Podcasts about survivorship

Seven-Lecture Series on Property Law Series Roadmaphttps://drive.google.com/file/d/1ceyxXw7KilPSTUMFf_Y8r6ktEzM_gm1Q/view?usp=sharingThe following are the unique links and domain names found in the provided source material:• https://civil.sog.unc.edu• https://en.wikipedia.org/w/index.php?title=Concurrent_estate&oldid=1300914748• https://en.wikipedia.org/w/index.php?title=Four_unities&oldid=1239034380• http://www.irs.gov/irm/part25/irm_25-018-001.html• andysirkin.com• BarExamToolbox.com• lexjuris.comThe podcast provides an overview of concurrent estates (or concurrent ownership), which is when two or more people own property simultaneously. In this type of ownership, co-tenants have an absolute right to possess and use the entire property, regardless of their specific fractional ownership shares.The three major forms of concurrent ownership discussed are:

Dr. Pedro Barata and Dr. Aditya Bagrodia discuss the evolving landscape of testicular cancer survivorship, the impact of treatment-related complications, and management strategies to optimize long-term outcomes and quality of life. TRANSCRIPT:  Dr. Pedro Barata: Hello and welcome to By the Book, a podcast series from ASCO that features engaging conversations between editors and authors of the ASCO Educational Book. I'm Dr. Pedro Barata. I'm a medical oncologist at University Hospitals Seidman Cancer Center and associate professor of medicine at Case Western Reserve University in Cleveland, Ohio. I'm also an associate editor of the ASCO Educational Book. We all know that testicular cancer is a rare but highly curable malignancy that mainly affects young men. Multimodal advances in therapy have resulted in excellent cancer specific survival, but testicular cancer survivors face significant long term treatment related toxicities which affect their quality of life and require surveillance and management. With that, I'm very happy today to be joined by Dr. Aditya Bagrodia, a urologic oncologist, professor, and the GU Disease Team lead at UC San Diego[KI1]  Health, and also the lead author of the recently published paper in the ASCO Educational Book titled, "Key Updates in Testicular Cancer: Optimizing Survivorship and Survival." And he's also the host of the world-renowned BackTable Urology Podcast. Dr. Bagrodia, I'm so happy that you're joining us today. Welcome. Dr. Aditya Bagrodia: Thanks, Pedro. Absolutely a pleasure to be here. Really appreciate the opportunity. Dr. Pedro Barata: Absolutely.  So, just to say that our full disclosures are available in the transcript of this episode.  Let's get things started. I'm really excited to talk about this. I'm biased, I do treat testicular cancer among other GU malignancies and so it's a really, really important topic that we face every day, right? Fortunately, for most of these patients, we're able to cure them. But it always comes up the question, "What now? You know, scans, management, cardio oncology, what survivorship programs we have in place? Are we addressing the different survivorship piece, psychology, fertility, et cetera?" So, we'll try to capture all of that today. Aditya, congrats again, you did a fantastic job putting together the insights and thoughts and what we know today about this important topic. And so, let's get focused specifically about what happens when patients get cured. So, many of us, in many centers, were fortunate enough to have these survivorship programs together, but I find that sometimes from talking to colleagues, they're not exactly the same thing and they don't mean the same thing to different people, to different institutions, right? So, first things first. What do you tell a patient perhaps when they ask you, "What can happen to me now that I'm done with treatment for testicular cancer?" Whether it's chemotherapy or just surgery or even radiation therapy? "So, what about the long term? What should I expect, Doctor, that might happen to me in the long run?" Dr. Aditya Bagrodia: Totally. I mean, I think that question's really front and center, Pedro, and really appreciate you all highlighting this topic. It was an absolute honor to work with true thought leaders and the survivorship bit of it is front and center, in my opinion. It's really the focus, you know, we, generally speaking should be able to cure these young men, but it's the 10, 15, 20 years down the way that they're going to largely contend with. The conversation really begins at diagnosis, pre-education. Fortunately, the bulk of patients that present are those with stage one disease, and even very basic things like before orchiectomy, talking about a prosthetic; we know that that can impact body image and self esteem, whether or not they decide to receive it or not. Actually, just being offered a prosthetic is important and this is something, you know, for any urologist, it's kind of critical. To discussing fertility elements to this, taking your time to examine the contralateral testicle, ask about fertility problems, issues, concerns, offer sperm banking, even in the context of a completely normal contralateral testicle, I think these things are quite important.  So if it's somebody with stage one disease, you know, without going too far down discussing adjuvant therapy and so forth, I will start the conversation with, "You know, the testes do largely two things. They make testosterone and they make sperm." By and large, patients are going to be able to have acceptable levels of testosterone, adequate sperm parameters to maintain kind of a normal gonadal state and to naturally conceive, should that be something they're interested in. However, there's still going to be, depending on what resource you look at, somewhere in the order of 10-30% that are going to have issues. Where I think for the stage one patients, it's really incumbent upon us is actually to not wait for them to discuss their concerns, particularly with testosterone, which many times can be a little bit vague, but to proactively ask about it every time. Libido, erectile quality, muscle mass maintenance, energy, fatigue. All of these are kind of associated symptoms of hypogonadism. But for a lot of kids 18-20 years old, it's going to be something insidious that they don't think about. So, for the stage one patients, it absolutely starts with gonadal function. If they are stage two getting surgery, I think the counseling really needs to center around a possibility for ejaculatory dysfunction. Now, for a chemotherapy-naive, nerve-sparing RPLND, generally these days we should be able to preserve ejaculatory function at high volume centers, but you still want to bring that up and again kind of touch base on thinking about sperm banking and so forth before the operation, scars, those are things I think worth talking about, small risk of ascites. Then, I think the intensity of potential long term adverse effects really ramps up when we're talking about systemic therapy, chemotherapy. And then there's of course some radiation therapy specific elements that come up. So, for the chemotherapy bits of it, I really think this is going to be something that can be a complete multi-system affected intervention. So, anxiety, depression, our group has actually shown using some population resources that even suicidality can be increased among patients that have been treated for germ cell tumor. You know, really from the top down, tinnitus, hearing changes, those are things that we need to ask about at every appointment. Neuropathy, sexual health, that we kind of talked about, including ED (erectile dysfunction), vertigo, dizziness, Raynaud's phenomenon, these are kind of more the symptoms that I think we need to inquire about every time. And what we do here and I think at a lot of survivorship programs is use kind of a battery of validated instruments, germ cell tumor specific, platinum treated patient specific. So we use a combination of EORTC questions and PROMIS questions, which actually serves as like a review of systems for the patient, also as a research element. We review that and then depending on what might be going on, we can dig into that further, get them over to colleagues in audiology or psychology, et cetera.  And then of course, screening for the hypertension, hyperlipidemia, metabolic syndrome with basically you or myself or somebody kind of like us serving, many times it's the role of the PCP, just making sure we're checking out, you know, CBC, CMP, et cetera, lipid parameters to screen for those kind of cardiac associated issues along with secondary malignancies. Dr. Pedro Barata: So that's super comprehensive and thorough. Thank you so much. Actually, I love how you break it down in a simple way. Two functions of the testes, produce testosterone and then, you know, the problem related to that is the hypogonadism, and then the second, as you mentioned, produce sperm and of course related to the fertility issues with that.  So, let's start with the first one that you mentioned. So, you do cite that in your paper, around 5-10% of men end up getting, developing hypogonadism, maybe clinical when they present with symptoms, maybe subclinical. So, I'm wondering, for our audience, what kind of recommendations we would give for addressing that or kind of thinking of that? How often are you ordering those tests? And then, when you're thinking about testosterone replacement therapy, is that something you do immediately or are there any guidelines into context that? How do you approach that? Dr. Aditya Bagrodia: So, just a bit more on digging into it even in terms of the questions to ask, you know, "Do you have any decrease in sexual drive? Any erectile dysfunction? Are your morning erections still taking place? Has the ejaculate volume changed? Physically, muscle mass, strength? Have you been putting on weight? Have you noticed increase in body fat?" And sometimes this is complicated because there's some anxiety that comes along with a cancer diagnosis when you're 20, 30 years old, multifactorial, hair loss, hot flashes, irritability. Sometimes they'll, you know, literally they'll say, "You know, my significant other or partners noticed that I'm really just a little bit labile." So I think, you know, there's the symptoms and then checking, usually kind of a gonadal panel, FSH, LH, free and total testosterone, sex hormone binding globulin, that's going to be typically pretty comprehensive. So if you've got symptoms plus some laboratory work, and ideally that pre-orchiectomy testosterone gives you some delta. If they started out at an 800, 900, now they're 400, that might be a big change for them. And then, when you talk about TRT (Testosterone Replacement Therapy) recommendations, you know, Pedro, yourself, myself, we're kind of lucky to be at academic centers and we've got men's health colleagues that are ultra experts, but at a high level, I would say that a lot of the TRT options center around fertility goals. Exogenous testosterone treats the low T, but it does suppress gonadal function, including spermatogenesis. So if that's not a priority, they can just get TRT. It should be done under the care of a urologist, a men's health, an endocrinologist, where we're checking liver chemistries and CBCs and a PSA and so forth. If they're interested in fertility preservation, then I would say engaging an endocrinologist, men's health expert is important. There's medications even like hCG, Clomid, which works centrally and stimulate the gonadal access. Niche scenarios where they might want standard TRT now, and then down the way, 5, 7 years, they're thinking about coming off of that for fertility purposes, I think that's really where you want to have an expert involved because there's quite a bit of nuance there in recovery of actual spermatogenesis and so forth.  To kind of summarize, you got to ask about it. Checking it is, is not overly complicated. We do a baseline pre-orchiectomy and at least once annually, you can tag it in with the tumor markers, so it's not an extra blood draw. And if they have symptoms of course, kind of developed, then we'll move that up in the evaluation. Dr. Pedro Barata: Got it. And you also touch base on the fertility angle, which is truly important. And I'm just curious, you know, a lot of times many of us might see one, two patients a year, right, and we forget these protocols and what we've got to do about that.  And so I'm interested to hear your thoughts about when you think about fertility, and how proactive you get. In other words, who do you refer for the fertility clinic, for a fertility preservation program? You know, do all cases despite getting through orchiectomy or just the cases that you're going to, you know you're going to seek chemotherapy at some point? What kind of selection or it depends on the chemo, like how do you do that assessment about the referral for preservation program that you might have available at UCSD? Dr. Aditya Bagrodia: Yeah, I mean I feel really fortunate to sit on the NCCN Testis Cancer Guidelines. It's in there that fertility counseling should be discussed prior to orchiectomy. So 100% bring it up. If there are risk factors, undescended testicles, previous history of fertility concerns, atrophic contralateral testicle, anything on the ultrasound like microlithiasis in the contralateral testicle, you kind of wanna get it there. And then again, there's kind of niche scenarios where you're really worried, maybe get a semen analysis and it doesn't look that good, arrange for the time of orchiectomy to have onco-testicular sperm extraction from the, quote unquote, "normal" testis parenchyma. You know, I think you have to be kind of prepared to go that route and really make sure you're doing this completely comprehensively.  So pre-orchiectomy all patients. Don't really push for it too hard if they've got a contralateral testicle, if they've had no issues having children. There's some cost associated with this, sperm banking still isn't kind of covered even in the context of men with cancer. If they've got risk factors, absolutely pre-orchiectomy. Pre-RPLND, even though the rates of ejaculatory dysfunction at a high-volume center should be low single digits, I'll still offer it. That'd be a real catastrophe if they were in that small proportion of patients and now they're going to be reliant on things like intrauterine insemination, where it becomes quite expensive.  Pre-chemo, everybody. That's basically a standard these days where it should be discussed and it's kind of amazing currently, even if you don't have an accessible men's health fertility clinic, there are actually companies, I have no vested interest, Fellow is one such company where you can actually create an account, receive a FedEx semen analysis and cryopreservation kit, send it back in, and all CLIA certified, it's based out of California. The gentleman that runs it, is a urologist and very, very bright guy who's done a lot of great stuff for testis cancer. So, even for patients that are kind of in extremis at the hospital that kind of need to get going like yesterday, we still discuss it. We've got some mechanisms in place to either have them take a semen analysis over to our Men's Health clinic or send it off to Fellow, which I think is pretty cool and that even extends to some of our younger adolescent patients where going to a clinic and providing a sample might be tricky.  So, I think bringing it up every stage, anytime there's an intervention that might be offered, orchiectomy, chemo, surgery, radiation, it's kind of incumbent on us to discuss it. Dr. Pedro Barata: Gotcha. That's super helpful. And you also touch base on another angle, which is the psychosocial angle around this. You mentioned suicidal rates, you mentioned anxiety, perhaps depression in some cases as well as chronic fatigue, not necessarily just because of the low testosterone that you can get, but also from a psychological perspective. I'm curious, what do the recommendations look like for that? Do these patients need to see a social worker or a psychologist, or do they need to answer a screening test every time they come to see us and then based on that, we kind of escalate, take the next steps according to that? Do they see a psychologist perhaps every so often? How should that be managed and addressed? Dr. Aditya Bagrodia: It's an excellent question and again, these can be rather insidious symptoms where if you don't really dig in and inquire, they can be glossed over. I mean, how easy to say, "Your markers look okay, your scans look okay. See you in six months," and keep it kind of brief. First off, I think bringing it up proactively and normalizing it, that, "This may be something that you experience. Many people do, you're not alone, there's nothing kind of wrong with you." I also think that this is an area where support groups can be incredibly useful. We host the Testicular Cancer Awareness Foundation support group here. They'll talk about chemo brain or just like a little bit of an adjustment disorder after their diagnosis. Support groups, I think are critical. As I mentioned, we have a survivorship program that's led by a combination of our med oncs, myself on the uro-onc side, as well as APPs, where we are systematically asking about essentially the whole litany of issues that may arise, including psychosocial, anxiety, depression, suicidality. And we've got a nice kind of fast path into our cancer center support services for these young men to meet with a psychologist. If that isn't going to be sufficient, they can actually see a psychiatrist to discuss medications and so forth. I do think that we've got to screen for these because, as anticipated from diagnosis, those first 2 years, we see a rise. But even 10, 15 years out, we note, compared to controls, that there is an increased level of anxiety, depression, suicidality that might not just take place at that initial acute period of diagnosis and treatment. Dr. Pedro Barata: Really well said. Super important.  So I guess if I were to put all these together, with these really amazing advances in technology, we all know AI, some of us might be more or less aware of biomarkers coming up, including microRNA for example, and others, like as I think of all these potential long term complications for these patients, look at the future, I guess, can we use this as a way to deescalate treatment where it's not really necessary, as a way to actually prevent some of these complications? Like, how do we see where we're heading? As we manage testicular cancer, let's say, within the next 5 or 10 years, do you think there's something coming up that's going to be different from what we're doing things today? Dr. Aditya Bagrodia: Totally. I mean, I think it's as exciting as a time as there's ever been, you know, maybe notwithstanding circa 1970s when platinum was discovered. So microRNAs, which you mentioned, you know, there's a new candidate biomarker, microRNA-371. We are super excited here at UCSD. We actually have it CLIA-certified available in our lab and are ordering these tests for patients kind of in their acute stage, you know, stage one and surveillance, stage two, post-RPLND, receiving chemotherapy. And essentially this is a universal germ cell tumor specific biomarker, except for teratoma, suffice it to say 90% sensitive and specific. And I think it's going to change the way that we diagnose and manage patients. You know, pre-orchiectomy, that's pretty straightforward. Post-orchiectomy, maybe we can really decrease the number of CT scans that are done. Maybe we can identify those patients that basically have occult disease where we can intervene early, either with RPLND or single cycle chemo. Post-RPLND, identify the patients who are at higher risk of relapse that may benefit from some adjuvant therapy. In the advanced setting, look at marker decline for patients in addition to standard tumor markers. Can we modulate their systemic therapy?  So, the international interest is largely on modifying things. There's really cool clinical trials that we have for stage one patients, that treatment would be prescribed based on a post-orchiectomy microRNA. I think the microRNAs are really exciting. Teratoma remains an outstanding question. I think this is where maybe ctDNA, perhaps some radiomics and advanced imaging processing and incorporating AI may allow us to safely avoid a lot of these post-chemo RPLNDs. And then identification using SNPs and so forth of who might be most susceptible to some of the cardiac toxicity, autotoxicity and personalizing things in that way as well. Dr. Pedro Barata: Super exciting, right, what's about to come? And I agree with you, I think it's going to change dramatically how we manage this disease.  This has been a pleasure sitting down with you. I guess before letting you go, anything else you'd like to add before we wrap it up? Dr. Aditya Bagrodia: Yeah, first off, again, just want to thank you and ASCO for the opportunity. And it's easy enough to, I think, approach a patient with the testicular germ cell tumor as, "This is an easy case. We're just going to do whatever we've done. Go to the guidelines that says do X, Y, or Z." But there's so much more nuance to it than that. Getting it done perfectly, I think, is mandatory. Whatever we do is an impact on them for the next 50, 60, 70 years of their life. And I found the germ cell tumor community, people are really passionate about it. If you're ever uncertain, there's experts throughout the country and internationally. Ask somebody before you do something that you can't undo. I think we owe it to them to get it perfect so that we can really maximize the survivorship and the survival like we've been talking about. Dr. Pedro Barata: Aditya, thanks for sharing your fantastic insights with us on this podcast. Dr. Aditya Bagrodia: All right, Pedro. Fantastic. Appreciate the opportunity. Dr. Pedro Barata: And also, thank you to our listeners for your time today. I actually encourage you to check out Dr. Bagrodia's article in the 2025 ASCO Educational Book. We'll post a link to the paper in the show notes. Remember, it's free access online, and you can actually download it as well as a PDF. You can also find on the website a wealth of other great papers from the ASCO Educational Book on key advances and novel approaches that are shaping modern oncology.  So with that, thank you everyone. Thank you, Aditya, one more time, for joining us. Thank you, have a good day. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Follow today's speakers:         Dr. Pedro Barata  @PBarataMD   Dr. Aditya Bagrodia @AdityaBagrodia Follow ASCO on social media:         @ASCO on X (formerly Twitter)         ASCO on Bluesky        ASCO on Facebook         ASCO on LinkedIn         Disclosures:      Dr. Pedro Barata:  Stock and Other Ownership Interests: Luminate Medical  Honoraria: UroToday  Consulting or Advisory Role: Bayer, BMS, Pfizer, EMD Serono, Eisai, Caris Life Sciences, AstraZeneca, Exelixis, AVEO, Merck, Ipson, Astellas Medivation, Novartis, Dendreon  Speakers' Bureau: AstraZeneca, Merck, Caris Life Sciences, Bayer, Pfizer/Astellas  Research Funding (Inst.): Exelixis, Blue Earth, AVEO, Pfizer, Merck   Dr. Aditya Bagrodia: Consulting or Advisory Role: Veracyte, Ferring  

