Experienced Oncologist Research Articles

Automatic cervical lymph nodes detection and segmentation in heterogeneous computed tomography images using deep transfer learning

To develop a deep learning model using transfer learning for automatic detection and segmentation of neck lymph nodes (LNs) in computed tomography (CT) images, the study included 11,013 annotated LNs with a short-axis diameter ≥ 3 mm from 626 head and neck cancer patients across four hospitals. The nnUNet model was used as a baseline, pre-trained on a large-scale head and neck dataset, and then fine-tuned with 4,729 LNs from hospital A for detection and segmentation. Validation was conducted on an internal testing cohort (ITC A) and three external testing cohorts (ETCs B, C, and D), with 1684 and 4600 LNs, respectively. Detection was evaluated via sensitivity, positive predictive value (PPV), and false positive rate per case (FP/vol), while segmentation was assessed using the Dice similarity coefficient (DSC) and Hausdorff distance (HD95). For detection, the sensitivity, PPV, and FP/vol in ITC A were 54.6%, 69.0%, and 3.4, respectively. In ETCs, the sensitivity ranged from 45.7% at 3.9 FP/vol to 63.5% at 5.8 FP/vol. Segmentation achieved a mean DSC of 0.72 in ITC A and 0.72 to 0.74 in ETCs, as well as a mean HD95 of 3.78 mm in ITC A and 2.73 mm to 2.85 mm in ETCs. No significant sensitivity difference was found between contrast-enhanced and unenhanced CT images (p = 0.502) or repeated CT images (p = 0.815) during adaptive radiotherapy. The model’s segmentation accuracy was comparable to that of experienced oncologists. The model shows promise in automatically detecting and segmenting neck LNs in CT images, potentially reducing oncologists’ segmentation workload.

Assessment of heterogeneity according to hospital or medical experience factors in outcomes of chemotherapy for advanced biliary tract cancer: a post-hoc analysis of JCOG1113.

JCOG1113 is a randomized phase III trial that showed non-inferiority of gemcitabine plus S-1 to gemcitabine plus cisplatin in patients with advanced biliary tract cancer. Assessment of inter-institutional heterogeneity in chemotherapy contributes to confirm generalizability and reliability of the study itself. However, there have been no studies conducted to assess the heterogeneity among participating centers in randomized phase III trials for biliary tract cancer. The objective of this post-hoc analysis was to assess the inter-institutional heterogeneity in the overall survival and progression-free survival of patients with advanced biliary tract cancer treated with first-line chemotherapy in the JCOG1113 trial. The heterogeneity in the overall survival and progression-free survival was assessed according to three factors: hospital volume, experience in medical oncology and experience in biliary intervention. A total of 300 advanced biliary tract cancer patients were analyzed. There were no statistically significant trends observed between hospital volume, experience in medical oncology, or experience in biliary intervention and overall survival (hospital volume: adjusted trend P value=0.6796; experience in medical oncology: adjusted trend P value=0.4092; experience in biliary intervention: adjusted trend P value=0.6112). Similarly, no statistically significant trends were observed between these factors and progression-free survival (hospital volume: adjusted trend P value=0.3000; experience in medical oncology: adjusted trend P value=0.1108; experience in biliary intervention: adjusted trend P value=0.2898). This study revealed no inter-institutional heterogeneity in the overall survival and progression-free survival in the JCOG1113 study population of advanced biliary tract cancer patients.

Through the lens of oncologists when communicating with non-Western migrants about cancer diagnosis, treatment, and prognosis: Results from a Dutch online survey.

