Podcasts about Fox Chase Cancer Center

On Feb. 8, Dr. Marianne Ritchie and Dr. Arielle Weiss, assistant professor of gynecologic oncology at Fox Chase Cancer Center, discussed cervical cancer and details about risks, screening tests and the vaccine.

Send us a textMichael J. Burton is the CEO of the Diabetes Research Institute Foundation ( https://diabetesresearch.org/ ), a philanthropic organization which funds the Diabetes Research Institute, one of the largest and most comprehensive research centers dedicated to curing diabetes.A passionate nonprofit executive, Michael has more than 30 years of experience in leading high-impact philanthropic programs and cultivating strategic relationships to secure transformative funding. Prior to assuming the role of CEO at DRIF, Michael advanced the missions of some of the nation's most dynamic and trusted institutions including Princeton University, The Pew Charitable Trusts and the American Association for Cancer Research (AACR).Michael's accomplished nonprofit career includes significant contributions in the advancement of cancer research and care, most recently as President and CEO of Gateway for Cancer Research, a Chicago-based nonprofit engaged in funding early phase clinical research, where he began his tenure as Chief Development Officer. Prior to that, Michael served as Chief Development Officer and Executive Director of the Foundation at the AACR, the nation's oldest and largest organization dedicated to the prevention and cure of all cancers. Michael's 15 years of experience in the oncology sector also includes leading the development program at Fox Chase Cancer Center as Senior Vice President and Chief Development Officer.Before working in the field of oncology, Michael had a distinguished career in higher education, most notably at the University of Pennsylvania, where he served as Special Assistant to the President during the tenure of Judith Rodin, the first female president of an Ivy League institution; and at Temple University, where he held the title of Assistant Dean and lead the development program at the Fox School of Business. Before entering higher education, Michael served as Legislative and Press Assistant to the late Congressman Tom Lantos, the only survivor of the Holocaust ever elected to Congress. Michael is a graduate of the University of Pennsylvania, where he earned a Bachelor's degree in Communications and a Master's degree in Public Administration. Prof. Dr. Matthias von Herrath, MD is the Scientific Director of the Diabetes Research Institute (DRI) and Stacy Joy Goodman Chair at the University of Miami School of Medicine ( https://med.miami.edu/faculty/matthias-georg-von-herrath ) where he is leading the DRI mission to conduct and accelerate research to delay, prevent and ultimately find a cure for type 1 diabetes.  He is widely recognized for his groundbreaking work in understanding the molecular mechanisms of T1D, an autoimmune disease in which the body's immune system attacks and destroys insulin-producing beta cells in the pancreas, and developing novel therapies for this disease. Prof. Dr. von Herrath served as a Professor and Director for the Type 1 Diabetes Research Center at La Jolla Institute for Allergy and Immunology, and also currently serves as Vice President and Senior Medical Officer at Novo Nordisk, a global healthcare company, where he is responsible for overseeing the company's research and development efforts in diabetes care.Prof. Dr. von Herrath earned his medical degree in 1988 from Freiburg Medical School, where he also completed a Ph.D. equivalent thesis on biochemistry. His postdoctoral training included an intensive care residency at Diakonie Hospital, Freiburg.#DiabetesResearchInstituteFoundation #T1D #Insulin #IsletCellTransplant #Regeneration #Immunomodulation #Immunoregulation #Autoimmune #UniversityOfMiami #Philanthropy #NovoNordisk #Instacart  #ProgressPotentialAndPossibilities #IraPastor #PodcSupport the show

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.      

Meet Tina Lucci from Allentown, Pennsylvania. She is a special education teacher and a mother of two boys. Tina is a survivor of pancreatic cancer, having been diagnosed during the holiday season of 2019. She first felt unwell at work, so she went to the emergency room. Her diagnosis was a shock, as she had no family history of pancreatic cancer and was a mother of two young boys. Tina chose not to share her diagnosis with her loved ones initially, preferring only her immediate family to know, especially since it was the holiday season. She felt ashamed and like she had somehow brought the cancer upon herself. Tina started chemotherapy treatment but had allergic reactions, such as swelling of her tongue, and had to switch to a different regimen. She traveled from Allentown to Philadelphia to Fox Chase Cancer Center for her treatments. However, her local hospital's oncology department also provided treatment closer to her home. To date, she has undergone over 70 chemotherapy treatments and counting, and has also had radiation therapy. Chemo has been effective for her during her nearly 5-year journey. She was scheduled to undergo an Appleby procedure, but the cancer had spread to her liver, leading to the cancellation of the surgery. After spending four days in the hospital, she continued chemotherapy to keep her tumor stable. Tina has become an advocate for herself and feels that chemotherapy is the best way to extend her time with her family rather than putting herself through a risky surgery. Tina describes how cancer has made her softer and more gentle. She finds herself letting minor annoyances go and living life more fully. She takes every opportunity to spend quality time with her sisters and friends. Overall, Tina is making the most of her experience with cancer, referring to it as her "prison time." She feels that she is serving time with this disease but is making the best of it. If you'd like to donate to Project Purple's mission of a world without pancreatic cancer, please visit https://www.projectpurple.org/. Tina welcomes emails at tlucci@gmail.com To learn more about Project Purple, visit https://www.projectpurple.org/ or follow us on social media at these links: https://www.facebook.com/Run4ProjectPurple https://www.instagram.com/projectpurple/ https://twitter.com/Run4Purple https://www.youtube.com/channel/UCgA8nVhUY6_MLj5z3rnDQZQ

In this episode of the Life Science Success Podcast, my guest is Dr. Russ Lebovitz. Dr. Lebovitz is a seasoned expert in the life sciences, with over 15 years of experience as a senior scientist and research physician. He has served on the faculties of Baylor College of Medicine and The Fox Chase Cancer Center. Transitioning from academia to industry, he has led biotech companies in the diagnostics field, focusing on early detection of neurodegenerative diseases. As the CEO of Amprion, Dr. Lebovitz is pioneering innovative technologies to revolutionize brain health. He collaborates with organizations like the Alzheimer's Drug Discovery Foundation and the Michael J. Fox Foundation to advance research and awareness. Join us as we delve into his remarkable journey and the groundbreaking work he's doing to transform the future of diagnostics. Dr. Lebovitz shares his extensive experience in life sciences, discussing the journey and development of Amprion from its early days to the present. He explains the science behind prion-like particles, misfolded proteins, and how they relate to neurodegenerative diseases such as Alzheimer's and Parkinson's. He also talks about the company's groundbreaking technology, its FDA recognition, and the critical role of collaborations with organizations like the Michael J. Fox Foundation and the Alzheimer's Drug Discovery Foundation. Tune in to learn about the innovations in diagnostics and the impactful strides being made in the field.   00:00 Introduction to Life Science Success Podcast 00:36 Sponsor Message: D3 Digital Media Marketing 01:27 Meet Dr. Russ Lebovitz 01:53 Dr. Lebovitz's Journey in Life Sciences 02:33 Founding Amprion: The Early Days 04:22 Breakthroughs in Neurodegenerative Disease Research 14:27 The Science Behind Amprion's Technology 19:41 Collaborations and FDA Support 24:52 Amprion's Unique Approach and Availability 32:05 Personal Insights and Reflections 37:20 Conclusion and Farewell

