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In the most recent ONCOLOGY On the Go hosted in collaboration with the American Psychosocial Oncology Society, Daniel C. McFarland, DO, spoke with Charles S. Kamen, PhD, MPH, about health equity for sexual and gender minority groups in oncology.

Sexual and gender minority groups, who constitute approximately 9.3% of the US population, experience significant and preventable disparities across all stages of the cancer care continuum, according to Kamen.

 He detailed how these inequities are largely driven by minority stress: the chronic psychological and emotional burden resulting from anticipated and experienced prejudice, discrimination, and stigma within health care settings.

McFarland and Kamen highlighted that a lack of comprehensive sexual and gender minority training in medical education often leaves clinicians feeling unprepared, compounding the patient’s anxiety and mistrust.

The path to correcting these disparities requires a fundamental shift to cultural humility: the readiness to acknowledge one’s own lack of knowledge and learn directly from the patient’s lived experience. The most critical, actionable step discussed was the systematic, safe, and affirmative collection of Sexual Orientation and Gender Identity (SOGI) data.

Kamen emphasized that SOGI data is a clinical tool, not just a demographic marker. When collected routinely—ideally non-verbally via intake forms—SOGI data are used to:

Ensure Biologically Appropriate Surveillance: Confirming that all necessary cancer screenings are offered based on the patient’s existing organs, regardless of current gender identity.

Facilitate Relationship-Centered Care: Appropriately recognizing and engaging the patient’s partners and chosen family; a critical component of sexual and gender minority support networks.

Tailored Psychosocial Navigation: Moving beyond a general "disparities mindset" to an "equity mindset" by using SOGI data to connect patients with LGBTQ-specific psychosocial resources that directly address discrimination-related distress drivers.

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being the psycho-oncology editorial advisory board member for the journal 

. Kamen is an associate professor in the Department of Surgery, Cancer Control (SMD) and holds joint appointments as an associate professor at the Center for Community Health and Prevention and the Department of Psychiatry (SMD) at the University of Rochester Medical Center.

Jones JM. LGBTQ+ identification in U.S. rises to 9.3%. News release. Gallup. February 20, 2025. Accessed December 3, 2025. https://tinyurl.com/48n8j8bd

Minority stress. American Psychological Association. Updated November 15, 2023. Accessed December 3, 2025. https://tinyurl.com/5n888ynr

Learning resources — collecting sexual orientation and gender identity data. National LGBTQIA+ Health Education Center. Accessed December 3, 2025. https://tinyurl.com/4btrn5y3

Daniel C. McFarland, DO, and Charles S. Kamen, PhD, MPH, focused on cultural humility, nonverbal data collection, and tailored resources to improve care.

Why Sexual and Gender Minority Care is an Oncologic Imperative 

In a collaborative podcast with the American Psychosocial Oncology Society hosted by Daniel C. McFarland, DO, guests Louis P. Voigt, MD, and Yesne Alici, MD, discussed the ethical and clinical complexities of assessing decision-making capacity (DMC) in oncology, emphasizing its role as the ethical core of person-centered care. The discussion began by dissecting modern medicine’s need for formal DMC assessment. Voigt framed DMC as a fundamental issue of patient rights and respect, asserting that every human being has absolute rights and that the integrity of a person requires honoring their self-determination. He advocated for clinicians to act as professionals, earn trust, customize their approach based on individual needs through precision medicine, and demonstrate humility by re-explaining information when a patient cannot summarize their understanding.

Alici provided a detailed clinical framework for DMC, defining it as a person’s ability to decide on the specific issue at hand while appreciating the foreseeable consequences. She outlined the 4 key elements, or pillars, of the assessment: the patient’s ability to understand the information, to appreciate the risks and benefits, to provide a rationalization for the decision to ensure no delusional thinking interferes, and to communicate a consistent choice. She clarified that DMC is decision-specific and time-dependent, emphasizing that conditions like dementia, schizophrenia, major depression, or even a central nervous system malignancy do not automatically mean a patient lacks capacity; it must be assessed for each situation and may be restored if cases like delirium are reversible. She cautioned that clinicians must be mindful of potential mislabeling when patients with aphasia interact, as simple gestures may not fully represent informed consent.