With rising cancer incidence rates and a growing migrant population in Europe, understanding oncologists' challenges in communication and providing cancer care to patients with a non-Western migration (NWM) background is crucial. This study aimed to explore the perspectives and experiences of oncologists, including those in training, as they interact with such patients about their cancer diagnosis, stage, treatment, and prognosis. Between June and September 2023, an online survey was conducted among medical oncologists and trainees (MO) and pulmonologists and trainees (PO) from university medical centers or regional hospitals in the Netherlands. The survey, hosted on LimeSurvey, included descriptive statistics, Chi-Square tests to compare the responses of MO and PO, and thematic qualitative analysis of responses to open questions. The survey included 112 oncologists, including trainees. The majority directly disclosed a cancer diagnosis to patients, often using family members as interpreters because of language barriers. When families opposed direct disclosure, most oncologists explored the patients' preferences. More than half of MO and PO were satisfied with their communication, with PO reporting higher levels of helplessness and discontent. Challenges included managing family expectations and addressing cultural differences. Qualitative analysis of open responses revealed six themes in decreasing frequency: person-centered care, cultural competence and ethics, education and research, third parties, communication, and palliative care. Nearly 80 percent of oncologists want more research to develop practical tools to optimize communication. Oncologists (in training) adhere to Western care practices when communicating with patients with an NWM background, which can lead to challenges because of different expectations and cultural beliefs. Oncologists express a need for tools to optimize communication with patients with an NWM background. The implementation of education and training programs can support oncologists in their daily work and promote culturally sensitive healthcare delivery in oncology.

Safety of the Off-Label Use of Antitumor Drugs in Real Clinical Practice: Experience of Oncologists of the Russian Federation

Introduction. One of the key issues associated with the off-label use of antitumor drugs is safety. Typically, the advantages of such prescriptions in oncology are linked to the potential clinical benefits outweighing the risks of complications.Aim. To assess the safety of the off-label antitumor drug therapy in comparison with the on-label drug administration in the context of real clinical practice among oncologists in the Tula region.Materials and methods. The study was conducted at the Tula Regional Clinical Oncology Center, Russia. Over a six-month period in 2019, clinical data, provided by the regional information system, were analyzed for 919 completed treatment cases of 201 patients over 18 years of age who received antitumor drug therapy for malignant neoplasms. The study enrolled patients who had at least one hospitalization and got off-label antitumor drug therapy, as well as those receiving on-label drug treatment. The study assessed the safety of the off-label antitumor drug therapy in comparison with that of the on-label treatment, estimating the frequency of adverse events (AEs), spectrum of adverse events, severity of adverse events, fatal outcomes, treatment delays and discontinuations, and hospitalizations due to toxicity. A comparative analysis involved the results of using off-label and on-label antitumor drug therapy in terms of the aforementioned parameters. Results and discussion. No unforeseen adverse events were revealed in the study. The spectrum of adverse events encompassed 40 clinical and laboratory abnormalities with varying frequencies across the studied groups. Adverse events were observed in the majority of patients across both studied groups (83% and 86%). A predominance of grade I and II toxicity was noted. In some instances, therapy was discontinued and treatment was suspended; however, the frequency of these occurrences was significantly lower compared to current literature data. One fatal outcome due to complications from the administered therapy was recorded. All adverse events were reported in both studied groups with similar frequencies. The most commonly observed adverse events in both groups included hepatotoxicity, anemia, thrombocytopenia, nephropathy, cephalalgia, leukocytosis, skin toxicity, dyslipidemia, hypertension, bone pain syndrome, and dizziness. Other adverse events occurred sporadically with similar frequency. The most severe presentations were noted in the following adverse events: thrombocytopenia, gastrointestinal toxicity, leukocytosis, hyperglycemia, and immune-mediated diabetes mellitus with ketoacidotic coma.Conclusion. In real clinical practice, the safety of off-label and on-label antitumor drug therapy reveals no significant difference.

"Engaged Nurses Are the Ones Who Love Their Profession": Work Engagement From the Perspectives of Oncology Nurses.

Work engagement in oncology nurses is crucial for improving nurse practice and healthcare outcomes. The study aimed to define and understand work engagement from the perspective of experienced oncology clinical nurses. This qualitative descriptive study used purposive sampling to select 15 oncology nurses from a University Oncology Hospital in Türkiye. Participants had at least 3 years of experience and volunteered for the study. Data were collected through face-to-face interviews using a "Nurse Data Form" and a "Semi-structured Interview Form." The analysis identified six themes and 12 sub-themes. These themes include a sense of engagement, personal resources, organizational resources, professional resources, elements specific to the nature of oncology, and areas that need improvement. Sub-themes indicate that facilitators of work engagement included altruism, job satisfaction, teamwork, and nursing competencies. Nurses may require assistance in caring for patients with high psychosocial demands, long-term care or repetitive hospitalizations. In conclusion, nurses emphasized the facilitating and challenging factors in work engagement in the oncology clinics. This study suggests that oncology nurses' work engagement can be enhanced by empowering them professionally, individually, and organizationally.

