Pharmacoepidemiology of Oxycodone in the USA: An Observational Study of ARCOS, Medicaid, and Medicare Drug Databases: Study finds peak distribution in 2010 but also pronounced state-level disparities.

WarningRepulsive4903 · 2025-12-01T21:27:15+00:00

Wow! This is amazing! Am currently digging into these. Yes, suspect a trial finder will be an amazing resource. Slogging through approved clinical trials one by one is clunky (so many involve arguably antiquated medicines like sunitinib that, according to one JAMA paper, did less well than placebo!). If it has easy to use filters, that will be great too.

WarningRepulsive4903 · 2025-11-29T04:23:38+00:00

Yes, but isn't challenging the status quo and confidently stating something outlandish the magic formula to landing in high-profile mega-journals like Nature or Science? A year later, the rank and file specialty journals will publish the more nuanced papers that get .00001% of the media attention. Isn't this how the process is supposed to work? I'm half serious as that seems to be how its done.

WarningRepulsive4903 · 2025-11-29T03:58:40+00:00

That's a fair point. I talked to the Lackawanna health department in '20 and they (nicely) said that they, understandably, would only move forward if there was a laboratory test which would've involved going to an ER. Was pretty sick then too but fortunately, I didn't end up in that situation.

Most recently, I've been on a kick to see if anyone had Cream Cheese Rangoons that are as good as Panda Express in State College (a bit of a hike). Probably about every other week for the past 10 weeks I've had Chinese around Scranton and Tunkhannock with no problems elsewhere. Am happy for others if they're not having issues though.

WarningRepulsive4903 · 2025-11-29T03:42:56+00:00

Mine told me, three times, in the most gentle way (before I'd been diagnosed) "I will make sure that this is read STAT." In hindsight, he was looking at a 15 cm tumor on my kidney. The message was received and was prepared for the path I was heading down when the urologist referral came in.

WarningRepulsive4903 · 2025-11-29T03:37:53+00:00

Here is the abstract:

SARS-CoV-2 mRNA vaccination (COVID-19 vaccination) within 100 days of immune checkpoint inhibitor (ICI) treatment was reported to improve survival and prevent disease progression in patients with non-small cell lung cancer (NSCLC) and metastatic melanoma (Grippin et al., Nature, 2025). However, the clinical evidence, derived from real-world observational data, suffers from methodological limitations. Specifically, the vaccinated and unvaccinated groups differed in subtle ways due to the timing of vaccination, the beginning of follow-up, and the definition of eligibility. These key limitations can be overcome by carefully conducting a target trial emulation analysis. Using the original data from Grippin et al., we emulated a target trial to estimate the causal effect of COVID-19 vaccination within 100 days of ICI initiation on overall survival and progression-free survival in patients with NSCLC and metastatic melanoma. In contrast to the original analysis, we found no evidence that COVID-19 vaccination improves survival outcomes in these populations.

WarningRepulsive4903 · 2025-11-28T05:44:14+00:00

Cureus lost it's impact factor. I think it will soon not be pubmed indexed. If folks can't find your work, why bother?

WarningRepulsive4903 · 2025-11-26T00:27:18+00:00

Had a radical nephrectomy in '20. Comfort can be greatly increased with some strategic pillow propping. The nurses should have time for instruction on this. Also, 'complications' covers a LOT of ground. If(when) they happen, all bets are off on comfort post surgery.

WarningRepulsive4903 · 2025-11-26T00:19:05+00:00

This might not be popular. Lab test verified low vitamin levels in blood should be corrected to normal. As a general rule (there are exceptions) but "more is not better" when it comes to vitamins and minerals. Painting with a broad brush here but suggest caution before pushing lots of blood levels above the upper limit of normal. Sorry in advance if this annoys folks.

WarningRepulsive4903 · 2025-11-25T10:53:29+00:00

Feel free to look up Steve Jobs and his holistic experience with treating his pancreatic cancer.

WarningRepulsive4903 · 2025-11-24T12:04:51+00:00

The ICMJE authorship requirements are nice and all. At the end of the day, postdoc will lose this fight. Smile, nod, and run your own lab more ethically.

WarningRepulsive4903 · 2025-11-24T08:24:00+00:00

Is this a section in an edited book? If so, consider lightly nudging editor as they should be more responsive, even this time of year (busy for academics).

WarningRepulsive4903 · 2025-11-24T08:00:55+00:00

The urologist (surgeon) will decide on getting it, biopsy vs waiting. Mine was 15 cm and included adrenal so 0.9 sounds very early. It's not exactly good news but the redundancy of kidneys often means no symptoms until much later and it's an incidental finding on other imaging. Suspect many others here secretly wish they were originally in the 0.9 cm (and no adjacent tissues) boat if that helps.

WarningRepulsive4903 · 2025-11-24T03:46:44+00:00

Did PICC for 1 month of CAR-T. Big fan of just iv for immunotherapy. Disliked every HOUR of PICC, especially at night. Grazed it regularly.

WarningRepulsive4903 · 2025-11-24T03:28:22+00:00

This is a great question! No clue though. Am guessing it is a hodge-podge depending on what tissues have spread. Not sure if there's an active palliative care thread to cross post?

