The Fellow on Call: The Heme/Onc Podcast

In the first episode in our highly-anticipated multiple myeloma series, we begin our discussion about introduction to testing/workup for plasma cell dyscrasias and having our initial discussion about monoclonal gammopathy of undetermined significance (MGUS). Contents: - What is a plasma cell ? - What is a plasma cell dyscrasia? - What is an "SPEP"? -What is "immunofixation"? -What are "serum free...

In this episode, we discuss the acute management of the bleeding patient with acquired hemophilia. Prior to starting this episode, we highly recommend you listen to Episode 036 to review: - Approach to Hemophilia (physical exam, workup) - Review coagulation cascade Contents: - When to suspect acquired hemophilia? - Mixing studies in acquired hemophilia patients - What are Bethesda Units and why ar...

In this episode, we discuss the acute management of the bleeding patient with hemophilia including factor replacement. Contents: - Factor replacement guidelines for Hemophilia A vs. Hemophilia B in the patient with an acute bleed - Management of patients taking emicizumab - Alternative/adjunctive options for treatment of an acute bleed Want to review the show notes for this episode and others? Che...

In this episode, we discuss the fundamentals and approaches to chronic management and treatment for patients with known inherited hemophilia. Contents: - What is hemophilia? - How is it inherited? - How do we grade the severity of one's hemophilia? - Chronic management of hemophilia - Mechanism of Emicizumab (Hemlibra) Want to review the show notes for this episode and others? Check out our websit...

In this episode, we break down the initial approach to the evaluation of a patient with a suspected bleeding disorder, particularly in regards to hemophilia, including standardized bleeding assessment tools, the basics of the coagulation cascade, and mixing studies. Contents: - "The Fellow on Call" Bleeding assessment! - Important tips for your physical exam - How do we think about bleeding disord...

We strongly recommend you listen to our previous episodes metastatic lung cancer (Episodes 0032 and 0033) to better be able to follow along with this conversation. Key trials mentioned in this episode include: CHECKMATE 227 KEYNOTE 024 Q:Do you send molecular testing (PDL1 and NGS) on the biopsy, peripheral blood or both? * Yield is highest from the tissue sample * Peripheral blood (circulating DN...

Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. This week, we begin to round out our NSCLC series with the first of two episodes where we interview Dr. Jack West from City of Hope! We strongly recommend you listen to our previous episodes on early stage lung cancer (Episodes 0...

Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. This week, we continue our discussion on metastatic non-small cell lung cancer, focusing on NSCLC with driver mutations. * The approach to treatment of a patient with widespread metastatic NSCLC (mNSCLC) is very different than a...

Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. This week, we start our discussion on metastatic non-small cell lung cancer, focusing on NSCLC without driver mutations. * The approach to treatment of a patient with widespread metastatic NSCLC (mNSCLC) is very different than a...

Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. This week, we sit down with Thoracic Surgeon, Dr. Jane Yanagawa to discuss surgical considerations in treatment of NSCLC. * How do you choose what type of surgical resection to do? - Considerations: --Lung anatomy --Location of t...

If you’ve been with us since the beginning, thank you! But we've had a lot of new friends join the party so we thought we'd interrupt our regular programming to re-introduce ourselves! So if you’re new here, welcome to the Fellow on Call! We are so glad you’re here.

Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. This week, we round out our discussion of early stage lung cancer treatment! * When deciding if a patient can get surgery upfront or not, remember the three “Fellow on Call” criteria for early stage lung cancer:   - Mass inv...

Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. An important component of treatment in lung cancer (and many other cancers) is the use of radiation. This week, we continue our discussion about the fundamentals of Radiation Oncology with our guest, Dr. Evan Osmundson.  *We...

Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. An important component of treatment in lung cancer (and many other cancers) is the use of radiation. Here, we discuss the fundamentals of Radiation Oncology with our guest, Dr. Evan Osmundson. Basic vocabulary: - Fraction/Fractio...

