#GynCSM Transcript

Healthcare social media transcript of the #GynCSM hashtag.
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See #GynCSM Influencers/Analytics.

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Christina Lizaso @btrfly12
Almost done with my chi tea latte and ready to chat with #gyncsm :)
GYN Cancer | #GYNCSM @gyncsm
Welcome to #gyncsm - a passionate community of gynecologic cancer survivors, caregivers, advocates and health care providers.
Dee Sparacio @womenofteal
RT @gyncsm: Welcome to #gyncsm - a passionate community of gynecologic cancer survivors, caregivers, advocates and health care providers.
GYN Cancer | #GYNCSM @gyncsm
Our co-moderators are @womenofteal @btrfly12 Our health care moderators are @ShannonWestin @temkins @journeycancer and our mental health moderator @DrBeckerSchutte #gyncsm
Dee Sparacio @womenofteal
RT @gyncsm: Our co-moderators are @womenofteal @btrfly12 Our health care moderators are @ShannonWestin @temkins @journeycancer and our mental health moderator @DrBeckerSchutte #gyncsm
GYN Cancer | #GYNCSM @gyncsm
We start out with brief intro’s - Please take a moment to introduce yourself. :) #gyncsm
Dee Sparacio @womenofteal
RT @gyncsm: We start out with brief intro’s - Please take a moment to introduce yourself. :) #gyncsm
Dee Sparacio @womenofteal
Dee here! Dx #ovca Stage3B 2005, OC research advocate, blogger & co-moderator #gyncsm
Christina Lizaso @btrfly12
Christina Lizaso – passionate re: community engagement and cancer. I’ll be moderating as @gyncsm today. #gyncsm
GYN Cancer | #GYNCSM @gyncsm
If you prefer to listen only during the chat, we'd love for you to tweet "#gyncsm" when you join - just to let us know you are here.
Tanya Temkin @tanyaltee
Oops! Forgot the hashtag #gyncsm. Hello from @tanyaltee in Berkeley
GYN Cancer | #GYNCSM @gyncsm
During this intro and welcome time, Dee and I will start in w/ some "ground rules" :) and tips for today's #gyncsm chat
Dee Sparacio @womenofteal
@tanyaltee So glad to see you here tonight , Tanya #gyncsm
Alexa Jett 🦋 @ohhiialexa
Hello everyone! I am Alexa Jett in East Texas, USA. I am a thyroid cancer survivor, blogger, and advocate. #GYNCSM
Dee Sparacio @womenofteal
RT @gyncsm: During this intro and welcome time, Dee and I will start in w/ some "ground rules" :) and tips for today's #gyncsm chat
GYN Cancer | #GYNCSM @gyncsm
The #gyncsm chat promotes community in a public forum. Learn more about risks/benefits: https://t.co/TipZUv1jQy
Dee Sparacio @womenofteal
@ohhiialexa Thanks for joining us tonight. #gyncsm
Dee Sparacio @womenofteal
#gyncsm tagged resources and referrals are not a substitute for speaking with your doctor who understands your needs and history.
Alexa Jett 🦋 @ohhiialexa
@womenofteal Thanks, Dee! Always glad to visit with #GYNCSM
GYN Cancer | #GYNCSM @gyncsm
@AdrienneEcana @womenofteal Hi - Thanks for being here. Hope you are able to join along. #gyncsm
GYN Cancer | #GYNCSM @gyncsm
Are you new to tweet chats? Follow hashtag #gyncsm and include it in every tweet during the next hour to engage with others about this topic.
Christina Lizaso @btrfly12
RT @gyncsm: Are you new to tweet chats? Follow hashtag #gyncsm and include it in every tweet during the next hour to engage with others about this topic.
Dee Sparacio @womenofteal
@AdrienneEcana @gyncsm Use the search - type in #gyncsm then go to latest in the tabs.
KD Richardson @KDRichardson924
@gyncsm @womenofteal Hi! Joining in for the first time.😊 #gyncsm
Dee Sparacio @womenofteal
Remember - Twitter is an open social network and posts are public. Use a Direct Messages to exchange email addresses/personal info #gyncsm
Dee Sparacio @womenofteal
@KDRichardson924 @gyncsm Thanks for joining us tonight. #gyncsm
GYN Cancer | #GYNCSM @gyncsm
We also welcome all those “listening in”. Be sure to tweet #gyncsm so we know you are here. You can always tweet, DM or email us with questions/comments after the chat is over. https://t.co/oAfi7Me49e
GYN Cancer | #GYNCSM @gyncsm
Tonight on #gyncsm we are discussing Goals of Care throughout the Cancer Experience.
Dee Sparacio @womenofteal
Thank you to all who have tweeted during the past month with the #gyncsm hashtag and those who RT'd about this chat #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @gyncsm: Are you new to tweet chats? Follow hashtag #gyncsm and include it in every tweet during the next hour to engage with others about this topic.
GYN Cancer | #GYNCSM @gyncsm
We’ll use a Topic format with T1:, T2:, etc. Include the corresponding T1:, T2:, etc. at the front of your answer/comment. There are 6 #gyncsm Topic questions tonight followed by a Today I Learned (TIL) segment.
Dee Sparacio @womenofteal
RT @gyncsm: We’ll use a Topic format with T1:, T2:, etc. Include the corresponding T1:, T2:, etc. at the front of your answer/comment. There are 6 #gyncsm Topic questions tonight followed by a Today I Learned (TIL) segment.
GYN Cancer | #GYNCSM @gyncsm
You can find information about tonight’s chat topics on our #gyncsm blog page: https://t.co/GNTsrvyBD0
Christina Lizaso @btrfly12
RT @gyncsm: You can find information about tonight’s chat topics on our #gyncsm blog page: You can find information about tonight’s chat topics on our #gyncsm blog page: https://t.co/GNTsrvyBD0
Catherine Gegaris @cgegaris1
@womenofteal #gyncsm
Dee Sparacio @womenofteal
RT @gyncsm: You can find information about tonight’s chat topics on our #gyncsm blog page: You can find information about tonight’s chat topics on our #gyncsm blog page: https://t.co/GNTsrvyBD0
Ann Becker-Schutte @DrBeckerSchutte
Hello #gyncsm! I have been lost for a while, but I made it back.
