ASCO: You’re listening to a podcast from Cancer.Net. This cancer information website is produced by the American Society of Clinical Oncology, known as ASCO, the world’s leading professional organization for doctors who care for people with cancer. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement. Cancer research discussed in this podcast is ongoing, so the data described here may change as research progresses. Brielle Gregory: Hi, everyone. I'm Brielle Gregory, a member of the Cancer.Net content team, and I'll be your host for today's Cancer.Net podcast. Cancer.Net is the patient information website of ASCO, the American Society of Clinical Oncology. Today we're going to be talking about hepatitis B virus. Our guests are Dr. Andrew Artz and Dr. Jessica Hwang. Dr. Artz is an associate clinical professor in the Department of Hematology and Hematopoietic Cell Transplantation, the director of the Program for Aging and Blood Cancers, and the deputy director of the Center for Cancer and Aging at City of Hope Comprehensive Cancer Center in Duarte, California. Dr. Hwang is a tenured professor in the Department of General Internal Medicine in the Division of Internal Medicine at the University of Texas MD Anderson Cancer Center in Houston, Texas. Thanks for joining us today, Dr. Artz and Dr. Hwang. Dr. Hwang: Thank you, Brielle. Nice to be here. Dr. Artz: Yes. Likewise, Brielle. Thank you so much. Brielle Gregory: Today ASCO is publishing a new provisional clinical opinion on hepatitis B virus screening and management for patients with cancer prior to therapy. Dr. Artz and Dr. Hwang served as the co-chairs for this provisional clinical opinion. Before we begin, we should mention that Dr. Artz has no relationships to disclose related to this provisional clinical opinion and Dr. Hwang has one relationship to disclose. Their full disclosure statements can be found on Cancer.Net. Now, let's talk a little bit about what this provisional clinical opinion means for people with cancer and those who care for them. Dr. Artz, to begin, what is a provisional clinical opinion and how does it influence cancer care? Dr. Artz; Yes. Absolutely. We appreciate that new information develops very quickly in oncology, and provisional clinical opinions are really a way to respond to the rapid information accumulation in the field. They're evidence-based guidances, and they're meant to offer timely direction to the ASCO membership, which means the physicians and the other providers in the oncology team. Usually it follows practice-changing information, and then there may be updates. Such is the case for this PCO, which was initiated in 2010, updated in 2015, and now we have the next version, the 2020 update that we're discussing today. Brielle Gregory: So basically, these opinions are updates with the latest information to make sure that patients are getting the most up-to-date care as possible. Is that correct? Dr. Artz: Yes. Absolutely. Brielle Gregory: And Dr. Hwang, can you define for us what hepatitis B virus is and how it's connected to cancer? Dr. Hwang: Hepatitis B virus infects the liver. In an acute setting, it can cause jaundice or yellowing of the eyes, yellowing of the skin, nausea, vomiting, abdominal pain. So that's really the acute phase. But oftentimes hepatitis can infect a person and not even cause any symptoms. This is a troublesome virus that can infect the liver, and once it infects the liver, it can live latently or very quietly in the liver for a long time, and maybe sometimes not even cause problems in certain people. But it can cause some really serious problems, like cirrhosis, which is harde