Dr. Monty Pal and Dr. Pauline Funchain discuss the latest efforts to diagnose, prevent, and treat the series of immune-related adverse events that have emerged in the era of immunotherapy. TRANSCRIPT Dr. Monty Pal: Hello, and welcome to the ASCO Daily News Podcast. I am Monty Pal, a medical oncologist, professor and vice chair of medical oncology at the City of Hope Comprehensive Cancer Center in Los Angeles, California. Now, it is probably no surprise to this audience that immunotherapy has transformed the treatment landscape for multiple cancer types. It remains a pillar of modern oncology. Having said that, I think we have all been baffled by certain toxicities that we run into in the clinic. Today, I am delighted to be joined by Dr Pauline Funchain to discuss some of the checkpoint inhibitor toxicities that people struggle with most. And we will also touch on some side effects of immunotherapy beyond checkpoint inhibitors: CAR-T cells, bispecifics, so on and so forth. Dr Funchain is a dear friend, and she is an associate professor and associate director of cancer research training and education at the Stanford Cancer Institute. She is co-director of the Immunotherapy Toxicity Program and the Skin Cancer Genomics Program at Stanford, where she also serves as associate program director of hematology and oncology fellowship. Dr. Funchain is also the co-founder of ASPIRE, and we are going to talk about that a little bit today, the Alliance for the Support and Prevention of Immune-Related Events. FYI for listeners, if you are interested in our disclosures, they are available at the transcript of this episode. Pauline, thanks so much for joining us today. Dr. Pauline Funchain: Monty, thank you for this invitation. It is always great to talk. Dr. Monty Pal: So, for the audience, Pauline and I know each other from my days as a fellow at City of Hope. She was a resident at Harbor UCLA and a stellar resident at that. It has just been amazing to sort of see your career grow and blossom and to witness all the cool things that you are doing. ASPIRE, in particular, sort of caught my eye. So again, for listeners, this is the Alliance for the Support and Prevention of Immune-Related Events. Can you tell us a little bit briefly about the genesis of that, how that came about? Dr. Pauline Funchain: So, there was a bunch of us who were really struggling, I mean, all of us have struggled with these immune-related adverse events, these irAEs. You know, they are new disease states, and even though they look like autoimmune diseases, they tend to need a whole lot more steroid than autoimmune diseases do and they do not totally present in the same way. And in fact, you know, Triple-M, or Triple-M overlap syndrome, is a completely new irAE, a new immune state that we have never had before the advent of checkpoint inhibitor. And so a Triple-M, for those of you who are not as familiar, that is the constellation of myocarditis, myositis, and myasthenia gravis, something that never occurs as a natural autoimmune disease. So we were starting to realize that there were some major differences with these irAEs and autoimmune diseases. We could not treat them the right way. We really needed to learn more about them. And a bunch of us who had interest in this said, "Look, we really need to be all in one space to talk about what we are doing," because all of our treatments were our own little homegrown brews, and we needed to really get together and understand how to treat these things, how to diagnose them, and then learn more about them. So, Dr. Alexa Meara from Ohio State, Dr. Kerry Reynolds from Mass Gen, we put together this research consortium, brought together all of our irAE friends, got our best subspecialists together in a research consortium, which is now only about a year and a half old. And we made this research consortium, the Alliance for Support of Prevention of Immune-Related Events, and we reached out to ASCO, and ASCO was so kind to grant us a [Alliance for Support and Prevention of Immune-Related adverse Events (ASPIRE)] Community of Practice. So we met for the first time as a Community of Practice at the ASCO Annual Meeting just this past June and really got an ASCO community together to really think about how to again, diagnose, prevent, treat irAEs. Dr Monty Pal: This is interesting to me. The ASCO Community of Practice phenomenon is something that I was not super familiar with. Can you explain to our listenership what is the ASCO Community of Practice model? If you have particular interests, how do you sort of get one started? Dr Pauline Funchain: Yeah, so ASCO has an entire page on their Community of Practice. There are multiple Community of Practice groups or COPs. There are ones for Supportive Oncology and Survivorship. There is Women in Oncology. There is a group for International Medical Graduates. And there is about, I think 10 or 12 now that have a physical presence at ASCO but also a virtual presence on the ASCO Community of Practice site. So, if you were interested in any one of these, and you can see them on the ASCO Communities of Practice sites, you would ask to become a member. Once granted membership, then there is a whole webpage of postings and conversations that people can have. You can get email digests of conversations that happen on the website, and then you can anchor it with in-person participation at the Annual Meeting. Dr Monty Pal: That is awesome, and I can think of so many different foci within oncology that really sort of deserve a Community of Practice. This definitely being one of them. You know, it strikes me as being so interesting. I mean, the checkpoint inhibitors have been around for a while now. I think when you and I were in training, gosh, back then, these were just a little bit of a pipe dream, right? But having said that, I would probably say that more than half of my kidney cancer practice is either on checkpoint inhibitors, and the vast majority have been on one at some point in their past, right? With that in mind, you know, we have all treated a lot of patients with these drugs. Why is it that we still struggle to manage the toxicities? And just to take that one step further, what are some of the toxicities that, perhaps through ASPIRE or through your experience, people struggle with the most? Dr Pauline Funchain: So, I think we are still struggling with these because again, they are new disease states, right? This is what we all experienced with COVID, a brand-new virus and a brand-new syndrome. We now have 20-plus of these as irAEs. And what we have realized about them is the immune activation that happens with these is so much more than what we have seen with autoimmune diseases. So for instance, if you have a Crohn's or ulcerative colitis, you will top out at 40 to 60 milligrams of prednisone if a Crohn's flare or ulcerative colitis flare happens. But for our severe IR colitises, you know, it is at least 1 mg per kg, often goes up to 2 mg per kg. We, in some cases, have done 1 gram pulses if we are worried that somebody is going to perforate. So that was sort of like the first 5 years of treating irAE, and then now in the sort of second 5 years of treating irAE, we have realized that that is a lot of immunosuppression, and we might be able to get away with less with the newer biologics that are on board. So, we are struggling to try to get the data for some of these irAEs that we knew, we have known for a while, but to try to get newer treatments that may immunosuppress less so that you may still be able to retain that tumor response. And in fact, some of the preclinical studies suggest that some of these biologics may actually synergize with the immunotherapy and actually make the immunotherapy more effective from a tumor perspective and calm down the irAE as sort of the bystander effect. So we are still trying to optimize those. Getting up trials in the space has been very difficult. That is one of the reasons for the genesis of ASPIRE because we realized we needed to band together to have a bigger voice in that realm. Then there are other things that are brand new. So we talked about Triple-M. So Triple-M, again, with Triple-M or any myocarditis or myasthenia, I mean, there is about a 50% chance of death from irAE based on the literature. I think we are getting better at recognizing this, and so at Stanford we have some data to say that if you serially follow troponin, that maybe your outcomes are better. You can potentially lower the percentage of cases that are fatal because you can catch them early. I mean, this is all preliminary data, but again, these are all things that are evolving, and we do not all have the right answer. I mean, even the serial troponin thing, I think, is pretty controversial. And in fact, at one of our quarterly Zoom meetings that we are doing in ASPIRE in December is going to sort of flush out that controversy about serial troponin measuring and what is the best thing to use? Would you use something like abatacept or would you use ruxolitinib? Which one is better? I think there is a lot of controversy still about these things. Dr Monty Pal: You have really piqued my curiosity here because you think about the cons of treating irAEs, right? And I worry exactly about what you had mentioned, right, which is, "Gosh, what is going on with this tumor in terms of immunosuppression?" But you think about some of the newer agents, you mentioned ruxolitinib, I have heard of dasatinib, for instance, in this setting. Frankly speaking, a lot of these, as you point out, are really thought of as being also anticancer drugs. So you have really got me thinking about the potential synergy between perhaps suppressing an irAE and augmenting antitumor activity, which I think is very interesting. Am I on the right track with that? Dr Pauline Funchain: I think so, but you will find that a lot of people will not even go there because they are worried about how much immunosuppression you are going to cause. I am at heart a geneticist, but I think an immunologist will happily tell you that the immune system is very complex. There are multiple pathways, and these drugs do not all target the same immune pathways. So if we understand a little bit more about the pathways we are targeting and pick apart the pathways that are really, really tumor relevant and the other pathways that are not tumor relevant, you may be able to piece together a better marriage of tumor response and irAE control. Dr Monty Pal: Kind of on this topic, and again, leaning on your background in genetics, where are we in terms of predicting these irAEs? I mean, you would think the holy grail would be picking out a snip or something of this for it, right, that could potentially identify that patient who is going to get Triple-M or, you know, at the very least a significant high-grade irAE event. Are we anywhere closer to that in 2025? Dr Pauline Funchain: There have been data published. There have been some big GWAS studies. All of the effect sizes are pretty small. So there are some prediction algorithms, but none of them are clinically useful. And I think when you look at the odds ratios, they will increase risk by maybe 20%. I think one of the things that we found in a very small series and supported anecdotally is something as easy as family history of autoimmune disease is probably more predictive at this point than any of those types of markers. I think we will get there, but we are not anywhere near where we would like to be. Things like TMB also, actually, there is some good data about higher TMB, higher risk of irAE too. Dr Monty Pal: Interesting. I see all this data coming through, IL-8 polymorphisms, etc. And I just wondered if any of that was ready for prime time. But I mean, this is a good message for the practicing clinician. Sounds like we are not quite there yet. And I could probably keep you on for another entire podcast to talk about this topic, but let us see if we can at least skim the surface. I never thought I would see the day when BiTEs and CAR-Ts were entering into my kidney cancer practice, but in fact, it is really become central to a lot of our clinical trials in RCC these days. I would be lying if I did not say that I was not struggling with the toxicities and so forth associated with these drugs. Can you give us a quick primer, maybe just good resources that people can go to for managing toxicity with BiTEs and with CAR and with some of these novel therapeutic modalities that we are using in the oncology clinics? Dr Pauline Funchain: I know there is a recently published toxicity manual for BiTEs in hematologic malignancies, I think it was in Blood. CAR-T is covered in many irAE guidelines. So ASCO guidelines actually has a CAR-T [cell therapy guideline], and I would be remiss not to point out that actually ASCO has a, I am a little biased, but a wonderful guideline on irAE that is actually being updated as we speak. We are hoping for publication next year. I find the format of that, there are many guidelines out there, actually. There is ASCO, SITC, ESMO has a guideline for irAE, but I find the formatting of the ASCO guideline to be much easier to flip through during clinic, just because of the visual format of the tables. But that is going to be updated next year. And with CAR-T, there is now multiple publications also in terms of guidelines. But what I will say about bispecifics and CAR-T, so they have very similar toxicities in terms of the cytokine release and also with the ICANS, so the neurotoxicity. But what we have been finding that is really interesting with BiTEs and CAR-T, and actually even with TIL, cytokine release is very similar to some of the IL-2 toxicities but not identical that we see with TIL treatment. But now we are starting to see overlap. So patients who have been treated with immunotherapy and then go on to get a bispecific or then go on to get TIL, so I have seen some colitises that have occurred after the fact. Some of the newer CAR-Ts without checkpoint have been causing some really interesting, probably not in a good way, but interesting biologically, colitises that are really refractory. So we are starting to see some overlap, and again, I think this field is just evolving constantly. Dr Monty Pal: Yeah, no, I almost think I need to go back to that fellowship that you and I did together 20 years ago and, you know, and see if I could repeat some coursework on CAR-T management.  You know, Pauline, I could probably keep you on the horn for hours, but this has just been terrific. Thank you so much for sharing all of your insights with us today on the ASCO Daily News Podcast. Dr Pauline Funchain: Thank you for the invitation. It was wonderful to talk about this, and it was wonderful to catch up a little bit, Monty. Dr Monty Pal: Same here, same here. And thanks to our listeners too. If you value the insights you heard today on the ASCO Daily News Podcast, please rate, review, and subscribe wherever you get your podcasts. Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.  Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Find out more about today's speakers:      Dr. Monty Pal    @montypal   Dr. Pauline Funchain @FunchainMD Follow ASCO on social media:       @ASCO on Twitter      ASCO on Bluesky     ASCO on Facebook       ASCO on LinkedIn     Disclosures: Dr. Monty Pal:     Speakers' Bureau: MJH Life Sciences, IntrisiQ, Peerview    Research Funding (Inst.): Exelixis, Merck, Osel, Genentech, Crispr Therapeutics, Adicet Bio, ArsenalBio, Xencor, Miyarsian Pharmaceutical    Travel, Accommodations, Expenses: Crispr Therapeutics, Ipsen, Exelixis    Dr. Pauline Funchain: Consulting or Advisory Role: Merck, Replimune, Sanofi/Regeneron, Immunocore, Tempus Research Funding (Inst.): Pfizer, Bristol-Myers Squibb, IDEAYA Biosciences, Linnaeus Therapeutics Travel, Accommodations, Expenses: Merck

