POPULARITY
Join the Behind the Knife Surgical Oncology Team as we discuss the presentation, work-up, and management of neuroendocrine tumors of the small bowel. Learning Objectives: In this episode, we review the basics of neuroendocrine (NE) tumors of the small bowel, including how to evaluate patients with presenting symptoms consistent with NE tumors, initial work-up, staging, and management. We discuss key concepts including DOTATATE scans and medical therapies high yield for direct patient care and board exams. Hosts: Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist/HPB surgeon at Kaiser LAMC in Los Angeles. Connor Chick, MD (@connor_chick) is a 2nd Year Surgical Oncology fellow at Ohio State University. Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a 1st Year Surgical Oncology fellow at MD Anderson. Beth (Elizabeth) Barbera, MD (@elizcarpenter16) is a PGY-6 General Surgery resident at Brooke Army Medical Center Links to Paper Referenced in this Episode: Strosberg J, El-Haddad G, Wolin E, Hendifar A, Yao J, Chasen B, Mittra E, Kunz PL, Kulke MH, Jacene H, Bushnell D, O'Dorisio TM, Baum RP, Kulkarni HR, Caplin M, Lebtahi R, Hobday T, Delpassand E, Van Cutsem E, Benson A, Srirajaskanthan R, Pavel M, Mora J, Berlin J, Grande E, Reed N, Seregni E, Öberg K, Lopera Sierra M, Santoro P, Thevenet T, Erion JL, Ruszniewski P, Kwekkeboom D, Krenning E; NETTER-1 Trial Investigators. Phase 3 Trial of 177Lu-Dotatate for Midgut Neuroendocrine Tumors. N Engl J Med. 2017 Jan 12;376(2):125-135. doi: 10.1056/NEJMoa1607427. PMID: 28076709; PMCID: PMC5895095. https://pubmed.ncbi.nlm.nih.gov/28076709/ ***SPECIALTY TEAM APPLICATION LINK: https://docs.google.com/forms/d/e/1FAIpQLSdX2a_zsiyaz-NwxKuUUa5cUFolWhOw3945ZRFoRcJR1wjZ4w/viewform?usp=sharing Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
This piece comes from Melbourne, Australia, at the World Congress of Prehabilitation and Perioperative Medicine, held alongside the Australian ERAS+ Conference. Recorded on the conference stage before an audience of guests and delegates, hear how the World Congress came to be where it is today. Presented by Mike Grocott, and Kate Leslie with Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), and Gerrit Slooter, MD, PhD, Surgical Oncologist, Maxima Medical Centre, The Netherlands.
Disclaimer: This video is intended solely for educational purposes and opinions shared by the guest are his personal views. We do not intent to defame or harm any person/ brand/ product/ country/ profession mentioned in the video. Our goal is to provide information to help audience make informed choices. Order 'Build, Don't Talk' (in English) here: https://amzn.eu/d/eCfijRu Order 'Build Don't Talk' (in Hindi) here: https://amzn.eu/d/4wZISO0 Follow Our Whatsapp Channel: https://whatsapp.com/channel/0029VaokF5x0bIdi3Qn9ef2J Subscribe To Our Other YouTube Channels:- https://www.youtube.com/@rajshamaniclips https://www.youtube.com/@RajShamani.Shorts
Khuspus with Omkar Jadhav | A Marathi Podcast on Uncomfortable topics
महिलांमधील breast कॅन्सर च प्रमाण का वाढतंय? कॅन्सर च early detection कसं करता येत? Menopause नंतर कॅन्सर ची risk वाढते का? obesity मुळे कॅन्सर चा धोका वाढतो का? Genetics आणि कॅन्सर चा काय संबंध? सगळ्या आजाराची लक्षणं कॅन्सर ची असतात का? कॅन्सर Prevention साठी काय करता येईल? Cancer Treatment साठी कोणत्या नवीन technology available आहेत? या सगळ्यावर आपण डॉ. रश्मी भामरे Consultant - Obstetrician & Gynaecologist, Manipal Hospital, Baner आणि डॉ.अमित पारसनीस (HOD & Surgical Oncologist, Manipal Hospital, Baner) यांच्याशी चर्चा केली आहे. How can we detect cancer early? Why is breast cancer on the rise among women, and how can it be identified? Does menopause or obesity increase cancer risk? What role do genetics play, and how can we prevent cancer? Join us as we discuss these critical questions and the latest advancements in cancer treatment with Dr. Rashmi Bhamare (Consultant Obstetrician & Gynaecologist) and Dr. Amit Parasnis (HOD & Surgical Oncologist) from Manipal Hospital, Baner. डॉ.अमित पारसनीस आणि डॉ. रश्मी भामरे यांना संपर्क साधण्यासाठी या link वर click करा! Manipal Hospital: https://www.manipalhospitals.com/baner/ https://www.manipalhospitals.com/khar... आणि मित्रांनो आपलं Merch घेण्यासाठी लगेच click करा! Amuktamuk.swiftindi.com Disclaimer: व्हिडिओमध्ये किंवा आमच्या कोणत्याही चॅनेलवर पॅनलिस्ट/अतिथी/होस्टद्वारे सांगण्यात आलेली कोणतीही माहिती केवळ general information साठी आहे. पॉडकास्ट दरम्यान किंवा त्यासंबंधात व्यक्त केलेली कोणतीही मते निर्माते/कंपनी/चॅनल किंवा त्यांच्या कोणत्याही कर्मचाऱ्यांची मते/अभिव्यक्ती/विचार दर्शवत नाहीत. अतिथींनी केलेली विधाने सद्भावनेने आणि चांगल्या हेतूने केलेली आहेत ती विश्वास ठेवण्याजोगी आहेत किंवा ती सत्य आणि वस्तुस्थितीनुसार सत्य मानण्याचे कारण आहे. चॅनलने सादर केलेला सध्याचा व्हिडिओ केवळ माहिती आणि मनोरंजनाच्या उद्देशाने आहे आणि चॅनल त्याची अचूकता आणि वैधता यासाठी कोणतीही जबाबदारी घेत नाही. अतिथींनी किंवा पॉडकास्ट दरम्यान व्यक्त केलेली कोणतीही माहिती किंवा विचार व्यक्ती/कास्ट/समुदाय/वंश/धर्म यांच्या भावना दुखावण्याचा किंवा कोणत्याही संस्था/राजकीय पक्ष/राजकारणी/नेत्याचा, जिवंत किंवा मृत यांचा अपमान करण्याचा हेतू नाही.. Guests: Dr. Amit Parasnis (HOD & Surgical Oncologist, Manipal Hospital, Baner) & Dr. Rashmi Bhamare (Consultant Obstetrician & Gynaecologist, Manipal Hospital, Baner) Host: Omkar Jadhav. Creative Producer: Shardul Kadam. Editor: Madhuwanti vaidya. Edit Assistant: Rohit landge, Sangramsingh Kadam. Content Manager: Sohan Mane. Social Media Manager: Sonali Gokhale. Legal Advisor: Savani Vaze. Business Development Executive: Sai Kher. Intern: Saiee Katkar, Mrunal Arve, Dipak Khillare. Connect with us: Twitter: / amuk_tamuk Instagram: / amuktamuk Facebook: / amuktamukpodcasts Spotify: Khuspus #AmukTamuk #MarathiPodcasts #Khuspus 00:00 - Introduction 02:55 - Types of cancer in women 04:22 - Statistics of cancer in women 06:36 - The symptoms of cancer in women 16:17 - Impact of Lifestyle for Cancer 25:28 - Rural & urban statistics of cancer in women 26:20 - Misconceptions related to women's cancer 32:38 - Obesity & Cancer 35:24 - Diagnosis & primary signs 48:25 - Age-wise diagnosis of cancer 49:55 - Genetics and cancer in women 50:30 - Treatments for cancer in women? 01:06:48 - Mental health of women during cancer Learn more about your ad choices. Visit megaphone.fm/adchoices
Khuspus with Omkar Jadhav | A Marathi Podcast on Uncomfortable topics
पुरुषांमध्ये कोणतेकोणते कॅन्सर दिसून येतात? Prostate Cancer म्हणजे काय? त्याची लक्षणं काय आहेत? Prostate कॅन्सर होण्याची कारणं काय असतात, आणि तो टाळता येतो का? Andropause आणि prostate cancer याचा काय संबंध? प्रोस्टेट ग्रंथींची वाढ वय वर्ष ५० नंतर का होते? प्रोस्टेट कॅन्सर बरा होतो का? यावर आपण डॉ.अमित पारसनीस (HOD & Surgical Oncologist, Manipal Hospital, Baner) आणि डॉ.आनंद धारस्कर (HOD, Urologist, Manipal Hospital, Baner) यांच्याशी चर्चा केली आहे. In this episode, we delve into essential aspects of men's health, focusing on prostate cancer, with two esteemed experts: Dr. Amit Parasnis (HOD & Surgical Oncologist, Manipal Hospital, Baner) & Dr. Anand Dharskar (HOD & Urologist, Manipal Hospital, Baner). We explore common cancers affecting men, the nature of prostate cancer, its symptoms, causes, and whether it can be prevented. The discussion also covers the relationship between andropause and prostate cancer, the reasons behind prostate gland enlargement after the age of 50, and the possibilities of curing prostate cancer. This insightful conversation is a must-watch to understand prostate health and take proactive steps toward well-being. Don't forget to like, share, and subscribe for more informative content! डॉ.अमित पारसनीस आणि डॉ.आनंद धारस्कर यांना संपर्क साधण्यासाठी या link वर click करा! Manipal Hospital: https://www.manipalhospitals.com/baner/ https://www.manipalhospitals.com/khar... आणि मित्रांनो आपलं Merch घेण्यासाठी लगेच click करा! Amuktamuk.swiftindi.com Disclaimer: व्हिडिओमध्ये किंवा आमच्या कोणत्याही चॅनेलवर पॅनलिस्ट/अतिथी/होस्टद्वारे सांगण्यात आलेली कोणतीही माहिती केवळ general information साठी आहे. पॉडकास्ट दरम्यान किंवा त्यासंबंधात व्यक्त केलेली कोणतीही मते निर्माते/कंपनी/चॅनल किंवा त्यांच्या कोणत्याही कर्मचाऱ्यांची मते/अभिव्यक्ती/विचार दर्शवत नाहीत. अतिथींनी केलेली विधाने सद्भावनेने आणि चांगल्या हेतूने केलेली आहेत ती विश्वास ठेवण्याजोगी आहेत किंवा ती सत्य आणि वस्तुस्थितीनुसार सत्य मानण्याचे कारण आहे. चॅनलने सादर केलेला सध्याचा व्हिडिओ केवळ माहिती आणि मनोरंजनाच्या उद्देशाने आहे आणि चॅनल त्याची अचूकता आणि वैधता यासाठी कोणतीही जबाबदारी घेत नाही. अतिथींनी किंवा पॉडकास्ट दरम्यान व्यक्त केलेली कोणतीही माहिती किंवा विचार व्यक्ती/कास्ट/समुदाय/वंश/धर्म यांच्या भावना दुखावण्याचा किंवा कोणत्याही संस्था/राजकीय पक्ष/राजकारणी/नेत्याचा, जिवंत किंवा मृत यांचा अपमान करण्याचा हेतू नाही.. Guests: Dr. Amit Parasnis (HOD & Surgical Oncologist, Manipal Hospital, Baner) & Dr. Anand Dharskar (HOD & Urologist, Manipal Hospital, Baner). Host: Omkar Jadhav. Creative Producer: Shardul Kadam. Editor: Madhuwanti vaidya. Edit Assistant: Rohit landge, Sangramsingh Kadam. Content Manager: Sohan Mane. Social Media Manager: Sonali Gokhale. Legal Advisor: Savani Vaze. Business Development Executive: Sai Kher. Intern: Saiee Katkar, Mrunal Arve. Fashion Partner For The Host: Cotton Cottage. Connect with us: Twitter: / amuk_tamuk Instagram: / amuktamuk Facebook: / amuktamukpodcasts #AmukTamuk #MarathiPodcasts Learn more about your ad choices. Visit megaphone.fm/adchoices
In 2022, Dr. Lauren Ramsey, a Texas-based breast surgical oncologist, lost a close friend and fellow surgeon to breast cancer. This tragic loss spurred her mission to protect women healthcare workers who face unique occupational risks. Recognizing that women orthopedic surgeons are nearly three times more likely to develop breast cancer than the general population, Dr. Ramsey innovated the BAT shield—a T-shirt-style radiation protection garment designed specifically for women in healthcare. Unlike traditional protective aprons, the BAT shield offers targeted protection for high-risk areas: the breasts, axilla, and thyroid. Clinical testing showed it reduced radiation exposure in the near-breast area by up to 97%, setting a new standard for healthcare safety. Partnering with Burlington Medical, a leader in radiation protective gear, Dr. Ramsey's BAT shield is now available in hospitals across Texas and through national vendors where Burlington Medical is supplied. The BAT shield's comfortable fit, mesh panels, and 15 size options ensure flexibility and cooling comfort for long hours in the operating room. Dr. Ramsey's goal is to make this garment a standard for all healthcare professionals, from doctors to nurses to radiologic technologists, who are exposed to radiation daily. Dr. Ramsey's innovation highlights her dedication to protecting healthcare workers while advancing safety standards in the medical field. Meet this brilliant surgeon and now inventor on The Debbie Nigro Show.
