Podcasts about treatment options

What matters most to patients with non-muscle invasive bladder cancer (NMIBC)? In this episode of BackTable Urology, Dr. Kelly Bree, Dr. Saum Ghodoussipour, and Meredith Donahue, N.P., join host Dr. Vignesh Packiam to discuss the power of shared decision-making across the NMIBC spectrum. They explore risk-adapted treatment selection, when to escalate or de-escalate therapy, and how to navigate conversations about recurrence risk, treatment burden, quality of life, and the possibility of cystectomy. --- Get the BackTable apphttps://www.backtable.com/app --- This podcast is supported by an educational grant from Johnson & Johnson. --- Timestamps 00:00 - Introduction01:55 - Second Opinions and Patient Counseling06:08 - Intermediate Risk Stratification12:13 - Treatment Options for Intermediate Risk NMIBC16:20 - BCG and Alternative Treatments for High Risk NMIBC26:49 - Options for BCG-Unresponsive NMIBC31:42 - Sequencing and Cystectomy37:03 - Financial and Time Toxicity41:08 - Biomarkers and ctDNA44:04 - Future Trials and NMIBC Innovations --- More about this episode They also review emerging therapies such as ZUSDURI, the evolving role of intravesical treatments, and the promise of biomarkers and ctDNA for personalized care. The discussion covers practical strategies for patient counseling, key updates to clinical guidelines, and a preview of innovations shaping the future of NMIBC management. --- Resources Active Surveillance Versus Intravesical Bacillus Calmette-Guérin for High-grade T1 Bladder Cancer with Negative Second Transurethral Resection: The Randomized Noninferiority Phase 3 JCOG1019 Trial:https://pubmed.ncbi.nlm.nih.gov/41571573/ Twelve-Month Results From the CISTO Study Comparing Radical Cystectomy Versus Bladder-Sparing Therapy for Recurrent High-Grade Non–Muscle-Invasive Bladder Cancerhttps://ascopubs.org/doi/10.1200/JCO-25-01324 CIRCULATING TUMOR DNA AS A BIOMARKER FOR UPSTAGING AND ADVERSE PATHOLOGY IN HIGH-RISK NON–MUSCLE-INVASIVE BLADDER CANCER:https://www.auajournals.org/doi/abs/10.1097/01.JU.0001191388.74345.c9.09 Preoperative Circulating Tumor DNA Predicts Upstaging and Recurrence in High-Risk Nonmuscle-Invasive Bladder Cancer Undergoing Radical Cystectomyhttps://pubmed.ncbi.nlm.nih.gov/41843048/ --- BackTable Urology is the go-to podcast for urologists, urologic oncologists, and urogynecologists. Download the free BackTable app to get early access to new episodes, cases, and courses curated by physicians in your specialty. ► https://www.backtable.com/app

In this conversation, Dr. Marc Smith shares his journey from hedge fund trading in New York's financial district to building an integrated ketamine psychiatry practice in California. After three years in finance doing trading and sales, Dr. Smith made the bold decision to completely pivot his career toward medicine, driven by a desire for purpose and meaning that his financial career couldn't provide.Dr. Smith's path took him through Columbia University for medical school, followed by psychiatry residency at USC, where he discovered his passion for interventional treatments like TMS and ketamine therapy. His unique perspective, having worked in both profit-maximizing finance and purpose-driven healthcare, provides valuable insights into the challenges of maintaining ethical medical practice in an increasingly commercialized healthcare environment.Dr. Smith's practice, Clear Ketamine + Psychiatry, represents an integrated model where he personally handles psychiatric evaluation, preparation therapy, ketamine treatment administration, and post-treatment integration sessions.What You'll Learn in This Episode· Career transition insights - How Dr. Smith navigated the complete pivot from finance to medicine, including the challenges and rewards of choosing purpose over profit in healthcare· Mental health crisis analysis - Dr. Smith's perspective on factors contributing to rising depression, anxiety, and suicide rates, including social isolation, technology impacts, and healthcare access barriers· Treatment-resistant depression understanding - Why 30% of patients don't respond to traditional antidepressants and how ketamine offers a different mechanism through NMDA receptor antagonism and neuroplasticity induction· Integrated practice model - Dr. Smith's unique approach combining psychiatric evaluation, preparation therapy, ketamine administration, and integration sessions all under one provider rather than outsourcing components· Intentions versus goals framework - How to help patients set internal emotional states they're striving for (intentions) alongside specific, measurable functional outcomes (SMART goals) for comprehensive treatment planning· Ketamine as catalyst concept - Understanding how ketamine works like "jumpstarting a car" to improve mood and motivation, while ongoing therapy and lifestyle changes provide the maintenance needed for sustained improvement· Ethical practice building - Dr. Smith's mission to combat ketamine stigma through evidence-based protocols while addressing concerns about recreational associations and inappropriate use in the field· Private practice autonomy benefits - How owning your own practice allows values-driven decisions that may conflict with profit maximization, contrasting with private equity-driven healthcare models· Business building practical advice - The importance of talking to other practice owners, understanding it's a marathon not a sprint, and knowing your limitations to outsource effectively· Biopsychosocial treatment approach - Addressing biological, psychological, and social elements of mental health through medications, therapy, exercise, sleep, nutrition, social connection, and nature exposureEpisode 58 show notes:00:00:00 - Teaser: Profit vs. Purpose in Healthcare 00:00:35 - Episode Introduction00:02:03 - Dr. Smith's Background: From East Coast to Medicine 00:02:30 - Career Transition: Three Years in Financial Industry 00:04:12 - Discovering Psychiatry Through Clinical Rotations 00:05:32 - Why Psychiatry: Deep Relationships and Human Connection00:08:50 - Tools in the Toolbox: TMS, Ketamine, and Treatment Options 00:09:30 - The Leap: Stepping Away from Finance Success 00:11:17 - The Marble Metaphor: Chiseling Away What We Aren't 00:12:46 - Self-Actualization and Gratitude in Medicine 00:14:01 - USC Residency and Academic Reception of Ketamine 00:16:54 - Evidence-Based Medicine and the Slow Pace of Change 00:19:17 - Mental Health Crisis: Social Isolation and Technology 00:22:50 - The Invisible Nature of Mental Health Challenges 00:25:28 - Private Equity vs. Patient Care: The Business Tension 00:30:18 - Private Practice Autonomy and Values-Based Decisions 00:32:15 - Clear Ketamine + Psychiatry: The Integrated Model 00:36:11 - Treatment Protocol: Six Sessions with Therapy Integration 00:37:56 - Ketamine as Jumpstart: The Car Analogy 00:42:00 - Intentions vs. Goals: Internal States and SMART Outcomes 00:46:30 - Ethical Standards and Combating Ketamine Stigma 00:50:15 - Practice Building Advice: Talk to Other Providers 00:52:55 - Rapid Fire Questions: Book Recommendation 00:54:52 - Last Meal 00:55:52 - Pickleball Obsession and the Philosophy of the Game 00:56:50 - Time Travel00:58:46 - Alternative Career01:00:04 - Advice to 20-Year-Old Self01:01:53 - Contact Information and Practice Details 01:03:03 - Final Thoughts: Gratitude and Evidence-Based Care 01:04:20 - Ending and ResourcesThanks for listeningConnect with Dr. Marc Smith at:Website: https://www.clearketapsych.comInstagram: @clearketapsych, @marcsmithmdLinkedIn: www.linkedin.com/in/marcsmithmdGoogle Maps: https://maps.app.goo.gl/GCHVy8q183c7WvfLA

What does good care actually look like for adults living with sickle cell disease?In this episode of our What Good Care Looks Like for Adults with Sickle Cell series, lifespan sickle cell expert Dr. Julie Kanter focuses on navigating treatment options and disease modifiers. Dr. Kanter breaks down the most prominent medications and therapies available today, including hydroxyurea, crizanlizumab, L-glutamine, and blood transfusions, explaining how patients and providers can work together to personalize care and find the best treatment path.Dr. Julie Kanter is the Co-Director of the Lifespan Comprehensive Sickle Cell Center at the University of Alabama at Birmingham and President of the ⁠National Alliance of Sickle Cell Centers⁠ (NASCC).This episode is part of Sickle Cell 101's Care and Treatment 101 Educational Initiative, a community resource dedicated to making care information accessible and actionable for the sickle cell community.Thank you to our Care and Treatment 101 sponsors: ⁠Vertex⁠, ⁠Chiesi⁠, ⁠Pfizer⁠, and ⁠Medunik⁠.

Discover what medical conditions qualify men for legal testosterone replacement therapy in Australia, the strict blood test thresholds required, and the compliant pathways to access doctor-supervised treatment—from GP referrals to telehealth options. Read more at https://trtaustralia.com/is-trt-legal-in-australia-status-treatment-options/ TRT Australia City: Hurstville Address: 7–11 The Avenue Website: https://trtaustralia.com/

A Place Called Hope: Dr. Francisco Contreras on Cancer Care, Faith, and Integrative Healing Episode Description In this episode of Conversations with a Chiropractor, Dr. Stephanie Wautier sits down with Dr. Francisco Contreras of Oasis of Hope in Tijuana, Mexico, for a thoughtful and deeply meaningful conversation about cancer care, hope, faith, prevention, and whole-person healing. Dr. Contreras shares the story of Oasis of Hope, founded by his father, Dr. Ernesto Contreras, more than 60 years ago. What began as a vision to care for the physical, emotional, and spiritual needs of cancer patients has grown into an international integrative oncology center serving patients from around the world. Stephanie and Dr. Contreras talk about the importance of treating the whole person, not just the diagnosis. Their conversation moves through integrative cancer care, immune support, natural and conventional treatment options, nutrition, exercise, stress, spiritual strength, early detection, breast cancer screening, biopsy concerns, and the role of hope in the healing process. Dr. Contreras also discusses why he believes patients need clear, understandable information when facing cancer. With so much information online, the process can feel overwhelming and frightening. His message is steady and compassionate: cancer is serious, but it does not have to immediately steal a person's joy, clarity, or hope. This episode includes discussion of cancer treatment, prevention, screening, integrative oncology, COVID vaccination concerns, and medical decision-making. It is meant to inform, encourage, and spark deeper questions, not replace personal medical advice. Anyone dealing with cancer, screening decisions, treatment options, supplements, or major health changes should work directly with a qualified medical team that understands their individual situation. In This Episode, Discover The story behind Oasis of Hope and its 60-year history How Dr. Ernesto Contreras helped shape a whole-person approach to cancer care Why Dr. Francisco Contreras believes emotional and spiritual support matter in healing What integrative oncology means at Oasis of Hope Why some natural therapies are studied but not widely approved or adopted How immunotherapy and immune support fit into the Oasis of Hope approach Dr. Contreras' perspective on rising cancer rates in younger people Simple lifestyle steps that may help reduce cancer risk The importance of fruits, vegetables, movement, stress reduction, and spiritual strength Why cancer symptoms often appear after disease is already present Mammograms, ultrasound, MRI, thermography, and early detection How Dr. Contreras thinks about biopsy risk versus diagnostic benefit When someone might consider contacting Oasis of Hope Why clear information matters when patients are overwhelmed The role of hope, mindset, faith, and joy during a cancer journey Stay Connected & Explore Learn More About Dr. Francisco Contreras and Oasis of Hope: Oasis of Hope: https://www.oasisofhope.com/ Dr. Francisco Contreras: https://www.oasisofhope.com/doctor/dr-francisco-contreras/ Request a Free Consultation: https://www.oasisofhope.com/contact-us/ Download Dr. Contreras' Free Cancer E-Book, The Art & Science of Undermining Cancer: https://www.oasisofhope.com/ Episode Sponsor: Learn more about Lemongrove Oil: https://www.lemongroveoil.com/ Connect with Conversations with a Chiropractor: Follow Us on YouTube: http://www.youtube.com/@ConversationswithaChiro Follow Dr. Stephanie on Facebook: https://www.facebook.com/wautierwellness Email for show-related inquiries and sponsorships: drstephaniewautier@yahoo.com Want to be a guest on Conversations with a Chiropractor? Send Stephanie Wautier a message on PodMatch, here: https://www.podmatch.com/hostdetailpreview/drstephanie Credits Podcast production by Brand|Sound. Start your podcast journey by emailing brandsoundpodcasts@gmail.com. Chapters 00:00 Introduction to Conversations with a Chiropractor 04:03 Meet Dr. Francisco Contreras 04:21 The Story Behind Oasis of Hope 08:08 Cancer Care Statistics and a Different Approach 08:46 Integrative Oncology and Treatment Options 10:47 Natural Therapies, Research, and FDA Approval 11:38 Immunotherapy and the Immune System 12:45 Science, Natural Therapies, and Patient Care 15:20 Rising Cancer Rates in Younger People 17:56 COVID Vaccination Questions and Cancer Concerns 21:20 Early Warning Signs and Cancer Prevention 22:23 Fruits, Vegetables, Exercise, and Risk Reduction 24:27 Stress, Immunity, and Spiritual Strength 26:05 Keeping Wellness Simple and Sustainable 29:36 Breast Cancer Screening, Mammograms, and Thermography 33:07 Biopsy Concerns, Risk, and Diagnostic Benefit 36:19 When to Contact Oasis of Hope 38:47 Referrals, Free Consultations, and Becoming a Patient 39:32 Dr. Contreras' Books and Free Cancer E-Book 42:10 Cancer Is Not Necessarily a Death Sentence 43:37 Hope, Mindset, and the Power of Joy 45:22 Final Thoughts and Closing

