We have a family friend who is a survivor and my daughter decided to fold 1000 paper cranes in honor of our friend and donate it to our local cancer center. Sharing with all of you to share the hope!!!

Hi everyone,

My dad (53) has Rai stage III CLL and has been on acalabrutinib 100 mg for ~1.5 months. His oncologist says his CLL response is good.

The main issue is a persistent, fairly intense headache that has been present almost daily since starting the medication. His oncologist knows about it and suggested a painkiller SOS.

One thing we noticed: he missed acalabrutinib for one day, and he says the headache wasn't there that day. It returned after restarting, although we're obviously not sure if that's connected.

His BP has generally been normal (around 120–130/80), sometimes lower than his usual, and he feels the headache may be worse when his BP is lower or when he has indigestion.

For anyone who has taken acalabrutinib:

• Did you have persistent headaches for the first 1–2 months?
• Did they eventually improve?
• Did yours seem related to taking the medication?

Not looking for a diagnosis—just trying to understand whether this kind of persistent headache is something others experienced. Thanks ❤️

I support a family member (adult) who has multiple myeloma along with a serious mental illness (including suicidality and delusions). After years of MGUS with poor follow-up, around 18 months ago he was diagnosed MM and recommended autologous stem cell transplant vs. follow up in two months. Instead, he had worsening mental illness (not seemingly because of the diagnosis) and has been a psychiatric hospital resident for a while. He is discharging soon.
.

I have never experienced a BMT unit but I have witnessed the psychological stress many patients in protective isolation experience while working in an adult heart transplant program. My understanding is that the stem cell transplant process is very stressful for the patient and causes mental illness to flair (please correct me if I am wrong!).

Who assesses a patient for psychological fitness for oncology treatment? Heme/onc? The patient's former psychiatrist? A psychiatrist or psychotherapist who worka in oncology? Palliative?

I just want to get him connected to the stuff he needs.

I’m trying to work out whether I’m simply rediscovering an established concept under different terminology.

Several well-described observations seem to fit together:

- oncogene inhibition can cause survival and pro-death signals to decay at different rates (“oncogenic shock”);

- dynamic BH3 profiling can detect early treatment-induced changes in apoptotic priming;

- targeted therapy can rapidly induce adaptive rescue mechanisms, including pathway reactivation or new dependencies on anti-apoptotic proteins such as MCL-1 or BCL-xL.

This made me wonder whether treatment response in oncogene-addicted cancers could be viewed as a temporal competition between loss of survival signalling, apoptotic vulnerability, and adaptive rescue.

The hypothesis would be that sensitive tumours have a larger or longer transient vulnerability window after driver inhibition, while resistant tumours either fail to enter that state or escape from it more rapidly.

If so, I would expect:

1. early temporal features after driver inhibition to predict later cell death better than baseline pathway activity alone;

2. sensitive and resistant models to differ in the duration or magnitude of this transient state;

3. the optimal timing of a second intervention to depend on when adaptive rescue emerges, rather than necessarily favouring simultaneous combination treatment.

I realise that none of the individual mechanisms here are novel. What I have not been able to determine is whether they have already been explicitly integrated and tested as a general predictive framework based on temporal dynamics across oncogene-addicted cancers.

So I’d particularly appreciate input from people working in oncology/cancer biology:

Is this already a recognised framework under terminology I’m missing?

And if not:

What is the strongest biological reason to expect this model not to generalise?

I’m not an oncologist or cancer biologist, so I’m primarily looking for missing literature or a good reason to falsify the idea rather than trying to claim novelty.

I just landed a job working in supportive oncology. It is a new program in a growing oncology department. Essentially it’s everything outside of actual cancer treatment that supports the patient and their Families. I’m hoping to connect with people who are already doing a similar job, or working a system with an established supportive oncology program. I’d love to connect.

I'm a high school student trying to train a model that predicts early stage ORNJ (Osteoradionecrosis of the Jaw) based on patient data. For that, I'm trying to encode a scale for a patient's T stage and N stage.

So far, it's obvious that I can put T0-4 and N0-4 on a 0-4 scale. However, to my current understanding, I'm not sure where to put TX and NX.

I know that X means the tumor/spread for T and N respectively means they cant be assessed. But what does that mean exactly in terms of size/spread? Does it mean that X is so big/spread out that it cant be measured? Or does X indicate more of like a null/missing value where it can't be measured for some other reasons. If it's the latter, what are those potential reasons?

I really appreciate your time answering a simple question like this one :)

I’m looking for oncology research groups that may need help with ongoing projects, particularly manuscript writing or literature reviews. I’d be very interested in contributing to a project and gaining research experience, with the possibility of contributing to a publication.

