Oncology On The Go

In this episode of Oncology On the Go, Daniel C. McFarland, DO, spoke with Erik Bengtsen, MD, a psychiatrist at Memorial Sloan Kettering Cancer Center (MSK), about interventional psychiatry and what emerging treatments such as ketamine, esketamine, and psilocybin may mean for patients with cancer.
Interventional psychiatry differs from talk therapy or take-home medication because patients come into the office for a monitored procedure, whether neuromodulation such as electroconvulsive therapy (ECT) and transcranial magnetic stimulation (TMS) or interventional pharmacology. Bengtsen described how Memorial Sloan Kettering launched an intranasal esketamine program in a small wing of a chemotherapy infusion suite, treating up to 4 patients at a time and completing approximately 70 visits in its first year. The FDA-approved agent's REMS program, which includes strict monitoring and required nursing education, helped secure institutional buy-in.
Patients who have benefited so far fall into 2 groups: those with severe depression, sometimes with passive suicidality, at diagnosis who urgently need to proceed with cancer treatment, and survivors with no evidence of disease whose depression has not responded to optimized antidepressant therapy. The experts explain the putative mechanism, NMDA receptor antagonism with downstream effects on brain-derived neurotrophic factor and neuroplasticity, and note that response is far faster than with standard antidepressants, often apparent after 3 sessions. Bengtsen also shared how his team pairs treatment with meaning-centered psychotherapy and how esketamine may help when conventional agents are contraindicated, such as in patients with severely low platelets after bone marrow transplant.
The conversation turned to psilocybin, which remains investigational but has shown promise for existential distress and fear of recurrence. Both experts stress the importance of safety, adherence to psychiatric standards of care, and treatment in monitored academic settings that know a patient's full oncology history, while noting that ECT continues to play a well-established role.
McFarland is the director of the Psycho-Oncology Program at Wilmot Cancer Institute and a medical oncologist who specializes in head and neck cancer and lung cancer, in addition to being a psycho-oncology editorial advisory board member for the journal ONCOLOGY®. Bengtsen, is an assistant attending psychiatrist and assistant director of the Consultation-Liaison Psychiatry Training Program at Memorial Sloan Kettering Cancer Center.

In a special edition of Oncology On the Go, CancerNetwork® joined Chinmay Jani, MD, in the studio to discuss key insights across different hot topics in the thoracic oncology field. He spoke about risk factors for lung cancer beyond smoking based on recent news regarding Pope Leo XIV, how the disease impacts younger populations, and what novel findings suggest about the role that comprehensive molecular testing can play to improve precision medicine.
In October 2026, the Vatican announced that Pope Leo XIV had undergone a right lower lobectomy to remove a lung nodule confirmed to be lung adenocarcinoma, despite a lack of smoking history. Later in the month, a subsequent oncological evaluation suggested that no further treatment was necessary for him. According to Jani, this development illustrates a need to change the historical paradigm and stigma equating lung cancer solely with tobacco use. He also noted that these events demonstrate the value of early detection through screening to help prevent the need for systemic therapy beyond surgery.
Jani also described findings from a study that he and colleagues published in eClinicalMedicine showing the contribution of factors including air pollution and asbestos to lung cancer mortality. Additionally, he reviewed research presented at the 2026 American Society of Clinical Oncology (ASCO) Annual Meeting examining global and US trends in lung cancer among young adults, especially those who have never smoked.
On top of research dedicated to non-tobacco risk factors, research that Jani and colleagues presented at the IASLC 2026 World Conference on Lung Cancer (WCLC) showed that younger patients who have never smoked more frequently harbor specific, potentially targetable genetic alterations, including mutations and gene fusions. These data point to the increasingly targeted nature of the therapeutic landscape for lung cancer, as clinicians have shifted from general chemotherapy to several specific combination and targeted regimens, such as tyrosine kinase inhibitors for ALK- or EGFR-mutated disease.
“For the general population, I would like to deliver one message: lung cancer is no [longer] smoking associated or tobacco associated. There are various other risk factors being associated with lung cancer, and beyond that, there are many lung cancers being diagnosed without any of these risk factors,” Jani concluded. “[The] earlier a cancer is diagnosed, the higher the chances of cure, and that's what oncology is working on: to make lung cancer curable in future.”
Jani is a medical oncologist at Sylvester Comprehensive Cancer Center of the University of Miami Miller School of Medicine.
References