They promise to boost energy, improve immunity, and even ‘cleanse' your body — but are herbal and dietary supplements really safe for your kidneys? Today, we're diving into the truth behind their labels. In todays episode we heard from: Calvin Meaney is a pharmacist and clinical associate professor of pharmacy practice at the University at Buffalo with specialization in kidney disease. He provides clinical care to patients at the Erie County Medical Center, where he precepts pharmacy students and residents. Calvin's recent research has focused on anemia management in dialysis patients and reducing polypharmacy in older adults. Desirée de Waal, MS, RD, CD, FAND is a Renal Dietitian and Research Coordinator at University of Vermont Medical Center. She has published a variety of articles and book chapters including the value of Medical Nutrition Therapy in Kidney Failure; Hyperlipidemia; Potential Harms of High Protein Diets for Athletes; Bariatric Surgery; Kidney Stones with Metabolic Syndrome; Weighty Issue of Treatment Options for Obese Dialysis Patients; and Nickel Allergy Masquerading as Irritable Bowel Syndrome. Desirée has spoken at multiple conferences on a variety of subjects including sodium, magnesium, home dialysis, obesity, adherence, supplements, and time constraints. She has volunteered as part of the Academy of Nutrition and Dietetics' Nutrition Care Manual as Renal Expert, Managing Editor for Renal Nutrition Forum and has participated in Evidence Analysis Library projects. She has been on the National Kidney Foundation Renal Dietitian Spring Clinicals Planning Committee. Desirée was awarded 2013 Vermont's Dietitian of the Year Award and NKF Council of Renal Nutrition 2025 Recognized Renal Dietitian. She is a Board member of the Vermont Affiliate for the Academy of Nutrition and Dietetics plus Treasurer for the Vermont Kidney Association.   Show Notes: Herbal Remedies Vitamins and CKD CKD Medicines Integrative Medicine: Search About Herbs from Memorial Sloan Kettering

Long COVID and sports injuries are becoming impossible to ignore—and this episode explores why more athletes may be dealing with fatigue, soft tissue breakdown, and prolonged recovery after viral illness. In this powerful conversation, Dr. Greg Jones sits down with Dr. Muhammad Mansour, a naturopathic doctor and regenerative medicine specialist who treats elite athletes at the highest levels.In this episode, you'll learn how long COVID may affect skeletal muscle, mitochondrial function, exercise tolerance, and systemic inflammation—and why these issues can persist even after the initial infection appears to resolve. Dr. Mansour explains how athletes can miss early warning signs, why “pushing through” fatigue may backfire, and how a more individualized recovery strategy may be critical in the post-pandemic era.If you're an athlete, coach, practitioner, or health-conscious listener trying to understand the intersection of long COVID, inflammation, and injury risk, this episode offers a science-informed perspective on what recovery may require now.

Learn about the teen schizophrenia treatment landscape with expert insights on symptoms, early intervention, and the four levels of care available. Discover how families can support long-term recovery and why treating the entire family system makes all the difference.Info: https://missionprephealthcare.com/what-we-treat/schizophrenia-treatment/ Mission Prep City: San Juan Capistrano Address: 30310 Rancho Viejo Rd. Website: https://missionprephealthcare.com/

This week's episode explores the impact of Alzheimer's disease, on women in particular, and features insights from cognitive neurologist Dr. Neelum Aggarwal and personal stories from psychotherapist and author Leah Fisher, who herself has been diagnosed with Mild Cognitive Impairment with elevated Alzheimer's risk. The discussion covers risk factors, diagnosis challenges, and management strategies, emphasizing the importance of awareness and early intervention. We'd like to thank the American Medical Women's Association and Eli Lilly & Co for sponsoring this episode. Watch the convo on YouTube: https://youtu.be/nBReOsqkz7g   https://www.mymarriagesabbatical.com/ My Marriage Sabbatical: A Memoir of Solo Travel and Lasting Love Order Leah's book on Amason: https://amzn.to/4wM4IoD   (00:00) Intros & Bios (04:43) The Disparity Of Alzheimer's Amongst Women (09:33) Leah's Personal Experience (20:01) Primary Care's Role In Alzheimer's Diagnosis (28:04) Leah's Process Of Receiving Her Diagnosis (32:34) The Importance Of Communication In Diagnosis (35:00) Patient-Doctor Dynamics (39:12) What Life Looks Like For Leah Now (45:36) Management & Treatment Options (50:19) Final Thoughts Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this episode, we explore how adult ADHD shows up differently, why difficulty concentrating alone doesn't mean you have ADHD, and why many people are diagnosed later in life. We also discuss treatments that can make a meaningful difference.  Learn more about Dr. Diane Ukwuoma 

Dr. Tami Rowen, renowned expert in sexual medicine and menopause, joins Dr. Rena Malik to discuss the neuroscience of female sexual desire, FDA-approved treatments, the impact of birth control on hormones, the difference between perimenopause and menopause, the role of testosterone and progesterone, and how to separate evidence from marketing in hormone therapy. They also address common myths, the importance of physical health, optimizing sexual wellness, and the critical role of relationships in long-term health and happiness. Become a Member to Receive Exclusive Content: renamalik.supercast.com Schedule an appointment with me: https://www.renamalikmd.com/appointments ▶️Chapters: 00:00:00 Introduction00:02:22 Understanding Low Desire00:06:21 Diagnosing Sexual Desire Issues00:15:10 Arousal vs. Desire00:22:58 Treatment Options for Low Desire00:28:39 Testosterone Myths and Evidence00:38:44 Hormone Advice and Misinformation00:47:15 Hysterectomy and Sexual Function00:51:08 Birth Control and Perimenopause01:00:07 Bone Health and Hormones01:15:58 Progesterone's Role in the Body01:28:21 At-Home Cervical Screening01:32:42 Vitamin D, DHEA, and Supplements01:39:23 Rethinking Women's Sexual Health Become a Fora Advisor today at http://Foratravel.com/drmalik Stay connected with Dr. Tami Rowen on social media for daily insights and updates. Don't miss out—follow her now and check out these links! INSTAGRAM - https://www.instagram.com/drtamirowen/ Let's Connect!: WEBSITE: http://www.renamalikmd.com YOUTUBE: https://www.youtube.com/@RenaMalikMD INSTAGRAM: http://www.instagram.com/RenaMalikMD TWITTER: http://twitter.com/RenaMalikMD FACEBOOK: https://www.facebook.com/RenaMalikMD/ LINKEDIN: https://www.linkedin.com/in/renadmalik PINTEREST: https://www.pinterest.com/renamalikmd/ TIKTOK: https://www.tiktok.com/RenaMalikMD ------------------------------------------------------ DISCLAIMER: This podcast is purely educational and does not constitute medical advice. The content of this podcast is my personal opinion, and not that of my employer(s). Use of this information is at your own risk. Rena Malik, M.D. will not assume any liability for any direct or indirect losses or damages that may result from the use of information contained in this podcast including but not limited to economic loss, injury, illness or death. Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Steven Bialick discusses treatment options for pancreatic cancer.

Please visit answersincme.com/NYR860 to participate, download slides and supporting materials, complete the post test, and get a certificate. Presented by Jill Liss, MD, MSCP; Denise Black, MD, FRCSC; and Danielle Covarrubias. In this activity, experts in women's health, joined by a patient advocate, discuss the burden of menopause-related vasomotor symptoms (VMS) and novel management strategies. Upon completion of this activity, participants should be better able to: Identify the impact and burden of VMS as a consequence of menopause; Outline the clinical rationale for novel therapeutic approaches to manage menopause-related VMS; Evaluate the efficacy and safety of novel neurokinin-targeted therapies for treating menopause-related VMS; and Implement patient-centered clinical approaches to improve outcomes for patients experiencing menopause-related VMS.

In this episode of the Optimal Body Podcast, doctors of physical therapy, Doc Jen and Doctor Dom, discuss hernias, explaining what they are, their types, causes, and treatment options. They differentiate hernias from conditions like diastasis recti and prolapse, emphasizing that hernias involve a fascial defect requiring surgery. Dr Dom shares her personal experience with bilateral inguinal hernias and inadequate post-surgical rehabilitation. Both hosts stress the importance of core and pelvic floor rehabilitation before and after surgery to manage symptoms and prevent recurrence, encouraging listeners to work with pelvic floor physical therapists and explore their Jen Health core and pelvic floor program. Jen Health Annual Membership Discount: Huge discount on Jen Health Annual Membership! Podcast listeners get over 50% off with code OPTIMAL10. Access 12 Therapy Plans and start your free trial now—move with us! We think You'll Love: Jen Health Annual Sale! Jen's Instagram Dom's Instagram YouTube Channel For full episode show notes and resources visit https://jen.health/podcast/458 What You'll Learn: 1:24 Introduction to hernias, their prevalence, and the episode's goal to explain anatomy, treatment, and recovery. 1:56 Clarifies what a hernia is, types of hernias, and distinguishes hernias from herniated discs and other conditions. 2:54 Explains fascia's role, causes of hernias (congenital, pressure, trauma), and anatomical weak points. 4:13 Discusses how hernias differ from diastasis recti and prolapse, focusing on tissue stretching versus protrusion. 6:14 Describes the umbrella of pressure-related abdominal canister problems and contributing factors. 6:42 Explains reducible, incarcerated, and strangulated hernias and their clinical significance. 7:31 Details inguinal and umbilical hernias, surgical repair options, recurrence rates, and chronic pain risks. 9:33 Doc Jen shares her experience with inguinal hernia surgery, chronic pain, and lack of post-surgical rehab guidance. 12:08 Highlights the need for core and pelvic floor rehabilitation before and after hernia surgery. 14:35 Discusses research on exercise for hernia management, symptom reduction, and the difference between fixing appearance and function. 16:49 Explains how proper pressure management enables return to activity, even with hernias or diastasis recti. 17:47 Covers the importance of prehab and rehab, timelines for... Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

