Podcast appearances and mentions of Fox Chase

JCO PO author Dr. Michael J. Hall, Professor of Medicine, Chairman of the Department of Clinical Genetics, and Co-Leader of the Cancer Prevention and Control Program at Fox Chase Cancer Center in Philadelphia, PA, shares insights into the JCO PO article, “Uptake of aspirin chemoprevention in patients with Lynch Syndrome.” Host Dr. Rafeh Naqash and Dr. Hall discuss the finding that only about 1 in 3 patients with Lynch Syndrome use aspirin for cancer chemoprevention. TRANSCRIPT  Dr. Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations, where we bring you engaging conversations with authors of clinically relevant and highly significant JCO PO articles. I'm your host, Dr. Rafeh Naqash podcast editor for JCO Precision Oncology and Assistant Professor at the OU Health Stephenson Cancer Center at the University of Oklahoma. Today, I'm excited to be joined by Dr. Michael J. Hall, Professor of Medicine, Chairman of the Department of Clinical Genetics and co-leader of the Cancer Prevention and Control Program at the Fox Chase Cancer Center in Philadelphia, and also the lead author of the JCO Precision Oncology article entitled, “Uptake of Aspirin Chemo Prevention in Patients with Lynch Syndrome.” At the time of this recording, our guest disclosures will be linked in the transcript. Dr. Hall, welcome to the podcast and thank you for joining us today to explain and help the listeners understand your interesting research that was just published in JCO Precision Oncology. Dr. Michael J. Hall: Thank you so much for having me and really thanks for the interest in our work. I think it's an important subject and I hope people will also find it as interesting as we do. Dr. Rafeh Naqash: Absolutely. I think your research touches upon a few things. One, obviously, touches upon Lynch syndrome germline assessments of individuals. It also touches upon chemo prevention, prevention in general, and it also touches upon the knowledge and understanding of chemo prevention aspects. So to start off, I would like to ask you, for the sake of our listeners, many of whom who may not necessarily fully understand the length and breadth of Lynch syndrome, maybe perhaps some residents or trainees out there, could you tell us what Lynch syndrome is, what some of the mutations are, what the implications are, and then we can try to go and delve more into the research topic. Dr. Michael J. Hall: Sure, I'd be happy to. Lynch syndrome is probably, in the hereditary cancer genetics world, one of the most common hereditary risk syndromes we encounter. Recent estimates are that probably roughly about 1 in every 280 individuals in the population is a carrier of a pathogenic variant, one of the Lynch syndrome genes, there are roughly four. There's sort of a fifth gene that is also involved with Lynch syndrome, but really, we largely think about four genes in Lynch syndrome, MLH1, MSH2, MSH6, and PMS2. Over time we've begun to learn, and I'll say that the guidelines that we develop have become more specialized for each of those genes. They are not sort of all the same in the cancers they cause and the way they behave. But roughly, what is Lynch syndrome? It's a syndrome of DNA mismatch repair. So, individuals who have Lynch syndrome have some degree of deficiency in their ability to repair DNA via the mismatch repair system. Depending on the pathogenic variant that is within a family, that may be related to a more severe deficiency of mismatch repair, repair, editing, or for instance, with the PMS2 gene, we've learned over time that actually the degree of DNA repair deficiency is actually a milder phenotype. These individuals over a lifetime are at risk of a variety of different kinds of cancers, the most common being colon cancer. And the risk of that is variable by gene. With MLH1 and MSH2, it's close to 50% over a lifetime. With MSH6 and PMS2, somewhat lower. There are also risks of endometrial cancer, gastric cancer, ovarian cancer, pancreas cancer, a number of other ones. But they're all related again to the same underlying molecular deficiency, and that's this deficiency of being able to repair mistakes made in the DNA accurately. And so, mutations accumulate in the genome of cells in various tissues of the body. Dr. Rafeh Naqash: Thank you for that very simplified version of a very complicated topic otherwise. So, as you mentioned, these different genes have different implications. Perhaps some have higher risks for colorectal cancer than others. What are some of the current standardized approaches for screening or following these individuals over the course of their journey until perhaps either get detected with cancer or while they're being monitored? Dr. Michael J. Hall: Sure. It's a great question, because this is very much a moving target in this disease. I'm going to give you a quick second of history that up until maybe about six or seven years ago, we had uniform guidelines, really, that any Lynch syndrome pathogenic variant carrier should start colorectal cancer screening. Usually, we were recommending between the age of 20 and 25, and this was usually annual colonoscopy. And for years that was the standard. In more recent years, we've stuck to that tight interval, particularly in the higher risk genes, MLH1 and MSH2, although the guideline now reads every one to two years, because we recognize people need some degree of flexibility to live their lives. And there are people in the population who are more risk averse, and there are those who want a colonoscopy every year because they want to stick to that schedule. For MSH6, we recommend a somewhat later start at age 30, and that can be every one to three years for colon screening and for PMS2, similar recommendations, although I think there is a chance in the coming years, we may actually expand the screening interval even more, again, because the risks are somewhat lower. We still have ways to go in terms of screening for the other cancers in Lynch syndrome. I'll say that, for instance, endometrial cancer, which is the second most common cancer in this disease, we still struggle with what is the best way to screen women for a risk of endometrial cancer. Our guidelines in the past were always somewhat draconian, that once women sort of finish childbearing, they should immediately have a total abdominal hysterectomy and oophorectomy. And I'll say that with greater input from the gynecologic and GYN ONC community, we have somewhat softened those recommendations, especially for the endometrial cancer and also the age at oophorectomy, because we recognize that there were compensatory risks of taking the ovaries out too early in some women, risks of bone loss and cardiovascular disease. So those are the most common. For other tumors in Lynch syndrome, for instance, gastric cancer and pancreas cancer, the guidelines are still really evolving, and different groups have put out guidance for clinicians. And I'll say NCCN, which I participate in and help write those guidelines, has very good recommendations for docs. But I'll say that it is again, back to the idea that it's a moving target. And as we learn more, hopefully, we'll have better recommendations. Dr. Rafeh Naqash: I completely agree as far as a moving target is concerned, and we often look at the disconnect between the recommendations and then what's implemented or followed in the real-world setting. So I have a question in that context, and my question is, when you identify these individuals with Lynch syndrome, perhaps let's talk about academic settings, and then we can try to delve into how this might work in the real world community oncology settings, where the real world population actually exists, 60, 70% of individuals get treated in the community. So, when you talk about an academic center, what is the flow of the individual? Does the individual stay within the geneticist when they're diagnosed? Does the individual go to the primary care and the geneticist makes the recommendation and the primary care follows the recommendation? How does it work for you and what are some of the models that you've seen work best perhaps at different academic centers? Dr. Michael J. Hall: I think you get at a really great question. And I'll say there is really no one model. And I think models have to be fluid these days because people with Lynch syndrome are really being identified in more and more diverse settings, and by diverse means. I'll say at my own center, we are more of a traditional practice. So, we do the pre-test and the post-test counseling. Once we have counseled individuals identified Lynch syndrome, we will usually make referrals. If folks don't have a gastroenterologist that they have interacted with before, we keep them in our own group and follow them. But their Lynch syndrome home really sits both in a continuity clinic that I run for patients to come back and circle around every one to two years just to review guidelines and review their screening results. However, I do really make an effort to, first of all, keep primary care docs involved, because I think some of the things we recommend, it is critical that the primary care doc is aware so that patients are keeping up with some of the recommendations. For instance, we often recommend skin screening to make sure that folks have had at least one good skin exam somewhere in the 40s. And I think the primary care doc can be very helpful in making sure that happens. It is somewhat different, I think, in the community where many more patients with Lynch syndrome are being identified these days. I suspect that much more of the burden of making sure Lynch syndrome patients are well hooked in with a gastroenterologist and with a dermatologist and maybe a urologist probably does fall on that primary care doctor. In my experience, some primary care physicians have really kind of jumped up in and taken hold of this and really know their Lynch syndrome well, and I think that's amazing. I do, however, as kind of an expert in this area, I do get a lot of referrals in from the community as well, from docs who just feel that they may not have quite that expertise that they can get at a comprehensive center. So, someone may come in to me just for a consult to review what my recommendations would be, hear about research, hear about what's going on in the field, and those folks will often touch base with me again every couple year or so. Often, another thing I've started to experience is that I may meet people once or twice early on in their diagnosis, and then they go back to their primary docs and I may not hear from them again until something more profound happens in the family or into the patient and they get their screening colonoscopy and a stage 1 cancer is found. Often then, that's the patient who, after four or five years, will contact me again and say, “We haven't talked in a while, but something has happened, and can we re-consult about what would be the best way to do things?” Dr. Rafeh Naqash: Again, like you said, lots of moving targets, moving aspects to this whole care of these individuals. Do you think, in your experience, nurse navigation, maybe some centers have already implemented that perhaps you might have that, do you think nurse navigation could play a certain level of role? You know how in the multidiscipline care we have nurse navigators that coordinate care between radiation oncologists, medical oncologists, thoracic surgeons. So that's something that is being implemented. My second part of that question is telehealth in this case, maybe it's a little more difficult for somebody to drive three hours to come to you for a visit just to check in versus maybe virtually talking to you or your team getting a sense of where things are at in terms of their screening and their follow ups. Dr. Michael J. Hall: I think both are great, great questions and absolutely, we use both of those pieces in our model. And I know from colleagues that they do as well. So, in terms of navigation, we do have an embedded nurse navigator within our department. She joins and kind of helps facilitate all of our high risk follow up clinics. Mine, for GI, we have a high-risk prostate clinic, we have several high-risk breast clinics and those are populated by providers. We have a couple of nurse practitioners in my genetics group and a PA they are sort of the main provider in those clinics, but they are very much supported by that nurse navigator who, as you well point out, really helps with the coordination of the care. Telehealth as well, I do 100% support because you're absolutely right, if you look at a map of the United States and you first of all look at where there are good counseling services available, of course, there's ample counseling in the major metropolitan areas all over the U.S., but the minute you get outside of those counseling and then other management expertise, then– So we do have a model where particularly for folks who are from central Pennsylvania and sometimes more towards western Pennsylvania, I do have some individuals who've been identified with Lynch syndrome who telehealth in, again, for that follow up. A sort of side notes on telehealth, I think we learned a lot from the pandemic about how to use telehealth more effectively. And thank goodness, we've all gotten up to speed in medicine of how to be better telehealth providers. Unfortunately, I feel like with the pandemic kind of waning, there's been a little bit of a regression of the telehealth laws. So now if I want to do telehealth with someone who is from New Jersey, even though New Jersey sits very close to where I practice, it's more complicated now. Again, I have to get a license and same thing with New York and same thing with Delaware. I sort of wish we had a little bit of a better and welcoming system in the states where you could have easier ability to practice, especially when states were quite close using telehealth. But nonetheless, that's for another podcast, I think. Dr. Rafeh Naqash: Well, thank you again for some of those interesting aspects to this whole topic. But let's dive into the thing that we are here to talk about, which is aspirin in these individuals. So can you give us some context of why aspirin, what's the biology there and what's the data there, and then talk about why you did what you did. Dr. Michael J. Hall: So, we've known for many years that aspirin has preventive properties in terms of preventing colorectal cancer. Many observational studies and some interventional studies have shown us that aspirin has benefits for reducing the risk of colon cancer in an average risk population. There was even an interventional trial a number of years ago that looked at individuals who made polyps, and this looked at particularly adenomas, which we know are the precancerous polyps and adenoma prevention using aspirin. And that study clearly showed that aspirin had benefits for lowering risk of recurrent polyps and adenomas. Particularly even a lower dose of aspirin, 81 milligrams, was effective in that setting. Aspirin's also been studied in other hereditary risk syndromes, the most visible one being FAP, where data have shown that aspirin does help reduce polyp count in FAP, although is certainly not a perfect chemo prevention for that disease. So, in that background of knowing that aspirin has many benefits for colorectal cancer prevention, a study was initiated in the UK a number of years ago called the CAPP2 study, with its lead investigator being John Burn. And in this study, it was a two-arm factorial study that was not just aspirin, but they were also looking at resistant starch, which there was a lot of excitement about resistant starch back then. But in this study, they looked at using aspirin as a way of lowering risk of colorectal cancer in patients with Lynch syndrome. And that study, which was initially reported in The New England Journal, the initial outcomes did not actually show benefits in its first analyses of adenoma risk and colon cancer risk. But what they found over time was that there was a delayed effect and, in a follow, up paper looking at 10 plus years of follow up, they showed a substantial reduction in risk of colon cancer, about 40% risk reduction, which was really striking and exciting in the field to see such a large benefit from aspirin. Now, one caveat was in the analyses they performed, it was those individuals who were able to stick to the aspirin dose in that study, which was 600 milligrams a day. I always say to folks that back in the day, that was not a lot of aspirin, although I think these days we're much more skeptical about taking larger doses of any drug. So, 600 milligrams is roughly about two adult aspirin in the U.S. So those folks who were able to stick to that dose for at least two years were the ones who gained benefit from being on aspirin. And what was interesting is that benefit endured for really 10 years after those two years of being able to take aspirin. So, this was striking and it really changed our thinking about whether there may be chemo prevention options for folks with Lynch syndrome. However, and I think what formed the background of our study here was that there was a somewhat equivocal endorsement of aspirin by the major guidelines committees, mainly because, as we all know in oncology, we love one first big study, but we always really love secondary studies that solidify the finding of the first study. And so, because this was such a niche group and no one else out there was doing big aspirin studies when this result came out in 2011, we've sort of been waiting for many years for some follow up data. And the NCCN guidelines have always been a little bit equivocal that people could consider using aspirin to lower risk in their patients with Lynch syndrome, but without that kind of strong, “Everyone should do this.” And so, this has kind of formed the background of why we performed the study that we did. Dr. Rafeh Naqash: Interesting. And then you had a bunch of observations. One of the most important ones being that use of aspirin was pretty low. Could you dive into that and help us understand what were some of the factors surrounding those low implementation aspects? Dr. Michael J. Hall: Of course. So, what we were interested in then again in that background was, here's a high-risk population, docs are getting somewhat maybe ambiguous information from the guidelines, but what actually is going on out there in practice? How many patients are actually using aspirin? What doses are they using, and what are some of the factors that drive it? So, we performed a survey that actually occurred in two parts. One started at Fox Chase in our population here, and then we expanded it online to a convenience sample. Overall, we had 296 respondents. And yeah, what we found actually was the uptake of aspirin was only about roughly 30%, 35% or so among patients who were eligible to take aspirin. When you actually drill down to those people actually taking aspirin because they wanted to prevent Lynch syndrome, it was even lower. It was in the range of 25% to 30%. This somewhat surprised us. And then when we looked at the doses that people were using, of course, thinking back to that 600-milligram dose that was tested in the study, we found actually that more than half of folks were taking low dose aspirin, like an 81 milligram, and only about 8% of our study participants were using that 600-milligram range. So, again, I would say this somewhat surprised us because we thought it might be higher than this. I'll say as a somewhat caveat to this though, is that back to my comment about we always like another study that confirms our findings, and at a meeting earlier this year, there was a study performed in a New Zealand population by a medical oncologist named Rebecca Tuckey. And she actually found almost the same identical results that we did in the New Zealand population - very, very similar uptake rates of aspirin in the New Zealand population with Lynch syndrome, so kind of confirming that something we've stumbled upon appears to be true. But how do we understand why some folks use aspirin and why others don't in this condition? Dr. Rafeh Naqash: You had a very robust question there from what I saw in the paper. And some of the questions that I had around that was, did you or were you able to account for demographics, education level of the individuals? Were you also able to assess whether these individuals felt that they had been counseled appropriately when they met with either a primary care physician or of any provider on the genetic side, physician or non-physician? So how did you get an assessment of whether it was an apples-to-apples comparison or were there a lot of confounders. Dr. Michael J. Hall: Very good question. And of course, in the setting, unfortunately, we weren't interviewing people, which we could have gotten much richer data in some ways. And there were other things we were looking at in this survey as well, so our aspirin questions, we had a number of them, but perhaps in retrospect, it would have been nice to even have more. We did have some common covariates, age, sex, ancestry, marital status, which gene was affected, whether they had a history of cancer. We did not have education, unfortunately. And I think your question is a great one, but we did not actually ask folks about whether they had been counseled by their provider or their genetic counselor or someone else about whether they should use aspirin or not. We simply wanted to see whether folks were using it. We did ask them again whether they were using it because they wanted to lower their risk of a Lynch syndrome cancer or whether they were using it for another reason or a combination of both. So, yes, in retrospect, we actually do have another study plan to kind of drill deeper into these questions of is it more of a hesitancy question? Is it more of a question of just not as much awareness? Are there other reasons? I think there's a lot to answer, and I think answering these questions is really important because we both want to make sure we're talking about interventions that we think can help people, but we need to understand also some of the barriers they may face. And if people do have barriers to some forms of chemo prevention or I think about some of the vaccine research that's going on right now, if the kinds of things that we're working on to develop are actually not going to be palatable to the patient, the population, then I think we kind of need to step back and say we need to maybe understand what people want so that we can have a good meeting of what's going to work and what's going to fit the needs and lifestyles of our patients. Because these are things they might have to do for many, many years and starting maybe even in their 20s or 30s. So, it makes a difference. Dr. Rafeh Naqash: From what you learned in the study, are you thinking of any subsequent interventional approaches, whether they involve a simple phone call to the patient regularly or perhaps, even though I'm not a big fan of EMR prompts, like an EMR prompt of some sort, where they talk, where they're instructing the provider, whoever is seeing the patient physician or the APP or the geneticist that, “Hey. Did you counsel the patient?” And its sort of a metric how in the oncology side they say, “Well, your metric is you should stage all patients and you should talk about toxicities from a reimbursement standpoint and also from a quality improvement metric standpoint. “Is that something you're thinking of? Dr. Michael J. Hall: 100%. So, when we looked at the barriers, many of the kind of the things that were the strongest predictors of who used aspirin versus who didn't were really patients' perceptions of whether aspirin would cause side effects or whether aspirin would be burdensome to take on a daily basis, also, just how much benefit they thought would come from taking aspirin. So, I think there's, number one, I think an intervention and our next delve into this as an interventional study would be both education about the delta prevention benefit that you get from aspirin, the safety profile of aspirin, which is really quite excellent. And also, I think the data that are so important that in this study by Burn et al, it was actually only two years of intervention that then paid off for 10 years down the line, right? So, I think that's important. The other thing that we actually learned as an aside in this study was actually the kind of intervention that patients wanted the most was actually not a drug and was not a vaccine and was not another kind of special scope to stick somewhere. What they actually were most interested in were interventions related to diet. People really see diet as being an important part of health, or I should say diet and nutrition. And so, I think a subsequent study would perhaps wed both a nutritional intervention of some kind with a chemo prevention in some sort of time limited fashion, so that folks felt like they were both focusing on something that was more important to them, but also, something that was related to the study that we wanted to look at. So that's kind of my idea of where we're going to go in the future with this. Dr. Rafeh Naqash: Excellent. Sounds like the next big RO1 for your group. Dr. Michael J. Hall: Let's hope so. Dr. Rafeh Naqash: Well, I hope the listeners enjoyed talking about the science and learning about aspirin Lynch syndrome. The last couple of minutes are about you as an individual, as an investigator. Can you tell us what your career journey has been like, how you ended up doing what you're doing, and perhaps some advice for early career junior investigators on what this whole space looks like and how you pace yourself and how they can learn from you? Dr. Michael J. Hall: I really got interested in oncology during my residency training. I really found that I really liked oncologists. I found them to be a bit more of a science focused group. They liked research, but you're in oncology because you understand the fears and the challenges of cancer. And so, it's both a combination of that love of science, but also that real human touch of taking care of people. The thing I always tell my fellows as well is the other thing I love about oncology is if you tell people they don't have cancer, they don't want to come back to you. Now, of course, that's modified in the prevention setting. But I really like that when people come to me in my GI oncology clinic, it's because they have a diagnosis and if I say you actually don't have cancer, they go off to their life, and so you're really spending your time on real subjects. The person who really got me most interested in Lynch syndrome and this kind of prevention research was a mentor from University of Chicago, Funmi Olopade, who really has been an enormous mentor for many, many people in the field. Actually, three people in my fellowship class all went on to careers related to genetics and genomics. So, she's been highly influential and continues to mentor me even in my mid-career. I think in terms of pearls or what keeps this interesting for me, I think as much as oncology treatment and new drugs and trials is super exciting, I love being able to step away from that into my genetics and prevention population and kind of focus on treating people in a different format. Patients who are healthy but are worried about cancer because of a family history or carrying a gene or otherwise, and I feel that that's where I can have also an important impact, but on a different level in educating people and helping them understand how genetics works in an understandable and simple way, but also giving them some tools. And one reason for this study, and the reason I study preferences related to prevention is, again, I don't want to just develop something and spend 10, 15 years of my life developing some intervention that everyone looks at and is like, “I don't really want to do that.” I want to really understand what it is that is important to the patients so that we can hopefully work together to develop things that can not only have impact but have impact on a wide scale. Dr. Rafeh Naqash: Awesome. You mentioned Dr. Olopade. I crossed paths with her actually at an international medical graduate community of practice session earlier this year at ASCO where she talked about her journey as an immigrant, talked about how she started, the kind of impact that she's had. It was obvious evident in the picture that she showed with all her mentees who have kind of gone all over the world. So that was very phenomenal. And it's surprising how small of a world we live in. Everybody knows everybody else. Dr. Michael J. Hall: It's crazy. More so than anyone I think I've met in my career; she is really a huge believer in mentorship and spending that extra time with your mentees. And she has been someone who has continued to promote me as an investigator and build me up and get me involved in things. And like I said, I've been in oncology now for quite a few years. But having that person who I think is always thinking about their trainees and people who have learned and grown under them, because what it does is it gives you that fire as well as an investigator to do the same thing for the people that you are a mentor for and train. So, I try to be just as good of a mentor to my genetic counselors and the fellows who come through me and my APPs to give them opportunities to get them excited about research and when they have these big moments to do that. So, yeah, I know Funmi just has had a huge impact on the field of genetics. I still remember some of our early conversations on the wards when she said to me, “Oh, this is such an interesting case. We don't really have anyone who's studying Lynch syndrome so much right now and you should really get into this area.” And I remember thinking, “Okay, I want to develop a niche and here's a niche that's waiting.” Dr. Rafeh Naqash: Clearly it paid off big time and you're paying it forward with your mentees. So, thank you again for joining us. This was an absolute pleasure. Hopefully, the listeners learned a lot about the science and also your journey and how you're trying to impact the field. Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all ASCO shows at asco.org/podcasts   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 opinion, experience and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity or therapy should not be construed as an ASCO endorsement.      