After you've finished breast cancer treatment it's common to think about how you'll move forward. You probably think all the hard stuff is behind you and you'll know exactly what to do now that diagnosis and treatment are in the rearview mirror. You think you've armed yourself with information about how to eat well so you can move into that “post-treatment phase” feeling confident. Except. . .no one told you to expect that sneaky, pervasive anxiety you feel about your food. In this episode I explore why it may feel like you're in unchartered food territory with no clue how to get yourself back on solid ground. ____________________________________________Click here to apply to my Peaceful Plate program! Get my FREE guide The Five Foods Survivors Should Eat; click here!Follow me on Instagram @hormone.breastcancer.dietitian

What does life look like after cancer, once the treatment is done and you're deemed cancer-free? On today's episode of PatientTalks, a spinoff of the DocTalks Podcast, Kellie Chouinard joins the show to discuss survivorship. From grief, to support systems, to follow-up appointments, Kellie's conversation with host, Mandi Fields, is an intimate and vulnerable look at life after breast cancer.   This is the final episode in the breast cancer PatientTalks series. Thank you to the women who shared their stories on our show and laid the groundwork for vulnerable conversations. If you haven't listened to the first three episodes, you can do so on whichever platform you're listening to this episode.  To learn about breast screening and St. Joseph Health Care London's (St. Joseph's) Breast Care Program, visit the St. Joseph's website. Did you know? Eligible patients can now self-schedule their OBSP mammogram appointments for St. Joseph's Hospital, online. Note: The content of St. Joseph's DocTalks Podcast is for informational purposes only. The material is not intended for and should not be used as a substitute for direct medical advice from a licensed health care practitioner. Brought to you in partnership with St. Joseph's Health Care Foundation. Produced by The Pod Cabin and Emily Mackey. 

When cancer treatment ends, the world expects celebration. The bell is rung, and everyone around breathes a sigh of relief. But for many survivors, that moment marks not an ending, but a new, confusing beginning. The medical team steps back, the appointments stop, and a quiet question creeps in: now what? Survivorship is more than the absence of disease. It's the long, often lonely process of learning how to live again, in a body, mind, and identity forever changed. Fatigue lingers. Treatment dulls memory and focus. Sleep becomes elusive. And beneath it all is the fear: what if it comes back? But what if recovery after cancer isn't just about waiting for the next scan; it's about reclaiming control? Through lifestyle medicine, survivors can begin to rebuild their strength, calm their nervous system, and lower their risk of recurrence. What measures are important for the survivor phase of cancer care? Why is connection and community so important? In this episode, the Medical Director of the Mass General Cancer Center in Waltham, Dr. Amy Comander, returns. The pioneer in lifestyle medicine for survivorship joins us to share what true recovery looks like. She shares insights from her groundbreaking Paving the Path to Wellness program, and we talk about how to have a healthy life after the end of cancer treatment. Things You'll Learn In This Episode -Survivorship isn't just surviving Finishing treatment is only the beginning of recovery. How do survivors move from merely existing to truly thriving? -Movement as medicine Exercise doesn't just build strength; it improves outcomes and lowers recurrence risk. What type of movement makes the biggest impact after cancer? -Food over fear The right diet can reduce inflammation, support immunity, and ease anxiety about recurrence. What does the research actually say about the best foods for survivors, and which supplements to avoid? -The overlooked healing power of connection Support groups and social bonds can dramatically improve the quality of life and survival. Why is community one of the most potent yet underused forms of medicine? Guest Bio Dr. Amy Comander specializes in the care of women with breast cancer. Dr. Comander is Medical Director of the Mass General Cancer Center in Waltham, where she also serves as Director of Breast Oncology and Cancer Survivorship at the Mass General Cancer Center in Waltham and at Newton Wellesley Hospital. She is the director of Lifestyle Medicine at the Mass General Cancer Center and an Instructor in Medicine at Harvard Medical School. She received her undergraduate degree and a master's degree in Neuroscience at Harvard University. She received her medical degree from Yale University School of Medicine. She completed her Internal Medicine residency training and Hematology-Oncology fellowship training at Beth Israel Deaconess Medical Center and Harvard Medical School. She is board-certified in Hematology and Medical Oncology, and she is a Diplomat of the American Board of Lifestyle Medicine. Dr. Comander has a strong interest in improving the quality of life and outcome of cancer survivors through important lifestyle interventions, including physical activity, diet, and mind/body interventions. She promotes healthy lifestyles for both her active treatment patients as well as those in the survivorship phase of care. She has launched PAVING the Path to Wellness, a 12-week lifestyle medicine-based survivorship program for women with breast cancer. Connect with Dr. Comander on LinkedIn. Resources The MGH Cancer Center is recruiting cancer survivors with insomnia for two behavioral treatment trials testing the Survivorship Sleep Program, a cognitive behavioral therapy for insomnia (CBT-I) skills program developed at MGH (PI: Daniel Hall, PhD; NCBI - WWW Error Blocked Diagnostic ; NCBI - WWW Error Blocked Diagnostic ). Eligible patients may be in treatment, post-treatment, or living with advanced cancer. All procedures are remote. Compensation is provided. Patients may see our study flyer and MGB Rally website (Rally | Cognitive Behavioral Therapy for Cancer Survivors with Insomnia ). Structured Exercise after Adjuvant Chemotherapy for Colon Cancer | NEJM Healthy Eating Plate • The Nutrition Source 10 Cancer Prevention Recommendations About Your Host Hosted by Dr. Deepa Grandon, MD, MBA, a triple board-certified physician with over 23 years of experience working as a Physician Consultant for influential organizations worldwide. Dr. Grandon is the founder of Transformational Life Consulting (TLC) and an outspoken faith-based leader in evidence-based lifestyle medicine. Resources Feeling stuck and want guidance on how to transform your spiritual, mental and physical well being? Get access to Dr Deepa's 6 Pillars of Health video! Visit drdeepa-tlc.org to subscribe and watch the video for free. ‌ Work with Me Ready to explore a personalized wellness journey with Dr. Deepa? Visit drdeepa-tlc.org and click on "Work with Me" to schedule a free intake call. Together, we'll see if this exclusive program aligns with your needs! Want to receive a devotional every week From Dr. Deepa? Devotionals are dedicated to providing you with a moment of reflection, inspiration, and spiritual growth each week, delivered right to your inbox. Visit https://www.drdeepa-tlc.org/devotional-opt-in to subscribe for free. Ready to deepen your understanding of trauma and kick start your healing journey? Explore a range of online and onsite courses designed to equip you with practical and affordable tools. From counselors, ministry leaders, and educators to couples, parents and individuals seeking help for themselves, there's a powerful course for everyone. Browse all the courses now to start your journey. ​​TLC is presenting this podcast as a form of information sharing only. It is not medical advice or intended to replace the judgment of a licensed physician. TLC is not responsible for any claims related to procedures, professionals, products, or methods discussed in the podcast, and it does not approve or endorse any products, professionals, services, or methods that might be referenced. Check out this episode on our website, Apple Podcasts, or Spotify, and don't forget to leave a review if you like what you heard. Your review feeds the algorithm so our show reaches more people. Thank you!

