53 episodes

The ASCO Education Podcast features expert conversations on the most talked-about topics in oncology today from physician burnout, medical cannabis, COVID and cancer and more…

ASCO Education American Society of Clinical Oncology (ASCO)

    • Health & Fitness
    • 4.4 • 29 Ratings

The ASCO Education Podcast features expert conversations on the most talked-about topics in oncology today from physician burnout, medical cannabis, COVID and cancer and more…

    Cancer Topics – Financial Toxicity

    Cancer Topics – Financial Toxicity

    In this ASCO Education episode moderated by Dr. Rami Manochakian (Mayo Clinic), two-time cancer survivor and patient advocate Ms. Samantha Watson and medical oncologist Dr. Lidia Schapira (Stanford) discuss the multifaceted impact of high cancer care cost on patients and survivors. They also review communication strategies and resources oncology providers can offer to help alleviate financial toxicity.
    If you liked this episode, please subscribe. Learn more at education.asco.org, or email us at education@asco.org.
     
    TRANSCRIPT
    Dr. Rami Manochakian: Hello, and welcome to the ASCO Education Podcast Series. My name is Dr. Rami Manochakian. I'm a thoracic medical oncologist at the Mayo Clinic in Jacksonville, Florida.
    As today's host, I'll be moderating a discussion on what I believe is a very important topic when it comes to cancer care and its financial toxicity. I am very excited to have two wonderful guest speakers who are joining us today. Dr. Lidia Schapira, who's a medical oncologist with a focus and specialty in breast cancer and cancer survivorship. She's a professor of medicine and oncology and director of the Cancer Survivorship Program at Stanford University.
    We also have with us, Miss Samantha Watson. She's a two-time cancer survivor, patient advocate, and Managing Director of Stewardship at Expect Miracles Foundation, which is an organization dedicated to providing emotional and financial assistance to people with cancer. It's a pleasure to have you both with us today.
    Samantha Watson: Thank you so much for the opportunity.
    Dr. Rami Manochakian: Miss Watson, I'm going to start with you. Your story that I got to learn about is very inspiring. You had cancer twice as a young adult. You've gone through a lot. Can you tell us what was it like to go through that journey with two cancers, and a lot of treatments? Also, during that journey, definitely, you must have experienced a lot of financial and other social challenges. I'd like to hear more about that, please.
    Samantha Watson: So, I was a senior in college, and I'd had recurring knee pain that nobody could really diagnose for any reason. And it would come and go throughout my years of college. And finally, when I was a senior in college, I had extensive testing and they found Ewing sarcoma, which I had never heard of.
    My mom actually was an oncology nurse at Memorial Sloan Kettering. And so, I don't think it was on anybody's radar screen, but she understood the language way better than I did.
    What I came to learn was that Ewing sarcoma was typically diagnosed in boys under 20. And I was female and 21 at that time, and it was diagnosed about 300 times a year. So, I had no frame of reference for this. I had been around Sloan Kettering when I was a kid because my mom worked there, but I didn't know what it meant. I didn't know what cancer felt like. And I certainly did not know anybody else who had gone through it.
    But at that age and life stage, I was getting ready for my future. I was looking forward to graduating from college, I was looking forward to living on my own and everything stood still.
    So, the cancer was in my leg. When I was diagnosed, I went through nine months of high-dose chemotherapy. I went through a 12-hour surgery. I had to relearn how to walk and did a lot of PT. In that time, my friends graduated and they started moving forward and they started creating their lives. And I sat back and watched.
    I spent about four months at home after my treatment for Ewing's and I did my physical therapy. And I tried to figure out where to place cancer in my life as a young adult. And I went back to school and I had one semester left and I started to catch every cold that went around and strep. Just everything that goes around a college campus, I was constantly down and my doctors kept saying, ‘Don't worry, your immune system just has been devastated by this chemo and you just need time to recover.’
    The day before my 23rd birthday, they did a

    • 34 min
    Oncology, Etc. - Rediscovering the Joy in Medicine with Dr. Deborah Schrag (Part 2)

    Oncology, Etc. - Rediscovering the Joy in Medicine with Dr. Deborah Schrag (Part 2)

    In the second of this two-part conversation Drs. Patrick Loehrer and David Johnson sit down with Dr. Deborah Schrag, the current Chair of the Department of Medicine at Memorial Sloan Kettering Cancer Center to continue the discussion of her roles as a leader, researcher, oncologist, public health expert, and more.
    If you liked this episode, please subscribe. Learn more at https://education.asco.org, or email us at education@asco.org.
     