Thank you for listening. Send us a text message. In this episode of Intentionally Overheard, Dave Bjork, "The Research Evangelist" shares his outlook on life, his lung cancer journey, and how living a life of purpose has inspired him to live his best life by helping others.     Dave Bjork is a lung cancer survivor, patient advocate and research evangelist with more than 25 years of progressive experience in community-building, nonprofit fundraising, and research advocacy.  Dave is host of the Research Evangelist Podcast where he interviews leaders in lung cancer research and care, and the Dinner with Dave Podcast where he shares lung cancer stories of inspiration and courage from patients and care partners. In addition, he is an advisor to Medidata Solutions where he serves on the Patient Insights Board team to bring the patient voice to the clinical trial experience. Previously Dave spent 8 years leading nonprofit fundraising and advocacy teams.Dave has made it his life mission to connect patients, biopharma companies, academic institutions, and other key influencers to forge strong partnerships to focus on cancer research and care. He proudly serves on the Advisory Board of the Cancer Epigenetics Institute at Fox Chase Cancer Center. Dave earned a BS in Economics and Finance from the Wharton School at the University of Pennsylvania.Twitter @bjork5 https://www.linkedin.com/in/davebjork/ https://www.instagram.com/theresearchevangelistpodcast/?hl=en https://www.facebook.com/david.bjork.71Support the show

La Dra. Nidia Paulina Zapata Canto, hematóloga adscrita al Instituto Nacional de Cancerología en la Ciudad de México, México, tiene como invitada especial en este episodio de “Preguntémosle al experto…” a la Dra. Iberia Romina Sosa, hematóloga adscrita al Fox Chase Cancer Center en Philadelphia, Pennsylvania, para comentar lo más destacado sobre neoplasias mieloproliferativas. Dentro de su conversación, los expertos resuelven las siguientes interrogantes: ¿Cuáles son las neoplasias mieloproliferativas más frecuentes en la población? ¿Cuál es la complicación más frecuente en trombocitemia esencial? En la policitemia vera, ¿qué opciones de tratamiento se utilizan en 1a, 2a y 3a línea? ¿En qué condiciones se manda a trasplante a los pacientes con mielofibrosis? Entre otras... Fecha de grabación: 25 de mayo de 2024.                 Todos los comentarios emitidos por los participantes son a título personal y no reflejan la opinión de ScienceLink u otros. Se deberá revisar las indicaciones aprobadas en el país para cada uno de los tratamientos y medicamentos comentados. Las opiniones vertidas en este programa son responsabilidad de los participantes o entrevistados, ScienceLink las ha incluido con fines educativos. Este material está dirigido a profesionales de la salud exclusivamente.

In this episode of the Epigenetics Podcast, we talked with Johnathan Whetstine from Fox Chase Cancer Center about his work on how histone demethylases affect gene expression and cancer cell stability. The Interview start by discussing a pivotal paper from Jonathan's lab in 2010, where they identified a role for the KDM4A histone demethylase in replication timing and cell cycle progression. They elaborate on the discoveries made regarding the link between histone marks, replication timing, and gene expression control. Jonathan explains the impact of microRNAs on regulating KDM4A and how protein turnover rates can influence cellular responses to treatments like mTOR inhibitors. Further, they explore the causal relationship between histone marks and replication timing, demonstrating how alterations in epigenetic regulation can affect genome stability. Jonathan shares insights from his latest research on H3K9 methylation balance at the MLL-KM2A locus, elucidating how these epigenetic modifications regulate amplifications and rearrangements in cancer cells. The episode concludes with a discussion on the establishment of the Cancer Epigenetics Institute at Fox Chase Cancer Center, aiming to bridge academia and industry to accelerate translational research in cancer epigenetics.   References Black, J. C., Allen, A., Van Rechem, C., Forbes, E., Longworth, M., Tschöp, K., Rinehart, C., Quiton, J., Walsh, R., Smallwood, A., Dyson, N. J., & Whetstine, J. R. (2010). Conserved antagonism between JMJD2A/KDM4A and HP1γ during cell cycle progression. Molecular cell, 40(5), 736–748. https://doi.org/10.1016/j.molcel.2010.11.008 Mishra, S., Van Rechem, C., Pal, S., Clarke, T. L., Chakraborty, D., Mahan, S. D., Black, J. C., Murphy, S. E., Lawrence, M. S., Daniels, D. L., & Whetstine, J. R. (2018). Cross-talk between Lysine-Modifying Enzymes Controls Site-Specific DNA Amplifications. Cell, 174(4), 803–817.e16. https://doi.org/10.1016/j.cell.2018.06.018 Van Rechem, C., Ji, F., Chakraborty, D., Black, J. C., Sadreyev, R. I., & Whetstine, J. R. (2021). Collective regulation of chromatin modifications predicts replication timing during cell cycle. Cell reports, 37(1), 109799. https://doi.org/10.1016/j.celrep.2021.109799 Gray, Z. H., Chakraborty, D., Duttweiler, R. R., Alekbaeva, G. D., Murphy, S. E., Chetal, K., Ji, F., Ferman, B. I., Honer, M. A., Wang, Z., Myers, C., Sun, R., Kaniskan, H. Ü., Toma, M. M., Bondarenko, E. A., Santoro, J. N., Miranda, C., Dillingham, M. E., Tang, R., Gozani, O., … Whetstine, J. R. (2023). Epigenetic balance ensures mechanistic control of MLL amplification and rearrangement. Cell, 186(21), 4528–4545.e18. https://doi.org/10.1016/j.cell.2023.09.009   Related Episodes The Impact of Chromatin Modifiers on Disease Development and Progression (Capucine van Rechem)   Contact Epigenetics Podcast on X Epigenetics Podcast on Instagram Epigenetics Podcast on Mastodon Epigenetics Podcast on Bluesky Epigenetics Podcast on Threads Active Motif on X Active Motif on LinkedIn Email: podcast@activemotif.com

