Articles related to PRACTICE PEARLS

Up to half of all patients with metastatic HER2+ breast cancer will eventually acquire brain metastases, which are associated with reduced overall survival and decreased quality of life. This comprehensive review examines current recommendations in 1st, 2nd, and later line therapies, discusses the status of novel agents, and provides recommendations to standardize care.

To date, FDA has approved three next-generation AR inhibitors for nonmetastatic CRPC: apalutamide, enzalutamide, and darolutamide. All three agents improve metastasis-free survival and overall survival. Selection of treatment can be guided by factors such as the patient’s overall health and frailty, potential drug-drug interactions, and the safety profile associated with each agent. This review summarizes the data from the practice-changing SPARTAN, PROSPER, and ARAMIS trials and provides insights on implementation in practice and promotes early intervention with AR inhibitors as standard of care for patients with high-risk nonmetastatic CRPC.

According to Dr. Keshav Khanijow, a hospitalist and an instructor of medicine at Johns Hopkins University School of Medicine in Baltimore: “Research has shown that using appropriate pronouns and terminology with transgender youth can be lifesaving. And I would posit that using appropriate pronouns and terminology for all LGBTQ people helps to build and foster trust with a medical provider, and that ultimately saves lives. It’s not the patient’s job to teach us while they’re battling illness. Rather, the onus is on us to learn it.”

Many patients have devoted time and effort to learning about their diagnosis and have engaged (or want to) in a collaborative relationship that benefits their care. This represents a shift from the more traditional health care paradigm, where the doctor is the primary content expert providing education and recommendations. To engage with expert patients, clinicians must acknowledge their existence as experts on their own diseases and that they can be a valuable resource and want to become more deeply involved.

A special tribute to Dr. John Cox, a Professor at The University of Texas Southwestern Medical Center and a practicing medical oncologist for more than 25 years in Dallas, Texas. He remains committed to transforming cancer care and enhancing the quality of patient care.

In an editorial published in KevinMD.com, a neurosurgeon discusses the myriad reasons she chooses to stay in clinical practice when many of her colleagues are leaving. The reasons range from job satisfaction from treating patients to family and financial considerations.