The Fellow on Call: The Heme/Onc Podcast

In this week’s episode, we discuss the management of stage II colon adenocarcinoma, which is defined by a lack of nodal involvement and invasion through the muscularis layer of the colon. If you have not done so already, be sure to check out episode 099 (overview of colorectal cancer) and episode 100 for stage III colon cancer, as we will building on concepts discussed already. Content: - Is there a role for adjuvant chemotherapy in stage II colon cancer patients? - What is the impact on MSI/MMR testing in stage II colon cancer patients? - Is there a role for evaluating circulating tumor DNA (ctDNA) in colon cancer patients? - Is there a role for immunotherapy in the adjuvant setting? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

This week, we kick off our discussion of adjuvant systemic treatment in colon cancer, beginning with Stage III colon cancer. We will review the evidence basis for adjuvant therapy as well as the two main chemotherapy regimens including duration and side effects. Content: - Why do we need adjuvant therapy in stage III colon cancer? - What is FOLFOX? What is CAPOX? When do we use what? - What is the optimal duration of therapy? - What are the characteristics deemed high risk? - Can we discontinue oxaliplatin early? - What is the role of oxaliplatin in older patients? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

Colorectal cancer is one of the most common cancers diagnosed each year worldwide. This highly anticipated series will take an in-depth look at this disease. In this first episode, we discuss the basics, including staging, tumor markers, and microsatellite instability testing, before tackling the management of colorectal cancer in upcoming episodes. Content: - What is the incidence of colorectal cancer (CRC) in the US? - How are CRC patients staged? - What is the role of CEA? - What are microsatellites and mismatch repair proteins, and how do they come into play for treatment purposes? - Who needs germline testing? - What is the TNM staging for CRC? - What are some high risk factors we need to pay attention to on the pathology report? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

With multiple options for frontline therapy in CLL, MRD has the potential to emerge as a factor that could be considered in our decision-making algorithm for sequencing treatment options. In this week’s episode, we dive into a deeper understanding of the role of MRD testing in CLL. Content: - What is the role of MRD testing in CLL? - What are the techniques we use to evaluate for MRD? - What is the prognostic role of MRD testing? - Is there data to change treatment based on MRD testing? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

This week, we continue our discussion of treatment of CLL, this time focusing on the relapsed/refractory CLL. If you have not done so, we recommend checking out our prior episodes since we will be building on these conversations! Content: -If you suspect your patient has relapsed, what do you do? -What is the approach to treatment in the relapsed/refractory setting? - What is Richter's transformation? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

We continue on our journey through chronic lymphocytic lymphoma (CLL), this time focusing our attention to the treatment of CLL. Content: - What are the indications for treatment? - Can I wait to treat and not impact OS? - What is our current approach to treatment ? - Fixed duration vs. indefinite treatment options? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

This week, we start a new series, this time all about the ins-and-outs of chronic lymphocytic leukemia (CLL) / small lymphocytic lymphoma (SLL)! Whether practicing general internal medicine, hospital medicine, or hematology/oncology, you will likely come across a patient with CLL. First, we go through initial diagnosis of this disease! Content: - What is CLL? How is this different than SLL? - What is the approach to diagnosis? - Do you need a bone marrow biopsy? Imaging? - How do we prognosticate patients? - Are smudge cells always suggestive of CLL? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

In this week’s episode, we finish our series on hemolytic anemias with a discussion on cold agglutinin disease along with a few other causes of acquired hemolytic anemia. Content: - What is "cold agglutinin disease"? - Why is it called "cold"? - How do we diagnose this disease? - How do we treat? - BONUS: What are some other examples of hemolysis? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

Next in our heme consult series is all about the workup and management of warm autoimmune hemolytic anemia (wAIHA), a very scary situation! These patients can often be very sick and there can be a lot of underlying issues that may be causing this to occur. Rest assured- after this episode, you’ll be a pro at identifying this disorder and know how to manage it should you ever come across this. If you have not done so already, we recommend you check out our initial episode about hemolytic anemias (Episode 091) Content: - How do we work up warm autoimmune hemolytic anemia (wAIHA)? - Is it safe to transfuse patients with wAIHA? What about DVT prophylaxis? - What is the approach to initial treatment of wAIHA? How do manage patients once their hemolysis stabilizes? - How do we approach more refractory or relapsed cases? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

In the next part of this heme consult series, we discuss several congenital causes of hemolytic anemias. These diseases are relatively rare, but in patients presenting with concerns for hemolysis on history and on labs, but with a negative DAT, it is important to have these in your differential diagnosis! We take you through how to think about these disorders, their diagnosis, and management. If you have not done so already, be sure to check out Episode 091 where we discuss our initial approach to the diagnosis of hemolytic anemias. We also discuss the most common inherited cause of hemolytic anemia, G6PD deficiency, in that episode! Content: - When should we suspect inherited causes of hemolytic anemia? - What are important examples of membranopathies that can cause hemolytic anemia? - What are important enzyme deficiencies that can cause hemolytic anemia? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

It’s time for another heme consult series, this time focusing on hemolytic anemias. In this multi-part series, we will go through our approach to thinking about concerns for hemolytic anemias. This is super high yield for anyone who cares for patients, especially those in hematology/oncology. It’s not uncommon to get a consult on the heme consult service for assistance with diagnosis and management of suspected hemolytic anemias! Content: - What is "hemolytic anemia"? - When should we suspect hemolytic anemias? - What is the workup for acquired hemolytic anemias? - What is G6PD deficiency? When should we suspect this? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