GYN Cancer | #GYNCSM @gyncsm
As we enter a new year where many make resolutions/aspirations/themes/etc., we thought we would discuss care goals. Here comes the first topic (T1:)... #gyncsm
Inspire @InspireIsHealth
RT @gyncsm: Tonight on #gyncsm we are discussing Goals of Care throughout the Cancer Experience.
GYN Cancer | #GYNCSM @gyncsm
T1: At diagnosis, what are some of the goals for care? Patients - What were your main goals? #gyncsm
Rebecca Previs @BeccaPrevisMD
Hi #gyncsm! Excited to be joining. Thank you @womenofteal for inviting me and speaking @NRGonc meeting last weekend!
Dee Sparacio @womenofteal
@DrBeckerSchutte Waving hi Anne! Happy New Year. Good to see you here. #gyncsm
Christina Lizaso @btrfly12
RT @gyncsm: T1: At diagnosis, what are some of the goals for care? Patients - What were your main goals? #gyncsm
Dee Sparacio @womenofteal
RT @gyncsm: T1: At diagnosis, what are some of the goals for care? Patients - What were your main goals? #gyncsm
Inspire @InspireIsHealth
Hello to the #gyncsm community, John Novack from Inspire checking in.
Dee Sparacio @womenofteal
@BeccaPrevisMD @NRGonc Hi Becca - So Glad you could join in. #gyncsm
Inspire @InspireIsHealth
RT @gyncsm: T1: At diagnosis, what are some of the goals for care? Patients - What were your main goals? #gyncsm
Tanya Temkin @tanyaltee
RT @gyncsm: T1: At diagnosis, what are some of the goals for care? Patients - What were your main goals? #gyncsm
Dee Sparacio @womenofteal
@teaminspire Hi John - Happy New Year. Glad you could join us #gyncsm
Dee Sparacio @womenofteal
#gyncsm
Christina Lizaso @btrfly12
T1: My diagnosis was as a previvor, so my immediate goal was to better understand and get educated. I have goals related to nutrition and screening. #gyncsm
Andrea @BraveBosom
Hey #gyncsm!!! Popping in to say Hello 🙌
Ann Becker-Schutte @DrBeckerSchutte
RT @gyncsm: As we enter a new year where many make resolutions/aspirations/themes/etc., we thought we would discuss care goals. Here comes the first topic (T1:)... #gyncsm
Dee Sparacio @womenofteal
@AdrienneEcana @gyncsm I agree - especially since we start from 0 knowledge in most cases. #gyncsm
Dee Sparacio @womenofteal
RT @btrfly12: T1: T1: My diagnosis was as a previvor, so my immediate goal was to better understand and get educated. I have goals related to nutrition and screening. #gyncsm
Alexa Jett 🦋 @ohhiialexa
A1: I think the main goals should be 1. Clear understanding of diagnosis. 2. Clear understanding of treatment plan. 3. A comfortable rapport with the care team where all concerns, questions, and side effects can be openly discussed now and later. #GYNCSM
Alexa Jett 🦋 @ohhiialexa
RT @btrfly12: T1: T1: My diagnosis was as a previvor, so my immediate goal was to better understand and get educated. I have goals related to nutrition and screening. #gyncsm
EcanaAdrienne @AdrienneEcana
RT @gyncsm: T1: At diagnosis, what are some of the goals for care? Patients - What were your main goals? #gyncsm
Christina Lizaso @btrfly12
#gyncsm :
Dee Sparacio @womenofteal
@AdrienneEcana Be sure to add #gyncsm to every tweet so all can see your response. ;o)
Ann Becker-Schutte @DrBeckerSchutte
RT @ohhiialexa: A1: A1: I think the main goals should be 1. Clear understanding of diagnosis. 2. Clear understanding of treatment plan. 3. A comfortable rapport with the care team where all concerns, questions, and side effects can be openly discussed now and later. #GYNCSM
Christina Lizaso @btrfly12
RT @ohhiialexa: A1: A1: I think the main goals should be 1. Clear understanding of diagnosis. 2. Clear understanding of treatment plan. 3. A comfortable rapport with the care team where all concerns, questions, and side effects can be openly discussed now and later. #GYNCSM
EcanaAdrienne @AdrienneEcana
RT @ohhiialexa: A1: A1: I think the main goals should be 1. Clear understanding of diagnosis. 2. Clear understanding of treatment plan. 3. A comfortable rapport with the care team where all concerns, questions, and side effects can be openly discussed now and later. #GYNCSM
Dee Sparacio @womenofteal
In addition to learning everything I could - Of course my goal was a cure - for forever . But my short term goal was making to my niece’s wedding the following May. #gyncsm
GYN Cancer | #GYNCSM @gyncsm
T2: Patients - Is a specific discussion of "goals of care" something you had with your doctor? Did they help you define your goals? Providers - Is this a discussion that you have with your patients and, if so, how often? #gyncsm
Dee Sparacio @womenofteal
RT @gyncsm: T2: Patients - Is a specific discussion of "goals of care" something you had with your doctor? Did they help you define your goals? Providers - Is this a discussion that you have with your patients and, if so, how often? #gyncsm
Inspire @InspireIsHealth
RT @gyncsm: T2: Patients - Is a specific discussion of "goals of care" something you had with your doctor? Did they help you define your goals? Providers - Is this a discussion that you have with your patients and, if so, how often? #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @gyncsm: T2: Patients - Is a specific discussion of "goals of care" something you had with your doctor? Did they help you define your goals? Providers - Is this a discussion that you have with your patients and, if so, how often? #gyncsm
IBC Research Fdn @IBCResearch
Hi...new to this chat but a regular on #bcsm. Dx with early stage endometrial ca in Nov. and surgery 2 wk ago. #gyncsm
Tanya Temkin @tanyaltee
@gyncsm T1. I didn’t understand the difference between remission and cure so had some unrealistic expectations #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @tanyaltee: @gyncsm T1. I didn’t understand the difference between remission and cure so had some unrealistic expectations #gyncsm
EcanaAdrienne @AdrienneEcana
@womenofteal #gyncsm I am sure our goals changed often depending on how treatment was going...at least mine did
Alexa Jett 🦋 @ohhiialexa
