Oncologic Emergency Medicine

Knox H. Todd • Charles R. Thomas, Jr. Kumar AlagappanEditors

Oncologic Emergency Medicine

Principles and Practice

Second Edition

EditorsKnox H. ToddFormer Professor and Founding Chair (Retired)The University of Texas MD Anderson Cancer CenterHouston, TX USA

Kumar AlagappanProfessor and ChairDepartment of Emergency MedicineThe University of Texas MD Anderson Cancer CenterHouston, TX USA

Charles R. Thomas, Jr.Professor and ChairDepartment of Radiation MedicineKnight Cancer InstituteOregon Health & Science UniversityPortland, OR USA

ISBN 978-3-030-67122-8 ISBN 978-3-030-67123-5 (eBook)https://doi.org/10.1007/978-3-030-67123-5

© Springer Nature Switzerland AG 2021, corrected publication 2021This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed.The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This Springer imprint is published by the registered company Springer Nature Switzerland AGThe registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

This book is dedicated to my wife, Courtenay Carmody, and my two sons, Samuel and Benjamin, whose love and support bring great joy to my life and purpose to my work.In memory of my mother, Mary Kate Todd, who left us much too early.

–Knox H. Todd

To my supportive wife, Muriel Elleen; our wonderful two children, Julian Franklin and Aurielle Marie; our parents; and siblings for their love and support of my career path.In memory of my mother, Ruth Marie Wilson Thomas, who fought gallantly in the war against cancer and whose prayers have blessed me over the past five decades.

–Charles R. Thomas Jr.

This book is dedicated to my wife, Bridget Shields, and my two daughters, Lakshmi and Jyothi.In memory of my father, Alagappa Alagappan PhD, an international civil servant who traveled to 95 countries. He always felt that learning was a treasure that would follow its owner everywhere.

–Kumar Alagappan

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This second edition of Oncologic Emergency Medicine: Principles and Practice has broad-ened the scope of emergency care for the oncological patient and rightfully so. More patients are living with cancer than ever before. Many cancer diagnoses are associated with greatly extended lifespans. With greater lifespan, cancer survivors are also at risk of acquiring compli-cations from their past medical, radiation, or surgical care, in addition to an underlying cancer.

Today’s patient living with a current or prior cancer diagnosis lives within a network of health care providers. The emergency physician and the oncologist must understand not only the underlying pathophysiology of the disease and its treatment, but also appreciate how patients present in distress and how care is optimized to meet the needs of the patient. Indeed, while using best practice options, the team of health care providers personalizes each patient’s treatment, stabilization, and recovery to optimize outcomes, seeking to match the expectations of the patient and family.

In this edition, cancer prevention approaches are discussed. Emergency physicians must be comfortable with cancer prevention approaches to minimize future risk for those living with cancer. As in the first edition, the text provides cutting-edge information related to specific oncologic conditions which may present in the emergency department. At times these condi-tions may be the initial presentation of the cancer. Other times these conditions may represent complications of therapy, disease progression, and/or secondary infection. Many of these con-ditions require a time-dependent response to minimize additional morbidity or mortality. This text provides unique information (including discussion of new immunologic therapies) that may be covered only superficially by other books or articles in the field.

The palliative aspects of cancer care are also covered. The learning points covered in these chapters are especially cogent in today’s changed world of opioid dependence and COVID-19. Guidance is provided regarding the management of pain, communication about the diagnosis/progression of cancer, and discussions regarding hospice and other related factors. These rep-resent key components of doctoring which require great skill and understanding of the patient, as well as the disease.

This edition also seeks to extend our understanding of health disparities and vulnerable populations, international approaches to oncological emergencies, and other topics on the cutting- edge cancer research, treatment, and management. The editors are to be congratulated for extending their earlier work and both recognizing and anticipating the needs of care provid-ers in oncologic emergency medicine. They have provided a powerful tool to enhance the care provided to cancer patients.

Jerris R. Hedges, MD, MS, MMMProfessor & Dean, Barry & Virginia Weinman – Endowed Chair

John A. Burns School of Medicine, University of Hawaii – Manoa Former Interim Director, University of Hawaii Cancer Center

Honolulu, HI, USA

Foreword

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It is with renewed excitement that we present the second edition of Oncologic Emergency Medicine: Principles and Practice, the major comprehensive textbook in this emerging field. Against the backdrop of rising numbers of cancer patients and survivors as the US population ages, and of a forecast shortage of cancer care providers, this book is designed to serve as the most authoritative, single-source clinical reference on oncologic emergencies. This compre-hensive text was specifically designed to address the complexities of understanding and man-aging cancer emergencies, with an emphasis on increasing communication and collaboration between emergency physicians and the multiple providers who participate in caring for those with cancer.