In this episode of the Veterinary Cancer Pioneers Podcast, host Dr. Rachel Venable welcomes Dr. Jolle Kirpensteijn, Chief Veterinary Officer at Hill's Pet Nutrition, to share his inspiring journey from aspiring fighter pilot to becoming a leader in veterinary surgical oncology. Dr. Kirpensteijn discusses the pivotal moments that shaped his career, including his transition from general veterinary practice to specializing in small animal surgery and his subsequent move into academia and industry. He highlights the importance of agility, open-mindedness, and risk-taking in oncology, as well as the evolving landscape of veterinary surgery, particularly the exciting advancements in minimally invasive and robotic surgery. Dr. Kirpensteijn also reflects on the value of continuous learning and embracing change to maintain passion in one's career. Tune in to hear his motivational insights and gain a deeper understanding of the dynamic field of veterinary oncology. Check out Dr. Kirpensteijn's Podcasts: CatCafe Podcast (For Veterinary Professionals): https://catcafepodcast.net/ PurrPodcast (For Pet Parents): https://purrpodcast.net/
Chat with the cutting-edge Surgical Oncologist at the Royal Marsden hospital in London, who is from Galway and who recently featured in the reality documentary series ‘Super Surgeons: A Chance At Life' on Channel 4
This week, we incorporate medical oncology back into our discussion with our Radiation Oncologist, Dr. Sanford, and our Surgical Oncologist, Dr. Bailey. We discuss how we approach the management of localized rectal cancer. Note that we will be heavily building off our discussions with our specialist. We recommend listening to these episodes if you have not done so already.Content: - What information do we need upfront for patients with newly diagnosed rectal cancer?- How did we get to the current treatment paradigm?- What is the data for long course vs. short course radiation?- What is total neoadjuvant therapy?- What are high risk features in rectal cancer?- Is surgery always needed?- Is radiation therapy always needed? ** 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
Dr. Sanjay Reddy, surgical oncologist and the Co-Director at the Marvin & Concetta Greenberg Pancreatic Cancer Institute, joins "Forbes Newsroom" to discuss pancreatic cancer following Rep. Sheila Jackson Lee's (D-TX) announcement that she has been diagnosed with the disease.See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.
Join the Behind the Knife Surgical Oncology Team as we discuss the presentation, work-up, and management of gastric cancer. Hosts: - Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center - Connor Chick, MD (@connor_chick) is a Surgical Oncology fellow at Ohio State University. - Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-6 General Surgery resident at Brooke Army Medical Center - Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-5 General Surgery resident at Brooke Army Medical Center Learning Objectives: In this episode, we review the basics of gastric cancer, including presentation, work-up, staging, and treatment modalities as well as high yield topics including the Siewert classification system. We also briefly discuss trials establishing peri-operative chemotherapy regimens for gastric cancer and the controversy of D1 vs. D2 lymphadenectomy. Links to Papers Referenced in this Episode Perioperative Chemotherapy versus Surgery Alone for Resectable Gastroesophageal Cancer. NEJM 2006 Jul;355(1):11-20. https://www.nejm.org/doi/full/10.1056/NEJMoa055531 Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesphageal junction adenocarcinoma (FLOT4): a randomized, phase2/3 trial Lancet 2019 May;393(10184):1948-1957. https://pubmed.ncbi.nlm.nih.gov/30982686/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here: https://app.behindtheknife.org/listen
Join Dr. Sonia T. Orcutt, Surgical Oncologist , to discuss Melanoma Awareness Month.
As part of our community health partnership with Valley Health, this month we talked with Dr. Maureen Hill, a board certified Surgical Oncologist and General Surgeon with Valley Health Surgical Oncology at Winchester Medical Center. May is Skin Cancer Awareness Month. We discuss the importance of skin cancer awareness, prevention, early detection, and treatment options including insights on the types of skin cancers, risk factors, misconceptions, and the significance of regular skin checks. Dr. Hill highlights the differences in skin cancer types, diagnostic procedures like biopsies, and treatment approaches. She emphasizes the importance of sun protection, regular skin examinations, and seeking medical advice for suspicious skin changes. Additionally, we touch on the role of genetics, sunscreen usage, and the impact of lifestyle choices on skin health.
This piece was originally the John Snow Plenary Lecture given at the World Congress of Prehabilitation in London. It is introduced by Franco Carli, Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University; our speaker is Gerrit Slooter, MD, PhD, Surgical Oncologist, Maxima Medical Centre, The Netherlands. If you would like to learn more about the conferences available this year checkout www.ebpom.org
This is the second part of a question and answer session which was originally presented at The World Congress of Prehabilitation. Featuring Mike Grocott, TopMedTalk's co-editor in Chief and the Professor of Anaesthesia and Critical Care Medicine at the University of Southampton as well as an NIHR Senior Investigator, Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), Franco Carli, Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, Gerrit Slooter, Surgical Oncologist, Maxima Medical Centre, The Netherlands and Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia. If you'd like to hear part one please go here: https://topmedtalk.libsyn.com/prehabilitation-where-are-we-now-part-1-the-world-congress-of-prehabilitation If you'd like to hear the excellent talk which prompted this discussion please go here: https://topmedtalk.libsyn.com/what-is-prehabilitation-the-world-congress-of-prehabilitation TopMedTalk is the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM), if you'd like to attend one of our forthcoming conferences go now to http://www.ebpom.org
This question and answer session was originally presented at The World Congress of Prehabilitation. It features Mike Grocott, TopMedTalk's co-editor in Chief and the Professor of Anaesthesia and Critical Care Medicine at the University of Southampton as well as an NIHR Senior Investigator, Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), Franco Carli, Professor of Anesthesia at McGill University and Associate Professor in the School of Dietetics and Human Nutrition at McGill University, Gerrit Slooter, Surgical Oncologist, Maxima Medical Centre, The Netherlands and Linda Denehy, Head of the Melbourne School of Health Sciences and Professor of Physiotherapy at The University of Melbourne, Australia. Although this piece works as a standalone listen, if you'd like to hear the excellent talk which prompted it please go here: https://topmedtalk.libsyn.com/what-is-prehabilitation-the-world-congress-of-prehabilitation Part two of this piece will follow soon, make sure you are subscribed to TopMedTalk to ensure you don't miss out. TopMedTalk is the broadcasting arm of Evidence Based Perioperative Medicine (EBPOM), if you'd like to attend one of our forthcoming conferences go now to http://www.ebpom.org
Join the Behind the Knife Surgical Oncology Team as we discuss “One versus Three Years of Adjuvant Imatinib for Operable Gastrointestinal Stromal Tumor: A Randomized Trial,” the randomized trial guiding duration of imatinib treatment for gastrointestinal stromal tumors (GIST). Hosts: - Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center. - Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist and current HPB fellow at MD Anderson. - Connor Chick, MD (@connor_chick) is a Surgical Oncology fellow at Ohio State University. - Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-6 General Surgery resident at Brooke Army Medical Center. - Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-5 General Surgery resident at Brooke Army Medical Center. Learning Objectives: In this episode, we discuss the article “One versus Three Years of Adjuvant Imatinib for Operable Gastrointestinal Stromal Tumor: A Randomized Trial” published in JAMA in 2012. This study demonstrated that 3 years of imatinib led to improved recurrence-free and overall survival compared to 1 year. Links to Paper Referenced in this Episode https://jamanetwork.com/journals/jama/fullarticle/1105116 ***Fellowship Application - https://forms.gle/5fbYJ1JXv3ijpgCq9*** Please visit https://app.behindtheknife.org/home to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our recent episodes here https://app.behindtheknife.org/listen
In this episode of the Veterinary Cancer Pioneers Podcast, host Dr. Rachel Venable talks with Dr. Sarah Boston, a veterinary surgical oncologist, best-selling author, and comedian. Dr. Boston shares her journey through veterinary medicine, her battle with cancer, and how it inspired her book and her leap into comedy. She discusses the importance of advocacy in patient care and brings humor into the conversation about dealing with difficult situations. Dr. Boston's multifaceted career offers a unique perspective on resilience and the healing power of laughter. Don't miss her insights and stories, which are sure to inspire and entertain. Dr. Sarah Boston's Website: https://www.drsarahboston.com Dr. Sarah Boston's Instagram: https://www.instagram.com/drsarahboston/ Comedicine Podcast: https://pod.link/1706569339 Transcripts are available at https://www.imprimedicine.com/podcast. To learn more about ImpriMed Personalized Prediction Profile, please visit https://www.imprimedicine.com/personalized-prediction-profile. Music Credit: Hazy by Beat Mekanik
Dr. Shannon Westin and her guests, Dr. Jeremy Davis and patient advocate Kathryn Carr, discuss the paper "Costs of Cancer Prevention: Physical and Psychosocial Sequelae of Risk-Reducing Total Gastrectomy" recently published and printed in the JCO. TRANSCRIPT Shannon Westin: Hello, everyone, and welcome to another episode of JCO After Hours, the podcast where we get in depth on manuscripts that are published in the Journal of Clinical Oncology. I am your host, Shannon Westin, a professor of GYN Oncology at MD Anderson, and the JCO social media editor. I am so thrilled to have wonderful authors here today who do not have any conflicts of interest. We are going to be discussing the “Costs of Cancer Prevention: Physical and Psychosocial Sequelae of Risk-Reducing Total Gastrectomy.” This was published in the Journal of Clinical Oncology online on October 30, 2023, and in print on February 1st, 2024. And I am excited. I am accompanied by the lead author, Dr. Jeremy Davis, who is an Associate Professor and Surgical Oncologist at the NIH, National Cancer Institute Intramural Research Program. Welcome, Dr. Davis. Dr. Jeremy Davis: Thank you. Shannon Westin: If it is okay with you, I'll call you Jeremy. Dr. Jeremy Davis: Yes, please. Shannon Westin: Fabulous. We also have patient advocate Kathryn Carr, who is a board member for No Stomach for Cancer. Welcome, Kathryn. Kathryn Carr: Thank you so much. Shannon Westin: So let's get right into it. I think this is really thought-provoking work. First, I'd love to level set. So this was work around hereditary diffuse gastric cancer syndrome. Can we get a little bit of information about what causes this and how common it is? Dr. Jeremy Davis: So, hereditary diffuse gastric cancer syndrome, also referred to as the diffuse gastric cancer and lobular breast cancer syndrome, is basically early-onset diffuse gastric cancer and in women, lobular type breast cancer attributed to germline mutations in the CDH1 gene. If we look at all cases of gastric cancer in the United States, only about 1-3% may be considered hereditary in nature. But when we do study hereditary causes of cancer, it is by far the most common one that we are aware of. Shannon Westin: