CANCER BUZZ

Learn how the creation of the first advanced practice radiation therapist (APRT) role in the United States established a new model of inpatient care, elevating the radiation therapy skill set and allowing for intervention at key points along the radiation oncology care pathway. Outcomes include improved quality, efficiency, and time and cost savings toward value-based care. Working in tandem with a rotation of radiation oncologists, the APRT aims to save physician time—and reduce physician burnout—by task-shifting and assuming lower-level responsibilities that support the care of resource intensive patient populations.

Samantha Skubish, MS, RT(R)(T)

Chief Technical Director, Department of Radiation Oncology

Mount Sinai Health System

"It's exciting to think about the opportunities that an advanced practice level of radiation therapy offers to the profession. It gives us the chance to work at the top of our license and even think and start to look at a scope expansion. For the rest of the care team that means improving quality outcomes, improving patient outcomes, and creating a better model for continuity of care."

This podcast is part of a special series with the 2023 ACCC Innovator Award winners. For a deeper dive into this and other content that will help your team reimagine how care is delivered at your cancer program or practice, register today for the ACCC 40th National Oncology Conference, Oct. 4-6, in Austin Texas.

Resources:

3D Virtual Reality: Changing the Standard of Care for Cancer Patients and Caregivers

Navigating the Unique Financial Challenges of Radiation Oncology

Developing and Implementing a Radiation Oncology App to Improve the Patient Experience

Improving Care of Advanced Cancer Patients with a Dedicated Palliative Radiotherapy Team

A Prospective Peer Review Model for Radiation Therapy

As care teams seek new ways to engage and support patients with rare cancers, CANCER BUZZ speaks with Jim Palma, executive director of TargetCancer Foundation, a patient-founded nonprofit organization dedicated to supporting patients living with, and researchers focused on, rare cancers. In this episode, hear about the fully remote TRACK (Target Rare Cancer Knowledge) clinical trial and its unique approach to providing access to biomarker testing for patients in community care settings by leveraging technology.

"It [access to biomarker testing] really is one of the biggest challenges that patients with rare cancer face, as well as access to interpretation of results in a way that leads them to the right treatment. So, what we've done is developed a [fully remote] clinical trial that offers testing to patients at no cost and eases their ability to enroll in the trial through remote consenting." – Jim Palma, Executive Director

This is the third episode in a podcast series developed in connection with the ACCC education program Emerging Biomarkers: Innovative Therapies for NTRK Gene Fusion Testing and was made possible with support by Bayer.

Jim Palma,

Executive Director

TargetCancer Foundation

Cambridge, MA

Additional Reading/Sources:

· Emerging Biomarkers: A Spotlight on NTRK Gene Fusion Testing (accc-cancer.org)

· NTRKers Patient Community & Support (ntrkers.org)

· NTRK Gene Fusion Infographic (ntrkers.org)

· NTRK fusion-positive cancers and TRK inhibitor therapy

Building awareness of rare cancers, such as NTRK gene fusion-positive cancers, is critical to improving access to biomarker testing and new treatment options for patients. In this episode, CANCER BUZZ speaks with Susan Spinosa, president and patient founder of NTRKers, an organization created to support patients with NTRK fusion-positive cancer, about her care journey and the importance of testing for NTRK gene fusions.

"What we want to have for every patient who is diagnosed with NTRK is accessibility...We need to test for it…it's a rare biomarker but in my mind, it should not be rare—the more testing we do the more routine it will become—and my hope is that 5 or 10 years from now, biomarker testing is routine and NTRK is not rare..." – Susan Spinosa, President of NTRKers

This is the second episode in a podcast series developed in connection with the ACCC education program Emerging Biomarkers: Innovative Therapies for NTRK Gene Fusion Testing and was made possible with support by Bayer.