The expanded cadre of contributors to the second edition includes a broad spectrum of experts in emergency medicine and nursing, surgical and medical oncology, hematology, diag-nostic and interventional radiology, palliative care, psychiatry, critical care, dermatology, oph-thalmology, clinical pharmacy, addiction psychology, social work, and health services research.

Emergency departments account for approximately one-half of all hospital admissions, and this proportion is even greater for those with cancer. While the largest portion of the book focuses on a number of clinical oncologic emergencies and their varied presentations to the emergency department, this text offers the opportunity to address more broadly and systemati-cally the vantage point of emergency physicians who work in a critical hub of patient care: the emergency department. Emergency department visits resulting from disease progression as well as toxicities of anticancer treatments serve as an important patient-oriented metric of cancer care quality. This text emphasizes the critical importance of emergency department care within a comprehensive cancer treatment system. The principles of care will be similar whether the emergency department is in a dedicated clinical cancer care facility or a matrix care struc-ture. The methods of executing best practices may differ based on the structure of the cancer care system; however, the vast majority of emergency care for those with cancer is similar across emergency department settings, whether in academic, community, or hybrid practice. The text is structured to cover multiple fundamental areas of emergency care:

Part I is centered on systems issues in oncologic emergency medicine. We discuss the epi-demiology of oncologic emergencies, existing models of emergency department care, infor-matics, the evolving role of quality measures, patient navigation, and the importance of emergency nursing and social work.

Part II considers the role of emergency medicine in primary and secondary cancer preven-tion, including smoking cessation, alcohol exposure, ionizing radiation and cervical cancer prevention and detection, as well as screening for lung cancer, colorectal cancer, and melanoma.

Part III will seem perhaps the most familiar to readers and includes a discussion of the evaluation and treatment of a variety of oncologic emergencies, organized by organ systems. This section also covers specific conditions common to many cancer types, including febrile neutropenia, thrombosis, and bleeding.

Part IV examines important issues related to treatment toxicity, including chemotoxicity, radiotoxicity, and post-surgical complications, as well as transplant-related issues and toxici-ties of novel antineoplastic agents such as checkpoint inhibitors and CAR T-cell therapy.

Preface

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Part V addresses palliative care issues pertinent to the intersection of emergency medicine and oncology. This section discusses end-of-life care, including the role of palliative surgery, the management of symptoms in those with advanced cancer, approaches to opioid analgesic use (and misuse), and the significance of emergency department use at the end of life.

Part VI deals with contextual issues critical to the subdiscipline of oncologic emergency medicine. It incorporates a chapter on the challenges to emergency medicine and oncology posed by COVID-19 and considerations of ethics, health disparities, and ongoing efforts to advance research and education. Finally, we conclude with a chapter by physicians regarding their personal experiences with cancer.

An added feature to this edition are board review questions accompanied by brief and con-cise explanations of the answers.

The editors and associate editors are extremely proud of this second edition of Oncologic Emergency Medicine: Principles and Practice and we wish to thank all of the contributors who have given their time, insight, and experience to create a truly unique text that will serve as a valuable resource for practitioners, researchers, policy makers, trainees, payors, and adminis-trators, as we care for those with urgent cancer needs. We would like to give a special acknowl-edgment to Ms. Katherine Kreilkamp of Springer for her efficient and diligent role in textbook development. We are deeply indebted to her and to Springer for their support.

Mendoza, Argentina Knox H. ToddPortland, OR, USA Charles R. Thomas Jr.Houston, TX, USA Kumar Alagappan

Preface

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Volume I

Part I Systems

1 Epidemiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Rebecca S. Lash, Janice F. Bell, and Sarah C. Reed

2 Models of Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13Michael G. Purcell

3 Informatics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23James P. Killeen, Christian J. Dameff, Jeremy S. Bass, Brian Khan, Ammar Mandvi, and Nathan Yung

4 Quality Measures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37Tracy E. Spinks and Michael G. Purcell

5 Patient Navigation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75David C. Seaberg and Donald Norris II

6 Nursing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83Petra Grami, Sorayah S. Bourenane, Danielle Milling, Karen McFarland, Robert T. Drew, and Linda Koppy

7 Palliative Social Work . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109Robin Rudy Lawson and Alison Snow

Part II Prevention

8 Tobacco Control . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121Steven L. Bernstein

9 Problem Drinking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 129Edouard Coupet Jr. and Federico E. Vaca

10 Ionizing Radiation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 139Richard T. Griffey

11 Cervical Cancer Screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151Natacha Phoolcharoen, Ellen S. Baker, and Mila Pontremoli Salcedo

12 Lung Cancer Screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161Marcelo Sandoval

13 Colorectal Cancer Screening . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 179Veronica Sikka, Raaj K. Popli, and Edward P. Cutolo Jr.