1. Burke D, Detrow S. Pope Leo has lung cancer, the Vatican announces after surgery. NPR. October 13, 2026. Accessed October 27, 2026. https://tinyurl.com/274jb6hh

Neergaard L. Tests show Pope Leo XIV won’t need further treatment for lung cancer, Vatican says. AP. October 22, 2026. Accessed October 27, 2026. https://tinyurl.com/tvyc2uem

Jani CT, Kareff SA, Morgenstern-Kaplan D, et al. Evolving trends in lung cancer risk factors in the ten most populous countries: an analysis of data from the 2019 Global Burden of Disease Study. EClinicalMedicine. 2025;79:103033. doi:10.1016/j.eclinm.2024.103033

Jani RT, Edwards K, Rauf A, Rodriguez E, Lopes G, Jani C. Lung cancer burden in AYAs: global and U.S trends. J Clin Oncol. 2026;44(suppl 16):8603. doi:10.1200/JCO.2026.44.16_suppl.8603

Lung cancer may develop differently in young adults. News release. University of Miami Miller School of Medicine. August 19, 2026. Accessed October 27, 2026. https://tinyurl.com/yra7jvea

In a special webinar from CancerNetwork®, Oncology Nursing News®, CURE®, and HCPLive®, a panel spanning multiple disciplines convened to speak about the use of GLP-1 receptor agonists (GLP-1 RAs) among patients undergoing treatment for breast cancer. The group covered whether GLP-1 RAs were safe for those with breast cancer and described the appropriate circumstances for care teams to consider them.
The panel was moderated by Neil M. Iyengar, MD, director of survivorship services at Winship Cancer Institute of Emory University, a clinical member of Winship’s Glenn Family Breast Center, an associate professor and co-director of the Breast Medical Oncology Program in the Department of Hematology and Medical Oncology at Emory University School of Medicine, and co-editor in chief of the journal ONCOLOGY®. He was joined by:
·      Diana Isaacs, PharmD, director of Education and Training in Diabetes Technology at the Cleveland Clinic;
·      La-Urshalar Brock, MSN, FNP-BC, CNM, an oncology survivorship nurse practitioner at Winship Cancer Institute of Emory University;
·      Emily M. Beard, RN, BSN, OCN, CBCN, an oncology survivorship and nurse navigator at Emory University School of Medicine;
·      and Kiana Wooten, a patient advocate of Living Beyond Breast Cancer.
The discussion explored how obesity and metabolic health impact breast cancer risk and recurrence, with Iyengar detailing observational data demonstrating a link between GLP-1 RA use to fewer obesity-related cancers. The panel also discussed a reported weight loss rate of 4% to 5% in patients on endocrine therapy, early signs of lower pathologic complete response rates with chemoimmunotherapy in patients with triple-negative breast cancer, and how slower stomach emptying may affect absorption of oral cancer drugs. 
Other key topics included navigating conversations related to GLP-1 in survivorship care, especially those on protecting muscle and bone with protein and resistance training. The speakers also highlighted insurance denials, cost, compounded products, and the care team members who should own the GLP-1 conversation with patients.