@womenofteal Dee, I love hearing things like this! I think short term goals of weddings, birthdays, or milestones should absolutely be honored if at all possible by the care team. #GYNCSM
Dee Sparacio @womenofteal
@IBCResearch Welcome and sorry to hear about your diagnosis. Hope your recovery is going well. #gyncsm
EcanaAdrienne @AdrienneEcana
RT @gyncsm: T2: Patients - Is a specific discussion of "goals of care" something you had with your doctor? Did they help you define your goals? Providers - Is this a discussion that you have with your patients and, if so, how often? #gyncsm
Christina Lizaso @btrfly12
T2: My gyn doc who tested me pretty much referred me along to other providers. My breast surgeon and I specifically discussed goals, which I appreciated. But I think I should spend more time thinking and actually write some things down. For myself and clarity in appts #gyncsm
EcanaAdrienne @AdrienneEcana
@gyncsm #gyncsm I can clearly recall NOT having this conversation with my Onc initially, given my stage I am not sure how optimistic he was
Alexa Jett 🦋 @ohhiialexa
A2: I started treatment during summer, so my oncologist asked me about my summer and vacation plans. I appreciated this! My main goal was being well enough for my brother’s birthday, a month and a half after my first surgery. #GYNCSM
Christina Lizaso @btrfly12
RT @AdrienneEcana: @gyncsm #gyncsm I can clearly recall NOT having this conversation with my Onc initially, given my stage I am not sure how optimistic he was
Dee Sparacio @womenofteal
@tanyaltee @DrBeckerSchutte @gyncsm I know many women who would say the same thing. #gyncsm
Christina Lizaso @btrfly12
RT @ohhiialexa: @womenofteal Dee, I love hearing things like this! I think short term goals of weddings, birthdays, or milestones should absolutely be honored if at all possible by the care team. #GYNCSM
Ann Becker-Schutte @DrBeckerSchutte
@gyncsm A2: Discussing goals of care is standard first visit territory for me, but therapy is a different critter than lots of other health care services. #gyncsm
EcanaAdrienne @AdrienneEcana
@ohhiialexa #gyncsm I love the idea of focusing on short term attainable goals...
Christine (Cissy) White @healWRITEnow
#GYNCSM T2: I was in such shock at diagnosis (was told a likely cyst) that it was cancer. That was post-op day with nerve complications. I wasn’t prepared for extent/length of surgery. It felt like I was put on a treatment treadmill I couldn’t slow down.
Dee Sparacio @womenofteal
A2: Goals for treatment we did discuss - I know I told my gyn onc that I did not want to vomit – that was my greatest fear. And she made sure that did not happen. #gyncsm
Alexa Jett 🦋 @ohhiialexa
@AdrienneEcana I absolutely agree! #GYNCSM
Christina Lizaso @btrfly12
@IBCResearch Glad to have you join us but sorry for the reason. Dee and I met on #bcsm and were inspired to form #gyncsm. We have some basic info on our gyncsm blog and are happy to be a resource in any way.
Ann Becker-Schutte @DrBeckerSchutte
RT @ohhiialexa: A2: A2: I started treatment during summer, so my oncologist asked me about my summer and vacation plans. I appreciated this! My main goal was being well enough for my brother’s birthday, a month and a half after my first surgery. #GYNCSM
Ann Becker-Schutte @DrBeckerSchutte
RT @healWRITEnow: #GYNCSM T2: #GYNCSM T2: I was in such shock at diagnosis (was told a likely cyst) that it was cancer. That was post-op day with nerve complications. I wasn’t prepared for extent/length of surgery. It felt like I was put on a treatment treadmill I couldn’t slow down.
Ann Becker-Schutte @DrBeckerSchutte
RT @womenofteal: A2: A2: Goals for treatment we did discuss - I know I told my gyn onc that I did not want to vomit – that was my greatest fear. And she made sure that did not happen. #gyncsm
EcanaAdrienne @AdrienneEcana
@healWRITEnow #gyncsm Diagnosis is a roller coaster and treatment is the car...
Alexa Jett 🦋 @ohhiialexa
RT @AdrienneEcana: @healWRITEnow #gyncsm Diagnosis is a roller coaster and treatment is the car...
Christina Lizaso @btrfly12
@DrBeckerSchutte @gyncsm But maybe every doctor appointment should start and end around goals :) #gyncsm s/o to @abrewi3010
Dee Sparacio @womenofteal
@AdrienneEcana @healWRITEnow You are so right! #gyncsm
Dee Sparacio @womenofteal
@btrfly12 @DrBeckerSchutte @gyncsm @abrewi3010 YES!! #gyncsm
EcanaAdrienne @AdrienneEcana
RT @btrfly12: @DrBeckerSchutte @gyncsm But maybe every doctor appointment should start and end around goals :) #gyncsm s/o to @abrewi3010
GYN Cancer | #GYNCSM @gyncsm
T3: When considering a treatment or clinical trial do you have a discussion about the research results or guideline recommendations? Do you try to match these to your/the patient's specific goals/needs? #gyncsm
Christine (Cissy) White @healWRITEnow
@gyncsm #gyncsm T2: An actual written plan of care done together would be great. There’s a big learning curve regarding disease, treatment, maintenance & clinical trials. It’s overwhelming for a while.
Dee Sparacio @womenofteal
RT @gyncsm: T3: T3: When considering a treatment or clinical trial do you have a discussion about the research results or guideline recommendations? Do you try to match these to your/the patient's specific goals/needs? #gyncsm
Dee Sparacio @womenofteal
RT @healWRITEnow: @gyncsm #gyncsm T2: @gyncsm #gyncsm T2: An actual written plan of care done together would be great. There’s a big learning curve regarding disease, treatment, maintenance & clinical trials. It’s overwhelming for a while.
Tanya Temkin @tanyaltee
@gyncsm # T1. Also trying to figure out the new terms and concepts being thrown around: BRCA. DIsease progression. Dose-dense. HIPEC.... #gyncsm
Christina Lizaso @btrfly12
RT @healWRITEnow: @gyncsm #gyncsm T2: @gyncsm #gyncsm T2: An actual written plan of care done together would be great. There’s a big learning curve regarding disease, treatment, maintenance & clinical trials. It’s overwhelming for a while.