Pennsylvania's courts declared that our school funding system is unconstitutional because the quality of students' education is determined by their zip code. This year lawmakers have a chance to end the underfunding via a proposed $1.8 billion increase for public schools and a long-term commitment to close the entire funding gap.  I'm joined by students who are part of Children First's Justice in Education Program who are advocates for equitable education funding.  They are: Gwen Shapiro, Tyrese Gordon,  Agnes Kane, Hannah Levere, Jaelyn Walker, Dell Salm, Talia Flavin and Regina Yajah.https://paschoolswork.org/https://www.childrenfirstpa.org/issues/education/justice-in-education/First, I speak to Dr. Camille Ragin, former Chair Minority In Cancer Research Council  for the American Association for Cancer Research.   Dr. Ragin is also  professor in the Cancer Prevention and Control Program at Fox Chase Cancer Center-Temple University Health System in Philadelphia and  Associate Director, Diversity, Equity and Inclusion at Fox Chase. The AACR is a recipient of a portion of the proceeds from the recent "Sista Strut" Breast Cancer Walk sponsored by WDAS FM, Power 99 and Rumba 1061.  Dr. Ragin, discuses the latest information on the health disparities for Black women when it comes to breast cancer. https://cancerprogressreport.aacr.org/disparities/https://www.foxchase.org/  

The "Boy in the Box" is the name given to an unidentified murder victim, a 4-to 6-year-old boy, whose naked, battered body was found in a bassinet box in the Fox Chase section of Philadelphia, Pennsylvania, on February 25, 1957. He is also commonly called "America's Unknown Child."

Amy Mackenzie, MD, grew up in Los Angeles but fled the scene in 1994 after college in rural New York to live and work in Japan for 3 years. She decided to pursue medicine at that time and headed back to the states to finish up pre-med work while working for the Japanese Consulate in Los Angeles. She then moved to Philadelphia in 2000 to work and apply to med school, ultimately enrolling at MCP-Hahnemann (now Drexel). After a year as part-time faculty at the med school, she went on to 3 years of IM residency at Temple and subsequently worked as a hospitalist at Fox Chase for a year between residency and fellowship. She completed heme/onc fellowship at Jefferson in 2013 and then became the first oncologist to do a geriatrics fellowship at Jefferson. She has 4 board certifications: internal medicine, hematology, oncology and geriatrics. She is an associate professor and a fellow of the American College of Physicians, actively participates in an older adults task force with ASCO (Amercian Society of Clinical Oncology) and sits on the board of the newly formed American Academy of Geriatric Oncology. Welcome to the show!___0:00 - Intro1:17 - Statistics About Oncology2:24 - What Is Hematology Oncology?7:06 - Journey Into Heme-Oncol.12:39 - Entering Med School Older Than Most People19:16 - What Was Heme-Oncol. Fellowship Like?26:29 - Getting Into Geriatrics30:07 - What Is It Like Being an Attending?37:33 - Dealing With Very Sick People41:23 - Delivering Bad and Good News50:24 - Lessons Learned From Treating Very Ill Patients55:32 - An Average Day/Week of a Hematologist Oncologist1:06:20 - If I Give You $100 Million, What Would You Do?1:09:09 - Worst Thing About Being a Hematologist Oncologist1:11:50 - Best Thing About Being a Hematologist Oncologist1:13:27 - Advice to People Looking Into Hematology Oncology1:16:36 - Maximizing Competitiveness Going Into Fellowship1:19:09 - Advice to People Entering a Career in Medicine1:25:22 - Super Important Question!!!1:27:24 - Closing Message1:30:22 - Outro__Resources___View the Show Notes Page for This Episode for transcript and more information: zhighley.com/podcast___Connect With ZachMain YouTube: @ZachHighley Newsletter: https://zhighley.com/newsletter/Instagram: https://www.instagram.com/zachhighley/?hl=enWebsite: https://zhighley.comTwitter: https://twitter.com/zachhighleyLinkedln: https://www.linkedin.com/in/zach-highley-gergel-44763766/Business Inquiries: zachhighley@nebula.tv___Listen for FreeSpotify: https://open.spotify.com/show/23TvJdEBAJuW5WY1QHEc6A?si=cf65ae0abbaf46a4Apple Podcast: https://podcasts.apple.com/us/podcast/the-zach-highley-show/id1666374777___Welcome to the Zach Highley Show, where we discuss personal growth and medicine to figure out how to improve our lives. My name is Zach a Resident Physician in Boston. Throughout these episodes I'll interview top performers from around the world in business, life, and medicine in hopes of extracting the resources and techniques they use to get to the top.The best way to help the show is share episodes on any platform. If you think a friend or family member will like a certain episode, send it to them!See Privacy Policy at https://art19.com/privacy and California Privacy Notice at https://art19.com/privacy#do-not-sell-my-info.

