Podcasts about Radiation therapy

Radiation therapy is the use of ionizing radiation—X-rays, gamma rays, or subatomic particles such as neutrons—to destroy cancer cells. Learn how it works, the types of radiation, and early and late side effects you may see. https://bit.ly/4cEClyUIn this Episode:01:52 - Road Trip - Louisiana, and Crunch Cake Recipe03:30 - Anna Quindlin - The Dividing Line06:52 - Radiation Therapy Explained12:16 - Radiation Side Effects17:35 - Late Effects of Radiation Therapy20:54 - Discussion - Not Being Able to Swallow26:06 - The Mole Agent and The Man on the Inside30:48 - OutroRelated Content:S6E2: Understanding Cancer Treatment Options: SurgeryS5E52: Cancer Gone Wild – Learn All About MetastasisS5E45: Why Does Cancer Exist? Empower Yourself With UnderstandingS5E46: “Why Do I Have Cancer?” Kismet, Chastisement or Coincidence?S5E47: MythBusters – Cancer Edition; Clarifying Common Cancer Myths & MisconceptionsS5E48: How to Read a CT Scan Report – Learn the Sections Relevant to Your DiagnosisS5E49: Are there Miracle Cures for Cancer? With Dr. Jeanna FordS5E50: What is Meant by Cancer Staging? Learn the Language of a Cancer DiagnosisSupport the showGet show notes and resources at our website: every1dies.org. Facebook | Instagram | YouTube | mail@every1dies.org

In this episode of the Dr. Geo Prostate Podcast, we welcome Dr. Jonathan Lischalk, Director of Genitourinary Cancers at MedStar Georgetown University Hospital and former Medical Director at NYU's NYCyberKnife Center. Dr. Lischalk breaks down the evolution of radiation oncology and how cutting-edge imaging and targeted SBRT (Stereotactic Body Radiation Therapy) are reshaping prostate cancer treatment.We explore how imaging advances like MRI and PSMA PET scans are enabling unprecedented precision, the future of genetic-based personalization in prostate cancer therapy, and why fewer, more focused radiation sessions might soon become the new standard. From understanding the biology of radiation dosing to upcoming trials eliminating ADT in select patients, this is a must-listen for anyone looking to stay informed on the forefront of cancer care.

Commentary by Dr. Sophie Jacob.

Welcome to another insightful trailer episode of A Couple of Rad Techs Podcast , hosted by the experienced medical imaging professional, Chaundria | Radiology Technologist . With over 22 years in the field, Chaundria | Radiology Technologist is here to share essential tips and tricks to help you elevate your career as an MRI Technologist.The ASRT is more than continuing education management. Medical Imaging and Radiation Therapy professionals are leaving career growth opportunities on the table when they aren't members or taking advantage of the ASRT membership. Listen to the full episode to learn more and visit www.asrt.orgSubscribe & Leave a ReviewDon't miss out on future episodes! Subscribe to A Couple of Rad Techs Podcast on your favorite podcast platform. If you enjoyed this episode, please rate it and leave a review.© 2025 A Couple of Rad Techs Podcast A Couple of Rad Techs Podcast website

Radiation therapy or radiotherapy, is a common treatment for cancer, but its effectiveness differs across patients. A recent study published as the cover for Volume 17, Issue 2 of Aging explored why this happens. The findings provide valuable insights, particularly for brain cancers like glioblastoma (GBM) and low-grade gliomas (LGG). Understanding Glioblastoma and Low-Grade Gliomas Glioblastoma and LGG are both brain tumors, but they behave in very different ways. GBM is highly aggressive, with most patients surviving only 12 to 18 months, even with surgery, chemotherapy, and radiation therapy. LGG, on the other hand, grows more slowly, and many patients live for decades with proper care. Despite their differences, LGG and GBM are biologically linked. Some LGG tumors eventually transform into GBM, making early treatment decisions critical. Given radiation therapy's effectiveness in GBM, it has often been assumed that LGG patients would also benefit from it. However, a new study titled “Variability in radiotherapy outcomes across cancer types: a comparative study of glioblastoma multiforme and low-grade gliomas” challenges this assumption. Full blog - https://aging-us.org/2025/03/how-radiation-therapy-affects-tumors-glioblastoma-vs-low-grade-gliomas/ Paper DOI - https://doi.org/10.18632/aging.206212 Corresponding author - Morten Scheibye-Knudsen - mscheibye@sund.ku.dk Video short - https://www.youtube.com/watch?v=j91rzDJHXTE Sign up for free Altmetric alerts about this article - https://aging.altmetric.com/details/email_updates?id=10.18632%2Faging.206212 Subscribe for free publication alerts from Aging - https://www.aging-us.com/subscribe-to-toc-alerts Keywords - aging, cancer, biomarkers, radiotherapy, GBM, LGG, survival About Aging-US The mission of the journal is to understand the mechanisms surrounding aging and age-related diseases, including cancer as the main cause of death in the modern aged population. The journal aims to promote 1) treatment of age-related diseases by slowing down aging, 2) validation of anti-aging drugs by treating age-related diseases, and 3) prevention of cancer by inhibiting aging. (Cancer and COVID-19 are age-related diseases.) Please visit our website at https://www.Aging-US.com​​ and connect with us: Facebook - https://www.facebook.com/AgingUS/ X - https://twitter.com/AgingJrnl Instagram - https://www.instagram.com/agingjrnl/ YouTube - https://www.youtube.com/@AgingJournal LinkedIn - https://www.linkedin.com/company/aging/ Pinterest - https://www.pinterest.com/AgingUS/ Spotify - https://open.spotify.com/show/1X4HQQgegjReaf6Mozn6Mc MEDIA@IMPACTJOURNALS.COM

In this PRO podcast, Bisham Chera MD, FASTRO, Danielle Margalit, MD, MPH, and David Sher, MD, discuss the recently published ASTRO clinical practice guideline of Radiation Therapy for HPV-Positive Oropharyngeal Squamous Cell Carcinoma. This manuscript was published in print in the September/October 2024 issue and was the 3rd most downloaded PRO article in 2024. Listen for their lively and meaningful discussion of the key recommendations and controversies.

In this episode, Dr. Geo welcomes Dr. Jonathan Haas, Director of Radiation Oncology at NYU Grossman School of Medicine in Long Island, to discuss the latest advancements in stereotactic body radiation therapy (SBRT) for prostate cancer. Dr. Haas, a pioneer in CyberKnife radiation, shares the latest research, treatment options, and what's on the horizon for prostate cancer care.Episode Highlights:✔ SBRT & CyberKnife Technology – How high-dose, highly targeted radiation is replacing traditional 9-week radiation therapy.✔ New Developments – Research is underway to reduce SBRT treatment from five sessions to just two, making therapy even more convenient.✔ Prostate Motion & Radiation Accuracy – The prostate moves during treatment—learn how advanced imaging and AI-powered tracking compensate for movement to improve precision.✔ Androgen Deprivation Therapy (ADT) & SBRT – Not all patients may need ADT. New studies explore whether men with Gleason 4+3 can avoid hormone therapy.✔ Who is a Candidate? – Understanding the differences between Gleason 6, 7, 8, and 9 patients and who may benefit most from SBRT.✔ Side Effects & Risk Factors – Discussing common side effects like bladder bleeding (2%), rectal irritation (5%), erectile dysfunction (25% over 5 years), and strictures (2%).✔ Artificial Intelligence & Radiation Therapy – The RayStation AI system is now optimizing radiation planning, increasing precision, and making treatments more effective.✔ Choosing the Right Treatment Center – Why it's crucial to seek multidisciplinary care, get second opinions, and explore clinical trials for the best possible outcome.Takeaway: The landscape of prostate cancer treatment is evolving rapidly. If you or a loved one is considering radiation therapy, ask about SBRT, AI-driven imaging, and new clinical trials to ensure you receive the most advanced and effective care.Join Dr. Geo each week for expert insights, science-backed advice, and empowering conversations designed to help you live better with age. ----------------Thank you to our partnersThe ProLon 5-Day Fasting Mimicking Diet is a plant-based meal program designed to provide fasting benefits while allowing food intake. Developed by Dr. Valter Longo, it supports cellular renewal, fat loss, and metabolic health through low-calorie, pre-packaged meals that maintain the body in a fasting state.Special Offer: Thank you for listening, you can purchase the ProLon kit for just $148 by using this link.We'd also like to thank our partner AG1 by Athletic Greens. AG1 contains 75 high-quality vitamins, minerals, whole-food sourced ingredients, probiotics, and adaptogens to help you start your day right. This special blend of ingredients supports your gut health, nervous system, immune system, energy, recovery, focus, and aging. All the essentials in one scoop. Enjoy AG1 by Athletic Greens.----------------Thanks for listening to this week's episode. Subscribe to The Dr. Geo YouTube...

Robert Den, Chief Medical Officer at Alpha Tau Medical, is changing cancer treatment using their Alpha DaRT technology to deliver a potent form of alpha radiation directly into solid tumors with minimal side effects. There is potential for the Alpha DaRT to be combined with immunotherapy and chemotherapy to further invoke an immune response. This one-time alpha radiation treatment has shown the ability to treat all solid tumors, only limited by the ability to deliver the Alpha DaRT directly to the tumor. Robert explains, "So alpha radiation is one of the three types of radiation that occur naturally, and it's been known as a very potent form of radiation for several decades now. The challenge with alpha radiation in the treatment of patients with localized disease and with solid tumors, meaning tumors not like leukemias or lymphomas but more like pancreas, lung, and prostate cancer, is that the alpha particles themselves aren't only able to travel a very short distance inside tissue or inside the cancer itself." "Before Alpha Tau and the Alpha DaRT technology, there was no pragmatic way to use this super potent and very safe type of radiation because you could not put enough alpha particles inside a tumor to cover the tumor with the radiation dose. What Alpha DaRT technology does is rely on the movement of what's called alpha-emitting daughter atoms." "So essentially, we take a biocompatible inert metal seed, which means that if you were to put this seed into the body, there would be no immune effect. Patients could have it inside them for the entirety of their life. Essentially, what we do is we cover this seed with a radiopharmaceutical called Radium-224. We just put Radium-224 on the outside of the seed. Then, we insert it either through a minimally invasive approach or using a different endoscopic approach inside the tumor directly. So now we have the seed covered with the radium inside the tumor, and this is basically where the magic happens."   #AlphaTauMedical #Cancer #TargetedRadiation #ClinicalResearch #RadiationOncology #Oncology #CancerTreatment #AlphaRadiation  alphatau.com Download the transcript here

Robert Den, Chief Medical Officer at Alpha Tau Medical, is changing cancer treatment using their Alpha DaRT technology to deliver a potent form of alpha radiation directly into solid tumors with minimal side effects. There is potential for the Alpha DaRT to be combined with immunotherapy and chemotherapy to further invoke an immune response. This one-time alpha radiation treatment has shown the ability to treat all solid tumors, only limited by the ability to deliver the Alpha DaRT directly to the tumor. Robert explains, "So alpha radiation is one of the three types of radiation that occur naturally, and it's been known as a very potent form of radiation for several decades now. The challenge with alpha radiation in the treatment of patients with localized disease and with solid tumors, meaning tumors not like leukemias or lymphomas but more like pancreas, lung, and prostate cancer, is that the alpha particles themselves aren't only able to travel a very short distance inside tissue or inside the cancer itself." "Before Alpha Tau and the Alpha DaRT technology, there was no pragmatic way to use this super potent and very safe type of radiation because you could not put enough alpha particles inside a tumor to cover the tumor with the radiation dose. What Alpha DaRT technology does is rely on the movement of what's called alpha-emitting daughter atoms." "So essentially, we take a biocompatible inert metal seed, which means that if you were to put this seed into the body, there would be no immune effect. Patients could have it inside them for the entirety of their life. Essentially, what we do is we cover this seed with a radiopharmaceutical called Radium-224. We just put Radium-224 on the outside of the seed. Then, we insert it either through a minimally invasive approach or using a different endoscopic approach inside the tumor directly. So now we have the seed covered with the radium inside the tumor, and this is basically where the magic happens."   #AlphaTauMedical #Cancer #TargetedRadiation #ClinicalResearch #RadiationOncology #Oncology #CancerTreatment #AlphaRadiation  alphatau.com Listen to the podcast here

