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Aug 5, 2020

Dr. John Sweetenham, medical oncologist at the Harold C. Simmons Comprehensive Cancer Center at UT Southwestern Medical Center and chief editor of the ASCO Daily News, and Dr. Don Dizon, head of Women’s Cancers at Lifespan Cancer Institute in Rhode Island and editor of the ASCO Educational Book, discuss the extraordinary breadth of issues in oncology that are covered in this year’s Educational Book, which is a continuing resource for the seminal ASCO20 Virtual. 



Dr. John Sweetenham: Hello, I'm Dr. John Sweetenham, a medical oncologist at the UT Southwestern Simmons Cancer Center, and chief editor of ASCO Daily News. I'm pleased to be the guest host of the podcast today and to welcome my colleague, Dr. Don Dizon. He's head of women's cancers at Lifespan Cancer Institute in Rhode Island, and editor of the ASCO Educational Book.

We'll discuss some of the compelling articles that have been published in the Educational Book, some of which are also going to be featured during the ASCO20 Virtual Education Program, and I'd also like to chat about important topics that perhaps aren't being covered during the program, but certainly deserve our attention. My guest and I report no conflicts of interest relating to the issues discussed in the podcast. Full disclosures relating to all Daily News podcasts are available on our episode pages. Don, it's great to have this opportunity to speak with you today.

Dr Don Dizon: I'm really happy to be here. Thanks a lot.

Dr. John Sweetenham: The ASCO Educational Book covers such an extraordinary breadth of issues from health services and quality improvement to symptom control, survivorship, and more. Can you tell us a little about what ASCO members can expect in the Educational Book this year?

Dr. Don Dizon: Sure. I'm always happy to speak about the Educational Book. At its most germaine, what I think we have attempted to do is really live up to our ASCO President Skip Burris' vision of the approach to oncology, which is not approaching cancer with an individual's perspective, but really to bring in the multiple voices that are seminally important in everyone's experience with cancer.

So we have strived very much, and our authors were exceptionally participatory in providing multidisciplinary articles on multiple cancer topics, as you just mentioned, so that the reader, who is importantly across the globe because the ASCO Educational Book is a free resource, can get that multiple perspective view on the topic related to malignancies.

Dr. John Sweetenham: Can you tell us a little about some of the issues that maybe are not going to be covered in the program, but you believe are going to be very relevant to what we experience as oncologists today?

Dr. Don Dizon: I think across the Educational Book, the topics that we dealt with are pretty detailed. Some of the ones that I think are of importance is a whole aspects of antibody drug conjugates, for example, which is covered in the developmental therapeutics track of the Educational Book, and there are multiple perspectives going from the basics of ADCs, all the way up to the clinical application of, not only FDA approved ones, but others that are in development. So that's very important, I believe.

Global oncology is also covered, and although most of us are practicing perhaps in the United States, we have attempted to bring in multiple voices internationally because we recognize that ASCO serves an international audience, and its members are not limited to the United States. In the area of breast oncology, we attempted to really cover multiple topics that are relevant across the continuum of breast cancer, really paying attention to what subgroups are guiding therapy these days, whether that be the hormone positive subset, triple negative, the role of the immunotherapy, but also the approaches to metastatic breast cancer.

So I believe that all throughout the Educational Book, you will find topics that are relevant, not only to the specialist, for a more contemporary view of where the field is at, but also very relevant for our folks who are in practice in our communities.

Dr. John Sweetenham: Great, thank you, and I think one of the real strengths of the Educational Book is that it covers many of those topics that I would say we think about some of the time, but maybe we should be thinking of a little bit more. I'm thinking specifically of adolescent and young adults with cancer, fertility problems associated with cancer and its treatments, and then some of these 'softer issues,' such as communication with our patients, and more primary palliative care. Can you comment on some of those areas that are going to be covered in the Educational Book this year?

Dr. Don Dizon: Yeah, absolutely, I think you had mentioned the issues concerning adolescents and young adults (with cancer), and certainly there are topics that are relevant for folks that we are hoping to cure and potentially are going to be alive for many, many decades. And I think for those folks, we do want to question the importance of addressing issues when we first meet them, rather than saving them for end of treatment, or even four or five years later. A classic example of that is fertility preservation, but equally important is the topic of sexual health in these patients, and I am very fortunate that our AYA topics did deal with these issues that aren't routinely discussed, but hopefully, this will really push our colleagues to embrace that these are important aspects.

