DrWarrenSwegal

I treat patients with head and neck cancer, salivary gland disease, thyroid disease, sleep apnea, and head and neck tumors.

[DrWarrenSwegal @DrWarrenSwegal]

Just finished at #AHNS2023 with the Head and Neck team. Great job everyone from #AHN

[DrWarrenSwegal @DrWarrenSwegal]

Wanted to confirm that Allegheny General Hospital Otolaryngology residency program matched our 2nd resident! We’re all excited to see who it is. #AHN #otomatch

[DrWarrenSwegal @DrWarrenSwegal]

Congrats to all of those who matched today!

[DrWarrenSwegal @DrWarrenSwegal]

At the Kick-Out-Cancer event with @RiverhoundsSC and @AHNtoday. Go Hounds!

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc It sounds a little cliché but, Cancer care is a team sport and a well-run multidisciplinary team is crucial to providing the best possible outcomes for our patients

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc For those who don’t regularly treated advance thyroid malignancies, I strongly advise referral to centers who do. We know that high volume care, whether it be surgical, radiation based, or medical provides for better care overall.

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc For those providers who regularly treat advance thyroid cancer, attendance at national meetings and staying up to date and involved in clinical trials is key to being able to provide your patients with the most cutting edge options.

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc @AHNtoday The personalized medicine aspect of treatment. With next generation sequencing and targeted therapy, options increase for patients. And with more knowledge we will be able to better tailor treatments to individual patients

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc @AHNtoday The role of systemic therapy in general is still an area that needs further exploration, especially how it is relates to and might be used in combination with other treatment modalities like surgery and radiation

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc Patients’ quality of life should not be sacrifice in the pursuit of disease resolution and these issues can often be overlooked by the primary treatment team who may be focused on the malignancy

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc Anyone with advanced cancer should be referred to other supportive services as well which include Psych Onc and Onc Rehab along as well as pain management services if needed.

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc It’s the combination of both. Overall lower toxicities and improved efficacy compared with traditional chemotherapy and similar results to other systemic options overall.

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc Its encouraging to say the least. Its not a magic bullet but adds to the arsenal of treatment options. The results from LIBRETTO-001 trial tell us that it may be used in patients with RET mutations before trying other targeted treatments

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc Sequence provides patients with more options up front. If you have a targetable RET mutation, then you can consider a wide range of systemic treatment options initially. If there is a RET mutation, you may start with selpercatinib and save the others if needed

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc @AHNtoday If there is a concern for persistent or distant disease than yes, I would order molecular analysis and sequence on the patient’s tumor.

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc @AHNtoday If there was evidence of locally aggressive disease where surgical morbidity would be extensive, then you could consider up from systemic therapy. But in the absence of this, it is important to remove the primary bulky disease

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc @AHNtoday I would not recommend systemic therapy first. Based on the case information, the disease appears limited to the neck and the concern for surgical morbidity is low with the information presented.

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc There is a lot of info presented and some missing in that discussion. I agree with the general approach to treatment though.

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc I would agree with Selpercatinib. It’s a good first choice for patients with RET mutations

[DrWarrenSwegal @DrWarrenSwegal]

@TargetedOnc @AHNtoday Thanks. Happy to be here