Rebecca Previs @BeccaPrevisMD
@gyncsm #gyncsm As a provider, I think this is critically important to discuss as early as possible! Incorporating shared decision making with a patient, her provider and the family can help set realistic (and hopeful) expectations.
Christina Lizaso @btrfly12
RT @gyncsm: T3: T3: When considering a treatment or clinical trial do you have a discussion about the research results or guideline recommendations? Do you try to match these to your/the patient's specific goals/needs? #gyncsm
Christina Lizaso @btrfly12
RT @gyncsm: T2: Patients - Is a specific discussion of "goals of care" something you had with your doctor? Did they help you define your goals? Providers - Is this a discussion that you have with your patients and, if so, how often? #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
I would be down with that—but I have a bias. #gyncsm
EcanaAdrienne @AdrienneEcana
@gyncsm #gyncsm I was never introduced to the possibility
Alexa Jett 🦋 @ohhiialexa
A3: This is obviously a health care provider question, but I as a patient was sure to make sure my voice was heard for my treatment preferences. I also regularly ask about clinical trials and are happy to do them if is a good fit for me. #GYNCSM
Rebecca Previs @BeccaPrevisMD
@healWRITEnow @gyncsm #gyncsm I love the idea of writing these down. I often make myself lists, so why not bring them to your doctor’s appt! Of course goals change with time, so it’s important to discuss evolving goals with your providers.
Dee Sparacio @womenofteal
A3 Initial DX I researched the trial I was offered and also talked to my PCP about it. When I recurred I asked for all my options then I tool a month to research what option I wanted to do. I was offered a clinical trial but chose surgery then chemo. #gyncsm Those matched my goal
Alexa Jett 🦋 @ohhiialexa
RT @BeccaPrevisMD: @gyncsm #gyncsm As a provider, I think this is critically important to discuss as early as possible! Incorporating shared decision making with a patient, her provider and the family can help set realistic (and hopeful) expectations.
Dee Sparacio @womenofteal
RT @BeccaPrevisMD: @gyncsm #gyncsm As a provider, I think this is critically important to discuss as early as possible! Incorporating shared decision making with a patient, her provider and the family can help set realistic (and hopeful) expectations.
Christina Lizaso @btrfly12
@BeccaPrevisMD @gyncsm Shared decision making makes so much sense but takes time and effort on both sides. Hopeful that more and more providers get on board with it as an overall concept. #gyncsm change takes time too though
Christina Lizaso @btrfly12
RT @BeccaPrevisMD: @healWRITEnow @gyncsm #gyncsm I love the idea of writing these down. I often make myself lists, so why not bring them to your doctor’s appt! Of course goals change with time, so it’s important to discuss evolving goals with your providers.
EcanaAdrienne @AdrienneEcana
Treatment is very overwhelming but at least an actual written plan of care might make you feel as if you has some semblance of control
Dee Sparacio @womenofteal
@AdrienneEcana @gyncsm Something that should never happen- did you not have time? or did not know that guidelines might exist. That sure needs to change #gyncsm
Dee Sparacio @womenofteal
RT @btrfly12: @BeccaPrevisMD @gyncsm Shared decision making makes so much sense but takes time and effort on both sides. Hopeful that more and more providers get on board with it as an overall concept. #gyncsm change takes time too though
Christina Lizaso @btrfly12
@ohhiialexa Treatment preferences can be important to speak up about and be sure that the "standard of care" or whatever is being offered you fits with your goals/daily life and preferences #gyncsm
Rebecca Previs @BeccaPrevisMD
@gyncsm #gyncsm I would encourage every patient to ask her provider at every treatment decision making time point if she would be eligible for a trial—often this is how we can offer exciting, new therapies (sometimes in addition to the standard of care)
Ann Becker-Schutte @DrBeckerSchutte
RT @btrfly12: @ohhiialexa Treatment preferences can be important to speak up about and be sure that the "standard of care" or whatever is being offered you fits with your goals/daily life and preferences #gyncsm
Christina Lizaso @btrfly12
RT @womenofteal: A3 Initial DX I researched the trial I was offered and also talked to my PCP about it. When I recurred I asked for all my options then I tool a month to research what option I wanted to do. I was offered a clinical trial but chose surgery then chemo. #gyncsm Those matched my goal
EcanaAdrienne @AdrienneEcana
@womenofteal @gyncsm #gyncsm I had time but did not know what a clinical trial entailed nor if I qualified...Neither do I know to ask. Is why I am here now!!!
Christine (Cissy) White @healWRITEnow
T3: #gyncsm I was interested in clinical trials, alternative/integrative approaches, things such as fasting during chemo & nutrition but those were not available (as would have been my plan). Made most of drug trials available & clinical team explained process beautifully.
Christina Lizaso @btrfly12
RT @BeccaPrevisMD: @gyncsm #gyncsm I would encourage every patient to ask her provider at every treatment decision making time point if she would be eligible for a trial—often this is how we can offer exciting, new therapies (sometimes in addition to the standard of care)
Dee Sparacio @womenofteal
I agree 100% . New trials are being started all the time. #gyncsm
Christina Lizaso @btrfly12
RT @healWRITEnow: T3: T3: #gyncsm I was interested in clinical trials, alternative/integrative approaches, things such as fasting during chemo & nutrition but those were not available (as would have been my plan). Made most of drug trials available & clinical team explained process beautifully.
Alexa Jett 🦋 @ohhiialexa
@btrfly12 @BeccaPrevisMD @gyncsm I think a problem we struggle in the #AYACancer community is the confidence to speak up with doctors who may be much older than us, or who we view as parents instead of a team. Speaking up is important! #GYNCSM
Christina Lizaso @btrfly12
RT @ohhiialexa: @btrfly12 @BeccaPrevisMD @gyncsm I think a problem we struggle in the #AYACancer community is the confidence to speak up with doctors who may be much older than us, or who we view as parents instead of a team. Speaking up is important! #GYNCSM
Ann Becker-Schutte @DrBeckerSchutte
RT @healWRITEnow: T3: T3: #gyncsm I was interested in clinical trials, alternative/integrative approaches, things such as fasting during chemo & nutrition but those were not available (as would have been my plan). Made most of drug trials available & clinical team explained process beautifully.