The hemophilia treatment landscape is evolving faster than ever. In this episode of Global Hemophilia Report, Patrick James Lynch and Dr. Donna DiMichele are joined by Drs. Hermans, Carpenter, and Hansen to break down the emerging class of rebalancing agents—therapies that don't replace clotting factor, but target new parts of the coagulation cascade. We explore what these treatments mean for patients, clinics, and shared decision-making around the world. Key takeaways include the urgent need for real-world data, better patient education, and the potential for new therapies to protect joint health in ways never seen before. Tune in to hear expert insights, practical considerations, and the future of hemophilia care. Guests: Dr. Cedric Hermans, MD, - Hemophilia Centre,  Saint-Luc University Hospital, Brussels  Dr. Shannon Carpenter, MD - Pediatric Hematology, Kansas City Hemophilia Center: CJ Hansen BSN, RN - Nurse Coordinator & Program Manager,  OSU Comprehensive Cancer Center, Patient Advocate   Senior Advisor: Donna DiMichele, MD   Hosted by: Patrick James Lynch   Featured Advertiser: Sanofi   Subscribe to the Global Hemophilia Report   Show Notes:   The Bigger Picture in Hemophilia B:  Hemophilia A and hemophilia B are different bleeding disorders with unique pathologies and clinical features.1 Due to the distinct behavior of factor IX, multiple PK parameters should be considered when assessing bleed prevention. Learn how a broader view of PK may influence evaluation of treatment and management for patients with hemophilia B.2,3 Learn more at thebiggerpictureinhemb.com  1. Castaman G, Matino D. Haematologica. 2019;104(9):1702-1709. 2. Dolan G, Benson G, Duffy A, et al. Blood Rev. 2018;32(1):52-60.  3. Mann DM, Stafford KA, Poon M-C, Matino D, Stafford DW. Haemophilia. 2021;27(3):332-339.   Connect with the Global Hemophilia Report Global Hemophilia Report on LinkedIn Global Hemophilia Report on X/Twitter Global Hemophilia Report on Facebook   Connect with BloodStream Media: BloodStreamMedia.com BloodStream on Facebook  BloodStream on X/Twitter   

Testosterone levels in men have declined more than 25% over the last two decades. And most people — men and women alike — have no idea why, what it means, or what to do about it.In this episode, Leslie sits down with Shalin Shah, CEO of Marius Pharmaceuticals and one of the leading voices in the testosterone therapy space, to have the conversation that a lot of doctors still aren't having. Leslie brings her own experience — she's been on topical testosterone as part of her HRT protocol — and together they go deep on why T levels are dropping, how to know if yours are low, and what the treatment landscape actually looks like in 2026.They cover the difference between total and free testosterone and why the number your doctor shows you may be almost meaningless. They talk about the FDA panel that convened in December 2025, what was asked of regulators, and why the outcome could change how millions of people access care. They discuss why testosterone got classified as a controlled substance in 1990, the faulty studies that put cardiovascular and prostate cancer warnings on labels for decades, and what the landmark 2023 Traverse Study finally put to rest.They also talk about women — because testosterone is a female hormone too, and the gap between how men and women access treatment is still significant.If you've been curious about this subject — whether for yourself, your partner, your father, or your sons — this is the conversation to start with.Follow Duologue on Instagram @duologuepod and subscribe so you never miss an episode.00:00:00 Introduction & Leslie's Personal Story 00:02:18 The State of Testosterone Today 00:05:57 What's Causing the Decline 00:08:00 Symptoms of Low T & Why You Should Get Tested 00:10:10 Why Your Doctor Probably Isn't Testing You 00:12:24 What's a Normal Testosterone Level? 00:16:20 Testosterone and Women 00:20:00 Leslie's HRT Journey & Treatment Options 00:25:20 Natural Ways to Boost Your Levels 00:30:03 The FDA Panel — What Was Discussed 00:33:20 The Prostate Cancer Study — 3 People, 80 Years of Policy 00:36:30 What Needs to Change & What's Next 00:40:34 OutroHosted on Ausha. See ausha.co/privacy-policy for more information.

Everything you thought you knew about menopause, weight gain, and hormones — a specialist just changed the conversation. Get the full show notes and information here: https://drdebbutler.com/524  

CME credits: 0.50 Valid until: 15-04-2027 Claim your CME credit at https://reachmd.com/programs/cme/retina-rumble-debating-modern-treatment-options/54609/ Current guidelines recommend the use of second-generation therapies for the treatment of retinal diseases; however, limited head-to-head study data make it difficult to determine which strategies to use for specific patients and at what time. In this activity, experts in the field of retinal diseases provide their preferred management strategies based on real-world and long-term clinical data using 3 patient cases.=

Join Dr. Clancy and his guests, Drs. Ejsmont, Castano-Heredia, and Rani, as they discuss the increased incidence of childhood diabetes as well as standards of care and new monitoring and treatment interventions.  Episode TranscriptCME Credit Available   Host: Gerard Clancy, MD Senior Associate Dean for External Affairs Professor of Psychiatry and Emergency Medicine University of Iowa Carver College of Medicine Guests: Lisa Ejsmont, PharmD, BCACP Assistant Professor Clinical Pharmacist Specialist Stead Family Children's Hospital University of Iowa Carver College of Medicine Gabriel Castano-Heredia, MD Assistant Professor in Pediatrics Stead Family Department of Pediatrics University of Iowa Carver College of Medicine Uzma Rani, MD Assistant Professor in Pediatrics Stead Family Department of Pediatrics University of Iowa Carver College of Medicine Financial Disclosures:  Dr. Gerard Clancy, his guests, and Rounding@IOWA planning committee members have disclosed no relevant financial relationships. Nurse: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this activity for a maximum of 1.00 ANCC contact hour. Pharmacist and Pharmacy Tech: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this knowledge-based activity for a maximum of 1.00 ACPE contact hours. Credit will be uploaded to the NABP CPE Monitor within 60 days after the activity completion. Pharmacists must provide their NABP ID and DOB (MMDD) to receive credit. JA0000310-0000-26-045-H01 Physician: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this enduring material for a maximum of 1.00 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other Health Care Providers: A certificate of completion will be available after successful completion of the course. (It is the responsibility of licensees to determine if this continuing education activity meets the requirements of their professional licensure board.) References/Resources:  American Diabetes Association Professional Practice Committee: 14. Children and Adolescents: Standards of Care in Diabetes - 2026. https://diabetesjournals.org/care/article/49/Supplement_1/S297/163923/14-Children-and-Adolescents-Standards-of-Care-in Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity. https://www.aap.org/en/patient-care/institute-for-healthy-childhood-weight/clinical-practice-guideline-for-the-evaluation-and-treatment-of-pediatric-obesity/ Point of Care Quick Reference: Diabetes Mellitus. American Academy of Pediatrics. https://doi.org/10.1542/aap.ppcqr.396154 The Rise of Type 2 Diabetes in Children and Adolescents: An Emerging Pandemic. https://doi.org/10.1002/dmrr.70029 Treatment Options for Type 2 Diabetes in Adolescents & Youth (TODAY) (Version 4) [Dataset] NIDDK Central Repository. https://doi.org/10.58020/2w6w-pv88  

In Part 2 of this conversation, the focus shifts from understanding tinnitus to how it's actually managed.Dr. Jennifer Gans returns to speak with Shari Eberts about tinnitus management strategies. Building on their previous conversation, she outlines a practical framework for evaluating treatments, centered on three core elements: reducing anxiety, providing accurate education, and supporting nervous system regulation. Rather than focusing on specific products or claims, the discussion emphasizes how individuals can make informed decisions in a crowded and often confusing landscape.Dr. Gans also explores mindfulness-based approaches, sound therapy, hearing aids, and common misconceptions around supplements and “quick fixes.” The conversation reinforces a key idea: tinnitus is less about eliminating the sound and more about changing the brain's response—offering a grounded, evidence-based perspective for clinicians, researchers, and individuals seeking to reduce tinnitus distress.**Check out Dr. Gans' weekly column at: https://hearinghealthmatters.org/tinnitus-education-corner**Learn more about Dr. Gans and her work at: https://mindfultinnitusrelief.com/Be sure to subscribe to our channel for the latest episodes each week and follow This Week in Hearing on LinkedIn, Instagram and X.- https://x.com/WeekinHearing- https://www.instagram.com/thisweekinhearing/- https://www.linkedin.com/company/this-week-in-hearingVisit us at: https://hearinghealthmatters.org/thisweek/

What does social anxiety really feel like, and what causes it? Learn about the physical and emotional symptoms, plus proven treatments like CBT, exposure therapy, and medication that actually work for long-term relief. Learn more at https://missionconnectionhealthcare.com/what-we-treat/anxiety-treatment/social-anxiety/ Mission Connection City: San Juan Capistrano Address: 30310 Rancho Viejo Rd. Website: https://missionconnectionhealthcare.com/

Did you know that up to 75% of women develop fibroids at some point in their lives? In this episode, I speak with Dr. Bryan Treacy about what fibroids are, how they can affect your health, and the treatment options available. Also we clarify some confusion from our last conversation on fibroids and blood flow. We cover: What fibroids are and why they form Case studies, including women with multiple fibroids How fibroids contribute to heavy menstrual bleeding Different causes of heavy bleeding in the presence of fibroids Uterine fibroid embolization (UFE) and why it's offered Fibroid recurrence after myomectomy Recurrent polyps after menopause and distinguishing polyps from cancer- Gaslighting in women's healthcare – when women are not heard, misdiagnosed or prescribed unnecessary medications *Point of Reference mentioned in the conversation; How fibroids can cause heavy bleeding: Increased surface area of the uterine lining = Submucosal fibroids stretch the lining, causing more tissue to shed. Distortion of the uterus = Fibroids interfere with normal uterine contractions, prolonging bleeding. Fragile blood vessels = Fibroids can form abnormal vessels that rupture easily. Local hormonal signaling = Fibroids can produce signals that overstimulate the endometrium. Venous congestion = Large fibroids compress veins, causing blood pooling. If you're curious about fibroid treatments or want to better understand your options, this episode is a must-watch. Dr BryanTreacy is an esteemed Ob/Gyn with over thirty years of experience, his mission is to empower individuals on their health journey. Dr. Treacy's transition from traditional medicine to health consulting and coaching has opened new avenues for personalized and intuitive healthcare. Dr Treacy has performed hundreds of hysterectomies and delivered just as many babies during his years of practice. His experience and expertise is invaluable to us all. Connect with Dr Treacy here; YouTube - ‪‪@healthwithoutrisk‬ Website - https://www.healthwithoutrisk.com/about LinkedIn - / bryantreacy Instagram - / healthwithoutrisk