JCO PO author Dr. Sanjeevani Arora shares insights into her JCO PO article, “Exploring Stakeholders' Perspectives on Implementing Universal Germline Testing for Colorectal Cancer: Findings from a Clinical Practice Survey” Host Dr. Rafeh Naqash and Dr. Arora discuss germline genetic testing for all colorectal cancer (CRC) patients and advantages and barriers of implementing universal germline testing (UGT).  TRANSCRIPT Rafeh Naqash: Hello and welcome to JCO Precision Oncology Conversations where we bring you engaging conversations with authors of clinically relevant and highly significant JCOPO articles. I'm your host, Dr. Rafeh Naqash, social media editor for JCO Precision Oncology and assistant professor at the OU Health Stephenson Cancer Center at the University of Oklahoma. Today we're excited to be joined by Dr. Sanjeevani Arora, assistant professor at Fox Chase Cancer Center, and author of the JCO Precision Oncology article, Exploring Stakeholders' Perspectives on Implementing Universal Germline Testing for Colorectal Cancer: Findings From a Clinical Practice Survey. At the time of this recording, our guest's disclosures will be linked in the transcript. Dr. Arora, welcome to our podcast and thank you for joining me today. Sanjeevani Arora: Hi, thank you so much for having me. It's a pleasure to be here. Rafeh Naqash: As it happens, you were in Vegas for your meeting, which is relevant to this publication since this was, I believe, presented at the meeting as well. Is that correct? Sanjeevani Arora: Yes. Rafeh Naqash: Great. So, Dr. Arora, for background purposes, could you tell us what is the main theme of this project and what was the reasoning for doing this project in this important space of germline testing for colorectal cancer? Sanjeevani Arora: So, we were interested in understanding what the stakeholder's perspectives would be for support as well as implementation of universal germline testing in all colorectal cancer patients. We know that colorectal cancer is one of the leading types of cancers in the United States as well as in the world.  And from what we understand is that the prevalence of mutations that would increase risk of colorectal cancer, that can vary in an unselected population, so somewhere about 15%. The criteria, however, to identify who might be harboring a variant that would predispose to colorectal cancer, there are various methods to do that. However, I think an important point to consider here is that many patients who harbor such variants do not meet established criteria for genetic testing. The problem with that is that that is a missed opportunity to not only manage a patient who may carry such variations, so that can impact their clinical management as well as in their family as well. So, missed opportunity for risk reduction and early detection with enhanced surveillance. So, really if you think about this is based on these, the NCCN itself has now recommended universal germline testing for individuals who are diagnosed with colorectal cancer who are younger than 50 years of age. And in June 2022, they also suggested to consider testing for those who are older than 50 years of age. But in spite of this, there is lack of data from stakeholders and lack of data on advantage of and barriers to implementing universal germline testing at different clinical practices. So, this was really the main reason why for us to go ahead and do this study so that we can understand what the challenges are related to universal germline testing and especially coming from the stakeholders and also to try to understand what the overall broad support is from the stakeholders. Rafeh Naqash: Thank you so much for that explanation. I personally work in the early phase clinical trial space. So, for me, genomics makes a huge difference for people with cancer and not just from a testing standpoint, but also from a target standpoint drug discovery standpoint. And I think as I've gradually progressed in my career, I have felt that catching individuals with germline predispositions can make a huge difference for their families, especially. Prevention is better than cure in most respects. So, this is a very relevant and a very timely topic. And outside of this study, from a logistics perspective, could you tell us, since our listeners are not just academic clinicians or geneticists, but perhaps a bunch of them are probably community oncologists also and hopefully other disciplines that are not in the academic setting, how does it work for you in your current setup at Fox Chase of how people get this germline testing, people with colorectal cancer? Sanjeevani Arora: The main challenge here is trying to, at least in terms of the perspectives of genetic counselors, is that currently they see all patients and eventually if there is implementation of universal setting in the way, they will perhaps only end up seeing those who truly are at high risk. So, that would really be a huge change in their own practice as well, like who they're seeing in the clinic. In terms of how this could be implemented, obviously there are multiple challenges here. So, for example, it would go on from not only just the who would order and who would consent, but also then who would be disclosing the results because there would be a big demand for this. So, the idea would be trying to really streamline if non-genetics providers could get the training to be involved in this. So, this system can be streamlined, I should say, that genetic providers would be more involved in the phase where they are truly required. So, perhaps that would be in the result disclosures or on a case-by-case basis. Rafeh Naqash: I think you bring an important point as far as testing and who is responsible for discussing the implications of the results. And I know you touched into that aspect in your survey. Could you elaborate a little more on the results section side of what you found that had clinical relevance or meaningfulness from your survey standpoint? Sanjeevani Arora: So, when we surveyed our respondents on support for the kind of providers who could be involved in ordering and consent for universal germline testing, the majority obviously supported genetics providers. So, here genetics providers were genetic counselors, medical genetics geneticists and genetic nurses. However, there was also broad support for medical oncologists, gastroenterologists, and surgeons. There was even a minor part of our respondents also supported other providers as well. So, it's good to see that while there is broad support for genetics providers, there is room for other providers to be involved in this aspect of universal germline testing in a program. We also looked at the opinions and how and when genetics education should be provided in such a program for universal germline testing. The majority of our respondents, said that pre-test genetic education is necessary. So, they all felt that this is an important aspect of a universal germline testing program. However, there were nuances on what materials could be provided as well as who could potentially be involved in this. So, based on what the respondents said in their survey, it looks like this could be a good place for non-provider staff to be involved in this. However, when we also asked them what the non-genetics providers in the knowledge that they have potentially when we directly ask them this, do they have the knowledge to consent for genetic testing? Going back to the consent point, again, the majority did not agree with this. However, there was a percent that also felt that they do have this knowledge, but when we asked them that if they have the knowledge to disclose results, there was a strong disagreement there. So, there definitely is room for non-genetics providers to get the right training or to be involved in this aspect if needed. But it looks like at least for the consent, there is more support. Rafeh Naqash: So, the more one thinks about this topic from a broader perspective, not just colorectal cancer but other tumor types. What comes to my mind as you have elaborated in your discussion and in your survey, is the education part of it that you just mentioned about. If you were to think out of the box, do you think that the NIH has a potential role in creating mechanisms to help facilitate some of that? Since I think the bigger question comes back to funding at the end of the day. Institutions need to invest time, energy, resources in trying to educate and expand on this aspect of genetic testing, which I think is immensely important for individuals with strong family history of cancer, or even find out that they don't have high risk features, but they end up having some germline variants that are potentially actionable for them or their family. So, have you as part of your association, the CGA, been able to think on some of those lines to get a stakeholder like the NIH to help facilitate fund some of these educational initiatives at institutions? Perhaps maybe to start with NCI-Designated institutions and then expand in the community. Sanjeevani Arora: I think NIH would have a big role in this or NIH as well as other funding agencies because I think this effort for a universal germline testing program in academic centers and then eventually going on to community-based centers or maybe both at the same time, this will require a collaborative effort between genetics and non-genetics providers that we identify is going to be really very important going forward. So, there is not only a big role for the institutions and the community itself, but also for the NIH as you mentioned, where this would be really necessary to really help us identify who is a high-risk individual and when the pre-test education and other post-test is required. Rafeh Naqash: I think because in the bigger picture it does play out into the amount of funding that a government agency like the NIH spends in individuals with advanced cancer, which they could potentially prevent if some of these programs are well implemented early on and help with reducing morbidity and mortality when these events do happen later on. But I guess these are discussions beyond the scope of this project in this podcast, but I was just thinking from an out of the box perspective, could that be an opportunity that your group can perhaps work with the NIH on? So, going back to the project, the publication, tell us a little bit more about the genes that were tested. You talk about the single gene versus the multi-gene panel. Could you elaborate a little more on that and what are the advantages of one or the other? Sanjeevani Arora: We did survey our respondents on what they thought would be the best way to move forward in a universal germline testing program. And you can see that the majority really supported a standardized multi cancer gene panel. And I thought that was really interesting because if you look at the data here is that while 46% support that, there's also a smaller majority, about 26% that only support colorectal and some common cancer genes. So, in terms of the large multi cancer gene panels, so this would be not only just the colorectal cancer genes, so these would be high risk, moderate risk or limited evidence, colorectal cancer genes, plus it would be all other genes that we test currently for hereditary cancer types. So, this would be a lot of data that would come about in a universal germline testing program. And then I think the idea would be how would this be managed? Because many of the genes currently, we don't understand if they would increase colorectal cancer is, so how would be manage the risk for perhaps other cancer types if there is a positive result? I think that's something to think about. The other would be how would the variance of uncertain significance would they be reported and how would that work about? So, those two would be really important as well to think about going forward in such a program. Rafeh Naqash: Now from a cancer standpoint, my experience with germline testing has been when I see individuals for clinical trials especially, and I do broad next generation sequencing the tumor tissue or on blood and identify something that has a very high variant allele frequency that triggers a question in my mind whether this is germline. Unfortunately, these days we don't do a great job in taking history from the individual where you ask them about family history extensively. Some clinicians are better in this perspective than others, but I think there's a gap there. And then you go back to the patient, you ask them whether they have a history, had a recent individual recently that had uveal melanoma, and then I identified a very high variant allele frequency in a gene called BAP1, which you might be aware of. And then went back to the patient asked them and they said, well yes, they have family history of mesothelioma, family history of this cancer that cancer, and that triggered germline testing, which was positive. So, from your perspective, since a bunch of these individuals would have first-line contact, I would imagine with oncologists, mostly medical oncologists rather than surgeons, what should one look out for? Let's say a program does not have universal germline testing implemented yet. If me or my colleagues sees an individual with colorectal cancer, what would be the three or four red flags that we should consider to focus on germline testing in those individuals? Let's say we're in the community and I'm someone who's not necessarily on the genomic side, I'm a clinician treating colorectal cancer. What would some of those things be that should prompt me to consider germline testing in that individual with colorectal cancer? From your perspective. Sanjeevani Arora: Once the universal germline testing program is implemented, and you wouldn't necessarily need those questions actually, but without such a program, obviously family history is a major red flag that is very important to consider. And another would be, for example, in terms of tumor set testing for Lynch, if there is any mutations in Lynch genes or MSI High that could at least trigger test if that came from the germline. Rafeh Naqash: I think those are important points. And in the clinical setting it does often happen that you see so many individuals and sometimes some of this thought process can get lost in translation. But I think it's important to emphasize, like you pointed out, asking for family history if the universal program for testing of these individual's not implemented, then inquiring on family history and these days we see a lot of young onset colorectal cancers. Interestingly enough, my colleagues talk about it all the time and I think those aspects of it should ideally prompt people to go for germline testing. Now, from an implementation standpoint, you also looked at that in your respondents which individuals would be the ideal candidates for this testing. Could you elaborate on that? Sanjeevani Arora: Which individuals would the ideal candidates, I mean, I think the idea here was what is the support overall for testing everybody? So, the idea is to move away from having certain criteria. Now it would be the NCCN recommends testing any colorectal cancer patient who is younger than 50 years for a germline multi-gene panel testing. And then the consideration is for those who are older than 50, I hope the NCCN will eventually decide to recommend it for all. But this way there would be no need for any criteria as such, but just test all patients. Rafeh Naqash: I absolutely agree with you, and I think organizations such as NCCN, NCGA should ideally partner on creating some of this framework so that everybody's on the same page. Because I think that does play into the fact that how payers consider reimbursement for some of this testing. Did you encounter that in your respondents as one of the reasons why it could be challenging to implement universal germline testing, from a payer standpoint, insurance standpoint? Sanjeevani Arora: One of the things that we did factor into the survey as one of the barriers that ... so, we had about 11 questions for what the clinical practice barriers would be in a universal germline testing program. And this was one of the questions that the respondents did majorly agree on that the insurance may not cover the cost of testing for all patients. So, I think obviously the things do have to modify in terms of coverage guidelines to include all patients. Rafeh Naqash: Right. Because that again plays into logistics of ordering this for individuals and those individuals not having to see several thousand dollars bills resulting in financial toxicity. So, Ithink having these discussions, in your collaborative group is leading, I think extremely important from that perspective. What would be the next step for this? You did the survey, you understood what are the pros, the cons, the limitations, the benefits, what is the next step that your group is planning to take to implement some of this, create the second stage for some of this work, if there is something that you would like to highlight. Sanjeevani Arora: In terms of just in general speaking about this, I think as we finished this survey and we got it through publishing this, some of the things that we thought about and not necessarily that we may be doing this as a group or it might be just individuals, but just to talk about what we think could be the next steps here is obviously, this survey, the stakeholders here were those who are experts in hereditary GI cancers. The idea would be to also see what the thoughts are for those who are not, because they would be big stakeholders in this as well. So, it would be good to understand what they also perceive as the barriers associated with this and how we could get this implemented and also see what their support is. So, I think that's one thing. The other thing that's I think really important to point out here is that we don't have patient perspectives on a universal germline testing program. And what do they think about this? What do they perceive could be potential barriers even for them? I think that would be very important so that there is really a real uptake in the real world. I think that's very important to do, that the patient focus is very important. Now, I'm not sure if we would be doing this, I would love to do this, but I think it's really important to really consider that going forward. Another thought that I had that was based on a question that I got asked when I presented this at the CGA-IGC meeting in Vegas just last week was that how one of the things that was pointed out were that the majority of our respondents were, and I've already kind of touched on this too, were genetics providers. So, perhaps the results could be for some of the perceived barriers for how non-genetics providers could be involved, could be skewed because the survey majorly had results from genetics providers. So, I think again, just pointing out that there is a real need for collaborative efforts between genetics and non-genetics providers to understand where are the areas that they could need help so that this could be realized. Rafeh Naqash: Absolutely. I think as you pointed out there are definitely limitations associated, but I think your work and this publication lays some very important groundwork to initiate the discussion, at least. It's understood that community providers take care of at least 60% of individuals. There's maybe more with cancer. So, having stakeholders from different aspects is important, but can be challenging also since your group is just starting this work. So, I think the patient perspective, the community perspective is definitely important and hopefully that'd be something that you and your group can further work on and hopefully in the years to come, maybe publish it again in JCOPO as you did this time. Sanjeevani Arora: Yeah, that would be the hope to really get even broader perspectives. Yeah. Rafeh Naqash: So, Dr. Arora, a couple of quick questions on you as a researcher now since you've touched upon your work. Could you tell us a little bit about your background, your professional background, your interest in genetics and your current role at your institution? Sanjeevani Arora: So, my background, I have a PhD in biochemistry and cancer biology, as a postdoc I really expanded into molecular genetics. That's what really led for me to work in this area. So, currently I have a research lab at Fox Chase Cancer Center, and I'm in the Cancer Prevention and Control program. And a major part of my research program is looking at the genetics of colorectal cancer. And I'm very interested in understanding what could be the other genetic risk factors that is really leading to this alarming rise in incidents, especially in the young population. So, that's one of the aspects of my work that I'm interested in. But another aspect of my work that I'm working on is looking at are there genetic factors in the germline that could potentially impact how individuals respond to their treatment? And so, yeah, I do have a big stake in knowing more about overall genetics of colorectal cancer. Rafeh Naqash: Excellent. Well, thank you so much. It was great talking to you about this topic and hopefully our listeners find this interesting as well. Thank you for listening to JCO Precision Oncology Conversations. Don't forget to give us a rating or review and be sure to subscribe so you never miss an episode. You can find all ASCOshows at asco.org/podcasts. 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. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.

