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The Fellow on Call: The Heme/Onc Podcast

Rouleaux University Medical Center

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We quickly realized we knew very little about hematology and oncology when we started fellowship. Our goal is to bring you the fundamentals, core concepts and important management approaches in our field, driven by the latest evidence and expert opinion. In each episode, we will provide bite-sized, simplified approaches to common questions in a way that is perfect for anyone interested in hematology and oncology, from students and trainees to advanced practice providers and practicing physic ...
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In a recent American Cancer Society publication, there are increasing data that rates of colorectal cancer are rising rapidly among people in their 20s, 30s and 40s. This has certainly caught the attention of the lay press, most recently in a widely circulated New York Times article published in March 2024. Today, we welcome Dr. Chris Cann, who is …
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This week, we incorporate medical oncology back into our discussion with our Radiation Oncologist, Dr. Sanford, and our Surgical Oncologist, Dr. Bailey. We discuss how we approach the management of localized rectal cancer. Note that we will be heavily building off our discussions with our specialist. We recommend listening to these episodes if you …
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We have another guest joining us this week! Dr. Allison Schepers, PharmD, BCOP is a Clinical Pharmacist Specialist at the Rogel Cancer Center at the University of Michigan where she focuses on GI, GU, and Thoracic malignancies! In this episode, Allison discusses the high yield points we need to know about important drugs we use in the colorectal ca…
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This week, we are joined by Dr. Christina Bailey, Associate Professor of Surgery and Program Director of the General Surgery Residency at Vanderbilt University Medical Center in Nashville, Tennessee, for a discussion about the role of surgery in the management of patients with colorectal cancer. This is another amazing multidisciplinary colorectal …
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This week, we are joined by Dr. Nina Sanford, Assistant Professor and Chief of Gastrointestinal Radiation Oncology Service, UT Southwestern Medical Center in Dallas, Texas, for a discussion about the role of radiation in colorectal cancer, with an emphasis on the role of radiation in rectal cancer. Dr. Sanford is a wealth of knowledge so this is an…
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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 …
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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?…
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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…
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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 t…
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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/r…
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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…
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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: - W…
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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? …
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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 t…
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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 thes…
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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 s…
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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…
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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 refreshe…
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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 eval…
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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 s…
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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 w…
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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 patie…
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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 d…
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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 c…
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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 vesican…
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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 previously released this episode as Episode 020. This episode is a must-listen for anyone who talks to patients about chemotherapy! —— Picture this: it's day 1 of fellowship and your attending needs you to "get consent fo…
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We started this conversation last week! This week, we focus on how to approach warfarin and enoxaparin failure! Be sure to check out Episode 079 for part 1! Content: - What do you do about "wafarin failure"? - What about lovenox failure? ** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall…
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It’s time for another Heme Consult series, this time focusing on another common question we see in the hospital and in clinic: “is this anticoagulation failure?” In this two-part series, we break down how we approach the workup to determine exactly this. In this episode, we discuss "DOAC failure". Content: - How to approach a "DOAC failure" situati…
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In this FINAL episode of our DLBCL series, we build on our conversation from last week, focusing on the management of relapsed DLBCL. If you have not done so already, we recommend you check out Episode 077! Content: - Treatment with selective antibodies against CD19 - How to approach relapsed disease after CAR-T - Use of BiTE therapy - Role of allo…
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In our last episode, we discussed our approach to primary refractory DLBCL. This week, we start our conversation about relapsed DLBCL! This is an important and complex discussion, so we have split it into two episodes to help you follow along. If you have not done so already, we recommend you check out episode 076 for a discussion about the primary…
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This week, we pick up on our discussion about management of DLBCL, focusing on the primary refractory setting. A big part of this discussion is the role of CAR-T therapy. If you have not done so already, we highly recommend you check out episode 075 for the fundamentals of CAR-T before proceeding with this episode! Content: - Definitions for "prima…
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In this week’s episode, we pause from our discussion about DLBCL to talk about the fundamentals of CAR-T, BiTE and autologous transplants, which will lay the foundation for subsequent discussions about DLBCL. These therapies are the talk of the town and have changed/will continue to change our approach to hematologic malignancies - definitely an ep…