     
    TRANSCRIPT
    Dr. Dave Johnson: Hi everyone, welcome back to Oncology, Etc. an ASCO educational podcast. My name is Dave Johnson. I'm at UT Southwestern Medical Center in Dallas. And I'm here with my good friend Dr. Pat Loehrer who serves as a director of Global Oncology and Health Equities at Indiana University. In the second half of our conversation with Dr. Deborah Schrag, the current chair of Medicine at Memorial Sloan Kettering Cancer Center in New York.
    In part one, we heard about Dr. Schrag's early life and background, as well as the importance of affordable cancer care and much more. Let's jump back into the conversation and hear about her current goals and initiatives at Memorial Sloan Kettering.
    I have a question for you. Jumping ahead a little bit. But I mean, you're such a role model for all of us. But you're now in a very powerful position as head of medicine at the preeminent cancer center in the world. So, I'd be interested in knowing what are your top initiatives? What did you come to this role wanting to do short-term and long-term? I'd be curious to hear from you about that.
    Dr. Deborah Schrag: Yeah. So, I have lots of specific initiatives, all the things that are probably very similar across medical cancer centers. We have to figure out the role of immuno-oncology. We have to figure out the role of CAR T-cell Therapy.
    There are lots of specific things, but let me tell you about three sort of overarching principles and things that I think we need to think about. So, one of the reasons why I decided to leave my job where I really focused on training researchers and building a research program to lead a department of medicine that has a mix of clinicians, educators, and investigators is that there's really a profound sense of exhaustion and disconnection. I'll use the word even burnout or people get the sense of losing the joy in the practice of medicine.
    And as corny as it sounds, and I know I'm going a little corny here, Dave. But I really want to help bring back and connect people to the joy in the practice of medicine. It's the joy that we experience when we crack a tough case, when we help a patient, when our patients make us laugh, when our patients and their families make us cry, when they drive us bananas, when they cook us food that is inedible, just reconnecting us to the joy, to the stories.
    I really wanted to try to be a different kind of leader because I felt that I could make a contribution to the field of academic medicine in general and oncology in particular, by working with faculty to set them up to tap into that joy, because I know they all started with it. I know they all went into medicine because they care about those human stories, because they do want to make a difference.
    This past week, a fellow intern of mine who you may know, passed away. His name was Paul Farmer. He was the head of Partners in Health and he was an infectious disease physician. There's a book about him by Tracy Kidder that's really moving. There's also a documentary about him called, Bending the Arc, which I would highly recommend.
    Paul was an incredible inspiration, just incredible, but he brought so much joy to the practice of medicine. I remember when Paul was going to some of the poorest places on the planet, specifically Cange, Haiti. He got an idea that he needed to bring chemotherapy because there were large cancers that were untreated. And he wanted to get leftover chemotherapy from the Dana-Farber.
    So, in the 1990s, when I was a fellow, he would ask me whethe

    • 30 min
    Oncology, Etc. – Rediscovering the Joy in Medicine with Dr. Deborah Schrag (Part 1)

    Oncology, Etc. – Rediscovering the Joy in Medicine with Dr. Deborah Schrag (Part 1)

    In part one of a two-part conversation, Drs. Patrick Loehrer and David Johnson sit down with Dr. Deborah Schrag to discuss her roles as a leader, researcher, oncologist and public health expert. The current Chair of the Department of Medicine at Memorial Sloan Kettering Cancer Center in New York, Dr. Schrag discusses the joy and passion she has found throughout her career, and more.
    If you liked this episode, please subscribe. Learn more at https://education.asco.org, or email us at education@asco.org.
     