During Breast Cancer Awareness Month 2023,  Rebecca M. Shulman, MD, an assistant professor in the Department of Radiation Oncology at Fox Chase Cancer Center, and Zachary Kiss, DO, a third-year resident physician in radiation oncology at Fox Chase, spoke about findings from their study, which assessed how BRCA1/2 mutations in patients with breast cancer do not appear to affect treatment outcomes with radiotherapy.  Shulman and Kiss presented these findings as part of a poster session at the 2023 American Society for Radiation Oncology (ASTRO) Annual Meeting. Disease-free survival (DFS) outcomes following radiation were reported to be comparable between patients with no BRCA mutations (n = 1482) and those with BRCA-mutated disease (n = 77; P = .26). Additionally, those with BRCA1/2 mutations tended to be younger (P = .004), have higher clinical stage disease (P

Welcome to ALIVE Radio Show, where positivity flows, empowering and inspiring people to create opportunities for their lives. In this episode Mr. Warren Chambers, featured in the Fox Chase website as a cancer survivor, talks about life vitality with MgSO4, magnesium sulfate. He talks about his recovery of two cancers and his successful professional journey with Magnesium Sulfate products in sports, recovering muscles before and after the game for the NFL and NBA teams. --- Send in a voice message: https://podcasters.spotify.com/pod/show/aliveshow/message Support this podcast: https://podcasters.spotify.com/pod/show/aliveshow/support

This week inside The Pastor's Office, Rev. Jonathan A. Mason sits down with Donovan West, candidate for Philadelphia City Council At-Large, then Dr. Mandy Manna, Administrator at Fox Chase Farm, a passionate educator striving to engage all students in experiential learning through agriculture.See omnystudio.com/listener for privacy information.

In this episode of the Crack House Chronicles Donnie and Dale discuss Joseph Augustus Zarelli - The Boy In The Box. On Feb. 25, 1957, a college student was wandering in a wooded area of Philadelphia's Fox Chase neighborhood when he found the dead body of a little boy in a box. The child had been beaten to death and wrapped in a blanket before being left in a JC Penney box he was found in. He was malnourished and had seven scars, three of which may have been surgical scars. Then, after nearly 66 years, on Dec. 6, 2022, Philadelphia police held a news conference to reveal they had used the latest DNA and genetic genealogy techniques to identify the boy, according to The New York Times. His name was Joseph Augustus Zarelli. He'd been born on Jan. 13, 1953, and he was only 4 years old when he died. https://www.crackhousechronicles.com/ https://www.tiktok.com/@crackhousechronicls https://www.facebook.com/crackhousechronicles Check out our MERCH! https://www.teepublic.com/user/crackhousechronicles Sources: https://www.investigationdiscovery.com/crimefeed/news/the-boy-in-the-box-finally-identified-65-years-after-his-body-was-discovered https://en.wikipedia.org/wiki/Murder_of_Joseph_Augustus_Zarelli https://allthatsinteresting.com/boy-in-the-box https://www.inquirer.com/news/live/boy-in-box-philadelphia-name-identity-solved-20221208.html    

The story of The Boy in the Box, also known as America's Unknown Child, is not a happy one. For 65 years the identity of that child found on a cold and rainy February morning in the Fox Chase neighborhood of Philadelphia remained a mystery. In December of 2022, his identity was finally released to the public. A good measure of closure, to be sure, but a question remains unanswered: with the knowledge that this was a homicide, who was the culprit? Welcome back to The Lore Lodge... Subscribe on Patreon to support The Lore Lodge for just $1 per month! https://patreon.com/thelorelodge Check out more of our stuff via https://linktr.ee/theaidanmattis Shop our curated storefront at https://amazon.com/shop/aidanmattis Discord: https://discord.gg/233tjGj46z Buy our signature coffee roast at https://tablowroastingco.com/products... Shop at Target and support The Lore Lodge at https://goto.target.com/lorelodge Shop sustainable products at https://www.gaiaindustrees.com/ using code "LORE"

A bassinet box, a tattered blanket, and a 65 year investigation. In February of 1957 the body of a young boy was found discarded in a rural area of Fox Chase, Pennsylvania. His identity was unknown. The case became known as the boy in the box case and the boy was only known as America's Unknown Child. After an investigation that spanned six decades, Joseph Augustus Zarelli's identity is finally known. If you have any information about the murder of Joseph Augustus Zarelli please contact Detective Robert Hesser at 215-686-3334. You can also call or text the tipline at 215-686-TIPS [8744]. There is a $20,000 reward for information leading to an arrest and conviction. America's Unknown Child: http://americasunknownchild.net/ Military Murder Podcast: https://militarymurderpodcast.com/ Least of These on Facebook: https://facebook.com/leastofthesepodcast/ Least of These Discussion Group: https://facebook.com/groups/288046119723080/?ref=pages_profile_groups_tab&paipv=1 Least of These on Instagram: www.instagram.com/least_ofthese/ Get your episodes ad free at: https:// www.patreon.com/leastofthesepodcast

Welcome to our first ever Case Update episode. In July of 2021, we covered the case of “The Boy in the Box” aka “America's Unknown Child”. The identity of the boy who was abused, murdered, and dumped in a trash pile on the side of the road in Fox Chase, Philadelphia, Pennsylvania in February of 1957 has finally been identified. In December of 2021, we also brought you the case of “Christmas Tree Jane Doe” aka “The Christmas Tree Lady” aka “Annandale Jane Doe”. In that story, the unidentified body of an elderly woman was found suffocated to death in the children's section of a cemetery in Annandale, Virginia in 1996. She, too, has finally been identified. In this short case update episode, we briefly discuss the most recent news articles and press conferences for each case. We would love to hear from our listeners to see what their thoughts are on these two groundbreaking identifications solved through Forensic Genealogy. TIME STAMPS 00:00:00 BOY IN THE BOX UPDATE 00:17:00 CHRISTMAS TREE LADY UPDATE Let us know if you enjoyed this episode or not by interacting with us on our instagram (@letsgethaunted) or on our subreddit (r/letsgethaunted). We will return on Wednesday with your regularly scheduled haunting. Relevant Links mentioned in the episode: - Boy in the Box Press Conference Livestream: https://www.youtube.com/watch?v=lrFVW83JuSc - Christmas Tree Lady news article: https://www.washingtonpost.com/crime-law/2022/07/07/christmas-tree-lady-identified/ —— WE ARE FINALISTS in the “Weird” category for the Signal Awards!!!! Voting for The Signal Listener's Choice goes through December 22nd at 11:29 EST. PLEASE VOTE FOR US LIKE YOUR LIFE DEPENDS ON IT AT THIS URL: https://bit.ly/LGHSignalAwards —— Other Important Stuff: Buy Our Merch: https://www.letsgethaunted.com Donate to our stupid show: https://ko-fi.com/dogmomusa Check out the photo dump for this week's episode: https://www.instagram.com/letsgethaunted Send us fan mail: PO BOX 1658 Camarillo, CA 93011 Send us your listener stories: LetsGetHauntedPod@gmail.com

On February 25, 1957, an unidentified male child dead, naked, and badly beaten body was found in a cardboard box along Susquehanna Road in Philadelphia's Fox Chase neighborhood. The unknown victim was listed as "America's Unknown Child." On December 08, 2022, 65 years after the homicide, the name of the victim was released to the public. --- Send in a voice message: https://anchor.fm/michael-c-bouchard/message Support this podcast: https://anchor.fm/michael-c-bouchard/support

Enter now for your chance to win a CreepTime giveaway! - ⁠⁠⁠⁠https://www.creeptime.com/giveaways⁠⁠⁠ On a cold morning in February, 1957 a passerby in Fox Chase, Philadelphia discovered a box in the woods containing the shriveled remains of a young boy. The child's body was highly disturbing and confused investigators. While he clearly had signs of extreme abuse he also showed signs that he was meticulously cared for. This included a fresh haircut, a cleaned body, trimmed nails, and even plucked eyebrows. Despite a lengthy and thorough search for who was behind the murder of this child police hit a dead end, and it appeared as if this boy had never even existed. To this day, the case has been an endless road of bad leads and mysterious details which we now refer to as “The Boy In The Box”. Subscribe to CreepTime premium for access to exclusive new episodes and solo mystery deep-dives for highly requested cases from fans. All completely ad-free! https://anchor.fm/creeptime/subscribe --- Send in a voice message: https://podcasters.spotify.com/pod/show/creeptime/message

Today Declan and Renu chat with two young doctors who have spent the past few weeks on the Poland-Ukraine border, helping with the refugee crisis triggered by Russia's invasion of Ukraine. Just amazing stories of desperation and tragedy, with some inspiring tales of resilience and generosity. Dr Laura Bukavina is a Urology Fellow at Fox Chase Cancer Centre in Philadelphia, and Dr Alberto Castro is a research Fellow at Fox Chase, soon to start his urology residency. Laura is a Ukrainian and tells the story of why she got on a plane as soon as the invasion started, and headed for the Ukrainian border. Alberto joined her within a few days. Some amazing stories.To do what you can to help, please visit Laura's gofundme page and make a donation. GU Cast hosts are Professor Declan Murphy and Dr Renu Eapen We also cross-posted this on YouTube including some amazing photos and videos from the border. Well worth a watch. Links:gofundmeDr Laura Bukavina TwitterDr Alberto Castro Twitter

We celebrate Black History month by recognizing one of country music's legendary musicians, DeFord Bailey. Alex takes over as host to break down Fox Chase. Hooky with Sloane by Bird Creek Creative Commons — Attribution 3.0 Unported— CC BY 3.0 https://creativecommons.org/licenses/... Music provided by FreeMusic109 https://youtube.com/FreeMusic109

In February 1957 a young man named John Stachowiak was setting up several muskrat traps in a field near Fox Chase, PA. This wasn't a particularly odd thing to do at the time, and this wasn't the first time John had set up these traps, so he was just going about his business just like he would any other day. As John walked through the field he stumbled upon a large cardboard box. As he grew closer he saw that the box contained something unexpectedly horrifying - the body of a young child.Listen to hear more. Sources: https://www.nbcphiladelphia.com/investigators/philly-detectives-closer-to-cracking-boy-in-the-box-cold-case-mystery/3045401/https://en.wikipedia.org/wiki/Boy_in_the_Box_(Philadelphia)https://allthatsinteresting.com/boy-in-the-boxhttps://medium.com/the-mystery-box/unsolved-mysteries-who-was-the-boy-in-the-box-172e19dbba85https://truecrimesocietyblog.com/2021/07/26/who-is-the-boy-in-the-box/https://theboyinthebox.weebly.com/overview.htmlhttps://www.ranker.com/list/facts-and-theories-about-the-boy-in-the-box/cat-mcauliffehttps://charleyproject.org/case/steven-craig-dammanhttps://www.americanhauntingsink.com/the-boy-in-the-boxhttps://archives.jdc.org/hungarian-refugee-cards-1956-1957-now-available-in-jdc-names-index/https://dalebrumfield.medium.com/child-erased-65c4ab969685

He would be approximately 70years old today, although no one really  knows exactly how old he would be, because no one knows when he was born, or his name,or his parents or who is favorite comic book hero was. No one knows anything,. We only know him as The Boy in a Box, or America's Unknown child. He is the  unidentified murder victim, 3 to 7 years old, whose naked, battered body was found in a cardboard box in the Fox Chase section of Philadelphia, Pennsylvania, on February 25, 1957.   Gift Bob received from the Vidocq Society     I KNEW the building would look like this!!     WARNING: PICTURES BELOW MAY BE DISTURBING TO SOME         Newest Grave stone, I hope it soon will say a name instead         Wanted Poster for information Detectives lovingly dressed him for photos and his funeral   None of the photos on this page belong to Haunting History Podcast. No copyright infringement intended and are only used as enhancements to the story told.    At times when reporting facts regarding a true crime, (and photos) multiple sources  use the same wording. Every effort is made to avoid any copyright infringements and no single work  was intentionally plagiarized when reporting the facts of the crimes or the telling of the stories.  Below is a  list of resources  used during the research and telling of this story. (partial)  Information Credits:   https://en.wikipedia.org/wiki/Boy_in_the_Box_(Philadelphia) https://medium.com/the-mystery-box/decades-after-he-was-found-there-is-still-hope-for-americas-unknown-child-678ce17ff7ec https://allthatsinteresting.com/boy-in-the-box https://www.ranker.com/list/facts-and-theories-about-the-boy-in-the-box/cat-mcauliffe https://philadelphia.cbslocal.com/2020/11/11/memorial-services-held-for-boy-in-the-box-decades-after-murder-remains-unsolved-mystery/ IMAGE CREDIT https://www.google.com/url?sa=i&url=https%3A%2F%2Fallthatsinteresting.com%2Fboy-in-the- https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.reddit.com%2Fr%2FUnexplainedPhotos%2Fcomments%2F23cp6w%2Fknown_also_as_americas_unknown_child_the_boy_in%2F&psig=AOvVaw2AbIGFv3JkjtrqjTFHbpYO&ust=1638399775050000&source=images&cd=vfe&ved=0CAwQjhxqFwoTCODxwvqYwfQCFQAAAAAdAAAAABAJ   https://www.google.com/url?sa=i&url=https%3A%2F%2Fallthatsinteresting.com%2Fboy-in-the-box&psig=AOvVaw2AbIGFv3JkjtrqjTFHbpYO&ust=1638399775050000&source=images&cd=vfe&ved=0CAwQjhxqFwoTCODxwvqYwfQCFQAAAAAdAAAAABAO   Bob Taft     and of course Ancestry.com, MyHeritage.com, Newspaperarchives, FamilySearch.org   This presentation is protected by US & International copyright laws. Reproduction & distribution of the presentation without written permission of the sponsor is prohibited. 