The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits.On this episode we have the caring Dr. Amy Comander :Quadruple board certified physician in Internal Medicine, Hematology, Medical Oncology & Lifestyle Medicine Breast oncologist and Director of Breast Oncology and Survivorship at the Massachusetts General Cancer Center Medical director of the Massachusetts General Cancer Center Instructor in medicine at Harvard Medical SchoolAuthorMarathon runner She shares:Her introduction into Lifestyle MedicineHer passion in improving the overall health and well-being of breast cancer survivors through lifestyle interventionsTools for breast cancer survivors and thrivers everywhere to live their best lives Patient transformationsMost recent published data on exercise oncologyPaving the Path to Wellness Group ProgramUsing running as a metaphor for life Power of social connection Newest book: Paving Your Path Through Breast Cancer and BeyondInformation for Dr. Comander:Book  (discount code: 25PAVINGBC)InstagramLinkedInInformation for Dr. Robyn Tiger & StressFreeMD:Check out StressFreeMD & CME offeringsGet the book: Feeling Stressed Is OptionalGet your 4 FREE stress relieving videosPhysicians: join our free private physicians-only Facebook groupRetreatsREVIVE! Lifestyle Medicine Well-Being Group CoachingPrograms on DemandPrivate 1:1 CoachingSchedule your FREE 30-Minute Stress Relief Strategy CallFollow me on Social Media: InstagramLinkedInFacebookTwitterPodcast websitePlease rate & Review the Show!Contactinfo@stressfreemd.net 

In this episode of Beyond the Clinic: Living Well with Melanoma, Dr. Samantha Siegel is joined by Katie Ostrovsky and Cheryl Marker from the MelaHomies community.Cheryl, diagnosed with Stage I melanoma in 2023, shares how she turned to online groups for education and support when her medical team left her with more questions than answers. Katie, a Stage IV survivor now, 11 years cancer-free, reflects on the emotional and practical challenges of survivorship — and how building the Mela Homies helped transform isolation into connection.Together, they explore the power of peer support, the gaps in survivorship care, and why community is just as vital as treatment.

Survival is only half the story — living well after cancer is its own journey. This episode explores the long-term physical side effects of gynaecological cancer, including menopause and fatigue, and the emotional and identity recovery that follows treatment. We also cover exercise, rehabilitation, and tailored survivorship support.Featuring lived experience stories from Jane Snarkis (New Zealand) and Ann Johnson (Australia), alongside expert insights from Professor Alison Brand, this episode highlights that survivorship deserves as much care as treatment. You're not alone — support is available every step of the way.

Love the episode? Send us a text!In this inspiring episode, host Laura Carfang, Ed.D. sits down with Tara Hoffmann of Recovery on Water and Miranda Baldwin, co-producer of Breast in Show. Together they explore life eight years after breast cancer — from navigating long-term side effects and hormonal therapy to finding joy, movement, and connection through rowing and burlesque.This is not just survivorship — it's strength, sisterhood, and self-expression.In This Episode:The power of exercise and rowing as tools for healing after treatmentNavigating hormonal therapies, side effects, and quality of life decisionsEndometriosis after breast cancer treatment — what survivors should knowCreating empowering spaces through movement and artBuilding connection and confidence through community-led initiatives like ROW and Breast in ShowThe upcoming Head of the Charles Regatta featuring the Recovery on Water teamHow Breast in Show blends humor, art, and advocacy to raise funds for survivorsLinks Mentioned:Recovery on Water https://recoveryonwater.org/Breast in Show Tickets (Eventbrite)https://www.eventbrite.com/e/breast-in-show-7-killer-breasts-from-outer-space-tickets-1670455781209?aff=ebdssbdestsearchAttend a free virtual SurvivingBreastCancer.org program (support groups, yoga, medication, expressive writing, art expression, and more!):https://www.survivingbreastcancer.org/eventsSubscribe to our weekly newsletterhttps://www.survivingbreastcancer.org/subscribeFollow us on InstagramSurvivingBreastCancer.org: https://www.survivingbreastcancer.org/Breast Cancer Conversations: https://www.instagram.com/breastcancerconversations/Support our Podcast, every dollar counts!https://givebutter.com/0fCiEUSupport the showLatest News: Join our Tell Cancer To Go #TakeAHike October 25, 2025 fundraiser! It's free to sign up! Learn more and start your team! Become a Breast Cancer Conversations+ Member! Sign Up Now.

Weight Gain After Breast Cancer: Hormones, GLP-1s, & Real Talk on Survivorship Weight gain after breast cancer is real — and rarely talked about. In this honest and empowering episode of the Besties with Breasties Podcast, hosts Sarah Hall and Beth Wilmes break down the physical, emotional, and hormonal changes that make post-treatment weight management so challenging. They share personal stories, expert insights, and practical tips to help survivors navigate hormones, menopause, GLP-1 medications, and emotional health — all with honesty, humor, and heart. ✨ In this episode, you'll learn: -The link between weight, cancer, and survivorship -How hormones and menopause affect weight gain -The truth about GLP-1 medications and diet trends -Tips for sustainable, self-compassionate weight management

Today on Hitting the Streets Podcast, I'm joined by the lovely Marissa Rusnow. Can't wait for you to hear her story!

It is essential for adolescents and young adults (AYAs) to have a foundation of care prior to discharge after their cancer treatment, and the multidisciplinary care team, including primary care providers (PCPs), must be equipped to support these patients. In this episode, CANCER BUZZ speaks with Scott J. Capozza, PT, MSPT, on his journey navigating care after cancer treatment as a young adult and his ASCO JCO Oncology Practice article, “Patient is Otherwise Healthy.” CANCER BUZZ then speaks with Melody Griffith, MSW, LMSW, Outpatient Adolescent and Young Adult (AYA) Oncology social worker at Mayo Clinic Arizona, on her role in patient navigation and how her department supports AYAs through their entire cancer continuum. CANCER BUZZ concludes with Cathy Lee-Miller, MD, director of AYA Oncology Clinic at the University of Wisconsin Carbone Cancer Center, on their cohort training program preparing PCPs for managing AYA survivorship care.    “The late effects for young adults are very real and a lot of times they are not recognized because we look otherwise healthy on the outside, but that belies what's going on internally.” - Scott J. Capozza, PT, MSPT   “We talk about post-traumatic stress, but also post-traumatic growth and what they bring with them and what they've learned through their process. It's not just the treatment, right? After treatment, there's a lot of years left to live.” - Melody Griffith, MSW, LMSW   “We really try and help empower these patients, particularly AYAs who maybe relied on their parents for their medical care before... We really try to spell that out for people so they can take responsibility and take charge of their own long-term health.” - Cathy Lee-Miller, MD   Scott J. Capozza, PT, MSPT Board Certified Clinical Specialist in Oncologic Physical Therapy  YNHH Outpatient Oncology Rehabilitation Services Smilow Cancer Hospital Adult Cancer Survivorship Clinic New Haven, CT   Melody Griffith, MSW, LMSW Outpatient Adolescent and Young Adult (AYA) Oncology Social Worker Mayo Clinic Arizona Phoenix, AZ   Cathy Lee-Miller, MD Director, AYA Oncology Clinic Associate Professor, Pediatric Hematology/Oncology/Transplant & Cellular Therapy University of Wisconsin Carbone Cancer Center Madison, WI    This podcast is part of the AYA Oncology Screening and Survivorship Services program, made possible through the support from The Arizona Clinical Oncology Society, Indiana Oncology Society, and Wisconsin Association of Hematology and Oncology. Resources: The Arizona Clinical Oncology Society: https://tacos.accc-cancer.org/resources/adolescent-and-young-adult-cancer-resources Indiana Oncology Society: https://inos.accc-cancer.org/resources/aya-cancer-resources Wisconsin Association of Hematology and Oncology: https://waho.accc-cancer.org/resources/adolescent-and-young-adult-cancer-resources

In this episode of the Bench to Bedside podcast, Dr. Roy Jensen, vice chancellor and director of The University of Kansas Cancer Center, is joined by Dr. Anthony Sung and Dr. Jennifer Klemp, leaders in cancer survivorship research. They discuss their personal motivations, the importance of comprehensive survivorship care starting from diagnosis, and the innovative programs and research efforts at the KU Center for Survivorship and Patient-Oriented Research. The conversation highlights the challenges faced by cancer survivors, the need for individualized care, and the role of community support and research in improving survivor outcomes. The episode emphasizes KU Cancer Center's mission to become a national leader in patient-oriented survivorship care and research. 00:00 Introduction to Bench to Bedside 00:33 Exploring Cancer Survivorship 01:09 Personal Motivations in Cancer Research 04:21 Defining Cancer Survivorship 07:40 Vision for the KU Center for Survivorship and Patient Oriented Research 13:29 Future of Cancer Survivorship Research 26:45 Conclusion and Resources Links from this Episode: ·       Learn more about Dr. Anthony Sung ·       Learn more about Dr. Jennifer Klemp ·       Learn more about the KU Center for Survivorship and Patient-Oriented Research To ensure you get our latest updates, For the latest updates, follow us on the social media channel of your choice by searching for KU Cancer Center.  

In this enlightening conversation, Jen Delvaux sits down with Anna Crollman to explore the often-overlooked aspects of cancer survivorship. Together, they uncover the emotional, physical, and relational challenges survivors face long after treatment ends. Anna shares her personal journey with breast cancer, how she's navigating bone health, and why she embraced GLP-1 therapy as part of her healing. This heartfelt discussion emphasizes the power of self-advocacy, the importance of holistic care, and the role of community in thriving beyond a diagnosis.