In this research paper, researchers demonstrate a promising new treatment option for refractory metastatic gastrointestinal cancers using a combination of two FDA-approved drugs. Researchers Jun Zhang, Lanlan Zhou, Shuai Zhao, and Wafik S. El-Deiry from Fox Chase Cancer Center and Brown University explore the potential of combining TAS102 (trifluridine/tipiracil) and regorafenib as a treatment option for gastrointestinal (GI) cancers. Their research paper, published in Oncotarget's Volume 15 on July 2, 2024, is entitled, “Regorafenib synergizes with TAS102 against multiple gastrointestinal cancers and overcomes cancer stemness, trifluridine-induced angiogenesis, ERK1/2 and STAT3 signaling regardless of KRAS or BRAF mutational status.” The Study The combination of two FDA-approved drugs, TAS102 and regorafenib, has shown promising results in preclinical studies. TAS102 is an oral formulation consisting of trifluridine (FTD) and tipiracil hydrochloride (TPI). It has been approved by the US FDA for the treatment of refractory metastatic colorectal cancer and metastatic gastric cancer. Regorafenib is a multi-target tyrosine kinase inhibitor that inhibits tumor angiogenesis and cell proliferation and is approved for the treatment of gastrointestinal cancers. Recent studies have shown that TAS102, in combination with regorafenib, can lead to improved survival and restrict tumor progression. The combination therapy has been found effective in multiple gastrointestinal cancer cell lines, including colorectal, gastric, and pancreatic cancers. Full blog - https://www.oncotarget.org/2024/08/09/combining-regorafenib-and-tas102-to-target-gastrointestinal-cancers-and-overcome-cancer-stemness/ Paper DOI - https://doi.org/10.18632/oncotarget.28602 Correspondence to - Wafik S. El-Deiry - wafik@brown.edu Video short - https://www.youtube.com/watch?v=tuEmJTkyyGQ Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28602 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, TAS102, regorafenib, ERK1/2, angiogenesis, microvessel density About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science). To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

This new podcast series, initiated by the CGA-IGC Research Committee in 2023, highlights the work of previous CGA-IGC Research Grant recipients. The second episode is hosted by Catie Neumann, MS., LCGC, a Cancer Genetic Counselor at Fox Chase Cancer Center, and features the 2022 grant recipient, Giovana Torrezan, PhD, an associate researcher at A.C. Camargo Cancer Center in Sao Paulo, Brazil.The podcast transcript is available here.

We often don't have the opportunity to hear directly from students about inclusive teaching practices. In this episode, Tracie Addy, Derek Dube, and Khadijah A. Mitchell, the authors of Enhancing Inclusive Instruction, join us to explore how student perceptions of inclusive teaching practices align with the growing consensus on what constitutes inclusive teaching.  After serving as the Associate Dean of Teaching and Learning at Lafayette College, Tracie will be transitioning to a new role this summer as the Director of the Institute for Teaching, Learning, and Inclusive Pedagogy at Rutgers University - New Brunswick. Derek Dube is an Associate Professor of Biology and the Director of the First-Year Seminar Program at the University of St. Joseph in Connecticut. Khadijah A. Mitchell is an Assistant Professor in the Cancer Prevention and Control Program at the Fox Chase Cancer Center in the Temple University Health System and Affiliated Faculty in the Department of Epidemiology and Biostatistics at the Temple University College of Public Health. A transcript of this episode and show notes may be found at http://teaforteaching.com.

It can be tough to avoid burnout, stay motivated, and retain your passion for patient care when facing the day-to-day challenges of medical practice. In this episode of the BackTable Urology Podcast, Dr. Alexander Kutikov from Fox Chase Cancer Center discusses keys to developing a sustainable and fulfilling career within urology.

BUFFALO, NY- July 8, 2024 – A new research paper was published in Oncotarget's Volume 15 on July 2, 2024, entitled, “Regorafenib synergizes with TAS102 against multiple gastrointestinal cancers and overcomes cancer stemness, trifluridine-induced angiogenesis, ERK1/2 and STAT3 signaling regardless of KRAS or BRAF mutational status.” Single-agent TAS102 (trifluridine/tipiracil) and regorafenib are FDA-approved treatments for metastatic colorectal cancer (mCRC). Researchers previously reported that regorafenib combined with a fluoropyrimidine can delay disease progression in clinical case reports of multidrug-resistant mCRC patients. In this new study, researchers Jun Zhang, Lanlan Zhou, Shuai Zhao, and Wafik S. El-Deiry from Fox Chase Cancer Center and Brown University hypothesized that the combination of TAS102 and regorafenib may be active in CRC and other gastrointestinal (GI) cancers and may in the future provide a treatment option for patients with advanced GI cancer. “We investigated the therapeutic effect of TAS102 in combination with regorafenib in preclinical studies employing cell culture, colonosphere assays that enrich for cancer stem cells, and in vivo.” TAS102 in combination with regorafenib has synergistic activity against multiple GI cancers in vitro including colorectal and gastric cancer, but not liver cancer cells. TAS102 inhibits colonosphere formation and this effect is potentiated by regorafenib. In vivo anti-tumor effects of TAS102 plus regorafenib appear to be due to anti-proliferative effects, necrosis and angiogenesis inhibition. Growth inhibition by TAS102 plus regorafenib occurs in xenografted tumors regardless of p53, KRAS or BRAF mutations, although more potent tumor suppression was observed with wild-type p53. Regorafenib significantly inhibits TAS102-induced angiogenesis and microvessel density in xenografted tumors, as well inhibits TAS102-induced ERK1/2 activation regardless of RAS or BRAF status in vivo. TAS102 plus regorafenib is a synergistic drug combination in preclinical models of GI cancer, with regorafenib suppressing TAS102-induced increase in microvessel density and p-ERK as contributing mechanisms. “The TAS102 plus regorafenib drug combination may be further tested in gastric and other GI cancers.” DOI - https://doi.org/10.18632/oncotarget.28602 Correspondence to - Wafik S. El-Deiry - wafik@brown.edu Video short - https://www.youtube.com/watch?v=tuEmJTkyyGQ Sign up for free Altmetric alerts about this article - https://oncotarget.altmetric.com/details/email_updates?id=10.18632%2Foncotarget.28602 Subscribe for free publication alerts from Oncotarget - https://www.oncotarget.com/subscribe/ Keywords - cancer, TAS102, regorafenib, ERK1/2, angiogenesis, microvessel density About Oncotarget Oncotarget (a primarily oncology-focused, peer-reviewed, open access journal) aims to maximize research impact through insightful peer-review; eliminate borders between specialties by linking different fields of oncology, cancer research and biomedical sciences; and foster application of basic and clinical science. Oncotarget is indexed and archived by PubMed/Medline, PubMed Central, Scopus, EMBASE, META (Chan Zuckerberg Initiative) (2018-2022), and Dimensions (Digital Science). To learn more about Oncotarget, please visit https://www.oncotarget.com and connect with us: Facebook - https://www.facebook.com/Oncotarget/ X - https://twitter.com/oncotarget Instagram - https://www.instagram.com/oncotargetjrnl/ YouTube - https://www.youtube.com/@OncotargetJournal LinkedIn - https://www.linkedin.com/company/oncotarget Pinterest - https://www.pinterest.com/oncotarget/ Reddit - https://www.reddit.com/user/Oncotarget/ Spotify - https://open.spotify.com/show/0gRwT6BqYWJzxzmjPJwtVh MEDIA@IMPACTJOURNALS.COM