What is the likelihood that someone who is a carrier of a germline CDH1 variant will develop gastric cancer? Dr. Jeremy Davis: That's a good question. Early on, when the syndrome was first described, the estimates of cancer risk were quite high, probably upwards of 70-80%. The good news is that more current estimates published in the last few years suggest that that risk in a lifetime is probably in the 25-40% range. It's interesting, we do have our own data that are under review right now, where in some families where there's no history of stomach cancer, that risk of stomach cancer in a lifetime getting a CDH1 mutation might be as low as 10%. So I think the takeaway is that there's clearly a spectrum and that spectrum of risk is probably based on factors that we don't quite yet understand. Shannon Westin: What are the options for management of this hereditary syndrome, really focusing on the gastric cancer syndrome portion today? How good does it do to reduce the risk? Dr. Jeremy Davis: The options are really two. One is probably the prevailing recommendation that most people would be aware of, is to prophylactically remove the stomach, and we choose to use the term most often ‘risk-reducing gastrectomy', but to remove the entire stomach and really eliminate the risk of cancer from ever developing. The other option is enhanced surveillance, and people might think of this as akin to other high risk cancer syndromes. But for this we would do yearly or annual endoscopic surveillance. Many people think that that may not be the best option, but it is certainly an option. We discussed some of that in the paper about what are the risks and benefits of gastrectomy, and then what may be the benefit of enhanced surveillance for some people. Shannon Westin: Well, I would love to hear Kathryn. I think this is a perfect opportunity to hear a little bit about your journey with carrying this variant, as much as you are willing to share with our listeners. Kathryn Carr: Yeah, absolutely. So I found out that I have this spicy little gene back in 2019. My whole family got tested so the gene comes down from my paternal great grandmother. There are five of us who actually all had our stomachs removed by Dr. Davis. Within a year, he had five Carr stomachs. For me when I found out, I was extremely overwhelmed. I mean, “You want to take my stomach out? Like, what do you mean?” But after talking to Dr. Davis and his entire care team, I knew for me, having the total gastrectomy was the only option simply because I know my personality type enough that I was not going to be able to move forward with life unless I got rid of this overwhelming worry. Shannon Westin: Yeah, I think that makes sense. I'm a GYN oncologist by trade, so I often reference all things surgery around that. We have the same thing when we talk about risk-reducing surgeries for endometrial and ovarian cancers. This seems more like what we do in Lynch syndrome, where patients are at risk for endometrial cancer. Removal of the uterus is almost definitive in its ability to reduce that risk, but it's obviously a very large surgery. Jeremy, can you review the gastrectomy in general? What are the most common short-term and long-term adverse events? What did you have to discuss with Kathryn and her five family members around what they could expect from this surgery? Dr. Jeremy Davis: Yeah, I think this is a great question because it's the thing at the top of most patients' minds. When I sit down to talk to somebody about gastrectomy, usually a lot of the conversation initially centers around ‘how long does the operation take, how long am I at the hospital, and what are the most likely risks of the operation?' The good news is that as operations go, it can be done in two to three hours, and most people are in the hospital for maybe five to seven days. The risks of this operation, however, at least during the operation or immediately afterward have to do with how we have to reconnect everything and reconnecting the intestine to the esophagus so that people can continue to eat. Because I think a lot of people wonder, "Well, how am I going to eat?” The stomach's gone, but we recreate intestinal continuity. We put things back together in a way that people can eat and absorb their food. But that connection we make between the esophagus and intestine is almost like the Achilles heel of this operation. It's the one thing that keeps surgeons up at night, and it's probably the one thing that causes the most trouble in terms of immediate risks, like leaking. If that connection leaks, it can lead to infection. There are other aspects of the operation that relate to any kind of intestinal surgery, such as leakage, blockage, or narrowing or something like that. So these are the things you need to worry about in the short term. But you mentioned the long-term consequences, and that was really one of the reasons why we wrote the paper. If you look in the literature, the focus is on the acute problems, things that happen within 30, 60, or 90 days of the operation. Which, yes, those are very, very important. But since we're talking about an operation that's supposed to prevent cancer and therefore allow the patient to live a long and happy life, I think it's important for us to think about what happens well beyond the time that the patient essentially heals from the operation. Shannon Westin: It's so critical. And I think before we go into the work that you did and what you all found, Kathryn, I would love to get your perspective. Having gone through the procedure, what was your experience? Give us as little or as much detail as you want, whatever you're comfortable with. But also, what did you wish you had known? What surprises kind of came up during the course? Kathryn Carr: I'm going to quote Rachel, who works with Dr. Davis at the NIH. She's the clinical dietitian. And my question to her was, "Seeing all the patients you've seen and knowing all that you know, what would be the advice that you would give me?" She told me to have the patience to get through the first year. I think that really set my expectation of, "Okay, this is not just a surgery where in a week or two weeks I'm going to be up skipping along." It is a marathon. I really worked hard with Dr. Davis in the hospital. I'm allergic to everything. I was convinced that my spleen was erupting. I think I scared many fellows, and they were like, "That's actually not where your spleen is. It's fine. You're okay. Stop getting on WebMD." But once I got home, those first eight weeks, they're hard. There were several moments where I would just sit and stare off into space and think, "Oh my gosh, what have I done?" But for me when Dr. Davis called to tell me the pathology report and that they did find some signet cells, I was 100% sure that I made the right decision. I would have been worried every second of every day that my body was going to turn on me. So once I kind of had that relief, it was like, "Okay, my body can do this. We're built to do hard things." Then it was just getting through the first six months, learning what I could eat, what I couldn't eat, working with Rachel on different strategies of, “Okay, I'm going to maximize my protein in the morning and then maybe get a little more adventurous as the day goes on.” But what I wish I had known before surgery, because I'm a planner, I want everything scheduled and figured out. I was in the hospital, I had a different outfit for every day, and I just wanted it to go perfectly. I think taking away the expectations of what your journey is going to look like would be the best advice I could go back and give myself. Because I am very competitive, and my dad and I were separated by seven months of this surgery. He can do things that I still can't do, and that's okay. Everyone's healing journey is going to look very different because everybody is going to respond incredibly different. It's like the body is doing roll call and the stomach is nowhere to be found, and everybody is going to respond totally differently to that. Shannon Westin: That's so insightful. I really appreciate that. I guess now it's a good time to turn to the work that you did, Jeremy, and you kind of already hinted at what your objectives were, but can you maybe walk through your primary objectives in the way you designed the study. Dr. Jeremy Davis: You know, I think as somebody who trained to take care of people with cancer and do big operations to cure people, this was a little bit of a different experience in the beginning for me. Because here I was taking ostensibly normal people - Kathryn may argue with that statement - but normal people, and I was going to take them to the operating room and do something to them to prevent a problem. And this is not a minor thing, it's a big deal. What I learned pretty quickly was how much I was disrupting people's lives. And what I mean by that is that a patient comes to clinic three or six months after surgery. We all document the typical things. They are healing well, they are recovering as expected, their incisions are healed and all this stuff. But it was the stuff that didn't always go down in the medical record. The comments that the patients made to my team, the nurses, the dietitian, about how their lives were being disrupted. And this started to change my viewpoint on, “Oh my goodness, we're paying attention to important things, but we're really not paying attention to what's happening.” So, the idea behind the study was really to explore those consequences that don't get talked about a lot. That was the nature of the idea behind the study. It was easy enough for us to conduct the study because my research at the NIH is about gastric cancer, but more specifically, this hereditary form of gastric cancer. We have a natural history study that allows us to follow people for a long time, not just within three or six months of surgery, and then we're done. So that longitudinal aspect of the study is really what allowed us to accomplish that. Shannon Westin: What I thought was really interesting here is how many different types of questionnaires you were able to utilize to really assess beyond kind of the straightforward quality of life Yes/No. Can you speak a little bit about some of the questionnaires you chose and why? Dr. Jeremy Davis: My concern going into this was that I had read a lot of the literature related to quality of life after gastrectomy for gastric cancer. There are certainly these validated questionnaires out there. And my sense was, having read those questions and papers, that those validated typical questionnaires- I'm referring to the FACT-G or the FACT-Ga might not capture the things that we wanted to capture. So, I spoke to our palliative care service here at the NIH clinical center, which is the hospital here on campus in Bethesda. They had developed a questionnaire many years ago that they called the NIH HEALS or Healing Experience of All Life Stressors. They designed that to identify stress causing changes associated with chronic illness. You might argue that having a germline mutation that puts you at risk for cancer is kind of a chronic condition. So, we thought we would use that. And then the last part was we just sat around the table and we thought, “Well, jeez, what are all these things that people are telling us that would never be captured in almost any questionnaire?” And that's when we designed a series of questions that we thought were relevant to our patient population because we wanted to capture all the things that people had told us. Those were things like, “I had to change my job because I couldn't do the same work anymore, right?” Or, “My partner, our relationship changed substantially, and we grew apart, and we ultimately got divorced.” How do you capture that? So that's how we designed it. We basically looked at all the patients that we had done the prophylactic gastrectomy on and applied all of those validated and unvalidated questionnaires. Shannon Westin: That's so great. And I bet, Kathryn, you participated quite a bit in that, in addition to other people in the study. Kathryn Carr: I