Showing posts with label endometrial cancer. Show all posts
Showing posts with label endometrial cancer. Show all posts

Wednesday, June 12, 2024

June 12, 2024 Gyn Cancer Research News

Tonight the #gyncsm community discussed Gynecologic Cancer Research News presented at the SGO (Society of Gynecologic Oncology) and ASCO (American Society of Clinical Oncology) annual meetings. You may find our transcript here and analytics here. 

Highlights from our chat: 

T1: What #SGOmtg presentations/posters did you find most interesting?

  • I attended #SGOmtg virtually this year and found a large number of studies focused on endometrial cancer and immunotherapies >> Combo’s like dostarlimab + chemo in the ENGOT-EN6-NSGO/GOG-3031/RUBY Trial showed improved OS
  • One Recurrent OC study with Antibody drug conjugates (ADC)s the CDH6 directed Raludotatug deruxtecan (R-DXd) showed promising response in early studies Duration of response was 11 months #gyncsm #

T2: Which #ASCO24 studies do you think may be of most interest to patients?


  • ASCO, one Trial for recurrent OC, AGO-OVAR 2.29 using Atezolizumab showed OS atezo arm 14.2 months vs 13.0 placebo arm, No better than without atezo , AE's higher in Atezo arm too. #ASCO24 #gyncsm
  • ASCO published these notable studies for 2024 including: advanced epithelial ovarian cancer may safely avoid having their lymph nodes removed during cancer surgery without it impacting survival. https://society.asco.org/practice-patients/patient-resources/breaking-cancer-news-patients#CARACO
  • T2 or this study People vaccinated for HPV have lower chances of developing HPV-related cancers, especially head and neck cancer in men and cervical cancer in women 
T3: In the last year, have there been any practice-changing gyn cancer studies patients should know about? Combo treatment studies, immunotherapy and antibody drug conjugate studies? Rare cancer therapies?

  • Use of biomarkers to target the best therapies to treat women with gyn cancer was talked about repeatedly at SGO.> Repair Assisted Damage Detection (RADD) as a potential predictive biomarker for immunotherapy response in ovarian cancer reported on by Dr Rocconi 
  • T3 Use of ctDNA was also a topic of interest at SGO and ASCO 1 study for cervical cancer Circulating #HPV 16/18 DNA detectable with 100% sensitivity in higher stage and 50% in low stage cervical cancer & at time of recurrence

T4: What are some of the "hot topics" in gynecologic cancer research currently? Will AI play a role? 

  • AI to predict homologous recombination deficiency in OC from histopathological images. #5578 deep neural networks (DNN), can provide a rapid/ scalable solution for HRD prediction, …model could significantly enhance efficiency, reduce the turnaround time and cost” #gyncsm
  • T4 Machine learning used in a study cfDNA fragmentomics - New Classification test for endometrial ca, reported sensitive even for early stage cancer
  • more emerging data and use in ongoing trials and practice in Her2 low endometrial with trastuzumab deruxtecan
  • T4 It was good to see research for low grade serous OC treatments: MAPK assoc tumors better outcomes. Endocrine treatment studies, MEk inhibitors and CDK 4/6 inhibitors being researched. #gyncsm
T5: Once again, cancer drug shortages were highlighted at both #SGOmtg and #ASCO24. What resources for health care providers and patients are available?
T6: Are there recent studies surrounding palliative care, survivorship, and psychosocial research that could help gyn cancer survivors?

Thanks to everyone who joined us. Remember you can continue our discussion about research on @smart_patients by joining Smart Patients at https://www.smartpatients.com/partners/gyncsm.

Our next Chat will be on September 11, 2024 at 8pm ET. See you then!

Dee and Christina


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Wednesday, September 13, 2023

9/13/2023 How do we #MoveTheMessage? Raising Awareness of Gyn Cancers


As we celebrated our 10th Anniversary as a Community on X/Twitter we were happy to be joined by Foundation for Women's Cancer, Cervivor, and Powell-Drescher Ovarian Cancer Research Foundation to discuss how to raise awareness of gynecologic cancers.

We had 19 participants and 1.2 million impressions. You may find more analytics here and the transcript here. 

Here are some tweets that highlighted key points mentioned during the chat.  

T1 What are some of the things you, or your organization, do to raise awareness of GYN cancers? Are there things you've tried in expanding your reach to underserved communities? 

