into the bladder indeed, but what are some of the top new therapies? Pick two or three that you're excited about that people should be looking out for in this intravesical space. Dr. Petros Grivas: For sure, for sure. In terms of the new up-and-coming therapies, there are a couple that come to mind. One of them is called TAR-200, T-A-R 200. This agent is actually a very interesting system. It's an intravesical delivery of a chemotherapy called gemcitabine, the one that I just mentioned a few minutes ago, that is actually being delivered through what we call a pretzel, which is like a rounded [pretzel-shaped] structure working like an osmotic pump, and that is being delivered inside the bladder intravesically by urologists. And this drug is releasing, through the osmotic release mechanism, this chemotherapeutic drug, gemcitabine, inside the bladder. And this can be replaced once every 3 weeks in the beginning. And the data so far from early-phase trials are really, really promising, showing that this agent may be potentially regulatory approved down the road. So TAR-200 is something to keep in mind. And similarly, in the same context, there is a different drug that also uses the same mechanism, and this osmotic release, this pretzel, it's just encoded with a different agent. The different agent is an FGFR inhibitor, a target therapy called erdafitinib, a drug that you and me may give in patients with metastatic urothelial carcinoma if they have an FGFR3 mutation or fusion. And that drug is called TAR-210. Dr. Sumanta (Monty) Pal: And can I ask you, in that setting, do you have to have an FGFR3 mutation to receive it? Or what is the context there? Dr. Petros Grivas: So for TAR-210, TAR-2-1-0, usually there is a checking to see if there is an FGFR3 mutation or fusion. And the big question, Monty, is do we have adequate tissue, right? From a limited tissue on what we call the TURBT, right, that urologists do. And now there is a lot of development in technology, for example, urine circulating tumor DNA to try to detect these mutations in the urine to see whether the patient may be eligible for this TAR-210. Both of those agents are not FDA approved, but there are significant promising clinical trials. Dr. Sumanta (Monty) Pal: So now let's go to a rapid-fire round. Give us two more agents that you're excited about in this intravesical space. What do you think? Dr. Petros Grivas: There is another one called cretostimogene. It's a long name. Dr. Sumanta (Monty) Pal: They really make these names very easy for us, don't they? Dr. Petros Grivas: They are not Greek names, Monty, I can tell you, you know. Even my Greek language is having trouble pronouncing them. The cretostimogene, it's actually almost what we call a growth factor, a GM-CSF. The actual name of this agent is CG0070. This is a replicating mechanism where GM-CSF is replicating in cells. And this agent has shown significant results again, like the TAR-200, in BCG unresponsive non-muscle invasive bladder cancer. I would say very quickly, two agents that actually were recently approved and they're already available in clinical practice, is nadofaragene firadenovec, another long name. That's a non-replicating vector that has the gene of interferon alfa-2b that stimulates the immune system in the bladder. It's given once every 3 months. And the last one that was, as I mentioned, already FDA approved, it's an interleukin-15 superagonist. It's another long name, which is hard to pronounce, but I will give it a try. It's a drug that was recently actually approved also in the UK. The previous name was N-803. It's given together with BCG as a combination for BCG unresponsive non-muscle invasive bladder cancer. Dr. Sumanta (Monty) Pal: This is a huge dilemma, I think, right? Because if you're a practicing, I'm going to say urologist for the moment, I guess the challenge is how do you decide between an IL-15 superagonist? How do you decide between a pretzel-eluting agent? How do you decide between that and maybe something that's ostensibly, I'm going to guess, cheaper, like gemcitabine and docetaxel? What's sort of the current thinking amongst urologists? Dr. Petros Grivas: Multiple factors play into our account when the decision is being made. I discuss with urologists all the time. It's not an easy decision because we do not have head-to-head comparisons between those agents. As you mentioned, intravesical chemotherapy with gemcitabine and docetaxel has been used over the years and this is the lowest cost, I would say, the cheapest option with good efficacy results. Obviously, the nadofaragene firadenovec every 3 months and the interleukin-15 superagonist, N-803, plus BCG have also been approved. The question is availability of those agents, are they available? Are they reimbursed? Cost of those agents can come into play. Frequency of administration, you know, once every 3 months versus more frequent. And of course, the individual efficacy and toxicity data, preference of the patients; sometimes the provider, the urologist, may have something that they may be more familiar with. But we lack this head-to-head comparison. Of course, I want to make sure I mention that radical cystectomy may still be the option for appropriate patients. So that complicates also the decision making and has to be individualized, customized, and personalized, taking into account all those factors. And there is not one size fitting all. Dr. Sumanta (Monty) Pal: So I think we discussed five intravesical therapies. As you point out, and you know, I'm going to get some calls about this: I think I referred to radical cystectomy as being a more primitive procedure. Not true at all. I think it's something that still is, you know, a mainstay of management in this disease space. But I guess it gets even more complicated, am I right, Petros? Because now we have systemic therapies that we can actually apply in this non-muscle invasive setting for at this point, refractory disease. Can you maybe just give us a quick two-minute primer on that? Dr. Petros Grivas: Absolutely, and systemic therapies now come into play, as you said. And a classical example of that, Monty, came from the KEYNOTE-057 trial that we published about 6 years ago. This is intravenous pembrolizumab, given intravascularly, intravenously, as opposed to the previously discussed intravesical administration of agents. Pembrolizumab was tested in that KEYNOTE-057 trial and showed efficacy about, I would say, one out of five patients, about 20%, had a complete response of the tumor in the bladder in a year after starting the treatment. Again, it's hard to compare across different agents, but obviously when we give something intravenously, there is a risk of toxicity, side effects systemically, what we call immune-related adverse events. And this can also play in the decision making, right? When you have intravesical agents versus intravascular agents, there is different toxicity profiles in terms of systemic toxicity. But intravenous pembrolizumab has been an option, FDA approved, since, if I remember, it was early 2020 when this became FDA approved. There are other agents being tested in this disease, but like atezolizumab through the SWOG study that Dr. Black and Dr. Singh led, but atezolizumab is not FDA approved for this indication. Again, this is for BCG unresponsive, high-risk, non-muscle invasive bladder cancer. Dr. Sumanta (Monty) Pal: So maybe teach us how it works, for instance, at an expert center like the Fred Hutch. When you see a patient with non-muscle invasive bladder cancer, there's obviously the option of surgery, there's the intravesical therapies, which I imagine the urology team is still really at the helm of. But then, I guess there has to be consideration of all options. So you've got to bring up systemic therapy with agents like pembrolizumab. In that context, are you involved that early on in the conversation? Dr. Petros Grivas: That's a great discussion, Monty. Paradigm is shifting as we mentioned together. The urologists have been treating these patients and still they are the mainstay of the treaters, the managers in this disease. But medical oncologists come to play more and more, especially with the FDA approval of intravenous pembrolizumab about 5 years ago [GC1]  [KM2] . We have the concept of multidisciplinary bladder cancer clinic here at Fred Hutch and University of Washington. This happens every Tuesday morning, and we're very excited because it's a one-stop shop for the patients. We have the urologist, a medical oncologist, radiation oncologist, and experts from radiology and pathology, and we all review cases specifically with muscle-invasive bladder cancer. But every now and then, we see patients with BCG unresponsive non-muscle invasive bladder cancer. And this is where we discuss and we talk to the patient about pros and cons of all those options. And that's a classic example where medical oncologists may start to see those patients and offer their input and expertise. In addition to that, sometimes we have clinical trials, we may see these patients because there are systemic agents that may be administered in this setting. We have the SunRISe trial program that includes also a systemically administered checkpoint inhibitor. So that's another example where we see patients either in the context of multi-clinic or in individual solo clinics to counsel the patients about the pros and cons of the systemically administered agents in the context of clinical trials. Usually checkpoint inhibitors are the class of agents that are being tested in this particular scenario. Dr. Sumanta (Monty) Pal: I can see a scenario where it's really going to require this sort of deep dive, much in the way that we do for prostate cancer, for instance, where the medical oncologist is involved very early on and planning out any sort of systemic therapy component of treatment or at the very least, at least spelling out those options. I think it's going to be really interesting to see what this space looks like 5 or 10 years down the road. In closing, I wanted to go through something that I think is so different in this space, at least for the time being, and that is the paradigm for FDA approval. When you and I have our fellows in the clinics, we always say, “Look, you know, the paradigm in this disease and that disease and the other disease needs to be phase 3 randomized trials, right? Big thousand patient experiences where you're testing clinical endpoints.” That's tough in non-muscle invasive bladder cancer, right? Because thankfully, outcomes can actually be quite good, you know, in this setting, right? It's tough to actually estimate overall survival in some of these early-stage populations. Tell me what the current regulatory bar is, and this is a tough thing to do in 2 minutes or less but tell me where you see it headed. Dr. Petros Grivas: You alluded to that before, Monty, when I was giving the background and we talked about the regulatory approval. And I have to very quickly go back in time about 10 years ago because it's important for context that can help us in other disease types too. We had workshops with the FDA and the NCI with the help of the International Bladder Cancer Group and other colleagues. And we try to define a framework, what endpoints are meaningful for those patients in this disease. It was a multidisciplinary, multiple stakeholders meeting, where we tried to define what is important for patients. What are the available agents? What are the trial designs we can accept? And what are the meaningful endpoints that the regulatory agencies can accept for regulatory approval? And that was critical in that mission because it allowed us to design clinical trials, for example, single-arm trials in a disease where there was no standard of care. There was intravesical valrubicin and chemotherapy anthracycline that was approved for many years, but was not practically used in clinical practice, despite being approved, the valrubicin. And because of that, the FDA allowed these single-arm trials to happen. And obviously the endpoint was also discussed in that meeting. For example, for carcinoma in situ, complete response, clinical complete response, because the bladder remains intact in many patients, clinical complete response was a meaningful primary endpoint, also duration of response is also very important. So what is the durable clinical complete response in 1 year or 18 months is relevant. And when you have papillary tumors like Ta or T1 with CIS, for papillary tumors, event-free survival becomes one of the key endpoints and you look at it over time, for example, at 12 or 18 months, what is the event-free survival? So clinical complete response, duration of response, event-free survival, depending on the CIS presence or papillary tumors, I think these are endpoints that have allowed us to design those trials, get those agents approved.  Now, the question going forward, Monty, and we can close with that is, since now we have the embarrassment of riches, many more options available compared to where we were 6 and 7 years ago, is now the time to do randomized trials? And if we do randomized trials, which can be the control group? Which of those agents should be allowed to be part of the control group? These are ongoing discussions right now with the NCI, with other agencies, cooperative groups, trying to design those trials and move forward from here.[GC3]  Dr. Sumanta (Monty) Pal: Well, it's awesome to have you here on the program so we can get some early looks into some of these conversations. I mean, clearly, you're at the table at a lot of these discussions, Petros. So I want to thank you for sharing your insights with us today. This was just tremendous. Dr. Petros Grivas: Thank you, Monty. You know, patients in the center, I just came back from the Bladder Cancer Advocacy Network meeting in Washington, D.C., and we discussed all those questions, the topics you very eloquently mentioned and asked me today, and patients gave us great feedback and patients guide us in that effort. Thank you so, so much for having me and congratulations for the amazing podcast you're doing. Dr. Sumanta (Monty) Pal: Oh, cheers, Petros, thanks so much.  And thank you to the listeners who joined us today. If you really like the insights that you heard on this ASCO Daily News Podcast, please rate, review, and subscribe wherever you get your podcasts. Thanks, everyone. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.   Find out more about today's speakers:      Dr. Sumanta (Monty) Pal  @montypal  Dr. Petros Grivas @PGrivasMDPhD   Follow ASCO on social media:     @ASCO on Twitter    ASCO on Bluesky   ASCO on Facebook     ASCO on LinkedIn     Disclosures:    Dr. Sumanta (Monty) Pal:   Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview  Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical  Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis  Dr. Petros Grivas: Consulting or Advisory Role: Merck, Bristol-Myers Squibb, AstraZeneca, EMD Serono, Pfizer, Janssen, Roche, Astellas Pharma, Gilead Sciences, Strata Oncology, Abbvie, Bicycle Therapeutics Replimune, Daiichi Sankyo, Foundation Medicine, Bicycle Therapeutics, Eli Lilly, Urogen Pharma, Tyra Biosciences Research Funding (Inst.): Bristol-Myers Squibb, Merck, EMD Serono, Gilead Sciences, Acrivon Therapeutics, ALX Oncology, ALX Oncology, Genentech Travel, Accommodations, Expenses: Gilead Sciences