In this in-depth expose, veterinary oncology technician specialist Jenny Fisher joins Molly Jacobson to explain the ins and outs of radiation therapy for dogs with cancer. Whether you're fearful as you consider radiation for your dog or just curious about how it works, this episode provides invaluable insights.  Topics Covered:  How radiation therapy works and the two types: diagnostic vs. therapeutic  The difference between teletherapy and brachytherapy  What to expect during radiation treatments, including anesthesia use  Short-term and long-term side effects of radiation therapy  When radiation therapy is recommended for dogs with cancer  How stereotactic radiosurgery like CyberKnife offers precision treatment  Tips for preparing your dog for radiation therapy and managing side effects  Your Voice Matters!   If you have a question for our team, or if you want to share your own hopeful dog cancer story, we want to hear from you! Go to https://www.dogcancer.com/ask to submit your question or story, or call our Listener Line at +1 808-868-3200 to leave a question.   Related Videos:  Radiation for a dog with TCC: https://www.youtube.com/watch?v=ZGoyn-1TBsA  What a veterinary technician does: https://www.youtube.com/watch?v=9m7pjiHLhGA   Related Links:  An overview of radiation therapy for dogs: https://www.dogcancer.com/articles/diagnosis-and-medical-procedures/radiation-for-dogs/  An in-depth article on stereotactic radiation: https://www.dogcancer.com/articles/diagnosis-and-medical-procedures/stereotactic-radiation-therapy-for-dogs/   Chapters:  00:00 Introduction  0:15 What Is Radiation Therapy for Dogs?  01:00 Types of Radiation: Teletherapy vs. Brachytherapy  02:45 Common Misconceptions About Radiation Safety  04:00 How Teletherapy Works for Dogs  06:30 The Role of Anesthesia in Radiation Therapy  08:45 How Radiation Targets Tumors  10:30 Curative vs. Palliative Radiation Intent  12:15 Stereotactic Radiosurgery Explained  14:00 Managing Side Effects: Short-Term and Long-Term Effects  18:00 Radiation-Induced Tumors: Risks and Realities  20:30 Preparing Your Dog for Radiation Therapy  23:00 How Technicians Create a Healing Environment  25:15 Tips for Dog Owners: What to Ask Your Vet  27:00 Closing Thoughts: Changing Perceptions Around Radiation    Get to know Jenny Fisher: https://www.dogcancer.com/people/jenny-cassibry-fisher-rvt-vts-oncology/  For more details, articles, podcast episodes, and quality education, go to the episode page: https://www.dogcancer.com/podcast/   Learn more about your ad choices. Visit megaphone.fm/adchoices

Send us a textIn our latest episode of MedStar Health DocTalk, Debra Schindler talks with MedStar Health breast surgeon, Maen Farha, MD, medical director of the Breast Center at MedStar Good Samaritan Hospital in Baltimore, about the most common breast cancer diagnosis: ductal carcinoma in situ (DCIS). Learn more about the contained, early-stage disease, the intricacies of diagnosis, and the personalized treatment options available. Dr. Farha shares valuable experience and a wealth of knowledge with hope for outstanding results, possible with proper care.For more episodes of MedStar Health DocTalk, go to medstarhealth.org/doctalk.

ABOUT THIS EPISODEWhat is radiation oncology, and how is it used for neuroendocrine cancer? UCSF radiation oncologists Dr. Will Chen and Dr. Alexandra Hotca-Cho describe external radiation therapy (SBRT) and how, when, and where it may be used for select patients with neuroendocrine cancers. They address common concerns about the planning process, safety concerns, and treatment sequencing.TOP TEN QUESTIONS ABOUT EXTERNAL RADIATION THERAPY FOR NEUROENDOCRINE CANCERS:1. What is radiation oncology? How does it work? How is it different from other types of radiation?2. What are the types of radiation therapies used for neuroendocrine cancer? 3. Which neuroendocrine cancers are they used for, and when are they used? How do you decide who is a good candidate and if it will be effective?Where in the body can SBRT be used? (bone, liver, pancreas, rectal?) Where can it not be used in the body, and when is SBRT NOT used?Is there a number or size limit of the tumor(s)?4. For Bone: How do NETs affect the bones? Are they “on” or “in” the bone, and does the tumor tend to weaken it?If given to the bone, does SBRT weaken the bone? What are the chances of fracture with radiation to the bone? Does it matter which area of the bone/body is treated? What other factors influence fracture risk? (age, dose, number of treatments)? Should patients have a bone density scan before SBRT?If bone lesions are causing pain, how soon after treatment might a patient expect to have pain alleviated?How common is increased pain after treatment to the bone? What causes that?5. Safety: How much radiation is given with these procedures? Is there a concern about radiation safety following the procedures? (Do patients need to avoid others in the hours or days after the treatment?)Is there a lifetime limit to the amount of radiation one can receive, especially considering surveillance CT & PET scans?How often can these procedures be repeated? Does it damage other tissues or organs? How common are secondary cancers? What types and how treatable are they?Is there a risk with fertility?What other risks are there?6. How do these therapies compare to PRRT or radioembolization in terms of safety? If someone has had PRRT or radioembolization, can they also receive radiation therapy to the liver or bones? Is there increased risks if someone has had PRRT, radioembolization or CAPTEM or alkylating agents? 7. Is there an optimal sequence for treatments? 8. What is SBRT like for patients? What is the planning and preparation process? How do you determine how many treatments and what dose to give?9. What does the patient experience during and after the procedure? Does it hurt? What are the side effects? How much time do I need to take off of work? 10. How effective is SBRT in terms of managing symptoms? How effective is SBRT in controlling or destroying the tumor?  How do you know if the treatment “worked”?Bonus: What is the future of radiation therapy in neuroendocrine cancer treatment?For more information, visit LACNETS.org.

In late 2018, Samina Cepal went in for her routine pap smear, but her visit turned out to be anything but routine.  It led to a CT scan, a pelvic ultrasound and a diagnosis of cervical cancer.  Samina underwent a grueling regimen of chemotherapy and radiation therapy.  She experienced acute fatigue, weight loss, hair loss and despair, but three months later, her doctor said she had no evidence of disease.  These days, Samina can exercise, which includes vigorous use of a hula hoop, and has regained her appetite and her pre-diagnosis weight.

Join host Rick Bangs and expert Dr. Kent Mouw, a radiation oncologist from Dana-Farber Cancer Institute and Harvard Medical School, as they dive deep into the transformative role of radiation therapy in treating bladder cancer. From debunking myths about radiation to exploring cutting-edge advancements like adaptive radiation and personalized treatment plans, this episode offers a comprehensive look at how modern techniques are improving outcomes and patient experiences. Whether you're a patient, caregiver, or medical professional, you won't want to miss this insightful conversation about the future of bladder cancer treatment.

Marc Mlyn is the President and CEO of RaySearch Americas, a wholly owned subsidiary of RaySearch Laboratories AB in Stockholm, Sweden.  Marc began work in medical physics doing research as an undergraduate in the late 1980's, and went on to become a certified medical dosimetrist (https://www.medicaldosimetry.org/about/medical-dosimetrist/). He worked in Radiation Therapy hospitals until 1997, when he went to work as a customer service specialist for ADAC, which was soon acquired by Philips Medical System in 2000. He worked as a senior service manager, traveling the world and working with distributors, sales staff and customers all over the globe.  In 2007 Marc went to CIVCO and became the vice president of Marketing, developing software and hardware systems for radiation therapy. When RaySearch Laboratories released a new software platform in 2011, he was asked to start up the Americas organization to provide sales, support and training.  RaySearch Americas grew from three people to fifty people over the next few years, and has built a successful organization with offices in New York City and Santa Clara California. Marc has an MBA from the New York Institute of Technology, and an MS in Cybersecurity from the Georgia Institute of Technology.

What does recent research say about the role of perirectal spacers in prostate cancer treatment? In this episode of the BackTable Urology Podcast, host Dr. Jose Silva discusses the use of perirectal spacers for prostate radiotherapy with guests Dr. Eric Chenven, Chief of Urology at Broward Health Medical Center, and Dr. Nadim Nasr, a radiation oncologist at Arlington Radiation Oncology. --- This podcast is supported by: Boston Scientific SpaceOAR Hydrogel https://www.spaceoar.com/about-spaceoar-hydrogel/how-spaceoar-hydrogel-works/?utm_source=google&utm_medium=cpc&utm_campaign=uro-ph-us-spaceoar-dtp&utm_content=nf-cs-prostatecancer_search_en_us_brand_conversion_dtp_uro-spaceoar-651995397243-res&gad_source=1&gclid=CjwKCAjw9eO3BhBNEiwAoc0-jTE63KEHSnZ1soXre9ovVRqweY2QctIuZ_iN2QUjk6Px4k6fK1757BoCVNgQAvD_BwE --- SYNPOSIS Their conversation delves into the use of Boston Scientific's SpaceOAR hydrogel to reduce radiation exposure to the rectum. The experts elaborate on the techniques and logistical challenges of placing spacers, as well as their effects on patient outcomes. They also discuss insurance hurdles, use of sedation, fiducial marker placement, and the impact of large prostate size on treatment efficacy. Finally, they touch on Barrigel, the newest spacer option. This episode emphasizes the need for collaboration between urologists and radiation oncologists to improve patient care. --- TIMESTAMPS 00:00 - Introduction 06:33 - Importance of Perirectal Spacing 11:17 - Techniques and Protocols 13:00 - Barrigel: The New Option 14:58 - Challenges and Practical Considerations 24:55 - Future Directions --- RESOURCES Boston Scientific SpaceOAR https://www.bostonscientific.com/en-US/products/hydrogel-spacers/spaceoar-hydrogel.html URO108 - Minimizing Radiation Therapy Side Effects https://www.backtable.com/shows/urology/podcasts/108/minimizing-radiation-therapy-side-effects URO123 - Perfecting Rectal Spacer Placement for Optimal Care https://www.backtable.com/shows/urology/podcasts/123/perfecting-rectal-spacer-placement-for-optimal-care

Cameron Tharp, MPH, RTT joins The Accelerators (Drs. Matt Spraker and Simul Parikh), and we host radiation therapist Shaun Caldwell, EdD, RTT to discuss the Advanced Practice Radiation Therapist (APRT) role. Here are some things we discussed during the show:Mohan et al. on record and verify systems (1984)American Society of Radiologic Technologists (ASRT)American Registry of Radiologic Technologists (ARRT)Health Education England Advanced Clinical Practice DefinitionHere are some peer reviewed publications on the APRT role:Lawlor and Leech. Scoping review of established APRT rolesSkubish et al. Exploring possibilities for the APRT in the USThe Accelerators Podcast is a production of Photon Media, a division of the Cold Light Legacy Company.If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.