    TRANSCRIPT
    Dr. Pat Loehrer: I'm Pat Loehrer. I'm the Director of the Center of Global Oncology and Health Equity at Indiana University.
    Dr. David Johnson: Yes. And hello, I'm David Johnson. I'm at UT Southwestern in Dallas, Texas.
    Dr. Pat Loehrer: And welcome to another version of Oncology, Etc.
    Dr. David Johnson: Yeah, great guest today, before we get started with our guests, though, Pat, what are you reading these days? What can you recommend to me?
    Dr. Pat Loehrer: Well, I'm reading Jamie Raskin's book, which is about his son and about the insurrection. It's really a wonderful read so far, particularly I think about the family nature and how much he deeply respected his son who unfortunately committed suicide.
    Dr. David Johnson: Right before one of the impeachment trials as I recall, right?
    Dr. Pat Loehrer: It was right before the January 6 insurrection.
    Dr. David Johnson: Yeah, terrible situation. I have a book I've been meaning to recommend for a while. It's one that I've given to all the chief residents I've worked with over the last several years. And today's guests made me think about this book. It's entitled, Osler: Inspirations from a Great Physician. It's written by Charles Bryan, who's the former Chair of Medicine at the University of South Carolina in Columbia.
    Dr. Pat Loehrer: You trained with Osler, didn't you?
    Dr. David Johnson: I was a couple of years behind him. He was my senior resident. For anyone who's an Oslerphile, it's a great book to have. But even if you're not, it's got some wonderful lessons to be learned about how to interact with one's colleagues, and a lot of information about leadership, which is why it made me think of today's guest, Dr. Deborah Schrag who we're really excited to welcome to Oncology, Etc.
    Dr. Schrag is the Chairman of the Department of Medicine at Memorial Sloan Kettering Cancer Center in New York. She's a highly accomplished healthcare leader, clinician-researcher, and expert in public health and population science.
    Deborah received her medical degree from Columbia University and completed her residency in internal medicine at Brigham and Women's. She obtained her medical oncology training at Dana-Farber in Boston and also received an MPH degree from the Harvard School of Public Health.
    After a brief stint on the faculty at DFCI and Brigham and Women's, she joined the division of gastrointestinal Oncology at Memorial Sloan Kettering, where she was an associate member and Associate Professor of Public Health and Medicine.
    In 2007, I believe it was, she returned to Dana-Farber and Brigham, where she continued her work focused on improving the delivery, quality, and effectiveness of cancer care. While there, she served as chief of the Division of Population Sciences until this past year when she returned to Memorial to chair the Department of Medicine.
    I also think she's the first woman to hold this position, but we'll learn about that momentarily. Deb is internationally recognized as a pioneer for her work engaging patients in reporting outcomes as a way to improve care.
    She has led pragmatic trials using informatics strategies to optimize patient and clinician wellbeing, efficiency and quality, and equity of care. In short, she's a true superstar, leading the department, the major department, in one of the world's foremost Cancer Institutes.
    Deb, welcome to Oncology, Etc. Thank you so much for accepting our invitation. This is a relatively new oncology p

    • 27 min
    Oncology, Etc. – Mr. Paul Goldberg: Interviewing the Interviewer (Part 2)

    Oncology, Etc. – Mr. Paul Goldberg: Interviewing the Interviewer (Part 2)

    Drs. David Johnson (University of Texas) and Patrick Loehrer (Indiana University) host the second half second half of their Oncology, Etc. interview with Mr. Paul Goldberg, the editor and publisher of the world-renowned publication The Cancer Letter. In part two, Mr. Goldberg talks about literary works he has developed outside of The Cancer Letter, his perspective on the Russian/Ukrainian conflict, and more.
    If you liked this episode, please subscribe. Learn more at https://education.asco.org, or email us at education@asco.org.
     