 


T2: What are some of the key points to share when raising awareness about #CervicalCancer? What do you wish others knew? #gyncsm #MovetheMessage 

 


T3: What are some of the key points to share when raising awareness about #UterineCancer and #EndometrialCancer? What do you wish others knew? #gyncsm #MovetheMessage 


T4: What are some of the key points to share when raising awareness about #OvarianCancer? What do you wish others knew? #gyncsm #MoveTheMessage

T5: Vaginal, vulvar, and several other gyn cancer types are rare. With fewer advocates and organizations to speak about these cancers, how can we educate more people? What is most important to know? #gyncsm #MovetheMessage

You can visit the #gyncsm community blog Resources page to find links to some of the groups and/or info for the rarer forms of gyn cancer gyncsm.blogspot.com/p/resources_9.

We'd love your feedback on these three #gyncsm community questions. Feel free to comment in the box below or on Twitter.

Question 1 : Approximately how long have you followed the #gyncsm hashtag? What has the cancer community on this platform meant to you?

Question 2: How are you feeling about the cancer community on this platform now? Do you have back-up plans if/when this platform is no longer a good fit for you?

 Question 3: What chat topics have you found most helpful? What topics would you like #gyncsm to cover in future chats? 


Note there is no #gyncsm chat in October. Stay tuned for information about our next chat in November on Wednesday, November 8th at 8pm ET. 

Thanks again to all our health moderators and supporters through the years.

Dee and Christina 

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Friday, September 11, 2020

What I Didn’t Get to Say

 

We are honored to share this post from recent chat guest Adrienne @AdrienneEcana who is a survivor of both endometrial cancer and ovarian cancer. She is a patient advocate and serves as an ambassador for the Endometrial Cancer Action Network for African Americans (ECANA).





Recently I was a guest for a live chat with #gyncsm (Gynecologic Cancer Social Media). I was honored to be asked because I had never done a live chat before, so I spent the day before writing and re-writing my answers to frame them correctly. I had a lot I wanted to say about how I felt my journey to diagnosis took longer than it needed to. I wanted to speak about how the invisible barriers that kept me from getting diagnosed sooner were just as important as the evident ones. But I soon found out that a tweet chat was not a platform that would readily support the way I wanted to tell my story. Even though I prepared for it, I quickly became flustered and started to feel a little inadequate by the lack of depth in my responses. So instead of trying to paint the bigger picture, I defaulted to one or two line answers that did little to bolster the points I was trying to make. My lack of familiarity in this space had me at a disadvantage and I couldn’t help but think that this was exactly how my cancer journey began. The countless doctors, gynecologist and emergency physicians that I readily opened my stir up supported legs to made little space for me to do the same with my mouth. My time there was always rushed and my words tripped over each other coming as I tried to describe how I felt about the changes my body was taking me through. It was dizzying.

In 2015, my body started authoring a story of menorrhagia confusion that left my head spinning. I never knew what to expect month to month. I began seeing a myriad of doctors but their level of concern never seemed to match my own. And each time I had left from being in front of one doctor with no answers, it would only leave me with more angst about having to seek out another. So, as I went from doctor’s offices to emergency rooms trying to string together words, dates, times and events that would give my story effective credibility, I began to realize that it just wasn’t going to be enough. The fact that my father died of colon cancer wasn’t enough. The fact that I had had a history of ovarian cancer wasn’t enough. The fact that I had been missing periods for months and they would then be marked by heavy bleeding for days wasn’t enough. The fact that it was almost always accompanied by debilitating pain that kept me out of work wasn’t enough. It only became enough when on March 28th 2016 I declared “This is enough”!!