Same thing goes with palliative care, and the role of the oncologists in the delivery of care, particularly for patients who are not dealing with curative intent illness. And so I think the Educational Book, not only summarizes the field, but with multiple people generating that manuscript really drives home an action item, which again, is one of the things we were pretty cognizant about because at that end of the day, it's nice to have a summary, but it's more important to provide guidance.

Dr. John Sweetenham: One of the other aspects of the Education Program as a whole that I really like this year is that I think that you and ASCO are tackling some issues which are a little more almost edgy and controversial, and I'm thinking in particular around issues such as disparities in access to care, gender disparities in the oncology workforce, which I think is a really interesting subject to address, and then some of my own kind of pet controversies, I guess, such as the use of real world data and cancer center advertising, which I think are all intriguing subjects to be covered in the Education Program. Can you comment just a little on how you decided to include those topics this year?

Dr. Don Dizon: You know I will credit the Education Committee for branching out just beyond the science of oncology and really going into the practice, as well as the art of oncology. The Educational Book and the topics we cover are only as reflective of what the society feels is important for that annual meeting. And I think in this regard, leadership really did embrace a broad range of topics and tried to achieve one important aspect across all of them, health equity and the approach to patients no matter who they are and who they love and how they identify themselves in terms of health equity, it was all about achieving balance, in terms of who was invited to speak, who wrote articles for and with us, and also the way the language of the Educational Book was structured is very deliberate. We wanted to make a stance that there is a better way to write about oncology, and there's a better way to speak with each other.

And I think you'll see this reflected, not only in the Education Session virtually, but hopefully you'll see that also approach in the Educational Book. So the book is a continuing resource, I think, for this seminal Education Program that was put together for 2020. Sadly, circumstances today led to the cancellation of the in-person meeting, but I think the Education Program virtually is going to be reflective of this exceptionally all encompassing view of oncology practice. Fortunately, the Education Program will live on for 2020 within the Educational Book.

Dr. John Sweetenham: All right, thank you. You mentioned this extraordinary time. The moment in August of 2020. It's difficult to talk about oncology and not bring up the issue of COVID-19 and the pandemic. Can we expect to see that addressed in the Education Program this year?

Dr. Don Dizon: The answer shortly is yes. The fact that the Education Program really worked to identify and address very contemporary issues is an important aspect of how reactive the program has had to be. So there are two sessions in the Education Program which are going to be really important, I think, for all of us. One from the trainees perspective and how programs are managing COVID-19's presence as we train the next generation of oncologists in our fellowship programs, this has, I'm sure, John, you feel the same.  It did impact the program here at Brown University, as it did, I'm sure, all across the country, and it's impacting how we select fellows for the coming year. Given that not everybody is able, willing, or should travel to meet with programs. So virtual interviews are on the horizon, and I think hearing from program directors about how they are going to manage that virtual aspect of interviewing, and more importantly, advice to people who are interviewing is going to be as important.

I think one of the quickest collaborations in the history of medicine, especially oncology, was around COVID-19 and cancer, and there will also be a roundtable on that specific issue that is going to be a part of the Education Sessions this year.

Dr. John Sweetenham: Yeah, I guess I hadn't really thought of it so much, but I guess that virtual interviews may require a very different skill set from the ones we use for our in-person interviews, right?

Dr. Don Dizon: I think it will be. I'm a big advocate for social media, for example, but people have critiqued your background. Where you are selecting to do the interview might be important for program directors to get a better sense of who you are, but it also behooves us as clinicians to appear professionally as well when we're representing our programs. 

Dr. John Sweetenham: Right, absolutely. Well, it's difficult to believe, but I think that we are just coming to the end of our time. Don, thank you for your time. It's been a real pleasure listening to you, and I just want to say congratulations on what I think is an outstanding Education Program. Very, very, very broad, and I think we're all going to learn a lot this year.

Dr. Don Dizon: Thank you so much, John. It's always a pleasure to speak with you. Hopefully, next year we'll be in person. Just one other shout out that for the Education Program, just for everyone who's attending, 74% of the sessions that are going to be presented have a companion Educational Book article, and I'm exceptionally proud of that. Thank you very much, John.

Dr. John Sweetenham: Thank you. That's outstanding, and thanks to our listeners for joining us today. Please take a moment to rate and review us on Apple Podcasts. Thanks again, and goodbye.

Disclaimer: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.


COI Disclosures:

Dr. John Sweetenham

Honoraria: Seattle Genetics

Dr. Don Dizon

Stock and Ownership Interests: InfiniteMD, NeuHope

Consulting/Advisory: i-Mab, Clovis Oncology, AstraZeneca, Regeron, Tesaro, Merck, Sharp & Dohme, Bristol-Myers Squibb, Kazia Pharmaceuticals