did, and I'm so grateful that Dr. Davis is doing this study because it is so important to look at what life is like without a stomach. You have this immediate thought of, “Okay, I just want to save my life. I want to make my life longer. But how is it going to change my life? How is it going to alter my day-to-day?” Because even Dr. Davis has said it would be weird if it didn't change your life. I mean, you're taking away a very important piece of the puzzle. So, I think this study is going to help people make more accurate decisions. I don't doubt my decision to have my gastrectomy at all, but this is beautiful information just so that you can be more well-prepared to walk into the surgery of, “Okay, now I have a very clear understanding of what my life could look like.” I've been very fortunate that I have not had a lot of the physical problems. I don't deal with a lot of bile reflux. My weight has stabilized, so I am very blessed in that way. But emotionally, this has been a really tough surgery. You start to feel misunderstood, like you have to walk into every day being very prepared of, “Okay, every two hours I have to eat something or else I get real hangry, not just a little hungry, real hangry. Also, my body will start to shake.” That's how I get my hunger signal. My whole body will start shaking, which is very scary. It's very unpleasant. I'm almost four years post-op, and so I lean into my schedule and routine. One piece of advice for anyone walking into this surgery is to make sure you're anchored in something. For me, my faith anchors me, but if you're not anchored in something that is secure and true, like, you are going to float away, because this is a storm. Shannon Westin: Jeremy, do you want to just pass on a few of the key findings? I encourage everyone to read the paper. There are so many different things that were explored and identified as part of this study. It's amazing with the number of patients that were involved, what the depth of the findings was. But perhaps you can kind of hit some of the major high points. Dr. Jeremy Davis: Yeah, I think the key takeaways for me, and obviously I'm still learning from all of this, is that I think we talk a lot about the surgery, in this case especially, but we don't talk enough about what life is like afterwards. I've started to talk to people about how much you think your stomach plays a role in your life, and you think about how much of our life centers around eating and drinking and holidays and family gatherings. And you have to imagine that means those activities are potentially disrupted. So for me, the key takeaways from this are, number one, we have to be aware. We have to be aware that risk reducing surgery of almost any kind has consequences. Yes, we want it to have a positive impact on the patient, but we have got to be aware of the negative impact. This is like systemic chemotherapy. It can do a lot of good, but toxicities are real. In terms of the specific findings from this study, listen, 94% of people in the study, 126 of people, 94% had some long term consequence. And it wasn't just like some long term, “Oh, I don't like my scar.” No, it was 94% of people had a long term problem, such as “I have daily bile reflux that interferes with my activities of daily living.” Something like that. And I think the range of consequences is really important, too. And so, again, they range from things like GI symptoms, which you would imagine would be quite typical for a gastrectomy, but mental health, right? People talking about worsening symptoms of anxiety or depression, some substance abuse. Whether it was alcohol or otherwise, disruptions in relationships, I mentioned earlier, and even occupation change. I can't physically do the job that I used to do. So I think as clinicians, as surgeons that walk into this, yes, we need to focus on the surgery and the immediate consequences, but we also need to think, “How am I going to change this person's life? Not just for the better, but how might I really impair their life in the long term?” Kathryn Carr: Well, in one, just very simple example. So like going out to eat with people. There's a natural cadence of conversation. I take a bite, you talk and vice versa. But when you're chewing your food to the nth degree it interrupts that natural cadence. I avoid dinner dates because then I have to talk about my stomach on a first date or going out to dinner with friends. It's nice if there's a group of us because then other people can carry the cadence but then you kind of feel left out of the conversation because you're like, “Oh, well. I've got to eat, otherwise I'm going to pass out.” So that's just like a very simple, you wouldn't think of, “Okay, I'm going to dinner at 7:30 so I should probably eat a snack before I go because I might not get my food until 8:00 or 8:30.” So it's just like you're constantly thinking about, “Okay, I've got to make sure that I have food in my body. Shannon Westin: It's so critical. Well, this has been an awesome discussion and I'm sad that it's coming to a close. I guess just final thoughts around what's next in this space. Like what are you working on now, Jeremy? Dr. Jeremy Davis: I'm a cancer surgeon and a cancer researcher so my goal is to find a way for us to prevent stomach cancer that doesn't require me having to take out somebody's stomach. So in the laboratory that's what we're doing, right? We're working on finding a way to prevent stomach cancer so that I don't have to do this operation anymore. But on the clinical side of things, the next thing that we're exploring is how do patients think about, talk about, or express concerns to their physicians about reproduction - reproduction in the setting of a cancer predisposition syndrome. And I think that's going to be really important work. Shannon Westin: That's great. Kathryn, any thoughts? Kathryn Carr: I know that being four years out, I'm not like an old timer, but I do just want to help anyone who's at the beginning stages of this journey and just making other patients feel less alone. I told Dr. Davis I just entered the world of TikTok to talk about gastrectomy and just opening up a conversation of what does life without a stomach look like? And just making people feel less alone and more understood throughout this process. Shannon Westin: Thank you both for the work you're doing, and thank you to all of our listeners for tuning in to JCO After Hours. Again, we were discussing the “Costs of Cancer Prevention: Physical and Psychosocial Sequelae of Risk-Reducing Total Gastrectomy.” Please do not be a stranger to our podcast. Check out our other offerings and reach out to us on X and Instagram if you have other topics you want us to cover. Have an awesome day. The purpose of this podcast is to educate and inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.
Surgical Oncologist and Cancer Researcher Dr Emma Davies found herself thrust into the unenviable position of carer for her partner who had been diagnosed with an aggressive stage IV cancer. While always having more than a passing interest in a wider view of healthcare, this development pushed her to take a deep dive into the wealth of resources within Integrative Medicine available to help her wife in these extremely difficult circumstances. What she found has made a world of difference to them both: "This has all of the evidence behind it, it's all positive things, it has no detrimental effects to her health, improved her quality of life… all people need to know about this."
In this edition of Cancer Registry World, Elliot Asare, MD, FACS, discusses the role of cancer registry data in developing staging strategies for the 9th Version of the AJCC TNM system. Dr. Asare is a surgical oncologist and Assistant Professor at the University of Utah School of Medicine and Attending Surgeon at the Huntsman Cancer Center in Salt Lake City, Utah. In addition, Dr. Asare is the Chair of the AJCC Editorial Committee. Please enjoy listening and learning!
Andrea Merrill, MD is an Assistant Professor of Surgery at the Chobanian and Avedisian School of Medicine and a Surgical Oncologist at Boston Medical Center. She is board-certified by the American Board of Surgery in General Surgery. She has particular interests and advanced training in the care of patients with breast cancer and endocrine diseases and cancer. Dr Merrill earned her undergraduate and medical degrees at Tufts University. She completed residency training in general surgery at Massachusetts General Hospital. While there, she performed research on breast cancer outcomes and completed an editorial fellowship at the New England Journal of Medicine. She then completed an advanced clinical fellowship in Complex Surgical Oncology at The Ohio State University. Dr Merrill has published research in numerous journals and presented her findings at nationally recognized conferences. Her research interests include breast cancer, gender bias in medicine, and surgical ergonomics. She is the faculty advisor for the BU association of women surgeons medical student chapter and enjoys mentoring and advising aspiring women surgeons. Dr Merrill also enjoys narrative writing and has published several narrative essays in JAMA, Annals of Surgery, and Annals of Internal Medicine. She believes we need to appreciate our creative sides outside of the OR and started a website called Scrubbed Out which highlights surgeons and their creative hobbies and passions. Outside of the OR, Dr Merrill enjoys food, wine, travel, reading, and photography. IG handles are @anjlm (personal) and @scrubbedoutsurgeon Website is www.scrubbedoutsurgeon.com The study mentioned by Katrina: Wallis, C. J., Ravi, B., Coburn, N., Nam, R. K., Detsky, A. S., & Satkunasivam, R. (2017). Comparison of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort study. Bmj, 359. Floss and Flip-Flops with the Sanders sisters features hosts dental hygienist and speaker Katrina M. Sanders, RDH, and podiatrist Dr Elizabeth Sanders, DPM. Together, the sisters discuss the oral-systemic link and its impact—from your teeth down to your toes. The podcast is produced monthly by Dental Products Report® and Modern Hygienist®, in partnership with The Sanders sisters. For additional content for dental professionals visit DPR and MH at dentalproductsreport.com. Katrina Sanders, RDH, can be reached at: Website: katrinasanders.com Facebook Instagram LinkedIn
Surgical Oncologist, Dr. Sarah Boston, talks about starting a veterinarian's comedy festival, how the American health care system might be better for animals than people, and how being a vet helps her in her stand up comedy. — Want to Learn About Dr. Sarah Boston? Podcast: https://pod.link/1706569339 Book: https://houseofanansi.com/products/lucky-dog Instagram: drsarahboston — To Get Tickets to Wife & Death: You can visit Glaucomflecken.com/live We want to hear YOUR stories (and medical puns)! Shoot us an email and say hi! knockknockhi@human-content.com Can't get enough of us? Shucks. You can support the show on Patreon for early episode access, exclusive bonus shows, livestream hangouts, and much more! – www.patreon.com/glaucomflecken -- We have a special offer for our audience here in the U.S. Learn more at http://www.ekohealth.com/KKH and use code [KNOCK50] for a 75-Day Risk Free Trial + Free Case + Free Shipping to the continental US (to get your CORE 500 Stethoscope). A friendly reminder from the G's and Tarsus: If you want to learn more about Demodex Blepharitis, making an appointment with your eye doctor for an eyelid exam can help you know for sure. Visit EyelidCheck.com for more information. Today's episode is brought to you by the Nuance Dragon Ambient Experience (DAX). It's like having a virtual Jonathan in your pocket. If you would like to learn more about DAX, check out http://nuance.com/discoverDAX and ask your provider for the DAX experience. Produced by Human Content Learn more about your ad choices. Visit megaphone.fm/adchoices
Dr. Sharon Lum, Surgical Oncologist and Chair of the Department of Surgery at Loma Linda University Health, discusses breast cancer awareness, prevention, and care.