Dan Gray is the Head of Insights at Equidam.If you're a tech and investing nerd like us, you'll love this conversation. We cover everything Dan's learned reading dozens of academic research papers on startups and venture capital, debunking many popular narratives of the industry.We talk about the dangers of pre-mature startup scaling, the importance of origination stage investing, the concept of startup catering and why so many startups look the same, and the role of mega funds play in the ecosystem.We also discuss what the data says about concentration vs diversification, what VC's get wrong about pattern matching, and why pivoting is more valuable than you thinkThanks to Ramp for supporting this episode. It's the corporate card and expense management platform used by over 40,000 companies, like Shopify, CBRE and Stripe. Time is money. Save both with Ramp. Get $250 for signing-up here: https://ramp.com/ThePeelTry Harmonic - The startup discovery engine https://harmonic.ai/turnerTimestamps:(6:43) What's the required rate of return in VC?(9:29) Venture capital needs new definitions(16:10) QSBS(18:23) Are we in an AI bubble?(24:07) Re-branding early and late stage venture(28:25) We need more origination stage capital(40:05) Survivorship bias in emerging manager outperformance(42:57) Incentives driving larger fund sizes(48:10) Raising overvalued rounds re-risks a startup(52:08) Startup catering: why all startups look alike(58:42) Are VC mega funds still an experiment?(1:08:06) Late stage VC is competing with PE(1:13:42) a16z's Fund 1 strategy(1:18:18) How diversified should VC funds be?(1:25:06) Performance of Generalist vs Specialist firms(1:30:35) How to value a startup(1:40:58) Why VC firm location correlates to returns, but startup location does not(1:44:05) Founder background doesn't predict success(1:48:27) Startups with one pivot are most successful(1:50:24) Premature scaling kills 70% of startups(1:54:47) Does mega fund model work for origination investing?(1:56:15) Value of Twitter and writing onlineReferenced Research PapersVenture Predation: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4437360Process Alpha: https://angelspan.com/process-alpha-how-to-construct-and-manage-optimized-venture-portfolios-joe-milam-journal-of-portfolio-management-august-2022/The Sunk Cost Fallacy in VC: https://www.sciencedirect.com/science/article/pii/S0929119924000518Predictably Bad Investments in VC: https://papers.ssrn.com/sol3/papers.cfm?abstract_id=4135861Startup Catering to Venture Capitalists: https://afajof.org/management/viewp.php?n=58968Premature Scaling: https://innovationfootprints.com/wp-content/uploads/2015/07/startup-genome-report-extra-on-premature-scaling.pdfReferenced BooksThe Otherland Tetrology: https://www.goodreads.com/series/43762-otherlandPermutation City: https://www.goodreads.com/book/show/156784.Permutation_City?from_search=true&from_srp=true&qid=lf7FuUR9se&rank=1Necromancer: https://www.goodreads.com/book/show/6088007-neuromancer?ref=nav_sb_ss_1_29Other Referenced ItemsQSBS changes: https://www.dwt.com/blogs/startup-law-blog/2025/07/qsbs-big-beautiful-bill-tax-code-upgradesMega funds and the great re-risking: https://nextview.vc/blog/megafunds-and-the-great-re-risking/Rex Woodbury's post on hot companies: https://www.digitalnative.tech/p/the-taxi-cab-theory-of-venture-capitalThe VC Performance Paradox: https://www.linkedin.com/pulse/performance-paradox-venture-capital-dan-gray-2fqrePrior episodes mentionedDan Feder: https://youtu.be/_Ou6D9PLSBIMichael Dempsey: https://youtu.be/UzSbG6DL8CMSolugen: https://youtu.be/ofkNiB2nI3QFollow DanTwitter: https://x.com/credistickBlog: https://credistick.comFollow TurnerTwitter: https://twitter.com/TurnerNovakLinkedIn: https://www.linkedin.com/in/turnernovakSubscribe to my newsletter to get every episode + the transcript in your inbox every week: https://www.thespl.it/

A generation of investors have used Self Managed Super Funds for property investment, but steadily the numbers have changed in this area with higher rates, higher upfront costs and a growing realisation it is not the deal it used to be. Financial adviser James O'Reilly from NorthEast Wealth joins Associate Editor - Wealth, James Kirby, in this episode. In today's show, we cover: SMSF property - A sub-optimal performer Survivorship bias - Why SMSF property may lose in the future Would you be better in a standard super fund? The limits of compulsory super rules See omnystudio.com/listener for privacy information.

In this survivor spotlight, hosts Val and Dana sit down with Lily Bakour — a two-time childhood cancer survivor, advocate, and longtime CKc partner.At 15, Lily faced surgery, traditional chemo, and radiation. After relapse, an immunotherapy clinical trial helped her reach remission. Today, she opens up about survivorship with honesty and hope: processing survivor's guilt, reclaiming your story on the internet, healing long-term treatment effects, and choosing calm, strength, and community.This conversation is a reminder that every survivor story is unique and deeply human. If you care about innovation in pediatric cancer and tangible hope for families, you are in the right place.What you'll hear:Lily's diagnosis, relapse, and the immunotherapy trial that workedSurviving adolescence, high school, and adulthood milestones while fighting cancerSurvivor's guilt, identity, and setting boundaries around your story onlineHealing from long-term effects and rebuilding health and routineWhy community action and research funding change outcomes for kidsWhy it matters:  Cannonball Kids' c*ncer Foundation (CKc) funds bold pediatric cancer research to create innovative treatment options, reduce toxicity, and improve long-term quality of life for children who grow up to be adults like Lily.If this conversation moves you, please like, comment, and share to help us educate for change. Leaving a review helps more families find tangible hope.Tune in to hear this inspiring and informative conversation. Don't forget to subscribe, leave a review, and join the fight to make Game Over: c*ncer a reality.Connect with Dana: https://www.linkedin.com/in/danaknichols/Connect with Val: https://www.linkedin.com/in/valerie-solomon/Upcoming Ckc Events: https://cannonballkidscancer.org/category/make-an-impact/events/----------------------------------Podcast Produced by Hi Hello Labs: Website: https://www.hihellolabs.com/

The survivorship period after treatment is an exciting and often scary phase of the cancer journey. Learn what to expect and how to be proactive in a post-treatment landscape. https://bit.ly/46fByDjFrom the Moment of DiagnosisAre you living with cancer? From dealing with physical symptoms to managing stress, everyone's cancer journey has challenges. Your cancer story is your own, navigating relationships, family, and sexual health is challenging after a cancer diagnosis. Find expert information, practical tips, and trusted resources that may help by listening to this week's podcast about cancer survivorship.In this Episode:03:23 - Road Trip to New Mexico: The Miracles of El Santuario de Chimayó and Biscochitos 06:10 - Cancer Survivorship - What is a Survivor?08:56 - Phases of Cancer Survivorship12:42 - How to Be Proactive In Your Survivorship23:16 - Ozzie Osbourne's Funeral Plans - Written 14 Years Before His Death25:19 - Outro #cancer #cancersurvivor #cancersideeffects #cancertreatment #cancersurveillance #secondarycancers #cancerprevention #survivorship #survivor #everydayisagift Support the showGet show notes and resources at our website: every1dies.org. Facebook | Instagram | YouTube | mail@every1dies.org

On episode 140 of Tatami Talk, we discuss survivorship bias.Things mentioned in this episodehttps://en.wikipedia.org/wiki/Survivorship_biashttps://www.youtube.com/watch?v=fUVlBY0Jh14------------------------------------------- 0:00 Intro07:03 Listener question on blue judogi15:33 Why we don't do reaction videos24:40 Survivorship bias-------------------------------------------Email us: tatamitalk@gmail.com Follow us on Instagram: https://www.instagram.com/tatamitalk Juan: https://www.instagram.com/thegr8_juan Anthony: https://www.instagram.com/anthonythrowsCheck out our Substack: https://tatamitalk.substack.com/Intro + Outro by Donald Rickert: https://www.instagram.com/donaldrickertCover Art by Mas: https://www.instagram.com/masproducePodcast Site: https://creators.spotify.com/pod/show/tatamitalk/Also listen on Apple iTunes, Google podcasts, Google Play Music and Spotify

A new strategic alliance between R. Kenner French and the Asset Defense Team combines tax, finance, and AI expertise with nationwide asset protection and estate-planning legal services. French frames the session around a simple premise: many owners postpone estate planning, but doing it early enables an orderly transfer of assets and can reduce taxes for heirs. The partnership aims to deliver “one-stop” guidance so business owners can focus on what they do best.Estate planning is defined as setting out how your property (assets and debts) will be managed and distributed after death—ideally in a tax-intelligent way. Key terms include estate, beneficiaries, grantor, trustee/fiduciary, and probate (a public, court-supervised process most families try to avoid). While wills are important, they have limits: they generally don't avoid probate, can't disinherit a spouse, and may be weaker without professional drafting. Kenner suggests that specialized legal oversight—often worth the extra cost—reduces challenges and ensures documents reflect complex, real-world needs.Trusts are the backbone of many estate plans. He distinguishes revocable vs. irrevocable, living vs. testamentary trusts, and covers marital/non-marital structures such as QTIP , general power of appointment trusts , and estate trusts. Insurance-related planning remains significant. Irrevocable Life Insurance Trusts (ILITs) can keep policy proceeds outside the taxable estate (again mindful of the three-year rule). Survivorship (“second-to-die”) policies pay after both spouses pass—often at lower premiums—while “first-to-die” pays on the first death. Beneficiary choices must be made carefully: naming individuals can be simpler but gives less control over how funds are used, whereas trusts allow you to dictate timing and conditions. He also highlights healthcare directives, living wills, guardianship designations, and even funeral wishes as integral parts of a complete plan.Finally, Kenner explains how estate and inheritance taxes differ and why net estate value (gross assets minus debts/expenses) matters. Charitable strategies—like Charitable Remainder Trusts (potentially deferring or mitigating capital gains on highly appreciated assets while providing lifetime income) and Charitable Lead Trusts (front-loading benefits to charities and potentially reducing gift/estate taxes)—can align philanthropy with tax efficiency. The close: don't wait for a “perfect” plan—start now, consult qualified advisors such as Bob Bluhm and the Asset Defense Team.Takeaways• Estate planning is crucial for a smooth transition of assets.• Many people delay estate planning, which can lead to complications.• A will alone may not be sufficient for comprehensive estate planning.• Trusts can provide more control and benefits than wills.• Charitable trusts can help avoid capital gains taxes.• Life insurance can be a valuable part of an estate plan.• Choosing beneficiaries requires careful consideration.• Planning for funeral wishes can be included in estate planning.• Consulting with a qualified advisor is essential for effective estate planning.• Proactive estate planning can provide peace of mind for families.Sound Bites• You cannot avoid probate.• Get something on paper, do it now.• You can plan your own funeral.Listen & Subscribe for More:

