Oncology On The Go

• S1 Ep178: Cardiovascular Considerations in Breast Cancer Treatment and Survivorship

  In this episode, CancerNetwork® spoke with Joseph S. Wallins, MD, MPH, cardiology fellow at Weill Cornell Medicine, about a review of cardiotoxicities associated with breast cancer treatment he coauthored in the June 2025 issue of ONCOLOGY® titled, “Cardio-Oncology Considerations for Breast Cancer: Risk Stratification, Monitoring, and Treatment.” Therein, he touched upon data for risk stratification tools for oncologists, as well as the development of cardiovascular testing for individual treatment regimens. Wallins discussed the basis for conducting the systemic review as well as noteworthy cardiotoxicities associated with specific classes of breast cancer therapies. Specifically, he highlighted an increase in cancer remission and survivorship for breast cancer, which has, in turn, created alternative health risks impacting survival outcomes, such as cardiovascular risks. Citing a study showing a nearly 2-fold risk in cardiovascular-related fatalities for breast cancer survivors vs the general population, he suggested that the review was warranted to identify cardiotoxicities, strategies for preventing and managing them, and tools for risk stratification and monitoring. Wallins further outlined considerations for optimizing risk stratification and monitoring strategies in patients at risk of experiencing cardiovascular toxicities as well as treatments that may help with their prevention or mitigation. To that end, he discussed identifying patients who are at a higher risk before initiating treatment and outlined risk assessment tools that serve to do so. Furthermore, he suggested that patients who experience a greater than moderate risk for cardiovascular issues should undergo cardioprotective strategies and have in-depth conversations with providers regarding treatment risks. He concluded by highlighting future steps to enhance cardiovascular outcomes for patients with breast cancer, among additional key takeaways. Of note, Wallins expressed that genetic testing may help elucidate cardiomyopathy-associated genes while calling for a more personalized approach to risk stratification and more sensitive and specific imaging techniques to better identify at-risk patients. Finally, he emphasized a need for upfront risk assessment to identify patients at a higher risk who could benefit from additional testing as well as more pronounced collaboration between oncologists and cardiologists. Reference Bradshaw PT, Stevens J, Khankari N, Teitelbaum SL, Neugut AI, Gammon MD. Cardiovascular disease mortality among breast cancer survivors. Epidemiology. 2016;27(1):6-13. doi:10.1097/EDE.0000000000000394

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• S1 Ep177: Man Up? The Truth About Men's Health After Cancer

  In a recent episode of the Oncology-on-the-Go podcast in collaboration with the American Psychosocial Oncology Society (APOS), host Daniel C. McFarland, DO, was joined by Christian J. Nelson, PhD, to discuss the often-overlooked subject of sexual health issues for men after cancer treatment. The discussion emphasized the importance of a nuanced approach to men's health, particularly in the context of genitourinary cancers like prostate and testicular cancer. McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer in addition to being the psycho-oncology editorial advisory board member for the journal ONCOLOGY®. He opened the conversation by highlighting that while cancer’s physical effects are well-documented, the mental and emotional toll is equally significant and often underappreciated in male patients. He highlighted that the field of psycho-oncology, which began with breast cancer, is now expanding to address men’s specific needs. Men, he noted, are less likely to seek mental health support, yet have a higher risk of suicide, particularly at key moments in their cancer journey like diagnosis and recurrence. Nelson, chief of Psychiatry Service, attending psychologist, and codirector of the Psycho-Oncology of Care and Aging Program at Memorial Sloan Kettering Cancer Center, underscored that cancer treatments, especially for prostate cancer, often have profound adverse effects (AEs) that impact a man’s sense of self and masculinity.  He detailed the effects of radical pelvic treatments and androgen deprivation therapy (ADT), which can lead to urinary incontinence, erectile dysfunction, and changes in sexual function and body image. These AEs can lead to feelings of being "broken," "inadequate," or "deflated." The pair discussed the "double-edged sword" of normalizing cancer, where patients are told their prognosis is good but are left unprepared for the life-altering AEs. This can lead to a sense of cognitive dissonance and isolation. The conversation stressed the need for clinicians to proactively normalize discussions about sexual health, making it clear that these are standard and expected aspects of the cancer experience. Both clinicians suggested that establishing a trusting relationship with patients is paramount and that referrals to psycho-oncology should be framed as an essential, not optional, component of treatment. They also recommend that clinicians consistently check in with their male patients about emotional and sexual well-being, even long after treatment has ended, to ensure they’re coping with the lasting impacts of their experience. 