EcanaAdrienne @AdrienneEcana
RT @womenofteal: I agree 100% . New trials are being started all the time. #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @ohhiialexa: @btrfly12 @BeccaPrevisMD @gyncsm I think a problem we struggle in the #AYACancer community is the confidence to speak up with doctors who may be much older than us, or who we view as parents instead of a team. Speaking up is important! #GYNCSM
Dee Sparacio @womenofteal
Excellent point - learning to advocate for yourself is difficult initially and maybe more so for a young adult. #gyncsm
Alexa Jett 🦋 @ohhiialexa
@btrfly12 Long term side effects/tolerance as well! #GYNCSM
Christina Lizaso @btrfly12
Many gyn cancers do have treatment guidelines available from @NCCN Patients can ask if their doctor is following the guidelines and have a discussion about why a variation for your case. So much is put on patients when diagnosed... #gyncsm
EcanaAdrienne @AdrienneEcana
It is a very intimidating world...cancer research. I am glad I have the opportunity to peak behind the veil!!
GYN Cancer | #GYNCSM @gyncsm
T4: What are Progression Free Survival (PFS) and Overall Survival (OS)? How do these endpoints line up with individual treatment goals? with clinical trial goals? #gyncsm
Catherine Gegaris @cgegaris1
@gyncsm #Gyncsm yes
Christine (Cissy) White @healWRITEnow
RT @BeccaPrevisMD: @healWRITEnow @gyncsm #gyncsm I love the idea of writing these down. I often make myself lists, so why not bring them to your doctor’s appt! Of course goals change with time, so it’s important to discuss evolving goals with your providers.
Ann Becker-Schutte @DrBeckerSchutte
RT @btrfly12: Many gyn cancers do have treatment guidelines available from @NCCN Patients can ask if their doctor is following the guidelines and have a discussion about why a variation for your case. So much is put on patients when diagnosed... #gyncsm
Tanya Temkin @tanyaltee
@gyncsm hmmm. I’m seeing the questions but not the replies. #gyncsm
Dee Sparacio @womenofteal
@ASCO has clinical practice guidelines too that can be reviewed too. #gyncsm
Dee Sparacio @womenofteal
RT @gyncsm: T4: T4: What are Progression Free Survival (PFS) and Overall Survival (OS)? How do these endpoints line up with individual treatment goals? with clinical trial goals? #gyncsm
Christina Lizaso @btrfly12
RT @womenofteal: @ASCO has clinical practice guidelines too that can be reviewed too. #gyncsm
Alexa Jett 🦋 @ohhiialexa
@womenofteal Absolutely, Dee! #GYNCSM
Christina Lizaso @btrfly12
#gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @womenofteal: @ASCO has clinical practice guidelines too that can be reviewed too. #gyncsm
Dee Sparacio @womenofteal
@tanyaltee @gyncsm are you following the hashtag #gyncsm or @gyncsm ? use the hashtag.
Rebecca Previs @BeccaPrevisMD
@btrfly12 @gyncsm I think the idea of shared decision making is really transforming oncology practice. This is certainly taught now during training! #gyncsm
Catherine Gegaris @cgegaris1
@gyncsm #gyncsm Very anxious-just wanted to survive surgery and know my dx. Then it was to get through chemo
Alexa Jett 🦋 @ohhiialexa
@AdrienneEcana That’s why I love these chats!! #GYNCSM
Christina Lizaso @btrfly12
@womenofteal @tanyaltee @gyncsm in Explore, type in #gyncsm or gyncsm and then click Latest. You'll have to reload the page if you want to load new tweets faster than Twitter default timing. :)
EcanaAdrienne @AdrienneEcana
@gyncsm #gyncsm T4??
Jeff Neurman @JNeurman
RT @ohhiialexa: Hello everyone! I am Alexa Jett in East Texas, USA. I am a thyroid cancer survivor, blogger, and advocate. #GYNCSM
Christina Lizaso @btrfly12
@AdrienneEcana @womenofteal @gyncsm So glad you joined and thanks for all you do as an advocate for yourself and others. Feel free to reach out to #gyncsm any time.
Christina Lizaso @btrfly12
RT @BeccaPrevisMD: @btrfly12 @gyncsm I think the idea of shared decision making is really transforming oncology practice. This is certainly taught now during training! #gyncsm
Rebecca Previs @BeccaPrevisMD
@ohhiialexa @btrfly12 @gyncsm Be empowered to speak up!! No one knows your journey and body better than you. You are the only expert on you. (Even if your doctor is older or younger!) #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @BeccaPrevisMD: @ohhiialexa @btrfly12 @gyncsm Be empowered to speak up!! No one knows your journey and body better than you. You are the only expert on you. (Even if your doctor is older or younger!) #gyncsm
Dee Sparacio @womenofteal
@AdrienneEcana @gyncsm Clinical trials have end points - Progression free survival or overall survival. Some trial results have better PFS but may not offer any longer overall survival . #gyncsm
Alexa Jett 🦋 @ohhiialexa
#AYACSM
Tanya Temkin @tanyaltee
@gyncsm T4. Aaah! One of my fave topics! There is much confusion in the PARP community about OS vs PFS. Many patients want PARPs because they think they’ll live longer. #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @womenofteal: @AdrienneEcana @gyncsm Clinical trials have end points - Progression free survival or overall survival. Some trial results have better PFS but may not offer any longer overall survival . #gyncsm
EcanaAdrienne @AdrienneEcana
@btrfly12 @womenofteal @gyncsm #gyncsm Becoming an advocate has been the biggest blessing that came out of being a patient!! Thanks for all the support everyone!!
Christina Lizaso @btrfly12
T4: Here's the best brief overview of the concepts of progression free survival vs. overall survival: https://t.co/FJe962VkGR Any of our healthcare folks have a boiled down couple sentences? So much terminology hurdles in cancer. #gyncsm
Rebecca Previs @BeccaPrevisMD
@MIShouldTalk @gyncsm #gyncsm absolutely! https://t.co/iOkqjRphg9 is a good launching point but can be not that easy to search. If you are willing to travel, make sure your provider knows that!
