Medical treatment that only affects a condition's symptoms
POPULARITY
8 episodes with supportive care
7 episodes with supportive care
4 episodes with supportive care
8 episodes with supportive care
3 episodes with supportive care
3 episodes with supportive care
3 episodes with supportive care
2 episodes with supportive care
2 episodes with supportive care
“We want to make sure that nurses, have opportunities both in our local communities as well as international communities, to engage in courageous dialog with others who may think or look different than we do and whose culture or language may also be different. The difference is what brings us together and allows us to have more of this tapestry of what we are about—ensuring that we advance health for all and that we are able to move forward together,” ONS member Ashley Leak-Bryant, PhD, RN, OCN®, professor at University of North Carolina (UNC) at Chapel Hill, told Darcy Burbage, DNP, RN, AOCN®, CBCN®, chair of the ONS 50th Anniversary Committee, during a conversation about international collaboration in oncology nursing. Burbage spoke with Leak-Bryant, ONS member Kristin Ferguson, DNP, MBA, RN, OCN®, senior director of strategic operations, bone marrow transplant, and cellular therapies at MedStar Georgetown University Hospital, and ONS member and Chief Clinical Officer Erica Fischer-Cartlidge, DNP, RN, AOCNS®, EBP-C, about their experiences working in the global oncology space and how ONS is advancing those efforts. Music Credit: “Fireflies and Stardust” by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Episode Notes ONS Podcast™ ONS 50th anniversary series ONS Voice articles: Bridging Borders and Advancing Oncology's Global Mission Building Collaboration, Education With Oncology Nurses in Malawi Cancer Terms' Negative Associations in African Languages Can Create Communication Barriers for Patients and Clinicians Latest Global Cancer Statistics Underscore the Stark Need to Address Resource-Based Disparities ONS Members Share Resources, Experiences With Philippine Colleagues Clinical Journal of Oncology Nursing articles: Amplifying the Global Impact of Oncology Nursing How Can a Global Experience Enkindle a Passion for Oncology Nursing? Connie Henke Yarbro Oncology Nursing History Center ONS Global Initiatives Joint position statement from ISNCC, MASCC, ONS, AONS, and EONS: Cancer Nursing's Potential to Reduce the Growing Burden of Cancer Across the World Asian Oncology Nursing Society City Cancer Challenge Canadian Association of Nurses in Oncology European Oncology Nursing Society Global Power of Oncology Nursing Health Volunteers Overseas International Society of Nurses in Cancer Care Multinational Association of Supportive Care in Cancer UNC Project Malawi Union for International Cancer Control Email Ashley Leak-Bryant Email Kristin Ferguson Email Erica Fisher-Cartlidge at ONS Global Initiatives 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 Leak-Bryant: “My first experience was when I was 21 years old. This was when I was in nursing school at UNC Greensboro. An opportunity came about where I had a chance to go to Honduras, and it was for a one-week service learning cultural immersion experience. And that really gave me my first entree into global health as well as global training. And so, as a first-generation college graduate who had never been out of North Carolina nor had ever flown, it was really an eye-opening experience that has led me now to my current role and passion for global health.” TS 3:24 Leak-Bryant: “In 2018, we had the Malawian delegation come to UNC Chapel Hill. University of North Carolina at Chapel Hill has one of the longest standing collaborations with Malawi, and we call it UNC Project Malawi, and it has been in existence for more than 30 years. … Those nurses and other allied health professionals came to UNC to our cancer center to see how we were making sure that we were engaged in best practices, then how they would be able to take that back to Malawi to make sure that they have what they need as they were opening up a new national cancer Center in Malawi.” TS 7:57 Ferguson: “I have volunteered with ONS at the Asian Pacific Breast Cancer Summit, which was in Indonesia in 2024, and then a few months ago in Singapore. And this is an exciting conference because it draws in nurses from the region, so you end up having five, six, maybe seven countries represented at these conferences, where oncology nurses are very eager to learn, meet one another. And so the teaching that we've provided there has been a combination of lectures and then roundtables where we've strategically placed nurses attending with nurses that are not at their same hospital so that they can connect and share experiences with myself and another ONS member and maybe some other local staff acting as moderators and facilitating conversations.” TS 18:04 Ferguson: “When I was in Tbilisi, Georgia, in 2019, the people there, most of them do not speak English, so they speak their native language Georgian. As I presented, I was wearing a headset, and all of the oncology nurses in the audience were wearing a headset, and I was live translated. What this means is when you're speaking, a translator is sitting in a booth close by and you can actually very quietly hear in your ear he or she quietly translating what you're saying into a language that the nurses can understand. It's actually a bit funny because when you make a joke or ask a question, expecting nods or head shakes, it takes several seconds for the translation to occur. You can get used to a 10-second delay, and you have to pause your speaking and allow actually a little bit more time in presenting if translation services are required.” TS 22:25 Fischer-Cartlidge: “I think that the professional organization role is absolutely critical in how we advance global oncology. Certainly, providing education and helping empower nurses to be more autonomous and equal partners on the care team is a big piece of that. But it's also through forming international partnerships and really elevating the collective voice of nurses in the specialty. This goes a long way in standardizing practices, promoted leadership development among oncology nurses, really across the world. We know that nurses are not seen the same country to country to country on the healthcare team. And so a big part of what we do is try to elevate the importance of what nurses bring to cancer care.” TS 36:14 Fischer-Cartlidge: “I have so many hopes. I hope more opportunities come up for us to raise awareness of this essential role and how we bring a greater spotlight to what nurses are doing across the world for patient care. I hope to see us have more collective global position statements in this space. I hope to see that we have more unified projects across nursing organizations across the world, where we then really can bring our resources and our members together to do great work more effectively and more efficiently. And I think the beginnings of that are happening right up to this point.” TS 41:17