FREE RESOURCE:  Try our Cyclical Nourishment Guide: https://rebeltribe.thrivecart.com/cyclical-living-nutrition/   In this conversation, Dr. Beverly Huang shares her personal journey through breast cancer, including her diagnosis, treatment options, and the emotional and physical challenges she faced.  The discussion highlights the importance of being informed and making empowered decisions regarding health care, particularly in the context of breast cancer treatment.  Dr. Huang emphasizes the significance of storytelling and community support in navigating such a life-altering experience.  She shares her journey through multiple surgeries, including a mastectomy and reconstruction.  She discusses the complexities of making surgical decisions, the emotional challenges faced during recovery, and the importance of understanding different reconstruction options.  The conversation highlights the personal nature of these decisions and the impact they have on body image and self-perception. Dr. Huang emphasizes the need for support and preparation for the realities of post-surgery life, as well as the lessons learned from her experiences.  In this conversation, Dr. Huang shares her journey through breast cancer treatment, emphasizing the importance of mobility, rehabilitation, and early detection.  She discusses her experiences with physical therapy, the significance of patient advocacy, and the creation of educational resources for women.  The dialogue highlights the power of storytelling in health education and the need for women to take charge of their health decisions.   Takeaways Dr. Beverly's journey began as a way to process her thoughts out loud. She discovered her breast density category was higher than she initially thought. The importance of being informed about breast cancer and treatment options. Surgery day was a long process, but she felt cared for by her medical team. Understanding the different types of breast cancer is crucial for treatment decisions. Mastectomy options include lumpectomy, single, or double mastectomy. The decision-making process is highly individual and influenced by personal circumstances. Efficiency in treatment was a significant factor for Dr. Beverly. Reconstruction options vary and can be tailored to individual needs. Community support and storytelling play a vital role in healing.  Recovery from surgery can be a complex decision-making process. Choosing between implants and going flat involves weighing personal desires and risks. Understanding the different reconstruction options is crucial for informed decisions. The emotional impact of surgery can lead to feelings of vanity and self-doubt. Post-surgery adjustments can be challenging, both physically and emotionally. Support from healthcare professionals can make a significant difference during recovery. It's important to prepare for unexpected challenges after surgery. Physical strength and fitness can aid in recovery from surgery. Women have diverse experiences and feelings about their bodies post-surgery. Sharing experiences can help others navigate similar journeys. Post-surgery mobility is crucial for independence. Manual lymphatic drainage significantly aids recovery. Rehabilitation should focus on gentle activation and mobility. Creating educational resources empowers women in their health journey. Early detection of breast cancer can lead to better treatment options. Patient advocacy is essential in navigating healthcare decisions. Women should be proactive about their health screenings. Storytelling can effectively communicate important health messages. Support systems play a vital role in recovery. Healthcare professionals need to provide accurate information for informed consent.   Chapters 00:00 Introduction and Personal Connection 03:31 Dr. Beverly's Journey with Breast Cancer 11:45 Surgery Day Experience 16:40 Understanding Breast Cancer Types and Treatment Options 23:36 Decision-Making in Mastectomy and Reconstruction 27:46 Navigating Surgical Decisions 29:34 Understanding Reconstruction Options 32:45 The Emotional Journey of Surgery 36:50 Post-Surgery Realities and Adjustments 42:00 Lessons Learned from Recovery 48:13 Post-Surgery Mobility and Independence 51:07 Rehabilitation and Physical Therapy Insights 54:14 Navigating Recovery and Future Plans 01:00:03 The Importance of Early Detection and Patient Advocacy 01:05:03 Empowering Women Through Shared Experiences   Stay Wild.  Connect with Dr. Beverly Huang on INSTAGRAM Connect with Dr. Michelle Peris on INSTAGRAM FREE RESOURCE:  Click the link and see if the SHED METABOLIC RESET PROGRAM is a good fit for you!  This episode is brought to you by: www.MichellePeris.com Ready to reclaim your Wild? JOIN THE WAITLIST Learn more about The Poppy Clinic: www.poppyclinic.com Is Naturopathic Medicine for you: LEARN MORE HERE Take our HORMONE QUIZ Are you a clinician looking for more impact? START HERE

In this episode of ASTCT Talks, host Corey Cutler, MD of Dana-Farber Cancer Institute and Harvard University sits down with Nosha Farhadfar, MD, medical director of research for Sarah Cannon Research Institute's transplant and cellular therapy program at Methodist Healthcare, and Pooja Khandelwal, MD, an associate professor within the division of bone marrow transplantation at Cincinnati Children's Hospital Medical Center, to discuss adult and pediatric treatment perspectives for cGVHD.Tune in for a conversation that covers:Adult and pediatric cGVHD treatment approaches,including frontline choices and the selection and effectiveness of medications.Expert practice experiences for use in cGVHD treatment.New therapeutics the experts are looking forward to in cGVHD treatment. This episode was made possible thanks to a grant from Incyte.

Have burning, electric shocks, tingling or numbness after chemo? Learn why and how to manage it.  https://bit.ly/3Nra074We dive into a common but often overlooked side effect of chemotherapy: chemotherapy-induced peripheral neuropathy (CIPN). Up to 40% of cancer survivors who receive certain chemotherapy drugs experience tingling, numbness, pain, or weakness in their hands and feet. We'll unpack which drugs are most likely to cause CIPN, why it happens, what symptoms to watch for, and how to manage or even improve function over time. From medications to physical and occupational therapy, balance training, and lifestyle strategies, this episode offers evidence-based insights to help cancer survivors and caregivers better understand and cope with CIPN.In this Episode:00:00 - Intro: Understanding Chemotherapy-Induced Peripheral Neuropathy (CIPN)02:07 - Marge Simpson and Santa's Little Helper's Visit to "The Pitt" ED05:33 - What is Chemotherapy-Induced Peripheral Neuropathy (CIPN)06:29 -  Why Chemo Causes Pins and Needles (The Science of Nerve Damage) 09:11 - Is there Hope of Recovering from CIPN? Treatment Options and Lifestyle Considerations13:40 - The Lived Experience of Chemotherapy-Induced Peripheral Neuropathy20:54 - OutroResources: Download our CIPN Symptoms & Safety Infographic Here S5E34: How to Avoid Falls, the Leading Cause of Death for Older Adults (Discusses many of the fall mitigation steps that can help someone with peripheral neuropathy)S6E5: Understanding Cancer Treatment Options: ChemotherapyS1E03: What is Palliative Care? (Learn how palliative care envelops symptom management along a treatment path, such as chemotherapy side effects.)S4E37: A Family's Perspective on Palliative Care – with Connie BakerS5E25: The Important Role of the Microbiome to Your Health and Immune Function (Good nutrition is important to neuron regeneration)S5E4: Inflammation: What it is, How It Causes Disease, and How You Can Decrease ItAll Cancer Topics (Everything You Wanted to Know About Cancer, But Didn't Have Anyone to Ask)Support the showConnect with Us: Email our Host: mail@every1dies.org Website: https://every1dies.org: Find show notes, links and expanded resources Follow Us: Facebook | Instagram | YouTube

Diagnosing hypertension, known as a "silent killer," is incredibly important. Interventional cardiologists Ricardo Yaryura, MD, Jeffrey Rossi, MD and Daniel Molloy, MD, explain the diagnosis, traditional treatments and a newer option for uncontrolled blood pressure. You can also watch the video recording on our Vimeo channel here. For more health tips & news you can use from experts you trust, sign up for Sarasota Memorial's monthly digital newsletter, Healthe-Matters.

People seem to always be full of advice about fertility, and while most of it comes from a place of wanting to be helpful, not all of it is well informed or welcome. When you are trying to conceive, the last thing you want to hear is that you need to "relax." Or "go on a vacation, drink some wine, and let nature run its course." Am I right?   In this episode, I'm sharing the types of treatments that fertility doctors offer to patients, including information about fertility pills, fertility shots, IUI, and IVF. I'm also outlining some of the natural things you can do to improve your chances of conceiving, like salt floats, hypnotherapy, and self care. Read the full show notes and transcript on Dr. Aimee's website Would you like to learn more about IVF?Click here to join Dr. Aimee for The IVF Class. The next live class call is on Monday, April 20, 2026 at 4pm PST, where Dr. Aimee will explain IVF and there will be time to ask her your questions live on Zoom.   Dr. Aimee Eyvazzadeh is one of America's most well known fertility doctors. Her success rate at baby-making is what gives future parents hope when all hope is lost. She pioneered the TUSHY Method and BALLS Method to decrease your time to pregnancy. Learn more about the TUSHY Method and find a wealth of fertility resources at www.draimee.org. Other ways to connect: Subscribe to my YouTube channel for more fertility tips Join Egg Whisperer School Subscribe to the newsletter to get updates

In this episode of "Next Steps 4 Seniors: Conversations on Aging," host Wendy Jones interviews exercise physiologist Kerri Branca about Parkinson’s disease. They discuss early signs such as loss of smell, constipation, and subtle movement changes, emphasizing the importance of early diagnosis and seeing a movement disorder specialist. Kerri highlights the critical role of exercise, education, and socialization in managing Parkinson’s, shares practical tips for staying active, and reviews treatment options like levodopa. The episode also points listeners to valuable resources, aiming to empower seniors and caregivers with knowledge and support. Every week brings two ways to grow: Tuesdays dive into the physical next steps with real-life guidance for seniors and families, and Fridays uplift the heart with spiritual and emotional next steps—encouragement, faith, and hope for the journey ahead. Today’s episode explores the transformative power of forgiveness and its vital role in experiencing an abundant life as we age. To learn more about Next Steps 4 Seniors, contact us at 248-651-5010 or visit us online at www.nextsteps4seniors.com.Learn more : https://omny.fm/shows/next-steps-4-seniors-with-wendy-jonesSee omnystudio.com/listener for privacy information.

I received the following reader question:My name is Mary and I'm a family doc (you can use my first name if you print this.) I wouldn't say that I'm fully onboard with being weight inclusive but I've been reading your work and I can't deny that what you are writing makes sense and is grounded in research (some of which I had never heard of in any of my training.) I have been thinking about what you wrote when you said how important it is that we ask our patients questions instead of making assumptions. I will admit to making assumptions about diet and exercise with patients who are what you would call higher weight. Thank you for helping me see that, but I'm having difficulty with what to do instead and how to ask the questions and I thought others might be as well. Is this something you would be interested in writing about?Thanks for the introspection, the open-mindedness, and the great question, I'm happy to write about this. Get full access to Weight and Healthcare at weightandhealthcare.substack.com/subscribe

Understanding the science behind TRT for muscle weakness, from injections to oral options, and how lifestyle choices and recent research are reshaping treatment for low testosterone. Learn more at https://trtaustralia.com/types-of-trt-treatments/ TRT Australia City: Hurstville Address: 7–11 The Avenue Website: https://trtaustralia.com/x

Termites in Miami never sleep, and by the time you see the signs, the damage is already serious. From "super termites" to hidden drywood colonies, here is how to choose the treatment that actually saves your home. Learn more at https://911homehelps.com/termite-control/ 911 Pest Experts City: Palmetto Bay Address: 9555 Southwest 175th Terrace #202 Website: https://911homehelps.com/ Phone: +1 786 269 6959 Email: info@911homehelps.com

Learn about Seattle's mental health resources, from outpatient programs and telehealth services to crisis lines and community support groups. Understand how to find treatment options, work with insurance coverage, and access personalized care that fits your life. Read more at https://missionconnectionhealthcare.com/our-facilities/washington/outpatient-mental-health-services-seattle/ Mission Connection City: San Juan Capistrano Address: 30310 Rancho Viejo Rd. Website: https://missionconnectionhealthcare.com/

Cardiomyopathy is a serious condition that affects the heart muscle, making it harder for the heart to pump blood the way it should. Rajeev Mohan, MD, a cardiologist specializing in advanced heart failure and transplant cardiology at Scripps Clinic, explains the different types of cardiomyopathy — including stress-induced "broken heart syndrome" — and what symptoms to watch for. Dr. Mohan also walks through how cardiomyopathy is diagnosed, the latest treatment options (from medications to implanted devices and surgery) and when it's time to see a doctor.