In this episode, we sit down with Sally Werner, CEO of Cancer Support Community, to explore her dual perspective as a longtime oncology professional and as a caregiver to her mother-in-law. We begin with Sally's background—first as an oncology nurse, then a healthcare administrator, and now a nonprofit leader. She calls this her “passion job,” driven by a deep commitment to support patients and caregivers alike.Sally opens up about her personal journey as a caregiver. Her mother-in-law, Patty Jo, was diagnosed with a rare renal cancer, and Sally became an essential part of her care team, despite living in a different city. As a seasoned professional, she brought clinical experience to the table, but she quickly learned that when the patient is someone you love, emotions can cloud objectivity. To manage this, she utilized Cancer Support Community's own navigation resources to bring a neutral party into the conversation—someone who could help guide medical decisions without the weight of family emotions.Second opinions played a crucial role in Patty Jo's care. Sally emphasized how vital they are, especially with rare cancers. In Patty Jo's case, an aggressive surgical recommendation was replaced with immunotherapy after a second opinion—an option that ultimately preserved her quality of life and kept her active. The family's concerns were met with clarity and reassurance, thanks to a coordinated, compassionate care approach.Caregiver support was another focal point. Sally discusses the emotional and physical toll on her father-in-law, who was the primary at-home caregiver. She stresses the importance of helping caregivers maintain their own wellbeing. Sally even moved in for a time to assist with daily tasks and give him a break, showing how essential family coordination and self-care are during intense medical periods.We also explore how to activate and manage support systems. Sally used Cancer Support Community's My Lifeline tool to keep extended family informed and to schedule help in ways that respected Patty Jo's wishes. This helped avoid overwhelming her while still allowing others to contribute meaningfully.Throughout the conversation, Sally returns to the theme of shared decision-making. She emphasizes that while friends and family often mean well, it's the patient who should drive treatment choices. Tools like Open to Options allow patients to articulate values and priorities, helping align treatment with what matters most to them.We end with a look into survivorship—what it means to live well after diagnosis. For Patty Jo, this means gardening, walking, spending time with family, and learning to manage fatigue. It also means embracing life differently and more deliberately. As Sally reminds us, cancer changes everyone. But with support, compassion, and the right tools, families can find strength and even joy on the other side of diagnosis.This season is sponsored by Sanofi: https://www.sanofi.com/And Jazz Pharmaceuticals: https://www.jazzpharma.com/More:Cancer Support Community: https://www.cancersupportcommunity.orgMy Lifeline Tool: https://www.mylifeline.orgTriage Cancer Financial Resources: https://triagecancer.orgnbmtLINK Finance Guide (English): https://www.nbmtlink.org/product/finance-guide-for-bone-marrow-stem-cell-transplant/nbmtLINK Finance Guide (Spanish): https://www.nbmtlink.org/product/guia-de-financiacion-para-trasplantes-de-medula-osea-celulas-madre/ National Bone Marrow Transplant Link - (800) LINK-BMT, or (800) 546-5268.nbmtLINK Website: https://www.nbmtlink.org/nbmtLINK Facebook Page: https://www.facebook.com/nbmtLINKFollow the nbmtLINK on Instagram! https://www.instagram.com/nbmtlink/The nbmtLINK YouTube Page can be found by clicking here.To participate in the GVHD Mosaic, click here: https://amp.livemosaics.com/gvhd Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Enjoy this beautiful life you've been given.  Don't ever take it for granted.  -Melissa Dupuis It's been two years since Melissa Dupuis shared her story on this series, and what a couple of years it has been.  At only 38,  this wellness enthusiast, Pilates instructor, and former professional ballet dancer was diagnosed with Stage 3 breast cancer.  Her little girl, Sage, was only one year old at the time, and although Melissa and her husband wanted to have another child someday, doctors said there was no time for egg retrieval and that the couple's chances of having another child after her rigorous treatments were over were slim to none.   In this interview, Melissa shares what happened next, and if you are emotional like me, you'll need a Kleenex to dry your tears of joy. Buoyed by the love of her family and a promise she made to be strong for her daughter, Melissa wrote a children's book called We Can Do Hard Things:  A Mother's Journey with Breast Cancer Through the Eyes of Her Daughter.  Published by the female-owned imprint www.brileybaxterbooks.com, this beautifully illustrated book is written for children ages 2-5 and can be pre-ordered with this link: https://a.co/d/3mIRJpD. Says Melissa:  “If you want to help your child understand illness in a lighter way, this book is for you because it's a true story. These conversations between Sage and me really happened.”   Survivorship is not easy, but Melissa has continued to be resilient.  Spoiler alert: Remember the baby Melissa hoped to have someday?   You'll have to hit that download button to find out what happened! #childrensbook #breastcancer #motherhood Melissa Dupois author, We Can Do Hard Things brileybaxterbooks.com

Join Racheal Reed-Maloney (she/her) as she speaks with Auraria Campus student, Devyn Dewey (she/her), about research they are doing focused on neurobiology and aggression, how our current systems fail to support survivors who have been charged as offenders of domestic violence, and how mandatory arrest laws harm survivors.Sources Mandatory Arrest Laws https://codes.findlaw.com/co/title-18-criminal-code/co-rev-st-sect-18-6-803-6/POST Training https://post.colorado.gov/sites/post/files/Manual%20-%20Program%20and%20Instructor%20Programs%20Jan%202024%20%282%29.pdfDV Colorado law https://www.denverda.org/domestic-violence/Black Women & Mandatory Arrest Laws https://www.justice.gov/ovw/page/file/926631/dl?inlineSame Sex Couples & Dual Arrest https://journals.sagepub.com/doi/10.1177/1077801220920378https://survivedandpunished.org/quick-statistics/ If you are in crisis and need immediate support, please call our 24/7 interpersonal violence helpline at 303-556-2255.Request an Appointment with an Advocate athttps://www.thepca.org/online-appointment-requestRequest a Violence Prevention Presentation at https://www.thepca.org/prevention-educationInstagram @phoenixauraria

In this inspiring episode, hosts Dana and Val from Cannonball Kids' c*ncer sit down with Andy Albert, an osteosarcoma survivor and the namesake of CKc's 2025 clinical trial grant with Dr. Allison O'Neill at Dana-Farber.Andy opens up about his diagnosis at age 12, the big decision to have a rotationplasty, becoming his own advocate during treatment, and life now as a curious, science-loving teenager who's into engineering, Minecraft, F1, fishing, and caring for his family's pet bearded dragon, Rusty.You will hear:What osteosarcoma looks like from first symptom to diagnosisAndy's rotationplasty explained in simple terms and why he chose itHow a 12-year-old advocated to change a painful hospital supply and helped other kids“Chemo brain,” going back to school, and learning to run againMinecraft, Jack Black, F1 engineering, and why curiosity matters in survivorshipThe story behind the Andy Alberts Next Step Clinical Trial Grant and how funding research creates options for kidsIf this conversation moves you, please like, comment, and share to help us educate for change. Leaving a review helps more families find tangible hope.Tune in to hear this inspiring and informative conversation. Don't forget to subscribe, leave a review, and join the fight to make Game Over: c*ncer a reality.Connect with Dana: https://www.linkedin.com/in/danaknichols/Connect with Val: https://www.linkedin.com/in/valerie-solomon/Upcoming Ckc Events: https://cannonballkidscancer.org/category/make-an-impact/events/----------------------------------Podcast Produced by Hi Hello Labs: Website: https://www.hihellolabs.com/

In this episode, CancerNetwork® spoke with Joseph S. Wallins, MD, MPH, cardiology fellow at Weill Cornell Medicine, about a review of cardiotoxicities associated with breast cancer treatment he coauthored in the June 2025 issue of ONCOLOGY® titled, “Cardio-Oncology Considerations for Breast Cancer: Risk Stratification, Monitoring, and Treatment.” Therein, he touched upon data for risk stratification tools for oncologists, as well as the development of cardiovascular testing for individual treatment regimens. Wallins discussed the basis for conducting the systemic review as well as noteworthy cardiotoxicities associated with specific classes of breast cancer therapies. Specifically, he highlighted an increase in cancer remission and survivorship for breast cancer, which has, in turn, created alternative health risks impacting survival outcomes, such as cardiovascular risks. Citing a study showing a nearly 2-fold risk in cardiovascular-related fatalities for breast cancer survivors vs the general population, he suggested that the review was warranted to identify cardiotoxicities, strategies for preventing and managing them, and tools for risk stratification and monitoring. Wallins further outlined considerations for optimizing risk stratification and monitoring strategies in patients at risk of experiencing cardiovascular toxicities as well as treatments that may help with their prevention or mitigation. To that end, he discussed identifying patients who are at a higher risk before initiating treatment and outlined risk assessment tools that serve to do so. Furthermore, he suggested that patients who experience a greater than moderate risk for cardiovascular issues should undergo cardioprotective strategies and have in-depth conversations with providers regarding treatment risks. He concluded by highlighting future steps to enhance cardiovascular outcomes for patients with breast cancer, among additional key takeaways. Of note, Wallins expressed that genetic testing may help elucidate cardiomyopathy-associated genes while calling for a more personalized approach to risk stratification and more sensitive and specific imaging techniques to better identify at-risk patients. Finally, he emphasized a need for upfront risk assessment to identify patients at a higher risk who could benefit from additional testing as well as more pronounced collaboration between oncologists and cardiologists. Reference Bradshaw PT, Stevens J, Khankari N, Teitelbaum SL, Neugut AI, Gammon MD. Cardiovascular disease mortality among breast cancer survivors. Epidemiology. 2016;27(1):6-13. doi:10.1097/EDE.0000000000000394

Join us for the next episode of Cancer Out Loud, The CancerCare Podcast, as guest host and oncology social worker, Sara Grisales Jaramillo, speaks with Jon Fox, a cancer survivor and former elementary school teacher. Jon shares his journey from diagnosis to survivorship, discussing the emotional and psychological challenges he faced, the grief of losing aspects of his former life, and the importance of community and support in navigating the complexities of life after cancer. He emphasizes the need for self-advocacy and finding the right resources to aid in recovery, while also reflecting on the duality of emotions experienced throughout the journey. Thank you to Jon for shedding light on the unique challenges and triumphs of those affected by cancer.Follow Jon on social media:InstagramKey TakeawaysCancer can interrupt any career or life stage. Survivorship is its own chapter with unexpected challenges. Many people feel isolated once treatment ends and support tapers off. Grief shows up in everyday ways—sometimes even in how food tastes or brings joy. Community and connection are key to feeling seen and supported. Many effects are invisible to others (fatigue, brain fog, anxiety, pain). Self-advocacy matters in follow-up care and day-to-day life. It helps to hold space for both what's been lost and what's newly possible. Healing isn't linear; patience, time, and support make a difference. 

Today's guest is Rebecca Thomas, also known as "Giddy Up" within her cancer community, due to her love of horses and her inspiring journey. Rebecca was diagnosed with Hodgkin's Lymphoma at age 18 and has been a survivor for 33 years now, including a breast cancer diagnosis in 2019. She embodies living a meaningful, vibrant life as a long term survivor.We talk about how diagnosis as a young adult shapes the rest of your life, the wonder of the human body and what it can do, the healing power of horses, the impact of long term survivorship, finding community, and so much more!! Resources:Rebecca's Facebook: Rebecca ThomasEpic Experience: https://www.epicexperience.org/Follow:Follow me: https://www.instagram.com/melissagrosboll/My website: https://melissagrosboll.comEmail me: drmelissagrosboll@gmail.com

Breaking Barriers, Making Healthy Choices, and Embracing Survivorship Breaking Barriers, Making Healthy Choices, and Embracing Survivorship. In this episode Yonni and Heather sit down with Dr. Laurie Kirstein from Memorial Sloan Kettering Cancer Center, who made history as the first female chair of the American College of Surgeons' Commission on Cancer. We will talk about breaking glass ceilings, access to quality healthcare, pain management and the impact of smoking on women's health outcomes. Dr. Laurie Kirstein is an Attending Breast Surgeon at memorial string Cancer Center. She attended downstate medical school, Montefiore Medical Center/Albert Einstein University for residency and Massachusetts General Hospital for Breast Surgery fellowship. Prior to arriving at Memorial Sloan Kettering she was attending surgeon and Breast Fellowship Director at the Rutgers Cancer Center Institute of New Jersey. At Memorial SloanKettering she is the Surgical Site Director for their Monmouth, NJ location. She is the current Chair for the American College of Surgeon's Commission on Cancer. She is the lead for the national quality improvement project Breaking Barriers: overcoming barriers to cancer care across America. Her research interests include surgical decision for breast cancer, postoperative pain management and tobacco cessation for cancer patients. Find Yonni & Heather here https://www.herhealthcompass.com/

In this episode, we speak with Ann Hamilton, founder of the Survivorship Collective: a survivor-led initiative offering legal, psychedelic-assisted therapy to people living with cancer. Ann is an educator, filmmaker and breast cancer survivor whose own journey through illness (and a life-altering psilocybin experience) led her to ask deeper questions about grief, mortality, and transformation. We talk about the liminal terrain of survivorship, the limitations of conventional medicine, and how a psychedelic journey helped her metabolize the kind of fear no doctor could treat. Today, the Survivorship Collective offers safe, science-informed, and deeply human psychedelic support to people facing the hardest truths life throws at us. Spread the Word: https://survivorshipcollective.com/help-us Retreats: https://survivorshipcollective.com/retreats

Join host Talaya Dendy on this special episode of 'Navigating Cancer TOGETHER.' Recorded in honor of National Cancer Survivor Month, this episode features an engaging and heartfelt panel discussion with five incredible cancer survivors: Annamaria Scaccia, Mary Wells, Russ Hedge, Terry Tucker, and Tom Reoach.They candidly reflect on their cancer journeys, the emotional and ongoing nature of survivorship, and the importance of connection, authenticity, and resilience. Tune in for powerful stories, shared wisdom, and practical advice for emotional well-being and rebuilding life that highlights the human side of cancer survivorship. This episode offers hope and insight for newly diagnosed patients, fellow survivors, caregivers, and those offering support.Don't miss these powerful stories. Tune in on Spotify, Apple Podcasts, YouTube, or your preferred podcast platform.