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This week, we continue our conversation about DLBCL, this time focusing our attention on the management of early stage disease. In this week’s episode, we delve into the management of advanced stage DLBCL. If you have not done so, we highly recommend you listen to our hemepath series before proceeding with this episode. Furthermore, if you have not…
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This week, we continue our conversation about DLBCL, this time focusing our attention on the management of early stage disease. If you have not done so, we highly recommend you listen to our hemepath series (https://www.thefellowoncall.com/rotationguide-intro-to-hematopathology) before proceeding with this episode. Furthermore, if you have not list…
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This week, we kick off a new series focusing on diffuse large B-cell lymphoma. In this first episode, we discuss the basics that everyone needs to understand before diving into the management of this disease. We highly recommend listening to our hemepath series before proceeding with this DLBCL series: https://www.thefellowoncall.com/rotationguide-…
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We revisit a topic covered previously as part of our “Heme/Onc Emergencies” series: heparin-induced thrombocytopenia (HIT) in Episode 017. As part of our return, we dive deeper into the pathophysiology, principles of diagnosis, and management of HIT to help you to better understand how to approach the question of “is this HIT?” as a Hematology cons…
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This week in our hematological consultation series, we continue our discussion on von Willebrand disease (vWD), this time focusing on the type 2 subtypes and we also discuss management. In case you missed it, we recommend checking out episode 069 for Part I of this vWD series, covering taking a bleeding history and about Type 1 and Type 3 disease. …
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We resume our hematological consultation series with an overview of von Willebrand disease, the most common inherited bleeding disorder. In this episode, we talk about the initial steps we should take to evaluate suspected von Willebrand disease (vWD) and how to differentiate the various subtypes. We will focus on vWD type 1 and 3! Be sure to tune …
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This week, we complete our breast cancer series, focusing on triple-negative breast cancer (TNBC). The last few months have been quite the journey! Please continue to refer to our shownotes to help navigate this complex disease treatment paradigm. Content: - What is the data about recurrence of disease of TNBC? - The history of how we got to our cu…
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We are not yet done with our breast cancer series, but we could not wait to share this incredibly personal conversation with a patient with a recent breast cancer diagnosis. This week, we sit down with Kaele Leonard, who herself is a Pulmonary/Critical Care fellow at Vanderbilt University Medical Center who was diagnosed with breast cancer in her e…
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This week, we continue our discussion about metastatic breast cancer, focusing on HER2+ disease. Content: - What is the data about recurrence of disease of different breast cancer subtypes? - The history of how we got to our current standards of care - Important trials to support our current treatment paradigm ** Want to review the show notes for t…
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After several weeks of covering localized disease, this week, we shift our discussion to metastatic breast cancer, focusing first on ER+ disease. Content: - Importance of taking a biopsy at time of disease progression - What endocrine therapy backbone do we choose in metastatic ER+ disease? - What agents can we add to endocrine therapy for metastat…
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This week, we round out our discussion on the early stage breast cancer, turning our attention to the triple negative subtype. Once again, there are a lot of trials and data, but be sure to check out the show notes for the highlights! Content: - What is TNBC? -What is the data to support the use of neoadjuvant therapy in this disease? - What is "pa…
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We continue on our journey through early stage breast cancer, this time turning our attention to HER2+ disease. There is a lot of data in this episode, as you will both hear and see. To make this easier, we highlight key takeaways to make understanding this even easier. Content: - What is HER2? - Discovery of trastuzumab - Data for use of trastuzum…
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This week’s episode is part 4 of 5 of a joint mini-series with our friends Two Onc Docs. In today’s episode, we will be recapping the current treatment of resectable NSCLC and discussing KEYNOTE 671, which was presented at ASCO 2023, looking at neoadjuvant chemo+immunotherapy followed by adjuvant immunotherapy. We also discuss the use of the “inter…
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This week’s episode is part 2 of 5 of a joint mini-series with our friends Two Onc Docs. In today’s episode, we recap the current treatment of classical hodgkin’s lymphoma and then dive into the the SWOG 1826 plenary session abstract from the ASCO 2023 annual meeting. We also cover the concept of “p-values” and what it means when trials say “the me…
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We are taking a small pause from our breast cancer series to discuss an important topic that is so critical to understand for clinical practice, no matter what discipline of medicine you are in: the fundamentals of transfusion medicine. This topic often shows up quite frequently on board exams, as well. In this episode, we talk about terms such as …
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Surprise! The teams at Two Onc Docs and The Fellow on Call are teaming up for his special series! Each episode will focus on a single abstract, poster, or oral presentation from ASCO 2023, and will feature a quick review of any guidelines and management pointers relevant to the disease state under study, followed by an overview of the study design …
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This week, we continue discussing the management of early stage ER+/HER2- breast cancer. If you have not done so already, be sure to check out Episode 057 for the first part of this discussion. Content: - Who warrants chemotherapy? - Who benefits from gene expression assays? - What are important gene expression assays used clinically? - Post-treatm…
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After several weeks of incredible discussions with our special guests, it’s time that we dive into the medical oncology regarding breast cancer. We start our discussion with the first of our two-part discussion on early stage (AKA non-metastatic) ER+/HER2- breast cancer. Content: - What information do we need to consider in patients with HR+ breast…
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