In the newest edition of Oncology On the Go, Matthew J. Frigault, MD, joined Adam D. Cohen, MD, to discuss the evolving cellular therapy paradigm in multiple myeloma practice. They highlighted what the newest guidelines and long-term clinical trial data mean for patient care and how academic centers and community practices can collaborate more effectively.
The conversation opened with a look at how recent updates to the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology for multiple myeloma position CAR T-cell therapy in early relapse. Frigault noted that the guidelines now support referral for CAR T-cell therapy as early as the second line in patients who are refractory to lenalidomide (Revlimid), emphasizing the utility of agents such as ciltacabtagene autoleucel (cilta-cel; Carvykti). 
The experts also touched upon the implications of updated findings from cohort A of the phase 2 CARTITUDE-2 trial (NCT04133636), in which investigators assessed cilta-cel in patients with lenalidomide-refractory disease following 1 to 3 prior lines of therapy. With all patients now beyond 5 years of follow-up, 10 of 20 were alive and showed no progression after a single infusion without any further therapy, although Cohen cautioned that the cohort is small and that long-term follow-up data from the phase 3 CARTITUDE-4 trial (NCT04181827) are needed to confirm these findings.
Early referral of patients for cellular therapy was also a key point, as Frigault described how less heavily pretreated populations experience better outcomes and that those with lower disease burden and better functional status have shown improved efficacy, fewer toxicities, and lower long-term mortality after CAR T-cell therapy. Looking toward the future of the field, Frigault and Cohen detailed how dual-targeting CAR T-cell products, first-line trials comparing CAR T-cell therapy with autologous stem cell transplant, and other novel modalities may continue to evolve the field and introduce even more therapeutic options.
Frigault is clinical director of the Cellular Immunotherapy Program at Mass General Brigham Cancer Institute. Cohen is director of Myeloma Immunotherapy and professor of medicine at the Hospital of the University of Pennsylvania.
References

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines). Multiple Myeloma. Version 2.2027. National Comprehensive Cancer Network. September 24, 2026. Accessed October 21, 2026. https://tinyurl.com/47x35wch

Cohen AD, Mateos M-V, Cohen YC, et al. Long-term (≥5-Year) remission and survival with ciltacabtagene autoleucel (Cilta-Cel) in relapsed/refractory multiple myeloma (RRMM) with 1-3 prior lines of therapy: CARTITUDE 2 Cohort A. Presented at: 23rd International Myeloma Society Annual Meeting; September 23-26, 2026; Glasgow, Scotland. Poster PA-288.

In this episode of Oncology On the Go, Daniel C. McFarland, DO, spoke with Ramy Sedhom, MD, about how to build a cancer practice where symptom management and emotional support are part of routine oncology care rather than an outside referral.
Sedhom traced his approach to mentorship from Thomas Smith, MD, during his oncology fellowship at Johns Hopkins and to his palliative care training at Memorial Sloan Kettering Cancer Center. Noting that most patients with cancer receive treatment in their local communities, he described a model in which medical oncologists share clinical space with palliative care and psycho-oncology teams. That proximity, he explained, improves access and normalizes supportive care as a standard part of treatment. Using the example of a young mother newly diagnosed with triple-negative breast cancer, he walked through how a real-time message through the electronic medical record can bring a psychologist into the room for a warm handoff before the patient leaves the visit, often leading to ongoing therapy such as cognitive behavioral therapy.
McFarland emphasized that therapeutic presence and the ongoing patient-clinician relationship are healing, even though they are difficult to measure or reimburse. He described the use of shared medical visits in his practice and the value of weekly team meetings that include therapists, chaplains, and other staff. Both clinicians discussed proactive distress screening at regular intervals, which Sedhom said can reveal concerns patients may not otherwise raise. They also highlighted the prognostic uncertainty and anticipatory distress faced by patients living for years with EGFR-mutated lung cancer on oral targeted therapy such as osimertinib (Tagrisso), as well as the confusion that can follow a “good prognosis” diagnosis.
The conversation also covered lessons psychiatry can offer oncologists, including reframing difficult patient behavior, loosening control of the visit agenda, building rapport before having honest conversations, and accepting ambiguity to help prevent burnout. The two closed by considering whether a broad supportive care umbrella could unite palliative care, psychiatry, psychology, and other disciplines, with McFarland urging clinicians to set aside silos and professional egos for the benefit of patients.
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 ONCOLOGY®. co-lead of Geriatric Oncology at Penn Cancer Service Line; clinical director of Medical Oncology at Penn Medicine Princeton Health; associate director of Penn Center for Cancer Care Innovation; co-lead of Psychosocial Oncology Services at Penn Medicine Princeton Health; division chief in the Palliative Care Division of Medical Oncology; and a clinical associate professor of medicine (Hematology-Oncology).