In this powerful episode of the Balancing Chaos podcast, Kelley Nemiro sits down with Dr. Katie Deming, oncologist and healthcare leader who has dedicated her career to making the cancer experience just a little bit easier. After caring for thousands of patients and achieving major milestones in her career in traditional Western Medicine, Katie's life took a dramatic turn following a near-death experience in 2020. At the height of her professional success, having been nominated for the prestigious position of National Medical Director of Cancer Services for a healthcare system serving over 12 million Americans, Katie realized she needed to leave traditional oncology behind. This pivotal experience led her on a new path to explore deeper healing methods for cancer patients. While she continues to recognize the value of traditional cancer treatments like radiation, chemotherapy, and surgery, Katie now focuses on the mind-body connection and the conditions that support true wellness and healing. She is passionate about helping cancer patients navigate the bridge between conventional cancer care and integrative healing approaches.In this episode, Kelley and Katie dive deep into:The limitations of chemotherapy and radiation—how these treatments kill cells but don't cure cancer—and the critical role of bolstering the immune system to truly heal.The debate on whether cancer is driven more by genetics or lifestyle, and the surprising insights that Katie has discovered through her research.The importance of holistic well-being, including emotional, mental, and spiritual health, in both cancer prevention and recovery.Effective strategies to mitigate the stress of modern living and how reducing stress can prevent the development of cancer.How emotional management, supportive environments, and empowering communication are essential components of cancer treatment.Rethinking healthcare to emphasize patient independence and self-reliance on their healing journey.Katie's insights into the right diet and supplements for cancer prevention and supporting the healing process.This conversation is full of eye-opening revelations for anyone seeking a deeper understanding of how to approach cancer treatment holistically. Whether you're navigating cancer yourself, supporting a loved one, or interested in proactive health strategies, Katie's expertise and perspective will inspire and empower you.Tune in to learn how we can go beyond traditional treatments and embrace a more comprehensive approach to cancer care that addresses the root causes of illness and fosters true wellness.Links & Resources:Learn more about Katie Deming's integrative oncology services HEREFollow Kelley on Instagram HEREBook a lab review with Kelley HEREDon't forget to subscribe, rate, and review the Balancing Chaos podcast!

The Accelerators (Drs. Matt Spraker and Simul Parikh) host Christine Gnaster, MS, DABR, FAAPM, Vice President of Product of Radformation and medical physicist Chelsea Page-Robertson for a #MedEd discussion of AutoContour, ClearCheck, and the use of AI in Radiation Oncology. Christine kicks us off with an approachable overview of how tools like AutoContour actually work. We discuss how Radformation have trained hundreds of models to help you contour in clinic. She also shares how they are approaching current challenges in the field of automated contouring. We then discuss ClearCheck, how it is linked to AutoContour, and why it is so much more than a checklist for dosimetry review. Chelsea shares how her and Matt have implemented AutoContour and ClearCheck in their practice. We close with a discussion of the "psychology" of implementing AI tools in the Radiation Oncology clinic. Should we trust the computer to draw clinical target volumes? Are we planning to green boxes? Are these tools going to us worse clinicians? Plus, all the (live) music that makes us happy.Here are some other things we discussed during the show:See a list of AutoContour's included modelsRadformation Acquires Limbus AITAP Re-irradiation EpisodeAAPM TG 132Dean et al., CB-CHOP plan review strategyChen et al., Physician vs. AI Chat Bot for cancerPhysics World, "Automation in the radiotherapy workflow"Batumalai et al., Survey of RO professionals perceptions of automationEditor's Note: While our love for their products is genuine, The Accelerators were compensated for this episode and Radformation participated in planning the content. The discussions in this episode are the opinions of the participants and are not clinical advice.Please see our website for complete information on our past and current sponsors.The Accelerators Podcast is a Photon Media production. 

As a dermatologist who treats skin cancers, I can't stress enough how important it is to understand skin cancers and how to prevent them. Skin cancers are one of the most common types of cancer, but with the right knowledge and actions, it's also one of the easiest to prevent and treat.  Regular check-ups, protecting your skin from the sun, and knowing your treatment options are key to keeping your skin healthy. If you have any concerns about your skin or need advice on how to treat or prevent skin cancer, it's important to talk to a dermatologist. Don't miss this week's podcast with Dr. Abigail Waldman, where she covers common and rare skin cancers, prevention and treatment methods. Key Takeaways: - The majority of skin cancers have a good prognosis when treated with surgery. - Sun exposure during childhood and cumulative sun exposure increase the risk of skin cancer. - Starting good sun protection habits early is really important for keeping your skin healthy in the long run - Discussing treatment options and preventive measures with a dermatologist is crucial. - Mohs surgery is considered the 'gold standard' for skin cancer treatment especially on the head and neck area. - If you need advice on how to treat or prevent skin cancer, it's important to talk to a dermatologist.  Check out Dr. Mina's top picks for skin care here. Download the free eBook 'Skincare Myths Busted' here. In This Episode: (9:52) Importance of Sun Protection (11:46) Nicotinamide and Sun Damage (13:49) How to Get Vitamin D (16:11) Laser Treatment for Pre-cancers and Early Skin Cancers (18:39) Merkel Cell Carcinoma (22:08 )Radiation Therapy for Skin Cancer (26:56) Overview of Mohs Surgery (34:33) Top Three Takeaways Dr. Abigail Waldman Abigail H. Waldman, MD, FAAD Director, Mohs and Dermatologic Surgery Center Director, Mohs Surgery, VA Boston Healthcare System Assistant Professor, Harvard Medical School Dermatology Leadership Title Director, Mohs and Dermatologic Surgery Center Director, Mohs Surgery, VA Boston Healthcare System Follow Dr. Waldman here: https://www.instagram.com/abby.waldmanmd/ https://www.youtube.com/@doctor-abby https://www.tiktok.com/@drabby6?_t=8otzFxFpbUF&_r=1 Follow Dr. Mina here:- https://instagram.com/drminaskin https://www.facebook.com/drminaskin https://www.youtube.com/@drminaskin For more great skin care tips, subscribe to The Skin Real Podcast or visit www.theskinreal.com Baucom & Mina Derm Surgery, LLC Email - scheduling@atlantadermsurgery.com Contact - (404) 844-0496 Instagram - https://www.instagram.com/baucomminamd/ Thanks for listening! The content of this podcast is for entertainment, educational, and informational purposes and does not constitute formal medical advice.