In this podcast episode, Dr. Givens discusses the complexities of dealing with CBRNE patients in the field, emphasizing the need for a methodical approach to treatment. He introduces the March concept, which integrates CBRNE protocols into tactical care, and outlines the importance of agent identification and treatment protocols. The conversation covers the management of CBRNE patients across different zones, the specific challenges posed by nerve agents and cyanide, and the necessity of supportive care for chemical exposures. Dr. Givens concludes with key takeaways for medical professionals working in high-stress environments.TakeawaysCBRNE is a significant concern in military medicine.A methodical approach is essential for managing CBRNE patients.The March concept can be adapted for CBRNE scenarios.Agent identification is crucial for effective treatment.Understanding the hot, warm, and cold zones is key to patient management.Nerve agents and cyanide require specific treatment protocols.Supportive care is vital for patients exposed to chemicals.Training and practice are necessary for effective response.Communication and teamwork are critical in high-stress situations.Basic skills in chemical exposure management are essential for all medical personnel.Chapters00:00 Introduction to CBRNE and Its Challenges02:53 Understanding CBRNE: A Methodical Approach05:38 The March Concept: Integrating CBRNE into Tactical Care08:47 Agent Identification and Treatment Protocols11:35 Managing CBRNEPatients: Hot, Warm, and Cold Zones14:48 Specific Agents: Nerve Agents and Cyanide17:30 Supportive Care for Chemical Exposures20:28 Key Takeaways and Final ThoughtsThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.comFor more content, go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
A few supportive care updates: 1. Skin prophylaxis to prevent severe dermatologic toxicity with Nivo/Ipi. Note* published in JCO Oncology Practice (NOT JAMA Oncol as stated in the episode Link: https://doi.org/10.1200/OP-25-00100 2. Stampede-Metformin and how metformin has some beneficial effects in prostate cancer patients who don't have diabetes Link: https://doi.org/10.1016/S1470-2045(25)00231-1
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
Chronic Myelogenous Leukemia CancerCare Connect Education Workshops
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
Triple Negative Breast Cancer CancerCare Connect Education Workshops
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
Metastatic Breast Cancer CancerCare Connect Education Workshops
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
Chronic Lymphocytic Leukemia CancerCare Connect Education Workshops
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
Marginal Zone Lymphoma CancerCare Connect Education Workshops
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
Waldenstrom’s Macroglobulinemia CancerCare Connect Education Workshops
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
Gastrointestinal Stromal Tumors CancerCare Connect Education Workshops
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
Acute Lymphoblastic Leukemia CancerCare Connect Education Workshops
- Overview of Cancer & the LGBTQI+ Community, Including HIV & HPV - The LGBTQI+ Community's Disproportionate Cancer Burden - Addressing the LGBTQI+ Health Disparities Gap, Including Mistrust of Health Care Providers - Barriers to Health Care Access, Including Discrimination - Health Care, Cancer Screening, Palliative & Supportive Care, Affordable Housing, Gay Men & Lesbian Cancer Issues - Transgender/Gender-Nonconforming People's Cancer Concerns - Challenges for LGBTQI+ Caregivers - Social Security Disability Benefits for LGBTQI+ People Living with Cancer - Military Service & the LGBTQI+ Community - Practical, Financial, Emotional & Social Concerns - Cancer Resources for the LGBTQI+ Community - Questions to Ask Our Panel of Experts
Gugs Mhlungu speaks to Professor Elana Moore, a Sociology expert from the University of Cape Town, about the changes needed to create a care system that effectively supports both older adults and their caregivers. 702 Weekend Breakfast with Gugs Mhlungu is broadcast on 702, a Johannesburg based talk radio station, on Saturdays and Sundays Gugs Mhlungu gets you ready for the weekend each Saturday and Sunday morning on 702. She is your weekend wake-up companion, with all you need to know for your weekend. The topics Gugs covers range from lifestyle, family, health, and fitness to books, motoring, cooking, culture, and what is happening on the weekend in 702land. Thank you for listening to a podcast from 702 Weekend Breakfast with Gugs Mhlungu. Listen live on Primedia+ on Saturdays and Sundays from 06:00 and 10:00 (SA Time) to Weekend Breakfast with Gugs Mhlungu broadcast on 702 https://buff.ly/gk3y0Kj For more from the show go to https://buff.ly/u3Sf7Zy or find all the catch-up podcasts here https://buff.ly/BIXS7AL Subscribe to the 702 daily and weekly newsletters https://buff.ly/v5mfetc Follow us on social media: 702 on Facebook: https://www.facebook.com/TalkRadio702 702 on TikTok: https://www.tiktok.com/@talkradio702 702 on Instagram: https://www.instagram.com/talkradio702/ 702 on X: https://x.com/Radio702 702 on YouTube: https://www.youtube.com/@radio702 See omnystudio.com/listener for privacy information.