The "Boy in the Box" is the name given to an unidentified murder victim, a 4-to 6-year-old boy, who's naked, battered body was found in a bassinet box in the Fox Chase section of Philadelphia, Pennsylvania, on February 25, 1957. He is also commonly called "America's Unknown Child." Submit your stories: popmediaagency@gmail.com

In February of 1957 a young boy was found dead inside a box in Fox Chase, Philadelphia. To this day he is still unknown although there are a few theories of who he may be and how he may have ended up as the boy in the box.

Hi Guys, thanks for listening and thanks for the feedback we have been receiving, we really appreciate every one of you and love to hear from you.This week the beautiful Kimberley is covering the  Boy in a box.this  is a sad story about a child that has been terribly abused. This episode is not overly graphic, however there is a trigger warning as the storyline is pretty awful.The "Boy in the Box" is the name given to an unidentified murder victim, a 4-to 6-year-old boy, whose naked, battered body was found in a bassinet box in the Fox Chase section of Philadelphia, Pennsylvania, on February 25, 1957. He is also commonly called "America's Unknown Child." His identity has never been discovered, and the case remains open.There are many theories about what happened to this little boy and Kim presents them in this episode.Police believe that there are still witnesses out there who can identify him, so if you know anything, please come forward.Investigators have now gained a DNA profile on the boy and hope to use this to identify him in the future.have a listen to this sad tale and have your tissues ready.Please take care and stay safe, Love Steph and Kim xx References:https://en.wikipedia.org/wiki/Boy_in_the_Box_(Philadelphia) https://storiesoftheunsolved.com/2020/04/24/the-boy-in-the-box/ https://www.americanhauntingsink.com/the-boy-in-the-boxPhotographs and additional reading.https://www.google.com/search?q=the+boy+in+the+box&rlz=1C1GCEA_enAU936AU936&sxsrf=AOaemvJfeyiDedA1IOt4TjYWuHJp9S8DoQ:1631493976660&source=lnms&tbm=isch&sa=X&ved=2ahUKEwiD4rnX3PryAhValEsFHY2dDr8Q_AUoAXoECAEQAw&biw=1280&bih=577   Resources:https://www.health.nsw.gov.au/mentalhealth/Pages/contact-service.aspx#24-hourhttps://www.beyondblue.org.auhttps://www.betterhelp.comFind us at:Instagram: SolvedunsolvedorspookyFacebook: Solvedunsolvedorspooky Email us at: podcast@solvedunsolvedorspooky.comWe have recently moved over to the patreon platform and would love your support so that we can grow the show.Support the show (https://www.patreon.com/user?u=45582970)

Welcome to Get Up in the Cool: Old Time Music with Cameron DeWhitt and Friends. This week's friend is Brian Zimmerman. We recorded this a couple weeks ago at the Centralia Campout in Centralia, Washington. Tunes and songs in this episode: * Shipping Port (1:15) * Five Miles To Town (22:36) * Jack of Diamonds (37:43) * The Fox Chase (49:18) * Give the Fiddler a Dram (58:09) * Bonus track: Centerville Buy No Name String Band's albums at their website: https://nonamestringband.com/ Sign up for Cameron's banjo workshops with Caffè Lena! Beginning Clawhammer: https://www.eventbrite.com/e/165579253003 Intermediate Clawhammer: https://www.eventbrite.com/e/166397971813 Support Get Up in the Cool on Patreon: https://www.patreon.com/getupinthecool Buy Get Up in the Cool merch like t-shirts, phone cases, and masks! https://teespring.com/new-get-up-in-the-cool-swag Sign up at https://www.pitchforkbanjo.com/ for my clawhammer instructional series! Check out Cameron's other podcast, Think Outside the Box Set: https://boxset.fireside.fm/

In 1957 a boy is found in the Fox Chase area of Philadelphia, Pennsylvania. Still unsolved and cold almost 7 decades later. --- This episode is sponsored by · Anchor: The easiest way to make a podcast. https://anchor.fm/app Support this podcast: https://anchor.fm/shayna-edwards/support

In this episode we cracked open the box of 'old cases' and pulled out a few John Does.First, we talk about the 4-6 year old Doe known as the "Boy in the Box." In 1957 this unidentified murder victim's battered body was found inside a bassinet box in the Fox Chase section of Philadelphia, Pennsylvania. It was determined the boy died of blunt force trauma. Investigators were puzzled because it appeared the boy had been abused and neglected but seemed well-groomed at the same time. Over the years this case garnered a lot of attention, but to this day the Boy in the Box remains unidentified - which has left us with some wild theories and ~*interesting*~ investigation tactics. Then, we talk about a few more lesser known John Does and for once, we leave you with a happy ending... Kind of?Support the show (https://www.paypal.com/paypalme/TrueCrimeSociety)

"The Boy in the Box" is one of the United States' most infamous true crime mysteries. Sometimes called "America's Unknown Child", our story begins in 1957 when the body of a young child was found in an abandoned cardboard box on the side of a rural road in Fox Chase, Philadelphia, Pennsylvania. Despite an extensive police investigation spanning many different cities and states and many promising leads, the identity of the boy remains a mystery to this day. Will the mystery finally be solved this year with the help of genetic genealogy?? Tune in to hear us discuss the true crime case that has lived in Aly's head rent free for years. LGH Charity Fundraiser 2021 for the Lupus Foundation of America, click here to join our team and donate: https://bit.ly/3hxVtUp LGH is nominated for 3 podcasting awards, click here to vote for us now: https://podcastawards.com/app/signup Send us mail: PO BOX 1658 Camarillo, CA 93011 Send us your listener stories: LetsGetHauntedPod@gmail.com Donate to the show and/or buy our merch: https://www.letsgethaunted.com https://ko-fi.com/dogmomusa Follow us: LinkTree: https://linktr.ee/letsgethaunted YouTube: https://www.youtube.com/c/letsgethaunted Reddit: https://www.reddit.com/r/letsgethaunted/ FB: https://www.facebook.com/letsgethaunted Twitter: https://twitter.com/letsgethaunted Insta: https://www.instagram.com/letsgethaunted/ Nat: https://www.instagram.com/seaaminals Aly: https://www.instagram.com/thealterry

This episode contains strong themes and language that may be not suitable for younger listeners. The “Boy in the Box” is the name given to an unidentified murder victim, a 4-to 6-year-old boy, whose naked, battered body was found in a bassinet box in the Fox Chase section of Philadelphia, Pennsylvania, on February 25, 1957. This week, Leah brings in the details to this dark cold case, while Chris and Gavin debate who the unknown child is. (Hint: Listen to find out!) Don't forget to follow on Facebook, Instagram, and Twitter! https://www.facebook.com/thisstrangeworldpodcast/ https://www.instagram.com/thisstrangeworldpodcast/ https://twitter.com/thisstrangepod/ And check out more This Strange World links here: https://linktr.ee/thisstrangeworldpodcast Sources https://medium.com/the-mystery-box/unsolved-mysteries-who-was-the-boy-in-the-box-172e19dbba85 https://www.historicmysteries.com/the-boy-in-the-box/

El niño en la caja es el nombre dado a un niño no identificado cuyo cuerpo sin vida fue encontrado en una caja de cartón en la sección Fox Chase en Filadelfia, el 25 de febrero de 1957. Su identidad aún no ha sido descubierta, y al día de hoy el caso permanece abierto.

In February 1957, a man walking through the woods of the Fox Chase area outside Philadelphia made a gruesome discovery. It was the body of a little boy, who had been badly beaten and discarded inside a cardboard box. More than six decades later, the identity of the little boy and who murdered him, remains a mystery. Patreon: https://www.patreon.com/theconspiratorspodcast Notes: https://www.phillymag.com/news/2006/05/15/who-is-the-boy-in-the-box-part-one/ https://www.inquirer.com/philly/blogs/real-time/the-boy-in-the-box-1957-DNA-philadelphia.html https://www.truecrimeedition.com/post/the-box-in-the-box https://the-line-up.com/boy-in-the-box-case https://www.nytimes.com/2007/01/01/us/01boy.html Music: Dexter Britain, The Tea Party https://dexterbritain.com/ Loss by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4003-loss License: https://filmmusic.io/standard-license Despair and Triumph by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/3641-despair-and-triumph License: https://filmmusic.io/standard-license Mesmerize by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4994-mesmerize License: https://filmmusic.io/standard-license Relaxing Piano Music by Kevin MacLeod Link: https://incompetech.filmmusic.io/song/4273-relaxing-piano-music License: https://filmmusic.io/standard-license

El 25 de febrero de 1957 en Fox Chase, Filadelfia, encontraron el cuerpo de un niño en una caja. Este caso sigue siendo un misterio más de 50 años después.On February 25, 1957 in Fox Chase, Philadelphia, a body of a young boy was found in a box. This case still remains a mystery 50 plus years later.Sources:https://allthatsinteresting.com/boy-in-the-boxhttps://philadelphia.cbslocal.com/2021/04/30/the-boy-in-the-box-ivy-hill-cemetery-unsolved-murder-philadelphia/https://en.wikipedia.org/wiki/Boy_in_the_Box_(Philadelphia)

Andie is running for the LLS man/Woman of the Year campaign, which is a 10 week window to collect as many donations as possible. There are about 20 or 25 other folks in the Philly area all vying for the title. The one who raises the most by Sunday, June 6th will win! Her sister Debbie was diagnosed with Lymphoma in 2014, just a few months after she was married. She and her husband, originally from Northeast Pa, spent months in Philly so she could be treated at Fox Chase where she underwent hours of chemo and a stem cell transplant; the research for which was funded by LLS. Andie's monetary goal is $100,000. If she wins, her goal is the use that money to fund gentler cancer treatments for children. When she thinks back to what her sister went through, she can't help but think of a child's little body having to endure. Treatment should never be a death sentence. If you'd like to make a donation, click HERE Check out these items on Andie's Auction for a Cure! See omnystudio.com/listener for privacy information.

The "Boy in the Box" is the name given to an unidentified murder victim, a 4-to 6-year-old boy, whose naked, battered body was found in a bassinet box in the Fox Chase section of Philadelphia, Pennsylvania, on February 25, 1957. He is also commonly called "America's Unknown Child." His identity has never been discovered, and the case remains open. --- Send in a voice message: https://anchor.fm/thedarkroompodcast/message

The "Boy in the Box" is the name given to an unidentified murder victim, a 4-to 6-year-old boy, whose naked, battered body was found in a bassinet box in the Fox Chase section of Philadelphia, Pennsylvania, on February 25, 1957. He is also commonly called "America's Unknown Child." His identity has never been discovered, and the case remains open. --- Send in a voice message: https://anchor.fm/thedarkroompodcast/message

It's the winter of 1957, when a boys body was discovered in the woods of the Fox Chase area of Philadelphia, PA. Who was this boy and what had happened to him?

Dr. Jonathan Chernoff, MD, PhD, is Senior Vice President, Deputy Director, and Chief Scientific Officer, at Fox Chase Cancer Center (https://www.foxchase.org/) where he coordinates and charts the future course of research for the organization. The Hospital of Fox Chase Cancer Center and its affiliates (collectively “Fox Chase Cancer Center”), a member of the Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation's first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Dr. Chernoff joined the staff in 1991 as an associate member and was promoted to member with tenure in 1996. In 2002 he was promoted to be a senior member in Fox Chase Cancer Center's Basic Science division, the equivalent of a full professor in a university. A molecular oncologist as well as a board-certified medical oncologist, Dr. Chernoff has a special interest in factors that control cell growth and movement, including oncogenes and anticancer or tumor-suppressor genes, and has made fundamental contributions in this research. Dr. Chernoff earned his MD and his PhD in biochemistry in 1984 at Mount Sinai School of Medicine in New York City. He completed his residency in internal medicine at the University Health Center of Pittsburgh and a clinical fellowship in medical oncology at Johns Hopkins Oncology Center. He then held a postdoctoral fellowship in cellular and developmental biology at Harvard University before coming to Fox Chase. In recognition of his national reputation in molecular oncology and biochemistry, Dr. Chernoff also holds the Stanley P. Reimann Chair in Oncology.

In this week’s episode, Grace and Olivia, discuss the unsolved murder of “The Boy in the Box.” The young boy was found naked and battered off the side of a road in Fox Chase, Philadelphia more than 63 years ago. Who could he possibly be? And how did he end up there? Joining the duo is Twitch streamer, @icmephit. Follow us on Instagram @murderessrowpod

Today we go back to 1957, in Fox Chase, Philadelphia, where a man chasing a rabbit through the woods comes across a box and takes a look inside...Accompanying pictures on Instagram @crimedarlingpodcast and Facebook @crimedarlingYou can also come say hi on Twitter @crimedarlingSee you there!Sources - https://en.wikipedia.org/wiki/Boy_in_the_Box_(Philadelphia)https://www.dreadcentral.com/editorials/316318/the-boy-in-the-box-who-is-americas-unknown-child/https://storiesoftheunsolved.com/2020/04/24/the-boy-in-the-box/https://www.unsolvedcasebook.com/boy-in-the-box/Intro and outro music by AlexisOrtizSofield from Pixabay See acast.com/privacy for privacy and opt-out information.

On today's episode I catch up with my friend Johnathan Whetstine from the Fox Chase Cancer Center in Philadelphia. He is a distinguished professor, Program Leader of the Cancer Epigenetics Program, and Jack Schultz endowed Chair in Basic Science at Fox Chase. Johnathan's passion for science, and for his family is palpable.

The "Boy in the Box" adalah nama yang diberikan kepada korban pembunuhan tak dikenal, berusia 3 hingga 7 tahun, yang tubuhnya telanjang dan babak belur ditemukan di dalam kotak kardus di bagian Fox Chase di Philadelphia, Pennsylvania, pada 25 Februari 1957. Dia juga biasa disebut "Anak Amerika yang Tidak Dikenal."

The "Boy in the Box" adalah nama yang diberikan kepada korban pembunuhan tak dikenal, seorang anak laki-laki berusia 4 sampai 6 tahun, yang tubuhnya telanjang dan babak belur ditemukan di sebuah kotak keranjang di bagian Fox Chase di Philadelphia, Pennsylvania, di 25 Februari 1957. Mau tau teori-teorinya?