In this week's episode, we'll learn about how TET2 is often mutated in myeloid malignancies and clonal hematopoiesis. In new work, expansion of Tet2-mutant HSPCs was dependent on Ncoa4, the cargo receptor mediating ferritinophagy. We'll iron out the implications. After that: a double-oh-seven license to kill in T-cell leukemia/lymphoma. WU-CART-007 is an off-the-shelf CAR T product with manageable safety and encouraging efficacy. With further work, it could become a new option for patients in urgent need of therapy. Finally: a comprehensive genetic study of classical Hodgkin lymphoma using circulating tumor DNA. This new research provides novel and complex insights on genetic subtypes, prognostic biomarkers, neoantigens in the disease environment, and more.Featured Articles:An in vivo barcoded CRISPR-Cas9 screen identifies Ncoa4-mediated ferritinophagy as a dependence in Tet2-deficient hematopoiesisPhase 1/2 trial of anti-CD7 allogeneic WU-CART-007 for patients with relapsed/refractory T-cell malignanciesA comprehensive genetic study of classic Hodgkin lymphoma using circulating tumor DNA

Click here to view the full article on Oncology Data Advisor: https://oncdata.com-ai-ascomind ASCOmind is a novel artificial intelligence (AI) framework designed to help clinicians, researchers, and industry teams synthesize the vast amount of data presented at the American Society of Clinical Oncology (ASCO) Annual Meeting. In the latest episode of Exploring AI in Oncology, Waqas Haque, MD, MPH, speaks with Xiaoyan Wang, PhD, Research Professor at Tulane University, and William Oh, MD, Professor of Internal Medicine at Yale School of Medicine, about the development, integration, and benefits of this valuable tool.

After years of carrying the weight of lead, Shannon and Cooper find a path out from under the darkness and into the sunlight.LEAD: how this story ends is up to us is an audio docudrama series that tells the true story of one child, his mysterious lead poisoning, and his mother's unwavering fight to keep him safe. A true story written by Shannon Burkett. Directed by Alan Taylor. Starring Merritt Wever, Alessandro Nivola, Cynthia Nixon, and Cooper Burkett.Lead was produced by Shannon Burkett. Co-produced by Jenny Maguire. Featuring Amy Acker, Tom Butler, Dennis T. Carnegie, James Carpinello, Geneva Carr, Dann Fink, Alice Kris, Adriane Lenox, Katie O'Sullivan, Greg Pirenti, Armando Riesco, Shirley Rumierk, Thom Sesma, and Lana Young. Music by Peter Salett. “Joy In Resistance” written by Abena Koomson-Davis and performed by Resistance Revival Chorus. Casting by Alaine Alldaffer and Lisa Donadio. Sound Design by Andy Kris. Recording Engineer Krissopher Chevannes.For corresponding visuals and more information on how to protect children from lead exposure please go to https://endleadpoisoning.org.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Dr. Douglas Flora, Executive Medical Director of Oncology Services at St. Elizabeth Healthcare Cancer Center and Editor-in-Chief of the journal AI in Precision Oncology, shares his pragmatic perspective on how AI is reshaping cancer care today and tomorrow. He discusses real-world applications such as FDA-approved pattern recognition tools in imaging and pathology, how AI may soon integrate with ctDNA to guide treatment decisions, and the clinical trials needed to advance this field. Dr. Flora also highlights how AI can enhance decision support in community oncology, expand care access in rural areas, and what his journal is doing to engage clinicians, researchers, and innovators in this rapidly evolving space. Check out Chadi's website for all Healthcare Unfiltered episodes and other content. www.chadinabhan.com/ Watch all Healthcare Unfiltered episodes on YouTube. www.youtube.com/channel/UCjiJPTpIJdIiukcq0UaMFsA

Today, we are sharing an episode of Your Healthiest Healthy, in which our Honorary Vice Chair, Paula Schneider, made an appearance. In the episode, she discusses her cancer journey, the current landscape, and Paula's new book, Love Stays Strong, which is out today, September 2.