In his weekly clinical update, Dr. Griffin with Vincent Racaniello in horror examine dismantling of public infrastructure for establishing vaccine guidelines, the creation of a autism taskforce by someone disciplined for practicing medicine without a license, the ongoing pertussis, bird flu and measles outbreaks, before Dr. Griffin reviews recent statistics on RSV, influenza and SARS-CoV-2 infections the Wasterwater Scan dashboard, the effective of oseltamivir vs supportive care when one is hospitalized with influenza infection, whether or not the NB.1.8.1 should be included in the fall 2025 vaccines, approval of another anti-RSV monoclonal antibody for treatment in infants, immunization recommendations for COVID-19 vaccines, where to find PEMGARDA, results from the phase 3 randomized clinical trial of pemivibart, provides information for Columbia University Irving Medical Center's long COVID treatment center, where to go for answers to your long COVID questions, how artery disease impacts SARS-CoV-2 infection outcomes, contacting your federal government representative to stop the assault on science and biomedical research and the recent public health programs that have been unfunded. Subscribe (free): Apple Podcasts, RSS, email Become a patron of TWiV! Links for this episode Vaccine Opponent Hired by RFK Jr. Scours Official Records for Link to Autism (Wall Street Journal) Correcting our record (Salon) You are FIRED! Kennedy removes all ACIP members, eyes replacement (CIDRAP) UPI Investigates: The vaccine conflict…..investigative reporting? (UPI) RFK Jr.: HHS Moves to Restore Public Trust in Vaccines…to avoid conflicts UGHHHH! (Wall Street Journal) GREAT Vaccine advisory panel (Great Barrington Declaration) National Vaccine Information Center (Wikipedia: National Vaccine Information Center) Nonprofit organization 501(c) (Wikipedia) Kennedy Announces Eight New Members of C.D.C. Vaccine Advisory Panel (NY Times) Whooping cough deaths! (Kentucky. Gov) Kentucky announces two pertussis deaths in infants this year (CIDRAP) H5 bird flu: current situation (CDC: Avian Influenza) Stability of influenza viruses in the milk of cows and sheep (medRxiv) Wastewater for measles (WasterWater Scan) Measles cases and outbreaks (CDC Rubeola) Weekly measles and rubella monitoring (Government of Canada) Canada's Ontario province reports death of child from measles (Reuters) Measles outbreaks continue with risk of holidays causing surge (gov.UK) Measles (WHO) Measles vaccine recommendations from NYP (jpg) Get the FACTS about measles (NY State Department of Health) Measles (CDC Measles (Rubeola)) Measles vaccine (CDC Measles (Rubeola)) Presumptive evidence of measles immunity (CDC) Contraindications and precautions to measles vaccination (CDC) Measles (CDC Measles (Rubeola) Adverse events associated with childhood vaccines: evidence bearing on causality (NLM) Measles Vaccination: Know the Facts (ISDA: Infectious Diseases Society of America) Deaths following vaccination: what does the evidence show (Vaccine) Influenza: Waste water scan for 11 pathogens (WastewaterSCan) US respiratory virus activity (CDC Respiratory Illnesses) Weekly surveillance report: clift notes (CDC FluView) Respiratory virus activity levels (CDC Respiratory Illnesses) Weekly surveillance report: clift notes (CDC FluView) Oseltamivir Treatment vs Supportive Care for Seasonal Influenza Requiring Hospitalization (JAMA) FDA-CDC-DOD: 2025-2046 influenza vaccine composition (FDA) RSV: Waste water scan for 11 pathogens (WastewaterSCan) US respiratory virus activity (CDC Respiratory Illnesses) RSV-Network (CDC Respiratory Syncytial virus Infection) Approval for Merck's ENFLONSIA™ (clesrovimab-cfor) for Prevention of Respiratory Syncytial Virus (RSV) Lower Respiratory Tract Disease in Infants Born During or Entering Their First RSV Season (Merck) Waste water scan for 11 pathogens (WastewaterSCan) COVID-19 deaths (CDC) COVID-19 national and regional trends (CDC) COVID-19 variant tracker (CDC) SARS-CoV-2 genomes galore (Nextstrain) Antigenic and Virological Characteristics of SARS-CoV-2 Variant BA.3.2, XFG, and NB.1.8.1 (biRxiV) COVID-19 vaccine for 6 months, 12 years (CDC: childhood vaccination) COVID-19 vaccine for65 years and older (CDC: Adult vaccination) Where to get pemgarda (Pemgarda) EUA for the pre-exposure prophylaxis of COVID-19 (INVIYD) Infusion center (Prime Fusions) CDC Quarantine guidelines (CDC) NIH COVID-19 treatment guidelines (NIH) Drug interaction checker (University of Liverpool) Infectious Disease Society guidelines for treatment and management (ID Society) Molnupiravir safety and efficacy (JMV) Convalescent plasma recommendation for immunocompromised (ID Society) What to do when sick with a respiratory virus (CDC) Managing healthcare staffing shortages (CDC) Steroids,dexamethasone at the right time (OFID) Anticoagulation guidelines (hematology.org) Daniel Griffin's evidence based medical practices for long COVID (OFID) Long COVID hotline (Columbia : Columbia University Irving Medical Center) The answers: Long COVID Long-term outcomes of patients with pre-existing coronary artery disease after SARS-CoV-2 infection (eBioMedicine) Reaching out to US house representative Trump Budget Eliminates Funding for Crucial Global Vaccination Programs(NY Times) Letters read on TWiV 1226 Dr. Griffin's COVID treatment summary (pdf) Timestamps by Jolene Ramsey. Thanks! Intro music is by Ronald Jenkees Send your questions for Dr. Griffin to daniel@microbe.tv Content in this podcast should not be construed as medical advice.
