Episode 107: Hot Topics Mini-Series: Gut Check - How the Microbiome Shapes CAR-T Therapy Outcomes

Proton therapy can deliver radiation with remarkable precision, limiting exposure to healthy tissue beyond a tumor. But does more precise always mean better care, and if the technology has been available for decades, why do so few patients have access to it? In this episode of Stanford Medcast, host Dr. Ruth Adewuya speaks with Dr. Billy Loo, professor of radiation oncology at Stanford Medicine, about the evolving role of proton therapy in cancer care. They explore how proton therapy differs from conventional radiation, which patients may benefit most, and why technological advantages do not always translate directly into better clinical outcomes. Dr. Loo also takes listeners inside the development of Stanford Medicine’s ultracompact proton therapy system, an approach designed to bring a technology once requiring a massive, dedicated facility into an existing cancer center. He discusses what a smaller footprint could mean for access, the importance of multidisciplinary expertise in determining the right treatment for each patient, and the barriers that remain. Looking ahead, the conversation turns to FLASH radiotherapy and the possibility that delivering radiation in fractions of a second could add a new dimension to precision cancer treatment, potentially changing not only where radiation is delivered, but how healthy tissue responds to it. Read Transcript: https://mcdn.podbean.com/mf/web/xip9itq4y4h473c2/Transcript_medcast_episode123.pdf CME Information: https://stanford.cloud-cme.com/medcastepisode123 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=4192

What actually happens in the brain during menopause, and why do some people experience hot flashes, sleep disruption, anxiety, and other symptoms more severely than others? In this episode of Stanford Medcast, host Dr. Ruth Adewuya speaks with menopause researcher and OB-GYN leader Dr. Genevieve Neal-Perry about the neuroscience of menopause and how new discoveries are changing treatment. They explore what happens in the hypothalamus as estrogen levels change, the role of KNDy neurons and neurokinin signaling in hot flashes, and how this research led to targeted nonhormonal treatments for vasomotor symptoms. Dr. Neal-Perry also discusses fezolinetant and other neurokinin receptor antagonists, including how these therapies differ from hormone therapy and why they may expand treatment options for people who cannot or choose not to use hormones. The conversation also examines findings from the Study of Women’s Health Across the Nation (SWAN), including differences in the timing, severity, and duration of menopause symptoms across populations. Dr. Neal-Perry explains why menopause may present through symptoms clinicians do not immediately recognize, including sleep problems, anxiety, heart palpitations, and joint pain, and why listening carefully to patients remains essential. From the brain biology behind hot flashes to emerging nonhormonal treatments, this episode explores what clinicians need to know about the evolving science of menopause and how it is reshaping menopause care. Read Transcript: https://mcdn.podbean.com/mf/web/mfgj27ddw3x6nec5/Transcript_medcast_episode122.pdf CME Information: https://stanford.cloud-cme.com/medcastepisode122 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=4179

What happens when prisons become responsible for caring for people with dementia, cancer, disability, and other complex health needs? In this episode of Stanford Medcast, host Dr. Ruth Adewuya speaks with Pulitzer Prize-winning investigative journalist Julieta Martinelli about the growing population of older adults in U.S. prisons and the healthcare challenges that come with aging behind bars. Drawing from her reporting, Martinelli shares the stories of Frank Ross, who was released from prison at age 93 after developing cancer and dementia, and Mechie, who navigated breast cancer diagnosis and treatment while incarcerated. Their experiences reveal the often-unseen realities of healthcare in prison, from incarcerated people serving as caregivers for one another to barriers to accessing timely care, the complexities of compassionate release, and the challenges of maintaining continuity of care after decades of incarceration. The conversation also explores what clinicians can learn from these experiences, including the importance of recognizing trauma, building trust, and understanding the health history a formerly incarcerated patient may carry into the clinical encounter. Read TranscriptCME Information: https://stanford.cloud-cme.com/medcastepisode121 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=4115

Kids aren't little adults — and in pediatric sports medicine, that difference shapes everything. In this episode of Stanford Medcast, host Dr. Ruth Adewuya speaks with Dr. Kevin G. Shea, Chambers-Okamura Endowed Professor of Pediatric Orthopedics and Division Chief of Pediatric Orthopedics and Sports Medicine at Stanford Medicine Children's Health, about caring for athletes whose bones are still growing. Dr. Shea explains why open growth plates make young athletes vulnerable to different injury patterns than adults, why ACL tears, meniscus injuries, and osteochondritis dissecans (OCD) are being seen more often and at younger ages, and how year-round, single-sport specialization may be driving overuse injuries. He also shares how multicenter research collaborations like ROCK, PRISM, and SCORE are building prediction tools that help families weigh surgery against nonoperative healing, why criteria-based return-to-sport assessment matters during the high-risk months after surgery, and what should prompt frontline clinicians to refer a young athlete to a specialist. Whether you're a pediatrician, family physician, emergency clinician, physical therapist, athletic trainer, or orthopedic specialist, this conversation offers a practical framework for protecting growing bodies and the long-term musculoskeletal and emotional health of young athletes. Read Transcript: https://mcdn.podbean.com/mf/web/afkpcckyu8xx4p8c/medcast_episode120.pdf CME Information: https://stanford.cloud-cme.com/medcastepisode120 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=4000

In this episode of Stanford Medcast, Dr. Geoffrey Tabin discusses the global burden of avoidable blindness and the systems-level barriers that continue to limit access to high-quality eye care worldwide. Drawing on decades of experience building scalable eye care programs in Nepal and Sub-Saharan Africa, Dr. Tabin explores how cost, workforce design, infrastructure, mentorship, and innovation shape the delivery of ophthalmologic care in low-resource settings. The conversation also examines lessons applicable to high-resource healthcare systems, including opportunities to rethink efficiency, sustainability, and equitable access to care. This activity is designed for clinicians and healthcare professionals interested in global health, healthcare delivery, systems innovation, and ophthalmology. Read Transcript: https://mcdn.podbean.com/mf/web/4m3dcruszi9hcvbc/medcast_episode119.pdf CME Information: https://stanford.cloud-cme.com/medcastepisode119 Claim CE: https://stanford.cloud-cme.com/Form.aspx?FormID=3955