Loading...
Sign in to edit your profile (add interests, mentoring, photo, etc.)

    Tanya Dorff, MD

    TitleAssociate Professor of Clinical Medicine
    SchoolKeck School of Medicine of USC
    DepartmentMedicine
    AddressNOR 3457
    Health Sciences Campus
    Los Angeles California 90089-9173
    Phone+1 323 865 3905
    vCardDownload vCard

      Collapse Overview 
      Collapse Overview
      Following a residency at Mt. Sinai Hospital in New York City, Dr. Dorff came to LAC + USC Medical Center for her hematology and medical oncology fellowship. She currently teaches in the Division of Oncology at the Keck School of Medicine of USC, focusing on genitourinary cancers. In addition to being a devoted clinician and translational researcher, Dr. Dorff has authored more than 40 peer-reviewed articles as well as 35 review articles/commentaries. Dr. Dorff serves as associate editor for Clinical Genitourinary Cancer and Therapeutic Advances in Medical Oncology. She has lectured on the topic of prostate cancer for patients in both English and Spanish throughout California, and has presented her research at national meetings for oncologists. Current research interests include the effects of fasting on chemotherapy side effects and cancer control and exercise during hormone therapy for prostate cancer. She has been the principal investigator for more than a dozen clinical trials, involving targeted therapy and immunotherapy, for genitourinary cancers.


      Collapse Biography 
      Collapse Clinical Trials
      Collapse Awards and Honors
      Keck School of Medicine of USC2014Faculty Teaching Award
      Keck School of Medicine of USC2010Faculty Teaching Award
      2005Fellowship Teaching Award
      Medical Honors Society2000AOA - Alpha Omega Alpha
      AMWA Janet M. Glasgow Memorial2000Achievement Citation
      ACP/ASIM James R. Klinenberg2000Certificate of Merit
      1992National Merit Scholar

      Collapse ORNG Applications 
      Collapse Websites
      Collapse Featured Videos
      Collapse In The News

      Collapse Bibliographic 
      Collapse Publications
      Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help.
      List All   |   Timeline
      1. Alumkal JJ, Chowdhury S, Loriot Y, Sternberg CN, de Bono JS, Tombal B, Carles J, Flaig TW, Dorff T. Effect of Visceral Disease Site on Outcomes in Patients With Metastatic Castration-resistant Prostate Cancer Treated With Enzalutamide in the PREVAIL Trial. Clin Genitourin Cancer. 2017 Mar 03. PMID: 28344102.
        View in: PubMed
      2. Wei M, Brandhorst S, Shelehchi M, Mirzaei H, Cheng CW, Budniak J, Groshen S, Mack WJ, Guen E, Di Biase S, Cohen P, Morgan TE, Dorff T, Hong K, Michalsen A, Laviano A, Longo VD. Fasting-mimicking diet and markers/risk factors for aging, diabetes, cancer, and cardiovascular disease. Sci Transl Med. 2017 Feb 15; 9(377). PMID: 28202779.
        View in: PubMed
      3. Buonerba C, Di Lorenzo G, Pond G, Cartenì G, Scagliarini S, Rozzi A, Quevedo FJ, Dorff T, Nappi L, Lanzetta G, Pagliaro L, Eigl BJ, Naik G, Ferro M, Galdiero M, De Placido S, Sonpavde G. Prognostic and Predictive Factors in Patients with Advanced Penile Cancer Receiving Salvage (2nd or Later Line) Systemic Treatment: A Retrospective, Multi-Center Study. Front Pharmacol. 2016; 7:487. PMID: 28066240.
        View in: PubMed
      4. Abreu A, Fay C, Park D, Quinn D, Dorff T, Carpten J, Kuhn P, Gill P, Almeida F, Gill I. Robotic salvage retroperitoneal and pelvic lymph node dissection for 'node-only' recurrent prostate cancer: technique and initial series. BJU Int. 2016 Dec 15. PMID: 27981731.
        View in: PubMed
      5. Yu SS, Quinn DI, Dorff T. Clinical use of cabozantinib in the treatment of advanced kidney cancer: efficacy, safety, and patient selection. Onco Targets Ther. 2016; 9:5825-5837. PMID: 27713636.
