Latest news with #DrMaurieMarkman
Medscape
19-05-2025
- Health
- Medscape
Cancer's Toll Raises Suicide Risk for Spouses
This transcript has been edited for clarity. Hello. I'm Dr Maurie Markman from City of Hope. I'd like to briefly discuss a very difficult topic, but one that I believe needs to be more openly discussed — not necessarily the specifics of the topic, but the implications of findings. The paper I'm referring to is entitled, 'Suicide attempt and suicide death among spouses of patients with cancer.' This was reported in JAMA Oncology . What we're looking at here in this analysis are data from Denmark. There are a number of countries, particularly in Scandinavia, that have a national registry of diseases, treatments, and outcomes. We are relying here on data from Denmark, but I would have no reason to believe it's any different than what we might see in the United States. We're looking at registry data from 1986 to 2016. The analysis was performed in August 2022. Again, what they were looking at here is the risk of suicide attempts among spouses of individuals with cancer. Clearly, we were looking at registries that relate to cancer, and then they would also have other registries related to attempted suicide or actual suicide deaths, a nd they were matching these databases. It's obviously complex registry data, which of course, we would not have in the United States, but it's potentially very relevant. T he term they used was exposed individuals, these were the spouses of individuals with cancer. There were 409,000 individuals, and they compared that to over 2 million individuals who would be unexposed. These must be individuals in the population, presumably age matched, without cancer. They saw that the risk of a suicide attempt among spouses of patients with cancer was much higher than the population without cancer,particularly notable in the first year after diagnosis. The hazard ratio of those at risk versus not at risk for a suicide attempt was 1.45, and 2.56 for suicide death for the exposed compared to the unexposed, two-and-a-half-time risk. It's noted in the paper that there was even a higher risk — and I think the numbers will get smaller here — if that family member was diagnosed with an advanced-stage cancer or if the individual died of cancer. This is not surprising. Clearly there's much to be discussed here, but the most important point to be made is the stress — both psychological and financial, fear, risk of depression (particularly in an individual who might already have some concerns) — is very real, and this paper makes it very palpable. As emphasized in the paper, b ehavioral support, social work support, and financial support over time, particularly at the beginning of the cancer journey, is really important. What we can do as individuals, as family, as friends, but also as a healthcare establishment, either at an individual physician level or at a public health level, to help families and to help spouses through this journey is critical to potentially avoidsuicide and certainly suicide deaths. This is a very complex subject and a very personal subject for many individuals but a very important one. Thank you for your attention.
Medscape
12-05-2025
- Health
- Medscape
Multigene Testing in Pancreatic Cancer: NCCN Impact
This transcript has been edited for clarity. Hello. I'm Dr Maurie Markman, from City of Hope. I'd like to present a very interesting analysis. I think it's open to interpretation, and follow up of what I'm going to discuss is necessary, but I think it makes a number of important points relative to the question of optimal utilization o f multi-panel molecular testing as we move forward in this very exciting world of targeted therapy. The paper is entitled, 'Utilization and outcomes of multigene panel testing in patients with pancreatic ductal adenocarcinoma.' This analysis was looking specifically at pancreas cancer and data that come from a Mayo Clinic analysis, from Mayo Clinic in Rochester, Arizona, and Florida. They were looking at the utilization of multi-panel testing in a population of 533 patients with pancreas cancer before and after guideline recommendations from NCCN (National Comprehensive Cancer Network) that suggested such testing. One of the advantages of the Mayo Clinic system is that the groups work very closely have a really robust database. One would not know if the information in this report is comparable to other organizations, but I think it's very provocative to look at and for organizations that ask themselves, 'How are we doing with such testing?' Of these 533 patients, 60% (321 patients) that they looked at in terms of the question of testing were before the NCCN recommendations, and 40% (212 patients) they looked at whether the testing was performed or whether a discussion was held with the patients and then testing performed. Again, they were looking at the electronic medical record after the recommendations. Here's what they found: Prior to the NCCN recommendations — where doctors made their decisions based upon their knowledge of t he field, what they had read, meeting information, and CME programs — 34% of the patients had had a documented discussion regarding this testing. Of these, 81% — that's 81% of the population that had the discussion — had the test actually performed. Post NCCN recommendations for the testing, that number increased minimally to 39%, of whom 75% of that population had the testing. WithNCCN recommendations, still only 40% of the patients had a discussion of the testing at the Mayo Clinic. They noted that among the patients who did have testing, 17% had pathologic variants identified, of whom 11%, so 1 out of 10, had documented prostate cancer-related abnormalities that are potentially quite relevant for their treatment and also for discussions with their family. This is a very important paper. It's a very important baseline, you might say. One must ask, how are we doing today? The implications of such testing are only greater compared to a year or two ago , both in terms of therapy and of course discussions with the family. It's an interesting analysis and an important can conclude that this is not so bad, considering it's new. You could say that we wished it would've been higher. I'd love to see a follow-up from Mayo Clinic. Where are they in 2024 or 2025? Th ank you for your attention.