We made it to the end of another series. In our FINAL episode of the prostate cancer series, we turn our attention to metastatic castrate-resistant prostate cancer! We discuss treatment options, the data behind why we do what we do, and more targeted agents. Content: - Approach to metastatic castrate-resistant prostate cancer - Refresher on what it means to be castrate-resistant - Role of bisphosphate therapy and denosumab - Treatment options and data surrounding sequencing of agents - Other options for prostate cancer (radium-223 and lutetium-177-PSMA-617) - Role of PARP inhibitors in BRCA-mutated disease ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

This week, we continue our discussion about metastatic castrate sensitive prostate cancer. Spoiler alert: there is not good guidance or biomarkers that help us pick one regimen over another. In this episode, we go through the data, our critical appraisal of the data, and some things to consider when selecting one regimen over another. As a refresher, be sure to check out our Pharmacology Episode and our introductory episodes, as we will be building on these concepts. Content: - Approach to metastatic disease - Who needs germline testing? - History of prostate cancer therapy - Selecting doublet vs. triplet therapy ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

As we continue our exploration of prostate cancer, we turn our focus to one of the earliest areas where medical oncologists are commonly involved: systemic therapy for non-metastatic prostate cancer. In this episode, we will review how to risk stratify localized prostate cancer, differences in FDA-approved prostate-specific PET tracers, how to evaluate for biochemical recurrence following surgical and radiation based treatments for localized prostate cancer, and when to consider utilizing systemic therapy in non-metastatic disease. Content: - A refresher on how we think about systemic treatment options for localized prostate cancer - What role does imaging play? - Definition of biochemical recurrence after upfront surgery vs. radiation - What is castrate-sensitive vs. castrate-resistant disease? - What to do if someone is already on ADT at the time of recurrence? - The fundamental design behind the pivotal STAMPEDE trial and the role it plays in helping us care for our patients with localized prostate cancer ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

Last, but not least, in our multidisciplinary discussions regarding the management of prostate cancer, we are thrilled to present a special episode featuring soon-to-be attending Radiation Oncologist Dr. Jacob Hall. Dr. Hall is a senior Radiation Oncology resident and Chief Resident at UNC-Chapel Hill. Today, he helps us better understand patient selection for radiation and helps define key terms. As a reminder, we previously discussed the fundamentals of Radiation Oncology with Dr. Evan Osmundson in Episode 027! Content: -What information should we include when referring a patient to radiation oncology? -How to counsel patients about effects of radiation oncology for prostate cancer -What is brachytherapy? -Is there a role for proton therapy? -What is the role of radiation for metastatic disease? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

In our next episode, we are joined by Dr. Sanjay Patel, a urologic oncologist from the Stephenson Cancer Center at the University of Oklahoma, who also happens to be Vivek’s older brother! We discuss the management of prostate cancer from the perspective of our urology colleagues. As medical oncologists, these are conversations and decisions that we are almost never a part of, as they are being had often before patients ever see us. It was so helpful to get to hear how Dr. Patel thinks about his patients! Content: - What considerations go into determining if a patient is a good candidate for a prostate biopsy? -What is the role of an MRI in the workup? -What are the steps involved in a biopsy? -When is additional imaging (such as PSMA PET) needed? -How does he decide surgery vs. radiation referral in unfavorable intermediate risk patients? -When is pelvic lymph node dissection recommended? -What does active surveillance entail? -What about management of high risk and very high risk localized prostate cancer? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

This week, we chat with Vineetha Thomas, PharmD, BCCCP, BCOP who is a clinical pharmacist specializing in genitourinary oncology at the Stevenson Cancer Center at the University of Oklahoma. In this episode, we discuss the ins-and-outs of how Dr. Thomas thinks about the various drugs available to treat prostate cancer and how she counsels her patients. Thanks to our friends at the Pharmacy Podcast Network for connecting us with Dr. Thomas! Content: - How do we pick one agent over another? - What are side effects of common drugs used for prostate cancer? - Why do we give prednisone with abiraterone? - What is the role of chemotherapy in the management of prostate cancer? - What is sipuleucel-T, radium-223, and lutetium-177? - Role of monitoring bone health in prostate cancer patients ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

Prostate cancer is one of the common cancers diagnosed each year in males. In this new series, we will go through the ins-and-outs of this disease. As medical oncologists, there is so much more to prostate cancer than we see. In our future episodes, we will also highlight the important role of pharmacists, radiation oncologists, and urologists in disease management! Content: - What is the incidence of prostate cancer? - What are the screening guideline recommendations? - How do we diagnose prostate cancer? - How do we risk stratify patients with prostate cancer? - What additional imaging, if any, is needed as part of our workup of prostate cancer? - What is the overview regarding treatment of prostate cancer? - What is the overview about what to expect after surgery or radiation for prostate cancer? - What are key terms we need to know in prostate cancer? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

In the final episode in our reboot of Pharmacology 101, we sit down with Renee McAlister, PharmD, BCOP to learn more about the nuances of pharmacology from an expert that does this day in and day out. Content: - How to manage extravasation accidents? - Pharmacy operations - What is "ideal body weight" vs. "AUC" - Why do we give G-CSF - Supportive care tips and tricks ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast

As we prepare for another round oncology series in the weeks to come, we thought we would pause and go back to to the basics. We continue on our Pharmacology 101 series this week. This is such a high yield episode for anyone who cares for patients receiving therapy for their cancer! Content: - What is an irritant? How is it different than a vesicant? - Does my patient need central access? - Overview of side effects of chemotherapy ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodes Love what you hear? Tell a friend and leave a review on our podcast streaming platforms! Twitter: @TheFellowOnCall Instagram: @TheFellowOnCall Listen in on: Apple Podcast, Spotify, and Google Podcast