        View in: PubMed
      6. Rini BI, Dorff T, Elson P, Rodriguez CS, Shepard D, Wood L, Humbert J, Pyle L, Wong YN, Finke JH, Rayman PA, Larkin JM, Garcia JA, Plimack ER. Active surveillance in metastatic renal-cell carcinoma: a prospective, phase 2 trial. Lancet Oncol. 2016 Sep; 17(9):1317-24. PMID: 27498080.
        View in: PubMed
      7. Kiwata JL, Dorff T, Schroeder ET, Gross ME, Dieli-Conwright CM. A review of clinical effects associated with metabolic syndrome and exercise in prostate cancer patients. Prostate Cancer Prostatic Dis. 2016 Dec; 19(4):323-332. PMID: 27349496.
        View in: PubMed
      8. Dorff T, Groshen S, Garcia A, Shah M, Tsao-Wei D, Pham H, Cheng CW, Brandhorst S, Cohen P, Wei M, Longo V, Quinn DI. Safety and feasibility of fasting in combination with platinum-based chemotherapy. BMC Cancer. 2016; 16(1):360. PMID: 27282289.
        View in: PubMed
      9. Dorff T, Schuckman AK, Schwartz R, Rashad S, Bulbul A, Cai J, Pinski J, Ma Y, Danenberg K, Skinner E, Quinn DI. Epidermal Growth Factor Receptor, Excision-Repair Cross-Complementation Group 1 Protein, and Thymidylate Synthase Expression in Penile Cancer. Clin Genitourin Cancer. 2016 Oct; 14(5):450-456.e1. PMID: 26935231.
        View in: PubMed
      10. Nussbaum N, George DJ, Abernethy AP, Dolan CM, Oestreicher N, Flanders S, Dorff T. Patient experience in the treatment of metastatic castration-resistant prostate cancer: state of the science. Prostate Cancer Prostatic Dis. 2016 Jun; 19(2):111-21. PMID: 26832363.
        View in: PubMed
      11. Barzi A, Klein EA, Dorff T, Quinn DI, Sadeghi S. Prostatectomy at high-volume centers improves outcomes and lowers the costs of care for prostate cancer. Prostate Cancer Prostatic Dis. 2016 Mar; 19(1):84-91. PMID: 26666409.
        View in: PubMed
      12. In G, Dorff T. Chemotherapy for Good-Risk Nonseminomatous Germ Cell Tumors: Current Concepts and Controversies. Urol Clin North Am. 2015 Aug; 42(3):347-57. PMID: 26216822.
        View in: PubMed
      13. Brandhorst S, Choi IY, Wei M, Cheng CW, Sedrakyan S, Navarrete G, Dubeau L, Yap LP, Park R, Vinciguerra M, Di Biase S, Mirzaei H, Mirisola MG, Childress P, Ji L, Groshen S, Penna F, Odetti P, Perin L, Conti PS, Ikeno Y, Kennedy BK, Cohen P, Morgan TE, Dorff T, Longo VD. A Periodic Diet that Mimics Fasting Promotes Multi-System Regeneration, Enhanced Cognitive Performance, and Healthspan. Cell Metab. 2015 Jul 7; 22(1):86-99. PMID: 26094889.
        View in: PubMed
      14. Dorff T, Hu J, Quinn DI. Relapsed and refractory germ cell tumors: Finessing the rough end of a beautiful story. Urol Oncol. 2015 Aug; 33(8):341-2. PMID: 26094170.
        View in: PubMed
      15. Dorff T, Pal SK. Hitting Prostate Cancer Where It Hurts: Maximizing Control of Osseous Metastases. Oncology (Williston Park). 2015 Jun 15; 29(6). PMID: 26091675.
        View in: PubMed
      16. Dorff T, Gross ME. Radium 223: how can we optimize this new tool for metastatic castration-resistant prostate cancer? Am Soc Clin Oncol Educ Book. 2015; 35:e270-3. PMID: 25993185.
        View in: PubMed
      17. Vashistha V, Quinn DI, Dorff T, Daneshmand S. Current and recent clinical trials for perioperative systemic therapy for muscle invasive bladder cancer: a systematic review. BMC Cancer. 2014; 14:966. PMID: 25515347.