Susan Spinosa

President and Patient Founder

NTRKers

Additional Reading/Sources:

· Emerging Biomarkers: A Spotlight on NTRK Gene Fusion Testing (accc-cancer.org)

· NTRKers Patient Community & Support (ntrkers.org)

· NTRK Gene Fusion Infographic (ntrkers.org)

· NTRK fusion-positive cancers and TRK inhibitor therapy

Personalizing care goals to account for a patient's values, preferences, or circumstances can make a significant difference in share decision-making and treatment planning. In this episode, CANCER BUZZ speaks with Melissa Kah Poh Loh, MBBCh, BAO, assistant professor of Geriatric Hematology and Oncology at the University of Rochester Medical Center's Wilmot Cancer Institute about strategies to optimize critical conversations with patients with acute myeloid leukemia.

"For older adults with acute myeloid leukemia, the treatment landscape has changed in the last few years…and their [patients'] preferences and goals really make a difference in what we ultimately choose together with patients and family members…incorporating this as part of the conversation is very important." – Melissa Kah Poh Loh, MBBCh, BAO

Melissa Kah Poh Loh, MBBCh, BAO

Assistant Professor of Geriatric Hematology and Oncology

University of Rochester Medical Center, Wilmot Cancer Institute

Rochester, NY

This is the second episode of a four-part series developed in connection with the ACCC education program Achieving and Maintaining Better Outcomes for Patients with Acute Myeloid Leukemia. This episode was made possible with support by Bristol Myers-Squibb.

Additional Reading/Sources

Strategies to Addressing Disparities in Patients with AML

· Shared Decision-making in Acute Myeloid Leukemia

· Talking about Acute Myeloid Leukemia (Cancer Support Community)

· Shared Decision-making: Practical Implementation for the Oncology Team (ACCC)

Significant declines in the screening, diagnosis, and treatment of patients with small cell lung cancer have increased challenges that impact patient care. Many patients with small cell lung cancer have a high symptom burden, poor prognosis, adherence challenges due to treatment-related adverse events, stigmatization, and emotional distress. The team at Atrium Health's Levine Cancer Institute is testing supportive care options with the goal of meeting the needs of all their patients.

CANCER BUZZ spoke to Michele Szafranski, MS, RD, CSO, LDN, Registered Dietitian, Susan Yaguda, RN, Manager, Integrative Oncology, and Kathryn F. Mileham, MD, FACP, Chief, Thoracic Medical Oncology at Levine Cancer Institute, Atrium Health in Charlotte, NC. Listen as we discuss supportive care initiatives such as music therapy through a multidisciplinary care team lens when caring for patients with small cell lung cancer (SCLC).

"Started an initiative to identify what some of those missing components may be, what do people most want. We tried to ensure we were aligning our goals with their (patient) goals. And we learned there were many needs, through patients and care providers that may not have been addressed previously."

Kathryn F. Mileham, MD, FACP

"In this initiative we really looked for community partners that were well-vetted. Patients had already had strong relationships with some of the lung cancer programs here in town, and so we tried to really partner with them. We got their input about what they think patients needed, (and) what was missing from our offerings that patients could benefit from."

Michele Szafranski, MS, RD, CSO, LDN

Kathryn F. Mileham, MD, FACP

Chief, Thoracic Medical Oncology

Levine Cancer Institute, Atrium Health

Charlotte, NC

Michele Szafranski, MS, RD, CSO, LDN

Registered Dietitian

Levine Cancer Institute, Atrium Health

Charlotte, NC

Susan Yaguda, RN

Manager, Integrative Oncology

Levine Cancer Institute, Atrium Health

Charlotte, NC

Resources:

Cancer Support Community

Go2 for Lung Cancer

LUNGEVITY

Lung Cancer Research Foundation

Mary B. Battaglia has been practicing clinical hypnosis for 10 years, working with clients to address many different issues like anxiety and stress. She's supported people with different medical issues, including brain, breast, lung, prostate, and skin cancers. Additionally, Battaglia was diagnosed with chronic myeloid leukemia in 2021 and has used medical hypnosis to as a complimentary therapy.