JCO PO author Dr. Jonathan D. Tward, M.D., Ph.D., FASTRO, at the HCI Genitourinary Cancers Center and the Huntsman Cancer Institute at the University of Utah, shares insights into his JCO PO article, “Using the Cell-Cycle Risk Score to Predict the Benefit of Androgen-Deprivation Therapy Added to Radiation Therapy in Patients With Newly Diagnosed Prostate Cancer.” Host Dr. Rafeh Naqash and Dr. Tward discuss how the cell-cycle risk score predicts the benefit of androgen-deprivation therapy in prostate cancer treatment. TRANSCRIPT Dr. Abdul Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash, Assistant Professor at the OU Health Stephenson Cancer center. Today, we are excited to be joined by Dr. Jonathan Tward, Leader at the HCI Genitourinary Cancer Center, and Vincent P. and Janet Mancini Presidential Endowed Chair in Genitourinary malignancies at the Huntsman Cancer Institute at the University of Utah. Dr. Tward is also the lead author of the JCO Precision Oncology article titled “Using the Cell-Cycle Risk Score to Predict the Benefit of Androgen-Deprivation Therapy Added to Radiation Therapy in Patients With Newly Diagnosed Prostate Cancer.”  At the time of this recording, our guest's disclosures will be linked in the transcript.  Doctor Tward, welcome to the podcast and thank you for joining us today. Dr. Jonathan Tward: Thank you so much, Dr. Naqash. I'm excited to share this important research with your audience.  Dr. Abdul Rafeh Naqash: Awesome. For the sake of simplicity, we'll refer to each other using our first names, if that's okay with you.  Dr. Jonathan Tward: That's great.  Dr. Abdul Rafeh Naqash: Okay. So, Jonathan, this complex but very interesting topic revolves around a lot of different subtopics as I understand it. There is genomics, there are implications for treatment, there is machine learning and computational data science research. So, to start off why you started this project or why you did this research, could you, for the sake of our audience, try to help us understand what androgen deprivation therapy is? When is it used in prostate cancer? When is it used in combination with radiation therapy? And that would probably give us a decent background of why you were trying to do what you actually did in this research. Dr. Jonathan Tward: Yes, thank you very much. So, men who are diagnosed with localized prostate cancer, which is the majority of prostate cancer diagnosis, are faced with a lot of treatment decisions. And those decisions range all the way from, “Should I just go on active surveillance with the idea that it might be safe to treat later?” to “Should I consider surgery or radiation?” And then there's various forms of radiation. Now, as a radiation oncologist, one of the things that I have to consider when I meet a patient with localized prostate cancer who is pondering receiving radiation therapy, is whether or not we want to intensify treatment by doing more than just radiation alone. And androgen deprivation therapy, very specifically also thought of as chemical castration, what that really is is some kind of therapy where you are trying to reduce a man's testosterone levels to nearly zero. And the rationale for using androgen deprivation therapy in prostate cancer and in this case, specifically localized prostate cancer, is that one can think of testosterone almost as the food and growth signal for prostate cancer. There have been numerous prospective randomized trials that have been performed in the past that have clearly demonstrated that adding androgen deprivation therapy to certain contexts of patients with localized prostate cancer receiving radiation improves the outcome, including risk of metastasis and overall survival.  The problem is, we don't want to just intensify therapy for everybody who walks through our doors with localized prostate cancer. Some men have lower risk disease, and some men have higher risk disease. And conventionally, the way we make this decision is by looking at things like NCCN risk groups, which kind of lump patients into a few different boxes, generally speaking, called low risk, intermediate risk, and high risk. And if you think of those risk groups, the patients with the contemporary standard of who to add ADT to are men who are considered high risk localized, or men who are considered unfavorable intermediate risk localized. That being said, I think there's a recognition that we're overtreating some unfavorable intermediate risk men and undertreating them, and the same could be said of high-risk disease. So, I think we're always looking for better tools that make it a little bit more personalized, rather than lumping men into just one of several boxes. Dr. Abdul Rafeh Naqash: Sure. And this sort of reminds me of the oncotype DX, in a way, trying to connect people with ER/PR, breast cancer, and where chemotherapy, plus anti-estrogen and progesterone therapy may be applicable. So, I think you were trying to do something similar in this research, and as far as I remember, please correct me if I'm wrong, this is knowledge that I remember from my board exams, we classify this high risk, intermediate risk, and low risk based on the Gleason score. Is that correct? Is that still true, or has this changed? Dr. Jonathan Tward: It's still true. Conventional risk stratification, which is still used, literally only looks at a few parameters. You mentioned one, which is the Gleason score, which is really a human subjective judgment by a pathologist about how deranged cells look under a microscope. That's one parameter. The second parameter is the PSA value at the time of diagnosis. And the third parameter is the cT stage, which is really based on the digital rectal exam. Now, when you ponder that the entirety of our risk classification system is based on two subjective and one objective pieces of information, meaning what a Gleason score looks like, what the T stage is based on human interpretation, and then the only objective piece of data, PSA, it's rather rudimentary way of classifying men. I mean, it's done us well since the late ‘90s, when that particular classification system was derived. But it strikes me as odd that we should take all newly diagnosed localized prostate cancer patients and say you fit into one of three boxes, when we know there's so much more complexity to people and so many different treatment options and choices out there, which we're trying to match to the patient to ensure that we right size the treatment for them. Dr. Abdul Rafeh Naqash: Understood. Now, as we go into the precision medicine component of this research, there's genomics research in metastatic cancers. But is there any genomics research in early-stage prostate cancer where there have been differences that have been identified between the intermediate low risk, high risk? Is that something that has been explored to date? Dr. Jonathan Tward: Well, there are certainly somatic mutations that track with certain aggressive features. But I think when I think about the spirit of your question, within the localized prostate cancer space, there's been several molecular signatures that have been developed and, in fact, been commercialized that have been shown quite clearly that if you have a certain array of gene expressions, let's say, that that can correlate with metastasis or risk of recurrence or death. And the work that we're talking about today is one that actually uses one of the commercially available biomarkers, commercially it's known as Prolaris. But very specifically, in the work that I think we're discussing today, what we're looking at is cell cycle progression genes. And these are genes that maybe, to simplify it, are sort of hallmarks of how quickly cells are turning over. And what's interesting about looking at cell cycle progression is it's not certainly particular to prostate cancer. I mean, you could make an argument that cell cycle progression genes are probably relevant measures in any cancers, but there's been much work done over the past 15 to 20 years that have clearly validated that this particular cell cycle progression gene signature, which is now commercially available, clearly correlates with risk of progression, risk of metastasis in localized prostate cancer patients, whether they're receiving surgery or radiation. But what we've done is we've built upon this molecular work and added clinical risk features and added results of prospective randomized trials to use this test to personalize the precise risk reduction of what would happen to a man who is pondering adding ADT to radiation therapy. So, it's a very powerful precision tool.  Dr. Abdul Rafeh Naqash: Sounds very interesting. When you go deeper into this platform, is this genomic testing platform, does it incorporate RNA transcriptome or is it DNA, or is it a composite of both? Dr. Jonathan Tward: There are various molecular tests that are out there. In this particular case, these are mRNA expression levels of cell cycle progression genes, and they are kind of calibrated against some normal housekeeping genes, which is how the test is run. Dr. Abdul Rafeh Naqash: Understood. So, from what I understand in the discussion, you very appropriately said, in fact in your first paragraph, the goal here is to match patient level precision medicine approaches and reconcile them with population level therapeutic options. It's a very catchy statement. Can you help explain for our audience how you tried to do that? And this goes back to the question that you were trying to understand, where to use combination therapy in a localized prostate cancer based on risk stratification and deriving that risk stratification from the cell cycle score and then arriving to certain thresholds. So could you go through that in simple terms to help us understand how you tried to do it and what was the outcome and what are the implications of that? Dr. Jonathan Tward: Sure, there's a lot to unpack there, but I'll do my best to simplify it. So, we'll start with the basic question that faces a patient and their radiation oncologist, which is, if they're going to receive radiation, should you add hormone therapy? And if hormone therapy was completely nontoxic, you'd say, “Sure, just add it to everybody if there's a benefit.” But the problem is, of course, hormone therapy is associated with all kinds of unpleasant side effects and additional risks, so we don't want to utilize it unless we're sure that the benefit is clear. When you think about the way most of oncology decides whether or not adding an intervention should be done in a particular patient context, it's actually been derived originally from prospectively randomized trials, which usually assigned a hazard ratio or some kind of known relative reduction to doing ‘thing B' versus ‘thing A' or ‘thing B' in addition to ‘thing A'. But what's curious about always looking at hazard ratios and saying that those are the reasons why you should do additional things, discounts a really important fact, which is the baseline risk of something bad happening has to be accounted for first before you decide whether or not it a relative risk reduction matters. So to state more clearly, if I knew a prostate cancer patient sitting in front of me only had a 2% risk of developing metastasis within 10 years, if I just did radiation alone, if I then say adding hormone therapy might cut that in half from 2% to 1%, a patient might say, “You know what? I'm not sure I want to accept the toxicity of many months of hormone therapy to cut my risk of metastasis from 2% to 1%.” But if you had a patient where that risk was 20% risk of metastasis with radiation alone, and you told them I can cut that risk down to 10% or 12%, then that's something they would seriously consider.   And so what this work really does is precisely that. It gives us a tool where, using the molecular signature of the cell cycle progression genes, which afford a patient a certain risk of metastasis, and also taking into account clinical risk factors that we know are prognostic, Gleason score, PSA, their age, how many cores of the biopsy were possible. We use all this information, and I'll use a strange term, multiplex it into a robust risk model that will prognosticate extremely clearly what that patient's precise risk of metastasis will be within the next 10 years, and this is the key point, if they receive radiation alone.   So, think of this work in two phases. Phase one is calibrate the risk in a patient if they get radiation alone, by using both molecular and clinical prognosticators. But then take the power of numerous randomized trials, which have clearly set the hazard ratio reduction for adding the hormone therapy, and then using mathematical principles, applying that hazard ratio risk reduction to the absolute risk. And then what you ultimately do is, at a very individual level, have a patient sitting in front of you where you can say, “Mr. Jones, I've run this test on you, and I can tell you definitively that if you receive radiation therapy for your localized prostate cancer, the risk of metastasis will be 12%. But if you add, let's say, six months of hormone therapy, that could be reduced to 7%, and the absolute risk reduction might only be 5%.” And if you think about that number in a number needed to treat mentality, then you could say, “Listen, I have to give 20 men identical to you, hormone therapy for one to benefit. Is that worth it to you?”   And what it really does is it empowers the patient. Rather than following a guideline that says, “Effectively, thou shalt do this for this risk group,” you really want to engage the patient in the conversation about the risk benefit of what you're going to do. And I think it's uncommon in oncology for physicians to be able to very precisely tell a patient sitting in front of them, if you do ‘thing A', this is the risk, something bad happen. If you do ‘thing B', this is how the risk reduces. And I think now we really get into shared decision making, rather than a, “Trust me, I'm a doctor,” paternalistic situation. Dr. Abdul Rafeh Naqash: That's a very interesting approach. Again, you're basically personalizing the personalized medicine approach, refining it further, and involving the patient in discussions, which helps them understand why something would make sense. And some of this, as you might already know, people have tried to do in some other tumor types, hasn't necessarily led to significant clinical decision-making changes. But I think the way the field is evolving, especially this research that you published on and others are working towards, will hopefully result in more personalized approaches for individual decision making for these patients.   Now, I do understand that simplicity sometimes results in more uptake of some information versus when sometimes things get more complex. So, in your assessment, when you came up with these results, you looked at the genomic score, you took the randomized clinical trial data, you did the absolute risk reduction. From what I understood in the manuscript, it does look like you did come up with a threshold of what would appropriately risk stratify individuals, meaning individuals that are at a higher risk if they cross that threshold, versus individuals that are at a lower risk if they cross that threshold. Is that a fair statement or is this a continuum? So there is no binary, but this is over a scale that this assessment can be made. Dr. Jonathan Tward: So, there are elements of your summary that are fair, but this is a continuum which allows any individual to accept whatever risk reduction they want. That being said, there is no standard in oncology for what percent risk should you intensify a treatment for? And when you poll physicians and doctors as to how much reduction in death or how much reduction in metastasis, doctors and patients are all over the map at what they consider to be a threshold. But we designed these thresholds actually from prior work, based on surveying both patients themselves, as well as experts who were on cooperative trial group steering committees, and ask them, essentially, “At what level of risk reduction would you want to intensify treatment?” And what's interesting is most people who are asked that question are willing to do more treatment intensity for an important outcome like metastasis if the absolute risk reduction of that event happening is 5%. So as a general principle, that's how it was set.  These thresholds in the current paper we're discussing actually weren't defined in this current work. They were defined in prior works, where we had clearly shown in retrospective data sets that they could discriminate very well who does or doesn't benefit from hormone therapy. What's, I think, novel about this paper, even though we had previously validated those thresholds, is that now that we're using the randomized trial data, it's extremely robust in our risk estimates, and we can say that it's truly a predictive biomarker. Because it's one thing to prognosticate an outcome, but predict a difference in treatment A versus treatment B usually requires randomized trial data so that you get the highest level of evidence and the confidence that it works. Dr. Abdul Rafeh Naqash: So the next steps for this very, very provocative research, is it something prospective validation or are you going to try to utilize maybe proper group trial data or other pharma trial data, individual patient data to risk stratify these individuals and validate?  Dr. Jonathan Tward: So these thresholds, for example, that you refer to are very well validated. There's multiple prior studies, well over at this point, 1500 patients where there's validation. And yes, we have reached out to cooperative groups to do some additional validation. That being said, this work is already ready for prime time and being used. In fact, this test is the commercially available Prolaris test. The results gleaned from this work are published on the score report that a patient and a physician receives. So the reality is that this is already existing as a clinical tool in the community. And the NCCN guidelines also support the use of this and other tests to move from a stratification to personalized medicine. So it's not like this is so much in the experimental realm as it is effectively a complete tool that is being used today. And effectively, it's available for any patient or physician diagnosed with localized prostate cancer to immediately order on biopsy tissue. Dr. Abdul Rafeh Naqash: One naive question, Jonathan, I wanted to ask is most prostate cancers tend to be prostatic adenocarcinoma. So if it's a neuroendocrine localized prostate cancer, does the same risk assessment apply? Because neuroendocrine tumors in general seem to be higher replication stress or higher tendency to metastasis. Does it change from your perspective, from the genomic assessment standpoint, the CCR score standpoint? Dr. Jonathan Tward: That's a very interesting question, because what I will tell you is that there are probably a lot of, well, I wouldn't say a lot, but there are some neuroendocrine cancers mixed in with the adenocarcinomas that no one identified as neuroendocrine, which in a way were baked into the cake of the risk signature. Even though that is so, I dont think we've independently looked very specifically at known neuroendocrine cancers and compared them to the adenocarcinomas. What I would actually argue though, is that if you have a neuroendocrine cancer sitting in front of you, the point about whether or not you're adding ADT is relatively moot because neuroendocrine cancers may or may not respond to ADT, and you have to start considering chemotherapeutic-like decisions.   So the question, which is very interesting and academic, is that I would presume the cell cycle progression score should be elevated, although I don't know that in a neuroendocrine cancer, this tool doesn't appear to be useful at this moment for neuroendocrine cancers because we're not making decisions about chemo. That's an interesting and provocative question, and now you make me want to study that. So potentially, the next paper would be neuroendocrine cancers, whether or not it might prognosticate using a topicide or something else like this. But we would have to rely on prospective trial data as well to see whether or not we could use it the same way.  Dr. Abdul Rafeh Naqash: Hopefully, if you do work on it, then you can submit the manuscript again to JCO PO for us to talk again. Dr. Jonathan Tward: Yeah, and you'll be on the author bar.  Dr. Abdul Rafeh Naqash: Appreciate the inclusion. So thank you so much, Jonathan, for talking to us about the science. And a few quick minutes about yourself. Can you tell us a little bit about your career trajectory, how you ended up doing what you're doing, and maybe some lessons learned and some advice for early career junior investigators that would be helpful for them?  Dr. Jonathan Tward: Yes, that's a happy memory. When I was a young undergrad, I was fortunate to do some volunteer work in a radiation oncology department and had mentors there who guided me into considering a career in medicine and specifically a career as a physician scientist. So I'll start with the best advice is to get mentors early on and throughout your career who are really interested in your career development and who are accomplished that can kind of help you along. But I went to medical school with an open mind and continued to love oncology. I think it has some of the most complex questions that are unanswered. It is very high stakes oncology. There's still a lot of death and disability and consequences of our therapies. And I just love the idea of working in an environment, both clinically and as a researcher, to try to solve some of those questions like, how do I improve outcomes? How do I make therapy less toxic?  And radiation oncology for me, was a nice fit in genitourinary cancer, I guess, specifically because mid GU cancer realm patients are presented with a menu of treatment options. It's kind of interesting. It's a little bit unlike other cancers. But I had fantastic mentors throughout both my medical school as well as residency program who really helped guide me and encourage me along the way. And so without spending too much time, I would say go out of your way to find people who are successful at what they do, are interested in making you better, and really sit at their knee and listen to them when they are trying to guide you because they really have your best interests in mind. And I think as a mentor and a mentee, what makes me most proud is watching people I've trained go out and succeed. I mean, the reward of being a mentor is watching your mentees succeed.  Dr. Abdul Rafeh Naqash: Thank you. Appreciate all those words of wisdom, Jonathan, and excited to see all the subsequent steps and results from the research that you're doing. Thank you again for joining us today and providing a very simple summary of a very complex topic which I think our audience and perhaps some of the trainees listening to this podcast will appreciate. We really appreciate your time.  Dr. Jonathan Tward: Thank you so much, Rafeh.  Dr. Abdul Rafeh Naqash: And thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcast.     The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement.     Dr. Tward Diclosures:   HonorariaCompany name: Bayer Consulting or Advisory RoleCompany name: Myriad Genetics, Blue Earth Diagnostics, Janssen Scientific Affairs, Merck, Bayer, Boston Scientific, Myovant Sciences, Myriad Genetics, Lantheus Medical Imaging Research FundingCompany name: Bayer, Myriad Genetics Travel, Accommodations, ExpensesCompany name: Myriad Genetics, Bayer

Our Editor in Chief Sue Yom hosts a discussion of two related articles, "Diagnostic CT-Enabled Planning (DART): Results of a Randomized Trial in Palliative Radiation Therapy" and its accompanying editorial, "'Sim-free' Palliative Radiation Therapy Greatly Reduces Time Burden for Patients." Guests are Melissa O'Neil, MSc, MRT(T), an Advanced Practice Radiation Therapist and Leader of the Rapid Response Clinic at London Health Sciences Center in Canada, who was the first author of the DART trial publication, as well as Dr. Katrina Woodford, Lead Radiation Therapist Clinician Scientist at the Peter MacCallum Cancer Centre, Honorary Senior Fellow at the University of Melbourne and Adjunct Senior Lecturer at Monash University, and first author of the accompanying editorial.