In today's episode, the discussion features Aditya Bardia, MD, MPH, FASCO. Dr Bardia is a professor in the Department of Medicine in the Division of Hematology/Oncology, the director of Translational Research Integration, and a member of Signal Transduction and Therapeutics at the UCLA Health Jonsson Comprehensive Cancer Center in Los Angeles, California.In the exclusive interview, Dr Bardia discussed the rationale and design of the phase 3 ELEGANT study (NCT06492616), which is evaluating elacestrant (Orserdu) compared with standard endocrine therapy in patients with estrogen receptor–positive, HER2-negative early breast cancer at high risk of disease recurrence.

Think beyond the esophagus. Up to 75% of eosinophilic esophagitis (EoE) patients have ENT-relevant atopic disease that is often best managed with a multidisciplinary approach. Get caught up on best practices in EoE diagnosis and treatment with this episode of the BackTable ENT Podcast, featuring dual board-certified gastroenterologist and allergist-immunologist Dr. John Leung and host Dr. Basil Kahwash. --- SYNPOSIS The discussion covers the definition, symptoms, and diagnosis of EoE, highlighting the role of food and environmental allergies. Dr. Leung and Dr. Kahwash cover diagnostic techniques like endoscopy and emerging non-invasive methods, as well as various treatment options including dietary modifications, pharmacology, and biologics. The doctors also emphasize the importance of multidisciplinary collaboration between gastroenterologists, allergists, and otolaryngologists to provide optimal care for patients with EoE. --- TIMESTAMPS 00:00 - Introduction 03:13 - Understanding Eosinophilic Esophagitis (EoE)05:45 - EoE Symptoms and Diagnosis08:41 - Role of ENT in EoE Diagnosis11:32 - Diagnostic Criteria for EoE16:34 - Treatment Options for EoE20:55 - Role of Allergists and Environmental Allergies23:24 - Pharmacological Management of EoE29:38 - Complications and Risks of EoE36:21 - Follow-Up Endoscopies and Surveillance40:34 - Future Directions in EoE Management45:21 - Conclusion and Final Thoughts --- RESOURCES Dr. John Leunghttps://www.bostonspecialists.org/dr-leung-full-profile

Frozen shoulder is characterized by progressive motion loss, distinct disease stages, and new treatment opportunities; raising important questions about timing, patient selection, and new interventional strategies. In this episode of the BackTable MSK Podcast, guest host Osman Ahmed welcomes orthopedic surgeon and upper extremity specialist Dr. Sameer Nagda to discuss the intricacies of adhesive capsulitis of the shoulder (“frozen shoulder”). --- SYNPOSIS Dr. Nagda shares his expertise on diagnosing and treating frozen shoulder, including the evaluation process, treatment options, and the role of early intervention. He emphasizes the importance of recognizing the stages of frozen shoulder and the potential benefits of embolization, particularly in the inflammatory stage. Dr. Nagda also shares his journey into shoulder specialization and his collaborative efforts with IR specialists to improve patient outcomes. --- TIMESTAMPS 00:00 - Introduction 04:29 - The Run Down: What is Frozen Shoulder?08:37 - Approaching the Diagnosis of Frozen Shoulder13:51 - Treatment Paradigms 22:48 - Comparing Traditional Treatments vs. Embolization26:39 - An Orthopedic Surgeon's Perspective on Embolization for Frozen Shoulder35:36 - Surgical Options and When to Consider Them 37:55 - Final Thoughts --- RESOURCES Dr. Sameer Nagda, MDhttps://www.sameernagdamd.com/sameer-nagda-md-sports-medicine-specialist-arlington-va.html Adhesive Capsulitis of the Shoulderhttps://journals.lww.com/jaaos/abstract/2011/09000/adhesive_capsulitis_of_the_shoulder.4.aspx Treatment of Adhesive Capsulitis of the Shoulderhttps://journals.lww.com/jaaos/abstract/2019/06150/treatment_of_adhesive_capsulitis_of_the_shoulder.3.aspx

Join Dr. Clancy and his guests, Drs. Evelyn Ross-Shapiro, Sarah Shaffer, and Emily Walsh, as they discuss the complex set of symptoms and treatment options for those with significant symptoms from menopause.  CME Credit Available:  https://uiowa.cloud-cme.com/course/courseoverview?P=0&EID=81895  Host: Gerard Clancy, MD Senior Associate Dean for External Affairs Professor of Psychiatry and Emergency Medicine University of Iowa Carver College of Medicine Guests: Evelyn Ross-Shapiro, MD, MPH Clinical Assistant Professor of Internal Medicine Clinic Director, LGBTQ Clinic University of Iowa Carver College of Medicine Sarah Shaffer, DO Clinical Associate Professor of Obstetrics and Gynecology Vice Chair for Education, Department of Obstetrics and Gynecology University of Iowa Carver College of Medicine Emily Walsh, PharmD, BCACP Clinical Pharmacy Specialist Iowa Health Care Financial Disclosures:  Dr. Gerard Clancy, his guests, and Rounding@IOWA planning committee members have disclosed no relevant financial relationships. Nurse: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this activity for a maximum of 1.00 ANCC contact hour. Pharmacist and Pharmacy Tech: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this knowledge-based activity for a maximum of 1.00 ACPE contact hours. Credit will be uploaded to the NABP CPE Monitor within 60 days after the activity completion. Pharmacists must provide their NABP ID and DOB (MMDD) to receive credit. JA0000310-0000-26-029-H01 Physician: The University of Iowa Roy J. and Lucille A. Carver College of Medicine designates this enduring material for a maximum of 1.00 AMA PRA Category 1 CreditTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Other Health Care Providers: A certificate of completion will be available after successful completion of the course. (It is the responsibility of licensees to determine if this continuing education activity meets the requirements of their professional licensure board.) References/Resources:   