I was away on a week long job orientation where the employer offered me health insurance day one of the job. I was ecstatic because I had lost insurance coverage with my previous employer of five years after the ACA allowed for businesses with less than 50 employees to have their workers find “affordable” care on the exchange. To make it work the Home Health and DME company had to separate into a two part business. The home health or nursing side kept their insurance because they had more employees but the DME side I was on was sent to the exchange. I was a young 40 something with pre-existing conditions and no dependents. It turned out to not be so affordable for me so I went without. On day two of my orientation, I woke up that morning met with a heavy flow of menstrual blood and I knew two things. The first was that I had had enough of the guessing game and two I finally had insurance to put it to an end. Admittedly, I was scared. It felt ominous and foreboding somehow, I knew this period was different because I hadn’t had one in months. I was told I was peri-menopausal and that my flows would become lighter and lighter. This didn’t look or feel like that all. For days I bled so heavily it soaked through two pads and my undergarments. Honestly, it felt more like I was having a miscarriage. Weeks later, when I was finally able to see a specialist, I was still bleeding. Despite the level of discomfort that it came with, I asked to have an internal exam anyway and held my breath listening for the words I knew would come. I breathed a sigh of relief as she said “I think it's time to schedule an ultrasound and biopsy to see if there is a possibility of cancer”. Somebody finally said it. Relief flooded over me after knowing that I wasn’t going to be coaxed or eased out the door by another conversation about fibroids or peri- menopause. For the first time I was being educated on how my high risk history coupled with my symptoms was more than likely the beginnings of what has now become my cancer chronicle. For months I had been trying to make my symptoms mean something to someone and this is what it took for someone to go the extra mile. Was it having the right amount of blood? Having the right amount of insurance or finally having the right doctor? Maybe it was the combination of all three met with the right amount of determination in my voice that this time I wasn’t walking away without a clear plan of action.

The story I’m telling however is not a new one. It’s been told by numerous others before me. So I am just one of many and whether by default or design, black women tend to share the common problem of aggregation when it comes to their reproductive health. Most of us at one time or another have been told that the culprit behind our monthly state of misery was due to the high incidence of fibroids that occur in our community. That it was likely due to our diet or DNA. We walked away with never any real plan of treatment and it was a risk factor we learned to accept even against our own self interest and to sometimes our own detriment. But for now, for me at least, I’d get some answers. Though I knew it would be nothing that I’d want to hear, I did take some solace in knowing that all the pain, all the abnormal bleeding, all the bloating and unpredictability had a name.

I was diagnosed with Endometrial Cancer stage IIIC in June 2016. I had a full hysterectomy that month to be followed by 6 rounds of carbo/taxol and 25 rounds of pelvic radiation. It’s funny that I felt almost relieved; knowing what treatment I was going to have to face felt less problematic than getting to that point. There is a settling that happens in resolution. It’s the not knowing that’s troublesome and my mind still tends to grapple with the one big problem throughout the beginning of my journey; the absence of any real urgency around what I now know were early symptoms of cancerous changes happening inside of my uterus. This begs the question of how could life threatening changes hide in plain sight from the very people I trusted to know what was going on when I didn’t have a name for it? To that end, I don’t think of it as an incidence to which one should apply blame. Only that it was a series of missed opportunities to engage in a power sharing conversation about my reproductive health and the direction of how my plan of care should evolve.

Now, in hindsight, I try to think about what more I could have done to have enriched those conversations. How I could have been more educated about endometrial cancer to where I would have been able to initiate the conversation about my own risks. If I had, would that have changed the dynamic? Would those uterine fibroids and ovarian cysts that appeared on ultrasounds somehow be seen as more menacing to the specialists? Would the heavy bleeding be given more thought provoking responses because I came more equipped in how to talk about it? Did I miss my window of opportunity by trying to paint the bigger picture when I was the bigger picture? I should have challenged them to see me, forced them to hear me, cajoled them into believing me. But if showing up as my Black self, with my high risks and cancer history; laying down my father’s death to colon cancer hadn’t gotten their attention there was not much left. Months of concern that drug me in and out of doctors offices remained void of validation that would have opened doors for questions I never considered before I had to jump feet first into the battle of my life.

As I am writing this, I realize that advocating for myself is where I should have prepared better. It’s where I should have recognized that the barriers weren’t invisible at all. They were all just the metaphorical walls of communication waiting to be scaled by my determination to fight for my reproductive health. I can see now that my cancer journey began long before I was ever diagnosed and had I known, I would have prepared for it the way I prepared for that tweet chat. I would have stated and re-stated all the important points first, using my space more wisely. I wouldn’t rush myself or care how long it took, I only would have cared that I was heard.

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Wednesday, August 12, 2020

August 12, 2020 Endometrial Cancer Chat

This evening the #gyncsm community gathered to chat about Endometrial Cancer - Risk, Symptoms, Treatments. We also discussed endometrial cancer care among women of color and the current disparities. We were pleased to have Adrienne Moore, @AdrienneEcana,  survivor and patient advocate, share her experience with us. We had 27 participants for this informative chat. You may find our transcript here and analytics here.