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14 Melanoma Screening. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 185Wei-Lynn Chong, Thomas M. Pitney, and Michael Sinnott

Part III Evaluation and Treatment

15 Acute Airway Obstruction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197Christopher H. Chang and Lakshmi Mudambi

16 Central Nervous System . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207Prashant Rai, Akhil Shivaprasad, Ivo W. Tremont-Lukats, and Sudhakar Tummala

17 Pituitary Apoplexy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225Daria Krivosheya and Ian E. McCutcheon

18 Spinal Cord Compression . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 237Jayne M. Viets-Upchurch and Sorayah S. Bourenane

19 Head and Neck . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247Ray Y. Wang, Eugene L. Son, Clifton D. Fuller, and Neil D. Gross

20 Ophthalmic Emergencies in Cancer Patients . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259Diana Chao, Mathieu F. Bakhoum, and Bita Esmaeli

21 Cardiovascular Oncologic Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 269Tarek Nafee, Dany Debs, Maria Isabel Camara Planek, Allison Zimmerman, Tawanna Charlton, Michelle Dimza, Alexandra Murphy, Stephen Dobbin, Ninian N. Lang, Sara Tyebally, Tarek Barbar, Syed S. Mahmood, Evelyn Horn, Umberto Campia, Arjun K. Ghosh, Ki Park, Michael G. Fradley, Rhian M. Touyz, Tochukwu M. Okwuosa, and Sherry-Ann Brown

22 Superior Vena Cava Syndrome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291Thomas C. Williamson, David E. Manthey, and Leslie R. Ellis

23 Pulmonary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 303Nagendra Y. Madisi and Wissam Abouzgheib

24 Venous Thromboembolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 317Nicholas R. Pettit and Jeffrey A. Kline

25 Gastroenterology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 327Jessica X. Yu, Jennifer L. Maranki, Gene Bakis, and Brintha K. Enestvedt

26 The Acute Abdomen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341Linda Ferrari and Alessandro Fichera

27 Diarrhea . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 357Sai-Ching Jim Yeung

28 Constipation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 367Demis N. Lipe

29 Endocrinology and Metabolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 377Sai-Ching Jim Yeung

30 Nephrology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 397Amit Lahoti

31 Urology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 407Shawn Dason, Cheryl T. Lee, and Ahmad Shabsigh

32 Gynecology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 425Loise W. Wairiri, Tatjana Bozanovic, Tanja Pejovic, and Jenna M. Kahn

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33 Orthopedics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 437Robert C. Weinschenk and Patrick P. Lin

34 Dermatology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 451Joanna Harp and Alina Markova

35 Pediatrics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 471Kathleen M. Stephanos and Lindsey Picard

36 Hyperleukocytosis and Leukostasis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 481Sharleen Yuan, Samantha J. Yarmis, and Kami M. Hu

37 Bleeding and Thrombosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 491Thomas G. DeLoughery

38 Infectious Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 501Nathanial S. Nolan, Michael J. Kim, and Stephen Y. Liang

39 Febrile Neutropenia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 513Christopher J. Coyne and Rahul V. Nene

40 Neutropenic Enterocolitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 521Steven McGaughey and Robert L. Cloutier

41 Sickle Cell Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 529Harsh P. Sule, Novneet N. Sahu, and Bernard L. Lopez

42 Radiological and Nuclear Terrorism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 543Carol J. Iddins, Jason E. Davis, Ronald E. Goans, and Cullen Case Jr.

43 Delirium . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 555Zahra Alhajji and Ahmed Elsayem

44 Suicide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 565Anis Rashid

45 Substance Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 573Adam Rzetelny, Tatiana Starr Kreitzer, Maria A. Farberov, and Steven D. Passik

46 Radiology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 589Jihoon Lim, Keith D. Herr, and Tarek N. Hanna

47 Ultrasound . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 611Sherwin Soltani, Konrad Karasek, Lamees M. Alshaikh, Ideen Zeinali, and Jennifer Carnell

Volume II

Part IV Toxicities

48 Chemotherapy Toxicities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 637Katy M. Toale, Tami N. Johnson, Maggie Q. Ma, and Ngoc H. Vu

49 Treatment Toxicity: Radiation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 663Thomas J. FitzGerald, Maryann Bishop-Jodoin, Fran Laurie, Eric C. Ko, Allison Sacher, Gregory A. Volturo, Daniel C. Han, Paul S. Rava, and Eric W. Dickson

50 Mucositis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 679Jennifer A. Novak and Arya Amini

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51 Stoma Complications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 691Patricia A. Brock and Kumar Alagappan

52 Hematopoietic Cell Transplant . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 699Sherilyn A. Tuazon, Victor A. Chow, Phuong T. Vo, and Masumi Ueda

53 Toxicities of Novel Antineoplastic Therapies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 711Eva Rajha and Sai-Ching Jim Yeung

54 Fluorouracil or Capecitabine Overdose . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 739Natalie R. Neumann and Christopher O. Hoyte

Part V Palliative Care

55 Emergency Department Use at End of Life . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 753Hsien Seow and Kayla McMillan

