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Though we have made ample advances in the field of medicine in recent years, our idea of professionalism continues to be based on the standard of how white men dressed in the nineteenth century. Such a standard of professionalism not only perpetuates gender bias, but also aims to remove the culture, traditions, and behaviors of minority groups with the goal of molding these individuals to resemble the majority, preventing ‘Afro’ heritage from entering medicine. By contextualizing our own experiences in the medical setting as physicians of color in the context of a variety of supporting literature, we provide an overview of professionalism, its role in medicine, the double standard faced by women, and how it continues to be weaponized against physicians of racial, ethnic, and religious minorities. We advocate for minority physicians to embrace their authenticity and for institutions to develop policies that openly, firmly, and enthusiastically welcome physicians of all ethnicities, religions, and genders. Positionality Statement: In the editorial you are about to read, we, the authors, collectively bring a rich tapestry of backgrounds and experiences to our discussion on healthcare disparities. Our team consists of two Hispanic/Latina oncologists, one Middle Eastern oncologist, one Black/Caribbean-American hematologist, and one White pre-medical student with Middle Eastern heritage. Our diverse backgrounds inform our perspectives and enhance our understanding of the complex and multifaceted nature of healthcare. We are united by a shared commitment to justice, equity, and the belief that every patient deserves high-quality care, regardless of their background. This editorial is informed by our professional expertise, personal experiences, and the diverse communities we serve, aiming to highlight the critical need for inclusivity and representation in healthcare. By acknowledging our positionality, we hope to provide a comprehensive and empathetic analysis that not only identifies the challenges but also offers actionable solutions to improve healthcare outcomes for all. We recognize the power of diversity in fostering innovation and driving positive change, and we are dedicated to using our voices and positions to advocate for a more equitable healthcare system.

Abstract Background The American Society of Clinical Oncology (ASCO) Language of Respect (LoR) guidelines were developed to promote the use of patient-centered language in all communications in 2020. The Language of Respect guidelines provide a directive to encourage the highest level of respect in addressing patients with cancer. In this study, we aimed to analyze the adherence to these guidelines in renal cell carcinoma (RCC) abstracts presented at the 2023 ASCO Annual Meeting, the largest international meeting of oncologists. Methods All RCC abstracts published in the 2023 ASCO Annual Meeting were evaluated. Statements from the abstracts were collected and stratified into the three categories of the LoR guidelines: (1) “Do not blame patients”, (2) “Respect the role of patients”, and (3) “Do not dehumanize patients”. Abstract and author data were summarized using descriptive statistics, and univariable and multivariable analyses were utilized to identify factors associated with odds of noncompliance with the guidelines. Results In total, 101 RCC abstracts were assessed. Most abstracts were published as poster presentations (51.5%) followed by online publication only (44.6%) and oral abstracts (4.0%). First authors affiliated with institutions in native English-speaking countries constituted 69.3% of the abstracts. Authors affiliated with institutions from a single country comprised 67.3% of the abstracts, whereas 32.7% of the abstracts were affiliated with authors from multiple countries. 40.6% of abstracts received no funding, 36.6% of abstracts received funding from a pharmaceutical company, and 22.8% received funding from non-profit organizations, institutions, or grants. There were 34 (33.7%) abstracts associated with clinical trials versus 67 (66.3%) associated with non-clinical trials. 51.5% of abstracts remained within 5% of the character count limit. Overall, 60.4% of the abstracts contained at least one statement that violated the guidelines. Abstracts with at least one statement violating “Do not dehumanize patients”, “Do not blame patients”, and “Respect the role of patients” directives were found in 46.5%, 21.8%, and 1.0% of abstracts, respectively. Abstracts within 5% of the character count limit were associated with increased odds of guideline noncompliance in the univariable analysis (OR 0.33 [95% CI 0.14-0.75], p=0.008). By multivariable analysis, abstracts within 5% of the character count limit were also associated with higher odds of violating the guidelines (OR 0.31 [95% CI 0.13-0.71], p=0.006). Conclusions A significant portion of RCC abstracts were found to violate the LoR guidelines. Our results highlight the importance of considering the expansion of the character count limit for abstract submissions to increase adherence to the LoR guidelines. With the incorporation of LoR guidelines in all forms of communication, the scientific community can promote increased use of respectful language in addressing patients, families, and colleagues.

Background The percentage of physicians identifying as Latina has not improved despite improvements in recruitment of Latina medical students, suggesting barriers to retention and career advancement. Discriminatory experiences and mental health inflictions throughout training may contribute to difficulties in recruitment, retainment, and advancement of Hispanic/Latinx trainees, a notably understudied population. Methods An anonymous, online survey was distributed to Latinas in the continental U.S. between June 22 to August 12, 2022. Eligibility criteria included: self-identifying as Hispanic/Latina, female/woman, and completing or have completed medical school, residency, or fellowship in the continental U.S. in the past 10 years. Recruitment was done via the Twitter account @LatinasInMed and outreach to Latino Medical Student Association chapters. Descriptive statistics summarized the self-reported experiences. Results The survey included 230 Hispanic/Latinx women, mostly medical students (46.9%). A majority (54.5%) reported negative ethnicity-based interactions from patients and/or patients’ families; 71.8%, from others in the medical field. High rates of depression (76.2%) and anxiety (92.6%) during training were reported by Latinas, especially medical students. Feelings of imposter syndrome and burnout were high at 90.7% and 87.4%, respectively. Conclusions This is the first study evaluating the unique experiences of Latinas in medicine, who reported discrimination and mental health struggles, specifically during medical school, at alarmingly high rates. Our findings could aid in creating the needed interventions to support Latinas in medical training to reduce the existing exodus of Latinas from medicine.