Finally, the experts addressed the crucial implications that follow an assessment of incapacity. Voigt highlighted that a lack of DMC is not a "stop sign"; decisions must still be made, requiring the health care team to look to a designated proxy or the patient’s next-of-kin. He stressed the need for hospitals to establish system-wide processes and workflows to prepare all stakeholders for these contingencies and help patients become familiar with advanced directives, thereby reducing the immense emotional burden placed on surrogates who must perform substituted judgment. McFarland concluded that being aware of DMC elevates the quality of care, reinforces an ethical climate, and enhances the entire organization.

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer, in addition to being the psycho-oncology editorial advisory board member for the journal 

Voigt is an intensivist and chair of the Ethics Committee at Memorial Sloan Kettering Cancer Center (MSKCC). Alici is vice chair of Clinical Operations in the Department of Psychiatry and Behavioral Sciences, clinical director, associate attending psychiatrist, and medical director of the Biobehavioral Health Clinic at MSKCC.

Daniel C. McFarland, DO, is joined by Louis P. Voigt, MD, and Yesne Alici, MD, who focused on decision-making capacity and patient-centered care.

Decision-Making Capacity: The Ethical Core of Patient-Centered Oncology

 focused on survivorship and supportive care. Stemming from conversations with leading clinicians in the field, the compilation highlights gaps and educational insights into multiple areas.

Covering topics like nutrition, oncodermatology, body image, sexual health, and mortality, these conversations explored how to truly optimize multidisciplinary cancer care.

, chair of the Department of Supportive Oncology at Atrium Health Levine Cancer Institute:

1:01-2:44: What is the importance of developing and managing supportive care at major oncology centers, and how can it be adapted across the US?

2:45-4:19: Supportive care is one piece of the multidisciplinary team. How can clinicians work with supportive care specialists to ensure that patients are receiving all the help that they need?

, of Atrium Health Levine Cancer Institute:

4:20-5:46: Some adverse effects (AEs) include severe nausea and vomiting. What nutritional strategies do you recommend to ensure adequate intake?

5:47-7:29: Taste and smell changes are common AEs. What advice do you give to patients to help cope and combat them?

, professor and chair of dermatology, director of the Residency Program, and director of translational research at George Washington Medical Faculty Associates in Washington, DC:

 found that a significant proportion of respondents, including those who have been previously treated for cancer, would decline anti-cancer therapies due to dermatologic AEs like hair loss. What are some crucial communication strategies oncologists should employ to address this?

9:25-11:37: What should all oncology clinicians know about how to manage mild to moderate dermatologic AEs?

11:38-24:54: Daniel C. McFarland, DO, the director of the Psycho-Oncology Program at Wilmot Cancer Center; a medical oncologist who specializes in head, neck, and lung cancer; and the psycho-oncology editorial advisory board member for the journal 

 spoke with different psycho-oncology colleagues regarding topics like body image, sexual health, and mortality.

These colleagues included Michelle Fingeret, PhD, founder of Fingeret Psychology Services; Christian J. Nelson, PhD, chief of Psychiatry Service, attending psychologist, and codirector of the Psycho-Oncology of Care and Aging Program at Memorial Sloan Kettering Cancer Center; and William S. Breitbart, MD, attending physician and the Jimmie C. Holland Chair in Psycho-Oncology at Memorial Sloan Kettering Cancer Center.

Menta N, Vidal SI, Whiting C, Azim SA, Desai S, Friedman A. Perceptions and knowledge of dermatologic side effects of anti-cancer therapies: a pilot survey. 

Experts discussed supportive care and why it should be integrated into standard oncology care.  

How Supportive Care Methods Can Improve Oncology Outcomes

hosts Manojkumar Bupathi, MD, MS, and Benjamin Garmezy, MD, discussed the role that circulating tumor DNA (ctDNA) may play in the monitoring and management of genitourinary cancers as well as other disease types with their colleague, Arnab Basu, MBBS, MPH, FACP.