We've seen tremendous progress in diagnosing and treating cancer, but not all people have benefited from that progress equally. The American Association for Cancer Research recently released their 2024 Cancer Disparities Progress Report, which highlights gaps in diagnoses, treatment, and outcomes for people in marginalized groups. What is being done to close those gaps? We talk with Mitch Stoller, Chief Philanthropic Officer and Vice President of Development for the AACR, and Dr. Camille Ragin, a professor and Associate Director of Diversity, Equity, and Inclusion at Fox Chase Cancer Center and a member of the steering committee for the AACR's report. And on Shara in the City, we get ready for the first year of Olympic breakdancing by visiting Philly's longest-running hip-hop and breakdancing event, The Gathering at The Rotunda. To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

In a recent American Cancer Society publication, there are increasing data that rates of colorectal cancer are rising rapidly among people in their 20s, 30s and 40s. This has certainly caught the attention of the lay press, most recently in a widely circulated New York Times article published in March 2024. Today, we welcome Dr. Chris Cann, who is an Assistant Professor of Hematology/Oncology at the Fox Chase Cancer Center in Philadelphia where he focuses on GI oncology and has a particular area of interest in early onset colorectal cancer. In his short career thus far, Dr. Cann is already making a name for himself in this space on a national level and so we are so glad he was able to join us for this special discussion. Dr. Cann sheds light on what we know and what we don't know about this phenomenon. Definitely an episode to check out!** Want to review the show notes for this episode and others? Check out our website: https://www.thefellowoncall.com/our-episodesLove what you hear? Tell a friend and leave a review on our podcast streaming platforms!Twitter: @TheFellowOnCallInstagram: @TheFellowOnCallListen in on: Apple Podcast, Spotify, and Google Podcast

Tune in to hear Jarred Matchett, Chief Financial Officer of Fox Chase Cancer Center, as he shares insights into his background, successful strategies implemented over the past year, current healthcare trends, and future growth plans.

Dr. Maureen Murphy is a Professor and Program Leader in the Molecular and Cellular Oncogenesis Program of the Wistar Institute Cancer Center in Philadelphia. She is also the Associate Vice president for Faculty Affairs and Associate Director For Education and Career Development there. Maureen's research is aimed at understanding and developing cures for cancer. Specifically, they focus on the p53 tumor suppressor protein that is responsible for stopping tumors from forming. When she's not in the lab, you can find Maureen hiking outside with her dogs. She loves nature and thinks dogs are wonderful for reminding us to take a break from our hectic schedules to enjoy life. Maureen is also a fan of traveling, cycling, and yoga. Maureen received her B.S. in biochemistry from Rutgers University and a Ph.D. in molecular biology from the University of Pennsylvania School of Medicine. After graduate school, she completed postdoctoral research at Princeton University. Maureen served on the faculty at the Fox Chase Cancer Center before accepting her current position at the Wistar Institute. Maureen is with us today to tell us all about her journey through life and science.

Rick Greene, MD, discusses with Anthony Villano, MD, a review the American College of Surgeons Commission on Cancer Standard 5.6, which pertains to curative intent colon resections performed for cancer. Dr. Villano is author of "Standardization of Colon Resection for Cancer: An Overview of the American College of Surgeons Commission on Cancer Standard 5.6." Dr. Villano is the Assistant Professor, Surgical Oncology, in the Department of Surgical Oncology, at Fox Chase Cancer Center in Philadelphia, PA.

Dr. Erica Golemis is a Professor, Deputy Chief Science Officer, Co-Leader of the Molecular Therapeutics Program, and Director of the High Throughput Facility at the Fox Chase Cancer Center in Philadelphia. In addition, Erica is an adjunct faculty member at the University of Pennsylvania, Drexel University School of Medicine, and the Temple University Lewis Katz School of Medicine. For most of her scientific career, Erica has been conducting cancer research. Her recent work investigates why some cancers are particularly malignant. Erica's research examines what genes cause cancer to change and progress, whether there are genes that can be targeted directly with different treatments to reverse this process, and if there is a therapeutic time window in which they could potentially reverse this process. When Erica finds free time, one thing she loves to do is read. She reads broadly and has been an avid reader since her early childhood. Erica also has fun attending theatre performances. There are multiple excellent theaters in her home city of Philadelphia, and she especially enjoys shows by British playwright Tom Stoppard. She completed her undergraduate studies in biology and English at Bryn Mawr College and was awarded her PhD in biology from the Massachusetts Institute of Technology. Afterwards, Erica conducted postdoctoral research at the Massachusetts General Hospital Department of Molecular Biology and Harvard Medical School department of Genetics before joining the Fox Chase Cancer Center. In this interview, Erica speaks about her experiences in both life and science.

Los jóvenes españoles confían menos en la ciencia que la gente mayor, según un estudio de las universidades Carlos III y de Santiago de Compostela. Resulta paradójico y preocupante que las generaciones con mayor acceso a la información y a la educación, las mejor formadas en nuestra historia, sean las que menos información consuman y las que más desconfíen de la ciencia. Hemos entrevistado a Carlos Elías, catedrático de Periodismo y coautor de la investigación. Este domingo, 4 de febrero, se celebra el Día Mundial contra el Cáncer. Verónica Fuentes nos ha informado de la identificación de una nueva diana terapéutica contra el cáncer de pulmón de célula pequeña. Con testimonios de Israel Cañadas, del Fox Chase Cancer Center, en Filadelfia (EE UU), líder del estudio. Hemos informado de la concesión del premio BBVA Fronteras del Conocimiento en Ecología y Biología de la Conservación a los mejicanos Gerardo Ceballos y Rodolfo Dirzo por cuantificar la magnitud de la Sexta Gran Extinción de especies. Fernando de Castro nos ha hablado del primer atlas de las células del cerebro humano, un paso monumental para comprender el funcionamiento de la memoria, las emociones o comportamientos complejos como la creatividad o la toma de decisiones éticas. Con Jesús Puerta hemos iniciado un repaso a la historia de los aceleradores de partículas, herramientas fundamentales nuestro conocimiento actual de la estructura de la materia y del universo (1ª parte). Javier Cacho se encuentra en la Antártida al frente de una expedición organizada por la Sociedad Geográfica Española y nos ha contado sus primeras impresiones en el continente blanco. Hemos informado de la celebración, el próximo 11 de febrero, del Día Internacional de la Mujer y la Niña en Ciencia. Escuchar audio