Dr. Monty Pal and Dr. Hope Rugo discuss advances in antibody-drug conjugates for various breast cancer types as well as treatment strategies in the new era of oral SERDs for HR-positive breast cancer. TRANSCRIPT Dr. Monty Pal: Hello, and welcome to the ASCO Daily News Podcast. I'm your host, Dr. Monty Pal. I'm a medical oncologist and vice chair of academic affairs here at the City of Hope Comprehensive Cancer Center, Los Angeles. Today, I'm thrilled to be joined by Dr. Hope Rugo, an internationally renowned breast medical oncologist and my colleague here at City of Hope, where she leads the Women's Cancers Program and serves as division chief of breast medical oncology. Dr. Rugo is going to share with us exciting advances in antibody-drug conjugates (ADCs) that are expanding treatment options in various breast cancer types. She'll also address some of the complex questions arising in the new era of oral SERDs (selective estrogen receptor degraders) that are revolutionizing treatment in the hormone receptor-positive breast cancer space. Our full disclosures are available in the transcript of this episode.  Dr. Rugo, welcome, and thanks so much for being on the podcast today. Dr. Hope Rugo: Thank you. Pleasure to be here. Dr. Monty Pal: So, I'm going to switch to first names if you don't mind.  The first topic is actually a really exciting one, Hope, and this is antibody-drug conjugates. I don't know if I've ever shared this with you, but I actually started my training at UCLA, I was a med student and resident there, and it was in Dennis Slamon's lab. I worked very closely with Mark Pegram and a handful of others. This is right around the time I think a lot of HER2-directed therapies were really evolving initially in the clinics. Now we've got antibody-drug conjugates. Our audience is well-familiar with the mechanism there but tell us about how ADCs have really started to reshape therapy for HER2-positive breast cancer. Dr. Hope Rugo: Yeah, I mean, this is a really great place to start. I mean, we have had such major advances in breast cancer just this year, I think really changing the paradigm of treating patients. But HER2-positive disease, we've been used to having sequenced success of new agents. And I think the two biggest areas where we've made advances in HER2-positive disease, which were remarkably advanced this year in 2025, have been in antibody-drug conjugates with trastuzumab deruxtecan and with new oral tyrosine kinase inhibitors (TKIs) that have less of a target on EGFR and more on HER2, so they have an overall more tolerable toxicity profile and therefore a potentially better efficacy in the clinic. At least that's what we're seeing with these new strategies that we couldn't really pursue in the past because of toxicities of the oral TKIs. So, although our topic is ADCs, I'm going to include the TKI because it's so important in our thinking about treating HER2-positive disease. In the metastatic setting, we've seen these remarkable improvements in progression-free and overall survival in the second-line setting with T-DXd, or trastuzumab deruxtecan, compared to T-DM1. And then sequencing ADCs with giving T-DXd after T-DM1 was better than an oral tyrosine kinase or a trastuzumab combination with standard chemotherapy. That was DESTINY-Breast03 and DESTINY-Breast02. So, then we've had other trials since then, and T-DXd has moved into the early-stage setting, which I'll talk about in just a moment. But the next big trial for T-DXd in HER2-positive disease was moving it to the first-line setting to supplant what has become an established treatment for now quite a long time: the so-called CLEOPATRA regimen, which used the combined antibodies trastuzumab, pertuzumab with a taxane as first-line therapy. And then we've proceeded on with maintenance with ongoing HP for patients with responding or stable disease. And we'd seen long-term data showing, you know, at 8 years there was a group of patients whose cancers had never progressed and continued improved overall survival. So, T-DXd was studied in DESTINY-Breast09, either alone or in combination with pertuzumab compared to THP. The patient population had received a little bit more prior treatment, but interestingly, not a lot compared to CLEOPATRA. And they designed the trial to be T-DXd continued until progression with or without pertuzumab versus THP, which would go for six cycles and then stop around six cycles, and then stop and continue HP. Patients who had hormone receptor-positive disease could use hormone therapy, and this is one of the issues with this dataset because, surprisingly in this dataset and one other I'll mention, very few patients took hormone therapy. And even in the maintenance trial, the HER2CLIMB-05, less than 50% took hormone therapy as maintenance. This is kind of shocking to me and highlights an area of really important education, that outcome is improved when you add endocrine therapy for hormone receptor-positive HER2-positive metastatic disease in the maintenance phase, and it's a really important part of treatment. But suffice it to say, you know, you're kind of studying continued chemo versus stopping chemo in maintenance. And T-DXd, as we all expected, in combination with pertuzumab was superior to THP in terms of progression-free survival, really remarkably improved. And you could stop the chemo with toxicity, but most people continued it with T-DXd. Again, not a lot of people got hormone therapy, which is an issue, and you stop the chemo in the control arm. So, this has brought up a lot of interest in trying to use T-DXd as an induction and then go to maintenance, much as we do with the CLEOPATRA regimen with hormone therapy. But it brings up another issue. So first, T-DXd is superior; it's a great treatment. Not everybody needs to have it because we don't know whether it's better to give T-DXd first or second with progression - that we need a little bit longer follow-up. But just earlier this week, interestingly, the third week of December, the U.S. FDA approved T-DXd in the DESTINY-Breast09 approach with pertuzumab. So as I mentioned earlier, there was a T-DXd-alone arm; that arm has not yet reported. So very interesting, we don't know if you need pertuzumab or not. So what about the maintenance? That's the other area where we've made a huge advance here. So, we all want to stop chemo and we want to stop T-DXd. You don't want somebody being nauseated for two years while they're on treatment, and also there's a small number of patients with mostly de novo metastatic HER2-positive disease who are cured of their disease. We'd like to expand that, and I think these new drugs give us the opportunity to improve the number of patients who might be cured from metastatic disease. So the first maintenance study we saw was adding palbociclib, the CDK4/6 inhibitor, to endocrine therapy and HP, essentially. There, we had a remarkable improvement in progression-free survival difference of 15.2 months: 29 to 44 months, really huge. At San Antonio this year, we saw data with this oral tyrosine kinase inhibitor tucatinib, already showed it was great in a triplet, but as maintenance in combination with HP, it showed also a remarkable improvement in progression-free survival. But the numbers were all shifted down. So in PATINA, the control arm was in the 24-month range; here it was the tucatinib-HP arm that was in the 25 months and 16 months for control. So there was a differential benefit in ER-negative and ER-positive disease. So I think we're all thinking that our ideal approach moving forward would be to give T-DXd to most patients, we see how they do, and treat to best response. And then, stop the T-DXd, start HP, trastuzumab, pertuzumab for ER-negative, with tucatinib for ER-positive with palbociclib. We also have early data that suggests that both approaches may reduce the development of brain metastases, an issue in HER2-positive disease, and delay time to progression of brain metastases as seen in HER2CLIMB-05 in very early data - small numbers, but still quite intriguing that you might delay progression of brain metastases with tucatinib that clearly has efficacy in the brain.  So, I think that this is a hugely exciting advance for our patients, and these approaches are quickly moving into the early stage setting. T-DXd compared to standard chemo, essentially followed by THP, so a sequenced approach resulted in more pathologic complete responses than a standard THP-AC-type neoadjuvant therapy. T-DXd alone for eight cycles wasn't better, and that's interesting. We still need the sequenced non-cross-resistant chemo. But I think even more importantly, the data from DESTINY-Breast05 looking at T-DXd versus T-DM1 in patients with residual disease after neoadjuvant HER2-targeted therapy showed a remarkable improvement in invasive disease-free survival with T-DXd versus T-DM1, and quite early. It was a high-risk population, higher risk than the T-DM1 trial with KATHERINE, but earlier readout with a remarkable improvement in outcome. We expect to be FDA approved sometime in the first half of 2026. So then we'll get patients who've already had T-DXd who get metastatic disease. But my hope is that with T-DXd, maybe with tucatinib in the right group of patients or even sequenced in very high-risk disease, that we could cure many more patients with early-stage HER2-positive breast cancer and cure a subset, a greater subset of patients with de novo metastatic disease. Dr. Monty Pal: That's brilliant. And you tackled so many questions that I was going to follow up with there: brain metastases, etc. That was sort of looming in my mind. I mean, general thoughts on an ADC versus a TKI in the context of brain mets? Dr. Hope Rugo: Yeah, it's an interesting question because T-DXd has shown quite good efficacy in this setting. And tucatinib, of course, had a trial where they took patients with new brain mets, so a larger population than we've seen yet for the T-DXd trials, and saw that not only did they delay progression of brain metastases and result in shrinkage of existing untreated brain mets, but that patients who develop a new brain met, they could stay on the same assigned treatment. They got stereotactic radiation, and then the patients who were on tucatinib with trastuzumab and capecitabine had a further delay in progression of brain mets compared to those on the placebo arm, even after treatment of a new one that developed on treatment. So, I think it's hard. I think most of us for a lot of brain mets might start with the tucatinib approach, but T-DXd is also a very important treatment. You know, you're kind of trading off a diarrhea, some liver enzyme elevations with tucatinib versus nausea, which you really have to work on managing because it can be long-delayed nausea, and this risk of ILD, interstitial lung disease, that's about 12%, with most but not all trials showing a mortality rate from interstitial lung disease of just under 1 percent. In the early-stage setting, it was really interesting to see that with T-DXd getting four cycles in the neoadjuvant setting, a lot less ILD noted than the patients who got up to 14 cycles, as I think they got a median of 10 cycles in the post-surgical setting, there was a little bit more ILD. But I think we're going to be better and better at finding this earlier and preventing mortality by just stopping drug and treating earlier with steroids. Dr. Monty Pal: And this ILD issue, it always seems to resurface. There are drugs that I use in my kidney cancer clinic, everolimus, common to perhaps the breast cancer clinic as well, pembrolizumab, where I think the pattern of pneumonitis is quite different, right? What is your strategy for recognizing pneumonitis early in this context? Dr. Hope Rugo: Well, it is, and you know, having done the very early studies in everolimus where we gave it in the neoadjuvant setting and we're like, "Hmm, the patient came in with a cough. What's going on?" You know, we didn't know. And you have mouth sores, you know, we were learning about the drug as we were giving it. What we don't do with everolimus and CDK4/6 inhibitors, for example, is grade 1 changes like radiation pneumonitis, we don't stop, we don't treat it. We only treat for symptoms. But because of the mortality associated with T-DXd, albeit small, we stop drug for grade 1 imaging-only asymptomatic pneumonitis, and some of us treat with a half dose of steroids just to try and hasten recovery. We've actually now published or presented a couple of datasets from trials, a pooled analysis and a real-world analysis, that have looked at patients who were retreated after grade 1 pneumonitis or ILD and tolerated drug very well and none of them died of interstitial lung disease, which was really great to see because you can retreat safely and some of these patients stayed on for almost a year benefiting from treatment. So, there's a differential toxicity profile with these drugs and there are risk factors which clearly have identified those at higher risk: prior ILD, for example. A French group said smoking; other people haven't found that, maybe because they smoked more in France, I don't know. And being of Japanese descent is quite interesting. The studies just captured that you were treated in Japan, but I think it's probably being of Japanese descent with many drugs that increases your risk of ILD. And, you know, older patients, people who have hypoxia, those are the patients. So, how do we do this? With everolimus, we don't have specific monitoring. But for T-DXd we do; we do every nine weeks to start with and then every 12 weeks CT scans because most of the events occur relatively early. Somebody who's older and at higher risk now get the first CT at six weeks. Dr. Monty Pal: This is super helpful. And I have to tell you, a lot of these drugs are permeating the bladder cancer space which, you know, is ultimately going to be a component of my practice, so thank you for all this. We could probably stay on this topic of HER2-positive disease forever. I'm super interested in that space still. But let me shift gears a little bit and talk about triple-negative breast cancer and this evolving space of HR-positive, HER2-low breast cancer. I mean, tell us about ADCs in that very sort of other broad area. Dr. Hope Rugo: So triple-negative disease is the absolute hardest subset of disease that we have to treat because if you don't have a great response in the early stage setting, the median survival is very short, you know, under two years for the majority of TNBCs, with the exception of the small percentage of low proliferative disease subsets. The co-question is what do we do for these patients and how do we improve outcome? And sacituzumab govitecan has been one strategy in the later line setting that was shown to improve progression-free and overall survival, the Trop-2 ADC. We had recently three trials presented with the two ADCs, sacituzumab govitecan and the other Trop-2 ADC that's approved for HR-positive disease, datopotamab deruxtecan. And they were studied in the first-line setting. Two trials with SG, sacituzumab govitecan, those trials, one was PD-L1 positive, ASCENT-04. That showed that SG with a checkpoint inhibitor was superior, so pembrolizumab was superior to the standard KEYNOTE-355 type of treatment with either a taxane or gemcitabine and carboplatin with pembrolizumab for patients who have a combined positive score for PD-L1, 10 or greater. So, these are patients who are eligible for a checkpoint inhibitor, and SG resulted in an improved progression-free survival.  The interesting thing about that dataset is that few patients had received adjuvant or neoadjuvant checkpoint inhibitor, which is fascinating because we give it to everybody now. But access is an issue and timing of the study enrollment was an issue. The other thing which I think we've all really applauded Gilead for is that there was automatic crossover. So, you could get from the company, to try and overcome some of the enormous disparities worldwide in access to these life-saving drugs, you could get SG through the company for free once you had blinded independent central review confirmation of disease progression. Now, a lot of the people who got the SG got it through their insurance, they didn't bill the company, but 80 percent of patients in the control arm received SG in the second-line setting. So that impacts your ability to look at overall survival, but it's an incredibly important component of these trials. So then at ESMO, we saw the data from SG and Dato-DXd in the first-line metastatic setting for patients who either had PD-L1-negative disease or weren't eligible for an immunotherapy. For the Dato study, TROPION-Breast02, that was 10 percent of the patients who had PD-L1-positive disease but didn't get a checkpoint inhibitor, and for the ASCENT-03 trial population it was only 1 percent. Importantly, the trials allowed patients who relapsed within a year of receiving their treatment with curative intent, and the Dato study, TB-02, allowed patients who relapsed while on treatment or within the first six months, and that was 15 percent of the 20 percent of early relapsers. The ASCENT trial, ASCENT-03, had 20 percent who relapsed between 6 and 12 months. The drugs were better than standard of care chemotherapy, the ADCs in both trials, which is very nice. Different toxicity profiles, different dosing intervals, but better than standard of care chemotherapy in the disease that's hardest for us to treat. And importantly, when you looked at the subset of early relapsers, those patients also did better with the ADC versus chemotherapy, which is incredibly important. And we were really interested in that 15 percent of patients who had early relapse. I actually think that six months thing was totally contrived, invented, you know, categorization and doesn't make any sense, and we should drop it. But the early relapsers were 15 percent of TB-02 and Dato was superior to standard of care chemo. We like survival, but the ASCENT trial again allowed the crossover to an approved ADC that improved survival and 80 percent of patients crossed over. In the Dato trial, they did not allow crossover, they didn't provide Dato, which isn't approved for TNBC but is for HR-positive disease, and they didn't allow, of course, pay for SG. So very few patients actually crossed over in their post-treatment data and in that study, they were able to show a survival benefit. So actually, I think in the U.S. where we can use approved drugs already before there's a fixed FDA approval, that people are already switching to use SG or Dato in the first-line setting for metastatic TNBC that's both PD-L1 positive for SG and PD-L1 negative for both drugs. And I think understanding the toxicity profiles of the two drugs is really important as well as the dosing interval to try and figure out which drug to use. Dr. Monty Pal: Brilliant. Brilliant. Well, I'm going to shift gears a little bit. ADCs are a topic, again, just like HER2-positive disease we could stay on forever. Dr. Hope Rugo: Huge. Yes. Dr. Monty Pal: But we're going to shift gears to another massive topic, which is oral SERDs. In broad strokes, right, this utilization of CDK4/6 inhibitors in the context of HR-positive breast cancer is obviously, you know, a paradigm that's been well established at this point. Where do we sequence in oral SERDs? Where do they fit into this paradigm? Dr. Hope Rugo: Ha! This is a rapidly changing area; we keep changing what we're saying every other minute. And I think that there are three areas of great interest. So one is patients who develop ESR1 mutations that allow constitutive signaling through the estrogen receptor, even when there's not estrogen around, and that is a really important mutation that is subclonal; it develops under the pressure of treatment in about 40 percent of patients. And it doesn't happen when you first walk in the door. And what we've seen is that oral SERDs as single agents are better than standard single-agent endocrine therapy in that setting. The problem that we've had with that approach is that we're now really interested in giving targeted agents with our endocrine therapies, not just in the first-line setting where CDK4/6 inhibitors are our standard of care with survival benefit for ribociclib and, you know, survival benefit in subsets with other CDK4/6 inhibitors, and abemaciclib with a numeric improvement. So we give it first line. The question is, what do you do in the second-line setting? Because of the recent data, we now believe that oral SERDs should be really given with a targeted agent. And some datasets which were recently presented, which I think have helped us with that, have been EMBER-3 and then the most recently evERA BC, or evERA Breast Cancer, that looked at the oral SERD giredestrant with everolimus compared to standard of care endocrine therapy with everolimus, where 100 percent of patients received prior CDK4/6 inhibitor and showed a marked improvement in progression-free survival, including in the subsets of patients with a short response, 6-12 months of prior response to CDK4/6 inhibitor and in those who had a PIK3CA pathway mutation. The thing is that the benefit looks like it's much bigger in the ESR1 mutant population, although response was better, PFS wasn't better in the wild type. So, we're still trying to figure that out. We also saw EMBER-3 with imlunestrant and abemaciclib as a second line. Not everybody had had a prior CDK4/6 inhibitor; they compared it to imlunestrant alone, but still the data was quite striking and seemed to cross the need for ESR1 mutations. And then lastly, we saw data from the single arms of the ELEVATE trial looking at elacestrant with everolimus and abemaciclib and showed these really marked progression-free survival data, even though single-arm, that crossed the mutation status. At least for the everolimus combination, abemaciclib analysis is still to come in the mutated subgroups. But really remarkable PFS, much longer.  Single-agent fulvestrant after CDK4/6 inhibitor AI has a PFS in like the three-month range and in some studies, maybe close to five months. These are all at 10-plus months and really looking very good. And so those questions are, is it ESR1 mutation alone? Is it all comers? We'd like all comers, right? We believe in the combination approach and we're learning more about combinations with drugs like capivasertib and other drugs as we move forward. Everybody now wants to combine their targeted agent with an oral SERD because they're clearly here to stay with quite remarkable data. The other issue, so the second issue in the metastatic setting is, does it make a difference if we change to an oral SERD before radiographic imaging evidence of progression? And that was the question asked in the SERENA-6 trial where patients had serial monitoring for the presence of ESR1 mutations in ctDNA. And those who had them without progression on imaging could be randomized to switch to camizestrant with the same CDK4/6 inhibitor or stay on their same AI CDK4/6 inhibitor. And they showed a difference in progression-free survival that markedly favored camizestrant. But interestingly, the people who were on the standard control arm had an ESR1 mutation, we think AIs don't work, they stayed on for nine more months. The patients who were on the camizestrant stayed on for more than 16 months. And they presented some additional subset data which showed the same thing: follow-up PFS data, PFS2, all beneficial in SERENA-6 at the San Antonio [Breast Cancer Symposium]. So, we're still a little bit unclear about that. They did quality of life, and pain was markedly improved. They had a marked delayed time to progression of pain in the camizestrant arm. So this is all a work in progress, trying to understand who should we switch without progression to an oral SERD based on this development of this mutation that correlates with resistance. And, you know, it's interesting because the median time to having a mutation was 18 months and the median time to switch was almost 24 months. And then there were like more than 3,000 patients who hadn't gotten a mutation, hadn't switched, and were still okay. So screening everybody is the big question, and when you would start and who you would change on and how this affects outcome. Patients didn't have access to camizestrant in the control arm, something we can't fix but we have experimental drugs. We're actually planning a trial, I hope in collaboration with the French group Unicancer, and looking at this exact question. You know, if you switch and you change the CDK4/6 inhibitor and then you also allow crossover, what will we see? Dr. Monty Pal: We're coming right to the tail end of our time here, and I could probably go on for another couple of hours with you here. But if you could just give us maybe one or two big highlights from San Antonio, any thoughts to leave our audience with here based on this recent meeting? Dr. Hope Rugo: Yeah, I mean, I talked about a lot of those new data already from San Antonio, and the one that I'd really like to mention which I think was, you know, there were a lot of great presentations including personalized screening presented from the WISDOM trial by my colleague Laura Esserman, fascinating and really a big advance. But lidERA was the big highlight, I think, outside of the HER2CLIMB-05 which I talked about earlier in HER2-positive disease. And this study looked at giredestrant, the oral SERD versus standard of care endocrine therapy as treatment for medium and high-risk early-stage breast cancer. And what they showed, which I think was really remarkable with just about a three-year median follow-up, was an improvement in invasive disease-free survival with a hazard ratio of 0.7. I mean, really quite remarkable and so early. It looked as though this was all driven by the high-risk group, which makes sense, not the medium risk, it's too early. And also that there was a bigger benefit in patients who were on tamoxifen compared to giredestrant versus AI, but for both groups, the confidence intervals didn't cross 1. There's even a trend towards overall survival, even though it's way too early. I think that, you know, really well-tolerated oral drug that could improve outcome in early-stage disease, this is the first advance we've seen in over two decades in the treatment of early-stage hormone receptor-positive disease with just endocrine therapy. I think we think that we don't want to give up CDK4/6 inhibitors because we saw a survival benefit with abemaciclib and a trend with giving ribociclib in the NATALEE trial. So we're thinking that maybe one approach would be to give CDK4/6 inhibitors and then switch to an oral SERD or to have enough data to be able to give oral SERDs with these CDK4/6 inhibitors for early-stage disease. And that's all in the works, you know, lots of studies going on. We're going to see a lot of data with both switching 8,000 patients with an imlunestrant switching trial, an elacestrant trial going on, and safety data with giredestrant with abemaciclib and soon to come ribociclib. So, this is going to change everything for the treatment of early-stage breast cancer, and I hope cure more patients of the most common subset of the most common cancer diagnosed in women worldwide. Dr. Monty Pal: Super exciting. It's just remarkable to hear how this has evolved since 25 years ago, which is really the last time I sort of dabbled in breast cancer.  Thank you so much, Hope, for joining us today. These were fantastic insights. Appreciate you being on the ASCO Daily News Podcast and really want to thank you personally for your remarkable contribution to the field of breast cancer. Dr. Hope Rugo: Thank you very much, and thanks for talking with me today. Dr. Monty Pal: You got it. And thanks a lot to our listeners today as well. You'll find links to all the studies we discussed today in the transcript of this episode. Finally, if you value the insights that you hear 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 opinion 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. Monty Pal @montypal Dr. Hope Rugo   @hoperugo Follow ASCO on social media:        ASCO on X  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. Hope Rugo:    Honoraria: Mylan/Viatris, Chugai Pharma   Consulting/Advisory Role: Napo Pharmaceuticals, Sanofi, Bristol Myer   Research Funding (Inst.): OBI Pharma, Pfizer, Novartis, Lilly, Merck, Daiichi Sankyo, AstraZeneca, Gilead Sciences, Hoffman La-Roche AG/Genentech, In., Stemline Therapeutics, Ambryx  