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• S1 Ep176: START Center Aims to Bring New Cancer Treatments, Trials to The Community

  In a conversation with CancerNetwork®, Geraldine O’Sullivan Coyne, MD, MRCPI, PhD, spoke about her new appointment as the principal investigator and director of Clinical Research at the Northwell Health unit of the Southern Texas Accelerated Research Therapeutics (START) Center for Cancer Research. Based on a strategic partnership formed between Northwell Health and START in May 2024, she will oversee early-phase clinical trial development at New York’s first START research site at the R.J. Zuckerberg Cancer Center in New Hyde Park. Coyne began by sharing her excitement to put all her efforts into making the unit a “good opportunity” to consider patients who reside in community settings for enrollment in new clinical trials. Although large academic centers may offer possibilities for enrolling in trials, Coyne highlighted how many patients may need to travel or leave their social networks behind as they undergo treatment, thus illustrating a need for expanded options in the community setting. “Having the privilege to be able to bring trial opportunities into the community—into the heart of the community—is what we are aiming to do,” Coyne stated about her new role. “We do believe that this will [allow] patients to access novel and powerful therapies that are now increasingly part of a personalized treatment paradigm for patients with advanced malignancies.” Emphasizing the pursuit of early-phase clinical investigations, Coyne described how the new unit may leverage START’s expertise to advance novel molecules across all stages of the drug development pipeline up to regulatory approval. She noted that being able to safely create and refine new therapeutic approaches in the community setting lies at the heart of a successful collaboration between Northwell Health and START. “A lot of the excitement surrounding the START unit and Northwell Health collaboration with them is exploring these novel molecules that will hopefully continue to build on the pursuit in oncology drug development, which has been finding better and more targeted therapies for patients in their treatment journey,” Coyne said. Reference Olt B. Northwell names Geraldine O’Sullivan Coyne, MD, PhD, to lead clinical trials at new START center. News release. Northwell Health. July 22, 2025. Accessed August 12, 2025. https://tinyurl.com/bdcua8ck

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• S1 Ep175: Beyond the Tumor: Addressing Body Image in Oncology

  In the inaugural podcast episode created in collaboration with the American Psychosocial Oncology Society (APOS), Daniel C. McFarland, DO, and Michelle Fingeret, PhD, explored the critical, yet often overlooked, issue of body image in patients with cancer. McFarland opened the discussion by acknowledging the significant psychosocial challenges clinicians face and highlighted the therapeutic power of the patient-oncologist relationship, which extends beyond medical treatments. Fingeret defined body image as a person’s total relationship with their body, encompassing not only appearance but also function and sensory experiences. She emphasized that body image changes are universal experiences for patients with cancer that affect all aspects of their lives. Despite their prevalence, Fingeret suggested that many clinicians feel ill-equipped to address these issues, and that patients are often reluctant to raise the topic due to feelings of shame or a desire not to "burden" their health care providers. The discussion delved into the spectrum of body image concerns, ranging from mild distress to severe functional impairment. Fingeret distinguished between clinical body dysmorphic disorder and other changes patients experience, stressing that their distress is a valid reaction to actual bodily alterations. She provided a framework for clinicians to assess a patient's concerns, urging them to listen carefully to the language patients use. Patients may describe their bodies with inflammatory words like "deformed" or use avoidance strategies, such as refusing to look in a mirror. Fingeret noted how these are important cues that signal a need for a deeper conversation. Practical advice was also offered on how to initiate these conversations. Instead of normalizing a patient’s concerns with platitudes like "Your hair will grow back," clinicians should validate their feelings by creating a safe space for them to talk openly. Simple, curious questions—such as "How does that make you feel?" or "Have you looked at yourself in the mirror?"—can open the door to a more meaningful dialogue. The goal of intervention, Fingeret explained, is not to force the patient to love their body, but to help them achieve a greater level of body image acceptance. The conversation concluded with a focus on redefining success. McFarland noted that patients often hope to "go back to where they were before," an unrealistic goal. Fingeret reinforced this point, stating that a key part of the work is helping patients develop flexible, realistic expectations. Success is often found in incremental progress, such as reducing avoidance behaviors or finding more fulfillment in social relationships, rather than in the complete elimination of body image distress. McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head and neck and lung cancer. He is also the psycho-oncology editorial advisory board member for the journal ONCOLOGY. Fingeret is the founder of Fingeret Psychology Services and specializes in body image and cancer. 