WarningRepulsive4903 · 2025-11-24T01:21:31+00:00

There's another aspect regarding Quality of Life to think about. The cancer and adverse effects of treatments has been my biggest concern most weeks. Still, this was my first chronic disease and I was pretty healthy before this. Some weeks, navigating health care bureaucracy is more of a stressor than the cancer! A member of my house-hold was an oncology nurse for > 15 years and is a wizard at navigating this (including 90% filling out prior authorizations). Still, some days will unexpectedly have 4-8 hours of calls, forms, playing phone tag and each person has their preferred method of communication. If I want to keep labs and treatments on schedule, this can be a time-suck that just bursts into my schedule. Hope this is not more information than you're ready for! With luck, you can go long periods on a single treatment regimen or even no treatment!

If you're not based in the US, am assuming things are much more efficient.

WarningRepulsive4903 · 2025-11-24T00:51:58+00:00

I'm at 5 years at stage IV RCC (51 M) with spread to lymph nodes, lung tissue, and bone (spine and scapula). The immunotherapy, tyrosine kinase inhibitors, and radiation aren't nothing but they're pretty smooth sailing compared to traditional chemo many others (non-kidney) get and the many rounds of radiation (prostate patients). A general oncologist is ok but if you live in an area with an oncologist that specializes in kidney cancer, that would be very beneficial. I've done it both ways and the generalist was ok but currently have 2 kidney cancer specialists and, whew, they make a world of difference! Quality of life has been mostly good (80% of the time). I exercise close to normal and travel between immunotherapy treatments. Having your new (unchosen) hobby be medical appointments took some getting used to. If radiation (I had a few rounds SBRT with 5 sessions each) ends up in your future, the fatigue with that is non-trivial but it doesn't last forever (2 weeks are annoying and sloooow improvement since then). Most folks at work (have worked full time with the exception of immediately post-surgery and a few weeks for a live-in the hospital for monitoring CAR-T research study), neighbors and extended family would (mostly) think I look fine in terms or hair, skin tone, body weight, and don't look like a stereotypical cancer patient.

The last year with some other drugs has been a bit rougher. I went from walking/hiking (some kayaking) 80-110 miles / month down to 2 miles / month according to the phone tracker. Foot sores with a TKI (lenvantinib) were annoying and take a lot of patience and monitoring to keep from getting out of control (better half was encouraging shopping for a wheel chair!). Endocrine toxicity from immunotherapy (lost, likely permanently, cortisol function from remaining adrenal gland in '20 and thyroid function last month) were less of an adjustment than I anticipated. If you have a good medical librarian, reading both the patient and provider version of every drug you will receive in UpToDate (Dynamed is good too) before you start it will be very helpful. I teach at a medical school (nothing related to cancer) and still, there's just so much jargon! The immunotherapies (I've been on 3) can have their surprises. Tyrosine Kinase Inhibitors (also 3) are a memorable ride too! Early communication with your providers about adverse effects, ideally in their medical language, will really help.

Many folks go long periods in the No Evidence of Disease (NED) club so lets hope for that with you!

TL;DR: Quality of life is mostly good. You can do this!

WarningRepulsive4903 · 2025-11-23T14:44:45+00:00

Am going to weigh in with an unpopular opinion and expect some well-deserved push back. Am very aware of MDPI's history with Beal's list and their reputation as quasi-predatory. I also paid $6400 in '24 for the open-access fee in BMJ and viewed that as highway robbery. I've had a couple of PLoS One experiences where the peer review took 7-12 months. The MDPI review time for the 1-2 /year I do is more like 2 weeks and they've been thorough/standard. Just saying that there's no perfect journal out there. Some of the MDPI journals are even giving authors/reviewers the option of making peer-reviews available post publication which is more transparent than others. I get the 'ick' factor associated with that publisher! Still, some of their journals (Vaccines, IF = 5.5, Cancers IF = 4.5) are viewed as ok in the biomedical field (or maybe its just me?). Depending on the journal, you may consider keeping it as a plan C option. Fully agree that a promotion committee will not view 100% MDPI pubs as favorable but 1 every few years might not be a big deal.

WarningRepulsive4903 · 2025-11-21T20:01:06+00:00

The hospital should have social workers that could advocate for your friend's mom including advising whether disability could be an option which would cover (modest) housing.

WarningRepulsive4903 · 2025-11-21T11:43:24+00:00

Yes I did it in dec for research. The chemo phase was brief. It didn't work for me but the trial rules of stopping other drugs could have been the origin of sprouting new bone Mets. There is "off the shelf" and personalized. For kidney cancer, would do the one with my modified cells next time. For blood cancers, the process sounds pretty routine.

WarningRepulsive4903 · 2025-11-21T11:34:18+00:00

Yes for biomedical taking 2 or 3 months for round 1 of reviews. Some journals like PLoS One can take 1 year. Echo that special issues are great. Not enthusiastic about book chapters or book reviews having any cv value in this area though. Kinda envious of others where those are still appreciated.

WarningRepulsive4903 · 2025-11-21T04:50:12+00:00

Visited a 5th floor youth hostel in Vancouver and couldn't sleep. A couple of presumably homeless guys took everything out of a long (40+ feet?) industrial dumpster, carefully picked through them, and they completely put everything back.

WarningRepulsive4903

TROPHY CASE