With Jaye Sciullo, Michigan Executive Director of Susan G. Komen & Dr. Shoshana Hallowell, Surgical Oncologist at Ascension Health The month of October is “Breast Cancer Awareness Month.” Throughout the month, we see the color pink everywhere to remind us of the critical need for early cancer detection and immediate access to the very best care. The entire month is symbolized by events and crowds dressed in pink, taking to the streets, chanting, and hoisting colorful signs. Pink merchandise of all types is available for purchase and there are even special pink pizza delivery boxes. For years, NFL players even wore pink on the playing field to help raise money and awareness for breast cancer research. Although there's an upbeat, fun quality to this carnival atmosphere, the sobering cause behind it remains the same. This year, more than 44,000 women in the U.S. alone could die from this disease. The two most common risk factors for developing breast cancer are being born female and getting older. Having a family history of breast cancer could increase that risk. But the news is not all bad. Early detection is one of the biggest weapons that we have in fighting the disease and proper screening can literally save lives. In addition, prioritizing good habits such as maintaining a healthy weight, proper nutrition, limiting alcohol consumption and regular exercise may lower your risk of breast cancer. Finally, it's important to remember that even if you or a loved one has been diagnosed with breast cancer, there are promising new treatments on the horizon that have proven effective in blocking a cancer cell's ability to proceed through the growth cycle, thereby preventing the cancer from spreading. Last year, Florine interviewed Jaye Sciullo, the Executive Director for the Michigan chapter of Susan G. Komen, and Dr. Shoshana Hallowell, a surgical oncologist with Ascension Health. Please listen to Florine's interview and learn how you can join the fight against breast cancer. What You'll Hear in This Episode: When did Jaye become involved with Susan G. Komen? The two major types of breast cancer. Why is breast cancer harder to treat than other cancers? Is it common to have the cancer go into the lymph nodes? What can we do to lessen our risk of cancer? Why is it important to get early screening and mammograms? 70% of breast cancers diagnosed in women under the age of 50 have been found by the women themselves. What is the BRCA gene, and how do you get tested? Susan G. Komen's 360-degree approach to conquer breast cancer and provide support. What role can a co-survivor play in help and healing? How can you help a loved one who may have recently been diagnosed with breast cancer? Some of the newer modalities to treat breast cancer and some promising news on the horizon. How a healthy lifestyle can help decrease your risk of developing cancer. What is a “smart bomb”? Today's Takeaway: A cancer diagnosis is life-changing and we're often filled with fear and uncertainty as to what may lie ahead. But the mission of the Susan G. Komen organization is dedicated to making sure that no breast cancer patient has to go it alone. Since Susan G. Komen was founded in 1986, we have seen a 40% reduction in breast cancer mortality. The Komen organization is committed to being alongside the patient throughout the entirety of their cancer journey. In addition to providing financial support when needed, there are virtual nurse navigators who will assist patients in preparing for doctors' appointments and provide a list of necessary questions to ask. Afterward, they can also help explain the mass of information that patients receive. Based on the statistics shared today, we all probably know someone battling breast cancer. We are hopeful that soon we can find a cure so that future generations can look forward to a life without this deadly disease. Remember that every single day is a gift and even when life throws us a curveball, we have the gift of freedom of choice. We get to choose our response and how we handle adversity is up to each and every one of us. We can choose to fight our battle with grace, dignity, and courage, knowing that we will find the support we need every step of the way. I'm Florine Mark, and that's “Today's Takeaway.” Quotes: “I think that it is difficult these days to not be touched by breast cancer in some way.” — Jaye [4:55] “I can be an advocate and I can be knowledgeable about the patient experience. But it isn't the same as experiencing it myself. And I try to be careful about not speaking for the breast cancer community in that capacity.” — Jaye [5:05] “Breast cancer is harder to treat because it's very complex. It's one of the few cancers that not only does tumor size and location matter but also how the tumor responds to hormones and different proteins.” — Dr. Shoshana Hallowell [6:26] “There are many things that you can do to lessen your risk of developing cancer. I think the most important thing is to be aware of your own health.” — Dr. Shoshana Hallowell [7:12] “Susan G. Komen is committed to a world without breast cancer. And our mission is to save lives by meeting the most critical needs of our communities and investing in breakthrough research to prevent and cure breast cancer.” — Jaye [11:54] “Ask the patient what they need. Not everyone needs a freezer full of casseroles or is ready to answer questions about what is inherently a very, very private diagnosis.” — Jaye [13:45] Brought to You By: Gardner White Furniture Mentioned in This Episode: Susan G. Komen Ascension Health Shoshana Hallowell, MD Stand For H.E.R Race for the Cure
Caprice Greenberg, MD, MPH is the Chair of the Department of Surgery at the University of North Carolina at Chapel Hill and a Surgical Oncologist. She is the President and Co-founder of the Academy for Surgical Coaching (https://surgicalcoaching.org/) and is responsible for most of the academic literature regarding surgical coaching and outcomes directly or inspirationally. We talk through the basics of surgical coaching from the operating room to the clinic, executive coaching through professional development for junior surgeons. We talk about the practicalities of coaching: who should be coaching, who should be coaching, and what are the good qualities for both. And we discuss all the ways coaching can be delivered – through personal coaches, intraoperative video assessments, and organizations like the Academy for Surgical Coaching. Enjoy!The Academy for Surgical Coaching: https://surgicalcoaching.org/Dr. Greenberg's Publications on Coaching (Pubmed Search): https://pubmed.ncbi.nlm.nih.gov/?term=Greenberg+CC+AND+coaching
Join the Behind the Knife Surgical Oncology Team as we discuss the presentation, work-up, and management of gastrointestinal stromal tumors (GISTs)! Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@usarmydoc24) is Surgical Oncologist and current HPB fellow at MD Anderson Connor Chick, MD (@connor_chick) is a Surgical Oncology fellow at Ohio State University. Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-6 General Surgery resident at Brooke Army Medical Center Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-5 General Surgery resident at Brooke Army Medical Center Learning Objectives: In this episode, we review the basics of gastrointestinal stromal tumors (GISTs), how to evaluate patients with presenting mass consistent with GIST, initial work-up, staging, and management. We discuss key concepts including the genetic background of these tumors and high-yield targeted therapies that are relevant both in direct patient care and board exams. Reference: Gold JS, Gönen M, Gutiérrez A, Broto JM, García-del-Muro X, Smyrk TC, Maki RG, Singer S, Brennan MF, Antonescu CR, Donohue JH, DeMatteo RP. Development and validation of a prognostic nomogram for recurrence-free survival after complete surgical resection of localised primary gastrointestinal stromal tumour: a retrospective analysis. Lancet Oncol. 2009 Nov;10(11):1045-52. doi: 10.1016/S1470-2045(09)70242-6. Epub 2009 Sep 28. PMID: 19793678; PMCID: PMC3175638. Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out our surgical oncology oral board exam review here: https://behindtheknife.org/premium/
On this episode of Seven Questions for a Specialist, we speak with Erin Ward, MD, who specializes in surgical oncology at University of Utah Health. What does a surgical oncologist do? Why did she choose the work she's gone into? What's thing can someone do each day that really keeps the doctor away?
Dr. Elisa Port, Surgical Oncologist at Mount Sinai joins the podcast to discuss her background, biggest issues she's following in healthcare in 2023, current nerves and excitements, and more!
Dr. Elisa Port, Surgical Oncologist at Mount Sinai joins the podcast to discuss her background, biggest issues she's following in healthcare in 2023, current nerves and excitements, and more!
During this episode of SurgOnc Today®, Austin D. Williams, MD, Fox Chase Cancer Center, Zachary J. Brown, DO, New York University - Long Island School of Medicine, and Allison Martin, MD, University of Texas MD Anderson Cancer Center, discuss the various career options within surgical oncology, including breast, hepatobiliary and colorectal. The discussion covers information specific to each of these surgical oncology subspecialties and provides information important for any trainee who is contemplating a career as a surgical oncologist.
In this Healthed lecture, , Surgical Oncologist & General Surgeon, A/Prof Robyn Saw will desribe how to identify a high risk patient, key steps in doing an effective skin check, the ideal biopsy, the implications that sentinel lymph node biopsies have for therapy and when to refer your patients.See omnystudio.com/listener for privacy information.
In this podcast episode, Nina Morena, MA, PhD Candidate at McGill University, and Ari Meguerditchian, MD, Surgical Oncologist at McGill University Health Center, sit down to talk about Ms. Morena's thesis topic and research, How reliable are post-mastectomy breast reconstruction videos on YouTube?, which she presented at the American Society of Clinical Oncology (ASCO) Annual Meeting. Her presentation encompasses the effects of social media platforms, specifically YouTube, on breast cancer patients.
Over the past 30 years, chronic wound care has developed a lot. Interestingly, very little has changed in the incision care wound landscape. In general, most incisions are treated with the same protocols and dressings as they were 25 or even 50 years ago. Guests: Sara Carvalhal, Surgical Oncologist and Member of the Multidisciplinary Wound Care Team, Portuguese Institute of Oncology, Lisbon Magnus Enerbäck, Global Marketing Manager, Mölnlycke Health Care Host: Andrea Culshaw, Global Director Professional Education, Mölnlycke Health Care The views, information, and/or opinions expressed in this podcast are solely those of the individuals involved and do not necessarily represent those of Mölnlycke Health Care (“Mölnlycke”). Mölnlycke is not responsible and does not verify the accuracy of any of the information contained in this podcast. The information presented is solely for informational and educational purposes. The presentation may contain information on Mölnlycke's products, educational content and/or demonstrate certain techniques used by the guest speaker. However, Mölnlycke does not provide any medical advice and this podcast shall thus not be perceived as a medical advice. Promotion of Mölnlycke's products is to be on-label and consistent with approved indications and intended uses. For detailed device information, including indications for use, contraindications, effects, precautions and warnings, please consult the product's Instructions for Use (IFU) prior to use. This presentation and the information presented may not be appropriate for all jurisdictions. The guest(s) are paid consultants of Mölnlycke.