CancerNetwork® spoke with Kamran Idrees, MD, MSCI, MMHC, FACS; Natalie A. Lockney, MD; and Milad Baradaran, PhD, DABR, about the potential utility of intraoperative radiation therapy (IORT) among patients with pancreatic cancer. The group detailed the design and mechanism, gradual technical advancements, and trial data supporting the application of this radiotherapy modality for this patient population.  Idrees is the chief in the Division of Surgical Oncology & Endocrine Surgery, an associate professor of surgery, an Ingram Associate Professor of Cancer Research, and director of Pancreatic and Gastro-Intestinal Surgical Oncology at Vanderbilt University Medical Center. Lockney is an assistant professor in radiation oncology and the program director for the radiation oncology medical residency at Vanderbilt University Medical Center. Baradaran is the head of quality assurance operations and assistant professor in the Department of Radiation Oncology at Vanderbilt University Medical Center. As part of this discussion revolving around IORT, the group outlined the optimal conditions for using this technique depending on the extent of disease resectability in patients. Specifically, Idrees categorized patients as belonging to one of 3 major groups: those with metastatic disease, those with resectable disease, and those with borderline resectable or locally advanced disease. When considering these factors, patients with borderline resectable disease may be suitable to undergo IORT in combination with chemotherapy, radiotherapy, and surgery.  The conversation also focused on a particular case involving a patient with pancreatic cancer who received IORT at their institution. Based on the outcome of this case, they highlighted how multidisciplinary collaboration in combination with careful patient selection may offer surgical resection through IORT. “[There] has to be a multidisciplinary team approach to carefully select these patients and [determine] who can benefit from this procedure,” Idrees said. “For the families and the physicians who are taking care of [patients with] pancreatic cancer, it's valuable to obtain a second opinion, even if [the tumor is] initially deemed unresectable. What's unresectable in one surgeon's hands may be resectable in a different team,” he added.

Homily - 18th Sunday in Ordinary Time - Spiritual Radiation Therapy

Don't Face Cancer Alone"The 6 Pillars of Healing Cancer" workshop series provides you valuable insights and strategies to support your healing journey - Click Here to EnrollCould changing what you eat dramatically improve your odds against cancer?Dr. Katie Deming sits down with radiation oncologist Dr. Hans Kim to explore how the ketogenic diet combined with radiation treatment could be the future of personalized medicine and empowered patient care.You'll learn about the science behind why cancer cells are more vulnerable when your body is in ketosis. Dr. Kim shares real-world examples from his practice, including how some patients have experienced surprising benefits from incorporating a ketogenic approach during their cancer treatment.References from episode:Trial at Cedar Sinai:  https://www.ljamaral.com/new-page-1The University of Iowa paper on ketogenic diet as an adjuvant treatment option for cancer: https://www.sciencedirect.com/science/article/pii/S2213231714000925Dr. Jethro Hu's trial on glioblastoma and ketogenic diet: https://clinicaltrials.gov/study/NCT03451799 Together, they explore how our modern diet might be at odds with our evolutionary biology. Prepare to gain a new perspective on nutrition that could influence your approach to overall health and wellness, whether you're dealing with a specific condition or simply aiming to optimize your well-being.You'll hear about ongoing clinical trials and the potential future of this innovative therapy combination. Plus, practical tips on how to safely explore ketosis.Listen and learn how the foods you eat could potentially enhance your body's ability to fight disease and support healing. Keto Mojo Blood Glucose and Ketone Meter:  Send us a Text Message.Don't Face Cancer Alone"The 6 Pillars of Healing Cancer" workshop series provides you valuable insights and strategies to support your healing journey - Click Here to Enroll MORE FROM KATIE DEMING M.D. Free Guide - 3 Things You Need to Know About Cancer: https://www.katiedeming.com/cancer-101/Work with Dr. Katie:www.katiedeming.comFollow Dr. Katie Deming on Instagram:The.Conscious.Oncologist Take a Deeper Dive into Your Healing JourneyFollow Dr. Katie Deming's Linkedin Here Please Support the Show Share this episode with a friend or family member Give a Review on Spotify Give a Review on Apple Podcast DISCLAIMER:The Born to Heal Podcast is intended for informational purposes only and is not a substitute for seeking professional medical advice, diagnosis, or treatment. Individual medical histories are unique; therefore, this episode should not be used to diagnose, treat, cure, or prevent any disease without consulting your healthcare provider.

With new advances in the treatment of brain cancer, patients have more options than ever. This week, Faith talks with Dr. Kathryn Beal, a radiation oncologist at NewYork-Presbyterian and Weill Cornell Medicine, to explore how breakthroughs in immunotherapy and stereotactic radiosurgery can successfully treat metastatic cancer in the brain. In recognition of Glioblastoma Awareness Day, Dr. Beal also explains treatment options for gliomas, and her hope for the future for patients with brain tumors and brain metastases.

The podcast episode features Dr. Sanjay Juneja interviewing Dr. Robert Den, a Harvard and Yale-trained physician and radiation oncologist. Dr. Den discusses the importance of trust in the patient-physician relationship and its impact on cancer treatment decisions. He emphasizes the need for personalized care, considering patients' individual circumstances and goals. Dr. Den introduces the innovative "DaRT" (Diffusing Alpha Radiation Therapy) technology, which targets tumors with alpha radiation, demonstrating promising results across various cancer types. He explains how this approach can offer new hope and treatment options, especially for patients with challenging cancer cases. The conversation highlights the potential of DART therapy to improve patient outcomes and quality of life.

In this episode, host Kathe Kline and guest Barbara delve into crucial aspects of end-of-life planning and the importance of safety for older adults. They discuss bathroom accessibility improvements, emphasizing the need for thoughtful renovations to prevent falls. Barbara shares her personal journey as a breast cancer patient, highlighting her experiences with radiation therapy and the significance of humor during such challenges. They stress the necessity of legal preparations like wills, medical directives, and trusts to ease future burdens on loved ones, and offer practical advice on managing personal belongings and organizing essential information for emergencies. The conversation underscores the emotional and practical aspects of aging and the importance of embracing comprehensive planning for retirement and beyond.

Join host Devin Carlson in this impactful episode of "Mending on the Fly," as he leads a profound discussion with Ashleigh Bauman about her remarkable journey through a breast cancer diagnosis, treatment, and recovery during the peak of the COVID-19 pandemic. Ashleigh candidly shares her emotional and physical struggles, the significance of self-advocacy, and how her involvement with Casting for Recovery provided her with a sense of peace and belonging. Don't miss out on Ashleigh's inspiring account of resilience, support, and the therapeutic influence of nature. Show Notes:00:00 Introduction and Initial Diagnosis00:47 The Irony of Cancer Awareness02:01 Discovery During the Pandemic02:44 Facing the Reality of Cancer05:53 Understanding Cancer Stages and Risks09:34 Genetic Testing and Family History11:18 Support Systems and Mental Health13:53 Navigating Treatment and Work19:41 Life After Diagnosis31:28 Casual Conversation and Humor31:52 Introduction to Casting for Recovery32:09 Discovering Fly Fishing34:13 Challenges and Persistence36:36 The Retreat Experience39:37 Therapeutic Benefits of Fly Fishing41:46 Support Groups and Therapy44:41 Continued Involvement and Community51:41 Advice and Personal Reflections57:42 Concluding Thoughts and Contact Information

Dr Akila Viswanathan talks with Dr Daniel Low, Vice Chair of Medical Physics Research and Innovation at UCLA Health, about MR Guided Radiation Therapy for Seminars in Radiation Oncology.

Sue Yom, our Editor in Chief, leads a discussion of Overview and Recommendations for Prospective Multi-institutional Spatially Fractionated Radiation Therapy Clinical Trials, a critical review from AAPM and NRG Oncology. Guests are first author Dr. Heng Li, Associate Professor in the Department of Radiation Oncology and Molecular Radiation Sciences at Johns Hopkins University and Chief Proton Physicist of the Johns Hopkins National Proton Center, supervising author Dr. Stanley Benedict, Professor and Vice Chair of Clinical Physics in the Department of Radiation Oncology at the University of California Davis, and co-author Dr. Nina Mayr, Professor in the College of Human Medicine at Michigan State University.

Host Talaya Dendy celebrates National Cancer Survivor Month with Dr. Thomas Eanelli, a radiation oncologist from New York. Dr. Eanelli shares his extensive experience and approach to compassionate cancer care. He discusses his involvement with Citizens Reunited to Overcome Cancer (CROC), a grassroots organization supporting cancer survivors and their families. Dr. Eanelli elaborates on his unique methods, such as wearing sports jerseys to make patients more comfortable, and emphasizes the importance of teamwork, information dissemination, and approachable care in oncology. The episode also touches on the historical context of cancer survivorship, the emotional and practical challenges faced by patients, and the four pillars of improving cancer care. Dr. Eanelli encourages new cancer patients to reframe their diagnosis, and offers insights on post-treatment life, stressing continual support and information. The episode highlights Dr. Eanelli's dedication to improving oncology care through patient empowerment and system reforms.✨Highlights from the show:[04:28] Dr. Eanelli's Jersey Tradition[08:51] Lessons from Patients[21:55] Defining Cancer Survivorship[30:09] Challenges in Cancer Care[40:35] Reframing the Cancer Diagnosis[47:11] The Broken Healthcare System[47:25] Introduction to CROC: Citizens Reunited to Overcome Cancer[01:02:12] The Power of Survivor NetworksReflection Question: Do you agree with Dr. Eanelli's perspective? Why or why not?

Host Kathe Kline sits down with guest Barbara, who shares her emotional journey after undergoing surgery for breast cancer. Barbara discusses the challenges of the surgical process, the physical and emotional toll of post-surgery recovery, and the impact of her diagnosis on her retirement plans. The conversation delves into the complexities of accessing medical care and the importance of addressing health issues as we age. Barbara's resilience and determination to find hope amidst uncertainty provide insights and inspiration for listeners navigating similar experiences. Tune in as they explore the snow globe analogy and discuss the integral role of mental, emotional, and spiritual support in pursuit of holistic healing.