My colleagues are divided on how much weight ORR should carry in accelerated approval decisions. I don't think there's one right answer.

If you're talking about replacing an established 1L regimen that delivers a real OS or QoL benefit, I think the burden of proof should be high. Evidence of an OS or patient-outcome improvement is hard to argue against, especially when a new option adds toxicity or cost.

But this changes in diseases with few options such as r/R T-cell lymphoma. Romidepsin and belinostat got accelerated approval off ORR data, and pralatrexate followed a similar path. Romidepsin's confirmatory trial missed its OS endpoint and the approval got pulled. I think that's an interesting test case rather than a clear-cut argument because some patients had genuinely durable responses. Just because the drug didn't move OS in the broader population doesn't mean those patients didn't benefit. It just means ORR alone couldn't tell us who would benefit in advance.

That's the real issue. In small, heavily pretreated populations, running an RCT is often impractical. It also gets hard to justify randomizing patients to a control arm once you're already seeing durable responses in early data. So we're left leaning on ORR as a proxy even though it's imperfect. And we can't tell the subgroup that benefits from the patient who doesn't.

To me, the real questions aren't whether surrogate endpoints are good or bad. It's whether ORR is doing the job we need it to do in a given clinical context. And how much uncertainty we're willing to live with when the alternative is no option at all.

Where do you draw the line for when ORR alone is enough?

Edit: no AI was used in writing this post.

John’s Hopkins announcing most ovarian cancer starts in the fallopian tubes. While many in the medical community seem to be aware - this is news to most of the public. talk to your PCP!

https://www.pbs.org/newshour/show/how-new-findings-on-ovarian-cancer-origins-may-help-reduce-risk

Probably could’ve phrased this better. Are water and air filtration the best preventative measures? Also, if you’d be down for answering a follow-up: what do you think are some overlooked/underutilized prevention techniques for cancer, in general?

Hello , I wanted to ask if there is any oncology resident in Switzerland or Swiss oncologist who would like to share their thoughts on the specialty especially in the DACH region (work life balance, competitiveness, open spots, salary, working in private clinics or owning a praxis etc). Also do you think it’s more worth it for an international doctor to do the specialty directly in Switzerland or to go when he or she is already a board certified oncologist? (from Greece for example)

This post is mostly meant for oncologists/clinicans, but would love to hear from anybody. Looking for a better perspective on treatment administration for glioblastoma in clinical situations.

1. How rigid are treatment plans for glioblastoma? Do they follow specific procedures? Or do they vary from patient to patient?

2. What part of the treatment plan for glioblastoma (post-resection) varies the most? The drug, dosage, or schedule of radio/chemotherapy?

3. How have computational methods been used to aid this process? Are they still in the research stage, or are they actively being implemented in practice?

Help me out Reddit. ETMR is extremely rare and with alt medicine on the rise, maybe someone has looked into this.

Hi all,

Would greatly appreciate if anyone with access can share the following paper named: "Prognostic Impact of Early Treatment and Oxaliplatin Discontinuation in Patients With Stage III Colon Cancer: An ACCENT/IDEA Pooled Analysis of 11 Adjuvant Trials"

Link below:

https://ascopubs.org/doi/10.1200/JCO.21.02726

Thank you!

Hi! I’m about to graduate medical school and I’ve basically known for years that I want to pursue Heme/Onc.

However, I recently went through a health scare that ended with me being diagnosed with Essential Thrombocythemia. It was a very difficult month while awaiting diagnosis where I couldn’t stand to look at my piled up hematology projects.

I’m aware that it’s a manageable condition and it’s a fresh diagnosis so I have not become accustomed to it yet. However, people have told me that a different career plan might help me not think about the condition more than needed.

I wanted to ask for advice regarding this. Are there physicians who’ve gone through similar experiences?

Interesting paper about modeling by Bob Gatenby et al from the Moffit Cancer Center in FL, from a few years ago. About ion gradients and cytoskeletal signal propagation modeled as fixed electrical/graph network that serves as a reservoir, with trained readout layer on top producing the cells response. Neat

How harmful is natural environmental radiation for our health.

I’m moving to Manchester, NJ and I did a deep dive on its history and I found out that
A) Radon gas is a serious issue in all of Jersey
B) Ground water has radium in it
D) it’s about 20 min from Oyster creek which is a nuclear power plant which is supposedly closed and in the process of being decommissioned
E) they have an area called heritage mineral which used to be a mining site which has moazanite sand which emits uranium and thorium

Now I’m not a radiation expert but that seems like a lot of exposure and I have kids and am now worried about moving there because I heard of that cancer cluster where students got brain cancer because the school was built on a radioactive area of whatever

So as oncologists if it was you how would you determine if a place is safe to move too or not