In this episode of Retire with Style, Alex Murguia and Wade Pfau explore key retirement planning strategies, including how couples can optimize Social Security benefits, what to do with surplus funds from bond ladders, and the potential benefits of purchasing single premium immediate annuities (SPIAs) from Roth IRAs. They highlight the importance of maintaining flexibility and tailoring strategies to each retiree's unique circumstances.   Takeaways Delaying social security can benefit the higher earner in a couple. The low earner has flexibility in claiming social security earlier. Using software can help determine optimal social security claiming strategies. Survivorship benefits are crucial in social security planning. Bond ladders are used for retirement income, not just reinvestment. Surplus funds from bond ladders can be invested in growth portfolios. Roth IRAs can be beneficial for purchasing SPIAs. SPIAs can provide tax-free income streams in retirement. Tax diversification is important in retirement planning. Real-life financial planning requires flexibility beyond strict rules. Chapters 00:00 Introduction and Overview 01:16 Social Security Strategies for Couples 06:41 Managing Bond Ladder Surplus Funds 16:29 Exploring SPIAs in Retirement   Links Explore the New RetireWithStyle.com! We've launched a brand-new home for the podcast! Visit RetireWithStyle.com to catch up on all our latest episodes, explore topics by category, and send us your questions or ideas for future episodes. If there's something you've been wondering about retirement, we want to hear it! The Retirement Planning Guidebook: 2nd Edition has just been updated for 2025! Visit your preferred book retailer or simply click here to order your copy today: https://www.wadepfau.com/books/ This episode is sponsored by McLean Asset Management. Visit https://www.mcleanam.com/retirement-income-planning-llm/ to download McLean's free eBook, “Retirement Income Planning”

As a Survivorship Coach, Marissa  Rusnow collaborates with clients to prioritize self-care, establish healthy boundaries, and embrace healing after life-altering events. Survivorship coaching focuses on embracing the new version of themselves with empowerment, fostering resilience, and inner peace, enabling individuals to transition from survival mode to thriving in their personal journeys.

Cancer therapies can save lives, but they often come with tough side effects that aren’t always fully addressed. What side effects should you expect from cancer treatments – and how can you manage them? We sat down with Elizabeth J. Cathcart-Rake, MD, an oncologist at Mayo Clinic, to explore how these effects impact patients’ physical, emotional, and financial well-being – and why quality of life deserves just as much attention. From nausea and fatigue to neuropathy and sexual side effects, we explore the most common fears and how to talk with your doctor. You’ll learn how different therapies (chemo, hormonal, immunotherapy, targeted therapy) impact your body, plus practical, evidence-based tools to help you feel like yourself during treatment.See omnystudio.com/listener for privacy information.

In this week's episode, we dig into two deceptively simple questions: When does someone become a cancer survivor, and should palliative care be in the business of caring for them? Spoiler: It's more complicated than it seems. We've invited two palliative care doctors to talk about survivorship with us: Laura Petrillo, a physician-researcher at Mass General Hospital and Harvard Medical School, and Laura Shoemaker, an outpatient palliative care doctor at the Cleveland Clinic. This episode is a must-listen for those navigating the evolving landscape of cancer care, and asking not just how we treat cancer, but how we support people who are living with it.  If you want some further reading on survivorship, check out some of these articles: A NEJM article titled “Time to Study Metastatic-Cancer Survivorship” A ASCO publication that includes a section on survivorship - Patient-Centered Palliative Care for Patients With Advanced Lung Cancer A webinar on survivorship - Blending Survivorship and Palliative Care (NCI)

In honor of National Cancer Survivor Month, guest host Christina Monaco, LMSW, sits down with young adult survivor Neema Philippe for an unflinching conversation about being diagnosed with cancer at age 29—and what comes next. Neema revisits the shock of her diagnosis, the whirlwind of treatments, and the grief of watching life plans shift overnight. She shares how vulnerability became a healing tool, why self-advocacy matters at every stage, and the small rituals that help her reclaim joy. Whether you're a survivor, caregiver, or clinician, Neema's reflections on self-care, community, and life “after” will leave you inspired—and better equipped to navigate your own path beyond cancer. Key takeaways: A cancer diagnosis at any age can be shocking and life-altering. The words “you have cancer” often bring intense emotional overwhelm. Life stage can deeply shape how someone experiences cancer, especially when it disrupts expectations or milestones. Medical decisions—like fertility preservation—carry emotional complexity and long-term considerations. Support systems play a vital role in coping with the isolation that can come with a cancer diagnosis. Embracing vulnerability can foster healing and a deeper connection. It's common to grieve the loss of imagined futures while navigating illness. Fear of recurrence can linger long after treatment ends. Finding moments of joy and meaning can help support emotional well-being during and after cancer treatment. Self-advocacy is essential when navigating the healthcare system and making informed decisions. 

Today, we're diving into something super important for anyone interested in mutual funds: the SPIVA Report, it's a big deal, and we'll break down why.But before we get to that, a quick note about August 4th. Chris, Daryl, and I are getting together that day to figure out how we can do even more to help you, not just now, but for the rest of your life as we all get closer to retirement. This is a huge goal, and we'd love your input! What can we do to improve our educational materials? Please email me your ideas at paul@paulmerriman.com. We're thinking about everything, from AI's role to helping you build a portfolio that truly lasts a lifetime, send your thoughts my way!The SPIVA Report: Active vs. Passive InvestingAlright, let's talk SPIVA. This report has been around since 2002, tracking the performance of active versus passive mutual funds. They analyze virtually every actively managed fund, comparing them to appropriate market indexes. They go to great lengths to ensure fair, "apples-to-apples" comparisons.A crucial aspect they address is survivorship bias. Many underperforming funds get merged or liquidated. If you were investing, these funds were part of your initial choices. SPIVA accounts for all funds, not just the ones that survived, giving a much more accurate picture. This is a key difference from other reports that only look at surviving funds, which can make active management look better than it is. They also track style consistency – ensuring funds stick to their stated investment approach, unlike some active managers who might "drift" in their investments.What the Data Reveals: The Long-Term AdvantageWhile single years can show active managers doing okay, the real story unfolds over longer periods. Let's look at large-cap core funds (like those tracking the S&P 500):·      1 year: ~76% underperform.·      10 years: 96% underperform!·      15 years: 97% underperform!·      20 years: 93% underperform.This is a powerful reason why I advocate for index funds. They're built on a formula, not on human managers trying to guess market winners. Across almost all equity asset classes, over 90% of actively managed funds underperform over 20 years.Why? The first advantage for index funds is lower expenses. While active fund fees have come down, they're still a major factor. The biggest hidden risk, though, is manager's picks and timing. Active managers try to beat the market with individual stock selections, but the data shows it's incredibly risky. (By the way the report doesn't address taxes on active funds and that can be another 1% drain annually.)SPIVA's quartile data highlights this: for small-cap value over five years, the top 25% of active funds started at 10% or more. But the bottom 25% earned significantly less than 7.8%. This means you're taking on volatility and the risk of vastly underperforming your chosen asset class.Survivorship & PatienceAnother eye-opening stat: over 20 years, only 36% of all domestic funds are still in business. For large-cap growth, where the action has been recently, only 26% of funds from 20 years ago are still around. This suggests poor performance led to closures or mergers, hiding underperformance from investors.In the end, you, the investor, are the hardest worker. Your discipline to stay the course during tough times is paramount. The SPIVA report is a quality piece of research, factual and fair. While the future won't be identical to the past, it often "rhymes." The longer your investment horizon, the more likely choosing index funds (traditional or non-traditional) will lead to success, avoiding performance that may be more luck than skill. Patience is key, and we want you to have patience in owning funds with a very high probability of success.WE ARE rooting for your investment success, not just for you, but for your children and grandchildren! So, good luck, and don't forget to send those suggestions for our August 4th meeting to paul@paulmerriman.com.

The cancer experience isn't just physical—it's deeply emotional. Join us for this special episode recorded onsite while filming our SHARE… The post LIVE! At SHARE: Emotional Wellness in Survivorship first appeared on The Bloodline with LLS.

In this episode, we speak with Emily Long Sarro, a board-certified family nurse practitioner specializing in adolescent and young adult (AYA) care at Memorial Sloan Kettering Cancer Center. We focus on the unique challenges AYAs face before, during, and after a stem cell transplant. Emily shares how this age group, defined as 15 years old to 39 years old by the National Cancer Institute, is often overlooked in the healthcare system, stuck between pediatric and adult care settings. They're navigating identity, relationships, careers, and independence—while also managing a serious illness, which can disrupt or halt life milestones.We discuss how Emily approaches AYA care with a holistic mindset—merging clinical treatment with emotional and mental health support. She emphasizes the importance of granting young patients autonomy and private space, especially when families may unintentionally overstep. She urges healthcare providers to always include mental health support in the treatment plan, noting that anxiety, depression, and even PTSD are common in this group, both during and long after treatment.Emily also stresses the need for daily coping tools like journaling, movement, and meditation to supplement infrequent counseling sessions. She encourages us to create trust by really listening, especially since many AYAs feel dismissed in early diagnostic stages due to their age.We then dive into critical but often unspoken topics: fertility preservation, sexual health, and survivorship. Emily outlines time-sensitive fertility options and highlights the emotional toll if these aren't addressed early. She covers the hidden costs of care and offers resource suggestions like Livestrong and Cancer and Careers. She also calls attention to "silent disabilities" that persist post-transplant and affect career and daily function, emphasizing self-advocacy in the workplace. Coworkers and others may not "see" these limitations, but accommodations are often necessary.We discuss milestones missed due to treatment and the emotional weight of watching peers move on through social media. Emily suggests practical ways to stay socially connected, such as virtual events and platforms like Cancer Buddy. For caregivers, she reminds us that support often means just being present and handling small tasks that feel overwhelming to the patient.  It's important to hold space for patients' sadness over missing milestones, but when appropriate, the big picture remains: they may be sacrificing a few milestones now to experience many more later.The episode closes with a deeply moving survivor story—a young man from The Bronx who overcame mistrust in the medical system, underwent a transplant, and now runs a thriving music production business. His resilience and transformation encapsulate the hope and strength that defines this patient group.More:Marrow Masters Season 9, Episode 2, with fertility resources in Show Notes: https://marrowmasters.simplecast.com/episodes/preserving-fertility-through-cancer-treatmentCancerCare – https://www.cancercare.orgImerman's Angels – https://imermanangels.orgLivestrong Fertility – https://livestrong.org/how-we-help/livestrong-fertility/Worth the Wait – https://worththewaitcharity.com/Maggie's Dream (Fertility Preservation Assistance)–https://www.teammaggiesdream.org/Cancer and Careers – https://www.cancerandcareers.orgCancer Buddy App (Bone Marrow Foundation) –https://bonemarrow.org/support-and-financial-aid-2/support/about-cancerbuddyThanks to our Season 17 Sponsors:Leukemia and Lymphoma Society (LLS): https://lls.org/and Incyte: https://incyte.com/ National Bone Marrow Transplant Link - (800) LINK-BMT, or (800) 546-5268.nbmtLINK Website: https://www.nbmtlink.org/nbmtLINK Facebook Page: https://www.facebook.com/nbmtLINKFollow the nbmtLINK on Instagram! https://www.instagram.com/nbmtlink/The nbmtLINK YouTube Page can be found by clicking here.To participate in the GVHD Mosaic, click here: https://amp.livemosaics.com/gvhd

Which patients with IDH-mutant glioma should receive an isocitrate dehydrogenase (IDH) inhibitor? A top neurosurgeon weighs in. Credit available for this activity expires: 6/9/2026 Earn Credit / Learning Objectives & Disclosures: https://www.medscape.org/viewarticle/1002598?ecd=bdc_podcast_libsyn_mscpedu

In this special episode of Navigating Cancer TOGETHER, host Talaya Dendy honors National Cancer Survivor Month by sharing deeply personal stories from eight incredible cancer survivors, including herself. The guests (Grisel Scarantino, Russ Hedge, Mary Wells, Tom Reaoch, Annamaria Scaccia, Terry Tucker, and Zoraida Morales) share deeply personal stories about their unique cancer journeys, revealing how their experiences transformed their perspectives on life, purpose, and personal growth. Each survivor discusses the challenges they faced after treatment, including physical side effects, emotional struggles, and the process of redefining their identity beyond their cancer diagnosis.Dive deeper into the themes of this episode in our companion blog post: https://www.ontheotherside.life/national-cancer-survivor-month-unpacking-the-dynamic-discoveries-of-life-after-cancerLearn more about National Cancer Survivor Month. https://cancercontrol.cancer.gov/ocs/about/survivorship-month

In this episode of Cancer Out Loud, guest host and oncology social worker Christina Monaco welcomes bladder cancer survivor Steven Gruber to explore life after diagnosis, just in time for May, Bladder Cancer Awareness Month. Steven recounts the moment he first saw blood in his urine, the frustrating run‑around he faced before landing in a world‑class NYC cancer center, and the decision to undergo radical bladder and prostate removal. He doesn't shy away from the complications—recurrent UTIs, emotional lows, and shifts in intimacy—but he also celebrates the community of caregivers, fellow survivors, and loved ones who carried him through.We're proud to partner with the Bladder Cancer Advocacy Network (BCAN) to highlight patient voices like Steven's. Today, he channels his experience into advocacy, reminding us all that survivorship is not just about living—it's about thriving.Key Takeaways:Early detection can improve outcomes.Persistence is key in navigating care.Treatment choices shape your path forward.Planning helps manage post‑treatment challenges.Emotional and spiritual strength sustains you.Relationships and intimacy can evolve after cancer.A strong support network is vital.Survivorship often inspires advocacy.Staying informed and taking action empowers you.