        View in: PubMed
      18. Piatek CI, Raja GL, Ji L, Gitlitz BJ, Dorff T, Quinn DI, Hu J, El-Khoueiry AB, Pham HQ, Roman L, Garcia AA. Phase I clinical trial of temsirolimus and vinorelbine in advanced solid tumors. Cancer Chemother Pharmacol. 2014 Dec; 74(6):1227-34. PMID: 25374407.
        View in: PubMed
      19. Liu SV, Tsao-Wei DD, Xiong S, Groshen S, Dorff T, Quinn DI, Tai YC, Engel J, Hawes D, Schally AV, Pinski JK. Phase I, Dose-Escalation Study of the Targeted Cytotoxic LHRH Analog AEZS-108 in Patients with Castration- and Taxane-Resistant Prostate Cancer. Clin Cancer Res. 2014 Dec 15; 20(24):6277-83. PMID: 25278449.
        View in: PubMed
      20. Dorff T, Groshen S, Tsao-Wei DD, Xiong S, Gross ME, Vogelzang N, Quinn DI, Pinski JK. A Phase II trial of a combination herbal supplement for men with biochemically recurrent prostate cancer. Prostate Cancer Prostatic Dis. 2014 Dec; 17(4):359-65. PMID: 25245366.
        View in: PubMed
      21. Agarwal N, Dorff T, Goldkorn A. New prostate cancer drugs: extending and improving life. Lancet Oncol. 2014 Sep; 15(10):1052-4. PMID: 25104108.
        View in: PubMed
      22. Cheng CW, Adams GB, Perin L, Wei M, Zhou X, Lam BS, Da Sacco S, Mirisola M, Quinn DI, Dorff T, Kopchick JJ, Longo VD. Prolonged Fasting Reduces IGF-1/PKA to Promote Hematopoietic-Stem-Cell-Based Regeneration and Reverse Immunosuppression. Cell Stem Cell. 2014 Jun 5; 14(6):810-23. PMID: 24905167.
        View in: PubMed
      23. Dorff T, Hu JS, Quinn DI. Salvage chemotherapy for refractory germ cell tumors. Oncology (Williston Park). 2014 Jun; 28(6):498-500. PMID: 25134324.
        View in: PubMed
      24. Pond GR, Milowsky MI, Kolinsky MP, Eigl BJ, Necchi A, Harshman LC, Di Lorenzo G, Dorff T, Lee RJ, Sonpavde G. Concurrent chemoradiotherapy for men with locally advanced penile squamous cell carcinoma. Clin Genitourin Cancer. 2014 Dec; 12(6):440-6. PMID: 24787971.
        View in: PubMed
      25. Pond GR, Di Lorenzo G, Necchi A, Eigl BJ, Kolinsky MP, Chacko RT, Dorff T, Harshman LC, Milowsky MI, Lee RJ, Galsky MD, Federico P, Bolger G, Deshazo M, Mehta A, Goyal J, Sonpavde G. Prognostic risk stratification derived from individual patient level data for men with advanced penile squamous cell carcinoma receiving first-line systemic therapy. Urol Oncol. 2014 May; 32(4):501-8. PMID: 24332646.
        View in: PubMed
      26. Dorff T, Pal SK, Quinn DI. Novel tyrosine kinase inhibitors for renal cell carcinoma. Expert Rev Clin Pharmacol. 2014 Jan; 7(1):67-73. PMID: 24308791.
        View in: PubMed
      27. Dorff T, Wilkins C, Hepgur M, Quinn DI. Durable complete remission from castration-resistant prostate cancer with sipuleucel-T after estrogen withdrawal. Clin Genitourin Cancer. 2014 Apr; 12(2):e55-8. PMID: 24331572.
        View in: PubMed
      28. Mitra AP, Skinner EC, Schuckman AK, Quinn DI, Dorff T, Daneshmand S. Effect of gender on outcomes following radical cystectomy for urothelial carcinoma of the bladder: A critical analysis of 1,994 patients. Urol Oncol. 2014 Jan; 32(1):52.e1-9. PMID: 24239476.
        View in: PubMed
      29. Brown A, Ma Y, Danenberg K, Schuckman AK, Pinski JK, Pagliaro LC, Quinn DI, Dorff T. Epidermal Growth Factor Receptor-targeted Therapy in Squamous Cell Carcinoma of the Penis: A Report of 3 Cases. Urology. 2014 Jan; 83(1):159-66. PMID: 24238569.
