Congratulations to the world-famous pathologist who, one year after an experimental cancer treatment based on his own research with melanoma, is still cancer free. Diagnosed with glioblastoma, Dr. Richard Scolyer received a combination of immunotherapy, surgery, radiotherapy, and personalized vaccine. He says he “couldn’t be happier.”

☕️Postcall’s one-sip markets update:

Nvidia’s earning call isn’t happening until this afternoon, but that hasn’t stopped it from rallying over the last couple of days. That, and the strong earnings reports coming from companies across various industries (like Sony and Merck) are contributing to the S&P hitting its all-time high (again).

Ready for this week’s stories? (5 min read)

Staying #Up2Date 🚨

1. Hold that Ozempic

The American Gastroenterological Association (AGA) has published a clinical practice update on withholding GLP-1 receptor agonists for upper endoscopy (increased risk of aspiration). An individualized approach is recommended: while GLP-1 agonists could be withheld in patients who take the drugs solely for obesity, in a patient with diabetes the risks may outweigh the benefits. For those on GLP-1s, proceed with the scope if an 8-hour solid-food fast and a 2-hour liquid fast has been observed (and no nausea/vomiting/abdominal distension).

2. Statins & ‘betes

A meta-analysis suggests that patients who take high-dose statins have about 1% higher risk annually for newly diagnosed type II diabetes. After crunching the numbers, new-onset diabetes was slightly but significantly higher with initiation of low-to-moderate–intensity statin (1.3% vs. 1.2% for placebo, annually) and higher still with high-intensity statins (4.8% vs. 3.5% for placebo, annually). Should we rethink primary prevention in patients with borderline indications for statin therapy?

3. Prostate cancer screening in Black individuals

A US panel conducted a systematic review of prostate cancer screening in Black individuals with the following recommendations: 

• Discussions about screening should begin as early as age 40, and if choosing to undergo screening, a baseline PSA should be obtained at age 40-45 (repeated q1y depending on health status). Although those with family history or high-risk genetic variants may require earlier screening (age 40). 

• Lowering the age for baseline PSA from 50 to 55 years of age and regular screening until 70 could reduce prostate cancer mortality in Black men (approximately 30% relative risk reduction) without substantially increasing overdiagnosis.

Note: Canada does not have formal guidelines for screening Black individuals, but the latest guidelines from 2014 acknowledge that practitioners may wish to discuss the harms/benefits with those at increased risk.

Speed Reads 🚤

1: 🩺 About time… The Supreme Court in BC has green-lit a lawsuit against RateMDs. The civil suit was brought by a Vancouver-based physician, Dr. Ramona Bleuler, who said that the site violates privacy laws. RateMD responded by saying that Bleuler doesn’t have a “reasonable expectation of privacy” and wants to “stifle warranted criticism with respect to how she practices medicine.”

2: 💊 The Public Health Agency of Canada (PHAC) announced new guidelines for prescribing antibiotics because of the increasing antimicrobial resistance (AMR). The goal is to optimize prescribing practices and prevent unnecessary use of antimicrobials. PHAC reported that there were 5,400 deaths directly attributed to AMR in 2018.

3: 💔 The daughter of BC emergency physician Dr. Caroline McIntyre passed away after a witnessed collapse from a fentanyl overdose. She says that if the campus security acted more urgently, her daughter would still be alive. She’s written an open letter, calling on the province to implement 7 harm reduction recommendations (including teaching CPR in high school and making naloxone mandatory in dorms). The province has vowed to take action, but it’s unclear when and how many of those recommendations will be implemented. If you'd like to support the open letter, you can find a link to a standardized email to send to David Eby and your MLA at www.SidneyShouldBeHere.ca.

4: 🥘 Can food be medicine? Vancouver General Hospital partnered with a celebrity chef to create the Planetary Health Menu Pilot Project, which offered 20 new appetizing menu items to encourage nutritious eating among patients. The 6-month project ended in March and is now undergoing an in-depth analysis.

The Tea on Wegovy ☕️

Why popular weight-loss drugs may or may not be right for your patients.

What happened? Wegovy, a weight-loss medication made by Novo Nordisk (same manufacturer as Ozempic) will hit shelves in Canada after being approved by the FDA in 2021.

How should it be prescribed? Wegovy has a higher dose of semaglutide than Ozempic starting at 0.25 mg a week. The dose gradually increases to 2.4 mg and is specifically approved for chronic weight management. 

Who should use it? 

Wegovy is recommended for people with a body mass index (BMI) of 27 or higher and who have at least one weight-related condition, like high cholesterol. The drug is intended to be used with a reduced-calorie diet and physical activity in order to receive the best results. GLP-1 drugs work by helping patients feel full so they don’t eat as much. Novo Nordisk, the maker of Wegovy, says the drug can reduce the risk of heart attack, stroke, or heart-related death by 20%.

But: The drug shouldn’t be taken as a cosmetic solution for quick weight loss, and there are gastrointestinal side effects like nausea, diarrhea, vomiting, and more. Also, Wegovy is not yet covered under public health insurance, and it’ll take some time before private plans begin to offer the drug. Which means, if you’re interested, you’ll have to cough up about $4,726 a year. One doctor says that because Wegovy only works as long as you take it, the patient must use the drug indefinitely if they want to keep the weight off.

For the full list of GLP-1 RA products approved in Canada, see here.

Notable Numbers 🔢

94: the average number of hours that anesthesiologist Dr. Sebo Amirkhanian Namagerdy, LA County’s highest-paid employee, works every week at Rancho Los Amigos National Rehabilitation Center. Was it worth it? He did earn $1.26M USD in 2023.

1989: the last year that someone in Ontario died from measles — until last week, when a child under the age of 5 passed. There have been about 100 cases documented in the last decade, 22 of which occurred in 2024.

$2.5M: the amount of money raised by Bronwyn Bridges for Parkinson’s to expedite patient care. About 6,600 Canadians are diagnosed with the disease every year.

Postcall Picks ✅ 

🌼 Plant: With April showers behind us, it's prime time to plant seeds (only $2 per pack)! Get outdoors, soak up some vitamin D, and prepare for the blooming beauty of May flowers.

✈️ Travel: Embark on a 2-week healing journey to Sri Lanka (Oct. 24 - Nov. 10) to learn about indigenous health practices and visit wellness sanctuaries and botanical gardens while obtaining 15 CME credits. Limited spots remaining. Register by May 27 and save $1,000/couple!

📖 Read: "When Breath Becomes Air," a memoir by Dr. Paul Kalanithi who was diagnosed with terminal cancer at the age of 36. Through poignant reflections, Dr. Kalanithi invites us to contemplate the nature of existence and the significance of living a meaningful life.

🤑 Extra savings: Attention BC docs! You can now pocket up to $16,000 (previously only $9,500) towards heat pump installations. Not only will your homes stay cozy, but you’ll also help reduce emissions — it's a win-win for both your wallets and the environment!

🤣 Laugh: at the words that no doctor wants to hear…

Game ⛳️

First question: What is the recent holiday that commemorates the "Mother of Confederation," a.k.a. May Two-Four?

If you enjoyed our puzzle, please share! ☺️