This narrative describes the realities of balancing career and family for physicians in training.

PurposePeer support networks have been suggested to have significant utility in the care of patients with cancer, especially among racial minorities. This article proposes an approach to integrate peer support networks into the care of racial minorities with cancer.MethodsMethods to integrate peer support groups across racial minorities with cancer include utilizing language and religion in strategic recruitment of peer supporters, recruiting minority peer supporters in online oncology peer support groups, and emphasizing relationship & trust building for participant retention.ResultsLanguage concordance among peer support groups may enhance patient understandability, emotional expression, and create a sense of community and safety. Religious integration may also promote support group accessibility, particularly among Blacks, who tend to depend on their religious communities for cancer care guidance to a greater extent. In addition to providing knowledge, online opportunities may also decrease cancer-related stress, depression, and trauma. Trust between individuals and their sociocultural environment and healthcare system, as well as between the community and the healthcare system, is necessary, particularly for racial minorities who may harbor a historical mistrust of the healthcare system.ConclusionsTo close the racial cancer care gap, a multi-pronged approach is crucial. This includes establishing tailored peer support networks within minority communities that account for language, religion, and cultural factors to build trust and meet psycho-social needs. However, peer support is just one tool. Other critical tools such as holding healthcare institutions accountable for providing equitable care to racial minorities is equally vital in reducing disparities and improving survival outcomes.

Abstract For women diagnosed with cancer, side effects affecting their sexuality are extremely common and can be distressing and life-changing; however, most women are left in the dark without any guidance from their oncology teams regarding possible side effects and treatment options. American Society of Clinical Oncology clinical guidelines provide guidance on the recommended assessments related to the domains of sexual function and their respective interventions. Despite the existence of these guidelines, the reality is that only a few women with cancer are asked about sexual concerns that result from cancer treatments. Common barriers to sexuality discussion reported by oncology providers include a lack of qualification and knowledge, not having a place to refer patients, and not knowing how to start the conversation. Social media remains a widely untapped resource regarding sexuality and cancer interventions, as people are increasingly turning to social media for health information and advice. This may be especially relevant for sexuality, as oncologists may not feel comfortable or well-trained to discuss the topic, and patients may be reluctant to bring up sexual concerns during their visits. Social media can play a critical role in studying sexual health and in sexuality interventions, particularly in adolescent and young adult patients with cancer. Here, we discuss the lack of inclusion regarding sexuality in oncology, the rates of sexual dysfunction in patients with cancer, treatment options for common sexual concerns, how to utilize the reach of various social media channels, and provide patient and provider resources. Studies show that many women with cancer experience sexual concerns. The goal of this review is to bring awareness to the rates of sexual dysfunction in women with cancer, highlight treatment guidelines for common sexual health side effects, and provide resources for patients and providers.

Executive summary Women interact with cancer in complex ways, as healthy individuals participating in cancer prevention and screening activities, as individuals living with and beyond a cancer diagnosis, as caregivers for family members and friends, as patient advocates, as health workers and health-care professionals, and as cancer researchers and policy makers. In many countries, regardless of geographic region or economic resources, women are more likely than men to lack the knowledge and the power to make informed cancer-related health-care decisions. Ensure data on sex, gender, and other sociodemographic factors are routinely collected in cancer health statistics, publicly reported, and updated. There are important under-examined social implications and economic repercussions for families and societies when individuals experience cancer, in any country, at any age. In many countries, regardless of geographic region or economic resources, women are more likely than men to lack the knowledge and the power to make informed health-care decisions.

Abstract Background Health-related quality of life (HRQoL) remains underassessed and underreporting in randomized clinical trials (RCTs) evaluating new therapies in metastatic non-small cell lung cancer (NSCLC). However, evaluation and preservation of favorable HRQoL are critically important in trials including patients in early-stage settings, in which the primary objective is cure. Herein, we evaluated whether HRQoL was adequately evaluated and reported in trials including immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) in resectable NSCLC. Methods A systematic search was performed on Embase and PubMed to identify RCTs testing TKIs or ICIs in resectable NSCLC. We selected full articles and abstracts from major meetings. Risk of bias and reporting assessment of HRQoL were collected. Results As of October 2024, we identified 25 RCTs. The primary endpoint was overall survival for 2 RCTs, while 21 and 7 RCTs evaluated risk of recurrence and tumour response as (co)-primary endpoints, respectively. Twelve RCTs (48%) did not assess HRQoL as an endpoint, while 13 (52%) included HRQoL evaluation as a secondary or exploratory endpoint. The most common tools utilized were FACT-L (6/13; 46%), EORTC-QLQ30/LC13 (4/13; 30%) and SF-36 (2/13; 15%). Phase II (33%) and adjuvant (44%) trials evaluated HRQoL in a lower rate than phase III (62%) and neoadjuvant/perioperative (66%) RCTs. Three out of 22 RCTs (14%) with available full-texts reported HRQoL results in the primary publication. Two out of the 19 remaining RCTs reported HRQoL in an indipendent publications, and 2 of them presented data in meeting abstracts. Remarkably, for 15 (68%) RCTs HRQoL evaluation is not available. Conclusions Our systematic evaluation revealed suboptimal evaluation and underreporting of HRQoL in patients treated with novel agents and combinations in resectable NSCLC. Systematic evaluation and reporting of HRQoL should be prioritized in future trials.