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• S1 Ep174: Navigating AE Management for Cellular Therapy Across Hematologic Cancers

  In a conversation with CancerNetwork® at the 2025 National Immune Cell Effector Therapy (ICE-T) Conference, Tiba Al Sagheer, PharmD, BCOP, BCACP; Rebecca Gonzalez, PharmD, BCOP, FASTCT; and Syeda Saba Kareem PharmD, BCOP, spoke about their presentations on managing adverse effects (AEs) across different hematologic malignancy populations. At the meeting, Al Sagheer, Gonzalez, and Kareem presented their ideas for treating patients with lymphoma, leukemia, and multiple myeloma, respectively. Al Sagheer is a Pharmacy Quality Improvement Coordinator and Transplant/Cellular Therapy and Hematology Clinical Pharmacy Specialist at Miami Cancer Institute of Baptist Health South Florida. Gonzalez is a clinical pharmacy specialist in Blood and Marrow Transplantation and Cellular Immunotherapy at Moffitt Cancer Center. Kareem is a clinical pharmacy supervisor in Malignant Hematology at Moffitt Cancer Center. Across different disease states, the presenters outlined the most common toxicities associated with CAR T-cell therapy, bispecific antibodies, and other novel immunotherapies. Additionally, they described strategies for reducing the severity of AEs such as cytokine release syndrome and immune effector cell-associated neurotoxicity syndrome as well as other oral, dermatological, and nail toxicities. Other key considerations for preserving quality of life among those receiving cellular therapy included risk stratifying patients based on tumor burden and inflammatory markers at baseline to inform prophylactic measures. Each presenter shared key takeaways for treating patients who experience treatment-related AEs based on their individual presentations. Al Sagheer emphasized that it is not “one size fits all” when it comes to therapy, as providers must tailor their use of specific drugs, prophylactic measures, and anti-infective medication to each individual patient. Kareem noted that cellular therapy represents an evolving field, as toxicity mitigation strategies will continue to change over time as new data emerge. Finally, Gonzalez underscored the intimate nature of the cellular therapy field, which presents opportunities to collaborate with other institutions and receive guidance on managing complex cases.  References Al Sagheer T. Mastering the management of adverse effects from cellular therapies in lymphoma. Presented at the 2025 National Immune Cell Effector Therapy (ICE-T) Conference; July 26, 2025; Orlando, FL. Gonzalez R. Navigating the challenges: managing adverse effects of cellular therapies in ALL. Presented at the 2025 National Immune Cell Effector Therapy (ICE-T) Conference; July 26, 2025; Orlando, FL. Kareem SS. Management of adverse events of CAR-T and T-cell engagers in myeloma. Presented at the 2025 National Immune Cell Effector Therapy (ICE-T) Conference; July 26, 2025; Orlando, FL.

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