Jeff Bennett, Chief Strategy and Innovation Officer at Modivcare, is addressing and expanding supportive care services to provide transportation, personal care services, and remote patient monitoring. A lack of transportation leads to missed appointments and therapies, necessitating a coordinated approach to support vulnerable populations. Modivcare utilizes remote sensors and AI to enhance human engagement and coordination, and is designed to be both preventative and predictive, keeping patients healthy and out of the hospital. Jeff explains, "Modivcare works on behalf of health plans, states, and risk-based entities. We provide supportive care services that meet the needs and address the needs of patients. One of those services is transportation, so non-emergency medical transportation. We also provide personal care services, which support members with activities of daily living, like bathing, meal preparation, and such. And then finally, I lead the monitoring organization, which provides services to monitor members or patients at home so they can live and age at home on their own." "The biggest need, at the top, is that our members have health-related social needs or SDOH needs. They also are living with chronic conditions, so they need supportive care services that not only provides that core service -- so there's the obvious "I need a ride" or "if I press the button because I've fallen and I need 911 to be called if I need an ambulance or my caregiver or family member to come help me." But most importantly, the services that they need are providing an engagement service. Really, what we provide is a supportive care service that drives human connection through cutting-edge technology that drives continuous engagement. They always know that we're here, and we listen to them. We understand their needs and try to address those needs, which could be healthcare-related, social-related, or simply loneliness. So it spans that broad spectrum. And any one of our services, we're delivering that core service, but we're also driving engagement and listening for what else the member needs." #Modivcare #SDOH #SupportiveCareServices #MedAI #DigitalHealth #CareCoordination modivcare.com Download the transcript here
Jeff Bennett, Chief Strategy and Innovation Officer at Modivcare, is addressing and expanding supportive care services to provide transportation, personal care services, and remote patient monitoring. A lack of transportation leads to missed appointments and therapies, necessitating a coordinated approach to support vulnerable populations. Modivcare utilizes remote sensors and AI to enhance human engagement and coordination, and is designed to be both preventative and predictive, keeping patients healthy and out of the hospital. Jeff explains, "Modivcare works on behalf of health plans, states, and risk-based entities. We provide supportive care services that meet the needs and address the needs of patients. One of those services is transportation, so non-emergency medical transportation. We also provide personal care services, which support members with activities of daily living, like bathing, meal preparation, and such. And then finally, I lead the monitoring organization, which provides services to monitor members or patients at home so they can live and age at home on their own." "The biggest need, at the top, is that our members have health-related social needs or SDOH needs. They also are living with chronic conditions, so they need supportive care services that not only provides that core service -- so there's the obvious "I need a ride" or "if I press the button because I've fallen and I need 911 to be called if I need an ambulance or my caregiver or family member to come help me." But most importantly, the services that they need are providing an engagement service. Really, what we provide is a supportive care service that drives human connection through cutting-edge technology that drives continuous engagement. They always know that we're here, and we listen to them. We understand their needs and try to address those needs, which could be healthcare-related, social-related, or simply loneliness. So it spans that broad spectrum. And any one of our services, we're delivering that core service, but we're also driving engagement and listening for what else the member needs." #Modivcare #SDOH #SupportiveCareServices #MedAI #DigitalHealth #CareCoordination modivcare.com Listen to the podcast here
Welcome to the fourth episode of ASTCT Talks' exclusive 8-part series, supported by an educational grant from Sanofi US. In this episode, former ASTCT President Dr. Corey Cutler sits down with Dr. Connie R. Shi from the Cutaneous Oncology Program at Dana-Farber Cancer Institute. They discuss Dr. Shi's recent article, Cutaneous Chronic Graft-Versus-Host Disease: Clinical Manifestations, Diagnosis, Management, and Supportive Care.Tune in as they explore the complexities of cutaneous GVHD, including acute and chronic presentations, diagnostic challenges and skin-directed treatment strategies such as topical steroids and phototherapy. They also cover key considerations for recognizing and diagnosing cutaneous GVHD in patients of all skin tones and managing long-term complications like skin cancer risk.
Dermatologic toxicities associated with oncology treatment can significantly impact quality of life and treatment adherence for patients with breast cancer. The Association of Cancer Care Centers (ACCC) is committed to providing up-to-date guidance on managing these dermatologic side effects to enhance clinical outcomes. In this episode of CANCER BUZZ, Allison Gordon, MD, a supportive oncodermatologist at Memorial Sloan Kettering Cancer Center, discusses the dermatologic toxicities associated with breast cancer treatment. Dr Gordon explores preventive measures that oncologists can implement early in the treatment course and offers alternative resources for oncology clinicians when an oncodermatologist referral is not feasible. Additionally, she highlights capivasertib, a recently approved antineoplastic drug, and reviews its associated cutaneous adverse events, along with supportive care and management strategies. Thank you to AstraZeneca for their support of this program. Allison Gordon, MD Dermatologist Memorial Sloan Kettering Cancer Center New York, NY “Because many of these medications can cause dry skin, which can be debilitating for patients... [we recommend] using a thick ointment or cream moisturizer on their damp skin after they shower... it doesn't have to be anything expensive... I always recommend that to all patients regardless of what treatment they're on.”– Allison Gordon, MD Additional Reading/Sources ACCC Supportive Care Strategies for Dermatologic Toxicities Related to Cancer Therapies education program (https://www.accc-cancer.org/home/learn/comprehensive-cancer-care-services/dermatologic-toxicities?) Targeted Therapy Side Effects – American Cancer Society (https://www.cancer.org/cancer/managing-cancer/treatment-types/targeted-therapy/side-effects.html) Oncodermatology: Advancing the Science and Care of Cancer Patients and Survivors (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10569770/) Dermatologic Adverse Events of Systemic Anticancer Therapies: Cytotoxic Chemotherapy, Targeted Therapy, and Immunotherapy (https://ascopubs.org/doi/10.1200/EDBK_289911) Multinational Association of Supportive Care in Cancer (MASCC) Oncodermatolgy Study Group (https://mascc.org/resources/mascc-guidelines/) Guidelines for the Prevention and Treatment of Radiation-Induced Skin Reactions (https://mascc.org/resources/mascc-guidelines/) Guidelines for Prevention and Management of Dermatological Toxicities Related to Anticancer Agents (https://pubmed.ncbi.nlm.nih.gov/33248228/)