    TRANSCRIPT
    Dr. Pat Loehrer: Hi, I'm Pat Loehrer, Director of Global oncology and Health Equity at Indiana University. I'm here with David Johnson, a medical oncologist at the University of Texas Southwestern in Dallas, Texas.
    This is the second half of our two-part Oncology, Etc. A conversation featuring Paul Goldberg, who's the editor of the prestigious oncology publication, The Cancer Letter. While, part one focuses more closely on Mr. Goldberg's early life - his introduction to writing and ecology and his work with The Cancer Letter - in part two, we're going to learn more about the literary works of Mr. Goldberg which are developed outside of The Cancer Letter. We'll also learn about his insight into the Russian Ukrainian conflict. We'll pick the conversation back up with Dave asking Paul about the most important changes he's seen in oncology throughout his career.
    Dr. David Johnson: What changes in oncology have you seen that have been most impressive in your mind, apart from therapeutic advances? What other changes have taken place that you've witnessed in your role as editor of Cancer Letter that you think really made a difference?
    Paul Goldberg: I think there's a lot less of this kind of, I have more friends now than I've ever had before, maybe I'm just getting old and I like a lot of people. There were a lot of people that I did not like early on. For me, culturally that's a difference. I think a lot of people are thinking along the same lines. There's a language of oncology. There's an understanding of the importance of clinical trials. People are arguing about whether to randomize. It wasn't that long ago that people were wondering about whether that's even a good thing.
    You mentioned Rick Pazdur. I don't know if it rises to the level of being able to say that I coined the term but the language of oncology, to some extent, is Pazdur-esque because he has gotten everybody on the same wavelength, and people do understand what it takes to get a drug to develop most of the time.
    So, that would be my first observation. There’s less to argue about the fundamentals. And also, a lot of the kids I came up with are now cancer center directors.
    Dr. Pat Loehrer: In one of the friendships, I think it's been really strong has been you and Otis Brawley was crucial. You guys wrote a book together. And I think part of that book, which was very interesting was the title says, First do no harm.
    There are a lot of things we do in medicine that we think we're doing well, but yet, by over-testing and overtreatment, we actually don't, in the long run, help the patients or help society.
    Tell me a little bit about that. You're not working on this project without us on the history of oncology. And so, the perspective of that and what are some of the most interesting historical stories that you know about?
    Paul Goldberg: I think he just at one point at one of the NCI meetings might have had something to do with NSABP, he started explaining to me, the NIH Reauthorization Act of 1993, and how women and minorities’ language was bizarre in there, and the definition of minorities and definition of race.
    So, here's this guy who is explaining stuff to me, which I wouldn't have really slowed down to think about because journalists generally don't slow down to think about things unless you tell them to, at least I didn't at the time. And then I said, well, this guy has been explaining stuff to me and I've

    • 23 min
    Cancer Topics – Medical Aid in Dying

    Cancer Topics – Medical Aid in Dying

    In this episode, moderated by Dr. Alissa Thomas (University of Vermont), patient caregiver Ms. Sandra Klima, hospice and palliative medicine physicians Dr. Gregg VandeKieft (Providence Institute for Human Caring) and Dr. Frank Ferris (Ohio Health), and medical oncologist Dr. Charles Blanke (Oregon Health and Science University) exchange perspectives on medical aid in dying, including legal, ethical and practical aspects.
    If you liked this episode, please subscribe. Learn more at https://education.asco.org, or email us at education@asco.org.
     
    TRANSCRIPT
    Dr. Thomas: Hello, and welcome to the ASCO Education podcast series. My name is Dr. Thomas, and I'm a Neuro-oncologist at the University of Vermont Medical Center, and  Associate Professor in the College of Medicine in the Department of Neurological Sciences in Burlington, Vermont. As today's host, I will be moderating a discussion on medical aid in dying with four guest speakers, Dr. Gregg VandeKieft, who is a Palliative Care Physician, Clinical Ethicist and Executive Medical Director at Providence Institute for Human Caring in Olympia, Washington. Dr. Charles Blanke, a Medical Oncologist and Professor of Medicine at Oregon and Health Sciences University in Portland, Oregon. Sandra Klima, who is the partner and caregiver of a patient who passed away using medical aid in dying in Vermont. And Dr. Frank Ferris, who is a hospice and palliative medicine physician, as well as executive director of Palliative Medicine Research and Education at Ohio Health in Columbus, Ohio.  

     

    For consistency during this talk, we'll be using the term medical aid in dying or MAID to refer to death with dignity and physician-assisted dying. So, to begin the discussion, I'd love to hear from Sandra about your perspective as a caregiver. Can you share with us what it was like caring for your partner and what your reaction was when you learned about his wishes? 

    Sandra Klima: Yes. Thank you. I'm glad to participate. My partner had died of glioblastoma in April of 2018. When we found out, it was pretty shocking. The very first thing he brought up was Act 39. And initially I was very surprised and uncomfortable with it because I didn't want to think about death, I wanted to think about living. And he was very quick, Rob was very quick. We made an appointment at the funeral parlor. He wanted to get everything taken care of quickly. So I was shocked that he wanted to use Act 39. I did not feel that it was, as I said, appropriate to talk about, but he explained he had a friend who had glioblastoma and she did not take that action. 

    And she kept a diary and he said it was very difficult to read. And he did not want to go through that process that she went through. He didn't want to lose who he was. He wanted to die as himself instead of a short time later as a lesser person. And wanted the choice, and Act 39 gave that to him. And I respected and supported his decision once we talked about it. Cancer is a progressive disease and there comes a time when you will not be in control. Facing that and knowing it only goes downhill is scary. So having the option that looked out before the end phase is a blessing, and it is death with dignity, and that's how it feels to me. 