Christine (Cissy) White @healWRITEnow
@gyncsm T4: From patient perspective, progression-free survival is jargon & focus on it rather than cure/survival alienating, academic or for benefit of battling drug companies. I’d always thought cure was goal of oncologists & research. Reality has been sobering/depressing.#gyncsm
Dee Sparacio @womenofteal
RT @btrfly12: T4: T4: Here's the best brief overview of the concepts of progression free survival vs. overall survival: https://t.co/FJe962VkGR Any of our healthcare folks have a boiled down couple sentences? So much terminology hurdles in cancer. #gyncsm
Christina Lizaso @btrfly12
@theNCI does have a Cancer Terms widget/dictionary that can be helpful https://t.co/G6okqor6c5 #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @btrfly12: @theNCI does have a Cancer Terms widget/dictionary that can be helpful https://t.co/G6okqor6c5 #gyncsm
GYN Cancer | #GYNCSM @gyncsm
T5: How do goals of care change over time? Are they reassessed upon recurrence? How can readjusting goals impact treatment decisions and also daily living? #gyncsm
Dee Sparacio @womenofteal
@MIShouldTalk @BeccaPrevisMD @gyncsm Some women I know had docs who would look at trials offered elsewhere.Mine did. They know that not every institution can offer every trial. #gyncsm
Dee Sparacio @womenofteal
RT @btrfly12: @theNCI does have a Cancer Terms widget/dictionary that can be helpful https://t.co/G6okqor6c5 #gyncsm
Christina Lizaso @btrfly12
One step at a time... One day or even one hour at a time can be what works best. #gyncsm
Dee Sparacio @womenofteal
RT @gyncsm: T5: T5: How do goals of care change over time? Are they reassessed upon recurrence? How can readjusting goals impact treatment decisions and also daily living? #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @btrfly12: One step at a time... One day or even one hour at a time can be what works best. #gyncsm
Christina Lizaso @btrfly12
RT @BeccaPrevisMD: @ohhiialexa @btrfly12 @gyncsm Be empowered to speak up!! No one knows your journey and body better than you. You are the only expert on you. (Even if your doctor is older or younger!) #gyncsm
Christina Lizaso @btrfly12
RT @gyncsm: T5: T5: How do goals of care change over time? Are they reassessed upon recurrence? How can readjusting goals impact treatment decisions and also daily living? #gyncsm
Christina Lizaso @btrfly12
#gyncsm :)
Christine (Cissy) White @healWRITEnow
@tanyaltee @gyncsm Yes. It’s not always clear what prolongs length vs. quality of life, what is done with intent to cure rather than delay recurrence, & benefits & risks of them if BRCA negative. #gyncsm
Alexa Jett 🦋 @ohhiialexa
A5: I really think this comes down to having a good relationship with care team. A recent example: At my last appointment in December I requested my cancer follow ups to go to yearly instead of bi-yearly. I explained why and they allowed it! #GYNCSM
Christina Lizaso @btrfly12
RT @ohhiialexa: A5: I really think this comes down to having a good relationship with care team. A recent example: A5: I really think this comes down to having a good relationship with care team. A recent example: At my last appointment in December I requested my cancer follow ups to go to yearly instead of bi-yearly. I explained why and they allowed it! #GYNCSM
Tanya Temkin @tanyaltee
@gyncsm 5. I realized after end of frontline that I might recur and have to let go of my”cure” fantasy. When I did recur, my goal was to get on a PARP at end of 2d line treatment and have me a good long remission. #gyncsm
Christina Lizaso @btrfly12
RT @healWRITEnow: @tanyaltee @gyncsm Yes. It’s not always clear what prolongs length vs. quality of life, what is done with intent to cure rather than delay recurrence, & benefits & risks of them if BRCA negative. #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @tanyaltee: @gyncsm 5. I realized after end of frontline that I might recur and have to let go of my”cure” fantasy. When I did recur, my goal was to get on a PARP at end of 2d line treatment and have me a good long remission. #gyncsm
Christina Lizaso @btrfly12
RT @tanyaltee: @gyncsm 5. I realized after end of frontline that I might recur and have to let go of my”cure” fantasy. When I did recur, my goal was to get on a PARP at end of 2d line treatment and have me a good long remission. #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @healWRITEnow: @tanyaltee @gyncsm Yes. It’s not always clear what prolongs length vs. quality of life, what is done with intent to cure rather than delay recurrence, & benefits & risks of them if BRCA negative. #gyncsm
Christina Lizaso @btrfly12
T5: Adjusting goals is part of the process but seems bittersweet - freeing, maybe clarifying, but also tough. As mentioned, having that good relationship with your doctor where goals are part of discussions can help set clear expectations and ease readjustments... #gyncsm
Rebecca Previs @BeccaPrevisMD
#gyncsm T4 providers use endpoints like progression-free survival and overall survival to understand the impact of particular treatment on the cancer... but other endpoints like patient reported outcomes (PROs), time without symptoms, quality of life may be as (or more) valuable
GYN Cancer | #GYNCSM @gyncsm
Last Topic T6: What are some things to consider when setting patient goals for care and in communication between providers and patients about goals of care? What are your tips? #gyncsm
Dee Sparacio @womenofteal
@gyncsm A 5 Side effects impacted my treatment on recurrence so my goals had to change. As we learn more about mutations that could change our goals and treatment too. #gyncsm
Christina Lizaso @btrfly12
RT @gyncsm: Last Topic T6: What are some things to consider when setting patient goals for care and in communication between providers and patients about goals of care? What are your tips? #gyncsm
Dee Sparacio @womenofteal
RT @gyncsm: Last Topic T6: What are some things to consider when setting patient goals for care and in communication between providers and patients about goals of care? What are your tips? #gyncsm
EcanaAdrienne @AdrienneEcana
@gyncsm #gyncsm A5 Right now my goal of care is to educate as many women as I can about EC and in the process heal from the scars it has left behind. I’m finding strength there and know now that You fear what you don’t understand
Alexa Jett 🦋 @ohhiialexa
A6: Care team, be honest! That is what helped me map out some of my future after my diagnosis. They didn’t tell me “you take the thyroid out and you’re done!” A line often repeated by those who don’t understand #thyroidcancer #GYNCSM @ThyCaInc
Tanya Temkin @tanyaltee