The Mighty Decibel completes its ninth discography review podcast, focusing on legendary southern rockers ... BLACKFOOT. From No Reservations to After The Reign, all 10 original studio albums are ravaged or lustily approved in this critical review ... with highlighted tracks to help set the record straight! Join us for the Fox Chase! (3:59) "Railroad Man" - No Reservations (7:30) "Stranger On The Road" - Flyin' High (12:03) "Train, Train" - Strikes (17:08) "Fox Chase" - Tomcattin' (23:21)"Good Morning" - Marauder (29:34) "We're Goin' Down" - Siogo (35:38) "In For The Kill" - Vertical Smiles (41:00) "Back On The Streets" (edit) - Rick Medlock and Blackfoot (43:00) "The Stealer" - Medicine Man (46:58) "Hang Time" - After The Reign

The "Boy in the Box" is the name given to an unidentified murder victim, a 4-to 6-year-old boy, whose naked, battered body was found in a bassinet box in the Fox Chase section of Philadelphia, Pennsylvania, on February 25, 1957. DelmarvaStudios.net

Tunes: O’Farrell: Oscar and Malvina, Irish Fox Hunt Piobaireachd: The Desperate Battle Dixon: The Stool of Repentance Bremner: Wright’s Rant Gunn: The Piper’s Son O’Farrell’s Irish Fox Hunt: https://digital.nls.uk/special-collections-of-printed-music/archive/87781370 If you haven’t seen it I highly recommend watching this clip of Liam O’Flynn talking about and playing the Fox Chase: https://youtu.be/EQU84O8xZlE O’Farrell’s Oscar & Malvina Set for the Pipes: https://digital.nls.uk/special-collections-of-printed-music/archive/87781238 Angus MacKay’s Manuscript for The Desperate Battle of the Birds, This isn’t really the version I played, but I learned it then forgot it then played it from Kilberry’s Ceol Mor, but I can’t really link to that. http://www.ceolsean.net/docs/AM%20titles/Desperate%20Battle%20of%20the%20Birds.pdf William Dixon’s The Stool of Repentance: https://www.mattseattle.scot/product-page/the-master-piper-new-edition Bremner’s Setting for Wright’s Rant: https://digital.nls.uk/special-collections-of-printed-music/archive/105003307 Gunn’s Setting for the Piper’s Son: https://ceolsean.net/content/Gunn/Book02/Book02%2021.pdf The David Allan Painting is the property of the National Galleries of Scotland, but also appears to have a Creative Commons tag on it. Anyway you can look at a very high resolution of the painting here: https://www.nationalgalleries.org/art-and-artists/8323/black-stool-stool-repentance Please take advantage of the Tune Collection tab: https://www.wetootwaag.com/tunesources Also Please take a minute to leave a review of the podcast! Listen on Apple Podcasts: https://podcasts.apple.com/us/podcast/wetootwaags-bagpipe-and-history-podcast/id129776677 Listen on Itunes: https://podcasts.apple.com/us/podcast/wetootwaags-bagpipe-and-history-podcast/id129776677 Listen on Spotify: https://open.spotify.com/show/5QxzqrSm0pu6v8y8pLsv5j?si=QLiG0L1pT1eu7B5_FDmgGA

The Boy in the box is one of Philadelphia's enduring mysteries. Who was the little boy found battered bruised and deceased in a box, in the Fox Chase section of Philadelphia? Who was this child who was found in a box that's outside read "Fragile Handle with Care" but in life did not receive any kind of care? He got much love and affection in death from the investigators and people who spent years trying to find out the identity of the child than he ever did in life. Follow this tragic tale of this unknown child and listen in on the clues that dropped like the tear drops that must have fallen down his once alive bruised and tattered cheeks.It is a never ending mystery, one that has stayed with the city since that cold February day in 1957 when he was found in a field, thrown alongside a road when he should have been home sleeping in a nice warm, cared for bed.The mystery of Barbara Jean Horn is also revealed at the end of this mystery, and although it is no mystery where Barbara Jean came from, it sure is a mystery of who killed her, and left her inside a box in the Northeast section of Philadelphia, July 12, 1988

America’s Unknown Child, an alias for a little boy unknown to the world, was a tragic enigma. His seemingly forgotten and abandoned life was cut short by an unexplainable, unsolved death in the days leading up to February 25th, 1957 leaving all who followed the John Doe case both locally and across the United States grasping for answers in a sea of evidence that drowned us all in doubt…As a hope to provide more substantial reasoning built upon observable evidence and situational analysis, this is an examination of the unidentified legacy of the Boy in the Box, and the unexplainable backstory to his life before he was discovered in the woods off Susquehanna Road in Fox Chase, Philadelphia…This is Cold Case Detective.Boy in the Box Case File Photographs: https://drive.google.com/drive/folders/1k_jQNnegmLQZl7l0lMxnf4reeLKeAqt0?usp=sharingAdditional Reading:[Wiki][General Reddit Thread][AUC Official Website][Case Summary]Researched and written by TJ RueschEpisode narrated by William EarlMusic by CO.AG________Our episodes deal with serious and often distressing incidents. Listener discretion is advised.Submit a Cold Case - https://forms.gle/usZ7B2vJeWwDjzJ19Visit our YouTube channel for more True Crime content - https://www.youtube.com/channel/UCdjslyNQupPSFxK_mSPcG-g

The cover for issue 26 of Oncotarget features Figure 8, "Proposed mechanism of action of ONC201," from Greer, et al. TRAIL, a member of the TNF family of ligands, causes caspase–dependent apoptosis through activation of its receptors, death receptor 4 and DR5. ONC201 was originally identified as a small molecule that inhibits both Akt and ERK, resulting in dephosphorylation of Foxo3a and thereby induces TRAIL transcription. Recently, two independent groups, Wafik El Deiry at Fox Chase and Michael Andreeff at MD Anderson,reported that ONC201 induces cell death via cell stress mechanisms, independent of TRAIL transcription. Gene expression profiling analysis revealed that ONC201 induces endoplasmic reticulum (ER) stress or integrated stress response –related genes, such as Activating Transcription Factor 4 (ATF4) and C/EBP–homologous protein (CHOP). The researchers in Dr. Lipkowitz's group at the Center for Cancer Research in the National Cancer Institute observed that ONC201 kills breast cancer cells via a TRAIL–independent mechanism. Time–lapse live cell imaging revealed that ONC201 induces cell membrane ballooning followed by rupture, distinct from the morphology of cells undergoing apoptosis. They found that ONC201 inhibits mitochondrial respiration and induces mitochondrial structural damage. Moreover, they found ONC201 reduces mitochondrial DNA copy number. Importantly, cells dependent on glycolysis, such as fumarate hydratase deficient cancer cells and multiple cancer cell lines with reduced amounts of mitochondrial DNA were resistant to ONC201. ONC201 induced ATF4 and CHOP in breast cancer cells, and the stress response it was partially dependent on the mitochondrial effects of ONC201. "Our work identifies a novel mechanism of ONC201 cytotoxicity that is based on the disruption of mitochondrial function, leading to ATP depletion and cell death in cancer cells that are dependent on mitochondrial respiration. Our study also suggests that cancer cells that are dependent on glycolysis will be resistant to ONC201" Dr. Stanley Lipkowitz, Chief, Women's Malignancies Branch, NCI. Full text – https://www.oncotarget.com/article/24... About Oncotarget Oncotarget is a weekly, peer-reviewed, open access biomedical journal covering research on all aspects of oncology. To learn more about Oncotarget, please visit https://www.oncotarget.com/ or connect with @Oncotarget Oncotarget is published by Impact Journals, LLC please visit http://www.ImpactJournals.com or connect with @ImpactJrnls Media Contact 18009220957x105 MEDIA@IMPACTJOURNALS.COM

Boy in the Box (Philadelphia) "Boy in the Box" adalah nama yang diberikan kepada seorang korban pembunuhan tak dikenal, bocah tersebut berusia kisaran 4 hingga 5 tahun, tubuhnya ditemukan dalam keadaan telanjang dan babak belur di dalam sebuah kotak kardus keranjang bayi daerah bagian Fox Chase di Philadelphia, Pennsylvania, pada 25, Februari 1957. Dia juga biasa dijuluki "America's Unknown Child." Identitasnya tidak pernah ditemukan, dan kasusnya tetap terbuka sampai saat ini.

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On the cold morning of February 26th, 1957, the body of an unidentified little boy was reported to Philadelphia police. He'd been wrapped and abandoned inside of a cardboard box on Sesquehanna Rd, a country lane in Fox Chase that was commonly used for dumping trash and debris. A hunt for the killer begins.. but will anyone reveal the identity of the Boy in the Box?

The "Boy in the Box" is the name given to an unidentified murder victim, a 4 to 5-year-old boy, whose naked, battered body was found in a bassinet box in the Fox Chase section of Philadelphia, Pennsylvania, on February 25, 1957. He is also commonly called "America's Unknown Child." His identity has never been discovered, and the case remains open. Episode Notes: https://en.wikipedia.org/wiki/Boy_in_the_Box_(Philadelphia) Follow True Crime Snacktime on Twitter, Instagram & Facebook @crimesnackpod Support the show on Patreon at patreon.com/truecrimesnacktimepodcast & 10% of your pledge will go to https://investigationsforthemissing.org/ Logo Design: Rachelle Somma Social Media Management: Erika Stampoulos Photo Credit: wikipedia.org Learn more about your ad choices. Visit megaphone.fm/adchoices

The "Boy in the Box" is the name given to an unidentified murder victim, a 4 to 5-year-old boy, whose naked, battered body was found in a bassinet box in the Fox Chase section of Philadelphia, Pennsylvania, on February 25, 1957. He is also commonly called "America's Unknown Child." His identity has never been discovered, and the case remains open. In February 1957, the boy's body, wrapped in a plaid blanket, was found in the woods off Susquehanna Road in Fox Chase, Philadelphia. The naked body was inside a cardboard box which had once contained a bassinet of the kind sold by J. C. Penney. The boy's hair had been recently cropped, possibly after death, as clumps of hair clung to the body. There were signs of severe malnourishment, as well as surgical scars on the ankle and groin, and an L-shaped scar under the chin The murder of Katarzyna Zowada occurred at the end of 1998 in Cracow, Poland. The victim was a 23-year-old female student, who was attending Jagiellonian University. Investigators and experts from other countries were called to assist in solving the crime, including the FBI. Police made the first arrest in 2017. 19 years later, after discovering new evidence. As of September 2019, the suspect remains in custody while investigators continue to gather evidence --- Send in a voice message: https://anchor.fm/insanityforever/message