Dr. Jim Dunlap discusses one of the honorable mention articles of 2024, titled “Early Surgery Versus Exercise Therapy and Patient Education for Traumatic and Nontraumatic Meniscal Tears in Young Adults—An Exploratory Analysis From the DREAM Trial,” which was originally published in the Journal of Orthopaedic & Sports Physical Therapy in April 2024. Dr. Jeremy Schroeder serves as the series host. Dr. Dunlap is a member of the Top Articles Subcommittee, and this episode is part of an ongoing mini journal club series highlighting each of the Top Articles in Sports Medicine from 2024, as selected for the 2025 AMSSM Annual Meeting. Early Surgery Versus Exercise Therapy and Patient Education for Traumatic and Nontraumatic Meniscal Tears in Young Adults—An Exploratory Analysis From the DREAM Trial: https://www.jospt.org/doi/full/10.2519/jospt.2024.12245

Why might simultaneous ablation and biopsy be the new standard for high-probability lung cancer cases where surgery isn't an option? In the penultimate episode of the 2025 NSCLC Creator Weekend™ series, our multidisciplinary tumor board panel discusses the intricacies and decision-making processes surrounding biopsy and ablation procedures in thoracic oncology. --- This podcast is supported by an educational grant from Johnson & Johnson and Varian. --- SYNPOSIS Topics include the prioritization of treatment versus tissue acquisition, the nuances of bronchoscopic versus percutaneous biopsies, and the latest advancements in robotic and cryo-biopsy techniques. The experts also share their approaches to managing pneumothorax, the value of multidisciplinary collaboration, and case studies that highlight personalized patient care. Listeners gain valuable insights into the evolving landscape of thoracic oncology procedures and the importance of patient-centered decision-making. --- TIMESTAMPS 00:00 - Introduction04:12 - Cryobiopy vs. Non-Cryobiopsy08:43 - Biopsy and Ablation: Strategies and Considerations15:31 - Post-Therapy Imaging and Follow-Up25:18 - Treatment Options and Patient Decisions27:08 - Evaluating Ablation Techniques28:59 - Managing Lung Cancer Recurrence39:41 - Case Study: Young Male with Ground Glass Nodule43:15 - Concluding Thoughts

Send us a textA lot of parents have difficulty to understand that just because they have Myopia, that doesn't mean their children will. However it's proven that genetics is one factor, and there are some significant others like amount of time spent near and far from a screen, education levels etc. I've had 15 years in my practice talking with parents about the importance of their children having regular eye exams and making them aware of the technological advances in this field. On today's episode of The Myopia Podcast, I will share with you some treatment options for Myopia and how you can present them to parents effectively. 

Welcome back to the Oncology Brothers podcast! In this episode, we continue the CME series on HER2-positive GEJ and gastric cancer, shifting focus to the essential topic of treatment toxicity management. We're joined by two leading experts: Dr. Geoffrey Ku from Memorial Sloan Kettering and Dr. Shruti Patel from Stanford University. Building on their previous discussion of upper GI treatment algorithm with Dr. Rutika Mehta, this episode delves into the practical realities of managing patients on complex regimens. Drs. Ku & Patel break down the side effect profiles across the treatment continuum—from frontline trastuzumab-based combinations to emerging therapies like zanidatamab—and provide actionable strategies for community oncologists. Episode Highlights: • Practical management of frontline side effects with FOLFOX/XELOX chemotherapy plus trastuzumab and pembrolizumab • Reality check on trastuzumab cardiotoxicity: incidence rates and monitoring protocols in gastric vs. breast cancer • Immune-related adverse events with checkpoint inhibitors: what's common vs. rare in GI cancers • Critical insights on zanidatamab's synergistic diarrhea toxicity and mandatory prophylaxis strategies • TDXd (Enhertu) in second-line: moving beyond ILD fears to address frequent cytopenias and marrow management • Expert consensus on infusion reaction management for novel biologics • The importance of managing baseline symptoms in patients with dysphagia and nausea This episode bridges the gap between trial data and clinical practice, offering real-world wisdom on keeping patients on effective therapies through proactive toxicity management. Follow us on social media: •⁠  ⁠X/Twitter: https://twitter.com/oncbrothers •⁠  ⁠Instagram: https://www.instagram.com/oncbrothers •⁠  Website: https://oncbrothers.com/ Don't forget to subscribe for our complete CME series covering treatment algorithms, FDA approvals, and practical management strategies! Accreditation/Credit Designation Physicians' Education Resource®, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. Physicians' Education Resource®, LLC designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Acknowledgment of Commercial Support This activity is supported by an educational grant from Jazz Pharmaceuticals, Inc. Link to gain CME credits from this activity: https://www.gotoper.com/courses/navigating-the-adverse-event-landscape-in-her2-gea-therapy

Peripheral Neuropathy: Causes, Symptoms, And New Treatment Options When nerves lose the energy they need to function, it leads to numbness, pain, and loss of mobility for millions of Americans. New research is uncovering how risk factors like obesity, high blood pressure, and food insecurity disproportionately affect certain communities. As scientists work to refine treatments and explore promising therapies that include GLP-1 medications, early detection, dietary changes, and improved access to healthcare remain critical to stopping the progression of this condition. How Improving Healthcare For People With Disabilities Helps Everyone Special Olympics is working to close major gaps in healthcare for people with intellectual and developmental disabilities. A new global report reveals widespread problems – from poor provider training to communication barriers – that prevent individuals with IDD from receiving informed, respectful, and effective care. The organization hopes to create a more inclusive system by improving physician training and empowering people with IDD to participate in their own health decisions. Medical Notes: We're Overusing Salt, How Feeding Birds Improves Our Quality Of Life, And Protecting Kids From HIV How can we save babies born with HIV? We're overusing salt – and not just in our pasta. Technology is only as good as it's creator. Is it time to invest in a bird feeder? Learn more about your ad choices. Visit megaphone.fm/adchoices