Dr. Mellar Davis discusses the joint guideline from MASCC, ASCO, AAHPM, HPNA, and NICSO on opioid conversion in adults with cancer. He reviews the limited evidence, and the formal consensus process used to develop the guideline. He shares the key recommendations on pre-conversion assessment, how opioid conversion should be conducted, including opioid conversion ratios, and post-conversion assessment. We touch on gaps and questions in the field and the impact of these new recommendations. Read the full guideline, “Opioid Conversion in Adults with Cancer: MASCC-ASCO-AAHPM-HPNA-NICSO Guideline” at www.asco.org/supportive-care-guidelines. TRANSCRIPT This guideline, clinical tools, and resources are available at http://www.asco.org/supportive-care-guidelines. Read the full text of the guideline in the Supportive Care in Cancer, https://link.springer.com/article/10.1007/s00520-025-09286-z Brittany Harvey: Hello and welcome to the ASCO Guidelines podcast, one of ASCO's podcasts delivering timely information to keep you up to date on the latest changes, challenges and advances in oncology. You can find all the shows, including this one at asco.org/podcasts. My name is Brittany Harvey and today I'm interviewing Dr. Mellar Davis from Geisinger Medical Center, lead author on “Opioid Conversion in Adults with Cancer: Multinational Association of Supportive Care and Cancer, American Society of Clinical Oncology, American Academy of Hospice and Palliative Medicine, Hospice and Palliative Nurses Association, Network Italiano Cure di Supporto and Oncologia Guideline.” Thank you for being here today, Dr. Davis. Dr. Mellar Davis: Thank you. I'm glad to be here. Brittany Harvey Before we discuss this guideline, I'd like to note that ASCO takes great care in the development of its guidelines and ensuring that the ASCO Conflict of Interest Policy is followed for each guideline. The disclosures of potential conflicts of interest for the guideline panel, including Dr. Davis, who has joined us here today, are available online with the publication of the guideline, which is linked in our show notes. So then, to dive into the content here, Dr. Davis, can you provide an overview of both the scope and purpose of this guideline on opioid conversion in people with cancer? Dr. Mellar Davis: This is an important topic in management of cancer pain and this topic came up as a result of a survey that MASCC had done, which involved 370 physicians in 53 countries. They were queried about how they change or convert one opioid to another, which is a common practice, and we found that there was quite a divergence in opioid conversion ratios. To step back a little bit, about two thirds of patients with advanced cancer have moderate to severe pain and most of the time they're managed by opioids. But about 20% or 40% require a switch either because they have an adverse reaction to it or they don't respond to it, or the combination of both. Rarely, it may be that they need a route change, perhaps because they have nausea or vomiting. So, the opioid conversion works basically because of the complexity of the new opioid receptor which has at least four exons to it as a result of that non-cross tolerance between opioids. As a result of the survey, we convened a group of specialists, 14 international specialists, to look to see if we could develop an international guideline. And we did a systematic review which involved viewing 21,000 abstracts and we came up with 140 randomized trials and 68 non-randomized trials. And after reviewing the data, we found that the data was really not strong enough to provide a guideline. As a result, ASCO, MASCC, the AAHPM, the HPNA and the Italian Group formed a supportive network that allowed us then to do a Delphi guideline based upon ASCO modified criteria for doing Delphi guidelines. And so we then involved 27 additional international experts informing the guideline to it. And this guideline is then the result of the Delphi process. It consists basically of a pre-conversion ratio recommendations, conversion ratios, which is actually a major contribution of this guideline, and then what to do after converting someone to another opioid. Our target audience was not only oncologists, but also we wanted to target nurses, pharmacists, hospitalists, primary care physicians, patients and caregivers. Brittany Harvey: I appreciate that background information, particularly on the evidence that is underpinning this and the lack of quality of evidence there, which really transformed this into a formal consensus guideline. We're glad to have all of these organizations coming together to collaborate on this guideline. So then next I'd like to review the key recommendations. So starting with, what is recommended for pre-conversion assessment? Dr. Mellar Davis: In regards to pre-conversion, physicians and clinicians need to be aware of pain phenotypes. That is, there are pains that are more opioid refractory than others, such as neuropathic pain, hence, they may be more resistant to the opioid that you're converting to. One needs to be aware of the fact that patients may not be compliant, they're either afraid of opioids not taking what was prescribed, so it's important to query patients about whether they are taking their opioid as prescribed. Occasionally, there are patients who will divert their medication for various reasons. Pain may be poorly controlled also because of dosing strategies that are poorly conceived, in other words, giving only ‘as needed' opioids for continuous cancer pain. And there are rare circumstances where an opioid actually induces pain and simply reducing the opioid actually may improve the pain. The other issue may be cancer progression. So that poorly controlled pain or rapidly increasing pain may actually be a result of progressive cancer and changing treatment obviously will be important. And you need to assess the pain severity, the quality of the pain, the radiating localizing effects, which does require not only a physical exam but also radiographic examinations. But the other thing that's very important in opioid conversions are pain scales with function. A significant number of patients don't quite understand a numerical scale which we commonly use: 0 to 10, with 10 being severe pain and 0 being no pain. They may in fact focus more on function rather than on pain severity or pain interference with daily activities or roles. Sometimes patients will say, “Oh, my pain is manageable,” or “It's tolerable,” rather than using a numerical scale. Choices of opioids may be based on cost, drug-drug interactions, organ function, personal history or substance use disorder so that one will want to choose an opioid that's safe when converting from one to another. And obviously social support and having caregivers present and understanding the strategy in managing pain will be important. Brittany Harvey: Thank you, Dr. Davis, for reviewing those pre-conversion assessment considerations and particularly the challenges around some of those. So, following this pre-conversion assessment, what are the recommendations on how opioid conversion should be conducted? Dr. Mellar Davis: Opioid conversions are basically the safe dose. People have used the term ‘equianalgesia', but the panel and the consensus group felt that that would be inappropriate. So a conversion ratio is the dose at which the majority of patients will not experience withdrawal or adverse effect. It would be the safe dose. Thereafter, the dose will need to be adjusted. So, in converting, that's only the first step in managing pain, the doses need to be adjusted to the individual thereafter. There are a significant number of conversions that are done indirectly, that is that there has not been a study that has looked at a direct conversion from one opioid to another in which one needs to convert through another opioid. We call that a ‘morphine equivalent daily dose'. So, most of the time a third opioid is used in the conversion. It allows you then to convert when there hasn't been a direct study that has looked at conversion between those two opioids, but it is less accurate and so one has to be a little bit more careful when using morphine daily equivalents. We found, and I think this is the major advantage to the guideline, is that commonly used opioids - oxycodone, morphine, hydromorphone - we did establish conversion ratios to which we found in the MASCC guideline they were widely divergent and hope that actually, internationally, they will be adopted. We also found some conversion ratios for second-line opioids. However, we felt also that an opioid like methadone, which has a unique pharmacology, should be left to experts and that experts should know at least several ways of converting from morphine usually to methadone. There is what appears