Los jóvenes españoles confían menos en la ciencia que la gente mayor, según un estudio de las universidades Carlos III y de Santiago de Compostela. Resulta paradójico y preocupante que las generaciones con mayor acceso a la información y a la educación, las mejor formadas en nuestra historia, sean las que menos información consuman y las que más desconfíen de la ciencia. Hemos entrevistado a Carlos Elías, catedrático de Periodismo y coautor de la investigación. Este domingo, 4 de febrero, se celebra el Día Mundial contra el Cáncer. Verónica Fuentes nos ha informado de la identificación de una nueva diana terapéutica contra el cáncer de pulmón de célula pequeña. Con testimonios de Israel Cañadas, del Fox Chase Cancer Center, en Filadelfia (EE UU), líder del estudio. Hemos informado de la concesión del premio BBVA Fronteras del Conocimiento en Ecología y Biología de la Conservación a los mejicanos Gerardo Ceballos y Rodolfo Dirzo por cuantificar la magnitud de la Sexta Gran Extinción de especies. Fernando de Castro nos ha hablado del primer atlas de las células del cerebro humano, un paso monumental para comprender el funcionamiento de la memoria, las emociones o comportamientos complejos como la creatividad o la toma de decisiones éticas. Con Jesús Puerta hemos iniciado un repaso a la historia de los aceleradores de partículas, herramientas fundamentales nuestro conocimiento actual de la estructura de la materia y del universo (1ª parte). Javier Cacho se encuentra en la Antártida al frente de una expedición organizada por la Sociedad Geográfica Española y nos ha contado sus primeras impresiones en el continente blanco. Hemos informado de la celebración, el próximo 11 de febrero, del Día Internacional de la Mujer y la Niña en Ciencia. Escuchar audio

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

A vast number of cancer patients will undergo radiotherapy during their treatment process. Because of this, experts are searching for ways to treat patients as effectively as they can through radiotherapy while also reducing the treatment's side effects as much as possible. One answer to this is adaptive radiotherapy. Recent advancements in AI and imaging technology have refined the process and made new solutions possible. These advancements have made it easier for healthcare professionals to adapt treatment to real-time images of the patient's anatomy. This helps to preserve the health of organs surrounding the targeted area and treat patients more effectively.Today, Sasa Mutic, Senior Vice President at Varian Medical Systems, a Siemens Healthineers company, is joined by Dr. Eric Horwitz, Chair of the Department of Radiation Oncology at Temple University and Fox Chase Cancer Center in Philadelphia; Jennifer Pursley, Medical Physicist and assistant professor at Harvard Medical School; and Kirsten Offereins-van Harten, a senior radiotherapeutic technician at Erasmus University Medical Center in Rotterdam, Netherlands. They discuss how advancements in adaptive radiology technology have transformed the patient experience and the field as a whole—and where it may take us in the future.What You'll Learn in This Episode:Adaptive radiotherapy allows real time scans of a patient in order to better, more precisely treat tumors.Improvement of imaging technology advances the ability to contour organs, which is a major aid in avoiding collateral damage around the target.Adaptive radiotherapy has the potential to reduce the ill effects of typical radiological treatments by focusing on a more precise target, therefore allowing patients to maintain their quality of life.Adaptive radiotherapy greatly changes the way that providers work together to create a treatment path. Artificial intelligence can potentially expedite the process of adaptive radiotherapy by allowing for a more accurate picture of the contours around affected organs. Connect with Sasa MuticLinkedInConnect with Dr. Eric HorwitzLinkedInConnect with Jennifer Pursley, PhDLinkedInConnect with Kirsten Offereins-van HartenLinkedIn Hosted on Acast. See acast.com/privacy for more information.

During this episode of SurgOnc Today®, Austin D. Williams, MD, Fox Chase Cancer Center, Zachary J. Brown, DO, New York University - Long Island School of Medicine, and Allison Martin, MD, University of Texas MD Anderson Cancer Center, discuss the various career options within surgical oncology, including breast, hepatobiliary and colorectal. The discussion covers information specific to each of these surgical oncology subspecialties and provides information important for any trainee who is contemplating a career as a surgical oncologist.

Dr Elizabeth Plimack from Fox Chase Cancer Center in Philadelphia, Pennsylvania, discusses available and emerging therapies for patients with urothelial bladder cancer. CME information and select publications here (https://www.researchtopractice.com/ONS2023Bladder/Audiointerview)

er video interview on Rumble is HERE. As you get to know Vera, I know you will enjoy her as much as I did. She is an entirely upbeat person who had a terrible trial by fire. The road to her cure involved more than a decade of painful treatments that damaged her health, but she has been disease-free for twelve years. Vera was sent home to die by her oncologists, but since she had been managing the online patient groups, she knew she had alternatives.  Here is Vera's article about her lymphoma odyssey on her old blog: How I beat the Reaper Posted by leavergirl under healing  [15] Comments  In 1995, still trying to get pregnant, I was diagnosed with immune system cancer. It was a moment that changed my life. I can still feel the echoes of that shock. I still remember my first oncologist trying to push chemo on me. When I asked for information about the substances he was recommending, his nurse rummaged through dusty closets and came up with nothing. I found a way out of despair by learning all I could to save my life. I learned that Non-Hodgkin's B-cell lymphoma comes in three varieties: slow-growing, intermediate, and fast-growing. The fast ones are often curable but rare. The slow ones are best not to treat right away (that first oncologist was a greedy liar), and respond well to chemo initially, but eventually they'll turn intermediate and kill you. Median survival? 7-9 years. Ugh. One thing I hold against conventional medicine is that it's so damn depressing, the way it presents information to patients. I spent several years studying both the conventional side — finding more hopeful stats — (thank you, Fox Chase Cancer Center, for making your library so patient-friendly!) and the alternative side. The alternative side is good at giving people hope and pluck. I spent some time experimenting with various concoctions they recommended. And while sifting the dross from the potential gold, which included talking to other lymphoma patients who also had the gumption to experiment, I found two alternative treatments that merited an "A" on my scale. One wasn't of use in lymphoma, which is usually disseminated (metastasized) by definition. That was hyperthermia (which has since made limited inroads into conventional cancer treatment). The other one was Coley's Toxins. I wrote one of the first well-researched internet articles on the toxins. The American Cancer Society had blacklisted Coley's Toxins for many years as a quack treatment and are not conventionally available to this day. They are cheap to make and unpatentable. My approach, recommended by my next oncologist, was to do "watchful waiting" until the disease progressed. When it did, I availed myself of the various toxic drips they give to cancer patients. By then, they were accompanied by monoclonal antibodies — bioengineered thingies that run through the immune system, gobble up B-cells, and improve the chemo's effectiveness. I also did a rare treatment that gave me a year of remission called Bexxar. But then, in '07, the lymphoma speeded up (underwent cellular transformation) and tried to kill me. I got hit by very harsh chemo and spent that summer doing treatments, transfusions, and Neulasta injections, weak as a newborn chick, wondering if my hair would ever grow back. For the rest, subscribe to robertyoho.substack.com. (preview) Support the show