Featuring perspectives from Ms Meetal Dharia, Dr Robert L Ferris, Dr Robert Haddad and Ms Lynsey P Teulings, including the following topics: Introduction (0:00) The Biology of Head and Neck Cancer (15:41) The Multidisciplinary Treatment of Head and Neck Cancer (18:14) Ongoing Screening and Prevention After Potentially Curative Therapy for Head and Neck Cancer (33:03) Radiation Therapy and Chemotherapy Side Effects (41:02) The Potential Short- and Long-Term Effects of Surgery for Head and Neck Cancer (49:50) Emerging Treatment Strategies Aimed at Improving Outcomes Associated with Localized or Locally Advanced Head and Neck Cancer (56:46) Tolerability Considerations with Xevinapant (1:06:13) The Established Role of Anti-PD-1/PD-L1 Antibodies in Therapy for Advanced Head and Neck Cancer (1:17:35) Newly Approved Immunotherapeutic Strategies for Nasopharyngeal Carcinoma (1:19:27) The Tolerability of Immune Checkpoint Inhibitors (1:24:09) NCPD information and select publications

Link for the discussion on Alzheimer's disease: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8935565/Link to Dr. Koneru's team: http://www.gopog.com/ ­­

A new report shows demand for radiation therapy now far exceeds the supply of equipment and required workers. Otago-based oncologist Dr Shaun Costello spoke to Ingrid Hipkiss.

This week, we are joined by Dr. Nina Sanford, Assistant Professor and Chief of Gastrointestinal Radiation Oncology Service, UT Southwestern Medical Center in Dallas, Texas, for a discussion about the role of radiation in colorectal cancer, with an emphasis on the role of radiation in rectal cancer. Dr. Sanford is a wealth of knowledge so this is an episode you do NOT want to miss. Of note, rectal cancer episodes will be released in a few weeks so if all of this does not make sense, don't worry. It nicely sets the stage for what is to come! Content: - What is the role of radiation in rectal cancer vs. colon cancer? Why do we use it more in rectal cancer?- How to evaluate your patients for radiation and how to decide long course vs. short course radiation - Side effects of radiation therapy for rectal cancer- Role of radiation for oligmetastatic colorectal cancer** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodesLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

As part of the 2024 Prostate Cancer Patient Conference, Dr. Julian Hong discusses radiation therapy as treatment for prostate cancer, including potential side effects, considerations in decision making, the radiation oncology care path. Series: "Prostate Cancer Patient Conference" [Health and Medicine] [Show ID: 39759]

Dr. Douglas Peterson presents the latest evidence-based guideline from ISOO, MASCC, and ASCO on the prevention and management of osteoradionecrosis (ORN) in patients with head and neck cancer treated with radiation therapy. He covers topics such as recommended initial workup, best practices for prevention of ORN of the head and neck before and after radiation therapy, nonsurgical and surgical management of ORN, and management of adverse events associated with ORN. Dr. Peterson also comments on the importance of this guideline and what researchers should address moving forward. Read the full guideline, “Prevention and Management of Osteoradionecrosis in Patients with Head and Neck Cancer Treated with Radiation Therapy: ISOO-MASCC-ASCO Guideline” at www.asco.org/head-neck-cancer-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/head-neck-cancer-guidelines. Read the full text of the guideline and review authors' disclosures of potential conflicts of interest in the Journal of Clinical Oncology, https://ascopubs.org/doi/10.1200/JCO.23.02750.   Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts, bringing you timely information to keep you up to date on the latest changes, challenges, and advances in oncology. You can find all our shows, including this one, at asco.org/podcasts.   My name is Brittany Harvey and today, I'm interviewing Dr. Douglas Peterson from UConn Health, lead author on “Prevention and Management of Osteoradionecrosis in Patients with Head and Neck Cancer Treated with Radiation Therapy: International Society of Oral Oncology, Multinational Association for Supportive Care in Cancer, American Society of Clinical Oncology Guideline.” Thank you for being here, Dr. Peterson. Dr. Douglas Peterson: Thank you, Brittany. My pleasure to be here. Brittany Harvey: Before we discuss the guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensures that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Peterson, who has joined us here today, are available online with the publication of the guideline in the Journal of Clinical Oncology, which is linked in the show notes.  So then, to dive into the topic we're here to discuss, Dr. Peterson, could you first provide an overview of the scope and purpose of this joint ISOO-MASCC-ASCO guideline? Dr. Douglas Peterson: I'll be pleased to do so, Brittany. Again, thank you for the opportunity to represent the panel in this guideline. The panel has strived to present a guideline that brings consistency in clinical practice regarding prevention and management of osteoradionecrosis of the jaw (ORN) based on the highest quality contemporary science. Given the mechanistic and clinical complexity of ORN, we also stress the importance of interprofessional oncology care of these patients. The team includes, but is not limited to, clinicians representing radiation oncology, head and neck surgery, medical oncology, otolaryngology, dental medicine, oral medicine, oral oncology, oral and maxillofacial surgery, and patient advocacy organizations. So it really is a collective enterprise that we bring to bear in the guideline.  In some cases, the panel has been fortunate to be able to utilize a high quality evidence base in the literature upon which we could build strong recommendations. In selected other cases, however, we utilized informal consensus given the low evidence quality in the field. The recommendations presented have been carefully framed in this context, with the goal of providing state-of-the-science guidelines in clinical decision making and management of ORN. I'd also like to point out that the guideline brings linkage to other guidelines published by ASCO and other major oncology organizations, regarding management of symptoms and other supportive care needs associated with ORN. These companion guidelines include addressing pain, dysphagia, oral care, trismus, and psychosocial impact and survivorship, to name a few. I'd also like to say that combining the expertise of ISOO, MASCC, and ASCO has provided an important opportunity to produce this guideline. This has been a comprehensive effort by many experts. In addition to the outstanding input from the panel, I am also personally so very grateful for the expert input from ASCO's Evidence-Based Medicine Committee, as well as endorsements from other key organizations, including the American Head and Neck Society, the American Society for Radiation Oncology, and the American Academy of Oral Medicine as endorsees of the guideline. Finally in addition, Dr. Nofisat Ismaila's leadership as ASCO staff has been absolutely invaluable as well.  Brittany Harvey: Excellent. I appreciate you providing that background on the development of this evidence-based guideline, which was developed by a multi-organizational and multidisciplinary panel.   So to dive into the key recommendations of this guideline, this guideline addresses six clinical questions. So, starting with question one, what key points would you like to highlight regarding how ORN is characterized, graded, and reported, and what is the recommended initial workup for patients?  Dr. Douglas Peterson: Osteoradionecrosis of the jaw of the mandible and maxilla should be characterized in the view of the panel as a radiographic, lytic, or mixed sclerotic lesion of bone, and/or visibly exposed bone, and/or, importantly, bone probed through a periodontal pocket or fistula. In the latter case, the clinical appearance of exposed bone may be extremely subtle. ORN is occurring within an anatomical site previously exposed to a therapeutic dose of head and neck radiation therapy. So we have a combined radiographic/clinical approach characterizing the lesion in the context of the patient having received previously a therapeutic dose of head/neck radiation therapy. We do recommend that clinicians evaluate ORN based on the most contemporary staging system, the ClinRad system, which is cited in the publication itself. We also advocate for the use of the ClinRad staging system not only in clinical assessment of patients, but also in clinical trials moving forward. We'll touch a little bit later on future research opportunities as well.  Finally, the initial evaluation of ORN should include a clinical intraoral examination, and again, the appearance of exposed bone may be extremely subtle, and/or a formal radiographic examination. The guideline delineates the various types of radiographic examinations that we recommend.  Brittany Harvey: Understood. Thank you for reviewing those recommendations regarding reporting and characterization of ORN, as well as the workup.   The next section of the guideline, it focuses on best practices to prevent ORN of the head and neck prior to radiation therapy. What are the key recommendations of that section?  Dr. Douglas Peterson: As with other adverse events in oncology patients, prevention is key. Prevention of ORN does require interprofessional management. The guideline lists several key recommendations along these lines. Now, an important caveat in what the guideline presents is that the target coverage of the tumor should not be compromised in order to avoid radiation dose to bone. So that's a very important caveat. Now having said that, focused effort should be made to reduce the mean dose to the jaw and the volume of bone receiving above 50 Gy whenever possible. So it's really a balance between maximizing target coverage of the tumor while limiting exposure to normal bone. In addition, a dental assessment by a dentist and dental specialist, if possible, is strongly advised prior to therapeutic-intent radiation therapy. The purpose of this assessment by the dental team is to identify and remove teeth which will place the patient at risk of developing ORN during the patient's lifetime, and to comprehensively educate the patient about the lifelong risk of ORN. Dental extraction in advance of radiation is often a consideration to these patients, and if clinically indicated, should occur at least two weeks prior to the commencement of radiation therapy. Now having said that, in the setting of a rapidly progressive tumor, extraction should be deferred and not cause delay in the initiation of radiation therapy. Brittany Harvey: So you just touched on key points of prevention prior to radiation therapy. Following those recommendations, what does the expert panel recommend regarding best practices to prevent ORN after radiation therapy? Dr. Douglas Peterson: This can be a challenging clinical issue. So the panel recommends that before finalizing dental treatment plans that may include extractions in patients with a history of head and neck radiation therapy, a review of the radiation therapy plan should be performed with particular attention focused on dose to the mandible and maxilla. For teeth in areas of high-risk for ORN, alternatives to dental extraction may be possible, for example, root canal or endodontic procedures, crowns, or dental restorations, or dental filling should be offered unless the patient has recurrent infections, intractable pain, or other symptoms that cannot be alleviated without extraction. So it really becomes a combined clinical decision making effort between the dental team and oncology team.  One controversial area has been hyperbaric oxygen being administered prior to dental extractions in patients who have received head and neck radiation therapy previously. The panel does not recommend routine use of prophylactic HBO prior to dental extractions in these patients who have received prior head and neck radiation therapy. However, the evidence base here is limited with low quality and we offer a weak strength of recommendation. It is a controversial area, so we did also include a qualifying statement that prophylactic HBO may be offered to patients undergoing invasive dental procedures at oral sites where a substantial volume of the mandible and/or maxilla receive at least 50 Gy. This is an area of controversy. We can talk about this in the future research directions, but clearly, new high quality research related to the role of HBO in the management of these patients is needed.  Brittany Harvey: Definitely. Thank you for touching on those points and that area of controversy. We can definitely touch on that a bit later as we talk about future research in this field.  As you mentioned, Dr. Peterson, this guideline addresses both prevention and management. So, in moving into the management of ORN, how should ORN be managed nonsurgically?  Dr. Douglas Peterson: The guideline relative to nonsurgical management of ORN is focused on the use of pentoxifylline. Now this maybe used in, and this is important, in cancer-free patients with mild, moderate, and severe cases of ORN. But pentoxifylline, the guideline also notes, is most likely to have a beneficial effect if the treatment is combined with tocopherol, antibiotics, and prednisolone as well. So there's clinical judgment involved in the nonsurgical management of ORN, centered with pentoxifylline in combination with tocopherol, antibiotics, and prednisolone. Brittany Harvey: Understood. And then expanding on the management of ORN, what are the key points for surgical management of ORN? Dr. Douglas Peterson: The panel offered several recommendations for which the strength of the recommendations was strong. Just to cite a few, in partial thickness ORN as defined by the ClinRad stage one and two that we talked about earlier, surgical management can start with transoral minor interventions which can lead to resolution over time. It may take time. It may take weeks or even a few months. Now this minimally invasive surgery may include debridement, sequestrectomy, alveolectomy, and/or soft tissue flap closure. Furthermore, small defects, clinically, for example, less than 2.5 cm in length, may heal spontaneously with local topical measures such as we described. It is recommended that larger defects, larger than 2.5 cm, in general be covered with vascularized tissue.  Brittany Harvey: Appreciate you reviewing those recommendations regarding surgical management of ORN. So to wrap up our discussion of the recommendations with the final clinical question, what is recommended for assessment and management of adverse events associated with ORN?  Dr. Douglas Peterson: This is a really important area as well in addition to prevention and management of ORN per se. The panel recommends that patients should be assessed by their healthcare providers for the presence of adverse events at the time of ORN diagnosis and periodically thereafter until the adverse event resolves based on patient status including any interventions or the adverse events that are clinically indicated. The panel and its literature evaluation learned that there is a relative lack of data specifically directed to the management of adverse events associated with ORN. However, this is such an important area that we wanted to address it head on. And so the management we recommend should be informed by pertinent available other guidelines that had been developed for analogous symptoms and/or disease states. The guideline provides links to these companion guidelines developed by ASCO as well as by MASCC and ISOO, the European Society of Medical Oncology, and NCCN. And so in the guideline we provide links on management of adverse events as produced by these other organizations. Table 3 presents a summary of the guidelines that address symptoms and supportive care needs associated with ORN.  Brittany Harvey: Thank you for reviewing all of these recommendations. It's clear that the panel put a lot of work and thought into these recommendations and provided needed guidance in areas with limited evidence. We'll have links available in the show notes for listeners to be able to go and read these recommendations for themselves and refer to the tables that you mentioned.  So in your view, Dr. Peterson, what is the importance of this guideline and how will it impact clinicians and patients with head and neck cancer? Dr. Douglas Peterson: As we talked about throughout this podcast, the guideline is designed to synthesize the contemporary science regarding ORN and translate that into recommendations for clinical practice in both prevention and management. As noted in the guideline, oncologists plus other interprofessional healthcare providers have been directly involved in the creation of the guideline, that interprofessional theme, which we believe is so essential given the mechanistic and clinical complexity of ORN.  Now, in addition to the expertise of the panel, the pending widespread distribution of the guideline represents an additional important opportunity for extending the impact across clinical oncology. So in addition to the publication in the Journal of Clinical Oncology, dissemination by MASCC and ISOO as well as our endorsees, the American Head and Neck Society, the American Society for Radiation Oncology, and the American Academy of Oral Medicine will also be key in broadening the impact and hopefully the utilization of the guideline. And members of these organizations may very well be involved in the management of these patients as well.  And then finally, the guideline is also designed to stimulate future research based on current gaps of the knowledge and we touched on some of those gaps, for example, with HBO for which new high quality research is needed.   Brittany Harvey: Absolutely. It's great to have so many partners in this guideline and we hope that this guideline will have a large impact for patients with head and neck cancer to improve their quality of life.   So then your final comment leads nicely into my last question and that we've already talked a little bit about some of the future research opportunities that this guideline highlights. So, to wrap us up, Dr. Peterson, what are the outstanding questions regarding osteoradionecrosis of the jaw secondary to head and neck radiation therapy in patients with cancer?  Dr. Douglas Peterson: There are several key areas that the panel identified as we went through a rigorous review of the highest quality literature. Some of the key areas to address moving forward include: prospective studies are needed to evaluate the clinical presentation, trajectory, and response to treatment of ORN-related symptoms and function impairment, in other words, the adverse event side of the story. In addition, social determinants of health, quality of life, and psychosocial impact of ORN warrant further investigation in head and neck cancer survivors as well. In addition, new research including randomized controlled trials and prospective multicenter trials regarding the systemic and surgical treatment of ORN is also warranted, and we touched on, for example, hyperbaric oxygen. Hyperbaric oxygen has been a long standing management strategy of ORN. However, the trials to date are of limited quality in relation to supporting its use. So high quality new research related to the role of HBO in these patients is needed.   And the expert panel also encourages creation of predictive tools, a priori tools, directed to development, grading, and staging of ORN. These could include, for example, bone turnover markers and genetic markers to name two. And finally, the research opportunities that are presented in the guidelines such as what I briefly summarized today should ideally be addressed in large prospective multicenter observational studies of risk, outcomes, and financial cost of ORN or the various treatment strategies that are highlighted in the guideline.    Brittany Harvey: Excellent. Well, we'll look forward to research that addresses those outstanding questions and I want to thank you so much for your all your work on this guideline and for taking the time to share the highlights of this guideline with me today, Dr. Peterson.  Dr. Douglas Peterson: Thank you. My privilege to do so, Brittany. Brittany Harvey: And thank you to all our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/head-neck-cancer-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app in the Apple App Store or the Google Play Store. If you have enjoyed what you heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.  