56 Pain Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 765Danielle M. McCarthy and Laurie M. Aluce

57 Dyspnea in the Dying Patient . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 777Ashley Shreves

58 Cardiopulmonary Resuscitation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 789Mohammad Adrian Hasdianda and Kei Ouchi

59 Palliative Surgery . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 797Caitlin Hodge and Brian Badgwell

60 Palliative Care . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 809Sangeeta Lamba and Rebecca Goett

61 Hospice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 821Bonnie K. Marr and Danielle J. Doberman

62 Communication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 831Bonnie K. Marr, Kate Aberger, and Rebecca Goett

63 Palliative Care Research . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 843Paul L. DeSandre and Gretchen E. Bell

Part VI Contextual

64 Ethics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 865Kenneth V. Iserson

65 Health Disparities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 881Marcia A. Perry and Joel Moll

66 Emergency Oncology in the United Kingdom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 887Tim Cooksley

67 Cancer Pain Management in Low- Resource Settings . . . . . . . . . . . . . . . . . . . . . . . 891Shiraz Yazdani and Salahadin Abdi

68 Curriculum Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 903Angela B. Creditt and Kevin Sing

69 National and Institutional Research Efforts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 915Cielito Reyes-Gibby and Jenny L. Ren

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70 COVID-19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 935Knox H. Todd

71 The Physician and Cancer: In Their Own Words . . . . . . . . . . . . . . . . . . . . . . . . . . 951Marshall T. Morgan, Patrick J. Crocker, Burton F. Dickey, Sherry-Ann Brown, and Knox H. Todd

Correction to: Endocrinology and Metabolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .C1Sai-Ching Jim Yeung

Multiple-Choice Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 959

Answers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 985

Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1003

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Knox H. Todd, MD, MPH (Retired) Department of Emergency Medicine, MD Anderson Cancer Center, Houston, TX, USA

Charles R. Thomas Jr., MD Department of Radiation Medicine, Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA

Kumar Alagappan, MD Department of Emergency Medicine, MD Anderson Cancer Center, Houston, TX, USA

Associate Editors

Patricia A. Brock, MD Department of Emergency Medicine, MD Anderson Cancer Center, Houston, TX, USA

Christopher  J.  Coyne, MD, MPH Department of Emergency Medicine, Department of Radiation Medicine and Applied Sciences, University of California, San Diego, San Diego, CA, USA

Sarah  B.  Dubbs, MD Department of Emergency Medicine, University of Maryland, Baltimore, MD, USA

Sai-Ching Jim Yeung, MD, PhD Department of Emergency Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Contributors

Salahadin  Abdi, MD, PhD Department of Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Kate  Aberger, MD Division of Palliative and Geriatric Medicine, Department of Internal Medicine, St. Joseph’s Health, Paterson, NJ, USA

Wissam Abouzgheib, MD Division of Pulmonary and Critical Care, Department of Medicine, Cooper Medical School at Rowan University, Camden, NJ, USA

Zahra Alhajji, MBBS, MD Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Lamees M. Alshaikh, MBBS, MPH Department of Emergency Medicine, Ben Taub General Hospital, Baylor College of Medicine, Houston, TX, USA

Laurie  M.  Aluce, MD Department of Emergency Medicine, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

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Arya Amini, MD Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, USA

Brian  Badgwell, MD, MS Department of Surgical Oncology, Division of Surgery, MD Anderson Cancer Center, Houston, TX, USA

Ellen S. Baker, MD, MPH Department of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Mathieu F. Bakhoum, MD, PhD Department of Ophthalmology, University of California, San Diego, La Jolla, CA, USA

Ophthalmic Plastic and Orbital Surgery, Department of Plastic Surgery, MD Anderson Cancer Center, Houston, TX, USA

Gene Bakis, MD Division of Gastroenterology and Hepatology, Department of Medicine, Oregon Health and Science University, Portland, OR, USA

Tarek  Barbar, MD Division of Cardiology, Department of Internal Medicine, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA

Jeremy S. Bass, MD, MEE Department of Psychiatry, Clinical Informatics, University of California San Diego, San Diego, CA, USA

Gretchen E. Bell, MD Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, GA, USA

Janice F. Bell, MN, MPH, PhD Betty Irene Moore School of Nursing, University of California at Davis, Davis, CA, USA

Steven L. Bernstein, MD Department of Emergency Medicine, Yale New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA

Maryann  Bishop-Jodoin, MEd Department of Radiation Oncology, University of Massachusetts Medical School, Worcester, MA, USA

Sorayah S. Bourenane, MSN, RN, CEN, CNL Emergency Department & Clinical Decision Unit, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Tatjana  Bozanovic, MD, PhD Clinic for Gynecology and Obstetrics, Clinical Centre of Serbia, University of Belgrade, Belgrade, Serbia