er video interview on Rumble is HERE. As you get to know Vera, I know you will enjoy her as much as I did. She is an entirely upbeat person who had a terrible trial by fire. The road to her cure involved more than a decade of painful treatments that damaged her health, but she has been disease-free for twelve years. Vera was sent home to die by her oncologists, but since she had been managing the online patient groups, she knew she had alternatives.  Here is Vera's article about her lymphoma odyssey on her old blog: How I beat the Reaper Posted by leavergirl under healing  [15] Comments  In 1995, still trying to get pregnant, I was diagnosed with immune system cancer. It was a moment that changed my life. I can still feel the echoes of that shock. I still remember my first oncologist trying to push chemo on me. When I asked for information about the substances he was recommending, his nurse rummaged through dusty closets and came up with nothing. I found a way out of despair by learning all I could to save my life. I learned that Non-Hodgkin's B-cell lymphoma comes in three varieties: slow-growing, intermediate, and fast-growing. The fast ones are often curable but rare. The slow ones are best not to treat right away (that first oncologist was a greedy liar), and respond well to chemo initially, but eventually they'll turn intermediate and kill you. Median survival? 7-9 years. Ugh. One thing I hold against conventional medicine is that it's so damn depressing, the way it presents information to patients. I spent several years studying both the conventional side — finding more hopeful stats — (thank you, Fox Chase Cancer Center, for making your library so patient-friendly!) and the alternative side. The alternative side is good at giving people hope and pluck. I spent some time experimenting with various concoctions they recommended. And while sifting the dross from the potential gold, which included talking to other lymphoma patients who also had the gumption to experiment, I found two alternative treatments that merited an "A" on my scale. One wasn't of use in lymphoma, which is usually disseminated (metastasized) by definition. That was hyperthermia (which has since made limited inroads into conventional cancer treatment). The other one was Coley's Toxins. I wrote one of the first well-researched internet articles on the toxins. The American Cancer Society had blacklisted Coley's Toxins for many years as a quack treatment and are not conventionally available to this day. They are cheap to make and unpatentable. My approach, recommended by my next oncologist, was to do "watchful waiting" until the disease progressed. When it did, I availed myself of the various toxic drips they give to cancer patients. By then, they were accompanied by monoclonal antibodies — bioengineered thingies that run through the immune system, gobble up B-cells, and improve the chemo's effectiveness. I also did a rare treatment that gave me a year of remission called Bexxar. But then, in '07, the lymphoma speeded up (underwent cellular transformation) and tried to kill me. I got hit by very harsh chemo and spent that summer doing treatments, transfusions, and Neulasta injections, weak as a newborn chick, wondering if my hair would ever grow back. For the rest, subscribe to robertyoho.substack.com. (preview) Support the show

On this episode of BackTable Urology, Dr. Jose Silva and Dr. Jay Simhan, director of reconstructive urology at Fox Chase Cancer Center, discuss how urologists can demonstrate their value to hospital systems. --- SHOW NOTES First, Dr. Simhan explains the changing nature of urology practice. He opts for the term “health systems urologist” over “private practice urologist” because many urologists are managed by smaller medical groups that are owned by larger hospital groups. He notes that this multi-tiered system of management can cause tension around decision making and increase senior leadership turnover when hospital finances change. Then, Dr. Simhan explains the four ways that doctors can generate value, which is clinical productivity, departmental service, academics or research, and teaching. Clinical productivity is often measured by the RVU system, which assigns a certain number of value units to a procedure. Hospital systems may encourage urologists to choose surgical procedures over office-based procedures to increase RVUs. Although RVUs are arbitrarily set by the Centers for Medicare & Medicaid Services (CMS), each hospital or medical group can increase the number of RVUs per procedure to their own discretion. Dr. Simhan believes that urologists should band together to negotiate fair RVU systems. Finally, they end the episode by discussing concrete ways to demonstrate value as a urologist. Generally, minimizing complications and maximizing RVUs is helpful. Dr. Simhan advises urologists who are joining a new system to build their name and referral network to earn a long term contract. Usually, there is no RVU requirement in the first employment contract. In the later years, he recommends putting in the effort to understand productivity metrics and downstream costs and revenues in order to maximize earnings and potential.

Her video interview on Rumble is HERE.As you get to know Vera, I know you will enjoy her as much as I did. She is an entirely upbeat person who had a terrible trial by fire. The road to her cure involved more than a decade of painful treatments that damaged her health, but she has been disease-free for twelve years. Vera was sent home to die by her oncologists, but since she had been managing the online patient groups, she knew she had alternatives. Here is Vera's article about her lymphoma odyssey on her old blog:How I beat the ReaperPosted by leavergirl under healing [15] Comments In 1995, still trying to get pregnant, I was diagnosed with immune system cancer. It was a moment that changed my life. I can still feel the echoes of that shock. I still remember my first oncologist trying to push chemo on me. When I asked for information about the substances he was recommending, his nurse rummaged through dusty closets and came up with nothing. I found a way out of despair by learning all I could to save my life. I learned that Non-Hodgkin's B-cell lymphoma comes in three varieties: slow-growing, intermediate, and fast-growing. The fast ones are often curable but rare. The slow ones are best not to treat right away (that first oncologist was a greedy liar), and respond well to chemo initially, but eventually they'll turn intermediate and kill you. Median survival? 7-9 years. Ugh. One thing I hold against conventional medicine is that it's so damn depressing, the way it presents information to patients.I spent several years studying both the conventional side — finding more hopeful stats — (thank you, Fox Chase Cancer Center, for making your library so patient-friendly!) and the alternative side. The alternative side is good at giving people hope and pluck. I spent some time experimenting with various concoctions they recommended. And while sifting the dross from the potential gold, which included talking to other lymphoma patients who also had the gumption to experiment, I found two alternative treatments that merited an "A" on my scale. One wasn't of use in lymphoma, which is usually disseminated (metastasized) by definition. That was hyperthermia (which has since made limited inroads into conventional cancer treatment). The other one was Coley's Toxins. I wrote one of the first well-researched internet articles on the toxins. The American Cancer Society had blacklisted Coley's Toxins for many years as a quack treatment and are not conventionally available to this day. They are cheap to make and unpatentable.My approach, recommended by my next oncologist, was to do "watchful waiting" until the disease progressed. When it did, I availed myself of the various toxic drips they give to cancer patients. By then, they were accompanied by monoclonal antibodies — bioengineered thingies that run through the immune system, gobble up B-cells, and improve the chemo's effectiveness. I also did a rare treatment that gave me a year of remission called Bexxar. But then, in '07, the lymphoma speeded up (underwent cellular transformation) and tried to kill me. I got hit by very harsh chemo and spent that summer doing treatments, transfusions, and Neulasta injections, weak as a newborn chick, wondering if my hair would ever grow back.For the rest, subscribe to robertyoho.substack.com. (preview)Support the show