What is lifestyle medicine, and how can it apply to cancer care? In this empowering episode, we explore the transformative role of lifestyle medicine in cancer survivorship. We spoke to Amy Comander, MD, medical director of the Mass General Cancer Center-Waltham and the Breast Oncology Program at Newton-Wellesley Hospital, who explains how intentional choices around nutrition, exercise, sleep, and mental health can play a powerful role in cancer care. From diagnosis through recovery, we explore how these interventions can complement treatments such as chemotherapy and radiation, helping patients regain a sense of control and improve their quality of life.See omnystudio.com/listener for privacy information.

Svava Brooks is a survivor of child sexual abuse and the co-founder of a nationwide child sexual abuse prevention and education organization in Iceland called “Blátt áfram.” She is also a certified instructor and facilitator for Darkness to Light Stewards of Children, as well as a certified Crisis Intervention Specialist, a certified Positive Discipline Parent Educator, a BellaNet Teen support group facilitator, a Certified TRE® Provider, and a Trauma Recovery Coach. The mother of three children, Svava has dedicated her life to ending the cycle of child sexual abuse through education, awareness, and by helping survivors heal and thrive. She is a certified facilitator for Advance!, a program created by Connections to restore authentic identity. Every week, she writes about healing after trauma on her blog and also leads a discussion forum on child sexual abuse healing and recovery online, in her private Facebook groups and on her YouTube channel. After living in the US for 30 years, Svava now lives in Iceland and has a thriving practice offering somatic healing through TRE, and now has two self-published workbooks for survivors available on Amazon.  Host: Katie Koestner Editor: Evan Mader Producers: Catrina Aglubat and Emily Wang

Naomi Shihab Nye opens the talk reading a new, recently penned poem, Current Affairs. Dr. Izzeldin Abuelaish then introduces himself and segways into the realities of his experiences growing up in Gaza, the Jabalia Camp, what he has seen and witnessed, the loss of his three daugthers and niece in 2009 from an Israeli tank shell (i.e., I Shall Not Hate) and his pride in his Palestinan heritage, family, and community. He shares his deep belief and conviction 'nothing is impossible in life.' He also expresses: Medicine as a great human equalizer Toward human rights, once people step away from the border of the hospitals, they become categorized and labeled 'Palestinian' or 'Israeli' If you believe in Humanity, we must all stand for all Human Rights is deeply tested in Gaza, people must stand up for human rights Advocate not for peace but for dignity, justice, freedom, and human rights for all: peace will follow when these conditions are cultivated Naomi shares her family history and the experiences of relocating after the Nakba. Naomi also shares: As a poet, every voice is important in the world, every voice represents humanity. Regarding Gaza, this is an overwhelming tragedy of sorrow The importance of actions based on one's convictions The power of the military industry complex to overide the voice of the majority and humanity's collective voice How can we be heard, how can we be listened to? Who is listening? The idea, our obligation is to our humanity, looking within our selves we recognize our humanity Dr Abuelaish shares his experiences as an author. The priority of Palestinians toward education. Human Rights, respect and dignity for all. What is our modern sense of responsibility and obligation toward our fellow humans, what is our modern sense of meaning, mission, and purpose. A human being is a human being [only] through another person. Truth telling as means of healing. The situation is Gaza and West Bank harms Israel deeply as well. Naomi shares Hibu Abu Nabab's poem, Not Just Passing. The political power and politics contrbuting to the crisis in Gaza and the West Bank. Dr. Abuelaish reviews the history of Gaza since 2000. And, Naomi closes with her poem, For Gaza The children are still singing They need & want to sing They are carrying cats to safe places Holding what they can hold Red hair brown hair yellow They will wear the sweater Someone threw away They will hope for something tasty You won't be able to own them Their spirits fly to safer worlds They planted seashells in the sand They never committed a crime A president pardons turkeys He pardons his own son He doesn't pardon children The children are still singing. Naomi Shihab Nye was born in St. Louis, Missouri. Her father was a Palestinian refugee and her mother an American of German and Swiss descent, and Nye spent her adolescence in both Jerusalem and San Antonio, Texas. She earned her BA from Trinity University in San Antonio. Nye is the recipient of numerous honors and awards for her work, including the Ivan Sandrof Award for Lifetime Achievement from the National Book Critics Circle, the Lavan Award, the Paterson Poetry Prize, the Carity Randall Prize, the Isabella Gardner Poetry Award, the Lee Bennett Hopkins Poetry award, the Robert Creeley Prize, and many Pushcart Prizes. She has received fellowships from the Lannan Foundation, the Guggenheim Foundation, and she was a Witter Bynner Fellow. From 2010 to 2015 she served as a Chancellor of the Academy of American Poets. In 2018 she was awarded the Lon Tinkle Award for Lifetime Achievement from the Texas Institute of Letters. Nye was the Poetry Foundation's Young People's Poet Laureate from 2019-2022. Dr. Izzeldin Abuelaish, MD, MPH, is a Palestinian medical doctor who was born and raised in Jabalia Refugee Camp in the Gaza Strip. He is a passionate and eloquent proponent of peace between Palestinians and Israelis and has dedicated his life to using health as a vehicle for peace. He has succeeded despite all odds through a great determination of spirit, a strong faith, and a stalwart belief in hope and family. He has received a number of awards and nominations in recognition of his promotion of peace through health, and has been given seven honorary degrees. He has been nominated three years consecutively for the Nobel Peace Prize, and support for his candidacy keeps growing exponentially every year. He is the recipient of the Stavros Niarchos Prize for Survivorship, and was also nominated for the Sakharov Prize for Freedom of Thought. Since 2010 Dr. Abuelaish has also been named one of the 500 Most Influential Muslims by the Royal Islamic Strategic Studies Centre in Amman, Jordan for three consecutive years, and was the first ever recipient of the Mahatma Gandhi Peace Prize. Dr. Abuelaish's book, I Shall Not Hate: A Gaza Doctor's Journey, an autobiography inspired by the loss of his three daughters Bessan, Mayar, and Aya and his niece Noor to Israeli shelling on January 16, 2009, has achieved critical acclaim. Published in 2010, it has become an international best-seller and has been translated into 23 languages. The book has become a testament to his commitment to forgiveness as the solution to conflict, and the catalyst towards peace. Naomi Shihab Nye's poem Current Affairs I don't want to be one of those modern people who reads about Gazans being crushed wholesale entire blocks extended families invisible kitchens then continues scrolling. We will not delete you. We would give you anything we have. Your pain is not money. Feel us from a far place. Howling in darkness. What are you supposed to? No one should have to bear. I love you so much I can smell the garlic in your shirt, the dirt on your shoes, the smoke in your air.

Learn the terms healthcare teams use after cancer treatment is complete, and why they hesitate to use the word "cured."  https://bit.ly/3FfnfUxAdvances in cancer diagnosis, screening, and treatment have greatly improved the 5-year survival rates of most people with cancer over the last 30 years. Long-term survivors of cancer are more and more common, and research is increasingly directed at helping people live well after a diagnosis of cancer. But even so, many oncologists still hesitate to use the word “cure” with their patients. We talk with Dr. Jeanne Ford about the difference between the terms No Evidence of Disease (NED), remission, cure, and cancer free.In this Episode: 03:11 | Travel-Vermont and Vermont Chicken Pot Pie04:25 | The Trouble with Using the Phrase "Cancer Free"10:20 | Why We Don't Say Cancer is Cured12:00 | How Dr Ford Explains NED to Her Patients19:17 | What Does "Cure" Really Mean?29:38  | How Do Native Communities Treat the Concept of a Cancer Cure32:51 | The Role of Hope and How to Deliver Honest Information37:28 | Addressing Fear of Recurrence and Uncertainty about Future44:13 | Cancer Survivorship and Surveillance46:03 | Outro#survivor #cancersurvivor #cancerfree #remisssion #NED #cancercured #treatmentfinished #survivorship #oncologynurse #caregiver #palliativecare #everyonedies #everydayisagift #cancerjourneySupport the showGet show notes and resources at our website: every1dies.org. Facebook | Instagram | YouTube | mail@every1dies.org

What does it take to improve quality of life after head and neck cancer? In this episode of Backtable ENT, guests Dr. Heather Starmer, a speech and language pathologist at Stanford University, and Dr. Michael Moore, a head and neck cancer surgeon at Indiana University explore the topic of head and neck cancer survivorship.---SYNPOSISThe discussion centers on the multifaceted challenges faced by survivors, including dysphagia, dry mouth, chronic pain, and mental health issues. The experts emphasize the importance of early intervention, community support, and comprehensive care to enhance the quality of life for survivors. Various resources, such as the Head and Neck Cancer Alliance, are highlighted to assist patients and providers in navigating survivorship. The conversation also outlines future directions in research and the need for more qualitative studies to better understand long-term survivorship outcomes.---TIMESTAMPS00:00 - Introduction03:23 - Understanding Survivorship & Challenges in Head and Neck Cancer14:06 - Managing Mobility and Lymphedema18:47 - Addressing Chronic Pain and Mental Health21:37 - Dental Care and Trismus Therapy25:58 - Long-Term Survivorship and Quality of Life31:36 - Survivorship Clinics and Multidisciplinary Care34:39 - Resources for Patients and Providers38:49 - Future Research and Educational Gaps---RESOURCESDr. Heather Starmerhttps://med.stanford.edu/profiles/heather-starmerDr. Michael Moorehttps://iuhealth.org/find-providers/provider/michael-g-moore-md-64028

What does it mean to survive a diagnosis, and live with cancer? For this episode, we return to the subject that launched the very first season of Overlooked: ovarian cancer, with Teresa Arthur - aka Golda's Mom. Teresa was diagnosed in 2018 and has been living with recurring ovarian cancer for the last seven years, spending almost half of every year in chemotherapy treatment. She talks candidly with Golda about her health challenges and quality of life in survivorship. Take a listen to Teresa's story with ovarian cancer, which we told in our very first season here: https://overlooked.simplecast.com/episodes/fluid-puppySubscribe to the newsletter for more background on this episode: https://overlookedpodcast.kit.com/e4b85028b6If you're in New York City, come to our first listener ‘Meet & Greet' at 787 Coffee in Manhattan on May 31st. Tickets are free but limited - register here.  https://www.eventbrite.ca/e/overlooked-podcast-meet-greet-tickets-1352683656229?aff=oddtdtcreator LIKE WHAT YOU HEAR? Support the show by:- Leaving a review on Apple, Spotify, or wherever you're listening.- Becoming a Patron - Overlooked is on Patreon, where you can and get rewards like merch, the ability to send in questions for expert guests, and a 'backstage pass' to the show. New to Overlooked? Welcome. Overlooked was launched in 2023 to tell the story of ovarian cancer through one woman's story. In 2024 the show started to cover other overlooked topics in women's health - and there are many. The show is hosted by Golda Arthur, an audio journalist and producer. EMAIL US: hello@overlookedpod.com FOLLOW US:Instagram https://www.instagram.com/overlookedpod/LinkedIn https://www.linkedin.com/company/105541285/admin/dashboard/ LEARN MORE: https://overlookedpod.com/ DISCLAIMER What you hear and read on ‘Overlooked' is for general information purposes only and represents the opinions of the host and guests. The content on the podcast and website should not be taken as medical advice. Every person's body is unique, so please consult your healthcare professional for any medical questions that may arise.