In episode 90 of the Outdoor Minimalist podcast, we get a look into the healing power of nature from Dr. Kelly McLean, a Surgical Oncologist specializing in treating Breast and Melanoma Cancer at the Christ Hospital in Cincinnati, OH. Kelly is the founder and Board President of Move Beyond Surviving, a non-profit organization designed to help breast cancer survivors move beyond their diagnosis and treatment by challenging themselves in nature. When not operating or spending time outside, she enjoys playing tennis and hanging out with her cats. INSTAGRAM: https://www.instagram.com/outdoor.minimalist.book/ WEBSITE: https://www.theoutdoorminimalist.com/ YOUTUBE: https://www.youtube.com/@theoutdoorminimalist ORDER THE BOOK: https://www.theoutdoorminimalist.com/book --------------- Move Beyond Surviving Website: https://movebeyondsurviving.org/ Facebook: https://www.facebook.com/profile.php?id=100083498284683 LinkedIn: https://www.linkedin.com/company/move-beyond-surviving/ --------------- Related Episodes #54 What We Need Nature #57 Max Your Inspiration, Not Your Impact #76 Grow Where You Are #81 How Do You Define Adventure? #82 Creating a More Adaptive Hiking Space #84 Take Ownership of Your Influence Through Action
This podcast is part of the historic meeting which officially announed the merging of the Perioperative Exercise Testing and Training Society (POETTS) and International Prehabilitation Society (IPS) to promote the professional practice of prehabilitatation and exercise testing. Hear how and why the society is moving forward with an international focus and an unmatched passion for prehabilitation. IPOETTS is here: https://ipoetts.org/ This piece is chaired by Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), Gerrit Slooter, Surgical Oncologist, Maxima Medical Centre, The Netherlands and Gerard Danjoux, consultant in Anaesthesia and Sleep Medicine at South Tees Hospitals NHS Trust, Mike Grocott, Professor of Anaesthesia and critical care at the University of Southampton, with questions and comments from the audience. -- Denny is a popular name here on TopMedTalk, if you liked this piece why not delve into our extensive free archive - with more presentations here: POETTS – Nutrition and patient living with and beyond cancer – the Macmillan Trust | EBPOM 2021 https://www.topmedtalk.com/poetts-nutrition-and-patient-living-with-and-beyond-cancer-the-macmillan-trust-ebpom-2021/ EBPOM 2020 London | Fit for surgery with Denny Levett https://www.topmedtalk.com/ebpom-2020-london-fit-for-surgery-with-denny-levett-2/
Join the Behind the Knife HPB team as we dive deeper into the complex world of IPMNs with a journal article review of a recent JAMA Surgery publication and the first author of the article! Learning Objectives: In this episode, we discuss the article, “Progression vs Cyst Stability of Branch-Duct Intraductal Papillary Mucinous Neoplasms After Observation and Surgery.” This article describes a multicenter retrospective study of centers in Italy, Korea, Singapore, and the US that specifically assessed what dynamic variables are associated with malignant progression in pathologically proven IMPNs under at least a year of initial surveillance. Hosts: Timothy Vreeland, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@DWNelsonHPB) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at William Beaumont Army Medical Center Connor Chick, MD (@connor_chick) is a PGY-6 General Surgery resident at Brooke Army Medical Center Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-5 General Surgery resident at Brooke Army Medical Center Beth Carpenter, MD (@elizcarpenter16) is a PGY-4 General Surgery resident at Brooke Army Medical Center Guest: Dr. Giovanni Marchegiani is a pancreas surgeon within the department of general and pancreatic surgery at the University of Verona in Italy. His research interests include exocrine and cystic neoplasms of the pancreas. He is the first author of the study discussed in the episode in addition to over 100 additional scientific, peer-reviewed articles. Journal Article: 1. Marchegiani G, Pollini T, Andrianello S, et al. Progression vs Cyst Stability of Branch-Duct Intraductal Papillary Mucinous Neoplasms After Observation and Surgery. JAMA Surg. 2021;156(7):654–661. doi:10.1001/jamasurg.2021.1802 Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other HPB episodes here: https://behindtheknife.org/podcast-category/hepatobiliary/
In this episode of SurgOnc Today®, Mio Kitano, MD, MS, FACS, FSSO, Surgical Oncologist at UT Health San Antonio, TX, is joined by Mashaal Dhir, MD, FACS, FSSO, Surgical Oncologist and Section Chief of HPB Surgery at The SUNY Upstate Medical University in Syracuse, NY, and Nathan Bahary, MD, PhD, Division Chief of Medical Oncology at the Allegheny Health Network Cancer Institute and Director of AHNCI Clinical Research in Pittsburgh, PA. They discuss the most up-to-date information on how to diagnose and manage small bowel NET. Moderator: Mio Kitano, MD, MS, FACS, FSSO - UT Health San Antonio Faculty: Mashaal Dhir, MD, FACS, FSSO - SUNY Upstate Medical University Nathan Bahary, MD, PhD - Allegheny Health Network
In this episode of SurgOnc Today®, Dr. Julie Hallet from the University of Toronto, and Vice-Chair of the SSO HPB disease site working group, is joinded by Dr. James R. Howe from the University of Iowa and Dr. Nadine Mallak from the Oregon Health and Science University. They discuss how somatostatin receptor PET imaging, such as DOTATE-PET, can be used to guide and support the surgical management of pancreatic neuroendocrine tumors. Moderator: Julie Hallet MD, Msc; Associate Professor of Surgery. University of Toronto, Toronto, Canada; Surgical Oncologist, Susan Leslie Clinic for Neuroendocrine Tumors – Sunnybrook Health Sciences Centre, Toronto, Canada Vice-Chair, HPB DSWG, SSO Faculty: James R. Howe, MD Professor of Surgery and Director of Surgical Oncology and Endocrine Surgery, Roy J. and Lucille A. Carver University of Iowa College of Medicine, Iowa City, Iowa Nadine Mallak, MD Associate Professor, Department of Diagnostic Radiology, Nuclear Medicine and Body Imaging sections Director, PET/MRI, Clinical, Oregon Health and Science University, Portland, OR References NANETS guidelines for the surgical management of pancreatic neuroendocrine tumors https://nanets.net/images/guidelines/2020_NANETS_Consensus_Paper_on_the_Surgical_Management_of_Pancreatic_Neuroendocrine_Tumors.pdf SNMMI appropriate use criteria for somatostatin receptor PET imaging in neuroendocrine tumors https://s3.amazonaws.com/rdcms-snmmi/files/production/public/Quality/jnm202275_New%20-%20revised.pdf
Dr. Shannon Westin and Dr. Mustafa Raoof discuss the paper "Medicare Advantage: A Disadvantage for Complex Cancer Surgery Patients" TRANSCRIPT Dr. Shannon Westin: Well, hello, everyone, and welcome back to another episode of the JCO After Hours podcast, where we get in-depth on articles that have been published in the JCO. I am your host Shannon Westin, and it is my pleasure to serve as the Social Media Editor for the Journal of Clinical Oncology, as well as a Professor in GYN Oncology at The MD Anderson Cancer Center in Houston. And today, I am very excited to be discussing a paper that was recently published in the JCO called “Medicare Advantage: A Disadvantage for Complex Cancer Surgery Patients.” And I am accompanied today by Dr. Mustafa Raoof, and he has no conflicts of interest to disclose. He is an Assistant Professor in the division of Surgical Oncology, Department of Surgery, and an Assistant Professor in the Department of Cancer Genetics and Epigenetics at the City of Hope Cancer Center. And there, he is a Surgical Oncologist with expertise in hepatobiliary and pancreatic cancer, and I'm thrilled to have him here today. Welcome, Dr. Raoof. Dr. Mustafa Raoof: Thank you. It's a pleasure to be here. Thank you for inviting me. Dr. Shannon Westin: Of course. And thank you for your incredible work. We're going to get right to it. This is, I think, a really timely and important paper because I think we are always trying to understand how the insurance coverage or the medical coverage that our patients have here in the United States impacts their overall quality of care. So, first, let's level set for the audience. Can you describe the basics of Medicare Advantage, which is what you explored in this paper, and how common is this coverage in the United States? Dr. Mustafa Raoof: So, Medicare Advantage is the privatized aspect of Medicare, and what we know is that since the 1970s there were some private plans that were part of Medicare. But really at the turn of the century, 2000 and onwards, Medicare Advantage has gained a lot of popularity. And this is where the government basically pays a lump sum cost for a beneficiary to private insurance companies to manage Medicare. And so, it's a privatized product. And the idea there is that it's supposed to be an all-encompassing product for the beneficiaries, and the biggest advantage, initially at least, was that there was an out-of-pocket maximum, so patients are not subjected to extreme financial stresses. The cost that was paid to Medicare Advantage plans per beneficiary were in the order of somewhere between 800 and $900 per beneficiary, per year. This was a little bit higher than what would have been the cost to Medicare, but that was to gain a lot of momentum into getting the private insurance interested in the plan. And then subsequently into that, there were a lot of incentives that were set for these Medicare Advantage plans based on some measures of quality, to kind of incentivize the quality products from this private insurance. And so, that's kind of the lay of the land for what the Medicare Advantage plans are. Now, in terms of, how popular are they? I think this has grown significantly over the last 10 years, especially, 46% of all Medicare beneficiaries nationally are part of this Medicare Advantage plan, and it's not one plan, every private insurance company has their own offerings. But a significant majority, I think it's estimated that more than half, and even, you know, going beyond 10 years, the majority of Americans will be insured by these Medicare Advantage plans. Dr. Shannon Westin: That's incredible, and certainly, that means this work that you did has such great impact with the number of patients that are going to be impacted. Can you give the listeners a little bit of an idea of how Medicare Advantage coverage might differ a little bit from the traditional? I know you mentioned the out-of-pocket costs, and that it's run by different companies, but any other kind of discerning features? Dr. Mustafa Raoof: Yeah. So, with the Medicare Advantage plans, as I mentioned, you know, there's an out-of-pocket maximum. In addition, vision and dental plans, as well as gym memberships are included as part of the plan, to kind of provide a holistic plan to the older Americans. And then, one of the things that kind of stands out is that what is the downside to Medicare Advantage plans from a company that is providing this kind of a product, and so, they have to cut costs somewhere. So, I think the main downside to patients would be that their options, in terms of specialist care, will be limited because the networks are generally narrower. There is a variability in different plans as to how big and small their networks are, but they could be more restrictive, and if a potential beneficiary is not aware of that, they could lose out on seeing some doctors that they would've otherwise wanted to see. Dr. Shannon Westin: Okay. That totally makes sense. And so, I guess the next natural question is, what led you to explore the impact of this coverage Medicare Advantage on patient outcomes in surgical practice? Dr. Mustafa Raoof: Yeah. So, as somebody who sees patients with advanced cancer, I think a lot of Medicare Advantage beneficiaries are caught by surprise at the time when they're seeking out care, and they think that they have Medicare, and they should be able to seek whatever care that they would like. Whereas, you know, when they contact their provider, they're told that they have to go to a certain doctor in a certain network. And the shock that this is, as a secondary