    Dr. Thomas: Thank you so much for sharing that experience. This has been a hot topic and I'd love to hear from our panel, what are some of the common misconceptions around medical aid in dying, and how is this different from concepts like euthanasia or assisted suicide? 

    Dr. VandeKieft: Well, for starters in the United States, all the states that allow aid in dying require the person to self administer the agent. So it's not euthanasia where somebody else administers the lethal agent. Our neighbors to the north in Canada actually do allow voluntary euthanasia and about 90% of their aid in dying individuals do it by voluntary euthanasia as opposed to self-administration. Another misconception is that it is

    • 33 min
    Oncology, Etc. – Mr. Paul Goldberg: Interviewing the Interviewer (Part 1)

    Oncology, Etc. – Mr. Paul Goldberg: Interviewing the Interviewer (Part 1)

    Drs. David Johnson (University of Texas) and Patrick Loehrer (Indiana University) host the first of two Oncology, Etc. episodes featuring Mr. Paul Goldberg, book author, investigative reporter, and Editor and Publisher of The Cancer Letter. In part one, Mr. Goldberg reflects on his two main interests − human rights and cancer, and his early career as a journalist and novelist.
    If you liked this episode, please subscribe. Learn more at education.asco.org, or email us at education@asco.org.
     
    TRANSCRIPT
    Dr. Pat Loehrer: Hi I’m Pat Loehrer, I'm the director of the Center for Global Oncology and Health Equity here at Indiana University.
    Dr. David Johnson: Hello, my name is David Johnson. I'm at UT Southwestern in Dallas, Texas. And we've got a great guest today and we’re excited about the interview.
    Dr. Pat Loehrer: Yeah, it's very timely too, I think it's terrific. Before we go on to that, are there any recent books that you've read that you want to recommend?

    Dr. David Johnson: Yeah, actually, I do. It's somewhat related to our topic today. I just finished a book entitled, Presumed Guilty by Erwin Chemerinsky, who's the Dean of the Law School at the University of California, Berkeley. It's actually recommended to me by a lawyer friend.

    I think most of our audience knows the fourth, fifth, and sixth amendments to the Constitution are the ones that provide protection for people accused of crimes. And I think most of us are familiar with the Warren Court in the 50s and 60s, which seemed to be a very, quote-unquote liberal court that provided many of the protections that you see on TV shows, police TV shows de including the Miranda protections, but as Chemerinsky points out in his book, that really is a historical aberration, that the Supreme Court from its founding really right through today is then on the opposite side of the fence in terms of protection to the accused can many landmark rulings over the last several years, including Terry versus Ohio and City of Los Angeles vs. Ryan, have actually provided protection and sanction stop in frisk activities, limited suits against police departments to institute reform, and even provided some benefit for the use of so-called lethal chokeholds.

    Smaller than I think, in light of what's happened over the last several months, really provided some insight, to me at least, about how the Supreme Court looks at the protection of the accused. I thought it was a very interesting book to read. And Chemerinsky does a great job of explaining these landmark cases in a way that simpleton like myself can understand them. So, I recommend it to you. I think you'd enjoy it.

    Dr. Pat Loehrer: Yeah, there’s a book called “Just Mercy” by Bryan Stevenson. I'm not sure if you've ever had a chance to read that. It is an outstanding read. They made a movie out of it but if you get a chance to read the book, it's really terrific. Again, it talks a lot about the inequities in terms of how our court systems have prosecuted people of color for minor crimes compared to people that are in the majority here. But I think both of those would be great reads.
    Dr. David Johnson: Yeah, I haven't read it, but I will.
    Dr. Pat Loehrer: Yeah, it's terrific. Go for it. Going ahead in getting started, it's our great pleasure to have Mr. Paul Goldberg join us today. Anyone in oncology knows him. He is the editor of the Cancer Letter. Interestingly, he was born in Moscow and emigrated here to the United States at the age of 14, where he went to Virginia.
    He got his undergraduate degree at Duke in economics. And shortly thereafter, he worked in a newspaper in Reston, Virginia, where he met his future wife. I think from there, they went to the Wichita Eagle in Kansas. His wife was actually the daughter of the founder of what was to become the Cancer Letter, Jerry Boyd. He rose to associate editor and finally editor in 1994, and publisher and editor about a decade ago.

    The Cancer Letter is

    • 17 min

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