Extended pelvic evisceration with lateral wall resection in malignant tumors

Patients with tumor involvement of lateral pelvic sidewall represent a peculiar category and were not assessed as the candidates for curative surgery up until recent years. The aim of the current review of literature is to display the working results of the most experienced surgical oncologists in pelvic surgery. We have analyzed issue-related articles, which were published from 1967 till 2023, considering the free margin status as a key prognostic factor. It is elucidated that R0 resection could be achieved in more than a half cases, 5 year overall survival ran up to 50 %, and postoperative mortality was less than 7 %. The majority of authors described high morbidity though (up to 82 %). Exenteration with laterally extended endopelvic resection could improve overall survival rate in patients with locally advanced pelvic malignancies granting sensible patient selection in expert medical care unit.

The Experience of Hematologic Oncology in Armenia

The Experience of Hematologic Oncology in Armenia

QLTI-10. IMPACT OF A NEURO-ONCOLOGY HOSPITALIST MODEL ON INPATIENT CANCER CARE DELIVERY AT A SINGLE INSTITUTION

Abstract Patients with brain tumors are often admitted to the hospital at critical stages of their disease course: initial diagnosis, relapse, end-of-life, and for management of serious complications. Patients who develop neurologic complications from systemic cancers and their treatments also frequently require management in the hospital setting. Most neuro-oncologists have busy outpatient practices and limited inpatient responsibilities. Their experience with hospital workflows, bandwidth to see inpatients, and comfort level managing certain diagnoses such as immunotherapy neurotoxicities may be variable, even within a single institution. Recent literature supports the beneficial role of the Oncology Hospitalist, a physician who specializes in the care of hospitalized patients with cancer. Oncology Hospitalist care improves length of stay, cost effectiveness, and the patient and oncologist experience. To our knowledge, the role of a hospitalist who specializes in the care of patients with neuro-oncologic issues has not yet been investigated. Here we describe the responsibilities and examine the impact of a Neuro-Oncology Hospitalist at a single institution over a 2-year period, with a focus on metrics of quality and efficiency of care. Patients and cancer care systems benefit from the dedicated inpatient presence of a neuro-oncologist, supporting the development of a Neuro-Oncology Hospitalist model.

The Carcinogenesis of the Human Scalp: An Immunometabolic-Centered View.

The human scalp is a common site of skin cancer in humans, with nonmelanoma skin cancer being exceedingly common. In this review, two dermatologists with extensive experience in cutaneous oncology will discuss unique features of the epidemiology of cancer of the scalp. Clinical observations on these common skin cancers lead to insight into the pathogenesis and potential prevention and treatment of cutaneous scalp neoplasia. Our hypothesis is that the presence of hair protects against the development of skin cancer but not by serving as a physical shield but rather by providing continuous IL-17-biased immunosurveillance. The loss of hair allows for a release from immunosurveillance, resulting in the expansion of neoplastic cells towards skin cancer. Both hair follicles and metabolic changes in stroma allow for permissiveness for tumor promotion.

Sharing Genomic Tumor Sequencing Results With Patients: Experiences of Advanced Practice Oncology Providers.

Patients with cancer routinely undergo genomic tumor sequencing, a component of molecular profiling (MP), to better characterize their cancer and identify potential targetable alterations. Targeted treatments potentially confer higher response rates and better efficacy. With increasing complexity, patients may require detailed explanations of MP results. Patient understanding of MP results increases the likelihood that eligible patients receive targeted treatment. Advanced practice providers (APPs), defined as nurse practitioners, physician assistants, and pharmacists, frequently review and discuss MP results with patients. Purpose: The aim of this study is to understand APP experiences discussing MP results with adult cancer patients. A qualitative study was conducted through virtual semi-structured interviews with APPs recruited via study invitation shared through the Advanced Practitioner Society for Hematology and Oncology (APSHO). Eligibility criteria included APPs with > 1 year of oncology experience and involvement in discussing MP results. Data were analyzed utilizing a constant comparative analysis and coded in three stages: open, axial, and selective. Thirteen participants were enrolled from across the United States. Participants discussed learning to understand and explain MP findings primarily through on-the-job experiences. Barriers to patient education were also described. Initially coded participant statements (open codes) produced six themes (axial codes). With MP now standard practice in oncology, APPs frequently discuss these results with patients. This study highlights that additional and continuing education related to MP is needed in communicating complex results. Patient educational tools, specific to patients' MP findings and tailored to their preferences and literacy levels, are critically needed.