Listen to ASCO's JCO Oncology Practice Art of Oncology article, "No Versus Know: Patient Empowerment Through Shared Decision Making” by Dr. Beatrice Preti, who is an Assistant Professor at Emory University. The article is followed by an interview with Preti and host Dr. Mikkael Sekeres. Dr Preti explores the challenges which may prevent oncologists from fully engaging with patients during shared decision making. TRANSCRIPT Narrator: No Versus Know: Patient Empowerment Through Shared Decision Making, by Beatrice T.B. Preti, MD, MMed, FRCPC  During a recent clinic, I saw three patients back-to-back, all from minority backgrounds, all referred for second opinions, all referenced in the notes for being different forms of difficult. Refused chemo, refused hospice, read one note. Refused surgery and chemo, read another, unsure about radiation. Yet, despite the documented refusals (I prefer the term, decline), they had come to my clinic for a reason. They were still seeking something. As an oncologist trained in a program with a strong emphasis on shared decision making between physician and patient, I approach such situations with curiosity. I consider optimal shared decision making a balance between the extremes of (1) providing a patient complete choice from a menu of treatment options, without physician input, and (2) indicating to a patient the best course of treatment, in the eyes of the physician.1 This is a balance between beneficence (which can often turn paternalistic) and patient autonomy and requires a carefully crafted art. Many of my consults start with an open question (Tell me about yourself…?), and we will examine goals, wishes, and values before ever touching on treatment options. This allows me to take the knowledge I have, and fit it within the scaffold of the patient in front of me. A patient emphasizing quantity of life at all costs and a patient emphasizing weekly fishing trips in their boat will receive the same treatment option lists, but with different emphases and discussions around each. Yet, many physicians find themselves tending toward paternalistic beneficence—logical, if we consider physicians to be compassionate individuals who want the best for their patients. All three patients I saw had been offered options that were medically appropriate, but declined them as they felt the options were not right for them. And all three patients I saw ended up selecting a presented option during our time together—not an option that would be considered the best or standard of care, or the most aggressive treatment, but an option that aligned most with their own goals, wishes, and values. This is of particular importance when caring for patients who harbor different cultural or religious views from our own; western medicine adopts many of its ideas and professional norms from certain mindsets and cultures which may not be the lenses through which our patients see the world. Even when a patient shares our personal cultural or religious background, they may still choose a path which differs from what we or our family might choose. It is vital to incorporate reflexivity in our practice, to be mindful of our own blinders, and to be open to different ways of seeing, thinking, and deciding. I will admit that, like many, I do struggle at times when a patient does not select the medically best treatment for themselves. But why? Do we fear legal repercussions or complaints down the road from not giving a patient the standard of care (often the strongest treatment available)? Do we struggle with moral distress when a patient makes a choice that we disagree with, based on values that we ourselves do not hold? Do we lack time in clinics to walk patients through different options, picking the method of counseling that allows the most efficiency in packed clinical systems? Is it too painful a reminder of our mortality to consider that, especially in the setting of terminally ill patients, aiming for anything other than a shot at the longest length of life might be a patient's preference? Or are we so burnt out from working in systems that deny us sufficient choice and autonomy (with regards to our own work, our own morals, and our own lives) that, under such repeated traumas, we lose touch with the idea of even having a choice? I have a number of patients in my clinic who transferred care after feeling caught between one (aggressive) treatment option and best supportive care alone. They come looking for options—an oral agent that allows them to travel, a targeted therapy that avoids immunosuppression, or a treatment that will be safe around dogs and small children. They are looking for someone to listen, to hold their hand, to fill in the gaps, as was told to me recently, and not skirt around the difficult conversations that both of us wish we did not have to have. Granted, some of the conversations are challenging—requests for ivermectin prescriptions, for example, or full resuscitation efforts patients with no foreseeable chance of recovery (from a medical standpoint) to allow for a possible divine miracle. However, in these cases, there are still goals, wishes and values—although ones that are not aligned with evidence-based medical practice that can be explored, even if they are challenging to navigate. As my clinic day went on, I spoke with my patients and their loved ones. One asked the difference between hospice and a funeral home, which explained their reluctance to pursue the former. Another asked for clarification of how one treatment can treat cancer in two different sites. And yet still another absorbed the information they requested and asked to come back another day to speak some more. All questions I have heard before and will continue to hear again. And again. There is no cure for many of the patients who enter my GI medical oncology clinic. But for fear, for confusion, perhaps there is. Cancer wreaks havoc on human lives. Plans go awry, dreams are shattered, and hopes are crushed. But we can afford some control—we can empower our patients back—by giving them choices. Sometimes, that choice is pitiful. Sometimes, it is an explanation why the most aggressive treatment option cannot be prescribed in good faith (performance status, bloodwork parametres), but it is a choice between a gentle treatment and no treatments. Sometimes it is a choice between home hospice and a hospice facility. I teach many of the learners who come through my clinic about the physician's toolbox, and the importance of cultivating the tools of one's specific specialty and area of work. For some (like surgeons), the tools are more tangible—physical skills, or even specific tools, like a particular scalpel or retractor. For others, like radiologists, it might be an ability—to recognize patterns, for example, or detect changes over time. For those of us in medical oncology, our toolbox can feel limiting at times. Although we have a handful of treatments tied to a specific disease site and histology, these often fall short of what we wish we could offer, especially when studies cite average survivals in months over years. But one of our most valuable tools—more valuable, I would argue, than any drug—is the communication we have with our patients, the way we can let them know that someone is there for them, that someone is here to listen, and that someone cares. Furthermore, the information we share—and the way we share it—has the potential to help shape the path that our patient's life will take moving forward—by empowering them with information to allow them to make the decisions best for them.2 Although having such conversations can be difficult and draining for the oncologist, they are a necessary and vital part of the job. My clinic team knows that we can have up to six, seven such conversations in the course of a half-day, and my clinic desk space is equipped for my between-patient routine of sips of tea and lo-fi beats, a precious few moments left undisturbed as much as possible to allow a bit of recharging. By finding a safe space where I can relax for a few moments, I can take care of myself, enabling me to give each of my patients the time and attention they need. When patients thank me after a long, difficult conversation, they are not thanking me for sharing devastating, life-altering news of metastatic cancer, prognoses in the order of months, or disease resistant to treatment. They are thanking me for listening, for caring, for seeing them as a person and affording the dignity of choice—autonomy. I have had patients make surprising decisions—opting for no treatment for locally-advanced cancers, or opting for gentle treatment when, medically, they could tolerate stronger. But by understanding their values, and listening to them as people, I can understand their choices, validate them, and help them along their journey in whatever way possible. Providing a choice affords a suffering human the right to define their path as long as they are able to. And we can give patients in such situations support and validation by being a guide during dark days and challenging times, remembering that medically best treatment is not always the best. When a patient says no to offered options, it does not (necessarily!) mean they are rejecting the expertise of the physician and care team. Rather, could it be a request to know more and work together with the team to find a strategy and solution which will be meaningful for them?   Mikkael Sekeres: Welcome back to JCO's Cancer Stories: The Art of Oncology. This ASCO podcast features intimate narratives and perspectives from authors exploring their experiences in oncology. I'm your host, Mikkael Sekeres. I'm Professor of Medicine and Chief of the Division of Hematology at the Sylvester Comprehensive Cancer Center, University of Miami. Today we're joined by Beatrice Preti, Assistant Professor at Emory University, Adjunct Professor at Western University, and PhD candidate with Maastricht University, to discuss her JCO Oncology Practice article, "No Versus Know: Patient Empowerment Through Shared Decision-Making." At the time of this recording, our guest has no disclosures. Beatrice, thank you so much for contributing to JCO Oncology Practice and for joining us to discuss your article. Beatrice Preti: Well, thank you so much for having me today. Mikkael Sekeres: It's an absolute treat. I was wondering if we could start with sort of a broad question. Can you tell us about yourself? What was your journey like that landed you where you are right now? Beatrice Preti: Oh goodness, that's a very loaded question. Well, I am originally from Canada. I did all my training in Canada at a couple of different schools, McMaster, Queens, Western University. Before medicine, I was always interested in the arts, always interested in writing, always interested in teaching. So that's something that's really, I guess, come forth throughout my medical practice. During my time at Western, I trained as a gastrointestinal medical oncologist, so that's my clinical practice. But on the side, as you've noted, I've done some work in medical education, got my Masters through Dundee, and now doing my PhD through Maastricht in the Netherlands, which I'm very excited about. Mikkael Sekeres: That's fantastic. What's your PhD in? Beatrice Preti: Health Professions Education. Mikkael Sekeres: Wonderful - can never get too much of that. And can I ask, are you at the stage now where you're developing a thesis and what's the topic? Beatrice Preti: Yeah, absolutely. So the program itself is almost exclusively research based. So I'm thinking of more of a social psychology side, looking at impression management and moral distress in medical trainees, and really along the continuum. So what we're looking at is when people act in ways or feel that they have to act in ways that aren't congruent with what they're feeling inside, why they're doing that and some of the moral tensions or the moral conflicts that go along with that. So a good example in medicine is when you're with a patient and you have to put on your professional face, but inside you might be squirming or you might be scared or worried or anxious or hungry, but you can't betray that with the patient because that would be unprofessional and also unfair to the patient. Mikkael Sekeres: Wow, that's absolutely fascinating. How does that change over the course of training? So how does it change from being a medical student to a resident or fellow to a junior faculty member? Beatrice Preti: So I'm only one year into the PhD, so I don't have all the information on this as yet. Mikkael Sekeres: You don't have all the answers yet? What are you talking about? Beatrice Preti: Yeah, they're telling me I have to finish the PhD to get all the answers, but I think that we certainly are seeing some kind of evolution, maybe both in the reasons why people are engaging in this impression management and the toll it takes on them as well. But stay tuned. It might take me a couple of years to answer that question in full. Mikkael Sekeres: Well, I just wonder as a, you know, as a medical student, we go into medical school often for reasons that are wonderful. I think almost every essay for somebody applying to medical school says something about wanting to help people, right? That's the basis for what draws us into medicine. And I wonder if our definition of what's morally right internally changes as we progress through our training. So something that would be an affront to our moral compass when we start as a medical student may not be such an affront later on when we're junior faculty. Beatrice Preti: Yes, definitely. And I think there's a lot of literature out there about coping in the medical profession because I think that by and large, especially in the lay community, so premedical students, for example, but even within our own profession as well, we don't really give enough credence to the impact a lot of the things that we do or witness have on us personally. That lack of insight doesn't allow us to explore coping mechanisms or at least think things through, and oftentimes what we're seeing is a survival instinct or a gut reaction kick in rather than something that we've carefully thought through and said, you know, “These situations are stressful for me, these situations are difficult. How can I cope? How can I make this more sustainable for me, knowing that this is an aspect of medicine that really isn't escapable.” Mikkael Sekeres: What a fascinating topic and area to be studying. I can't wait for all of the findings you're going to have over the course of your career. But oncology is a field that's, of course, rife with these sorts of conflicts. Beatrice Preti: Yeah, definitely. Mikkael Sekeres: I'm curious if you can talk a little bit about your own story as a writer. You say you've always been a writer. How long have you been writing reflective pieces? Beatrice Preti: Oh, goodness. So there's certainly a difference between how long I've been writing reflective pieces and how long I've been writing good reflective pieces. I can vaguely remember, I think being perhaps 10 years old and writing in school one recess period, sort of both sides of a loose leaf piece of paper, some form of reflection that would have ended up straight in the rubbish bin. So that was probably when it started. Certainly in medical school, I published a fair bit of reflective writing, poetry. That continued through residency, now as a junior attending as well. Mikkael Sekeres: Well, you're excellent at it and I can't see any rubbish can that would accept your pieces for the future. If you feel comfortable doing so, can you tell us what prompted you to write this particular piece? Beatrice Preti: Yes. So this piece was written Friday night around 9:00, 10:00 at night, literally at the end of the clinic day that I described. Coming on the heels of talking about coping, I think for many people in medicine, writing is a coping mechanism and a coping strategy that can be quite fruitful and productive, especially when we compare it to other potential coping strategies. Sometimes it's certainly difficult to write about some of the things we see and certainly it's difficult sometimes to find the words. But on this particular night, the words came quite easily, probably because this is not an isolated incident, unfortunately, where we're seeing patients coming for second opinions or you're encountering patients or you're encountering people who you are not directly treating in your everyday life, who express frustrations with the health care system, who express frustrations with not feeling heard. I think all you have to do is open social media, Facebook, Reddit, and you'll see many, many examples of frustrated individuals who felt that they weren't heard. And on one hand, I'm not naive enough to think that I've never left a patient encounter and had that patient not feeling heard. I'm guilty of many of the same things. Sometimes it's nothing that we've done as physicians, it's just you don't develop a rapport with the patient, right? But it made me think and it made me wonder and question, why is there this mismatch? Why are there so many patients who come seeking someone who listens, seeking a solution or a treatment that is maybe not standard, but might be a better fit for them than the standard? As you know, oncology is very algorithmic, and certainly, as many of the the fellows and residents who come into my clinic learn, yes, there are guidelines and yes, there are beautiful flow charts that teach us if you have this cancer, here's the treatment. But for me, that's only half of the practice of oncology. That's the scientific side. We then have the art side, which involves speaking to people, listening to them, seeing them as people, and then trying to fit what we're able to do, the resources we have, with what the patient's goals are, with their wishes or desires are. Mikkael Sekeres: I completely agree with you. I think sometimes patients come to our clinics, to an examination room, and they look at it as a place to be heard, and sometimes a safe space. You'll notice that, if you've been practicing long enough, you'll have some couples who come in and one of our patients will say something and the partner will reflect and say, "Gee, I never heard you say that before. I never knew that." So if people are coming in expecting to be heard in a safe space, it's almost nowhere more important to do that when it comes to treating their cancer also. Beatrice Preti: Yes. And as I say again to many of our learners, different specialties have different tools to treat or help alleviate sickness, illness, and suffering. For example, a surgeon has quite literal tools. They have their hands, they have their eyes, they're cutting, they're performing procedures. By and large, especially in medical oncology, we are quite limited. Certainly I have medications and drugs that I can prescribe, but in the world of GI oncology, often these are not going to lead to a cure. We are talking about survival in the order of months, maybe a year or two if we're very lucky. So the tool that we have and really the biggest, best treatment that we can give to our patients is our words and our time, right? It's those conversations that you have in clinic that really have the therapeutic benefit or potential for someone who is faced with a terminal illness and a poor prognosis more so than any drug or chemotherapy that I can give as a physician. Mikkael Sekeres: I love the notion that our words and our time are our tools for practicing medicine. It's beautiful. You mentioned in your essay three patients who, quote, and you're very deliberate about using the quote, "refused" because it's a loaded term, "refused" recommended medical intervention such as chemotherapy or surgery. Can you tell us about one of them? Beatrice Preti: Ah, well, I would have to be quite vague. Mikkael Sekeres: Of course, respecting HIPAA, of course. We don't want to violate anything. Beatrice Preti: But I think that was another thing too on this day that struck me quite a bit that it was three patients back to back with very similar stories, that they had been seen at other hospitals, they had been seen by other physicians - in one case, I think a couple of different physicians - and had really been offered the choice of, “Here is the standard of care, here is what the guidelines suggest we do, or you can choose to do nothing.” And certainly in the guidelines or in recommended treatment, you know, doublet chemotherapy, triplet therapy, whatever the case may be, this is what's recommended and this is what's standard. But for the patient in front of you, you know, whose goal may be to go to the beach for two months, right? “I don't want to be coming back and forth to the cancer center. Can I take a pill and maybe get blood work a few times while I'm there?” Or you have a patient who says, “You know, I tried the chemotherapy, I just can't do it. It's just too strong. And now they've told me I have to go to hospice if I'm not going to take the recommended treatment.” While in the guideline this may be correct for this patient who's in front of you, there may be another option which is more, in quotes, “correct”, because, is our goal to kill as many cancer cells as we can? Is our goal to shrink the cancer as much as we can? Is our goal even to eke out the maximum survival possible? As an oncologist, I would say no. Our goal is to try to line up what we can do, so the tools, the medications, the chemotherapies, the drugs that we do have in our tool kit, and the symptom medications as well, and line those up with what the patient's goals are, what the patient's wishes are. For many people, I find, when faced with a terminal illness, or faced with an illness with poor prognosis, their goal is not to eke out the last breath possible. They start to look at things like quality of life. They start to look at things like hobbies or travel or spending time with family. And oftentimes, the best way to facilitate that is not by doing the most aggressive treatment. Mikkael Sekeres: In my memory, you evoke an essay that was written for JCO's Art of Oncology by Tim Gilligan called "Knuckleheads" where he had a patient who was, big quotes, "refusing" chemotherapy for a curable cancer. And one of his colleagues referred to the patient as a knucklehead and they asked Tim to see the patient to try to suss out what was going on. And Tim, he used one of our tools. He talked to the person and it turns out he was a seasonal construction worker and it was summer and he was a single dad where the mother of his children wasn't involved in their care at all. And the only way he had to make money during the year was the work he did during the summer because he couldn't work in the winter. So for very primal reasons, he needed to keep working and couldn't take time to take chemotherapy. So they were able to negotiate a path forward that didn't compromise his health, but also didn't compromise his ability to make a living to support his family. But again, like you say, it's that people bring to these interactions stories that we can't even imagine that interfere with our recommendations for how they get cared for. Beatrice Preti: That's a beautiful example of something that I really do try to impress on my learners and my team in general. When someone comes to you and if a recommendation is made or even if they are skeptical about a certain treatment pathway, there is always a ‘why'. One of the challenges and one of the things that comes with experience is trying to uncover or unveil what that ‘why' is because unless you address it and address it head on, it's going to be very difficult to work with it, to work with the patient. So as you said, it's common people have family obligations, job obligations. Oftentimes as well, they have personal experience with certain treatments or certain conditions that they're worried about. Perhaps they had a loved one die on chemotherapy and they're worried about toxicities of chemo. And sometimes you can talk through those things. That needs to be considered, right? When we talk about shared decision-making, you, the patient, and it might be an experience that the patient has had as well that are all in the room that need to be taken into account. Mikkael Sekeres: You invoke the phrase "shared decision-making," which of course, you talk about in your essay. Can you define that for our listeners? What is shared decision-making? Beatrice Preti: Oh, goodness. There are different definitions of this and I am just cringing now because I know that my old teachers will not be happy regardless of what definition I choose. But for me, shared decision-making means that the decision of what to do next, treatment along the cancer journey, etc., is not decided by only one person. So it is not paternalism where I as the physician am making the decision. However, it's not the patient unilaterally making their own decision as well. It's a conversation that has to happen. And oftentimes when I'm counseling patients, I will write down what I see as potential treatment options for this patient and we will go through them one by one with pros and cons. This is usually after an initial bit where I get to know the patient, I ask them what's important to them, who's important in their life, what kind of things do they enjoy doing, and trying to weave that into the counseling and the discussion of the pros and cons. Ultimately, the patient does make the choice, but it's only after this kind of informed consent or this informative process, I guess, so to speak. And for me, that is shared decision-making where it's a conversation that results in the patient making a decision at the end. Mikkael Sekeres: You know, it's so funny you use the word ‘conversation'. I was going to say that shared decision-making implies a conversation, which is one of the reasons I love it. It's not a monologue. It's not just us listening. It's a back and forth until you know, we figure each other out. Beatrice Preti: Yes. Mikkael Sekeres: I wonder if I could ask you one more question. In your essay, you ask the question, "Do we struggle with moral distress when a patient makes a choice that we disagree with based on values that we ourselves do not hold?" Do you think you can answer your own question? Beatrice Preti: So this is getting to my academic work, and my PhD work that we spoke a little bit about in the beginning. I think it's something that we need to be mindful of. Certainly in my training, certainly when I was less experienced, there would be a lot of moral distress because we are not all clones of each other. We are people, but we have our own beliefs, we have our own backgrounds, we have our own experiences. There are times when people, and not just in medicine, but certainly in medicine, certainly patients make decisions that I don't quite understand because they are so different from what I would make or what I would choose for myself or for a family member. On the flip side, I think I've gotten myself, and I've had enough experience at this point in my career, to be able to separate that and say, you know, “But this is someone who has clearly thought things through and based on their own world view, their own perspectives, their own life experiences, this is the choice that's best for them.” And that's certainly something that I can support and I can work with a patient on. But it takes time, right? And it takes very deliberate thought, a lot of mindfulness, a lot of practice to be able to get to that point. Mikkael Sekeres: Well, I think that's a beautiful point to leave off with here. We've been talking to Beatrice Preti, who is an assistant professor at Emory University and an adjunct professor at Western University, and a PhD candidate with Maastricht University to discuss her JCO Oncology Practice article, "No Versus Know: Patient Empowerment Through Shared Decision-Making." Beatrice, thank you so much for joining me today. Beatrice Preti: Absolutely. Mikkael Sekeres: If you've enjoyed this episode, consider sharing it with a friend or a colleague or leave us a review. Your feedback and support helps us continue to have these important conversations. If you're looking for more episodes and context, follow our show on Apple, Spotify, or wherever you listen, and explore more from ASCO at asco.org/podcasts. Until next time, this has been Mikkael Sekeres for JCO Cancer Stories: The Art of Oncology. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Show Notes: Like, share and subscribe so you never miss an episode and leave a rating or review. Guest Bio: Dr Beatrice Preti is an Assistant Professor at Emory University Additional Material: Knuckleheads, by Dr Timothy Gilligan and accompanied podcast episode.  