By guiding people through hypnosis, Battaglia helps them let go of thoughts by entering the subconscious where their memories and imagination are. Learn how an individual can hold on to traumas, pain, or emotions from their past, as well as how these emotions can all be released via medical hypnosis, therefore, helping in the healing process.

Guest:

Mary B. Battaglia

Certified Clinical Hypnosis and Sound Practitioner, Speaker, and Author

Resources:

· Medical Hypnosis: Where Cancer & Hypnotherapy Meet

· Mind, Body, and Spirit: How Robust Integrative and Complementary Services Can Bring an Entire Cancer Program Together

· A Pandemic's Silver Lining: Building a Collaborative Integrative Therapy Program

· Integrating Yoga Therapy into Oncology Care

· Safe Essential Oil Practice in Cancer Centers

· This Lyrical Life: Music Therapy in Oncology

This podcast is part of a special series with ACCC's Oncology Issues journal. For a deeper dive into this content, read Battaglia's article.

While there are many factors why patients with acute myeloid leukemia are ineligible for allogeneic stem cell transplant, such as age, financial hurdles, or other comorbidities, these factors are often compounded by social determinants of health, which can act as a significant barrier to consolidation therapy and long-term remission for these patients. In this episode, CANCER BUZZ speaks with Keri Maher, DO, Director of the Acute Leukemia Program, and assistant professor at Virginia Commonwealth University's Massey Cancer Center about strategies to address these disparities and optimize care and treatment options for patients with acute myeloid leukemia who do not receive a transplant.

"We know that patients who are ineligible for transplant may be so because of social determinants in and of themselves…[It is important to understand that] there are three categories of barriers that patients face when accessing care. I like to think of them as patient-based barriers, institutional-based barriers, and social-based barriers." – Keri Maher, DO

Guest:

Keri R. Maher, DO MS

Assistant Professor of Medicine

Director, Acute Leukemia Program

Massey Cancer Center

Virginia Commonwealth University

Richmond, VA

This is the first episode of a four-part series developed in connection with the ACCC education program Achieving and Maintaining Better Outcomes for Patients with Acute Myeloid Leukemia and was made possible with support by Bristol Myers-Squibb.

Additional Reading/Sources

· Healthcare Disparities Among African Americans Are Pervasive in the Treatment of AML. Blood. (2022)

· Minority Health Disparities in Acute Myeloid Leukemia: A Metropolitan, Single-Center Retrospective Analysis. Blood. (2021)

· The American Association for Cancer Research - Cancer Disparities Progress Report

· Structural racism is a mediator of disparities in acute myeloid leukemia outcomes. Blood. (2022)

· Disparities in mortality among acute myeloid leukemia-related hospitalizations. Cancer Med. (2023)

Working under the hypothesis that a subset of de novo oligometastatic breast cancer patients who are treated with a combination of systemic therapy, surgery, and radiation or ablation of metastatic sites will have long-term distant metastasis free and overall survival, this multi-cohort, prospective, nationwide registry study will enroll newly diagnosed oligometastatic (operationally defined by local tumor boards as disease where all metastatic lesions can be ablated) HER2+ breast cancer patients. Using an online portal, physicians can download a consent form, register patients, receive a multimodality treatment pathway that can potentially cure a subset of these patient, and enter information regarding what treatment the patient received, follow up, and outcomes information. The portal also gives patients access to input quality of life and patient reported outcome measures.

Guest:

Mariya Rozenblit, MD

Assistant Professor of Medicine

Yale School of Medicine

"Registry trials are helpful because they represent real-world data…So, for example, our trial is an online registry trial. All the information is collected online, so no one has to travel. And there's no criteria for participation except that you must have this specific type of breast cancer...We're hoping that by offering this clinical trial online, we can have a much more diverse patient population participating. We are hoping to get community practices from all over the country because there are less barriers to participation."