The group began by providing an overview of ctDNA’s importance in the field, with Basu highlighting his initial use of the marker when treating patients with colorectal cancer who were experiencing toxicity in the adjuvant setting. Additionally, Basu distinguished between tumor-informed and tumor-uninformed testing, emphasizing an approach that monitors for actionable genes that can inform targeted decision-making from a therapeutic standpoint. Describing how the chance of a false positive is less than 1%, Basu stated that a positive result in the adjuvant setting almost certainly guarantees the need for therapy.

As part of the discussion, the experts considered the utility of ctDNA based on prior findings from studies like the phase 3 NIAGARA trial (NCT03732677), in which higher ctDNA clearance from baseline to the time before radical cystectomy correlated with an enhanced benefit with the addition of durvalumab (Imfinzi) to neoadjuvant chemotherapy. Regarding the potential next steps in the field, the group spoke about the potential use of urine ctDNA testing in bladder cancer, the possibility of investigating the de-escalation of imaging, and the need for additional cross-comparison data on different mechanisms of ctDNA testing.

Bupathi is executive cochair of the Genitourinary Cancer Research Executive Committee at Sarah Cannon Research Institute (SCRI) and medical oncologist with Rocky Mountain Cancer Centers specializing in solid tumors and genitourinary cancers. Garmezy is associate director of genitourinary research and executive cochair of the Genitourinary Cancer Research Executive Committee at SCRI and medical oncologist at SCRI Oncology Partners specializing in genitourinary cancers. Basu is the senior associate consultant and a medical oncologist specializing in the care of genitourinary cancers at Mayo Clinic Comprehensive Cance Center.

Powles T, Van Der Heijden MS, Wang Y, et al. Circulating tumor DNA (ctDNA) in patients with muscle-invasive bladder cancer (MIBC) who received perioperative durvalumab (D) in NIAGARA. 

2025;43(suppl 16):4503. doi:10.1200/JCO.2025.43.16_suppl.4503

Experts discuss key considerations for applying ctDNA to clinical practice, such as distinguishing between tumor-informed and tumor-uninformed testing.

Diving Into the Practical Applications of ctDNA in Oncology Care

, in collaboration with the American Psychosocial Oncology Society, Daniel C. McFarland, DO, welcomes William S. Breitbart, MD, to discuss how clinicians can address patients’ existential concerns. Although oncologists often focus on treatment and the drive for life, the core concern for many patients remains mortality. Breitbart’s work in meaning-centered therapy provides a framework for these difficult conversations.

Breitbart emphasizes that patients grappling with fear, uncertainty, and depression may not always express it directly. The goal of meaning-centered therapy is to help patients find a sense of purpose and peace, even as they face a terminal illness. This approach is not about eliminating suffering but about helping patients find meaning in their experiences. The conversation covers the practical application of these principles, including how to bring up topics of death and dying and the importance of validating a patient's fears without resorting to platitudes.

The discussion also touches on the concept of existential guilt, which Breitbart links to the human awareness of one’s own existence and mortality. He notes that many clinicians are drawn to oncology or psycho-oncology because of their own personal experiences with death and illness. Overall, the episode is a reminder for oncologists and their multidisciplinary team members to look beyond the treatment and its clinical outcomes and engage in human conversations that can significantly improve a patient’s quality of life, emotional support, and overall well-being.

; Breitbart is an attending physician and the Jimmie C. Holland Chair in Psycho-Oncology at Memorial Sloan Kettering Cancer Center.

Daniel C. McFarland, DO; and guest William S. Breitbart, MD, discuss the critical role of meaning-centered therapy in addressing the psychosocial needs of patients with cancer.

How to Discuss Death: A Conversation of Mortality in Cancer Care

In a recent episode of the Oncology-on-the-Go podcast in collaboration with the American Psychosocial Oncology Society (APOS), host Daniel C. McFarland, DO, was joined by Christian J. Nelson, PhD, to discuss the often-overlooked subject of sexual health issues for men after cancer treatment. The discussion emphasized the importance of a nuanced approach to men's health, particularly in the context of genitourinary cancers like prostate and testicular cancer.

McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Center and a medical oncologist who specializes in head, neck, and lung cancer in addition to being the psycho-oncology editorial advisory board member for the journal 

. He opened the conversation by highlighting that while cancer’s physical effects are well-documented, the mental and emotional toll is equally significant and often underappreciated in male patients. He highlighted that the field of psycho-oncology, which began with breast cancer, is now expanding to address men’s specific needs. Men, he noted, are less likely to seek mental health support, yet have a higher risk of suicide, particularly at key moments in their cancer journey like diagnosis and recurrence.

Nelson, chief of Psychiatry Service, attending psychologist, and codirector of the Psycho-Oncology of Care and Aging Program at Memorial Sloan Kettering Cancer Center, underscored that cancer treatments, especially for prostate cancer, often have profound adverse effects (AEs) that impact a man’s sense of self and masculinity.

He detailed the effects of radical pelvic treatments and androgen deprivation therapy (ADT), which can lead to urinary incontinence, erectile dysfunction, and changes in sexual function and body image. These AEs can lead to feelings of being "broken," "inadequate," or "deflated."

The pair discussed the "double-edged sword" of normalizing cancer, where patients are told their prognosis is good but are left unprepared for the life-altering AEs. This can lead to a sense of cognitive dissonance and isolation. The conversation stressed the need for clinicians to proactively normalize discussions about sexual health, making it clear that these are standard and expected aspects of the cancer experience.

Both clinicians suggested that establishing a trusting relationship with patients is paramount and that referrals to psycho-oncology should be framed as an essential, not optional, component of treatment. They also recommend that clinicians consistently check in with their male patients about emotional and sexual well-being, even long after treatment has ended, to ensure they’re coping with the lasting impacts of their experience.

Christian J. Nelson, PhD, dives into the complexities of sexual health concerns with men following cancer treatment, specifically with genitourinary cancers. 

Man Up? The Truth About Men's Health After Cancer

, Geraldine O’Sullivan Coyne, MD, PhD, MRCPI, spoke about her new appointment as the principal investigator and director of clinical research at the Northwell Health Unit of the Southern Texas Accelerated Research Therapeutics (START) Center for Cancer Research. With a strategic partnership formed between Northwell Health and START in May 2024, she will oversee early-phase clinical trial development at New York’s first START research site at the R.J. Zuckerberg Cancer Center in New Hyde Park.

Coyne began by sharing her excitement to put all her efforts into making the unit a “good opportunity” to consider patients who reside in community settings for enrollment in new clinical trials. Although large academic centers may offer possibilities for enrolling in trials, Coyne highlighted how many patients may need to travel or leave their social networks behind as they undergo treatment, thus illustrating a need for expanded options in the community setting.

“Having the privilege to be able to bring trial opportunities into the community—into the heart of the community—is what we are aiming to do,” Coyne stated about her new role. “We do believe that this will [allow] patients to access novel and powerful therapies that are now increasingly part of a personalized treatment paradigm for patients with advanced malignancies.”

Emphasizing the pursuit of early-phase clinical investigations, Coyne described how the new unit may leverage START’s expertise to advance novel molecules across all stages of the drug development pipeline up to regulatory approval. She noted that being able to safely create and refine new therapeutic approaches in the community setting lies at the heart of a successful collaboration between Northwell Health and START.

“A lot of the excitement surrounding the START unit and Northwell Health collaboration with them is exploring these novel molecules that will hopefully continue to build on the pursuit in oncology drug development, which has been finding better and more targeted therapies for patients in their treatment journey,” Coyne said.

Olt B. Northwell names Geraldine O’Sullivan Coyne, MD, PhD, to lead clinical trials at new START center. News release. Northwell Health. July 22, 2025. Accessed August 12, 2025. https://tinyurl.com/bdcua8ck

Geraldine O’Sullivan Coyne, MD, PhD, MRCPI, discusses how the START center may expand access to novel therapies for patients who reside in a community setting.

START Center Aims to Bring New Cancer Treatments, Trials to the Community

The medical oncology board examinations are a pivotal time in a clinician's career. However, preparing for and taking this examination comes as a crucial moment when residents/fellows begin their transition to attending.