Impact of 18F-FES PET/CT on Clinical Decisions in the Management of Recurrent or Metastatic Breast Cancer.

The clinical impact of 16α-18F-fluoro-17β-estradiol (18F-FES) PET/CT on patient management has not been well investigated. The aim of this study was to assess the clinical impact of 18F-FES PET/CT on the management of patients with recurrent or metastatic breast cancer. Methods: Study subjects were identified retrospectively from a database of a prospective trial for postmarketing surveillance of 18F-FES between 2021 and 2023. Patients who were suspected or known to have recurrent or metastatic estrogen receptor-positive breast cancer based on a routine standard workup were included. Planned management before and actual management after 18F-FES PET/CT were assessed by 2 experienced medical oncologists via medical chart review. A 5-point questionnaire was provided to evaluate the value of 18F-FES PET/CT for management planning. The rate of intention-to-treat and interdisciplinary changes, and the impact of 18F-FES PET/CT according to PET/CT result or clinical indication, were examined. Results: Of the 344 included patients, 120 (35%) experienced a change in management after 18F-FES PET/CT. In 139 (40%) patients,18F-FES PET/CT supported the existing management decision without a change in management. Intention-to-treat and interdisciplinary changes accounted for 64% (77/120) and 68% (82/120) of all changes, respectively. A higher rate of change was observed when lesions were 18F-FES-negative (44% [36/81]) than 18F-FES-positive (30% [51/172]) or mixed 18F-FES-positive/negative (36% [33/91]). Regarding clinical indications, the highest rate of change was shown when evaluating the origins of metastasis of double primary cancers (64% [9/14]). Conclusion: 18F-FES PET/CT modified the management of recurrent or metastatic breast cancer, serving as an impactful imaging modality in clinical practice.

Empowering survivors, elevating care: The vital role of oncology primary care clinics.

362 Background: Due to increasing numbers of cancer survivors, there is a greater focus on the longitudinal management of treatment-related comorbidities. Cancer survivors have increased risk of cardiovascular (CV) disease, CV-related mortality, and second primary cancers (SPCs). Primary care providers (PCPs) are responsible for most of the care of long-term survivors, however, many report uncertainty around long-term effects and survivorship guidelines. While fostering strong primary care-oncology relationships is one approach to support those impacted by cancer, the development of oncology primary care clinics enhances patient outcomes and ensures patients receive comprehensive survivorship care. Despite this, few tertiary cancer care centers offer such clinics. Methods: In 2021, the University of Cincinnati Cancer Center established an oncology primary care clinic. Patients are eligible if they have a current or prior cancer diagnosis or cancer hereditary syndrome (CHS). The clinic is comprised of two-family medicine physicians, one with survivorship experience, and one fellowship-trained in palliative and hospice medicine. Clinical team members include an RN with oncology experience, medical assistants, a clinical service specialist, two oncology clinical pharmacists, and an oncology social worker. A clinical registry was developed to longitudinally measure patient outcomes. Electronic medical records of patients (n=683) seen between 1/2021 and 1/2024 were extracted and entered in REDCap. Data was summarized using SAS. Results: The mean age was 56 years (range 20-93), and 12% received a diagnosis in the pediatric/adolescent/young adult age range (0-39 years). The most common types included breast (23%),hematologic cancers (15%), and CHS (16%). Notably 43% of patients are on active treatment and 53% completed or are on maintenance treatment. Over 61% struggle with obesity, while 45% report being a current or former smoker. Comorbidities were common with 79% of patients having at least one CV diagnosis. Of 57% patients eligible for cardiomyopathy screening, 78% received recommended echocardiograms. Many patients received their recommended screenings including breast (79%), colon (43%), cervical (56%), prostate (46%), and lung (55%). Patients were referred to a variety of supportive services including physical therapy (42%), cancer exercise (18%) and psychiatry (14%). Conclusions: This model of care is a viable option for connecting cancer survivors with PCPs knowledgeable about survivorship care. CV-related comorbidities were common, and their management is a critical need during and after cancer. Survivors have increased risk of SPCs, and while the number of patients up to date on recommended cancer screenings is low, screenings are on the rise with ongoing efforts. Patient registries enable objective measurement of outcomes and can inform future research and care.