We've heard a ton about medical advancements that happened really quickly in response to COVID - meanwhile, scientists and doctors have been working on a cure and treatments for cancer for decades. Where does that research stand today? Are we any closer to finding a cure…or is that the wrong thing to look at? Dr. Jonathan Chernoff, Cancer Center Director at the Fox Chase Cancer Center, talks us through the progress that we have made, and why it might be slower than we'd like. He also explains what's on the horizon and how new technologies, like mRNA, could help. To learn more about listener data and our privacy practices visit: https://www.audacyinc.com/privacy-policy Learn more about your ad choices. Visit https://podcastchoices.com/adchoices

We meet with Dr. Joseph Friedberg, a thoracic surgeon at Temple University Hospital-Main Campus and Fox Chase Cancer Center. Joseph Friedberg, MD, FACS, is Thoracic Surgeon-in-Chief of Temple University Health System, Vice Chair of Surgical Services for the Department of Thoracic Medicine and Surgery, Professor of Thoracic Medicine and Surgery at the Lewis Katz School of Medicine at Temple University, and Co-Director of the Temple Health Mesothelioma and Pleural Disease Program. He is interviewed by Shannon Sinclair, RN, BSN, OCN, who serves as the patient services director at the Mesothelioma Applied Research Foundation. www.curemeso.org. MesoTV is a program by the Mesothelioma Applied Research Foundation. This program is made possible by our generous sponsors: Maune Raichle Hartley French & Mudd, LLC (MRHFM); Bristol Myers Squibb; Novocure, Merck, The Gori Law Firm, TCR2, AstraZeneca, Early Lucarelli Sweeney & Meisenkothen. Search our previous episodes for topics/speakers of interest to you at www.curemeso.org/mesotv.

Today's podcast is titled, “Polymorphism and Human Disease.” Dr. Baruch S. Blumberg, Fox Chase Cancer Center, winner of the 1976 Nobel Prize in Physiology/Medicine, and Prof. H. Sharat Chandra, Indian Institute of Science, Bangalore, India, discuss polymorphism and human disease. Listen now, and don't forget to subscribe to get updates each week for the Free To Choose Media Podcast.

In this episode of StemZ Perspectives, hosts Daniel and Evan delve into the intersections of healthcare and research, gleaning interesting insights from the unique perspective of Dr. Jonathan Chernoff, M.D., Ph.D., Cancer Center Director and Senior Vice President at the Fox Chase Cancer Center. Dr. Chernoff received his undergraduate degree from Yale University graduated from the MD/PhD program at the Icahn Sinai School of Medicine at Mount Sinai. In this interview, Dr. Chernoff discusses his background in medicine, explains what Chernoff Lab is currently researching, and illustrates the importance and necessity of his field of research in our daily lives. --- Send in a voice message: https://podcasters.spotify.com/pod/show/stemz-perspectives/message

Over the last decade, the number of treatment options for patients with advanced cancers has greatly expanded. In this episode, we look at treatments currently available to patients diagnosed with advanced or metastatic bladder cancer and discuss ways to cope with this difficult diagnosis. Our guests are Dr. Daniel Geynisman and Monica Scanlan, BSN, RN, both of Fox Chase Cancer Center at Temple Health, and Rachel Saks, MSS, LSW, OSW-C, Senior Director, Education at the Cancer Support Community.

Over the last decade, the number of treatment options for patients with advanced cancers has greatly expanded. In this episode, we look at treatments currently available to patients diagnosed with advanced or metastatic bladder cancer and discuss ways to cope with this difficult diagnosis. Our guests are Dr. Daniel Geynisman and Monica Scanlan, BSN, RN, both of Fox Chase Cancer Center at Temple Health, and Rachel Saks, MSS, LSW, OSW-C, Senior Director, Education at the Cancer Support Community.

In this episode of BackTable Urology, Dr. Bagrodia and Dr. Jay Simhan, director of reconstructive urology at Fox Chase Cancer Center, discuss how to demonstrate value at a private or academic physician job. The CE experience for this Podcast is powered by CMEfy - click here to reflect and earn credits: https://earnc.me/DU5Nmx --- SHOW NOTES The doctors first briefly discuss the process of obtaining a physician job. Dr. Simhan believes that physicians should negotiate their contracts only out of necessity. He encourages new attendings to demonstrate their own value to the administrators who create their contracts. Next, the doctors move onto advice for the first 3 months in a new job. Both doctors agree that the goal should be to learn who people are and earn their respect, whether they are residents, trainees, other attendings, nurses, MAs, or administrators. Dr. Simhan also emphasizes the importance of building your own cultural philosophy and deciding what you care about. Then, the doctors discuss the traditional 3 A's: available, affable, and able. Dr. Simhan notes that for a new physician, availability and affability are probably more heavily weighted for new hires. Dr. Bagrodia believes that accountability should be the 4th A because physicians should know when to accept their mistakes and move forward. Finally, Dr. Simhan explains how he had to learn the landscape of his new department at Fox Chase Cancer Center in order to figure out how he could build and fit in his reconstructive urology program. Finally, the doctors discuss how to engage in tactful self-promotion to demonstrate your value. Dr. Simhan explains that recognition is not a negative result to seek, as it can fuel your passion (e.g. bigger patient base, support for funding, etc.). He encourages doctors to have a personal website, to always update referring doctors after clinical visits and surgeries, and to be available to trainees and nurses. Additionally, Dr. Bagrodia advises physicians to meet with their department chairs and mentors to discuss progress and ask for help. He discourages physicians from giving unsolicited advice to their colleagues. Finally, the doctors share some of their miscellaneous tips for demonstrating value within a hospital system. Dr. Bagrodia notes that it is helpful to be prepared with talking points, ideas, and solutions when meeting with hospital administrators. Dr. Simhan adds that it is important to fully commit to the responsibilities that you agree to take on.

In this episode of Lung Cancer Considered, host Dr. Stephen Liu leads a discussion on the management of metastatic, PDL1 negative NSCLC. He is joined by Dr. Hossein Borghaei and Dr. Reyes Bernabe Caro. Dr. Borghaei is a professor and Chief of Thoracic Oncology at Fox Chase Cancer Center in Philadelphia. He was the lead author for CheckMate 057, was involved in many of the landmark immunotherapy trials, and is the national PI for the ongoing INSIGNA trial. Dr. Reyes Bernabe Caro is the Section Chief of Medical Oncology and Head of the Thoracic Tumor Unite at the Hospital Universitario Virgen Rocio in Seville, Spain. She also has extensive experience in immunotherapy combinations and is an author on the NADIM and CheckMate 227 studies.