Sherry-Ann  Brown, MD, PhD Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

Umberto Campia, MD, MS Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

Jennifer  Carnell, MD Department of Emergency Medicine, Ben Taub General Hospital, Baylor College of Medicine, Houston, TX, USA

Cullen  Case Jr., EMPA Radiation Injury Treatment Network, National Marrow Donor Program, Minneapolis, MN, USA

Christopher H. Chang, MD Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health and Science University, Portland, OR, USA

Diana Chao, MD Intelligent Eye Care, Arcadia, CA, USA

Ophthalmic Plastic and Orbital Surgery, Department of Plastic Surgery, MD Anderson Cancer Center, Houston, TX, USA

Tawanna  Charlton, MS Department of Medicine, Cardiology, College of Medicine, University of Florida, Gainesville, FL, USA

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Wei-Lynn Chong, MBBS Emergency Department, Princess Alexandra Hospital, Brisbane, QLD, Australia

Victor A. Chow, MD Division of Medical Oncology, University of Washington School of Medicine, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

Robert L. Cloutier, MD, MCR Pediatric Emergency Medicine, Department of Emergency Medicine, Office of Admissions, School of Medicine, Oregon Health & Science University, Portland, OR, USA

Tim Cooksley, MBChB (Hons), FRCPE Department of Acute Medicine, The Christie NHS Foundation Trust, Manchester, Lancashire, UK

Edouard  Coupet Jr., MD, MS Department of Emergency Medicine, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, USA

Angela  B.  Creditt, DO Department of Emergency Medicine, Virginia Commonwealth University Medical Center (VCU Health), Richmond, VA, USA

Patrick J. Crocker, DO, MS Department of Emergency Medicine, Dell Children’s Medical Center, Austin, TX, USA

Department of Emergency Medicine, Brackenridge Hospital, Austin, TX, USA

Edward P. Cutolo Jr., MD Veterans Integrated Service Network 8 (VISN 8), St. Petersburg, FL, USA

Christian  J.  Dameff, MD, MS Department of Emergency Medicine, Department of Biomedical Informatics, University of California San Diego, San Diego, CA, USA

Shawn Dason, MD Department of Urology, The Ohio State University, Columbus, OH, USA

Jason E. Davis, PhD Oak Ridge Associated Universities, Radiation Emergency Assistance Center/Training Site, Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA

Dany Debs, MD Roger Williams Medical Center, Department of Medicine, Boston University School of Medicine, Providence, RI, USA

Thomas G. DeLoughery, MD Division of Hematology/Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, OR, USA

Paul L. DeSandre, DO Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA

Burton F. Dickey, MD Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Eric  W.  Dickson, MD, MHCM Department of Emergency Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, USA

Michelle  Dimza, DO Division of General Internal Medicine, Department of Medicine, Cardiology, University of Florida, Gainesville, FL, USA

Stephen  Dobbin, MBChB, MRCP Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, UK

Danielle J. Doberman, MD, MPH, HMDC Section of Palliative Medicine, Department of Emergency Medicine, Johns Hopkins Hospital, Johns Hopkins University, Baltimore, MD, USA

Robert T. Drew, MBA, MSN, RN, CEN, CCRN, NE-BC Emergency Department & Clinical Decision Unit, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

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Leslie  R.  Ellis, MD, MSHPEd Division of Hematology and Oncology, Department of Internal Medicine, Comprehensive Cancer Center, Wake Forest Baptist Health, Winston- Salem, NC, USA

Ahmed Elsayem, MD Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Brintha K. Enestvedt, MD, MBA Division of Gastroenterology and Hepatology, Department of Medicine, Oregon Health and Science University, Portland, OR, USA

Bita Esmaeli, MD Ophthalmic Plastic and Orbital Surgery, Department of Plastic Surgery, MD Anderson Cancer Center, Houston, TX, USA

Maria A. Farberov, MPA Clinical Research Education, Department of Medicine, Northwell Health, Staten Island University Hospital, Staten Island, NY, USA

Linda Ferrari, MD Colorectal Department, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK

Alessandro  Fichera, MD Division of Colon and Rectal Surgery, Department of Surgery, Baylor University Medical Center, Dallas, TX, USA

Thomas J. FitzGerald, MD Department of Radiation Oncology, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, USA

Michael  G.  Fradley, MD Division of Cardiovascular Medicine, Department of Medicine, Perelman Center for Advanced Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA

Clifton D. Fuller, MD, PhD Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Arjun K. Ghosh, MBBS, MRCP, MSc, PhD Barts Heart Centre, Barts NHS Health Trust, Department of Cardiology, St. Bartholomew’s Hospital, London, England, UK

Ronald E. Goans, PhD, MD, MPH MJW Corporation, Clinton, TN, USA

Rebecca  Goett, MD Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA

Petra Grami, DNP, RN, CCRN, NE-BC, CVRN Critical Care, Clinical Decision Unit and Acute Dialysis, Nursing Administration, MD Anderson Cancer Center, Houston, TX, USA