Experiences of moral distress among health care professionals in oncology and palliative care in Australia: a qualitative investigation

Abstract Background: Cancer care involves challenging clinical problems requiring expertise of multiple disciplines and frequently necessitates nuanced decision-making. When decision-making and patterns of care conflict with the values of health care professionals (HCPs), moral distress may arise. Moral distress is defined as the unease resulting from the perceived violation of professional or personal values and ethical principles. It has been associated with increased burnout and lower workforce retention among HCPs. This study aimed to investigate moral distress among Australian oncology and palliative care HCPs to understand how, when, and why it is experienced. Method: We conducted a qualitative interview study, with an online survey to collect demographic, practice-related characteristics, and level of moral distress. Interviews were conducted with oncology and palliative care HCPs in Australia to explore participants' experiences of moral distress. Interviews were audio-recorded and transcribed. A thematic analysis was conducted using a framework analysis approach. Results: We interviewed 33 participants, who were predominantly female (78%) and nurses (42%) with 50% having 15 years or more experience in oncology/palliative care. Thematic analysis revealed one meta-theme, Power and Hierarchy, and four themes: (1) values and their conflicts; (2) moral distress and the system; (3) moral distress and interpersonal interactions; and (4) internalized moral distress. At the core of HCPs' experiences of moral distress were patient-centered and care-centered values and the imperative to not violate the oath to “Do No Harm.” Moral distress was perceived to be covert, primarily arising in response to day-to-day clinical dilemmas and resulted from interactions with other HCPs and structural factors. Moral distress appeared to be cumulative over time. Conclusion: Moral distress arises when there are conflicts between an individual's values and organizational culture, within teams, and within the HCPs themselves. Power and hierarchy within health care are critical elements contributing to moral distress where poor communication and limited recognition of differing views are present. There is a need for interventions facilitating open discussion of ethical concerns to reduce likelihood of moral distress and retain an experienced oncology and palliative workforce.

A five-year, multi-institutional mentorship program in radiation oncology: the Society for Women in Radiation Oncology experience: Short running title: SWRO Mentorship Program

BackgroundMentorship in the field of radiation oncology (RO) promotes career development and satisfaction. Many individuals, however, do not have access to mentorship or are unsatisfied with their mentorship experience, potentially due to insufficient gender-concordant mentorship opportunities. To address this, the Society for Women in Radiation Oncology (SWRO) created the SWRO Mentorship Program for women, gender minorities, and those with intersecting marginalized identities at all stages of training for physicians and medical physicists. We present the five-year experience of the largest multi-institutional mentorship program, to our knowledge, in RO. MethodsPublicly available information and the SWRO mentorship sign-up form were used. Descriptive statistics and binomial tests compared to reference points were conducted. ResultsBetween January 2018 and June 2023, 296 individuals from 19 countries participated in the mentorship program, generating 225 mentee-mentor pairs. The majority were female (89.2%), based in the United States (US; 84.8%), and on the physician-track (96.6%). The remainder of the analysis focused on US-based, physician-track participants (n = 244), the majority of whom were female (96.7%) and trainees (58.2%). Among those who have completed RO residency, most accepted a first job in academia (82.1%) and remained in academia at the time of the analysis (76.3%). A significantly higher proportion of SWRO mentorship participants compared to the reference point took a first job in academia (82.1% vs 58.3%; p<0.0001). The most common disease sites of focus for the physician-track trainees who finished residency are breast (50.4%), central nervous system (32.7%), and gynecologic malignancies (30.1%), with 54% listing more than one. The most common expressed goals of mentorship are research (35.8%), leadership (24.5%), and building connections within a specific geography or institution (19.2%). ConclusionsThe SWRO experience demonstrates the feasibility of a large-scale, multi-institutional mentorship program in RO.