to be a dose-related increased potency of methadone relative to morphine, which makes it more difficult, particularly at higher doses, to have an accurate conversion ratio. Most patients will have transient flares of pain. We came up with two suggestions. One is using a 10 or 15% of the around-the-clock dose for the breakthrough dose, but we also realized that there was a poor correlation between the around-the-clock dose and the dose used for transient flares of pain. And so the breakthrough dose really needs to be adjusted to the individual responses. There was also a mention of buprenorphine. One of the unique things about buprenorphine is that if you go from high doses of a drug like morphine to buprenorphine in a stop-start dosing strategy, you can precipitate withdrawal. And so one has to be careful and have some experience in using buprenorphine, which can be an effective analgesic. Brittany Harvey: Yes, I think that the conversion ratios that you mentioned that are in Table 3 in the full guideline are a really useful tool for clinicians in practice. And I appreciate the time that the panel and the additional consensus panel went through to develop these. I think it's also really key what you mentioned about these not being equianalgesic doses and the difficulties in some of these conversions and when people need to really look to specialists in the field. So then, following opioid conversion, what assessments are recommended post-conversion? Dr. Mellar Davis: Post-conversion, probably the cardinal recommendation is close observation for response and for toxicity. And I think that probably summarizes the important parts of post-conversion follow up. So assessment should be done 24-48 hours after conversion and patients followed closely. Assessment scales should include patient personalized goals. Now, it used to be in the past that we had this hard stop about a response being below 4 on a 0 to 10 scale, but each patient has their own personal goals. So they gauge the pain severity and their function based upon response. So a patient may function very well at “a severity of 5” and feel that that is their personal goal. So I think the other thing is to make sure that your assessment is just not rote, but it's based upon what patients really want to achieve with the opioid conversion. The average number of doses per day should be assessed in the around-the-clock dose so those should be followed closely. Adverse effects can occur and sometimes can be subtle. In other words, a mild withdrawal may produce fatigue, irritability, insomnia and depression. And clinicians may not pick up on the fact that they may be actually a bit under what patients have or they're experiencing withdrawal syndrome. It's important to look for other symptoms which may be subtle but indicating, for instance, neurotoxicity from an opioid. For instance, visual hallucinations may not be volunteered by patients. They may transiently see things but either don't associate with the opioid or are afraid to mention them. So I think it's important to directly query them, for instance, about visual hallucinations or about nightmares at night. Nausea can occur. It may be temporary, mild, and doesn't necessarily mean that one needs to stop the second opioid. It may actually resolve in several days and can be treated symptomatically. Pruritus can occur and can be significant. So close observation for the purposes of close adjustments are also necessary. As we mentioned, you want to start them on an around-the-clock of breakthrough dose, but then assess to see what their response is and if it's suboptimal then you'll need to adjust the doses based both upon the around-the-clock and the breakthrough dose or the dose that's used for breakthrough pain. Also looking at how patients are functioning, because remember that patients frequently look at pain in terms of function or interference with their roles during the day. So, if patients are able to do more things, that may, in fact, be the goal. Brittany Harvey: Thank you for reviewing all of these recommendations across pre-conversion assessment, how opioid conversion should be conducted, including conversion ratios, and what assessments are recommended after opioid conversion. I think it's really important to be watching for these adverse events and assessing for response and keeping in mind patient goals. So, along those lines, how will these guideline recommendations impact both clinicians and people with cancer? And what are the outstanding questions we're thinking about regarding opioid conversion? Dr. Mellar Davis: I think it's important to have a basic knowledge of opioid pharmacology. There's, for instance, drugs that are safer in liver disease, such as morphine, hydromorphone, which are glucuronidated. And there are opioids that are safer in renal failure, such as methadone and buprenorphine, which aren't dependent upon renal clearance. I think knowing drug-drug interactions are important to know. And sometimes, for instance, there may be multiple prescribers for a patient. The family physician's prescribing a certain medication and the oncologist is another, so being aware of what patients are on, and particularly over-the-counter medications which may influence opioid pharmacokinetics. So complementary medications, for instance, being aware of cannabis, if patients are using cannabis or other things, I think, are important in this. There are large gaps and questions and that's the last part of the guideline that we approach or that we mentioned that I think are important to know. And one is there may be ethnic differences in population in regards to clearance or cytochrome frequencies within communities or countries, which may actually alter the conversion ratios. This has not been explored to a great extent. There's opioid stigmata. So we are in the middle of an opioid crisis and so people have a great fear of addiction and they may not take an opioid for that reason, or they may have a relative who's been addicted or had a poor experience. And this may be particularly true for methadone and buprenorphine, which are excellent analgesics and are increasingly being used but may in fact have the stigmata. There are health inequalities that occur related to minority groups that may in fact not get the full benefit of opioid conversions due to access to opioids or to medical care. Age, for instance, will cause perhaps differences in responses to opioids and may in fact affect conversion ratios. And this may be particularly true for methadone, which we have not really explored to a great extent. And finally, the disease itself may influence the clearance or absorption of an opioid. So for a sick patient, the opioid conversion ratio may be distinctly different than in a healthy individual. This is particularly seen with transdermal fentanyl, which is less well absorbed in a cachectic patient, but once given IV or intravenously has a much longer half life due to alterations in the cytochrome that clears it. And so conversion ratios have frequently been reported in relatively healthy individuals with good organ function and not that frequently in older patient populations. So just remember that the conversion ratios may be different in those particular populations. Brittany Harvey: Yes. So I think a lot of these are very important things to consider and that managing cancer pain is key to quality of life for a lot of patients and it's important to consider these patient factors while offering opioid conversion. I want to thank you so much for your work to review the existing literature here, develop these consensus-based recommendations and thank you for your time today, Dr. Davis. Dr. Mellar Davis: Thank you. Brittany Harvey: And thank you to all of our listeners for tuning in to the ASCO Guidelines podcast. To read the full guideline, go to www.asco.org/supportive-care-guidelines. You can also find many of our guidelines and interactive resources in the free ASCO Guidelines app available in the Apple App Store or the Google Play Store. If you have enjoyed what you've heard today, please rate and review the podcast and be sure to subscribe so you never miss an episode. The purpose of this podcast is to educate and 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.