Richard  T.  Griffey, MD, MPH Department of Emergency Medicine, Department of Medicine, Barnes Jewish Hospital/Washington University School of Medicine, St. Louis, MO, USA

Neil  D.  Gross, MD Division of Surgery, Department of Head and Neck Surgery, The University of MD Anderson Cancer Center, Houston, TX, USA

Daniel  C.  Han, MD Department of Radiation Oncology, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, USA

Tarek N. Hanna, MD Department of Radiology and Imaging Sciences and Department of Emergency Medicine, Emory University, Atlanta, GA, USA

Joanna Harp, MD Department of Dermatology, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY, USA

Mohammad  Adrian  Hasdianda, MD, MSc, MMS Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USA

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Keith  D.  Herr, MD Department of Radiology and Imaging Sciences and Department of Emergency Medicine, Emory University, Atlanta, GA, USA

Caitlin  Hodge, MD, MPH Department of Surgery, Abington Hospital-Jefferson Health, Abington, PA, USA

Evelyn Horn, MD Department of Medicine, Cardiology Division, Perkin Center for Heart Failure, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA

Christopher O. Hoyte, MD Rocky Mountain Poison and Drug Safety, Denver Health and Hospital Authority, Denver, CO, USA

Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA

Kami M. Hu, MD Department of Emergency Medicine, Department of Internal Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

Carol  J.  Iddins, MD Radiation Emergency Assistance Center/Training Site, Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA

Kenneth V. Iserson, MD, MBA Department of Emergency Medicine, University of Arizona, Tucson, AZ, USA

Tami  N.  Johnson, PharmD, BCPS, FCCM Department of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Jenna  M.  Kahn, MD Department of Radiation Medicine, Oregon Health & Science University, Portland, OR, USA

Konrad  Karasek, MD Department of Emergency Medicine, Ben Taub General Hospital, Baylor College of Medicine, Houston, TX, USA

Brian  Khan, MD, MBA Department of Medicine, Clinical Informatics, University of California San Diego, San Diego, CA, USA

James  P.  Killeen, MD Department of Emergency Medicine, Department of Biomedical Informatics, University of California San Diego, San Diego, CA, USA

Michael  J.  Kim, MD Division of Emergency Medicine, Department of Medicine, Barnes Jewish Hospital/Washington University School of Medicine, St. Louis, MO, USA

Jeffrey  A.  Kline, MD Department of Emergency Medicine, Eskenazi and Methodist Hospitals, Indiana University School of Medicine, Indianapolis, IN, USA

Eric C. Ko, MD, PhD Department of Radiation Oncology, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, USA

Linda Koppy, BSN, BBA Emergency Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Tatiana Starr Kreitzer, MA University of South Florida College of Nursing, Tampa, FL, USA

Daria  Krivosheya, MD Department of Neurological Surgery, Cleveland Clinic Lerner College of Medicine, Akron, OH, USA

Amit Lahoti, MD Department of Nephrology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Sangeeta Lamba, MD Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA

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Ninian N. Lang, BSc (Hons) MBChB, PhD, FRCP Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, UK

Rebecca S. Lash, PhD, MPP, RN School of Nursing, Indiana University, Fort Wayne, IN, USA

Fran Laurie, BS Department of Radiation Oncology, University of Massachusetts Medical School, Worcester, MA, USA

Robin Rudy Lawson, LMSW Empath Health, Suncoast Hospice, St. Petersburg, FL, USA

Cheryl T. Lee, MD Department of Urology, The Ohio State University, Columbus, OH, USA

Stephen Y. Liang, MD, MPHS Divisions of Emergency Medicine and Infectious Diseases, Department of Medicine, Washington University School of Medicine, St. Louis, MO, USA

Jihoon  Lim, MD Department of Radiology and Imaging Sciences and Department of Emergency Medicine, Emory University, Atlanta, GA, USA

Patrick  P.  Lin, MD Department of Orthopedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Demis N. Lipe, MD Department of Emergency Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Bernard L. Lopez, MD, MS Department of Emergency Medicine, Sidney Kimmel Medical College, Thomas Jefferson University & Hospitals, Philadelphia, PA, USA

Maggie  Q.  Ma, PharmD, BCPS Department of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Nagendra Y. Madisi, MD Division of Pulmonary and Critical Care, Department of Medicine, Cooper Medical School at Rowan University, Camden, NJ, USA

Syed S. Mahmood, MD, MPH Division of Cardiology, Department of Internal Medicine, New York-Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA

Ammar Mandvi, MD Department of Family Medicine, Clinical Informatics, University of California San Diego, San Diego, CA, USA

David E. Manthey, MD Department of Emergency Medicine, Wake Forest Baptist Health, Winston-Salem, NC, USA

Jennifer L. Maranki, MD, MSc Division of Gastroenterology and Hepatology, Department of Medicine, Penn State Hershey Medical Center, Penn State College of Medicine, Hershey, PA, USA