Dr. Hayes interviews Dr. Young about his time with CHOP and MOPP TRANSCRIPT   Disclaimer: 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. Dr. Hayes: Welcome to JCO's Cancer Stories, The Art of Oncology, brought to you by the ASCO Podcast Network, a collection of nine programs, covering a range of educational and scientific content, and offering enriching insight into the world of cancer care. You can find all of the shows, including this one, at podcast.asco.org. Welcome to Cancer Stories. I'm Dr. Daniel Hayes. I'm a medical oncologist and translational researcher at the University of Michigan, Rogel Cancer Center. And I've also had the pleasure of being past president of the American Society of Clinical Oncology. I'm privileged to be your host for a series of podcast interviews with people I consider the founders of our field. Over the last 40 years, I've really been fortunate to have been trained and mentored and inspired by many of these pioneers. It's my hope that through these conversations we can all be equally inspired by gaining an appreciation of the courage, the vision, and also the scientific understanding that led these men and women to establish the field of clinical cancer care over the last 70 years. By understanding how we got to the present and what we now consider normal in oncology, we can also imagine and we can work together towards a better future for our patients and their families during and after cancer treatment. Today, my guest on this podcast is Dr. Robert Young. Among many designations he has, my favorite I think for Dr. Young is that he was considered one of the, quote, "gang of five," end of quote, I think self-named, who were responsible for developing the first curative chemotherapy regimen for Hodgkin's disease and non-Hodgkin's lymphomas at the National Cancer Institute in the early 1970s. Dr. Young is currently president of RCY Medicine, a private consulting firm based in Philadelphia. He was raised in Columbus, Ohio, where he couldn't get into the University of Michigan. So he went to a second-rate community college in Columbus called Ohio State. My bosses made me say it that way, Bob, here at the University of Michigan. Dr. Young: Not the correct way, The Ohio State University. Dr. Hayes: So he received his MD then at Cornell in 1965, followed by an internship at the New York Hospital. He spent the next two years as a clinical associate in the medicine branch at the National Cancer Institute. And then he completed his residency in medicine at Yale New Haven Medical Center. In 1970, he returned to the NCI, where he stayed for the next 18 years, serving during most of that as the chief of the medicine branch. Dr. Young accepted the role as president of the Fox Chase Cancer Center in Philadelphia and served in that role and then chancellor in 2009. Dr. Young has authored over 400 peer reviewed papers regarding a broad range of both scientific and policy issues in oncology. But in addition to the I consider astonishing and precedent-setting reports of cures in Hodgkin's disease and non-Hodgkin's lymphoma, perhaps most importantly with his longtime colleague and friend Dr. Robert Ozols, he led many of the early and groundbreaking studies in ovarian cancer diagnosis and treatment that I think still guide our care today for patients with this disease. He's won too many awards and honors for me to go through. But of the major ones, he won the prestigious Bristol-Myers Squibb award, which he shared with Dr. Ozols in 2002, the Margaret Foley Award for Leadership and Extraordinary Achievements in Cancer Research from the American Association of Cancer Research, and ASCO's Distinguished Service Award, one of our highest awards, for Scientific Leadership in 2004. Of note and close to my own heart, Bob served as the ASCO president 1989/1990, which I consider a really critical time in the evolution of our society. Dr. Young, welcome to our program. Dr. Young: Thank you. Dr. Hayes: So as I noted, you grew up in Columbus, Ohio, or again, as we say in Ann Arbor, that town down south, but more importantly that your father was a surgeon. And I've heard you tell the stories as a boy you went on rounds with him and that inspired it. Was he academic or was he a really community physician or both? Dr. Young: Well he was a little of both. He was primarily a community physician. But he did, particularly at the time of the Second World War, because he was a very skilled hand surgeon, he got involved with a lot of hand surgery related to a company called North American Aviation that produced a lot of World War II planes. And there were a lot of injuries in that setting. And so he became quite a skilled hand surgeon and actually taught at Ohio State's Medical Center. So he had both an academic and community-based practice. But primarily he was a practicing community surgeon. Dr. Hayes: And did you actually go into the OR with him as a boy? Dr. Young: Oh, yeah. Oh, sure. Dr. Hayes: Wow. Dr. Young: You know, in those days, there weren't any rules and regulations about that. And so I went in and watched surgery and held retractors and participated, you know, when I was a youngster. Dr. Hayes: Wow. What a privilege. You're right, that would not be allowed now. That's a good story. What did you see, bad and good, compared to medicine now then. I mean, if you had to say here are a couple things that we've lost that you regret. Dr. Young: Well, I think that it was more under the control of the physician than it is in this day and age in so many ways. For instance, my father practiced in three different hospitals. And he admitted patients depending upon what kind of surgical support and nursing support they needed. If they were complex, he went to a bigger hospital. If they were very straightforward cases, he put them into a smaller hospital. And so he had a lot more control over how his patients were dealt with and the circumstances under which they were cared for. And, of course, most of his practice was before Medicare and all of the insurance sort of thing, so that people paid what they could pay. And so it was a much simpler and much more physician-driven practice than it is today. Dr. Hayes: Just as an aside, there's a wonderful book called The Brothers Mayo, written by a woman named Clapesattle in the 1930s after both Charlie and Will died. And it's a history of the Mayo Clinic. But in it, she says that Will basically charged people what they could afford to pay. So if you were wealthy, he charged you a lot. And if you were poor, he gave it to you for free and everything in between. And he sort started made up the billing schedule the way he wanted it to happen. And one of his more wealthy patients challenged him on this, and he said, go somewhere else. Dr. Young: Yeah, well, that's exactly the kind of practice my father ran. Dr. Hayes: Yeah. Anyway, I'm intrigued by year two-year stint at the NCI in the late '60s before you then went back and finished at Yale. And hopefully this is not insulting and I know you're considered one of the so-called yellow berets. But tell me, tell us all about your choice to interrupt your residency and go to the NIH. I don't think our young listeners really understand the political climate and the circumstances of the time that led so many of you to go there. Dr. Young: Well, I think that's a great question, because it will lead to some of the other discussions we have later. But essentially, I graduated from medical school in 1965 at the height of the Vietnam War. And in those days, there was not only a general draft, there was a physicians draft. So graduating in medical school in those days, you had one of three choices. You could either take your chances-- and again, the numbers, your priority scores at the time, didn't really have anything to do with it, because they took as many doctors of whatever kind of type they wanted for whatever purpose they wanted. So that you couldn't be sure if you had a low number that you'd not be drafted. But you could take your chance. And in those days, a lot of people did. And a lot of people got drafted. Or you could join the Berry Plan, which was at the time an opportunity to continue your specialty training until you were finished. But then you owed back the military the number of years that you had been in specialty training. Or you could do a much less well-known track and that is with the US Public Health Service. And amongst the opportunities for the US Public Health Service were things like the Indian Health Service and the Coast Guard Service and those sorts of things, or the National Institutes of Health, about which at the time I knew almost nothing except that it existed. And I owe it to some of the folks that I worked with at Cornell, primarily a hematologist oncologist by the name of Dick Silver, Richard Silver, who's still at practice at New York Hospital, who when I was working in the labs there, because I was doing some research when I was at Cornell, and they were telling me about the fact that you could actually apply for a position at the NIH. And you would be in the US Public Health Service. So it took me about 3 milliseconds to figure out that for me that was clearly a track that I wanted to explore. And I had done some research in platelet function and platelet kinetics and so forth. And there was a guy by the Raphael Schulman who is at the NIH at the time. And I said, that would be a miracle if I could get this. So the way it worked was that you applied. And then you actually interviewed with a whole bunch of different people. And as it turned out, I didn't get a position with Dr. Schulman. But I was introduced to the National Cancer Institute and both the leukemia service and the then called the solid tumor service. And I applied to various things like that. And I actually got in on the leukemia service. So I walked in after I signed up and was taking care of little kids with acute leukemia, having never been a pediatrician or knowing anything about leukemia. But it was a baptism of fire and a very exciting place even then. Dr. Hayes: I want to get back to that in a second because that's a critical part of this. But, again, going back to the political climate, my opinion, this entire issue and your personal journey and many others had a profound effect on both the scientific and medical community of this country as a whole. I think it was an unintended effect. But because of the Vietnam War and because the NIH was such a great place to train in those days. Do you agree with me? Dr. Young: You are absolutely correct. I mean, one of the things that needs to be said is that this was a transformational phenomenon for cancer research. But it also took place in every other field. And the NIH at the time was just swarming with people of all medical disciplines who were coming to take advantage of the opportunities that existed within the NIH, but also to serve in this capacity as opposed to some of the alternatives that were around. And I think I heard a figure one time, which I'm sure is true, and that is at one point in time, 30% of the chairmen of medicine in the United States had done training at the NIH before they ended up being chairmen of medicine. So that gives you an idea of the impact of this. And you're absolutely right, it was a totally unintended consequence. Nobody ever designed it that way. Nobody ever planned for it to happen that way. But in retrospect, when looked at it and you can see exactly why what happened happened. Dr. Hayes: Yeah. And I interrupted you, but I did it on purpose, because it didn't sound to me like you really had a plan to go into cancer treatment, but sort of landed there serendipitously. Is that true? I mean how do you end up there? Dr. Young: Oh yeah, oh, yeah, I mean I did get very interested in hematology when I was in medical school. I first went to medical school, of course, thinking I was going to be a surgeon, because my father had a great practice and he had a wonderful experience with surgery and it was really cool. But I just found that I just wasn't designed just the same way. And it was increasingly clear that cancer was not my not my goal-- I mean, surgery was not my goal. And so, you know, I knew I wanted to stay in internal medicine. And I got interested in the research. And I had done some significant research and in platelet function, as I said. I knew that's what I wanted to do, some sort of clinically-related research in medicine. If I'd had my choices, of course, I would have gone into a sort of pure hematology track. And, of course, it's worth saying that it's difficult for oncologists nowadays to understand how big an outlier oncology was. There was no subspecialty in oncology at the time I went to train down there. There was a subspecialty in hematology. And, of course, all of us, the Gang of Five that you mentioned, all of us took hematology boards. And that's because it wasn't clear that there was going to be oncology. When oncology came along we all took the first oncology boards ever given. So that gives you an idea of how early in the history of oncology we were in the late '60s, early 1970s. Dr. Hayes: So we're talking 1970 or so right when you started? Dr. Young: Well, 1967 to '69, I was a clinical associate. Then I was at Yale for a year. And then in 1970, I came back on the senior staff. Dr. Hayes: And who were the characters above you when you came in? I know Doctors Frei and Freireich had been there before. Dr. Young: Yes. Frei and Freireich had just left the year before. One went off to MD Anderson, the other went off to the Memorial. And George and Vince-- George Cannellos, Vince DeVita-- had stayed on, with Vince as the head of the medicine branch. And then when we came back, Vince sort of brought two of us back that he'd had before, Bruce Chabner and I. He'd sort of sent us off to Yale and said they could buff us up a little bit. And he didn't offer us a job coming back. But we went off, and we were training up there. And he called us both up and says, why don't you to come back and join the senior staff. He recruited Phil Schein as well. And so that was the Gang of Five that we started out. Four of us ended up being president of ASCO at one time or another. And I suspect the only one who didn't, Bruce Chabner, probably would have except for the fact that he was the director of the Division of Cancer Treatment of the NCI for a long time. And the NCI and the NIH changed its attitude toward allowing people to participate in major leadership positions nationally, a tragedy as far as I'm concerned, which has I think affected the morale of the NIH and a lot of other things and deprived a lot of good people of opportunities to serve nationally. But that was the way it was, otherwise we would all ended up at some point leading-- Dr. Hayes: So the Gang of Five was you Bruce Chabner, George Cannellos, Phil Schein, and Vince DeVita, right? Dr. Young: Right, exactly. Dr. Hayes: And what were the dynamics among you? I mean, so were you and-- Dr. Young: Well, I mean, it was an incredible time. You know, there was enormous talent that had poured into the NIH, as we talked before. And an enormous amount of talent was present and was recruited in during this period of time. I mean, you know, Paul Carbone was still there. John Minna was recruited. Harman Ayer, who was the longtime chief medical officer of the American Cancer Society. Tom Waldman was a world class hematologist. Max Wicha was a part of this group. Sam Broder, Allen Lichter, an other ASCO president, Steve Rosenberg, Phil Pizzo was the head of the pediatric oncology branch, now dean at Stanford. And it goes on and on and on. And so there's a massive amount of talent and a lot of freedom. And so Vince was clearly the leader, he had a lot of ideas and a lot of creativity. But he let out a lot of people do whatever they wanted at the same time. And it was sort of a situation in which we all participated, because we were all attending at the same time. So Vince and George did a lot of the lymphoma and Hodgkin's disease stuff. We all participated. I got interested in ovarian cancer. And you talked about that. Bruce Chabner and Phil Schein were always very pharmacologically oriented. And so they did a lot of the phase 1 and phase 2 trials and a lot of the laboratory backup associated with the studies we did. And everybody shared. And so there was really not a lot of competition in that sense. Everybody was I think very competitive. Because it was all sort of shared, it worked out so that everybody felt that they were getting a substantial part of the recognition that was going on in the group. Another thing that was unusual about the NIH, but it had unintended, but important consequences is that nobody had anything to do with what they got paid. So that you could go to events and say, well, you know, I deserve to be paid more, but it didn't have anything to do with what you got paid. We had no control over anybody's salary. So that I don't think the whole time I was there, the whole 14 years I was chief of the medicine branch, I don't think I ever had a conversation with anybody about money, because I didn't have anything to do with what people got paid. Let me tell you, that's a big change. It actually has a remarkable, remarkable effect on the way people work. Because if for some reason somebody wanted to make more money, they just had to leave. There wasn't any way to do it. So you either had to accept that this is what everybody got paid and that you were rewarded by the opportunities to do the kinds of research that were done. Or you said, look, I need to go on and go somewhere else. Dr. Hayes: Now, just between you and me, and maybe a few thousand other people who are listening to this, who is the first guy to say let's give combination chemotherapy to Hodgkin's disease? Dr. Young: Well, actually, I don't know the answer to that. I think if I had to guess, I would say Vince, because Vince and George had been around in the Frei and Freireich days. And of course, you know, they'd already had experience with the impact of combination chemotherapy in leukemia. And so the concept was you took drugs that were active in the disease and put them together if they had different kinds of toxicity. And you were then able to utilize the combined impact on the tumor and sort of spread around the toxicity. So it was more tolerable. And that was the concept. And I think that because Vince and George were treating chronic leukemias and treating Hodgkin's disease, the notion of combining it with combinations was pretty straightforward evolution from the experience in leukemia. There are other people who claim that. I think from time to time both Jay Freireich and Tom Frei have claimed it. I think that there was a dust up between Vince and Paul Carbone and George because there was some suggestion by somebody that Paul was the one who originated the idea or Gordon Zubrod. And quite frankly, I don't know. If I knew, I would tell you. But I don't actually know. I can tell you this, that the emotional and passionate driver of the concept of combination chemotherapy as a successful modality in Hodgkin's disease and lymphoma was Vincent. Dr. Hayes: Your answer is very consistent with what other people have said the same thing. It must have been somewhere along the line that all of you began to see that there really were cures. And did you realize, as a group, that you were making history? Or was it just day to day-- Dr. Young: Well, you know, it's interesting. I can tell you one of the most transformational experiences that I had in the early days is, of course, we were following all these patients who had started on MOP. And so to do that you had to sort of go back and pull out the charts and all this kind of stuff. You know, we didn't have electronic systems that had all the stuff recorded. You just had to go down and pull off the charts. And what struck me so tremendously was the attitude of the physicians that had first started some of these patients on this therapy, because the notes made it very clear that they were sort of flabbergasted when these people came back after the first couple of months and they were watching their disease disappear, and that they really didn't anticipate at all, initially, that they were going to see these people after a couple of weeks. And it was very clear in the notes. By the time we had gotten there, of course, there were a significant number of people already on the trial. And it was already clear that we were seeing things that nobody had ever seen before. And I think that's when it first began to dawn on everybody. And as soon as we saw it in Hodgkin's disease based on the experience that we'd seen with non-Hodgkin's lymphoma, we had a suspicion that it would likely be the case as well there. Dr. Hayes: So you already bounced across it, but as I was looking through your CV I knew this anyway, you really mentored a who's who of oncology-- Rich Schilsky, Dan Longo, Max Whishaw, Dan Van Hoff-- and you noted already that oncology training has evolved. I mean BJ Kennedy pushed through boards I think in '74 or '75, something around there. What have you seen in the evolution on oncology training that you think is good or bad? Dr. Young: Oh, I think in general, it's much better. And I think it's much better because, of course, there's a lot of success that's been built into what's been accomplished. And that makes it a lot easier to teach people about how to treat Hodgkin's disease well, than we ever could at the time we were doing it because nobody knew the answer to those things. And I think there's also a lot more of it. You know, I think at the time we were at the NIH, you know, I think credibly you could count on both hands the number of really established academic oncology programs in the United States. And now, there are probably 100. And so the quality of training and the quality of mentoring is dramatically better than it was in those days. In those days, you know, hematologist we're doing most of the treatment of cancers. And they were all sort of in the Sidney Farber mode. You take one drug, and you give it as long as it works. And then you switch to another drug and use that as long as it works. And that was pretty much the way hematologists approached the disease. And by all means, you don't cause any toxicity. Dr. Hayes: I picked up several adults who had been Sidney Farber's patient when I was at the Dana-- Sidney Farber Cancer Institute in those days in the early '80s. So I had his handwritten notes. And sadly, I did not photocopy them. I would have love to have had it. But he had a very different mindset in terms of the way-- Dr. Young: Oh, absolutely, absolutely. And as far as I can tell, this is just my own personal reaction, is that I don't think either George or Vince at the time we got here shared any of that attitude. George is a little more cautious than Vince, as everybody knows. But neither one of them for a minute ever suggested that we were being too aggressive, that it was unfair and immoral to treat people with these kinds of toxicities, not that they desired to make people sick. But they were absolutely convinced that aggressive therapy could make a dramatic difference in the natural history of these diseases. Dr. Hayes: Yeah, certainly, Dr. Frei felt that way too. Dr. Young: Yes. And well, they were his mentors. I mean, you know, all these guys were there at the same time. And they were all influencing one another. Dr. Hayes: You know, it's amazing, I think all of us-- there are 44,000 members of ASCO now-- basically are derived from about 10 people in the 1950s and '60s, most of the DNA, not completely-- Karnofsky and some others around, but-- Dr. Young: Oh, yeah. Dr. Hayes: Well, the other thing is actually, you were talking about the safety, what are the war stories? I mean, how did you give chemotherapy? Were you guys mixing it up and giving it yourself? You know, we got all these bells and whistles. Dr. Young: Well, I mean, for instance, you know this is the first time really protocols were written. And the reason that we wrote protocols was simply because we were working with fellows. And they literally needed the recipe of what it was they were supposed to give and when. And so we wrote up these what were the first of the clinical trial protocols. There was no formal informed consent at the time of these studies. We had, of course, informed consent, the same way you do informed consent now, really. And that is you talk to the patient. You explain to the patient what the treatment is and what your expectations for the treatment are. And the patient understands the disease they face and decide that they can do it or not do it. And it's actually still the same today. The only difference is we now have 14, 17-page informed consent documents that make lawyers happy, but don't really impact, at least in my view, whether patients decide to participate or not. But we didn't have those. So I think that was the other one of the great things about the setting at the NIH, not that I'm anti-informed consent, but it was simpler. It was easier to get something done. You could do unconventional treatment and nobody looked at you and said, "you can't do that, that's never been done before, you're not allowed to do that." We didn't have academic constraints. One of the things that always surprised me is when, you know, we would develop a particular technique, like peritoneoscopy or laparoscopy for ovarian cancer staging, and when guys left the program having been well-trained to do this, they couldn't do it when they went to their new institutions because gastroenterologists did this. That was the sort of thing that the constraint wasn't here. There were also very easy-- I mean, all you had to do was to get an idea and write it up. I took a look at ovarian cancer and said, you know, "It seems to me, here's a disease that's now being managed by gynecologic oncologist. Internists never see these patients. They're all treated with the melphalan. And those that happen to live a long time develop acute leukemia from that treatment. They ought to be something better than what we're doing." And so we just decided that we would begin to take patients with advanced ovarian cancer into the NIH. And the rest sort of is history. But you couldn't do that in another hospital. You know, the biggest treaters of ovarian cancer probably program-wise was MD Anderson. But all his patients were treated by gynecologic oncologists. You couldn't have gone into the MD Anderson and said, "OK, we're going to take over the treatment of advanced ovarian cancer." They would have laughed in your face. Dr. Hayes: Actually, you just segued into my next question. And again, you and Dr. Ozols, in my opinion, completely changed the course of ovarian cancer treatment. Did you get a lot of pushback from the gynecologic community? Dr. Young: Well, no, actually. It's interesting. Now I don't know what we got behind the lines, you know when they were all sitting around the bar after the meetings. We really didn't. First of all, one of the other advantages of being at the NIH is that when you said something, people listened. And the other thing is, of course, when we got really going with ovarian cancer-- this was after the passage of the National Cancer Act-- and there was money at the NIH. So one of the things we did, for instance, was to put on a series of symposia about ovarian cancer treatment, what was going on, what wasn't going on, and brought the movers and shakers of this field together in meetings and talked about what was being done and what should be done and what information we didn't have that we needed. And we actually got funded for a period of time, a group called the Ovarian Cancer Study Group, which eventually evolved into the Gynecologic Oncology Cooperative Group, National Cooperative Group. So we had some other tools that we could bring to bear to drum up an interest in new research in ovarian cancer. And, of course, gynecologic oncologists couldn't prevent us from taking patients that were referred to us. And our surgeons, for instance, none of whom were gynecologic oncologists, were happy to help and to operate on them when they needed to be operated on. And Steve Rosenberg's group has fantastic surgeons. So we didn't have any problem getting state of the art surgery done on these people. And, in fact, they are general surgeons learned some gynecologic oncology at the same time. Dr. Hayes: Yeah, you know, it's been interesting to me that the surgeons, the general surgeons, willingly gave a systemic therapy. But that still in this country, there are very few medical oncologist who do GYN oncology. It's still mostly done by GYN oncologists. Dr. Young: Yes. Dr. Hayes: And there are very few trained medical oncologist in this. And I think it's gotten too complicated for a surgeon to do both. I don't really see why that hasn't happened based on, especially your model and Bob's model, that's my own soapbox. Dr. Young: Yeah, that's an interesting point, because at the NIH, when we were there, Steve Rosenberg and Eli Gladstein in radiation therapy, there were no rules that said that they couldn't do chemotherapy. And, in fact, they did it sometimes. And we didn't say anything about it. Usually, they called on us and said, hey, look, you know, we need you to help us or participate with us or whatever. But there were no rules that said that they couldn't. And sometimes they did. But for the most part they said, "look, this is not the business we're in. We want you guys to do the chemotherapy." And so for the most part we were able to do that. Dr. Hayes: The entire NSABP, those guys were all given their own surgery, their own chemotherapy. And they ultimately handed most of it over to medical oncology through the years. But that's not happened so much in GYN. OK, I want to go into your role in ASCO at the end here. And as I noted, I think you were president during a really critical turning point for the society. And just a few things, you already mentioned that I think you were already at Fox Chase when you ran. So you'd left NCI. And what made you run? But more importantly, tell us about your role in the evolution at that time of the society. Dr. Young: I think actually they recruited me to run just at the time that I was looking to leave. And so I left in December of 1988. And I was president of ASCO 1989 to 1990. At the time, I had moved from the medicine branch and ran the cancer center's program for a year. And I decided that I liked it. I thought, well, maybe I'll just stay here for the rest of my life, the way Steve Rosenberg did and others have done very successfully. But I said, well, you know, it's either sort of now or never. And so I decided that I would make the jump. But when I got into the sort of ladder, if you will, of ASCO through the board and so forth, it became clear that there were a couple of things that were a real challenge for the society. The society had at the time for the most part been essentially run on contract, that there was no organization of ASCO at all. It was it was all run by a contract organization. And it was clear that we had grown to a size such that we really needed to begin to recruit our own leadership staff. And so my year as president was actually the first year we hired a full-time employee. And she was based in a law firm that we used for ASCO legal business. But that was the first employee ever hired by ASCO. And that was in 1990, or 1989, I don't remember which, put in that year anyway. The other thing that was going on, which was critical for the society, is that, of course, there's always been a 'town gown' challenge in all aspects of medicine. And medical oncology was no different. So it had originally been the province of academic oncologists. But the numbers began to change dramatically. And it became clear that there was an enormous number of community-based oncologists, who looked at the challenges that face the organization somewhat differently than the academics. And this is one of the things that I think I benefited from growing up with a father that had both his feet in the community-based practice and the academic practice. And I realized how private practicing physicians view academics and view academic control of organizations. And I realized-- and others did too. I wasn't alone on this-- that we really needed to build up the recognition of community-based oncology as a first class citizen in the society. And so we began to create and bring in all of these state society organizations. And we began to get leadership roles who were based in community oncology, rather than just academics. And Joe Bailes was our first head of the Public Relations Committee of the society and grew this into a national presence and became the first community-based president of ASCO. So I think I think those are the two things that I saw that hopefully I made an impact on. And it always amazes me to realize that the society was really that young. I mean, people can't believe that it's just, what, 30 years ago when we had our first employee. Dr. Hayes: Yeah, that's why I'm doing these podcasts. We make sure we get this history. You know, it's interesting, I often give you credit for the ladder. As president myself, it was made very clear to me that 90% of the patients in this country with cancer are treated by community oncologists, maybe 85% or so. And about 2/3 of our membership are community oncologists. So we now have designated seats on the board of directors. We started a Department of Clinical Affairs that Steve Grubbs is running. That's just a few years old. But, boy, it's been fabulous. We now have a designated chair, the state affiliate council is invited to the board of directors and sits in and presents. And the state affiliate councils meets at ASCO headquarters at least once a year. And we've had a couple presidents who are, besides Joe, Doug Blayney and Skip Burris now coming in in June. So I think we've been reaching out. It always struck me when I sat in the headquarters, the seven founding members were, for the most part, community people. They met just to talk about how do you give chemotherapy. It wasn't, you know, about Tom Frei or Freireich or Jim Holland. It was folks in the community. And then it grew into an academic society. And I think you and then Joe Bailes and others kind of brought us back and grounded us. And to me, that's a really critical evolution in our society. I think it's made us much stronger. So those are most of my questions. You've answered almost everything I had written down that I always wanted to ask you if I got a moment in a cab with you. I want to thank you for taking time to do this. But more importantly, I want to thank you for all the contributions you have made to the field. I mean, I don't think I would be here and I don't think most of us who do oncology would be here if it weren't for you and the Gang of Five and the things you've done, both by the courage to moving forward to giving the kinds of chemotherapy and stuff, establishing science in the field, but also the policy stuff. Your articles in The New England Journal over the years, I think have been classics. You should put this all in a book and send them out to everybody because they have to do with not just giving chemotherapy, but the whys and hows of what we do. So I know I'm being long-winded, but that's because I'm a big fan. Well, thank you very much. Dr. Young: You know one of the things, I got to say is that I've just been a very lucky person. I happened to have had great opportunities. And I think I was able to take advantage of those opportunities. But somebody gave me those opportunities and put me at the right place at the right time. And so I am a very lucky guy. Dr. Hayes: Well, and I want to finish up and say how nice it is to see at least one graduate of Ohio State University do well. You know, it doesn't come very often. So congrat-- Dr. Young: Yeah, yeah, yeah, yeah, yeah The team up north, the team that will not be named, yes. Dr. Hayes: Thank you so much. And appreciate all you've done. Again, appreciate your taking time with us. Dr. Young: Thank you very much, Dan. Dr. Hayes: Until next time, thank you for listening to this JCO's Cancer Stories, The Art of Oncology podcast. If you enjoyed what you heard today, don't forget to give us a rating or review on Apple Podcasts or wherever you listened. While you're there, be sure to subscribe so you never miss an episode. JCO's Cancer Stories, The Art of Oncology podcast is just one ASCO's many podcasts. You can find all the shows at podcast.asco.org.