In a recent episode of the Oncology-on-the-Go podcast in collaboration with the American Psychosocial Oncology Society (APOS), host Daniel C. McFarland, DO, was joined by Christian J. Nelson, PhD, to discuss the often-overlooked subject of sexual health issues for men after cancer treatment. The discussion emphasized the importance of a nuanced approach to men's health, particularly in the context of genitourinary cancers like prostate and testicular cancer. McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer in addition to being the psycho-oncology editorial advisory board member for the journal ONCOLOGY®. He opened the conversation by highlighting that while cancer's physical effects are well-documented, the mental and emotional toll is equally significant and often underappreciated in male patients. He highlighted that the field of psycho-oncology, which began with breast cancer, is now expanding to address men's specific needs. Men, he noted, are less likely to seek mental health support, yet have a higher risk of suicide, particularly at key moments in their cancer journey like diagnosis and recurrence. Nelson, chief of Psychiatry Service, attending psychologist, and codirector of the Psycho-Oncology of Care and Aging Program at Memorial Sloan Kettering Cancer Center, underscored that cancer treatments, especially for prostate cancer, often have profound adverse effects (AEs) that impact a man's sense of self and masculinity.  He detailed the effects of radical pelvic treatments and androgen deprivation therapy (ADT), which can lead to urinary incontinence, erectile dysfunction, and changes in sexual function and body image. These AEs can lead to feelings of being "broken," "inadequate," or "deflated." The pair discussed the "double-edged sword" of normalizing cancer, where patients are told their prognosis is good but are left unprepared for the life-altering AEs. This can lead to a sense of cognitive dissonance and isolation. The conversation stressed the need for clinicians to proactively normalize discussions about sexual health, making it clear that these are standard and expected aspects of the cancer experience. Both clinicians suggested that establishing a trusting relationship with patients is paramount and that referrals to psycho-oncology should be framed as an essential, not optional, component of treatment. They also recommend that clinicians consistently check in with their male patients about emotional and sexual well-being, even long after treatment has ended, to ensure they're coping with the lasting impacts of their experience. 

We are happy to welcome back the Honorary Vice Chair of Susan G. Komen, Paula Schneider, and today she is also joined by her two daughters Zoe and Chloe. Paula faced a triple-negative breast cancer diagnosis in 2007 – after losing her mother to metastatic breast cancer years before. It goes without saying that Paula's work is beyond personal. Since joining Komen in 2017, Paula has helped the organization usher in new programs, support services and policies that are helping families have a better chance of survival and a greater quality of life. This year, Paula has also published a children's book inspired by her own breast cancer experience – which drops THIS WEEK on Sept. 2nd. Love Stays Strong is a book about the strength of a family's love, especially during times of illness – designed to help parents or caregivers talk to young children about any kind of serious illness in the family.

This episode is the first of a two-part mini-series where Michael and Josh attempt to untangle the complex topic of germ cell tumours, an area that requires specialist experience and a high-volume multi-disciplinary centre to treat adequately. Or, you could just listen to Oncology for the Inquisitive Mind and be a pro in no time!Studies discussed in this episodeEORTC-30982de Wit et al (2001)For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer, Gilead Pharmaceuticals and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content. Hosted on Acast. See acast.com/privacy for more information.

Featuring perspectives from Dr Natalie S Callander and Dr Sagar Lonial, including the following topics:  Introduction (0:00) A Farmer with Myeloma; Is Myeloma the New Chronic Myeloid Leukemia? (2:06) Clinical Trials (12:34) Chimeric Antigen Receptor Therapy (16:11) Bispecific Antibodies (21:38) Antibody-Drug Conjugates; a Patient on Belantamab Mafodotin for 3 Years (30:45) Treatment Options for Relapsed Disease (40:46) Neuropathy (44:43) Alternative Therapies (48:36) 164 Questions (53:20) CME information and select publications

Dr Natalie S Callander and Dr Sagar Lonial provide clinical perspectives on the treatment and disease-management course for patients with relapsed/refractory multiple myeloma. CME information and select publications here.

BUFFALO, NY – August 29, 2025 – A new #research paper was #published in Volume 16 of Oncotarget on August 29, 2025, titled “In vivo manipulation of the protein homeostasis network in rhabdomyosarcoma.” In this study led by first author Kristen Kwong and corresponding author Amit J. Sabnis from the Department of Pediatrics, Division of Oncology, University of California San Francisco, researchers discovered that disrupting the protein quality control system in cancer cells slows tumor growth in rhabdomyosarcoma (RMS), the most common pediatric soft tissue cancer. This finding points to a new strategy for treating high-risk childhood cancers that often resist current therapies. Rhabdomyosarcoma is a rare and aggressive cancer that primarily affects children and adolescents. Standard treatments like chemotherapy and radiation often have limited long-term success in high-risk cases. This study explored a different approach: targeting the cellular machinery that maintains protein quality, known as the proteostasis network. Cancer cells rely heavily on this system to survive stress caused by rapid growth and genetic instability. “To examine whether MAL3-101 or more drug-like proteostasis inhibitors represent a new therapeutic strategy for RMS, we screened proteostasis components that might recapitulate the effects of MAL3-101 in vivo.” The researchers first used a compound called MAL3-101 to disrupt protein control in RMS cells. They then identified which parts of the protein quality system were affected. Based on those findings, they searched for more drug-like compounds that could target the same pathways. They focused on a protein called p97, which plays a critical role in removing damaged or misfolded proteins. When they blocked p97 using a drug called CB-5083, the cancer cells could no longer manage internal stress and began to self-destruct. In both laboratory models and mice implanted with human RMS tumors, the treatment significantly slowed or stopped tumor growth. The drug triggered a stress response in the cells known as the unfolded protein response, which can lead to either recovery or programmed cell death. However, not all tumors responded the same way. Some resisted the treatment by activating a backup system called autophagy, which allows cells to recycle parts of themselves under stress. By comparing tumors that responded well to those that did not, the researchers found that higher autophagy activity could serve as a warning sign for resistance. This insight may help identify which patients are more likely to benefit from therapies that target protein quality control. While the results are promising, the drug's effectiveness depended on the tumor's genetic profile and how it handled stress. Combining p97 inhibition with other treatments or blocking alternative survival pathways like autophagy may improve outcomes. The researchers also noted the importance of developing safer and more targeted drugs to reduce side effects. This study opens new possibilities for personalized cancer treatment, particularly for children with aggressive or relapsed RMS. By weakening the systems that cancer cells depend on to survive, rather than only using toxic treatments to kill them, scientists aim to develop more effective and less harmful therapies for young patients. DOI - https://doi.org/10.18632/oncotarget.28764 Correspondence to - Amit J. Sabnis - amit.sabnis@ucsf.edu Video short - https://www.youtube.com/watch?v=YsdffTkXNRQ To learn more about Oncotarget, visit https://www.oncotarget.com. Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

BioOsteosarcoma Webinar Series: Brian Ladle, MD, PhD, Assistant Professor of Oncology and Pediatrics at The Johns Hopkins University School of Medicine, joins us on OsteoBites to discuss deciphering the impact of STING agonists on the tumor microenvironment in osteosarcoma.We have learned that more engagement of the immune system and osteosarcoma results in better outcomes - even when patients are given standard chemotherapy. We have found that drugs that activate the STING pathway in osteosarcoma tumors result in greater immune cell invasion into the tumors. This corresponds with improved outcomes when combined with chemotherapy and other immunotherapies. Dr. Ladle will discuss these findings and what steps we are taking to bring this closer to clinical trials for osteosarcoma patients.Dr. Brian Ladle is a pediatric oncologist, sarcoma specialist, and immunotherapy researcher at Johns Hopkins University. His research centers around the goal of generating potent immune responses against pediatric sarcoma tumors - especially osteosarcoma. Ongoing projects encompass preclinical work using osteosarcoma mouse models and osteosarcoma clinical trials in both dogs and humans. He really believes immunotherapy approaches can be effective against osteosarcoma and will become a key piece to "Make It Better" for osteosarcoma patients.