Resources:

The CHLOE Study

ACCC Community Oncology Research Institute (ACORI)

ASCO-ACCC Equity, Diversity, and Inclusion Research Site Self-Assessment

Just ASK™ Training Program

Just ASK™ Training Facilitation Guide

Clinical Terms Glossary

[PODCAST] Ep 84: Increasing Clinical Trial Access for Blood Cancers

[VIDEO] ACORI Call to Action Summit: Activating Equity in Community Oncology Research

[EXECUTIVE SUMMARY] ACORI Call to Action Summit: Activating Equity in Community Oncology Research

Virtual Navigation to Clinical Trials

As biomarker testing can play a critical role in the diagnosis of rare cancers, such as NTRK gene fusion-positive cancers, hear what care teams need to know about identifying patients who may be eligible for this testing. In this episode, CANCER BUZZ speaks with Eric Konnick, MD, MS, associate professor of Laboratory Medicine and Pathology and associate director of Genetics and Solid Tumor Laboratory at the University of Washington Medical Center Fred Hutch Cancer Center about the importance of testing for NTRK gene fusions.

"It's really important to test our patients for these [NTRK gene fusions] because there are very effective treatments now that can have dramatic effects on the outcome of these patients' disease course, so identifying patients that can be eligible for therapy is critical…" - Eric Konnick, MD, MS

This is the first episode in a four-part podcast series developed in connection with the ACCC education program Emerging Biomarkers: Innovative Therapies for NTRK Gene Fusion Testing and was made possible with support by Bayer.

Dr. Eric Konnick, MD, MS

Associate Professor of Laboratory Medicine and Pathology

Associate Director of Genetics and Solid Tumor Laboratory

Director of Genetics Preanalytical Services

Fred Hutch Cancer Center, University of Washington Medical Center

Seattle, WA

Additional Reading/Sources:

· Emerging Biomarkers: A Spotlight on NTRK Gene Fusion Testing (accc-cancer.org)

· NTRKers Patient Community & Support (ntrkers.org)

· NTRK Gene Fusion Infographic (ntrkers.org)

· NTRK fusion-positive cancers and TRK inhibitor therapy

Members of the multidisciplinary cancer care team—and cancer program leadership—recognize the importance of taking care of one's own mental health to be able to provide the best possible care to patients. Yet, many care team members are hesitant to share sensitive information and/or ask for support. Breaking down the social stigma that is often still associated with seeking mental health services is key to making cancer care clinicians and staff feel a "sense of safety" and that they will not be penalized for accessing mental health services. Normalizing the conversation around mental health is critical to developing this sense of safety and culture of caring.

Guests:

Christine Cha, MD

Radiation Oncologist

System Medical Director Cancer Service Line

PeaceHealth St. Joseph Medical Center, St. Joseph Cancer Center

Tricia Wooden, MD

System Medical Director, Provider and Caregiver Wellness

PeaceHealth St. Joseph Medical Center, St. Joseph Cancer Center

"First of all, we have to acknowledge that oncologists are human—just like their patients...Everyone benefits from good mental health. And just like physical health, you have to take care of your mental health…Speaking as someone who has experienced depression and burnout out in an earlier part of my career, it is really important to understand that you are not alone and that there are resources that are aimed to help you."

"Helping clinicians understand where their power is and helping them to feel better has wide-reaching implications on the care of our patients and the way they [clinicians] show up and function in our care teams…It is really difficult, as a non-clinician, to work for a clinician who is experiencing mental health issues and burnout. To some degree, we need to address the well-being of our clinicians first as we start to help to improve the whole health of the care team."

Read more in ACCC's Call to Action: Delivery of Psychosocial Care in Oncology Summit. Thank you to BeiGene, USA for supporting this important work.

Resources:

A Psychological First Aid Program in the COVID-19 Era

Community-Based Psychological First Aid for Oncology Professionals

Improving the Culture of Your Cancer Center, One Idea at a Time

Can You Hear Me Now?

Caring for the Caregiver

Removing the Blame from Burnout