Some sample responses to our topic questions appear below. Resources shared during the chat may be found within the sample responses and at the end of this post.

T1: What increases a woman's risk of developing #endometrialcancer? Age/Genetics/Other Factors? How common is endometrial cancer and how aware are women about it? 

  • Endometrial Cancer is diagnosed 60,000 X per year in the US. Cure rate 85%. Risks: Obesity, late menopause, infertility, fam history of Lynch Syndrome. Treatment surgery+\-radiation and chemo. Genomic testing recommended.
  • Obesity and older age are the typical risk factors for endometrial cancer. A small number of women have a genetic risk. At a population level declining rates of hysterectomy for benign gynecologic disease has also led to increasing endometrial cancer diagnoses.
  • An estimated ~3% of endometrial cancer is hereditary -- primarily due to increased risks associated with #LynchSyndrome. There are several LS genes, each with different levels of risk to develop endometrial cancer 
  • Lynch syndrome can also increase someone's lifetime risk for other cancers, like ovarian and colorectal cancer. If you have a family history of these cancers, talk to your health care team + a genetic counselor to better understand your risk+ prevention options
T2: How are cancers of the uterus diagnosed? What symptoms are women experiencing that lead to diagnosis?
  • Symptoms are most commonly irregular vaginal bleeding.Diagnosis is through endometrial biopsy either in the office or the operating room.
  • T2/A2 I experienced heavy bleeding for 3 weeks before a doctor would see me.
  • Recognizing the symptoms of endometrial cancer https://www.youtube.com/watch?v=MalYxhuIH5c&feature=youtu.be via @YouTube #WomensHealth #gyncsm
  • My main symptom was abnormal menstrual cycles. I went to several gynecologist because of it and sadly not one ever brought up endometrial cancer.
  • @GYNCancer - Symptoms ” warning sign for uterine cancer, including endometrial cancer, is abnormal vaginal bleeding.” In older women, any bleeding, spotting, or brownish discharge after menopause may symptom #gyncsm
  • @frandrescher experienced a Delay in diagnosis of endometrial cancer due to her young age and sense from the medical establishment that she was unlikely to have a cancer. Biopsy should be done on any women over 35 with irregular bleeding. #gyncsm
  • T2: Women also run into weight bias at the doctor's office when reporting symptoms. The age thing, as mentioned, can be a diagnosis barrier for most of the gyn cancers or any cancer. Not just older women get cancer.
T3: What are the different types of #EndometrialCancer? Are they treated differently?
  • There are multiple different types of endometrial cancer, most commonly endometrioid, also carcinosarcoma and papillary serous + clear cell subtypes as well as adenosarcoma. All are treated differently due to different genetic fingerprints and susceptibility to treatment. 
  • T3: Terms and types and subtypes within cancer make my brain hurt. There are 2 main types of uterine cancer - endometrial (90% of uterine cancers) and sarcoma. Then for endometrial there are varieties. Most treated with surgery/radiation/chemo.
  • within endometrial cancers often divided by low risk (type1) and high risk cell types (type2). High risk types like serous, clear cell, carcinosarcoma are often treated more aggressively due to presentation at higher stages or due to higher recurrence risks. 
  • Subtyping of endometrial cancer is so behind other disease sites! We having even reached the ER/PR/HER2 categorizations that define breast cancers. Research is needed on the molecular categories - POLE, MMR, and p53
  • Yes both everolimus and temsirolimus have activity in endometrial cancer. We might have been stuck in applying these drugs indiscriminately instead of to patients more likely (by molecular subtype) to respond. 
T4: Studies have found African-American women experience higher mortality from #endometrialcancer than any other group of women. What factors are researchers looking into to explain and address this disparity?
  • Generally, barriers to diagnosis and treatment which allow for advanced stage at diagnosis.
  • There are disparities particular to WOC. Doctors are less likely to believe our symptom & often misdiagnose #gyncsm
  • WOC are more likely not to be believed when reporting symptoms. Racism, African American Women, and Their Sexual and Reproductive Health: A Review of Historical and Contemporary Evidence and Implications for Health Equity https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6167003/  
  • Assessment of Prediagnostic Experiences of Black Women With Endometrial Cancer in the United States https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2766042
  • In 2019 @ECANAwomen convened survivors and researchers to come together and talk about policies to address the issues of bias in research
  • @KemiDoll @ECANAwomen and others are doing great research and advocacy in this area. https://newsroom.uw.edu/postscript/spotlighting-common-female-cancer-and-health-disparity
  • We need to make endometrial cancer information easily accessible to our young ladies as well as all ladies especially in the gynecologist office. I would have handled my abnormal bleeding differently if I had known it was a symptom of the disease 
  • from ASCO20 Uterine cancer histology and stage at presentation in black & white women: A cohort study of 488,000 Compared to white women black women are more likely to be dx with serous, clear cell,carcinosarcoma, leiomyosarcomas at adv stages
  • T4: Black women more often develop high grade/aggressive types of endometrial cancer. Could be genetic, environmental factors? Also advanced stage at presentation plays a role. Need to educate about sxs, address insurance, systemic racism. Devoting my career to this!
  • T4: public health researchers study system-level factors causing differences in health outcomes sometimes called "social determinants of health": includes factors that create barriers to accessing healthcare/health insurance, systematic racism in healthcare, etc
T5: What are the side effects of #endometrialcancer and its treatments that may impact a woman’s quality of life? What can be done to improve the lives of women diagnosed with endometrial cancer?
Please join us our next #gyncsm chat on Wednesday, September 9th at 9pmET as we discuss Rare Gyn Cancers during Gynecologic Cancer Awareness Month. 