@btrfly12 T5: when I got on my PARP I told my gyn onc that I expected to become resistant to it at some point. We started talking about what my third line of treatment might involve if-when I recur. She brought up possibility of clinical trial. #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
It doesn’t hurt to seek outside help. There are lots of resources if you need them. Therapy, a pastor, support groups. Getting help is courageous. #gyncsm
Dee Sparacio @womenofteal
@gyncsm Being sure we have access to the best and latest information on treatment for our cancer , including clinical trials is crucial in helping set goals of care. #gyncsm
Christina Lizaso @btrfly12
T6: @abrewi3010, in addition to advocating for goal discussions at every care interaction, suggests that patients share about themselves as a person and get to know their provider as a person. Even a couple minutes can lay foundation for working as team #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @btrfly12: T5: T5: Adjusting goals is part of the process but seems bittersweet - freeing, maybe clarifying, but also tough. As mentioned, having that good relationship with your doctor where goals are part of discussions can help set clear expectations and ease readjustments... #gyncsm
Christina Lizaso @btrfly12
RT @womenofteal: @gyncsm Being sure we have access to the best and latest information on treatment for our cancer , including clinical trials is crucial in helping set goals of care. #gyncsm
Dee Sparacio @womenofteal
RT @ohhiialexa: A6: A6: Care team, be honest! That is what helped me map out some of my future after my diagnosis. They didn’t tell me “you take the thyroid out and you’re done!” A line often repeated by those who don’t understand #thyroidcancer #GYNCSM @ThyCaInc
Christina Lizaso @btrfly12
RT @DrBeckerSchutte: It doesn’t hurt to seek outside help. There are lots of resources if you need them. Therapy, a pastor, support groups. Getting help is courageous. #gyncsm
Dee Sparacio @womenofteal
RT @DrBeckerSchutte: It doesn’t hurt to seek outside help. There are lots of resources if you need them. Therapy, a pastor, support groups. Getting help is courageous. #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @btrfly12: T6: T6: @abrewi3010, in addition to advocating for goal discussions at every care interaction, suggests that patients share about themselves as a person and get to know their provider as a person. Even a couple minutes can lay foundation for working as team #gyncsm
Christina Lizaso @btrfly12
RT @ohhiialexa: A6: A6: Care team, be honest! That is what helped me map out some of my future after my diagnosis. They didn’t tell me “you take the thyroid out and you’re done!” A line often repeated by those who don’t understand #thyroidcancer #GYNCSM @ThyCaInc
Christina Lizaso @btrfly12
#gyncsm
Christina Lizaso @btrfly12
RT @AdrienneEcana: @gyncsm #gyncsm A5 Right now my goal of care is to educate as many women as I can about EC and in the process heal from the scars it has left behind. I’m finding strength there and know now that You fear what you don’t understand
Dee Sparacio @womenofteal
Love this! #gyncsm
EcanaAdrienne @AdrienneEcana
@gyncsm #gyncsm A6 Always consider a patient’s level of support. Emotional, Physical and Financial. It has a direct relationship with compliance.
Alexa Jett 🦋 @ohhiialexa
@DrBeckerSchutte Yes! I feel like spiritual support is often an under utilized resource that should be more discussed with patients, even as a provider. “Have you talked to a spiritual advisor lately?” #GYNCSM
Alexa Jett 🦋 @ohhiialexa
RT @AdrienneEcana: @gyncsm #gyncsm A6 Always consider a patient’s level of support. Emotional, Physical and Financial. It has a direct relationship with compliance.
GYN Cancer | #GYNCSM @gyncsm
Thanks all for the wonderful conversation. We like to wrap up the chat by sharing closing thoughts on what we learned/were reminded of/comments on the topic. We use TIL: at the start of the tweet for Today I Learned... #gyncsm
Christina Lizaso @btrfly12
RT @AdrienneEcana: @gyncsm #gyncsm A6 Always consider a patient’s level of support. Emotional, Physical and Financial. It has a direct relationship with compliance.
Dee Sparacio @womenofteal
RT @gyncsm: Thanks all for the wonderful conversation. We like to wrap up the chat by sharing closing thoughts on what we learned/were reminded of/comments on the topic. We use TIL: at the start of the tweet for Today I Learned... #gyncsm
Inspire @InspireIsHealth
RT @gyncsm: Last Topic T6: What are some things to consider when setting patient goals for care and in communication between providers and patients about goals of care? What are your tips? #gyncsm
Catherine Gegaris @cgegaris1
@womenofteal @gyncsm #Gyncsm My chronic pain is a result of it starting during cycle 3 of my 6 cycles. They kept insisting it was not the chemo A5
GYN Cancer | #GYNCSM @gyncsm
Please join us for our next chat on Feb 12, 2020 at 9pmET when we will be discussing Cancer pre-hab. And, as always, remember to tweet things of interest with hashtag #gyncsm to keep the conversation going between chats.
Ann Becker-Schutte @DrBeckerSchutte
I strongly dislike “compliant” being applied to people. There are so many factors that go into “compliant” or “non-compliant.” We need to step back and look at the whole person. #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @ohhiialexa: @DrBeckerSchutte Yes! I feel like spiritual support is often an under utilized resource that should be more discussed with patients, even as a provider. “Have you talked to a spiritual advisor lately?” #GYNCSM
Alexa Jett 🦋 @ohhiialexa
TIL that goals should be discussed more at every appointment. Both care goals (exercise, diet, sticking to medication routine) and patient’s goals (school, marriage, new job, birthdays.) Once again: Communication, communication, communication! #GYNCSM
Christina Lizaso @btrfly12
As we wrap up, wanted to share this recent study involving survivor/advocate @Stigetta "Ovarian cancer survivors' acceptance of treatment side effects evolves as goals of care change over the cancer continuum" https://t.co/be5PnqlaNI #gyncsm
EcanaAdrienne @AdrienneEcana
@gyncsm #gyncsm TIL Tweet chats move at the speed of light...and that I have Love for you All!!! Thanks Everyone
Dee Sparacio @womenofteal
TIL that communication between patient and physician is the key to a patient's goals being realized. And that those conversations are not a happening as often as they should #gyncsm
Dee Sparacio @womenofteal
RT @gyncsm: Please join us for our next chat on Feb 12, 2020 at 9pmET when we will be discussing Cancer pre-hab. And, as always, remember to tweet things of interest with hashtag #gyncsm to keep the conversation going between chats.