Virtual Waiting Room: The New Narrative of Waiting in Oncology Care.

This conceptual study introduces the "virtual waiting room," an innovative, interactive, web-based platform designed to enhance the waiting experience in oncology by providing personalized, educational, and supportive content. Central to our study is the implementation of the circular entry model, which allows for non-linear navigation of health information, empowering patients to access content based on their immediate needs and interests. This approach respects the individual journeys of patients, acknowledging the diverse pathways through which they seek understanding and manage their health. The virtual waiting room is designed not only to support patients but also to facilitate stronger communication and shared understanding between patients, caregivers, and families. By providing a shared digital space, the platform enables caregivers and family members to access the same information and resources, thereby promoting transparency and collective knowledge. This shared access is crucial in managing the emotional complexities of oncology care, where effective communication can significantly impact treatment outcomes and patient well-being. Furthermore, the study explores how the circular entry model within the virtual waiting room can enhance patient autonomy and engagement by offering customized interactions based on user feedback and preferences. This personalized approach aims to reduce anxiety, improve health literacy, and prepare patients more effectively for clinical interactions. By transforming passive waiting into active engagement, the virtual waiting room turns waiting time into a meaningful, informative period that supports both the psychological and informational needs of patients and their support networks.

High-quality expert annotations enhance artificial intelligence model accuracy for osteosarcoma X-ray diagnosis.

Primary malignant bone tumors, such as osteosarcoma, significantly affect the pediatric and young adult populations, necessitating early diagnosis for effective treatment. This study developed a high-performance artificial intelligence (AI) model to detect osteosarcoma from X-ray images using highly accurate annotated data to improve diagnostic accuracy at initial consultations. Traditional models trained on unannotated data have shown limited success, with sensitivities of approximately 60%-70%. In contrast, our model used a data-centric approach with annotations from an experienced oncologist, achieving a sensitivity of 95.52%, specificity of 96.21%, and an area under the curve of 0.989. The model was trained using 468 X-ray images from 31 osteosarcoma cases and 378 normal knee images with a strategy to maximize diversity in the training and validation sets. It was evaluated using an independent dataset of 268 osteosarcoma and 554 normal knee images to ensure generalizability. By applying the U-net architecture and advanced image processing techniques such as renormalization and affine transformations, our AI model outperforms existing models, reducing missed diagnoses and enhancing patient outcomes by facilitating earlier treatment. This study highlights the importance of high-quality training data and advocates a shift towards data-centric AI development in medical imaging. These insights can be extended to other rare cancers and diseases, underscoring the potential of AI in transforming diagnostic processes in oncology. The integration of this AI model into clinical workflows could support physicians in early osteosarcoma detection, thereby improving diagnostic accuracy and patient care.

A Quality Approach to Blinatumomab Delivery in Pediatric Oncology: A Children's Oncology Group Study.

Background: Blinatumomab is a promising immunotherapy agent that has been shown to improve survival outcomes in children diagnosed with relapsed B-lineage acute lymphoblastic leukemia. Expanded use of blinatumomab in the treatment of childhood cancer is expected; however, clinician perspectives regarding administering this agent in healthcare and home settings have not been explored. Method: Semistructured interviews were conducted with clinicians (N = 13) from pediatric institutions across the United States and Canada. Qualitative data were analyzed using a constant comparative analysis three-stage method. Results: Participants were primarily nurses (92%), female (77%), and had greater than 10 years of pediatric oncology experience. The selective code and overarching theme identified was "A quality approach to blinatumomab delivery in pediatric oncology." Clinicians described detailed processes that were created and implemented to promote a common goal of safe blinatumomab administration across the continuum of care. Clinicians shared how they engaged in planning activities and considered a variety of factors prior to and during blinatumomab administration. Clinicians also expressed a need to reflect and evaluate on previous patient experiences to create new or revise existing processes and workflows. Communication was also central to clinicians' work. Clinicians provided recommendations to assist others with blinatumomab administration and offered suggestions for items that could help with implementing future clinical trials containing similar agents. Discussion: Findings suggest nurses are pivotal to establishing processes which support safe administration of immunotherapies, such as blinatumomab, while also considering patient-specific needs and promoting quality of life.