Stay well and safe. 

Dee 
#gyncsm co-moderator


OTHER RESOURCES SHARED:

Recognizing the symptoms of endometrial cancer https://www.youtube.com/watch?v=MalYxhuIH5c&feature=youtu.be

Assessing endometrial cancer risk among US women: long-term trends using hysterectomy-adjusted analysis https://www.ajog.org/article/S0002-9378(19)30682-9/abstract

Losing Weight Linked to Lower Risk of Uterine Cancer https://www.cancer.net/blog/2017-02/losing-weight-linked-lower-risk-uterine-cancer

Managing the Side Effects of Endometrial Cancer https://www.cancersupportcommunity.org/article/side-effects-management-endometrial-cancer
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Friday, August 7, 2020

Endometrial Cancer #gyncsm Chat August 12, 2020

 

Join the #gyncsm community on Wednesday, August 12th at 9pmET / 8pmCT as we discuss Endometrial Cancer - Risk, Symptoms, Treatments along with special guest Adrienne Moore @AdrienneEcana who is a survivor and patient advocate.

Topic Questions for Wednesday's chat:

T1: What increases a woman's risk of developing #endometrialcancer? Age/Genetics/Other Factors? How common is endometrial cancer and how aware are women about it? #gyncsm

T2: How are cancers of the uterus diagnosed? What symptoms are women experiencing that lead to diagnosis? #gyncsm

T3: What are the different types of #EndometrialCancer? Are they treated differently? #gyncsm  

T4: Studies have found African-American women experience higher mortality from #endometrialcancer than any other group of women. What factors are researchers looking into to explain and address this disparity? #gyncsm

T5: What are the side effects of #endometrialcancer and its treatments that may impact a woman’s quality of life? What can be done to improve the lives of women diagnosed with endometrial cancer? #gyncsm

Here are some Endometrial Cancer resources and we hope to see you at the chat.


Uterine/Endometrial Cancer:

Christina, #gyncsm co-founder

 

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Wednesday, April 11, 2018

SGO Annual Meeting Research Review and Ask the Doc April 2018

Twenty-four participants shared what they had learned at the SGO Annual Meeting or asked questions about research presented at the meeting during this month's #gyncsm chat. You may find more analytics here. You may find a transcript from the chat here.

We covered a number of different research areas from treatments to survivorship to funding for research.

T1: What were the results of the study comparing minimally invasive surgery (MIS) w/ radical hysterectomy in early cervical cancer. Will the results change practice?