In today's episode, supported by Nuvation Bio, we spoke with Joel Neal, MD, PhD, and Christian Rolfo, MD, PhD, about the FDA approval of taletrectinib (Ibtrozi) for the treatment of patients with locally advanced or metastatic, ROS1-positive non–small cell lung cancer (NSCLC). Dr Neal is a professor of medicine in the Division of Oncology at the Stanford Cancer Institute at Stanford University in Palo Alto, California. Dr Rolfo is the director of the Division of Medical Oncology at The Ohio State University Comprehensive Cancer Center—James and a professor in the College of Medicine at The Ohio State University in Columbus. In our conversation, Drs Neal and Rolfo discussed the significance of this approval, key data from the pivotal phase 2 TRUST-I (NCT04395677) and TRUST-II (NCT04919811) trials, and taletrectinib's current role in the NSCLC treatment paradigm.

In this week's episode we'll learn about targeting NPM1 in acute myeloid leukemia. Researchers report the first clinical evidence of a menin inhibitor inducing complete remissions in AML with a NPM1 mutation. This validates NPM1 as a new therapeutic target in AML, alongside FLT3, IDH1/2, and KMT2A. Also on the podcast: targeting CD137 to prevent graft-versus-host disease. In nonhuman primates, a single dose of a CD137 antibody-drug conjugate provided long-term protection, with one important caveat: the potential for viral reactivation.Featured Articles: Menin inhibition with revumenib for NPM1-mutated relapsed or refractory acute myeloid leukemia: the AUGMENT-101 studyA single dose of a CD137 antibody–drug conjugate protects rhesus macaque allogeneic HCT recipients against acute GVHD

Blood Editor, Dr. Thomas Coates interviews Dr. Emanuele Angelucci on his paper, "How I manage iron overload in the hematopoietic cell transplantation setting" which is featured in Blood's "How I Treat Series on Iron Overload in Hematologic Disorders". See the full How I Treat series in volume 145 issue 4 of Blood. 

In today's episode, supported by Boehringer Ingelheim, we spoke with Ticiana Leal, MD, and Misako Nagasaka, MD, PhD, about the FDA approval of zongertinib (Hernexeos) for previously treated patients with HER2 TKD–mutant advanced non–small cell lung cancer (NSCLC). Dr Leal is an associate professor and director of the Thoracic Medical Oncology Program in the Department of Hematology and Medical Oncology at Emory University School of Medicine in Atlanta, Georgia; as well as medical director of the Clinical Trials Office and leader of the Lung Cancer Disease Team at the Winship Cancer Institute of Emory University. Dr Nagasaka is an associate professor of medicine in the Division of Hematology and Oncology at the University of California, Irvine (UCI) School of Medicine; as well as a medical oncologist at UCI Health. In our conversation, Drs Leal and Nagasaka discussed the significance of this approval, key efficacy and safety findings from the pivotal phase 1 Beamion LUNG-1 trial (NCT04886804), and where zongertinib currently fits into the NSCLC treatment paradigm.

The deficits from the lead poisoning continue to intensify, Shannon channels her anger and grief into holding the people who hurt her son responsible.LEAD how this story ends is up to us is a true story written and produced by Shannon Burkett. Co-produced by Jenny Maguire. Directed by Alan Taylor. Starring Merritt Wever, Alessandro Nivola, Cynthia Nixon, and Cooper Burkett.EP4 features Eboni Booth, Sasha Eden, Kevin Kane, April Matthis, Alysia Reiner, and Mandy Siegfried. Casting by Alaine Alldaffer and Lisa Donadio. Music by Peter Salett. Sound Design by Andy Kris. Recording Engineer Krissopher Chevannes.For corresponding visuals and more information on how to protect children from lead exposure please go to https://endleadpoisoning.org.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Can belief measurably change your immune markers during treatment?Why can the word remission quietly program us to expect a relapse—and what language serves better?Which daily foods have the strongest evidence for anti-cancer support—and how much actually matters?Sugar, insulin, IGF-1—how do they shape cancer risk, and what’s the fruit nuance?Can circadian alignment extend survival for people living with cancer? In this episode of A Really Good Cry, Radhi sits down with Ayurvedic practitioner and integrative medicine expert Sam Watts, whose understanding of healing goes far beyond conventional treatments. Rooted in ancient wisdom and backed by science, Sam offers an entirely different way to look at cancer—not just as a physical disease, but as a disconnection from our internal intelligence, lifestyle, and emotional ecosystem. They talk about the mind-body connection, and how emotions like fear and helplessness can literally suppress your immune system, while belief and empowerment activate healing at the cellular level. Sam shares the foods that actively kill cancer cells, the lifestyle habits that disrupt our circadian rhythm and hormones, and why "hope" is the single strongest predictor for survival in cancer patients. In this episode, you’ll learn: How belief and mindset directly influence immune function and recovery What foods (like turmeric, matcha, and EVOO) are backed by science as anti-cancer powerhouses Why poor sleep and synthetic skincare might be more dangerous than you think How Ayurveda offers personalized, intuitive tools for healing The importance of circadian alignment and Ojas in preventing disease What it means to support someone beyond just conventional medicine How to detox from microplastics and endocrine disruptors—naturally Whether you're on a healing journey, supporting someone who is, or just want to better understand how to live preventatively and purposefully—this is one of the most profound health episodes Radhi has ever recorded. Follow Sam: Purchase The Ayurvedic Approach to Cancer http://drsamwatts.com/https://www.instagram.com/drsamwattshttps://youtube.com/@drsamwattshttps://www.facebook.com/share/16r3mqSRAP/?mibextid=wwXIfr Follow Radhi:https://www.instagram.com/radhidevlukia/https://www.youtube.com/channel/UCxWe9A4kMf9V_AHOXkGhCzQhttps://www.facebook.com/radhidevlukia1/https://www.tiktok.com/@radhidevlukiaSee omnystudio.com/listener for privacy information.

Dr Azra Raza is a Professor of Medicine, Clinical Director of the Evans Foundation MDS Center, and Executive Director of The First Cell Coalition for Cancer Survivors at Columbia University in New York. She is the best-selling author of "The First Cell: And the human costs of pursuing cancer to the last". She started her research in Myelodysplastic Syndromes (MDS) in 1982 and moved to Rush University, Chicago, Illinois in 1992, where she was the Charles Arthur Weaver Professor in Oncology and Director, Division of Myeloid Diseases. The MDS Program, along with a Tissue Repository containing more than 50,000 samples from MDS and acute leukemia patients was successfully relocated to the University of Massachusetts in 2004 and to Columbia University in 2010. Before moving to New York, Dr Raza was the Chief of Hematology Oncology and the Gladys Smith Martin Professor of Oncology at the University of Massachusetts in Worcester. She has published the results of her laboratory research and clinical trials in prestigious, peer-reviewed journals such as The New England Journal of Medicine, Nature, Blood, Cancer, Cancer Research, the British Journal of Hematology, Leukemia, and Leukemia Research. Dr Raza serves on numerous national and international panels as a reviewer, consultant, and advisor and is the recipient of a number of awards.TIMESTAMPS:(0:00) - Introduction (0:50) - The First Cell: and the human costs of pursuing cancer to the last(4:10) - Defining Cancer(7:50) - A Cancer Paradigm Shift: Finding the First Cell(11:16) - "The Cure for Cancer"(19:05) - Azra's Journey, Development & Reception(24:40) - Hope, Honesty & Harm in a Clinical Setting(33:00) - Current Medical Politics vs Revolutionary Detections/Treatments(39:00) - Increasing Lifespan & Healthspan(43:01) - "Michael Levin Should Win The Nobel Prize!"(51:00) - A Good Life & a Good Death(56:00) - How Words distort our relationship with Disease(1:00:00) - How Disease & Death Shape Our Lives(1:05:40) - The First Cell Book(1:09:15) - A Better Healthcare System(1:12:27) - Conclusion EPISODE LINKS:- Azra's Website: https://azraraza.com- Azra's Books: https://azraraza.com/books- Azra's X: https://x.com/AzraRazaMD- Azra's YouTube: http://www.youtube.com/@AzraRazaMDCONNECT:- Website: https://tevinnaidu.com - Podcast: https://creators.spotify.com/pod/show/mindbodysolution- YouTube: https://youtube.com/mindbodysolution- Twitter: https://twitter.com/drtevinnaidu- Facebook: https://facebook.com/drtevinnaidu - Instagram: https://instagram.com/drtevinnaidu- LinkedIn: https://linkedin.com/in/drtevinnaidu=============================Disclaimer: The information provided on this channel is for educational purposes only. The content is shared in the spirit of open discourse and does not constitute, nor does it substitute, professional or medical advice. We do not accept any liability for any loss or damage incurred from you acting or not acting as a result of listening/watching any of our contents. You acknowledge that you use the information provided at your own risk. Listeners/viewers are advised to conduct their own research and consult with their own experts in the respective fields.

Episode Resources:View the JWOCN® article “Clean Versus Sterile: Management of Chronic Wounds”View the infographic “Clean Versus Sterile: The Ongoing Debate in Chronic Wound Care”About the Speaker:Andrew Storer, PhD, DNP, RN, NP, CWCN-AP, FAANP. Dr. Andrew Storer serves as the Clinical Editor for the WOCN Society where he provides leadership and editorial expertise for the development, revision, and publication of WOCN clinical and professional practice literature. He is board certified in Advanced Practice in Wound Care and triple board certified as a family, emergency and acute care nurse practitioner. He is recognized nationally as a Fellow in the American Association of Nurse Practitioners for his contributions to nurse practitioner education and practice. He serves as the Senior Vice President of Patient Care Services, Chief Nursing Officer, and Associate Professor of Oncology at Roswell Park Comprehensive Cancer Center in Buffalo, NY. At Roswell Park his colleagues and he were awarded the first K-12 grant in the country with a focus on post-doctoral training for PhD prepared nurse scientists to focus on translational research, bridging the gap between laboratory science and bedside intervention. Dr. Storer holds his PhD from the University at Hawaii at Manoa and a Doctor of Nursing Practice degree from Thomas Jefferson University.Editing and post-production work for this episode was provided by The Podcast Consultant.

A breast cancer diagnosis can bring more than just emotional and physical challenges — it can also create a heavy financial burden. From the cost of treatment to lesser-known expenses like transportation, childcare and lost wages, the impact can be overwhelming. In this episode of Real Pink: Health Equity Revolution, we're joined by Toni Lee, Senior Manager of Susan G. Komen's Patient Care Center. Toni shares powerful insights about the real costs of breast cancer, how Komen supports patients financially — even when the Financial Assistance Program is closed — and how trained patient navigators can help individuals access the resources they need to reduce the burden. If you or someone you love is navigating breast cancer, this episode will leave you feeling seen, supported and empowered.