Alina Markova, MD Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

Bonnie K. Marr, MD Section of Palliative Medicine, Johns Hopkins Hospital, Baltimore, MD, USA

Danielle  M.  McCarthy, MD, MS Department of Emergency Medicine, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA

Ian  E.  McCutcheon, MD Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Karen McFarland, MSN, BSN, VA-BC Emergency Department & Clinical Decision Unit, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

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Steven  McGaughey, MD Department of Emergency Medicine, Oregon Health & Science University, Portland, OR, USA

Kayla McMillan, BPH Department of Oncology, Juravinski Cancer Centre, Hamilton, ON, Canada

Danielle Milling, MSN, RN, CPN, CNL Emergency Center and Clinical Decision Unit, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Joel  Moll, MD Department of Emergency Medicine, Virginia Commonwealth University, Richmond, VA, USA

Marshall  T.  Morgan, MD Division of Emergency Medicine, Department of Medicine, UCLA Medical Center, Los Angeles, CA, USA

Lakshmi Mudambi, MBBS Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health and Science University, Portland, OR, USA

Division of Pulmonary and Critical Care, VA Portland Health Care System, Portland, OR, USA

Alexandra Murphy, MBBS Department of Cardiology, Austin Health & The University of Melbourne, Melbourne, VIC, Australia

Tarek Nafee, MD, MMSc Roger Williams Medical Center, Department of Medicine, Boston University School of Medicine, Providence, RI, USA

Rahul V. Nene, MD, PhD Department of Emergency Medicine, University of California, San Diego, San Diego, CA, USA

Natalie R. Neumann, MD Department of Emergency Medicine, Yale University School of Medicine, New Haven, CT, USA

Nathanial S. Nolan, MD, MPH Division of Infectious Disease, Department of Medicine, Barnes Jewish Hospital/Washington University School of Medicine, St. Louis, MO, USA

Donald Norris II, MD Department of Emergency Medicine, Summa Health, Akron, OH, USA

Department of Emergency Medicine, Northeast Ohio Medical University, Rootstown, OH, USA

Jennifer  A.  Novak, MD, MS Department of Radiation Oncology, City of Hope National Medical Center, Duarte, CA, USA

Tochukwu  M.  Okwuosa, DO Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA

Kei Ouchi, MD, MPH Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, USA

Ki Park, MD, MS UF Women’s Cardiovascular Health Sciences, Malcom Randall VAMC, Division of Cardiovascular Medicine, Department of Medicine, Cardiology, University of Florida, Gainesville, FL, USA

Steven  D.  Passik, PhD Scientific Affairs, Research and Development, Collegium Pharmaceutical, Stoughton, MA, USA

Tanja  Pejovic, MD, PhD Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA

Marcia A. Perry, MD Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA

Nicholas  R.  Pettit, DO, PhD Department of Emergency Medicine, Eskenazi Hospital, Indiana University School of Medicine, Indianapolis, IN, USA

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Natacha  Phoolcharoen, MD Department of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Department of Obstetrics and Gynecology, King Chulalongkorn Memorial Hospital, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand

Lindsey  Picard, MD Department of Emergency Medicine, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, NY, USA

Thomas  M.  Pitney, MBBS Department of Dermatology, The Mater Public Hospital, Brisbane, QLD, Australia

Maria  Isabel  Camara  Planek, MD Department of Medicine, Rush University Medical Center, Chicago, IL, USA

Raaj K. Popli, MD Department of Internal Medicine, University of Central Florida College of Medicine, Orlando, FL, USA

Michael G. Purcell, MD Department of Emergency Medicine, Ohio State University Wexner Medical Center, Columbus, OH, USA

Prashant  Rai, MBBS Department of Neurology, University of Texas Medical Branch, Galveston, TX, USA

Eva Rajha, MD Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA

Anis Rashid, MD Department of Psychiatry, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Paul S. Rava, MD, PhD Department of Radiation Oncology, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, USA

Sarah  C.  Reed, PhD, MPH, MSW Division of Social Work, California State University, Sacramento, CA, USA

Jenny L. Ren, BS, BA Department of Emergency Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Cielito  Reyes-Gibby, DrPH Department of Emergency Medicine, Division of Internal Medicine, Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Adam Rzetelny, PhD Department of Medical Affairs, Collegium Pharmaceuticals, Stoughton, MA, USA

Allison  Sacher, MD Department of Radiation Oncology, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, USA

Novneet  N.  Sahu, MD, MPA Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA

Mila Pontremoli Salcedo, MD, PhD Department of Gynecologic Oncology & Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

The Obstetrics and Gynecology Department, Federal University of Health Sciences of Porto Alegre (UFCSPA)/Santa Casa de Misericordia Hospital of Porto Alegre, Porto Alegre, Brazil

Marcelo Sandoval, MD Department of Emergency Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