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In this episode I interview Jordania Fox - the maker of Queen Bee Podcast! We go deep into exes, and talk about which is the best colour. (Yellow, of course) Make sure to subscribe to this podcast for more fun! Chase the sun! -Jordan

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www.foxchase.org https://twitter.com/FoxChaseCancer https://www.facebook.com/foxchasecancercenter

www.foxchase.org https://twitter.com/FoxChaseCancer https://www.facebook.com/foxchasecancercenter

www.foxchase.org https://twitter.com/FoxChaseCancer https://www.facebook.com/foxchasecancercenter

www.foxchase.org https://twitter.com/FoxChaseCancer https://www.facebook.com/foxchasecancercenter

www.foxchase.org https://twitter.com/FoxChaseCancer https://www.facebook.com/foxchasecancercenter

www.foxchase.org https://twitter.com/FoxChaseCancer https://www.facebook.com/foxchasecancercenter

Episode 102 On Friday night, November 11, 1994, 16 year old Eddie Polec and his younger brother Billy planned on spending a typical evening with their friends in the Fox Chase neighborhood in Philadelphia; hanging out at a local park, hopping between the nearby McDonald’s and Pizza hut, and getting home in time for their … Continue reading "Little Eddie Polec"

He would be approximately 68 years old today, although no one really  knows exactly how old he would be, because no one knows when he was born, or his name,or his parents or who is favorite comic book hero was. No one knows anything,. We only know him as The Boy in a Box, or America’s Unknown child. He is the  unidentified murder victim, 3 to 7 years old, whose naked, battered body was found in a cardboard box in the Fox Chase section of Philadelphia, Pennsylvania, on February 25, 1957.         WARNING: PICTURES BELOW MAY BE DISTURBING TO SOME                     Wanted Poster for information Detectives lovingly dressed him for photos and his funeral

Our last two episodes were pretty intense, so this episode we decided to keep it a little lighter and bring it all back to Philly. Stephanie starts us off with the story of the Boy in the Box. In 1957, the body of an unidentified child was found in a JC Penny bassinet box in the woods of the Fox Chase neighborhood of Philadelphia. While the case has brought on sporadic media attention through the last six decades, it remains open to this day. Sarah tells us about the Hag of Pine Street. Possibly a ghost of one of our two hosts from the future who went back in time, she chases children and happy couples through the Society Hill neighborhood. Her only motivation seems to be to wipe the smiles off of their faces. Our stories are kept short while we butter you up with banter, spoilers about horror movies Sarah has never seen, and educate you with some Philadelphia culture. Listen to E18 Get Off My Jawn! Subscribe, rate, and review today. Don’t forget, we’re still giving away stickers! To get yours, review us on iTunes and/or Facebook, send us a screenshot with your address, and BOOM, sticker. You can reach out to us on any of our social media platforms or by emailing us directly at deadtimestoriez@gmail.com ! #deadtimestoriez #podcast #ladies #besties #jokes #darkhumor #mysteries #ghoststories #hauntings #haunted #laugh #please #itunes #googleplay #stitcher #soundcloud #scary #scarystories #scarystoriestotellinthedark #allthehashtags #boyinthebox #hagofpinestreet #philadelphia #philly #jawn #getoffmyjawn #thisjawnistight #thatjawnwassofine #spiceupyourjawn

Alex and Rob cast an irreverent eye over local news from their respective home towns. Listeners can submit stories from their local area to:lapodcast.net@gmail.com  Stories this week include: Band of rogue journalists deny stealing fencing for new theme park. Social worker subjects reluctant family to fried chicken.  Elvis fans flock to Croydon after misleading promotional video. 49-year-old former primary school pupil attacked by superimposed fox. Also revealed: We make a desperate plea for reviews.

Here's a good jig.  It's often played as part of "The Fox Chase" but I've given up fox hunting as the animals used to wreak havoc in my house.