shock, in addition to the shock of a cancer diagnosis and needing a surgical intervention. So, early on in my training, I had seen some of that, and, you know, I really wanted to delve deeper into helper based problems, is: does it even matter if they go with different specialists, as long as there is some quality to that? And so, I started looking into the quality of the Medicare Advantage network from there on. Dr. Shannon Westin: That leads us directly into your study. Why don't you give us a rundown of the design, and how you wanted to achieve those objectives that you just discussed? Dr. Mustafa Raoof: So, leading up to the study, we had a publication in Annals of Surgery that looked at what do the networks look like for these Medicare Advantage plans. And that kind of information is hard to find. As you could tell, a lot of patients don't even know if a certain hospital will be covered by their insurance. And so, through a collaboration with Gretchen Jacobsen who studies this as well, they had compiled data on the networks for different hospitals, and for different plans in LA County, as to which hospitals were covered. So, we looked at that, and we found that a lot of these Medicare Advantage plans don't have access to high-volume hospitals, which was our way of measuring quality. And so, that kind of set the tone for this, and then we wanted to ask if there is a difference in outcome between patients who are insured by Medicare Advantage versus those who are insured by traditional Medicare. Medicare Advantage data has been a little bit tricky to obtain for a lot of folks that I think it wasn't released because of data quality issues. We were a little bit lucky, in that we had access to the California Cancer Registry dataset, which includes all patients diagnosed with cancer in California, and that data was linked to discharge data from inpatient hospitalizations. And so, one of the categories that is collected is patients' insurance, whether it's Medicare or not, and whether it's managed or not. So, with that, we thought it was the perfect opportunity to ask a very simple question, and that question is, what are the differences in terms of access to high-volume surgery or quality cancer surgery, and what are the impacts on the outcome for the two different kinds of insurance plans? So, the design is a retrospective cohort analysis, and we included all patients who were undergoing elective inpatient cancer surgery. We selected some index cancers, and we realized that it's not comprehensive, but we wanted to give it a go with some of the more common cancer diagnoses. So, we included lung, colon, and rectal, and then we also included some high complexity operations such as esophagus, stomach, pancreas, and liver, and we included all data from 2000 to 2020. And in terms of the primary objective of the study, we wanted to look at hospital mortality, so we looked at the association between 30-day hospital mortality, but we also looked at complications, readmissions, and failure to rescue. One of the other objectives of this study was to look at the association between insurance stipend, access to care-- we defined access to care in several different ways. Because there's no singular definition, we said access to care would be somebody getting access to cancer surgery at a Commission on Cancer-designated hospital, or NCI-designated cancer center, or a high-volume hospital, as defined by other authors previously, or a teaching hospital. So, we used several different definitions to kind of see if there is association between insurance and patients' access to care. Dr. Shannon Westin: And let's hear it. What were the results? How did Medicare Advantage compare to traditional Medicare? Dr. Mustafa Raoof: Given our previous work on MA networks data, this was not a surprise, but when we saw that for all of the cancers that we looked at, there were significant barriers to access, in terms of getting to an NCI-designated cancer center, or a high-volume cancer center. So, no matter how we looked at it, we felt that there was a significant disparity in getting to these specialist hospitals, which we associate with quality of cancer surgery. But what was interesting in a major finding of the paper was that for certain cancers, for example, gastrectomy, pancreatectomy, and hepatectomy, we found significantly increased early-day mortality for those operations. And so, for example, for gastrectomy, there was 1.4-fold higher mortality, for pancreatectomy 1.9-fold, and then for hepatectomy, 1.4-fold. So, these are tangible figures in-- you know, the idea is that if somehow we can improve access to high-quality surgery within MA plans, to match that of traditional Medicare, which is not ideal still, but I think just by doing that, we could impact, potentially reduce cancer deaths from surgery itself. Dr. Shannon Westin: So, I was struck by the fact that there was a difference between the outcomes you mentioned - stomach, pancreatic, liver surgery, and colon cancer. You know, why do you think there might be a difference? Dr. Mustafa Raoof: That's a great question. So, I think colon cancer surgery has-- I wouldn't say it is low-complexity, but it's intermediate-complexity. And I think as a surgical workforce, a lot of surgeons who may or may not be trained with fellowship specialization, they are able to do a really good job of colon resection, and so, there are many high-volume surgeons that do not actually sit in NCI-designated cancer centers or CoC-accredited hospitals, and they're doing a really good job. And so, I think we see that the impact of access is less in colon surgery, and I think that may explain why that is. Dr. Shannon Westin: We've looked at this, and I know you said that you picked some common cancers, and I know you did that because, you know, I'm a GYN Oncologist, so I was definitely interested in outcomes here. We definitely see that, in especially ovarian cancer surgery, which is rare, is that high-volume centers matter. And it can be a comprehensive cancer center, or it can just be a really high-volume center that draws a lot of ovarian cancer, it doesn't necessarily have to be a cancer center. So, that certainly makes a lot of sense. I guess the next question really is what happens next for this work? Like, what can we do to make a difference here? Dr. Mustafa Raoof: So, just reading the landscape on health insurance, I think there's significant incentives for Medicare Advantage plans. So, I think that is going to exist, and I think that will be in the future. I think the important aspect will be to ensure the quality of Medicare Advantage plans. And I think the data that is presented in this study, we hope that it will shed some light, and give a voice to patients who are dealing with a situation where they need complex cancer surgery. And we also hope that there would be some transparency when patients are signing up for the insurance plans, they should be able to say, "Okay, well, with the Medicare Advantage plan, we are getting this quality of cardiac care, this quality of cancer surgical care", and I think that should be an important component. You know, some Medicare Advantage plans may excel in one aspect of care, for example, you know, Alzheimer's care or cardiac care, but may do poorly in cancer surgery care, or cancer care in general. So, I think those are some of the things that the policymakers will need to balance and incentivize. Medicare Advantage plans are really great at cutting utilization because they manage healthcare effectively, but it does introduce some sort of inefficiencies in the system where everything requires a prior authorization; a lot of physicians are familiar with that - a patient needs life-saving surgery, and the authorization is nowhere to be found for two, three weeks, four weeks, and that's a really difficult problem for the patient to go through, and their caregivers. It's a difficult time for them. So, I think those inefficiencies can be mitigated as long as those who require cancer surgery are seen as a distinct population who need timely access to high-volume surgery. I think modifying MA plans in a better way to reflect that, will be the future. Dr. Shannon Westin: Yeah. We've seen this come up on the podcast multiple times as we're talking about inequities and quality of care. You know, it's on us as physicians and practitioners to interact with our policymakers. We've not always been really good at that, but I think this type of work that you've done really helps us have that objective data that we can bring to these policymakers so this change can be enacted. Well, thank you so much, Dr. Raoof. We really appreciate you taking the time being on the podcast. And again, for our listeners, this was a discussion of “Medicare Advantage: A Disadvantage for Complex Cancer Surgery Patients,” and we were with the first author, Dr. Mustafa Raoof. Please make sure you check it out, and please feel free to check out our other podcasts on the JCO website. Until next time, this has been Shannon Westin, with JCO After Hours. Have a great day. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. 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.
What's the one clinical scenario where you can really save a patient's life with a pancreatectomy? An IPMN with high-grade dysplasia! Join the Behind the Knife HPB Team for a deep dive into the complex decision-making surgical management of IPMNs. Learning Objectives In this episode, we review the basics of intraductal papillary mucinous neoplasms, how to evaluate patients with a cystic mass of the pancreas, guidelines for surveillance, and indications for resection. We discuss key concepts such as Worrisome Features and High-Risk Stigmata and how those influence surgical decision-making, and tackle a few of the most challenging scenarios surgeons may face when treating patients with IPMNs. Hosts: Timothy Vreelant, MD, FACS (@vreelant) is an Assistant Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@usarmydoc24) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at William Beaumont Army Medical Center Connor Chick, MD (@connor_chick) is a PGY-6 General Surgery resident at Brooke Army Medical Center Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-5 General Surgery resident at Brooke Army Medical Center Beth Carpenter, MD (@elizcarpenter16) is a PGY-4 General Surgery resident at Brooke Army Medical Center Links to Papers Referenced in this Episode Revisions of international consensus Fukuoka guidelines for the management of IPMN of the pancreas Pancreatology. 2017 Sep-Oct;17(5):738-753. https://pubmed.ncbi.nlm.nih.gov/28735806/ Number of Worrisome Features and Risk of Malignancy in Intraductal Papillary Mucinous Neoplasm. J Am Coll Surg. 2022 Jun 1;234(6):1021-1030. https://pubmed.ncbi.nlm.nih.gov/35703792/ Extent of Surgery and Implications of Transection Margin Status after Resection of IPMNs. Gastroenterology Research and Practice 2014, 1–10. https://pubmed.ncbi.nlm.nih.gov/25276122/ Please visit https://behindtheknife.org to access other high-yield surgical education podcasts, videos and more. If you liked this episode, check out other Hepatobiliary Surgery episodes here: https://behindtheknife.org/podcast-category/hepatobiliary/
Dr. Alyssa Throckmorton, a breast surgical oncologist with Baptist Medical Group and the Medical Director for the Breast Oncology Program, joins Wake Up Memphis to answer all of Ben's questions regarding breast cancer prevention as it is Breast Cancer Awareness Month.See omnystudio.com/listener for privacy information.
Rick Greene, MD, discusses with Anne O'Shea, MD, and Timothy Vreeland, MD, the role of neoadjuvant chemotherapy or chemoradiation in the treatment of localized pancreatic adenocarcinoma, and the effect of downstaging on overall survival. Dr. O'Shea and Dr. Vreeland are authors of “Downstaging of Pancreatic Adenocarcinoma with Either Neoadjuvant Chemotherapy or Chemoradiotherapy Improves Survival.” Dr. Anne O'Shea is Resident of Surgery in the Department of Surgery at Brooke Army Medical Center, Ft. Sam, San Antonio, TX. Dr. Timothy Vreeland is a Surgical Oncologist also at the Brooke Army Medical Center, Ft. Sam, San Antonio, TX.