        View in: PubMed
      30. Dorff T, Tsao-Wei DD, Groshen S, Boswell W, Goldkorn A, Xiong S, Quinn DI, Pinski JK. Efficacy of oxaliplatin plus pemetrexed in chemotherapy pretreated metastatic castration-resistant prostate cancer. Clin Genitourin Cancer. 2013 Dec; 11(4):416-22. PMID: 24099865.
        View in: PubMed
      31. Jayaratna IS, Mitra AP, Schwartz RL, Dorff T, Schuckman AK. Clinicopathologic Characteristics and Outcomes of Penile Cancer Treated at Tertiary Care Centers in the Western United States. Clin Genitourin Cancer. 2014 Apr; 12(2):138-42. PMID: 24210829.
        View in: PubMed
      32. Dorff T, Wong MK. Weighing the evidence for immune therapy and targeted therapy in renal cancer and melanoma. Oncology (Williston Park). 2013 Jul; 27(7):691-2, 694. PMID: 23977764.
        View in: PubMed
      33. Dorff T, Glode LM. Current role of neoadjuvant and adjuvant systemic therapy for high-risk localized prostate cancer. Curr Opin Urol. 2013 Jul; 23(4):366-71. PMID: 23619581.
        View in: PubMed
      34. Jadvar H, Desai B, Ji L, Conti PS, Dorff T, Groshen SG, Pinski JK, Quinn DI. Baseline 18F-FDG PET/CT parameters as imaging biomarkers of overall survival in castrate-resistant metastatic prostate cancer. J Nucl Med. 2013 Aug; 54(8):1195-201. PMID: 23785174.
        View in: PubMed
      35. Hepgur M, Sadeghi S, Dorff T, Quinn DI. Tivozanib in the treatment of renal cell carcinoma. Biologics. 2013; 7:139-48. PMID: 23788831.
        View in: PubMed
      36. Dorff T, Quinn DI. Speeding dating for docetaxel and recent debutantes in castration-resistant prostate cancer: 'plus or minus' may be a minus. Ann Oncol. 2013 Feb; 24(2):270-2. PMID: 23341479.
        View in: PubMed
      37. Sonpavde G, Pagliaro LC, Buonerba C, Dorff T, Lee RJ, Di Lorenzo G. Penile cancer: current therapy and future directions. Ann Oncol. 2013 May; 24(5):1179-89. PMID: 23293117.
        View in: PubMed
      38. Fairey AS, Daneshmand S, Quinn D, Dorff T, Dorin R, Lieskovsky G, Schuckman A, Cai J, Miranda G, Skinner EC. Neoadjuvant chemotherapy with gemcitabine/cisplatin vs. methotrexate/vinblastine/doxorubicin/cisplatin for muscle-invasive urothelial carcinoma of the bladder: A retrospective analysis from the University of Southern California. Urol Oncol. 2013 Nov; 31(8):1737-43. PMID: 23141776.
        View in: PubMed
      39. Fahed E, Hansel DE, Raghavan D, Quinn DI, Dorff T. Small cell bladder cancer: biology and management. Semin Oncol. 2012 Oct; 39(5):615-8. PMID: 23040258.
        View in: PubMed
      40. Dorff T, Crawford ED. Management and challenges of corticosteroid therapy in men with metastatic castrate-resistant prostate cancer. Ann Oncol. 2013 Jan; 24(1):31-8. PMID: 22831986.
        View in: PubMed
      41. Jadvar H, Desai B, Ji L, Conti PS, Dorff T, Groshen SG, Gross ME, Pinski JK, Quinn DI. Prospective Evaluation of 18F-NaF and 18F-FDG PET/CT in Detection of Occult Metastatic Disease in Biochemical Recurrence of Prostate Cancer. Clin Nucl Med. 2012 Jul; 37(7):637-43. PMID: 22691503.
        View in: PubMed
      42. Thara E, Dorff T, Averia-Suboc M, Luther M, Reed ME, Pinski JK, Quinn DI. Immune response to sipuleucel-T in prostate cancer. Cancers (Basel). 2012; 4(2):420-41. PMID: 24213318.