This ASPEN podcast is on the process and tools used for Nutrition Management of Oncology Patients for Malnutrition Awareness Week 2025. This podcast features Valaree Williams, MS, RDN, CSO, LDN, CNSC, FAND, and focuses on the nutritional status and impact of cancer and cancer treatments. Information on the nutrition process and nutrition management in patients with cancer. This podcast has been supported by Nestle Health Science Business Corporate by Alex Menco | alexmenco.net Music promoted by www.free-stock-music.com Creative Commons Attribution 3.0 Unported License creativecommons.org/licenses/by/3.0/deed.en_US August 2025

In this episode, Josh and Michael take a trip down a road less travelled by both patients and researchers, and examine the evidence (or lack thereof) of non-clear cell renal cell cancer, a less common cluster of siblings to the much better established clear cell RCC. Treatment is on very similar patterns, so their studies today involve a lot of immunotherapy with a smattering of tyrosine kinase inhibitors.Studies discussed in this episodeKEYNOTE-B61Checkmate 920For more episodes, resources and blog posts, visit www.inquisitiveonc.comPlease find us on Twitter @InquisitiveOnc!If you want us to look at a specific trial or subject, email us at inquisitiveonc@gmail.comArt courtesy of Taryn SilverMusic courtesy of AlisiaBeats: https://pixabay.com/users/alisiabeats-39461785/Disclaimer: This podcast is for educational purposes only. If you are unwell, seek medical advice.Oncology for the Inquisitive Mind is recorded with the support of education grants from our foundation partners Pfizer, Gilead Pharmaceuticals and Merck Pharmaceuticals. Our partners have access to the episode at the same time you do and have no editorial control over the content. Hosted on Acast. See acast.com/privacy for more information.

Dr. Sumanta (Monty) Pal and Dr. Arielle Elkrief discuss the clinical relevance of the gut microbiome in cancer immunotherapy and the importance of antibiotic stewardship, as well as interventions currently being explored to treat gut dysbiosis and optimize immunotherapy response. TRANSCRIPT Dr. Sumanta (Monty) Pal: Hi everyone, I'm Dr. Monty Pal, welcoming you to the ASCO Daily News Podcast. I'm a medical oncologist. I'm a professor and vice chair of academic affairs at the City of Hope Comprehensive Cancer Center in Los Angeles.  Today we're here to discuss one of my favorite topics, which is the gut microbiome. It's almost hard to avoid the gut microbiome nowadays if you look at medical literature within oncology. It's an emerging phenomenon, but there are a couple of individuals that I would really define as pioneers in the field. And one of them is actually with me today, Dr. Arielle Elkrief, to discuss the clinical relevance of the gut microbiome, particularly amongst patients receiving immunotherapy, although I imagine our conversation today will take many twists and turns. Arielle is an assistant professor and clinician scientist in the Department of Oncology at the University of Montreal, and she is co-director of the CHUM Microbiome Center there.  FYI for the listeners, we have our full disclosures in the transcript of this episode.  Arielle, thank you so much for joining us today. Dr. Arielle Elkrief: Thanks so much, Monty. This is going to be amazing. Dr. Sumanta (Monty) Pal: Well, I have to tell you what sort of inspired me to bring you on as a guest. It was one of many things, but it was this really terrific ASCO Educational [Book] article that you wrote. Now, I have to tell you, I've read all the articles sort of cover to cover in the book, and they're always a wonderful primer, so if our audience is studying for board research or something of that sort, it's a terrific resource to go through. I have to tell you, this piece on the gut microbiome that you wrote is nothing short of a masterpiece. If you read this cover to cover, it's actually going to give you, I think, a sense of the current state and future state of the field. I wanted to start by just sort of beginning with sort of the origin story for a lot of this, which is this association between the gut microbiome and immunotherapy response. This takes us back several years to this pivotal series of papers in Science. Maybe you could walk our audience through that. Dr. Arielle Elkrief: Absolutely. Well, thank you so much for your kind words about the ASCO [Educational] Book. It was a team effort with a lot of key opinion leaders in the field, so I'm really glad to learn that you've liked it.  Moving backwards in terms of how we came to understand that the gut microbiome is essential to priming a response to cancer immunotherapy actually goes back to 2015 and seminal papers that looked at what happens when we take mice that are germ-free mice that have never been exposed to a microbiome. These are mice that are born by cesarean section and essentially live in a bubble. And when we give those mice tumors and treat them, in the first papers with anti-CTLA-4 treatment, we realized that these antibodies don't work at all. And that was the first observation that the presence of a gut microbiome was essential to mounting an anti-cancer immune response. When we supplemented those same mice with beneficial bacteria or feces from responder patients, we were able to restore the response to immunotherapy. And so those were really the first preclinical observations that made us understand the critical role of the microbiome in immunotherapy response. Moving a little bit in the future, we examined the fecal microbiome composition using shotgun metagenomic sequencing in different cohorts of patients with solid tumors, namely lung cancers, kidney cancers, and also skin tumors like melanoma, and found that patients who responded to immunotherapy had a distinct microbiome that was characterized by beneficial bacteria compared to patients who experienced resistance to immunotherapy that had a dysbiotic or diseased microbiome. Dr. Sumanta (Monty) Pal: So, you know, it's interesting, these techniques that we're using to sequence the gut, they're a little bit different. So I wonder if you can give the audience a quick primer on these techniques that you're so well versed in, shotgun metagenomic sequencing, 16S rRNA sequencing. If you had to describe this in 30 seconds, which is a tall task, how would you do that? Dr. Arielle Elkrief: That's a tall task. Much of what we know about the microbiome initially came from a technique called 16S rRNA sequencing. This is a technique that amplifies the 16S region and basically tells you at the genus level what's going on at the level of bacterial composition. This technique is fast, relatively cheap, and can be performed on a laptop computer, which is excellent. The problem is that it's prone to a lot of technical variations. Different primers might give you different results, and you're really limited at the genus resolution. You can't get a good resolution in terms of species, and we're learning that different species from the same genus might have different physiological properties, and the same thing goes at the strain level. So when we really zone in and look at inter-species changes, we're seeing that these actually have specific functions in the host. So that brings us to metagenomic sequencing, which is a whole genome sequencing, next-generation sequencing based method that looks at the whole composition and gives you information not only on bacteria, but you might also get fungal and viral properties. You can zoom in on the strain level. You can also get functional output, so we can examine what the metabolic properties of specific species or strains might look like. The negative aspects of shotgun metagenomic sequencing is that it takes a lot of computational power in order to analyze the results and it might take a little bit longer. And certainly, within the clinical setting, not something that's feasible yet.  And that brings us to more novel point-of-care biomarker tools that we've collaborated in developing along with Dr. Laurence Zitvogel and Dr. Lisa Derosa at Gustave Roussy, that learning from the shotgun metagenomics results designed a probe using quantitative PCR which looks for this specific bacteria we know to be important and developed a ratio of harmful bacteria to beneficial bacteria. This is called the TOPOSCORE, and it actually is able to predict quite nicely the response to immunotherapy using a stool sample and a really good turnaround time of almost 72 hours. Dr. Sumanta (Monty) Pal: That was a perfect overview and a lot of information in a short amount of time. It also makes you take out your high school biology textbooks, doesn't it, to understand that the bacterial ribosome, right, is a different size and shape, and that's what we're sequencing here. But these techniques I think are incredibly important, and I'm glad you actually discussed this, this RT-PCR based strategy of calculating the TOPOSCORE. It lends itself to this phenomenon of dysbiosis, and I think for our audience, that's going to be an important term to understand as time goes on. There's the normal healthy gut and then there's this phenomenon of dysbiosis, which is, I guess, simply put, an unhealthy gut. But tell us about, you know, how often you see dysbiosis in a cancer patient, maybe versus a normal healthy adult. Dr. Arielle Elkrief: So, I think we can split up your question into two parts. One is we know from cohort studies and population level-based studies that the microbiome of patients with cancer is distinct from healthy patients or healthy people. And we know that because of the global composition. We also think that there are diversity metrics that lend themselves to being described as dysbiotic. But we do know that the microbiome of people with cancer is distinct from healthy volunteers. That's the first point.  In terms of how frequently dysbiosis occurs in patients with cancer, it's not very well defined. We know that even among healthy people, there is a certain level of dysbiosis. Laurence in her talk mentioned that to be about 10% to 20%. And the other fascinating component is that when we're thinking about dysbiosis and the cancer associated microbiome, in terms of the species that are enriched, it's quite striking that a lot of these dysbiotic or negative bacteria are also found to be enriched in patients with metabolic disease, like cardiovascular disease, for example. And so it's unclear if dysbiosis is the cause or consequence, but there definitely seems to be a general pattern of disease when looking at the microbiome compared to healthy people. Dr. Sumanta (Monty) Pal: That's interesting. So, I'll tell you, my second favorite portion of your article, and I'll tell you my favorite portion as well in the context of this podcast, but my second favorite part was the section around antibiotic stewardship. You know, the utilization of antibiotics in a very pragmatic fashion amongst our patients. Can you describe why that's so critical in the context of the microbiome? Dr. Arielle Elkrief: Antibiotics can disrupt the gut microbiome composition. We know this from mouse studies, but also cohort studies of patients that are exposed to antibiotics. And most importantly, we know that patients who are exposed to antibiotics, either before or during the immunotherapy period, have significantly worse progression-free survival and overall survival to immunotherapy. And this is true for immunotherapy in the monotherapy setting, but also when combined with chemotherapy. What's striking is that when we look at patients who are just treated with chemotherapy, we don't see the negative outcome of antibiotics on outcome and progression-free survival and overall survival, suggesting that the negative impact of antibiotics on outcomes is really specific to immunotherapy backbones. The other important point is that this negative signal is maintained even after adjusting for standard prognostic variables in the specific malignancies that we're looking at. And then most importantly, at the mechanistic level, we were able to actually pinpoint the mechanism behind this antibiotic related dysbiosis. And we see this with a bloom of negative bacteria which induces a loss of MAd-CAM, which is an endothelial gut checkpoint immune marker, and that causes an efflux of immunosuppressive T cells, which are usually in the gut, to go straight into the tumor where they make the tumor unamenable to an immunotherapy response. And so now we finally have the mechanism as to why antibiotics are harmful and why we need to practice antibiotic stewardship. Dr. Sumanta (Monty) Pal: And just to be clear for the audience, I mean, if a patient needs antibiotics, they need antibiotics. But perhaps it just suggests that, and we have, I suppose, this predilection as oncologists, just for the minor cold or cough or what have you, we maybe should be a little bit more cognizant of whether or not antibiotics are truly necessary. Is that fair? Dr. Arielle Elkrief: Absolutely. So what we're advocating for is antibiotic stewardship, and this is the clear recommendation that we can make. So that means confirming a bacterial infection. If it's there and antibiotics are indicated, to choose the most narrow spectrum for the shortest course and constantly re-evaluate the indication of antibiotics. And of course, we need to work with our colleagues in infectious diseases who've done incredible work in antibiotic stewardship. And all along this process we also need to be mindful of other medications and polypharmacy, such as proton pump inhibitors or narcotics, for example, we think that these other medications which are frequently prescribed in our cancer population can also potentially have negative impacts on the microbiome and immunotherapy response. Dr. Sumanta (Monty) Pal: I think that's a terrific summary and big guidance for the audience.  I promised you I'd tell you my favorite part of your article, and this is this huge table. I think the table is two and a half pages long, if I remember correctly, but it's an awesome table, and I highly recommend our audience to check this out. It lists literally every therapeutic trial for the microbiome under the sun. And so it begins with the approach of fecal microbiota transplant, which I'm going to ask you to tell us about in a second, but it also hinges on a lot of really cool sort of novel therapies, live bacterial products, mixes of different microbial products. Maybe take us through this whole approach of FMT (fecal microbiota transplantation). I actually wasn't aware of the dozens of trials that you listed there in this space. It seems like it's a very active area of research. Dr. Arielle Elkrief: Definitely. So, as you alluded to, FMT or fecal microbiota transplantation is the most well studied and direct way to modify the patient's microbiome. This technique aims to replace the patient's dysbiotic microbiome with that of a healthy microbiome, either from a healthy donor volunteer that's been heavily screened, or from a patient who experienced response to immunotherapy. And, as three landmark studies so far that have been published demonstrated the potential of FMT to reduce primary resistance or secondary resistance to immunotherapy, and this has been in melanoma.  We also recently reported on the results of our FMT-LUMINate trial, which looked at patients with lung cancer and melanoma. Once again, FMT, when combined with immunotherapy was safe and led to a higher proportion of responses than we would normally expect.  We're now also looking at randomized trials that have come out. So the first being the TACITO trial in kidney cancer, which compared FMT plus pembrolizumab and axitinib to placebo in patients with RCC, and again, FMT was safe and feasible and also led to an increased progression-free survival at one year, meeting the study's primary endpoint.  And so, so far, there's a wealth of data really showing the promise of FMT when combined with immunotherapy, and we're now in the process of conducting larger randomized trials, including in melanoma with the CCTG (Canada Cancer Trials Group) in our ME17 or Canbiome2 trial, where we're going to be enrolling 128 patients with metastatic melanoma to receive FMT and standard of care immunotherapy compared to standard of care immunotherapy alone. Dr. Sumanta (Monty) Pal: You're very humble, so I've got to highlight for our audience. This was a mega grant that Arielle received to fund really the largest prospective exploration of FMT that will exist to date. So I'm really excited about that. I wish this was something we could participate in stateside.  Before we jump into the other approach, which is live bacterial products and mixes thereof, where do you see FMT going? I think that one of the perceived challenges with FMT is that it's hard to implement, right? You need to have a really robust framework when it comes to gastroenterology, the preparation's challenging. Is there a way to envision FMT use being more generalized? Dr. Arielle Elkrief: Those are great questions. So we're lucky in Canada to work with pioneers in FMT, Michael Silverman, Saman Maleki, and John Lenehan in London, Ontario, who had this really robust FMT healthy donor screening program, which literally screens for every pathogen under the sun, and we haven't had any problems with feasibility or implementing FMT in Canada. But I think that once we're going to hopefully start doing larger scale, randomized phase three studies, that we might run into problems with scalability. And I think also with regards to reproducibility, and that's the feedback that we're getting from some regulatory authorities, especially at the level of the FDA, where there are some concerns around inter- and intra-donor variability because, of course, we can't guarantee that every fecal sample is going to be the same. So that has really pushed the field to think about other strategies, such as live biotherapeutic products which take modified FMT or bacteria from stools from either healthy donors or from responder patients and basically turn them into drugs that are regulated as drugs and can then be studied in the context of investigational new drugs or products. Dr. Sumanta (Monty) Pal: I like this and, you know, I do think that there's a future for it. We just have to kind of put our heads together and figure out how to get over all of these logistical hurdles, but, you know, I agree, I think your group and others have demonstrated, especially with this trial that you're fanning out all throughout Canada, that it can potentially be done.  This is a topic that could probably go on for another couple of hours, right, especially based on the size of the table that you put together in this brilliant article, but tell us about live bacterial products or LBPs, as we call them these days. What's the current status, what's the future there? And maybe I'll give you less than two minutes here, although again, I realize it's a two-hour topic. Dr. Arielle Elkrief: You're probably better suited to speak about that because you've been one of the pioneers in terms of this. So we can think about LBPs in terms of single strain organisms, like CBM588 for an example, which your group did some amazing work in showing that, in a randomized setting, that this led to better responses than we would expect compared to just work with controls. We also know that LBPs can have multiple strains, up to 30. We're collaborating with a company called Cannabis Bioscience that is actually working on much larger communities of consortia. And so we're really excited about the direction that that's taking in terms of taking these LBPs and developing them from the drug perspective. In addition to LBPs, we know that there are other ways that we can change the microbiome, notably prebiotics, which are compounds which can have a beneficial impact on the microbiome. And one of these is camu camu, which I know your group is leading a clinical trial looking at camu camu and kidney cancer, and we're excited to see how that compares to FMT or LBPs, because that might be a potentially scalable alternative. Dr. Sumanta (Monty) Pal: That's awesome. What a terrific overview, and that was less than two minutes. I don't know how you did it. That's terrific.  Arielle, this has been such an insightful conversation. I just want to thank you for, again, a terrific article in the ASCO Educational Book. I highly recommend all of our listeners to go there and check it out, and also for sharing all these terrific insights on the podcast today. Dr. Arielle Elkrief: Thank you so much, Monty. Dr. Sumanta (Monty) Pal: And thanks to our listeners, too. If you value the insights that you heard today on the ASCO Daily News Podcast, please rate, review, and subscribe wherever you get your podcasts. Thanks, everyone. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers:    Dr. Sumanta (Monty) Pal  @montypal Dr. Arielle Elkrief Follow ASCO on social media:     @ASCO on Twitter    ASCO on Bluesky   ASCO on Facebook     ASCO on LinkedIn     Disclosures:    Dr. Sumanta (Monty) Pal:   Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview  Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical  Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis  Dr. Arielle Elkrief: Honoraria: AstraZenica, Bristol-Myers Squibb, Merck, EMD Serono Consulting or Advisory Role: Bristol-Myers Squibb Research Funding (Inst.): Kanvas Bioscience, AstraZeneca, Merck Other Relationship: Royal College of Surgeons and Physicians of Canada, Cedar's Cancer Center (Henry R. Shibata Fellowship), Canadian Institutes of Health Research (CIHR)