Janani S. Reisenauer, MD; Patrick W. Eiken, MD; and Dawn Owen, MD PhD, join journal CHEST Podcast Moderator Dominique Pepper, MD, to discuss new research comparing outcomes for metastasis-directed therapies including sublobar resection, stereotactic body radiation therapy, and percutaneous ablation.

Jason Efstathiou and Piet Ost discuss the data for and against this approach.

Thomas Zilli and Pierre Blanchard discuss this topic from Lugano.

Today Debbie talks to Patty Ivey about life changes and opportunities opening up for her after being diagnosed with and treated for breast cancer last year. Inspiring doesn't really cover it as a way to describe Patty. Neither does [b]old, as in [B]OLD AGE. Patty and Debbie go back at least 15 years, when Debbie was a regular at Patty's Down Dog yoga studio in DC. It was always special when Patty, the owner, taught a class. Her classes were different. They offered all the benefits that practicing yoga offers beyond what happens on the mat; with Patty teaching, the class was mind-expanding. She made yoga open up new possibilities for how to live. So when Debbie saw Patty posting beautiful, bald photos of herself on her LinkedIn page, she immediately got in touch to find out how she was doing. As Patty explains it, she is using life principles from yoga, which include leaving room for what we don't know and focusing on something bigger than ourselves, as she looks ahead.  She acknowledges an identity shift that has come with cancer. Some older version of herself is no longer there, but she's okay with that. Like most women, Debbie is terrified of getting breast cancer, but with Patty as a guide (she's also a mentor and a life coach as well as being a serial entrepreneur), it seems there could be an upside. We hope you are as inspired by this conversation as Debbie was.  //////////Don't miss the Behind The Scenes  for every podcast episode in Debbie's [B]OLD AGE newsletter on Substack.////////// Mentioned in this episode or useful:Patty's website: https://thepattyivey.com/Patty on LinkedIn: https://www.linkedin.com/in/pattyiveyHer studio in DC: https://www.downdogyoga.com/Her yoga teacher Baron Baptiste: https://www.baptisteyoga.com/Connect with Debbie:debbieweil.com[B]OLD AGE podcast[B]OLD AGE newsletter on SubstackEmail: thebolderpodcast@gmail.comDebbie and Sam's blog: Gap Year After SixtyFacebook: @debbieweilInstagram: @debbieweilLinkedIn: linkedin.com/in/debbieweil Our Media Partners:CoGenerate (formerly Encore.org)MEA and with thanks to Chip ConleyNext For Me (former media partner and in memory of Jeff Tidwell) How to Support this podcast:Leave a review on Apple PodcastsSubscribe via Apple Podcasts, Google Podcasts, Stitcher or Spotify Credits:Host: Debbie WeilProducer: Far Out MediaMusic: Lakeside Path by Duck Lake

This week we got a few of us RA's to come together and discuss some of the positive things we are seeing in the profession and what the positive moment is bringing with it. Listen in as Marcelene Forbus, Reece Burgoon, Derek Maderios, Sue Wertz, Sean Wiley, and Will Bryant hit on topics like career opportunities, recognition with legislators, state/national discussions, RA travelers, and attending the ARPE and SRPE conferences. We want to thank all of those who listen to the podcast and advocate for the profession. Advocacy is more than just seeing the value in the RA pathway, it's about advocating for the pathways all of us have available in Medical Imaging and Radiation Therapy! Keep finding that value and letting everyone know it's there!

(2) Angela Oliveira, MPA, RT(T) | LinkedInThe Radiation Therapy Pocket Guide is available on Amazon!Radiation Therapy Pocket Guide: Oliveira, Angela: 9798878977388: Amazon.com: Books

In this episode of the BackTable Podcast, host Dr. Aaron Fritts interviews guest Dr. John Qiao about exploration of physicians' role in medical innovation, particularly among interventional radiologists. Dr. Qiao shares insightful information about the origin of RadioClash and details his journey as an entrepreneur. Through this discussion, Dr. Qiao covers the challenges encountered during the startup phase, the invention of a single-probe electroporation device, and the future applications of this novel medical technology. The episode concludes with broader advice on how to manage the demands of professional work, entrepreneurship, and personal life. --- CHECK OUT OUR SPONSORS Reflow Medical https://www.reflowmedical.com/ Medtronic Concerto https://mobile.twitter.com/mdtvascular --- SHOW NOTES 00:00 - Introduction 02:39 - Dr. Qiao's Journey into Medicine and Entrepreneurship 11:40 - Birth of Radioclash: A Unique Solution for Cancer Treatment 17:58 - Future of RadioClash: Targeting Metastatic Cancer 25:20 - Future of Electroporation Therapy 35:21 - Challenges of Building a Company 44:37 - Path to Market and Future Plans 47:28 - Balancing Clinical Practice and Entrepreneurship --- RESOURCES RadioClash website: https://www.radioclash.co/ News Article on Dr. John Qiao: https://voyagehouston.com/interview/meet-john-qiao-m-d-of-radioclash-ltd-co/ Radiation Therapy as a Modality to Create Abscopal Effects: Current and Future Practices: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086111/ The Abscopal Effect: A Reemerging Field of Interest: https://ascopost.com/issues/november-25-2018/the-abscopal-effect-a-reemerging-field-of-interest/ BackTable VI Episode #402 - Immunotherapy in HCC: Evolving Treatment Paradigms: https://www.backtable.com/shows/vi/podcasts/402/immunotherapy-in-hcc-evolving-treatment-paradigms Tavo and Pembrolizumab in Patients With Stage III/​IV Melanoma Progressing on Either Pembrolizumab or Nivolumab Treatment (Keynote-695): https://clinicaltrials.gov/study/NCT03132675 PANFIRE-3 Trial: Assessing Safety and Efficacy of Irreversible Electroporation (IRE) + Nivolumab + CpG for Metastatic Pancreatic Cancer: https://classic.clinicaltrials.gov/ct2/show/NCT04612530 Radiofrequency Ablation for the Palliative Treatment of Bone Metastases: Outcomes from the Multicenter OsteoCool Tumor Ablation Post-Market Study (OPuS One Study) in 100 Patients: https://pubmed.ncbi.nlm.nih.gov/33129427/ The improvement of irreversible electroporation therapy using saline-irrigated electrodes: a theoretical study (Northwestern study): https://pubmed.ncbi.nlm.nih.gov/21728392/ Irreversible electroporation reverses resistance to immune checkpoint blockade in pancreatic cancer: https://www.nature.com/articles/s41467-019-08782-1