        View in: PubMed
      43. Zhang SY, Thara E, Quinn D, Dorff T. Blood cells and their use in active immunotherapy of prostate cancer. Hum Vaccin Immunother. 2012 Apr 1; 8(4):528-33. PMID: 22370509.
        View in: PubMed
      44. Dorff T, Liu SV, Xiong S, Cai J, Hawes D, Pinski J. Ethnic differences in neuroendocrine expression in prostate cancer tissue. Anticancer Res. 2011 Nov; 31(11):3897-901. PMID: 22110216.
        View in: PubMed
      45. Dorff T, Gross ME. The epothilones: new therapeutic agents for castration-resistant prostate cancer. Oncologist. 2011; 16(10):1349-58. PMID: 21964003.
        View in: PubMed
      46. Mitra AP, Quinn DI, Dorff T, Skinner EC, Schuckman AK, Miranda G, Gill IS, Daneshmand S. Factors influencing post-recurrence survival in bladder cancer following radical cystectomy. BJU Int. 2012 Mar; 109(6):846-54. PMID: 21812902.
        View in: PubMed
      47. Dorff T, Vogelzang NJ. Use of testosterone replacement therapy in patients with prostate cancer. Curr Urol Rep. 2011 Jun; 12(3):223-8. PMID: 21365235.
        View in: PubMed
      48. Thara E, Dorff T, Pinski JK, Quinn DI. Vaccine therapy with sipuleucel-T (Provenge) for prostate cancer. Maturitas. 2011 Aug; 69(4):296-303. PMID: 21621934.
        View in: PubMed
      49. Dorff T, Pinski J. Advanced prostate cancer: new agents, new questions. Oncology (Williston Park). 2011 May; 25(6):509, 512. PMID: 21717905.
        View in: PubMed
      50. Dorff T, Flaig TW, Tangen CM, Hussain MH, Swanson GP, Wood DP, Sakr WA, Dawson NA, Haas NB, Crawford ED, Vogelzang NJ, Thompson IM, Glode LM. Adjuvant androgen deprivation for high-risk prostate cancer after radical prostatectomy: SWOG S9921 study. J Clin Oncol. 2011 May 20; 29(15):2040-5. PMID: 21502546.
        View in: PubMed
      51. Raffaghello L, Safdie F, Bianchi G, Dorff T, Fontana L, Longo VD. Fasting and differential chemotherapy protection in patients. Cell Cycle. 2010 Nov 15; 9(22):4474-6. PMID: 21088487.
        View in: PubMed
      52. Mori R, Dorff T, Xiong S, Tarabolous CJ, Ye W, Groshen S, Danenberg KD, Danenberg PV, Pinski JK. The relationship between proangiogenic gene expression levels in prostate cancer and their prognostic value for clinical outcomes. Prostate. 2010 Nov 1; 70(15):1692-700. PMID: 20564320.
        View in: PubMed
      53. Dorff T, Quinn DI. Cabazitaxel in prostate cancer: stretching a string. Lancet. 2010 Oct 2; 376(9747):1119-20. PMID: 20888974.
        View in: PubMed
      54. DeSancho MT, Dorff T, Rand JH. Thrombophilia and the risk of thromboembolic events in women on oral contraceptives and hormone replacement therapy. Blood Coagul Fibrinolysis. 2010 Sep; 21(6):534-8. PMID: 20581664.
        View in: PubMed
      55. Dorff T, Goldman B, Pinski JK, Mack PC, Lara PN, Van Veldhuizen PJ, Quinn DI, Vogelzang NJ, Thompson IM, Hussain MH. Clinical and correlative results of SWOG S0354: a phase II trial of CNTO328 (siltuximab), a monoclonal antibody against interleukin-6, in chemotherapy-pretreated patients with castration-resistant prostate cancer. Clin Cancer Res. 2010 Jun 1; 16(11):3028-34. PMID: 20484019.
        View in: PubMed
      56. Safdie FM, Dorff T, Quinn D, Fontana L, Wei M, Lee C, Cohen P, Longo VD. Fasting and cancer treatment in humans: A case series report. Aging (Albany NY). 2009 Dec; 1(12):988-1007. PMID: 20157582.
        View in: PubMed
      57. Dorff T, Quinn DI. Perioperative chemotherapy for urothelial cancer: how have we made a "sow's ear" out of a chemotherapy-sensitive tumor? Cancer. 2009 Nov 15; 115(22):5139-42. PMID: 19645028.