Send me a question or story!Solar dermatitis (actinic keratosis) is skin damage from prolonged UV exposure, affecting both dogs and cats, particularly those with light-colored or thin coats. So, pets that have white fur and live in high UV exposure areas (like the southern US) are predisposed. Symptoms include redness, scaling, hair loss, and thickened, crusty skin. Commonly affected areas include the nose, ears, abdomen, and inner thighs. This condition can lead to more severe issues, including pre-cancerous lesions and aggressive skin cancer like squamous cell carcinoma. We will discuss ways to identify this disease and treatment options such as CO2 laser ablation, etc.00:00 – Intro04:06 – Nasal Solar Dermatitis06:32 – Classic Canine Solar Dermatitis08:15 – Treatment Options for Solar Dermatitis16:52 – Outro

PPPD (AKA: persistent postural perceptual dizziness) is a chronic form of dizziness which is very manageable. But everyone wants to know “is there a cure for PPPD?”  To get to that answer, we've got to go all the way back to the beginning to uncover why PPPD is happening in the first place. Because PPPD is always caused by another underlying diagnosis. It's both under and overly diagnosed—and this episode is built to be a resource for you. So you can finally feel empowered to understand what's going on and what to do about it next. In this episode, we'll dig into: What persistent postural perceptual dizziness (PPPD) is What symptoms are mistakenly associated with PPPD What generally makes PPPD better or worse Places and events that are more challenging with PPPD What usually triggers PPPD How PPPD is diagnosed Personality types that are more likely to have PPPD Why dizziness and anxiety are so closely linked If there is a cure for PPPD What the Wheel of Management is The best treatment options for PPPD You do not need to be dizzy everyday for the rest of your life. PPPD is treatable, but you need a treatment plan that works for you.  A great place to start is VGF! Support, education, and community—all of that plus more resources than you can imagine are waiting for you in Vestibular Group Fit. If you're in the holiday challenge and listening today, please send me a DM for extra credit. Links: Neurahealth (virtual neurology, use code VERTIGODOCTOR15 for 15% off) Vestibular Group Fit (code GROUNDED at checkout!) Join Vestibular Virtual Summit Waitlist Related Episodes: Episode 5: Can We Break The Dizzy Anxious Dizzy Cycle? with Dr. Emily Kostelnik, PhD⁠ Episode 40: ⁠The Importance of Hope and Mindset for Vestibular Migraine with Dr. Emily Kostelnik, PhD⁠ More Links/Resources: ⁠The 4 Steps to Managing Vestibular Migraine ⁠The PPPD Management Masterclass⁠ ⁠What your Partner Should Know About Living with Dizziness⁠ ⁠The FREE Mini VGFit Workout⁠ ⁠The FREE POTS - safe Workouts⁠ ⁠Vestibular Group Fit (code GROUNDED at checkout for 15% off your first subscription cycle!) ⁠ Connect with Dr. Madison: ⁠@⁠⁠TheVertigoDoctor ⁠ ⁠@TheOakMethod⁠ ⁠@VestibularGroupFit⁠ Connect with Dr. Jenna @dizzy.rehab.therapist  Work with Dr. Madison 1:1, Vestibular Rehabilitation Therapy Vestibular Group Fit Small Group Coaching (offered throughout the year, sign up for our email list to learn when!) Why The Oak Method? Learn about it here! Love what you heard? Reviews really help us out! Please consider leaving one for us.  This podcast is for informational purposes only and may not be the best fit for you and your personal situation. It shall not be construed as medical advice. The information and education provided here is not intended or implied to supplement or replace professional medical treatment, advice, and/or diagnosis. Always check with your own physician or medical professional before trying or implementing any information read here. ————————————— Can PPPD be cured, what is PPPD, what is pppd disease, pppd symptoms, persistent postural perceptual dizziness treatment, chronic dizziness, diagnostic criteria, vertigo, vestibular disorder, vestibular migraine, BPPV, anxiety disorder, low tox lifestyle, mindset shift, autonomic dysregulation, PPPD management, nervous system regulation

In this episode of The Performance Medicine Show, Dr. Rogers answers YOUR health and wellness questions! What did you think of this episode of the podcast? Let us know by leaving a review!Connect with Performance Medicine!Check out our new online vitamin store:⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://performancemedicine.net/shop/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Sign up for our weekly newsletter: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠https://performancemedicine.net/doctors-note-sign-up/⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Facebook: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@PMedicine⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Instagram: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠@PerformancemedicineTN⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠YouTube: ⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠⁠Performance Medicine⁠⁠⁠⁠⁠

If you've ever been told your FSH is too high or that you're not a good candidate for IVF, today's episode will help you understand what that number actually means and the many ways you can still support your fertility. When most people hear "high FSH," they immediately think poor ovarian reserve or low egg count. That's not the full story. In this episode, we look at what high FSH signals, how to interpret it alongside other markers, and what both conventional and functional fertility options can help you move forward with clarity. You'll learn: • What high FSH actually measures and why context matters when paired with AMH, estradiol, and AFC • How inflammation, stress, thyroid imbalance, sleep, and environmental toxins influence FSH • Conventional treatment options such as mini IVF, natural cycle IVF, Letrozole, and individualized stimulation protocols • How functional fertility improves the internal environment so your ovaries respond better to any treatment • The key labs, nutrients, and lifestyle factors that support egg quality and hormone communication in high FSH cases This episode is especially for you if: • You've been told you have high FSH or diminished ovarian reserve and worry the window is closing • You've had canceled IVF cycles or poor responses and want to understand what else you can do • You want to see how a functional fertility approach can support egg quality so your next steps feel strategic and not desperate Sarah Clark is the founder of Fab Fertile Inc. and the host of Get Pregnant Naturally. Her team specializes in functional approaches for low AMH, high FSH, diminished ovarian reserve, premature ovarian insufficiency, recurrent miscarriage and helping couples prepare their bodies for pregnancy success naturally or with IVF. Next Steps in Your Fertility Journey Subscribe to Get Pregnant Naturally for evidence-based guidance on functional fertility, and share this episode with anyone on their fertility journey. Not sure where to start? Download our most popular guide:  Ultimate Guide to Getting Pregnant This Year If You Have Low AMH/High FSH it breaks everything down step by step to help you understand your options and take action For personalized support to improve pregnancy success, book a call here. --- TIMESTAMPS 00:00 – What High FSH Really Means for Fertility What FSH actually measures, why it does not reflect egg quality, and why high FSH is often misunderstood in conventional fertility care. 01:00 – The Emotional Impact of High FSH and Canceled IVF Cycles Understanding why high FSH triggers fear, how it influences IVF decisions, and how a functional lens shifts your strategy. 02:00 – Real Case Story: FSH in the 60s Reduced to 7 A Fab Fertile client lowered FSH dramatically after three failed IVFs and conceived with her own eggs after being told donor eggs were the only option. 03:00 – Drivers of High FSH: Inflammation, Stress, Thyroid, Sleep, and Toxins FSH as feedback, not failure. Exploring how inflammation, poor sleep, blood sugar imbalance, thyroid dysfunction, and environmental toxins impact ovarian response. 04:00 – Conventional Treatment Options for High FSH Mini IVF, natural-cycle IVF, Letrozole, Clomid, individualized protocols, medication dosing considerations, and how clinics determine next steps. 05:00 – Why Medication Alone Isn't Enough: The Functional Fertility Lens How functional testing identifies hidden blocks like gut infections, food sensitivities, chronic inflammation, nutrient deficiencies, and nervous system dysregulation. 06:00 – Hidden Stressors That Disrupt Egg Quality and Hormone Signaling Parasites, H. pylori, bacterial overgrowths, mold exposure, toxin load, fragrances, plastics, and irregular cortisol patterns that impact egg development. 09:00 – Key Fertility Labs for High FSH Optimal vs normal ranges for thyroid markers, vitamin D, ferritin, fasting insulin, A1C, homocysteine, and how methylation affects hormone detox and ovarian health. 12:00 – Functional Testing That Personalizes Your Fertility Plan GI-MAP, food sensitivity testing, DUTCH hormone mapping, genetic testing (MTHFR, COMT, GST), and vaginal microbiome tests for implantation and inflammation insights. 18:00 – When to Pause IVF and Re-Evaluate Your Strategy Why repeating protocols isn't effective when the internal environment isn't optimized. When a 3–6 month reset can improve ovarian response and IVF success. 19:00 – Final Takeaway: High FSH as a Message, Not a Verdict High FSH is information, not a dead end. How combining functional optimization with conventional care improves egg quality, hormone signaling, and overall fertility outcomes. RESOURCES

Vision loss is never a purely clinical journey. As Dr. Jennifer Lyerly shares at the start of this Defocus Media episode, geographic atrophy affects patients emotionally, socially, and psychologically. Optometrists, therefore, play a central role in offering meaningful support throughout the entire geographic atrophy experience—especially as new treatment options, including Izervay, enter the landscape.

In this episode of The Pediatric Pharmacist Review, we explore the phenomenon of seasonal affective disorder (SAD) and its relevance to children, adolescents, and families. Our guest, Tim Horton, is a seasoned psychiatric nurse‑practitioner (APRN, CNP) and founder of PeopleFirst Clinic in Woodbury, Minnesota, where he specializes in holistic, medication‑management and therapy‑integrated care for youth and adults. With his unique background in pediatric mental health, patient‑centered approaches, and collaborative provider work, Tim brings deep insight into how biological and environmental factors converge in seasonal depression—and what practical actions caregivers and clinicians can take to mitigate its impact. Key Discussion Points: Biological & Environmental Contributors: We unpack how changes in daylight exposure, circadian rhythm shifts, neurotransmitter variations (serotonin, melatonin), and geographic/seasonal factors contribute to SAD in children and teens. Lifestyle & Environmental Interventions: Tim and I discuss actionable strategies such as structured light‑exposure (dawn simulators, 10,000 lux boxes), daily outdoor activity, consistent sleep schedules, and nutritional supports (timing of meals, nutrient‑dense foods, healthy fats) to reduce symptom severity. Treatment Options & Efficacy: We review standard of care for SAD—starting with behavioral and lifestyle measures, then progressing to light therapy and pharmacologic treatment (SSRIs, SNRIs, augmentation) when needed, including considerations unique to pediatric populations. Vitamin D and Seasonal Depression: We examine the evidence linking vitamin D deficiency with increased SAD risk, discuss screening thresholds in younger patients, supplementation strategies, and how this fits into a broader preventive mindset. Preventive Measures Ahead of Winter: Tim outlines a pre‑winter readiness plan—adjusting indoor lighting, optimizing outdoor daylight exposure, establishing routine exercise, reinforcing healthy diet patterns, and monitoring early warning signs for a proactive response. Misconceptions and Under‑Recognition: We address common myths—such as SAD only occurring in extreme northern latitudes, or that “it's just the blues” and will self‑resolve—highlighting how under‑recognition in pediatric settings can delay helpful intervention. Resources & Links: Tim Horton LinkedIn: https://www.linkedin.com/in/tim-horton-248858359/ PeopleFirst Clinic: https://www.peoplefirstmn.com/

More than half of U.S. adults experience dry eye symptoms, but only a small fraction have received a formal diagnosis or treatment Common symptoms include burning, stinging, gritty sensations, blurred vision, and eye fatigue, often worse at night or with prolonged screen use Environmental and lifestyle factors — including digital device use, indoor HVAC, contact lenses, and certain medications — are major drivers of dry eye disease Remedies range from simple lifestyle changes and home routines (blink breaks, warm compresses, humidifiers) to over-the-counter drops, prescription medications, and device therapies Ignoring persistent symptoms increases the risk of corneal damage, chronic inflammation, and permanent vision changes, making professional evaluation necessary