Catherine Gegaris @cgegaris1
@womenofteal A6 critical, there is a person behind the disease,get to know them.#gyncsm
Christine (Cissy) White @healWRITEnow
@gyncsm T6. #gyncsm Great question. I think matching the care to the patient rather than the patient to the care. Being partners & collaborators & open to new ideas, possibilities & approaches.
Christina Lizaso @btrfly12
@cgegaris1 @womenofteal @gyncsm I feel like I hear this a lot and am getting pretty irritated about it. Women speaking up about side effects/symptoms during treatment but it not being really addressed and even dismissed. #gyncsm
Dee Sparacio @womenofteal
@AdrienneEcana @gyncsm Thank you! So glad we got to meet in person. Keep up that advocacy. #gyncsm and I are here for you.
Christina Lizaso @btrfly12
RT @gyncsm: Please join us for our next chat on Feb 12, 2020 at 9pmET when we will be discussing Cancer pre-hab. And, as always, remember to tweet things of interest with hashtag #gyncsm to keep the conversation going between chats.
Dee Sparacio @womenofteal
RT @btrfly12: As we wrap up, wanted to share this recent study involving survivor/advocate @Stigetta "Ovarian cancer survivors' acceptance of treatment side effects evolves as goals of care change over the cancer continuum" https://t.co/be5PnqlaNI #gyncsm
Christina Lizaso @btrfly12
RT @ohhiialexa: TIL that goals should be discussed more at every appointment. Both care goals (exercise, diet, sticking to medication routine) and patient’s goals (school, marriage, new job, birthdays.) Once again: Communication, communication, communication! #GYNCSM
Ann Becker-Schutte @DrBeckerSchutte
RT @ohhiialexa: TIL that goals should be discussed more at every appointment. Both care goals (exercise, diet, sticking to medication routine) and patient’s goals (school, marriage, new job, birthdays.) Once again: Communication, communication, communication! #GYNCSM
Christina Lizaso @btrfly12
RT @womenofteal: TIL that communication between patient and physician is the key to a patient's goals being realized. And that those conversations are not a happening as often as they should #gyncsm
Ann Becker-Schutte @DrBeckerSchutte
RT @btrfly12: @cgegaris1 @womenofteal @gyncsm I feel like I hear this a lot and am getting pretty irritated about it. Women speaking up about side effects/symptoms during treatment but it not being really addressed and even dismissed. #gyncsm
Christina Lizaso @btrfly12
RT @healWRITEnow: @gyncsm T6. #gyncsm Great question. I think matching the care to the patient rather than the patient to the care. Being partners & collaborators & open to new ideas, possibilities & approaches.
Dee Sparacio @womenofteal
Grateful for our #gyncsm co-moderators! @btrfly12 Grateful for our #gyncsm co-moderators! @btrfly12 @DrBeckerSchutte here tonight and our regular moderators @ShannonWestin @temkins @journeycancer #gyncsm
Alan Brewington @abrewi3010
It’s easier to practice symptom management medicine when we are just a number on a chart. It’s easier to practice human centered care when everyone thinks of the other as a person (human). Human centered caring is the antidote to paternalistic care. #gyncsm
Christine (Cissy) White @healWRITEnow
RT @btrfly12: @cgegaris1 @womenofteal @gyncsm I feel like I hear this a lot and am getting pretty irritated about it. Women speaking up about side effects/symptoms during treatment but it not being really addressed and even dismissed. #gyncsm
GYN Cancer | #GYNCSM @gyncsm
Thanks again to all who shared and joined along for #gyncsm Have a wonderful evening.
Dee Sparacio @womenofteal
Remember to check https://t.co/Df2f7Okp35 for a transcript of the chat and resources #gyncsm
Alexa Jett 🦋 @ohhiialexa
Thank you as always to @gyncsm , @btrfly12 , and @womenofteal for a great #GYNCSM chat tonight! https://t.co/H4hEvCbPXk
Dee Sparacio @womenofteal
RT @gyncsm: Thanks again to all who shared and joined along for #gyncsm Have a wonderful evening.
Dee Sparacio @womenofteal
@ohhiialexa @gyncsm @btrfly12 Thanks again for join us and sharing your experience and insights. #gyncsm
Catherine Gegaris @cgegaris1
@btrfly12 @womenofteal @gyncsm #gyncsm As I went to rheumatologists,neurologists etc looking for a dx and treatment,not narcotics,had one doctor ask me if I knew how lucky I was to have survived. I wanted to say,walk a mile in my shoes..biting my tongue
IBC Research Fdn @IBCResearch
Thanks for the opportunity to lurk & learn!! I'm hopeful surgery has taken care of my early stage disease but I'm also mindful that knowledge is power! #gyncsm
Dee Sparacio @womenofteal
@IBCResearch So glad you listened in. Thanks for joining us.Speedy recovery. #gyncsm
Christina Lizaso @btrfly12
@cgegaris1 @womenofteal @gyncsm Grrr.... This line of thinking that survivors should just be grateful to have survived is just... not ok. #gyncsm
Christine (Cissy) White @healWRITEnow
RT @abrewi3010: It’s easier to practice symptom management medicine when we are just a number on a chart. It’s easier to practice human centered care when everyone thinks of the other as a person (human). Human centered caring is the antidote to paternalistic care. #gyncsm
Christina Lizaso @btrfly12
Loved chatting along with #gyncsm. Thanks and hope to see you all again :)
Spectrum One @GlenBrundage
RT @abrewi3010: It’s easier to practice symptom management medicine when we are just a number on a chart. It’s easier to practice human centered care when everyone thinks of the other as a person (human). Human centered caring is the antidote to paternalistic care. #gyncsm
Dee Sparacio @womenofteal
@cgegaris1 @btrfly12 @gyncsm Sorry that was the response you got. Side effects as we survive longer can pop up at any time or progress. Too bad more centers don't have survivorship clinics - have people who know the side effects that could happen treat them. #gyncsm
Dee Sparacio @womenofteal
Thanks to everyone for the wonderful conversation. Please join us on Feb 12, 2020 at 9pm ET when we will be discussing Cancer pre-hab. #gyncsm
Catherine Gegaris @cgegaris1
@womenofteal @btrfly12 @gyncsm I have the best oncologist,moved back to Pa and finding him was my gift. He cares,listens and is wonderful.#gyncsm
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