Join us for an insightful episode featuring seasoned Pediatric Nurse Practitioner Meggan Mikal-DeMont DNP, APRN-FPA, PCNS-BC, CPNP-PC, CHPPN ®, FPCN® with more than10 years of experience in palliative care and pain management. In this whole-hearted interview, she reflects on her husband's nine-month experience with Stage IV colorectal cancer and offers an insider's perspective as both a palliative care clinician and caregiver- how as a couple they navigated the miracle they were hoping for within the system, how these experiences have transformed Meggan's clinical practice, and how life has unfolded since then. Listen for what the health care teams did well, areas where they could improve, and how administrators can champion hospice and palliative care services to make end of life easier for patients and their families. Meggan Mikal DNP, APRN-FPA, PCNS-BC, CPNP-PC, CHPPN®, FPCN®Meggan Mikal-DeMont is the nurse practitioner of Pediatric Advance Care Team - Palliative & Pain at Advocate Children's Hospitals in Oak Lawn, IL. Pursuing her interest in working with families that have children living with complex and series illnesses, Meggan has completed a fellowship in pediatric neurodevelopmental disabilities through the Illinois Leadership Education in Neurodevelopmental and Related Disabilities (LEND) program. She also has completed a fellowship in pediatric palliative and hospice nursing through University of Illinois in Chicago and through the Coleman Foundation. This led her to also become a board-certified pediatric hospice and palliative nurse in 2009. Meggan, along with an interdisciplinary committee, started the Pediatric Palliative and Supportive Care program at Advocate Children's Hospital - Oak Lawn in October of 2012. Her background as a pediatric intensive care nurse is where her love and passion for working with children with critical and chronic illness grew. She is an End-of-Life Nursing Education Consortium (ELNEC) trainer and received that training at St. Jude's Hospital in Memphis, TN. Meggan is an active member of the Hospice and Palliative Nurses Association (HPNA) where she serves on the Advocacy and Legislative Committee. She participated as both an item writer and chair for the pediatric hospice and palliative nurse exam from 2010-2016. Meggan was also recently inducted as a Fellow of Palliative and Hospice Nursing (FPCN®) and is so thrilled to be recognized for her true passion and purpose to this field. Becoming a widow and a solo parent in 2017 after her husband Andrew died from advanced colorectal cancer has only grown her passion for delivering and advocating for nothing short of the best delivery of palliative and hospice care. Meggan is blessed to be given a new chapter and now lives with her husband Nate, eight year old son Andy, bonus seven year old daughter Elizabeth, and two and a half year old rescue dog Zoey, in Plainfield. Within palliative care, Meggan has a strong interest in the areas of patient-provider boundaries, patient and family advocacy, and the delivery of diverse, equitable, and inclusive care. Meggan believes that caring for children with serious illnesses truly starts at the grassroots of relationships. She believes that the family is the center of the care being provided and it is a relationship built on partnership. Helping children live life to their fullest ability without burdensome symptoms is something that she strives to achieve each day. Brett Snodgrass, DNP, FNP-C, ACHPN®, FAANP Dr. Brett Snodgrass has been a registered nurse for 28 years and a Family Nurse Practitioner for 18 years, practicing in multiple settings, including family practice, urgent care, emergency departments, administration, chronic pain and palliative medicine. She is currently the Operations Director for Palliative Medicine at Baptist Health Systems in Memphis, TN. She is board certified with the American Academy of Nurse Practitioners. She is also a Fellow of the American Association of Nurse Practitioners and an Advanced Certified Hospice and Palliative Nurse. She completed a Doctorate of Nursing Practice at the University of Alabama – Huntsville. She is a nationally recognized nurse practitioner speaker and teacher. Brett is a chronic pain expert, working for more than 20 years with chronic pain and palliative patients in a variety of settings. She is honored to be the HPNA 2025 podcast host. She is married with two daughters, two son in laws, one grandson, and now an empty nest cat. She and her family are actively involved in their church and she is an avid reader.