In this week's episode we'll learn about how by combining PET response with circulating tumor DNA, or  ctDNA, in newly treated patients with follicular lymphoma, investigators identify those patients likely to progress within 24 months of initial treatment, also known as POD24. After that: Immune hotspots in aplastic anemia. These newly identified hotspots potentially represent sites in the bone marrow where the active immune response takes place, driving the destruction of hematopoietic stem and progenitor cells. Finally, allogeneic transplantation for Hodgkin lymphoma in the checkpoint inhibitor era. In a large, retrospective study, patients with prior checkpoint inhibitor exposure had remarkable outcomes, particularly when post-transplant cyclophosphamide was used.Featured Articles: Combined PET and ctDNA response as predictors of POD24 for follicular lymphoma after first-line induction treatmentImaging Mass Cytometry Reveals the Order of Events in the Pathogenesis of Immune-Mediated Aplastic AnemiaOutcomes of Allogeneic HCT in Hodgkin Lymphoma in the Era of Checkpoint Inhibitors: A Joint CIBMTR and EBMT Analysis

In this very informative episode of Dear Cancer, I'm Beautiful, Melissa sits down with Dr. Krystle Zuniga, a Board Certified Oncology Dietitian, to talk about a concern many breast cancer patients face: weight gain during treatment. Dr. Zuniga sheds light on why the number on the scale doesn't tell the whole story and shares why nutrition combined with resistance training is key to overall health and well-being. Tune in as they explore Dr. Zuniga's path into oncology nutrition, her research on diet's impact on cancer prevention and treatment, and practical tips to support muscle health and metabolism. Together, they debunk common diet myths and emphasize how proper nutrition paired with exercise helps patients take control of their recovery and quality of life. Join Melissa and Dr. Zuniga for a candid, hopeful conversation that goes beyond weight to what truly matters throughout the cancer experience.

Send us a textThe countdown is on! The Cancer Rehab Community Conference 2025 (#TCRCC2025) is happening virtually November 7–8, 2025, and you don't want to miss it.We're going behind the scenes on the AMAZING sessions by the incredible speaker lineup, plus all the juicy deets of #TCRCC2025.And yes,#TCRCC2025 is approved for both PT & OT CEUs!Listen now to get a preview, plus how to save on early bird registration.Follow TheOncoPT on Instagram.Follow TheOncoPT on LinkedIn.

The effects of the neurotoxin are taking their toll on Cooper as Shannon desperately tries to navigate the severity of their new reality.LEAD how this story ends is up to us is a true story written and produced by Shannon Burkett. Co-produced by Jenny Maguire. Directed by Alan Taylor. Starring Merritt Wever, Alessandro Nivola, Cynthia Nixon, and Cooper Burkett.E43 features Jenny Maguire, JD Mollison, Laith Nakli, Deirdre O'Connell, Carolyn Baeumler, Zach Shaffer, and Monique Woodley. Casting by Alaine Alldaffer and Lisa Donadio. Music by Peter Salett. Sound Design by Andy Kris. Recording Engineer Krissopher Chevannes.For corresponding visuals and more information on how to protect children from lead exposure please go to https://endleadpoisoning.org.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

  As a young person starting over in a new country—one where she didn't even yet know the language—young Yelena faced no shortage of challenges. But she also found opportunity she believes might not have existed in her native country.  “As an Armenian individual growing up in Azerbaijan, going by my parents' and my family's experience, I don't think I would have had an opportunity to be a physician there,” Dr. Janjigian says. “There was a clear limitation on who got to be a physician, and it's a prestigious position anywhere in the world. As a relative minority, I wouldn't have been able to do that. My parents certainly had the courage it took to leave and to come to a foreign country.”  That same brand of courage led Dr. Janjigian to her current work as a gastrointestinal medical oncologist at Memorial Sloan Kettering Cancer Center. A specialist in esophageal and stomach cancer, she presented the results of her gastric cancer clinical trial during the plenary session of this year's ASCO Annual Meeting in Chicago. The presentation was the culmination of more than eight years of work involving nearly 1,000 patients and collaborators. Much of that work, she says, started when she received her first grant from Conquer Cancer, a Young Investigator Award. Receiving that funding, she recalls, was a career-defining moment.      In this episode of Your Stories, Dr. Janjigian speaks with host Dr. Mark Lewis about her journey to become an oncologist, along with her vision for a world where a cancer diagnosis isn't nearly as frightening as it is today. 

In today's episode, supported by Daiichi-Sankyo, we spoke with Ronan J. Kelly, MD, MBA, FASCO; and Michelle Shiller, DO, AP/CP, MGP, about HER2 immunohistochemistry (IHC) testing in non–small cell lung cancer (NSCLC). Kelly is director of the Charles A. Sammons Cancer Center and chief science officer at Baylor University Medical Center in Dallas, Texas; the W.W. Caruth Jr. Endowed Chair of Immunology at Baylor University Medical Center; chief of Oncology at Baylor Scott & White Health System; founder and medical director of the Texas Cancer Interception Institute; a clinical professor at the Texas A&M University College of Medicine; an adjunct associate professor of oncology at the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins in Baltimore, Maryland; and a professor in the Clinical Sciences Division at the Translational Genomics Research Institute in Phoenix, Arizona. Shiller is a molecular genetic pathologist at Baylor University Medical Center.  In our conversation, Drs Kelly and Shiller discussed the importance of performing IHC testing for HER2 in NSCLC, how IHC results may influence treatment decision-making beyond the scope of next-generation sequencing results, and recommendations for more efficient and collaborative IHC testing implementation in clinical practice. 