  • "Disease-free survival following minimally invasive procedures significantly lagged behind radical hysterectomies done by open laparotomy," -Pedro T. Ramirez, MD. I found this fascinating.
    • some suggested uterine manipulator use (not assessed in the study), also discussed immature data, early stopping.
    • Any reasons would be speculation. But I think we get bigger tissue margins with open surgery
    • data safety monitoring committee (filled with GYN ONCS) said the study should be stopped
T2: Several studies used targeted therapies to treat #ovariancancer - Which results stood out for you? Were side effects critical in any of the studies?
  • The #PARPi combinations are very exciting - responses and improved outcomes regardless of #BRCA status are encouraging
  • From our Scientific Director, Dr. Deb Zajchowski, “Exciting preliminary results for PARP inhibitors combined with immune checkpoint inhibitors — particularly in platinum-resistant patients.” (@ClearityFnd) 
T3: Which studies presented at the meeting will impact treatment of women with #endometrialcancer #uterinecancer #sarcoma?

  • The combo of everolimus & letrozole was quite successful in #endometrialcancer - this is the 2nd study to demonstrate this
  • Excited re our study (in rodents) of everolimus-eluting IUD pres by @JDottinoMD - could allow pts to avoid surgery in endo ca


  • My friend Matt Anderson, MD, PhD, presented on the genomic profiling of #uterine #leiomyosarcoma from The Cancer Genome Atlas as well as his own lab in Baylor. Data from @ALazarMDPhD was included. This is bigly important for us
  • I was not at SGO but results from the phase 2 trial looking at carbo/taxol vs carbo/tax + trastuzimab (herceptin) in uterine serous CA with Her2/neu overexpression were presented. Improved PFS w/addition of herceptin.
    • Agree... exciting abstract. Several pre-analytical issues that can affect Her2 testing results which will be important to consider for the future
T4: What research on palliative care and survivorship do you think will impact patients lives the most - or that survivors should ask their gyn/onc's about?

  • There was a study that finally measured and estimated rates of post op lymphedema which were much higher than anticipated. If we can measure it we can look for ways to reduce it. 
  •  Overall, I think it has been great to see an increase each year in survivorship studies and talk of long-term care planning and navigators/coordinators. Patients living longer and more emphasis on support.
T5: Once again studies showed less gyn cancer clinical trials and lower funding for gyn cancer research. What suggestions were made to increase enrollment and funding?
  • We MUST advocate for gynecologic cancer funding - write your Congressman and tell them that this funding must be INCREASED!!
  • the photo in this tweet shows how great the need is via @ShannonWestin
  • Outcomes are better for minorities who have access to #clinicaltrials - we need funding to ensure these trials are available 
    • I thought this was an important study. #clinicaltrials are an important part of cancer care. Many in general population still think trials are last resort and consider them "experimental" in a very negative risky way.
  • From our Scientific Director, Dr. Deb Zajchowski, “We need more funding. We also need to get the word out to enroll in the many clinical trials that are already available. There are more than 300 #clinicaltrials that #ovariancancer patients can enter.”
We have several questions/thoughts out there - feel free to now add any additional tweets re: the latest gynecologic cancer research.
  • Here is a link to a study reported at SGO on a vaccine to prevent recurrence in OC https://t.co/phQx2osDcN
  • Can you please tell us a little more about check point inhibitors and what that they’re used for in regards to #Lynchsyndrome cancers
    • Right now - they are FDA approved for any tumor that has MSI (microsatellite instability) - that includes Lynch Syndrome assoc tumors
    • Essentially the MMR in LS makes the cells more susceptible to attack by the immune cells. The checkpoint inhibitors allow the immune system to be more effective.
  • Still on #uterine #leiomyosarcoma: I'm glad the #sarcoma med oncs talked about the many lines of chemo -- I can think of at least 6 -- they might give. Some gyn oncs offer fewer
  • I was very surprised that chemo for early stage endometrial Cancer didn’t improve outcomes. Especially after last years ASCO when it was discussed that it may replace radiation.
  • Great video to share (from SGO) on clinical trial basics! https://t.co/UWjBqxQ584
  • There was a study that finally measured and estimated rates of post op lymphedema which were much higher than anticipate…
Additional resources mentioned during the chat may be found below. 

Patients and caregivers are invited to continue our discussion on the Smart Patients platform at  https://www.smartpatients.com/partners/gyncsm

Join us next month on Wednesday May 9,2018 at 9pm ET for our chat on Palliative Care - When and Why? with guest Christian Sinclair @ctsinclair (#hpm). 

See you then, 

Dee
#gyncsm Co-founder


Resources:


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