In the face of terminal illness and loss, hope can feel elusive, yet it remains one of the most powerful forces guiding us through life's darkest moments. In this episode, your host, Cindy Watson sitsdown with Debra Parker Oliver, the Ira Kodner Professor of Research in Supportive Care at Washington University, to discuss the powerful topic of Negotiating Hope. With over 20 years as a hospice social worker and administrator, Debra has dedicated her life to improving hospice care, contributing more than 200 peer-reviewed articles on palliative and hospice care. Together with her late husband, David, she created a blog to share their cancer journey, offering guidance and advocacy for those facing terminal illness. Even after David's passing, Debra continues to share her story of grief and healing, inspiring hope for others navigating similar challenges. Key takeaways: Negotiating with the doctors What is the love-grief equation? What is hope and how to define your hope? Dealing with a loved one with a terminal illness How can we prepare for tragic events or obstacles in our life while still holding on to hope? What are some of the benefits of of hope, of seeking hope, of living a hopeful life? And many more! Learn more about Debra: Website: www.legaciesfromthelivingroom.com Facebook: https://www.facebook.com/legaciesfromthelivingroom/?ref=embed_page YouTube: https://www.youtube.com/@Legaciesfromthelivingroom Email: oliverd@wustl.edu Get her book: Legacies from the Living Room: A Love-Grief Equation If you're looking to up-level your negotiation skills, I have everything from online to group to my signature one-on-one mastermind & VIP experiences available to help you better leverage your innate power to get more of what you want and deserve in life. Check out our website at www.artofFeminineNegotiation.com if that sounds interesting to you. Get Cindy's book here: Amazon https://www.amazon.com/Art-Feminine-Negotiation-Boardroom-Bedroom-ebook/dp/B0B8KPCYZP?inf_contact_key=94d07c699eea186d2adfbddfef6fb9e2&inf_contact_key=013613337189d4d12be8d2bca3c26821680f8914173f9191b1c0223e68310bb1 EBook https://www.amazon.com/Art-Feminine-Negotiation-Boardroom-Bedroom-ebook/dp/B0B8KPCYZP?inf_contact_key=94d07c699eea186d2adfbddfef6fb9e2&inf_contact_key=013613337189d4d12be8d2bca3c26821680f8914173f9191b1c0223e68310bb1 Barnes and Noble https://www.barnesandnoble.com/w/the-art-of-feminine-negotiation-cindy-watson/1141499614?ean=9781631959776 CONNECT WITH CINDY: Website: www.womenonpurpose.ca Facebook: https://www.facebook.com/womenonpurposecommunity/ Instagram: https://www.instagram.com/womenonpurposecoaching/ LinkedIn: linkedin.com/in/thecindywatson Show: https://www.womenonpurpose.ca/media/podcast-2/ X(Twitter): https://twitter.com/womenonpurpose1 YouTube:https://www.youtube.com/@hersuasion Email: cindy@womenonpurpose.ca
In this episode, Dennis and Doug discuss acute liver injury, its causes, recognition, and management. They explore the liver's vital functions, the implications of liver injury in shock situations, and the importance of early recognition and treatment. The conversation also touches on the role of supplements and heat injury in exacerbating liver issues, emphasizing the liver's resilience and the need for vigilant care in critical situations.TakeawaysThe liver plays a crucial role in toxin clearance and blood metabolism.Acute liver injury can result from hypoxia, heat stroke, and toxins like acetaminophen.Recognizing signs of liver injury early can significantly impact patient outcomes.Supportive care for liver injury includes maintaining glucose levels and managing coagulopathy.The timeline for liver injury can vary, often showing signs later than other organ failures.Preventing acute liver injury involves early recognition and treatment of shock.Supplements can increase the risk of liver injury, especially in heat-related cases.The liver's resilience allows it to withstand significant damage before showing dysfunction.Monitoring lactate and glucose levels can help in diagnosing liver injury.Effective resuscitation is key to preventing progression to severe liver injury.Chapters00:00 Introduction to Acute Liver Injury02:58 Understanding Liver Functions and Injury06:04 Recognizing Acute Liver Injury08:57 Supportive Care for Liver Injury11:47 Challenges in Managing Acute Liver Injury15:04 The Timeline of Liver Injury17:47 Preventing Acute Liver Injury21:13 The Role of Supplements and Heat Injury24:07 Conclusion and Key TakeawaysThank you to Delta Development Team for in part, sponsoring this podcast.deltadevteam.com For more content go to www.prolongedfieldcare.orgConsider supporting us: patreon.com/ProlongedFieldCareCollective or www.lobocoffeeco.com/product-page/prolonged-field-care
In today's episode, we're finishing up our series on kidney failure treatment options with a discussion on conservative care. What exactly is conservative care and who can benefit from it? Christine Corbett, Associate Chief Nursing Officer and nurse practitioner specializing in palliative care is here to answer that question and more. Sara Hicklin and Bobbie Reed who have firsthand experience with conservative care in their families are also here to share their perspectives on this treatment option. Christine Corbett, DNP, APRN, FNP-BC, CNN-NP, FNKF is the newly appointed Assistant Research Professor at George Washington University and Executive Director for the Coalition for Supportive Care of Kidney Patients. She is a practicing Nurse Practitioner specializing in kidney palliative care, and a Trauma-Sensitive HeartMath Certified Practitioner. Dr. Corbett has over 25 years of nephrology experience and four years of experience in Palliative Care. Her doctoral focus was shared decision-making, advance care planning and appropriate palliative care referral for select patients with chronic kidney disease. In the past four years she developed, implemented, and managed the Comprehensive Conservative Kidney Care Clinic for patients who choose to forego dialysis at an academic safety net hospital in Kansas City. Bobbie Reed is on a mission for her son and for the millions of others living with chronic kidney disease. A graduate of Indiana University of Pennsylvania with a Bachelor of Family Consumer Science degree, Bobbie is the office manager at her family's insurance business. She wants to pay it forward by helping others with their struggles in dealing with kidney disease. As part of the NKF's Kidney Advocacy Committee, Bobbie is not only the Pennsylvania Liaison, but is the immediate past Region 2 leader for the group. She continues to help her son navigate his kidney disease journey and, in addition, use her experience to benefit and advocate for many others afflicted with kidney disease. Sara Hicklin and her family has a genetic kidney disease called Polycystic Kidney Disease or PKD. With this family and personal history, Sara is passionate about educating others about kidney disease, along with recruiting and educating potential organ donors. She is also fascinated by the advances in treatment options in three generations and wants to contribute in a small way to what may become available for treatment of kidney disease in generations to come. Additional Resources Coalition for Supportive Care Palliative Care Resources Palliative Care Resources Advanced Directives The Patient Will See You Now by Eric Topol Palliative Care in Nephrology Definitions from the episode: Durable Power of Attorney (DPOA) Portable Medical Orders (POLST): https://polst.org/ Do you have comments, questions, or suggestions? Email us at NKFpodcast@kidney.org. Also, make sure to rate and review us wherever you listen to podcasts.
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