        View in: PubMed
      58. Leibowitz RL, Dorff T, Tucker S, Symanowski J, Vogelzang NJ. Testosterone replacement in prostate cancer survivors with hypogonadal symptoms. BJU Int. 2010 May; 105(10):1397-401. PMID: 19912179.
        View in: PubMed
      59. Dorff T, Goldkorn A, Quinn DI. Targeted therapy in renal cancer. Ther Adv Med Oncol. 2009 Nov; 1(3):183-205. PMID: 21789121.
        View in: PubMed
      60. Sunami E, Shinozaki M, Higano CS, Wollman R, Dorff T, Tucker SJ, Martinez SR, Mizuno R, Singer FR, Hoon DS. Multimarker circulating DNA assay for assessing blood of prostate cancer patients. Clin Chem. 2009 Mar; 55(3):559-67. PMID: 19131636.
        View in: PubMed
      61. Cheung E, Pinski J, Dorff T, Groshen S, Quinn DI, Reynolds CP, Maurer BJ, Lara PN, Tsao-Wei DD, Twardowski P, Chatta G, McNamara M, Gandara DR. Oral fenretinide in biochemically recurrent prostate cancer: a California cancer consortium phase II trial. Clin Genitourin Cancer. 2009 Jan; 7(1):43-50. PMID: 19213668.
        View in: PubMed
      62. Dorff T, Tangen CM, Crawford ED, Petrylak DP, Higano CS, Raghavan D, Quinn DI, Vogelzang NJ, Thompson IM, Hussain MH. COOPERATIVE GROUP TRIALS - SOUTHWEST ONCOLOGY GROUP (SWOG) INNOVATIONS IN ADVANCED PROSTATE CANCER. Ther Adv Med Oncol. 2009; 1(2):69-77. PMID: 21085622.
        View in: PubMed
      63. Dorff T, Tsao-Wei D, Miranda G, Skinner DG, Stein JP, Quinn DI. Adjuvant chemotherapy for locally advanced urothelial carcinoma: an overview of the USC experience. World J Urol. 2009 Feb; 27(1):39-44. PMID: 19020886.
        View in: PubMed
      64. Tagawa ST, Dorff T, Rochanda L, Ye W, Boyle S, Raghavan D, Lieskovsky G, Skinner DG, Quinn DI, Liebman HA. Subclinical haemostatic activation and current surgeon volume predict bleeding with open radical retropubic prostatectomy. BJU Int. 2008 Nov; 102(9):1086-91. PMID: 18671791.
        View in: PubMed
      65. Cheung E, Wadhera P, Dorff T, Pinski J. Diet and prostate cancer risk reduction. Expert Rev Anticancer Ther. 2008 Jan; 8(1):43-50. PMID: 18095882.
        View in: PubMed
      66. Dorff T, Shazer RL, Nepomuceno EM, Tucker SJ. Successful treatment of metastatic androgen-independent prostate carcinoma in a transsexual patient. Clin Genitourin Cancer. 2007 Jun; 5(5):344-6. PMID: 17645834.
        View in: PubMed
      67. Dorff T, Quek ML, Daneshmand S, Pinski J. Evolving treatment paradigms for locally advanced and metastatic prostate cancer. Expert Rev Anticancer Ther. 2006 Nov; 6(11):1639-51. PMID: 17134367.
        View in: PubMed
      68. Quek ML, Daneshmand S, Rodrigo S, Cai J, Dorff T, Groshen S, Skinner DG, Lieskovsky G, Pinski J. Prognostic significance of neuroendocrine expression in lymph node-positive prostate cancer. Urology. 2006 Jun; 67(6):1247-52. PMID: 16697447.
        View in: PubMed
      69. Daneshmand S, Dorff T, Quek ML, Cai J, Pike MC, Nichols PW, Pinski J. Ethnic differences in neuroendocrine cell expression in normal human prostatic tissue. Urology. 2005 May; 65(5):1008-12. PMID: 15882754.
        View in: PubMed
      70. Pinski J, Dorff T. Prostate cancer metastases to bone: pathophysiology, pain management, and the promise of targeted therapy. Eur J Cancer. 2005 Apr; 41(6):932-40. PMID: 15808959.
        View in: PubMed