How do we think about treatment of lung cancer? Recap on staging (see Episode 025) * Pro-tip: Highly recommend that you “forget” about the actual staging and focus more on the individual T, N, and M status  * Tumor size: **T1a <1 cm  **T1b <2 cm  **T1c <3 cm  **T2a <4 cm  **T2b <5 cm  **T3 5-7 cm **T4 cm  *Nodal status: **Double digit nodes = hilar...

Lung cancer specialized testing in NSCLC: What do we do if we biopsy a suspected metastatic lesion? * Immunohistochemistry (IHC): **Confirm if it is metastatic NSCLC **Confirms the histology of the NSCLC (such as adenocarcinoma vs. squamous cell) **Used to determine the type of chemotherapy that can be administered for treatment *PDL1 testing: **PDL1 is a protein expressed by certain cancer cells...

Lung Cancer Histology and Staging *Workup for a nodule that is concerning: **Ensure there is a dedicated CT scan of the chest to evaluate **Try to obtain old imaging; the rate of change is important **Can get PET, but even if a lesion if not FDG-avid, but growing quickly we should consider biopsy anyway **Referral to pulmonary medicine, who can assist with biopsy and also regional lymph node evalu...

Lung cancer is one of the most commonly diagnosed type of cancer and so it is fitting that we start the first of our disease-specific oncology series with this diagnosis. This week, we sit down with guest pulmonologist Dr. Greta Dahlberg to discuss how she thinks about and works up lung nodules concerning for malignancy. Lung nodules: * For discussions about incidental lung nodules and lung cancer...

We have now covered the fundamentals of pharmacology. This week, 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. *The products/resources we share are our OWN opinions. Naming of resources are not endorsements. We are not sponsored by any of these entities. Pharmacology Capstone: * Irritant vs. Vesicant...

Picture this: it's day 1 of fellowship and your attending needs you to "get consent for treatment." Huh? How do you educate your patient? We share our tips! In this episode, we discuss important considerations, including “does my patient need a port?”, “what if drugs extravasate?”, “how do I keep side effects of drug classes straight?!” *The resources we share are our OWN opinions. Naming of resou...

Picture this: it's day 1 of fellowship and your attending needs you to "get consent for treatment." Huh? How do you educate your patient? We share our tips! In this episode, we discuss the fundamentals and some of our favorite resources. *********The resources we share are our OWN opinions. Naming of resources are not endorsements. We are not sponsored by any of these entities. ********* 1) How do...

Emergencies happen in hematology and oncology. This is a fact. But how do we manage these emergencies? Look no further. In this episode, we’ll talk about one of the key hematologic malignancies that you’ll encounter as a fellow, one that requires immediate action to reduce mortality: acute promyelocytic leukemia (APL or APML) - Acute Promyelocytic leukemia (APL or APML): **Stay tuned for our upcom...

Emergencies happen in hematology and oncology. This is a fact. But how do we manage these emergencies? Look no further. In this episode, we talk all about our fourth hematologic emergency: thrombotic thrombocytopenic purpura (TTP). Thrombotic thrombocytopenic purpura (TTP): - Be sure to check out episode 009 on thrombocytopenia for a general approach and differential! - New anemia and thrombocytop...

Emergencies happen in hematology and oncology. This is a fact. But how do we manage these emergencies? Look no further. In this episode, we talk all about our third hematologic emergency: heparin-induced thrombocytopenia (HIT)! Be sure to check out episode 009 on thrombocytopenia for a general approach and differential! HIT: - Any time a patient with heparin exposure and now with a new thrombotic...

Emergencies happen in hematology and oncology. This is a fact. But how do we manage these emergencies? Look no further. In this episode, we talk all about our second hematologic emergency: disseminated intravascular coagulation (DIC) with an added bonus of an intro to thrombotic microangiopathic anemias (TMAs). Be sure to check out episode 009 on thrombocytopenia for a general approach and differe...