Although in theory the process of taking an examination and then beginning a new job sounds simple, it is quite complex. The hematology/oncology boards require rigorous preparation. The examination is followed by the new attending position, where clinicians, for the first time, are on their own, making treatment decisions and leading a team.

 as well as those who are just beginning their careers about this time and how they handled studying while experiencing personal and professional changes.

Eric K. Singhi, MD, assistant professor in the Department of General Oncology in the Division of Cancer Medicine and assistant professor in the Department of Thoracic/Head and Neck Medical Oncology at The University of Texas MD Anderson Cancer Center, focused on:

His transition from fellow to attending (0:58)

Where students should focus their efforts on studying (2:11)

Advice he would give to those currently studying (2:47)

Nicholas James Hornstein, MD, PhD, assistant professor at Northwell Health Cancer Institute, discussed:

Studying for the boards while balancing a new career (3:18)

Specific study areas the examination focuses on (5:43)

Marc J. Braunstein, MD, associate professor in the Department of Medicine at NYU Grossman Long Island School of Medicine, fellowship program director in hematology/oncology at NYU Langone Health—Long Island, and codirector of the Hematology-Oncology System at NYU Grossman Long Island School of Medicine, highlighted:

How to prepare fellows for the career transition (7:11)

Advice he gives about this transition (8:17)

Nerea M. Lopetegui-Lia, MD, assistant professor in the College of Medicine at The Ohio State University Comprehensive Cancer Center–The James, spoke about:

Best review practices for the examination (9:01)

Advice she would give to those studying (10:15)

MinhTri Nguyen, MD, a medical oncologist with Stanford Medicine, focused on:

As a leadership coach, helping prepare residents/fellows for the career transition (11:36)

Advice he would give to those studying (14:34)

A group of clinicians gives study advice on how to best prepare for the medical oncology board examinations. 

Best Practices for the Medical Oncology Boards

In this episode, CancerNetwork® spoke with Eric Winer, MD, director of the Yale Cancer Center; president and physician-in-chief at Smilow Cancer Hospital; deputy dean for cancer research, Alfred Gilman Professor of Pharmacology, and Professor of Medicine at Yale School of Medicine; and chair of the association board for the American Society of Clinical Oncology (ASCO), about the current state of oncologist burnout, steps that can be taken to ameliorate it, and how it currently impacts professionals in the field.

Causes of workplace burnout that authors identified in a paper published in the 

 in January 2025 included the use of electronic health records, staffing levels, payer authorizations, hours worked, and age. Additionally, published results from the survey revealed a 14% increase in the rate of oncologists who experienced workplace burnout from 2013 to 2023 (

<.01). Moreover, a significant correlation between being a caregiver for someone at home and workplace burnout was observed.

Winer began by defining workplace burnout, emphasizing that it is not exclusive to oncology, and that many oncologists resist burnout by focusing on the mission-driven nature of the work. Then, he speculated how oncologist burnout may have increased from 2013 to 2023, suggesting that it may have been related to a larger societal trend due to increased awareness of it. Furthermore, he suggested that the COVID-19 pandemic may have exacerbated fatigue, as well as the growing utilization of telehealth and documentation, which take oncologists away from personal engagement with patients.

He then explored how the workforce might be impacted by burnout, highlighting a sizable percentage of oncologists who claim to be nearing retirement age. Based on this trend, there may be a need for workforce expansion, as well as the need to embrace a more multidisciplinary approach to help oncologists deliver patient care. Winer concluded by outlining how he mitigates burnout personally, as well as his thoughts regarding how oncology has progressed since his career began.

Schenkel C, Levit LA, Kirkwood K, et al. State of professional well-being, satisfaction, and career plans among US oncologists in 2023. 

 Published online January 29, 2025. doi:10.1200/OA.24.00010

Professor of pharmacology Eric Winer, MD, spoke about a publication he authored exploring the state of oncologist burnout and how it impacts practice.

Exploring Burnout Causes and Management in Oncologic Practice

2025 American Society of Clinical Oncology (ASCO) Annual Meeting,

Experts in gynecologic cancer, genitourinary malignancies, and other disciplines highlight noteworthy clinical data slated for presentation at ASCO 2025.

Oncology

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