“Social work was involved because we could be radiation gung-ho, ready to go; chemo can be ready, but whoops, this patient doesn't have a ride. It can be little things like that, you know, where we kind of forget. That's why you need kind of a multidisciplinary approach. If it's not your social worker, your navigator is going to know more and be like, ‘This patient needs a ride. I'm working on gas cards.' Something like that can also halt a patient starting [treatment],” ONS member John Hollman, RN, BSN, OCN®, senior nurse manager of radiation oncology at AdventHealth Cancer Institute in Orlando, FL, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a conversation about care coordination between radiation oncology and other oncology subspecialties. Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at myoutcomes.ons.org by March 1, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation.  Learning objective: Learners will report an increase in knowledge related to coordination of care to assist with the management of radiation-related side effects.   Episode Notes Complete this evaluation for free NCPD. Oncology Nursing Podcast: Episode 12: The Intersection of Radiation and Medical Oncology Nursing Episode 60: Radiation Side Effects With Head and Neck Cancers—ONS Congress Episode 128: Manage Treatment-Related Radiodermatitis With ONS Guidelines™ Episode 272: Oncologic Emergencies 101: Radiation Therapy for Emergent and Urgent Interventions Episode 298: Radiation Oncology: Nursing's Essential Roles Clinical Journal of Oncology Nursing articles: Patient Handoff Processes: Implementation and Effects of Bedside Handoffs, the Teach-Back Method, and Discharge Bundles on an Inpatient Oncology Unit Radiation Therapy Pain Management: Prevalence of Symptoms and Effectiveness of Treatment Options Partial Breast Irradiation: A Longitudinal Study of Symptoms and Quality of Life Oncology Nursing Forum article: Symptom Clusters in Patients With Brain Tumors Undergoing Proton Beam Therapy ONS Voice articles: The Intersection of Radiation and Medical Oncology Nursing (featuring an interview with John Hollman) Today's Immunotherapy Combinations New Treatments in Radiation Oncology 49th Annual ONS Congress® Radiation Track and John Hollman's radiopharmaceuticals session ONS book: Manual for Radiation Oncology Nursing Practice and Education ONS course: ONS/ONCC Radiation Therapy Certificate™ ONS Communities: Radiation ONS Huddle Cards: External beam radiation Brachytherapy Proton therapy Radiation Find your local ONS Chapter's next meeting. RT Answers American Brachytherapy Society To discuss the information in this episode with other oncology nurses, visit the ONS Communities. To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library. To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org. Highlights From This Episode “Skin reaction is a big thing in our field for breast cancer. Managing it with lotions, creams, and stuff like that is temporary. To something more complicated, like the head and neck cancer patients with base of the tongue, where the beam is directed straight at that area of the body, which is very delicate, as we know, very, very, very tough treatment. You know, anything from esophagitis to dysphagia, dry mouth, no taste. Salivary glands are affected. So it really kind of depends, obviously, where we aim the machine.” TS 2:04 “I think it really determines on how that radiation nurse knows how radiation affects the cells that we treat. So, for instance, I always tell my patients when I'm educating them for head and neck, and I know they're going to be getting concurrent cisplatin or something like that once a week, I'm going to tell them, like, ‘The majority of your acute side effects are us. Like, the chemo is going to work as a sensitizer. You're going to have fluids that you're going to be needing, but the difficulty swallowing, you know, all that stuff is our fault.'” TS 6:12 “If your med-onc is not affiliated with your rad-onc site, that can be a horrible barrier to try to break through because you don't know anybody in that office. You identify yourself on the phone as someone from a competing company. . . . But it's just breaking through that, and it just takes that nurse's initiative and, hopefully, physician coordination as well, to work on, rad-onc between med-onc and getting that to kind of facilitate that.” TS 11:29 “Social work was involved because we could be radiation gung-ho, ready to go; chemo can be ready, but whoops, this patient doesn't have a ride. It can be little things like that, you know, where we kind of forget. That's why you need kind of a multidisciplinary approach. If it's not your social worker, your navigator is going to know more and be like, ‘This patient needs a ride. I'm working on gas cards.' Something like that can also halt a patient starting [treatment].” TS 20:52 “I love the ONS radiation communities. We do a lot of idea sharing on communities. A rad-onc nurse from New York can post something like, ‘Hey, what are you guys doing for this side effect? We're not having any luck with this.' And you get some buy-in. And as long as the nurses remember evidence-based practice is always key. You know, just because you use one lotion, it doesn't mean, it's going to be good for everybody. I like to see the evidence behind it.” TS 22:42 “With the ever-evolving radiopharms that are coming out, you know, that we're doing here, too, it's turning more into nurses are actually giving the treatment. And that's what I'm speaking on in Congress, is a nurse's evolving role in radiation and radiopharms especially. It's a huge breakthrough. It's the future pretty much.” TS 24:19

“We are there for whatever issue, whether it's skin management or helping just cheer them on and manage small things or big things, you know, to get them through these treatments. And then as a patient completes the treatment, we continue the nurse education and [managing] the late toxicities,” Michele “Michi” Gray, RN, radiation oncology care coordinator at the Cleveland Clinic in Ohio, told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS®, manager of oncology nursing practice at ONS, during a discussion about what you should know about nursing's important role in radiation oncology.   You can earn free NCPD contact hours after listening to this episode and completing the evaluation linked below.   Music Credit: “Fireflies and Stardust” by Kevin MacLeod  Licensed under Creative Commons by Attribution 3.0  Earn 0.75 contact hours of nursing continuing professional development (NCPD), which may be applied to the nursing practice or oncology nursing practice  ILNA categories, by listening to the full recording and completing an evaluation at myoutcomes.ons.org by February 9, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of NCPD by the American Nurses Credentialing Center's Commission on Accreditation.  Learning outcome: Learners will report an increase knowledge of the radiation oncology nurse role.   Episode Notes  Complete this evaluation for free NCPD.  Oncology Nursing Podcast:  Episode 272: Oncologic Emergencies 101: Radiation Therapy for Emergent and Urgent Interventions  Episode 104: How Radiation Affects All Areas of Oncology Nursing  ONS Voice article: The Intersection of Radiation and Medical Oncology Nursing  ONS course: ONS/ONCC Radiation Therapy Certificate Course  ONS book: Manual for Radiation Oncology Nursing Practice and Education (fifth edition)  ONS Huddle Card: Radiation  ONS Congress® Radiation Track  American Society for Radiation Oncology  To discuss the information in this episode with other oncology nurses, visit the ONS Communities.   To find resources for creating an ONS Podcast Club in your chapter or nursing community, visit the ONS Podcast Library.  To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.  Highlights From Today's Episode  “There's many different forms of therapeutic radiation. External beam radiation is probably the most common type of radiation therapy used in cancer treatments. Using x-rays and gamma rays are types of external beam, and that is the most common and what everybody thinks of when we talk about radiation therapy. Also, particles would be another type. Particles would be electrons and protons. Then there's brachytherapy. That's internal radiation, which is a technique that is sealed radioactive sources placed directly into or adjacent to the tumor.” TS 3:13  “First step [in the treatment coordination process] is that consult—getting the patients in the door. Quite honestly, this consult can be a long day for the patients. They may just have a consult with the radiation oncologist. [But if they're coming from a distance,] they might seeing a multidisciplinary clinic, so they are seeing all the physicians all in one day: the medical oncologist, the radiation oncologist, a surgeon.” TS 6:31  “We have a clinic team that oversees a lot of the clinical nursing side of things with rooming and then anesthesia recovery and things like that. And then we have the nursing working with the physicians and care coordination. We kind of have two different nursing roles within the Cleveland Clinic. So, education from both sides, you know, doing education, providing care for the patients and the patients' families.” TS 16:28  “This is one of the many phone calls that we get, I should say, almost daily. We get several phone calls from patients who say, ‘I've looked at my chart, I don't see my radiation treatment. Why are they no longer there? I don't see them. What's going on?' And it is because your radiation treatments ... do not interface with [the electronic health record]. You will be given a handout when you come because there is an issue with the system we use. We use a different system for the computerized radiation treatment, and then we use a different system for our computer charting. And they do not interface, they do not like each other. So, all of their radiation treatments do not show up in their [electronic health record]. They do not show up in their computer system.” TS 19:09  “Within the first two weeks, at least at the Cleveland Clinic, our plan is to give those patients a call back, see how they're doing, how they're doing with their side effects. Have they got scheduled for their follow-up? Do a check-in. Some of our patients have tox visits at six weeks with their nurse care coordinators, and that's just to check and see if they're having any lingering side effects, as well. And then we continue to get calls.” TS 26:31  “Listening to tumor board if you have the patience, so you know what patients that are going to be coming down the pike, because you've heard all the physicians discussing these cases. So, you know the plan because you've heard the surgeon, the radiation oncologist, the medical oncologist discuss the case. So, you know kind of what the plan is, then you can kind of get an idea, ‘Hey, I this one might be coming to me soon, and maybe I should be watching out for this patient or discussing this with my physician if I haven't seen it.'” TS 34:46  “In reality, it can be those days afterward, after they finish, that actually can be the worst. Letting the patients know that and that we're still only a phone call away and, you know, we're there for them. So, you know, continuing to educate also on when to call us—when to call, when to show up in clinic. We're there. We will get them an appointment. We will get them hydrated. We will do whatever they need.” TS 39:16  “Radiation therapy is not only used to treat cancers and malignant conditions. It is also used to treat quite a few benign conditions: arthritic knees, V-tach [ventricular tachycardia] in cardiac patients, Dupuytren's contractures—if you've watched the commercials that they're showing all over now—so, the Dupuytren's contractures of the hands and even plantar warts. So we use a lot of radiation therapy to treat these benign conditions, so it's not just malignant cancers.” TS 42:42 

A discussion of the neurological complications of systemic cancer treatments, with Drs. Kevin Yan and Mary Barden.Note: This podcast is intended solely as an educational tool for learners, especially neurology residents. The contents should not be interpreted as medical advice.Further Reading:Taylor JW. Neurologic Complications of Conventional Chemotherapy and Radiation Therapy. Continuum (Minneap Minn). 2023 Dec 1;29(6):1809-1826. doi: 10.1212/CON.0000000000001358. PMID: 38085899.Wang N. Neurologic Complications of Cancer Immunotherapy. Continuum (Minneap Minn). 2023 Dec 1;29(6):1827-1843. doi: 10.1212/CON.0000000000001362. PMID: 38085900.

Weighing the possible side effects of prostate cancer treatments while considering various treatment options can be a daunting challenge for men and their loved ones. We are excited to partner with BioProtect for this episode, with our distinguished guest, Dr. Jonathan Tward, a Radiation Oncologist and tenured professor in the Department of Radiation Oncology at the University of Utah Health. Dr. Tward will fill us in on a progressive new technology that aims to minimize both short and long-term side effects of radiation therapy for prostate cancer. Dr. Tward is a highly regarded authority and key opinion leader in the management of prostate cancer. He earned a Ph.D. in biochemistry at UCLA, a Medical Degree at Tufts University in Boston, and he completed his radiation oncology residency training at the University of Utah. He holds the Vincent P. and Janet Manzini Presidential Endowed Chair at Huntsman Cancer Institute in genitourinary malignancies. Dr. Tward specializes in delivering precisely targeted radiation therapy for numerous genitourinary malignancies, including prostate cancer. He utilizes various advanced technologies, including intensity-modulated radiotherapy, image-guided radiotherapy, stereotactic body radiotherapy, and low and high-dose-rate brachytherapy. Dr. Tward has contributed to over 100 published peer-reviewed journal articles. He also actively serves on the National Comprehensive Cancer Network clinical practice guidelines committees for prostate, bladder, and penile cancers. Disclaimer: The Prostate Health Podcast is for informational purposes only. Nothing in this podcast should be construed as medical advice. By listening to the podcast, no physician-patient relationship has been formed. For more information and counseling, you must contact your personal physician or urologist with questions about your unique situation. Links: Follow Dr. Pohlman on Twitter and Instagram - @gpohlmanmd  Get your free What To Expect Guide (or find the link on our podcast website)   Join our Facebook group  Follow Dr. Pohlman on Twitter and Instagram  Go to the Prostate Health Academy to sign up.  You can access Dr. Pohlman's free mini webinar, where he discusses his top three tips to promote men's prostate health, longevity, and quality of life here. Connect with Dr. Tward Dr. Jonathan D. Tward BioProtect BioTech Balloon Spacer Procedure Video Symmetry, Visibility, and Control: The Advantages of the BioProtect Balloon in Prostate Cancer Treatment - Edward Soffen VideoAvailable Rectal Spacer Options for Patients With Prostate Cancer Undergoing Radiation Therapy Video Urology Times Video