David C. Seaberg, MD Department of Emergency Medicine, Summa Health, Akron, OH, USA

Department of Emergency Medicine, Northeast Ohio Medical University, Rootstown, OH, USA

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Hsien Seow, PhD Department of Oncology, McMaster University, Hamilton, ON, Canada

Ahmad Shabsigh, MD Department of Urology, The Ohio State University, Columbus, OH, USA

Akhil  Shivaprasad, BE, MBBS Stanley H.  Appel Department of Neurology, Houston Methodist Hospital, Houston, TX, USA

Ashley Shreves, MD Palliative Medicine & Supportive Care, Emergency Medicine, Ochsner Medical Center, New Orleans, LA, USA

Veronica Sikka, MD, PhD, MHA, MPH Clinical Contact Center, VA Sunshine Healthcare Network (VISN 8), St. Petersburg, FL, USA

Associate Professor of Emergency Medicine, School of Medicine, University of Central Florida, Orlando, FL, USA

Kevin  Sing, MD Division of Hematology, Oncology, and Palliative Care, Department of Medicine, Virginia Commonwealth University Medical Center (VCU Health), Richmond, VA, USA

Michael Sinnott, MBBS, FACEM, FRACP The University of Queensland Medical School, Brisbane, QLD, Australia

Alison Snow, PhD, LCSW-R, OSW-C Cancer Supportive Services, Cancer Center, Mount Sinai Beth Israel, New York, NY, USA

Sherwin  Soltani, MD Department of Emergency Medicine, Ben Taub General Hospital, Baylor College of Medicine, Houston, TX, USA

Eugene L. Son, MD Department of Head & Neck Surgery, Kaiser Permanente, Fontana, CA, USA

Tracy  E.  Spinks, BBA Medical Clinical Operations, Oncology Value Creation Team, UnitedHealthcare, Sugarland, TX, USA

Kathleen  M.  Stephanos, MD Department of Emergency Medicine, Strong Memorial Hospital, University of Rochester Medical Center, Rochester, NY, USA

Harsh P. Sule, MD, MPP Department of Emergency Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA

Katy  M.  Toale, PharmD, BCPS Department of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Rhian  M.  Touyz, MBBCh, PhD Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, Scotland, UK

Ivo W. Tremont-Lukats, MD Kenneth R. Peak Brain and Pituitary Tumor Center, Department of Neurosurgery, Houston Methodist Hospital, Houston, TX, USA

Sherilyn  A.  Tuazon, MD, MS Division of Medical Oncology, University of Washington School of Medicine, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

Sudhakar  Tummala, MD Department of Neuro-Oncology, MD Anderson Cancer Center, Houston, TX, USA

Sara  Tyebally, MBBS, BSc Barts Heart Centre, Barts NHS Health Trust, Department of Cardiology, St. Bartholomew’s Hospital, London, England, UK

Masumi  Ueda, MD Division of Medical Oncology, University of Washington School of Medicine, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

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Federico E. Vaca, MD, MPH Department of Emergency Medicine, Yale New Haven Hospital, Yale School of Medicine, New Haven, CT, USA

Jayne M. Viets-Upchurch, MD Department of Emergency Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Phuong  T.  Vo, MD Division of Medical Oncology, University of Washington School of Medicine, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

Gregory  A.  Volturo, MD Department of Emergency Medicine, UMass Memorial Health Care, University of Massachusetts Medical School, Worcester, MA, USA

Ngoc  H.  Vu, PharmD, BCPS Department of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Loise  W.  Wairiri, MBBS Department of Radiation Medicine, Oregon Health & Science University, Portland, OR, USA

Ray Y. Wang, MD Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, TX, USA

Robert C. Weinschenk, MD Department of Orthopedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

Thomas C. Williamson, MD Division of Hematology and Oncology, Department of Internal Medicine, Comprehensive Cancer Center, Wake Forest Baptist Health, Winston-Salem, NC, USA

Samantha  J.  Yarmis, MD Department of Emergency Medicine, Department of Internal Medicine, University of Maryland Medical Center, Baltimore, MD, USA

Shiraz Yazdani, MD Interventional Pain Management, Lubbock Spine Institute, Lubbock, TX, USA

Jessica  X.  Yu, MD, MS Division of Gastroenterology and Hepatology, Department of Medicine, Oregon Health and Science University, Portland, OR, USA

Sharleen Yuan, MA, PhD, MD Department of Emergency Medicine, Department of Internal Medicine, University of Maryland Medical Center, Baltimore, MD, USA

Nathan  Yung, MD, MS Department of Medicine, Clinical Informatics, University of California San Diego, San Diego, CA, USA

Ideen Zeinali, MD Department of Emergency Medicine, Ben Taub General Hospital, Baylor College of Medicine, Houston, TX, USA

Allison Zimmerman, MS, MD Department of Medicine, Rush University Medical Center, Chicago, IL, USA

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