Differences in compassion satisfaction and compassion fatigue among oncology nurses in Oman: A multi-center cross-sectional study.

Oncology nurses are constantly exposed to occupational exposure to the suffering of others, which can lead to vicarious traumatization, low professional quality of life (ProQOL), and inability to provide quality nursing care. The purpose of the study is to explore the ProQOL of oncology nurses working in Oman and the characteristics that lead to differences in compassion satisfaction (CS) and compassion fatigue (CF). A cross-sectional design was conducted between March and December 2020 using the ProQOL scale to collect data from 242 oncology nurses in Oman using a convenience sampling technique. The rates of CS and CF [(secondary traumatic stress (STS) and burnout (BO)] were summarized using descriptive statistics. The characteristics leading to differences in CS and CF were assessed using the independent-sample t-test. Only 35% reported high levels of CS. Most nurses reported moderate STS (60%) and BO (65%). Nurses aged ≥36 years, ≥10 years of professional experience, ≥6 years of oncology experience, married, and desiring to work with cancer patients reported higher levels of CS. Omani oncology nurses have low levels of CS. The nurses' desire to work with cancer patients, professional experience, and the age of cancer patients regularly affected the experience of CF. The identified characteristics can be exploited to mitigate deterioration in oncology nurses' ProQOL using targeted interventions for high-risk individuals. Beneficial interventions may focus on continuing education, stress management, coping, work environment, teamwork, and communication of oncology nurses and other members of the healthcare team.

Expert Opinions on Uveal Melanoma: Insights from the 58th Ophthalmic Oncology Group Meeting

Introduction: Clear evidence for the best clinical management of uveal melanoma is lacking in some areas. Therefore, reports on expert opinions in the field can be valuable. Methods: A questionnaire comprising 10 questions was distributed to potential participants of the 58th Ophthalmic Oncology Group Meeting in Stockholm, Sweden, in June 2024. Results: Among 34 respondents, 13 (38%) had >20 years of postresidency experience in ophthalmic oncology. The maximum recommended tumor thickness for ruthenium-106 plaque brachytherapy was 5.7 mm (SD 1.1). Twenty-three respondents (68%) indicated that radiological surveillance for metastatic disease should be conducted irrespective of primary tumor characteristics. A majority (74%) would treat a lesion with a 6 mm diameter and 1.5 mm thickness without waiting for evidence of growth if sufficient risk factors were present. Most experts did not currently recommend sampling of circulating tumor DNA or circulating tumor cells. There were no significant differences in responses based on the experience of respondents (≤20 vs. >20 years) or their annual volume of new cases (≤50 vs. >50). Conclusion: This article reports the opinions of 34 experts in ophthalmic oncology on various contemporary topics in uveal melanoma. The responses illustrate both agreements and differences in opinions among experts.

The Impact of a Pilot Oncology Summer Internship on Oncology Awareness Among Early Medical Students from Underrepresented Backgrounds: A Mixed-Methods Study.

Oncology is a field of medicine projected to face provider shortages as cancer prevalence rises. Moreover, the diversity of oncologists remains subpar compared to that of the general population despite initiatives to increase the number of students from underrepresented backgrounds (UIM). Thus, first-year UIM medical students interested in oncology were invited to participate in a 4-week oncology summer internship (OSI) to gain clinical exposure and mentorship experiences. The OSI connected students with oncologists for mentorship, provided tours of oncologic facilities, and coordinated shadowing opportunities. The impact of the OSI was assessed via a mixed-methods approach. Pre- and post-survey data were collected from eight of the nine OSI students. Quantitative data demonstrated improvement of students' understanding of oncology as a discipline, for example its training pathways (p = .02), and awareness of patient experiences in oncology, for example socioeconomic challenges (p = .008). Students reported an increased ability to identify with those in oncology and identify mentors in the field (p = .03 and p = .05, respectively). Qualitative data demonstrated continued interest in oncology with increased commentary on the patient experience and social determinants of health. Post-survey, students provided more commentary on the need for diversity in the field and possible increased professional connections in medicine. The OSI improved students' understanding of oncology and oncology patient experiences with potentially increased identification of and connection with others in the field. Further work will focus on assessing the impact of future OSIs on professional identity formation.