In this week's episode, we'll learn more about how exogenous CD19 stimulation affects CAR T-cell persistence in B-cell acute lymphoblastic leukemia treated with CD19 CAR T-cell therapy; new algorithms that incorporate sequential rapid immune-assays, intended to improve diagnosis of heparin-induced thrombocytopenia, and resource-adaptive survival prediction models to help guide management of patients with chronic myelomonocytic leukemia.Featured Articles:Outcomes of PLAT-02 and PLAT-03: evaluating CD19 CAR T-cell therapy and CD19-expressing T-APC support in pediatric B-ALLSequential combinations of rapid immunoassays for prompt recognition of heparin-induced thrombocytopeniaBLAST: a globally applicable and molecularly versatile survival model for chronic myelomonocytic leukemia

Donna Wentz is marking a remarkable milestone: 10 years of no evidence of breast cancer. Her journey began at just 39 years old, when she received the life-changing diagnosis of estrogen receptor-positive breast cancer. Faced with fear and uncertainty, Donna leaned on the unwavering support of her family, friends, and colleagues. Their encouragement carried her through the challenges of surgery, treatment, and recovery, helping her find strength she didn't know she had. Today, she reflects not only on surviving, but on the resilience, gratitude, and deeper connections that emerged from her experience.

Featuring perspectives from Dr Natalie S Callander and Dr Sagar Lonial, including the following topics:  Introduction: Multiple Myeloma — 2005 to 2025 (0:00) Questions from the Beginning (7:53) Choosing Options (13:54) Clinical Trials (18:03) Neuropathy (23:55) Chimeric Antigen Receptor (CAR) T-Cell Therapy (28:40) Bispecific Antibodies (35:18) Antibody-Drug Conjugates (43:08) Interacting with the Oncology Team (51:47) Other Questions (57:30) Educational and presenter information

For this patient-focused webinar, medical oncologist Dr Neil Love is joined by Dr Natalie S Callander from the University of Wisconsin Carbone Cancer Center in Madison and Dr Sagar Lonial from the Winship Cancer Institute of Emory University in Atlanta, Georgia, to discuss the patient experience associated with the diagnosis and treatment of relapsed/refractory multiple myeloma. Educational and faculty information here.

BUFFALO, NY – August 15, 2025 – A new #research paper was #published in Volume 16 of Oncotarget on August 13, 2025, titled “Clinical and analytical validation of MI Cancer Seek®, a companion diagnostic whole exome and whole transcriptome sequencing-based comprehensive molecular profiling assay.” In this study, first authors Valeriy Domenyuk and Kasey Benson, along with corresponding author David Spetzler from Caris Life Sciences in Irving, Texas, introduce MI Cancer Seek, an FDA-approved test designed to deliver comprehensive tumor profiling. MI Cancer Seek demonstrated strong concordance with other FDA-approved companion diagnostics and serves as a powerful tool to guide treatment decisions in both adult and pediatric cancer patients. Cancer remains one of the most complex and diverse diseases to treat. With many targeted therapies currently FDA-approved, selecting the right one for a specific patient requires detailed genetic insights. MI Cancer Seek addresses this need by analyzing both DNA and RNA from a single tumor sample. The tool identifies key biomarkers linked to FDA-approved treatments for several major cancers, including breast, lung, colon, melanoma, and endometrial cancers. One of the most significant strengths of MI Cancer Seek is its ability to deliver accurate and reliable results from minimal tissue input (50 ng). Even when analyzing formalin-fixed paraffin-embedded samples, which are widely used but often degraded, the test maintained high levels of accuracy. It successfully detected important genetic alterations such as PIK3CA, EGFR, BRAF, and KRAS/NRAS mutations and measured tumor mutational burden (TMB) and microsatellite instability (MSI), both of which are key indicators for immunotherapy response. In clinical comparisons, the test achieved over 97% agreement with other FDA-approved diagnostic tools, confirming its reliability in detecting critical biomarkers. Notably, it showed near-perfect accuracy in identifying MSI status in colorectal and endometrial cancers. The researchers also demonstrated that the test maintains precision across different lab conditions and varying DNA input levels, confirming its robustness for routine clinical use. Beyond its role as a companion diagnostic, MI Cancer Seek incorporates additional features developed under its predecessor, MI Tumor Seek Hybrid. These include detection of homologous recombination deficiency, structural variants, and cancer-related viruses. It also includes advanced tools such as the Genomic Probability Score for identifying the tissue of origin in cancers of unknown primary, as well as a gene signature to guide first-line chemotherapy in colorectal cancer. “One limitation to be considered is the low PPA for ERBB2 CNA detection.” By offering deeper genetic insights from a single, small sample, MI Cancer Seek has the potential to streamline diagnostics, reduce testing costs, and connect patients to effective therapies more quickly. As precision medicine continues to expand, this assay stands out as a comprehensive and efficient solution for meeting the evolving needs of modern oncology. DOI - https://doi.org/10.18632/oncotarget.28761 Correspondence to - David Spetzler - dspetzler@carisls.com Video short - https://www.youtube.com/watch?v=D4hd2FxCYY8 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

In this compelling episode, host Melissa Berry continues the series "Decoding Destiny: Navigating Breast Cancer with Genetic Insight" with a heartfelt conversation with Krista Brown, also known on Instagram as the Cancer Prevention Coach. Krista, an oncology nurse navigator and breast cancer survivor, shares her journey of living with an ATM gene mutation and the empowering role of genetic testing in her life. Together, they explore the importance of education, nutrition, and self-advocacy in managing hereditary cancer risks. Tune in to discover how Krista's personal experiences have shaped her mission to fill gaps in patient education and support others on their cancer prevention journeys. Special thanks to AstraZeneca for making this episode possible.

Tom Frieden is the president and chief executive officer of Resolve to Save Lives and former director of the Centers for Disease Control and Prevention. Stephen Morrissey, the interviewer, is the Executive Managing Editor of the Journal. T.R. Frieden. Dismantling Public Health Infrastructure, Endangering American Lives. N Engl J Med 2025;393:625-627.

With over 27 years of experience as a registered dietitian nutritionist, Natalie is a well-seasoned practitioner. A board-certified specialist in oncology nutrition, Natalie is the founding dietitian for the nutrition program at the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center and is the clinical nutrition specialist at Smith Integrative Oncology in San Francisco. On a daily basis, she works with patients through her integrative & functional nutrition private practice. Utilizing an integrative and functional nutrition approach, Natalie develops practical and client-centered diet and lifestyle plans designed to promote vitality and wellness. Her areas of focus are working with adults during and beyond cancer treatment and supporting individuals who are navigating chronic health concerns Connect with Natalie: www.natalieledesma.com https://www.instagram.com/natalieledesma_nutrition/ _____________ To learn more about the 10 Radical Remission Healing Factors, connect with a certified RR coach or join a virtual or in-person workshop visit www.radicalremission.com. To watch Episode 1 of the Radical Remission Docuseries for free, visit our YouTube channel here.  To purchase the full 10-episode Radical Remission Docuseries visit Hay House Online Learning. To learn more about Radical Remission health coaching with Liz or Karla, Click Here Follow us on Social Media: Facebook  Instagram YouTube ____________ If you've been listening to our podcast, you know just how important it is to address and release suppressed emotions. The evidence supporting this healing factor is growing, and we talked a lot about it in our podcast episode with Avinoam Lerner. Avinoam is a Cancer and Trauma specialist whose work highlights the cancer/trauma connection and addresses the root cause of suffering for enhanced immune function and more favorable treatment outcomes. He offers people facing cancer an evidence-based approach to increasing their odds of healing and recovery. Visit www.avinoamlerner.com for your personalized approach to releasing your suppressed emotions  VA link to www.avinoamlerner.com Mobilize Your Mind to Heal Your Body, Book your Free Discovery Session VA link to https://www.avinoamlerner.com/cancer-immune-enhancement Learn more about the Mindful Remission Program  VA link to https://www.avinoamlerner.com/cancer-wellness-programs 

As the lead wreaks havoc on Cooper's development, Shannon searches for answers. Desperate to get a handle on what was happening to her son, she grabs onto a lifeboat - nursing school. Andy tries to piece together the past to make sense of the present.LEAD how this story ends is up to us is a true story written and produced by Shannon Burkett. Co-produced by Jenny Maguire. Directed by Alan Taylor. Starring Merritt Wever, Alessandro Nivola, Cynthia Nixon, and Cooper BurkettEP2 features Keith Nobbs and Frank Wood. Music by Peter Salett. Sound Design by Andy Kris. Recording Engineer Krissopher Chevannes. Casting by Alaine Alldaffer and Lisa Donadio.For corresponding visuals and more information on how to protect children from lead exposure please go to https://endleadpoisoning.org.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

Host: Darryl S. Chutka, M.D. Guest: Stacy D. D'Andre, M.D. When we diagnose a patient with cancer, we typically focus on finding the most effective treatment for that malignancy: surgery, radiotherapy, chemotherapy, or immunotherapy. However, to a patient, the diagnosis of cancer means much more. Patients commonly experience fear and anxiety just from receiving the diagnosis. Other symptoms may include insomnia, depression, pain, and symptomatic effects from the treatment including nausea, loss of appetite and fatigue to name just a few. The Mayo Clinic Comprehensive Cancer Center has developed an integrative approach to help patients manage the variety of symptoms associated with malignancy. It centers around a multi-disciplinary team which assesses each patient individually and incorporates a variety of complementary treatments as well as physical and emotional support. It also includes nutrition and dietary supplement counseling and recommendations regarding exercise and movement. In this podcast, we'll learn more about this fascinating approach to treating patients with cancer as we discuss “Integrative Oncology” with my guest, Stacy D. D'Andre, M.D., from the Department of Oncology at the Mayo Clinic. Connect with us and learn more here: https://ce.mayo.edu/online-education/content/mayo-clinic-podcasts Are you a medical professional, ready to ignite your passion and fuel your success? Join us October 23rd-25th in beautiful Pasadena, California or via livestream for GRIT, where innovation meets inspiration. GRIT in Medicine: Growth, Resilience, Inspiration & Tenacity 2025 will empower healthcare professionals with skills and resources to excel through productivity, personal development, and professional community. Leaders in business and healthcare will present evidence-based strategies and practical tips and tools to promote professional and personal well-being, and you'll leave encouraged and energized for excellence. Visit ce.mayo.edu/GRIT2025 by September 1st with the discount code GRIT2025 to save $100 on registration. See you soon for GRIT!

Life changes in a split second when you hear the words, “you have breast cancer.” Shawna Bramel and Marian Santos know this personally. Shawna was diagnosed after having her first child, completely upending her family's plans for more children. Marian was diagnosed at a time when she should have been thinking about her future, planning a family and focusing on preserving her reproductive health. Both ladies struggled mentally, emotionally and physically with their diagnoses and are joining us today to share more.