Dr T.K. Pandian, Surgical Oncologist at The Center for Advanced Medicine at Siteman Cancer Center joins Tom Ackerman and Carol Daniel talking about the Thyroid and what is it's purpose.
With Jaye Sciullo, Michigan Executive Director of Susan G. Komen & Dr. Shoshana Hallowell, Surgical Oncologist at Ascension Health What goes through your mind when you hear the word “cancer?” Fear of the unknown? How will this affect my loved ones? Will I survive? Second only to heart disease, cancer is a leading cause of death for adults in the United States. Although the word “cancer” in itself is scary, not all cancers are alike. In fact, there are types of cancer that are easier to treat and often result in full remission. With more than 290,000 new diagnoses predicted for 2022 alone, breast cancer is the second leading cause of death in women. Approximately 13% of women in the U.S. will be diagnosed with breast cancer at some point in their lives. This means there is a 1-in-8 chance a woman living in the U.S. will develop breast cancer. But this also means there is a 7-in-8 chance she'll never have the disease. Thankfully, advances in genetic testing, immunotherapy, and other promising new trials are transforming the way we treat breast cancer. Today, we're going to talk with Jaye Sciullo and Dr. Shoshana Hallowell, a surgical oncologist with Ascension Health. Jaye is the Executive Director for the Michigan chapter of Susan G. Komen, the world's leading breast cancer organization. They're with us today to answer our questions and tell us about the latest advances in breast cancer treatment. What You'll Hear on This Episode: When did Jaye first become involved with Susan G. Komen? How difficult is it for Jaye to put herself in the shoes of the women she represents? What are the different types of breast cancer? Why is breast cancer often harder to treat than other cancers? Besides not smoking, what are other things can we do to lessen our risk of cancer? How important are mammograms? What exactly are the BRCA genes and what does it mean? How does Susan G. Komen help patients and families? What do you recommend for friends and family members who want to help support co-survivors and patients? Some promising information about new trials and treatments. What role do diet and exercise play in developing and progressing cancer? What is a smart bomb? All about the 2022 Komen Detroit Race for the Cure. Today's Takeaway: A cancer diagnosis is life-changing, and we're often filled with fear and uncertainty as to what may lie ahead. But the mission of the Susan G. Komen organization is dedicated to making sure that no breast cancer patient has to go it alone. Since Susan G. Komen was founded in 1986, we have seen a 40% reduction in breast cancer mortality. The Komen organization is committed to being alongside the patient throughout the entirety of their cancer journey. In addition to providing financial support when needed, there are virtual nurse navigators who will assist patients in preparing for doctor appointments and provide a list of necessary questions to ask. Afterward, they can also help explain the mass of information that patients receive. Based on the statistics shared today, we all probably know someone battling breast cancer. We are hopeful that soon we can find a cure so that future generations can look forward to a life without this deadly disease. Remember that every single day is a gift and even when life throws us a curveball, we have the gift of freedom of choice. We get to choose our response and how we handle adversity is up to each and every one of us. We can choose to fight our battle with grace, dignity, and courage, knowing that we will find the support we need every step of the way. I'm Florine Mark and that's “Today's Takeaway.” Quotes: “I think that it's difficult these days to not be touched by breast cancer in some way.” — Jaye “Breast cancer is harder to treat because it's very complex.” — Dr. Hallowell “There are many things that you can do to lessen your risk of developing cancer. I think the most important is to be aware of your own health.” — Dr. Hallowell “70% of breast cancers diagnosed in women under the age of 50 have been found by the women themselves.” — Dr. Hallowell “Screening is important. The modality in which you're screened is also important.” — Dr. Hallowell “Susan G. Komen is committed to a world without breast cancer.” — Jaye “Our mission is to save lives by meeting the most critical needs of our communities and investing in breakthrough research to prevent and cure breast cancer.” — Jaye “When you're newly diagnosed, you don't know what you don't know. And it's often a very winding path of self-discovery and learning how to advocate for yourself.” — Jaye “No two paths are alike.” — Jaye “Women with dense breast tissue need additional screening and women that are high risk need additional screening.” — Dr. Hallowell Brought to You By: Gardner White Furniture Mentioned in This Episode: Susan G. Komen of Michigan 2022 Komen Detroit Race for the Cure Dr. Shoshana Hallowell — Ascension
This episode is sponsored by BTG Speciality Pharmaceuticals. BTG provides rescue medicines typically used in emergency rooms and intensive care units to treat patients for whom there are limited treatment options. They are dedicated to delivering quality medicines that make a real difference to patients and their families through the development, manufacture, and commercialization of pharmaceutical products. Their current portfolio of antidotes counteracts certain snake venoms and the toxicity associated with some heart and cancer medications. --- Dr. Canter is a Surgical Oncologist with clinical expertise in the multidisciplinary management of sarcomas. He also runs a translational research laboratory which focuses on the therapeutic and mechanistic effects of combining natural killer (NK) cell immunotherapy with other treatment modalities to overcome NK dysfunction in the tumor microenvironment of solid tumors, including sarcomas in both humans and dogs. He serves as the co-leader of UC Davis Comprehensive Cancer Center's Comparative Oncology Program, and his laboratory is one of a select group of labs internationally which is studying canine NK cells, including first-in-dog studies of canine immunotherapy and adoptive transfer of NK cells in dogs with osteosarcoma. Dr. Rebhun is a an Associate Professor in the Department of Surgical and Radiological Sciences at the Center for Companion Animal Health at the UC Davis School of Veterinary Medicine. His research focus is in the field of comparative and translational oncology, with specific interests in metastasis and novel therapeutics. --- What We Do at MIB Agents: PROGRAMS: ✨ End-of-Life MISSIONS ✨ Gamer Agents ✨ Agent Writers ✨ Prayer Agents ✨ Healing Hearts - Bereaved Parent Support ✨ Ambassador Agents - Peer Support ✨ Warrior Mail ✨ Young Adult Survivorship Support Group ✨ EDUCATION for physicians, researchers and families: ✨ OsteoBites, weekly webinar & podcast with thought leaders and innovators in Osteosarcoma ✨ MIB Book: Osteosarcoma: From our Families to Yours ✨ RESEARCH: Annual MIB FACTOR Research Conference ✨ Funding $100,000 annually for OS research ✨ MIB Testing & Research Directory ✨ The Osteosarcoma Project partner with Broad Institute of MIT and Harvard ... Kids are still dying with 40+ year old treatments. Help us MakeItBetter.
In this episode of the Talking Circle we introduce Dr. Michelle Huyser who is at the end of her two-year surgical oncology fellowship here at Roswell Park. Dr. Huyser describes her educational journey to medicine and her most recent experiences as a surgeon specializing in oncology. She is a wealth of knowledge and we invite you to tune in!
After graduating college, Kimberly Moore Dalal was commissioned as a Second Lieutenant in the United States Air Force; however, it was quickly realized that her time was best served studying to become a doctor. She discusses her journey to becoming a surgeon, the biases she overcame, and the factors that pushed her forward. Kimberly has worked as a general surgeon, a trauma surgeon, and an adult cancer surgeon, she has also performed surgery on a 10-month-old baby boy. She talks about memorable and powerful moments in oncology, and the differences between trauma surgery and other types of surgery. Key points include: 16:43: On being a trauma surgeon 22:48: Advice on choosing a doctor 49:03: The personalities of surgeons
Colorectal liver metastasis (CRLM) is a complex clinical situation requiring multidisciplinary management. In this episode from the Hepato-Pancreato-Biliary team at Behind the Knife, we review the genomics of CRLM, discuss a journal article investigating the frequency and impact of these mutations on survival in patients with stage IV disease, and interview the senior author Dr. Jean-Nicholas Vauthey about this research and his career in HPB. Hosts: Timothy Vreeland, MD, FACS (@vreelant) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at Brooke Army Medical Center Daniel Nelson, DO, FACS (@usarmydoc24) is an Associate Professor of Surgery at the Uniformed Services University of the Health Sciences and Surgical Oncologist at William Beaumont Army Medical Center Connor Chick, MD (@connor_chick) is a PGY-5 General Surgery resident at Brooke Army Medical Center Lexy (Alexandra) Adams, MD, MPH (@lexyadams16) is a PGY-4 General Surgery resident at Brooke Army Medical Center Beth (Elizabeth) Carpenter, MD (@elizcarpenter16) is a PGY-3 General Surgery resident at Brooke Army Medical Center Guest: Jean-Nicholas Vauthey, MD (@VautheyMD) is a Professor of Surgical Oncology, Chief of HPB, and Dallas/Fort Worth Living Legend Chair for Cancer Research at MD Anderson. He is the Principal Investigator of the study discussed in the episode in addition to numerous other articles describing the genomics of colorectal liver metastases. Learning Objectives: In this episode, we review basic mutations found in metastatic colorectal cancer and broadly discuss these in a clinical context. We review a journal article from Kawaguchi et al. in which authors analyze prognostic relevance of signaling pathways in patients undergoing resection of CRLM, later validated in an external cohort of unresected patients. We conduct an interview with the senior author of the study regarding relevant methodologic details, next steps in his research, and how to apply this information now and in the future to the care of patients with CRLM. Links to Papers Referenced in this Episode: Journal Article: Kawaguchi Y, Kopetz S, Kwong L, Xiao L, Morris JS, Tran Cao HS, Tzeng CD, Chun YS, Lee JE, Vauthey JN. Genomic Sequencing and Insight into Clinical Heterogeneity and Prognostic Pathway Genes in Patients with Metastatic Colorectal Cancer. J Am Coll Surg. 2021 Aug;233(2):272-284.e13. doi: 10.1016/j.jamcollsurg.2021.05.027. Epub 2021 Jun 7. PMID: 34111531; PMCID: PMC8666966. Recommended Additional Podcasts on CRLM: The AHPBA Podcast: 1. Episode 1: Dr. Jean Nicolas Vauthey - Colorectal Liver Metastases (https://podcasts.apple.com/us/podcast/episode-1-dr-jean-nicolas-vauthey-colorectal-liver/id1501441845?i=1000467381474) Please visit behindtheknife.org to access other high-yield surgical education podcasts, videos and more.
Claire has a conversation with her former boss about the future (and history) of breast cancer treatments - the President of the Medical University of South Carolina, Dr. David Cole. Dr. Cole has been practicing surgical oncology for over 20 years, with additional work in the research of breast cancer treatments. He is now serving as the president of the Medical University of South Carolina while continuing his surgery practice. Dr. Cole shares vital information on everything from risks, treatment options, what it's like caring for cancer patients and what women can consider doing from a lifestyle standpoint to lower their risk of breast cancer. See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.