Bio:   Shari Short is a patient advocate, a professional in healthcare communications and naturally, a standup comedian. As Senior Director of Insights and Strategy at Bionical Solutions, she has over 20 years of experience in patient education from behavior change to clinical trial recruitment. A developmental psychologist by training, Shari has held positions with the National Cancer Institute, Centers for Disease Control, Virginia Department of Health, Fox Chase Cancer Center, and various healthcare marketing firms. Shari received her M.A. in developmental psychology from Columbia University Teachers College.    Shari has been living with Multiple Sclerosis for 14 years. As a Patient Advocate, Shari has shared insights from living with Multiple Sclerosis to the New Jersey statewide advocacy committee of the National MS Society as well as written for their national magazine, Momentum. She incorporated her experience with MS into a sold-out one-woman show called “It's My Mother's MS, I just Have It” and a satire letter series from “The Crazy Cane Lady”. Shari has been featured on multiple podcasts. She has been performing standup comedy since her teen years (read: the 80s) and has opened for performers such as Shawn Colvin and Sandra Bernhard.   Questions:   Welcome to the program, Shari, and thanks so much for joining us on Living Well with MS. You have a very eclectic background, from standup comedy to developmental psychology. Can you tell us a bit about how that all ties together and has helped you forge your current path focused on behavior change? We know humor is important to you, an essential part of your personal and even professional identity. And we'll dig into that in a moment. But first, I'd like to understand your experience with MS. Can you give us a bit of an intro to that, anything you feel comfortable sharing? Was there a point when you developed a philosophy or even a methodology for using humor to cope with some of the challenges of MS? Can you tell our audience about that journey? You've produced a lot of humorous output about MS. Some notable things to mention (incidentally links to many of these can be found in the show notes, so I encourage everyone to have a look): a one woman show called “On My Nerves”; a satirical piece for Momentum, the National MS Society magazine; presentations at the University of Pennsylvania; various podcast appearances, including this one. Do any of these stand out for you, and if so, how? I understand that humor has personally helped you deal with scary situations, reframe your current physical abilities, and not take yourself too seriously. How transferable are these “benefits” to the broader MS community, and how would you advise people who don't have the same organic relationship with humor that you do tap into them? How do you overcome the discomfort some people may feel when you apply a humorous or jokey spin to a “serious” topic such as MS? There's a principle I understand you have called “laughing on purpose”. Can you tell us a little more about that? So I'm getting the sense that humor can be many things as applied to MS: a coping tool, a teaching tool, or even a defense mechanism. What's your best advice for how Joe Q. Public with MS can harness humor to its maximum positive advantage? Thanks so much for being our guest on Living Well with MS, Shari. We are thrilled to learn about the amazing work you're doing to help people with MS ease their burdens and get the most out of life using humor. And I encourage everyone to learn more about you and your work by checking out the links and more in our show notes for this episode. Thanks again, Shari.   Links:   Connect with Shari on LinkedIn Read Shari's humorous piece in Momentum Magazine, the official magazine of the National MS Society Check out Shari's satirical take on pharma marketing Here's a collection of Shari's videos connected to the 2021 Tody Awards Check out selections from Shari's 2011 one-woman show, "It's My Mother's MS, I Just Have It" – clip 1 and clip 2   Coming up next:   Starting June 27, please join us for the 33rd installment of our Living Well with MS Coffee Break series. On this journey into the lives of our global OMS community, we have a special surprise for you – a mystery guest. Their location won't be disclosed until the episode because you'd likely guess who it is it were. But we assure you that you'll relish some of the behind-the-scenes details of this person's life and OMS journey.   Don't miss out:   Subscribe to this podcast and never miss an episode. You can catch any episode of Living Well with MS here or on your favorite podcast listening app. For your convenience, a full episode transcript is also available on all platforms within 72 hours of each episode's premiere. If you like our program, don't be shy and leave a review on Apple Podcasts or wherever you tune into the show. And feel free to share your comments and suggestions for future guests and episode topics by emailing podcast@overcomingms.org.   S4E53 Transcript Laughter is the Best Medicine   Geoff Allix (00:00): Welcome to Living Well with MS, the podcast from Overcoming MS, the world's leading multiple sclerosis healthy lifestyle charity, celebrating its 10th year of serving the MS community. I'm your host, Geoff Allix. The goal of our organization and this podcast is to inform, support, and empower people with MS to lead full and happy lives. We're excited you could join us for this new episode.   Make sure to check out this episode's show notes for more information and useful links. You can find these on our website at www.overcomingms.org/podcast or on whichever podcast platform you use to tune into our program. If you enjoy the show, please spread the word about us on your social media channels or leave a review wherever you tune into our podcast. Have questions or ideas to share? Email us at podcast@overcomingms.org or you can reach out to me directly on Twitter, @GeoffAllix. We'd love to hear from you. Finally, don't forget to subscribe to Living Well with MS on your favorite podcast platform so you never miss an episode. And now, let's meet our guest for this episode.   Welcome to the Living Well with MS podcast. This episode is Laughter is the Best Medicine, with guest, Shari Short. Shari is a patient advocate, a professional in healthcare communications, and naturally, a stand-up comedian. As senior director of insights and strategy at Bionical Solutions, she has over 20 years of experience in patient education, from behavior change to clinical trial recruitment. A developmental psychologist by training, Shari has held positions with the National Cancer Institute, Centers for Disease Control, Virginia Department of Health, Fox Chase Cancer Center, and various healthcare marketing firms. Shari received her MA in Developmental Psychology from Columbia University Teacher's College.   Shari has been living with multiple sclerosis for 14 years. As a patient advocate, Shari has shared insights from living with multiple sclerosis to the New Jersey Statewide Advocacy Committee of the National MS Society, as well as written for their national magazine, Momentum. She incorporated her experience with MS into a sold-out one-woman show called, It's My Mother's MS, I Just Have It, and a satire letter series from The Crazy Cane Lady. Shari has been featured on multiple podcasts. She had been performing stand-up comedy since her teen years and has opened for performers such as Shawn Colvin and Sandra Bernhard. Welcome to the program, Shari, and thanks so much for joining us on Living Well with MS.   Shari Short (02:34): Thank you for having me.   Geoff Allix (02:37): You have a very eclectic background, from stand-up comedy to developmental psychology. Can you tell us a bit about how that all ties together and has helped you forward your current path focused on behavior change?   Shari Short (02:51): Sure. I mean, doesn't it sound like such a natural path, from stand-up comedy to developmental psychology. It's like a board game, really, it's like a party game. I basically started out really wanting to be in the arts and especially stand-up, I preferred stand-up to acting. I sing, I act, whatever, but stand-up was my favorite. And I for some reason had the guts to start it at 14 years of age when I had braces and was in high school and was able to go into the comedy clubs and just watch, watch and learn. And the older comics there just, they adopted me and took really good care of me. I read John Belushi's book, a book about John Belushi by Woodward, at a young age, and it scared me to have to depend on my sense of humor for finances.   So I said, "Well, I want to have like a solid degree and a solid job and do stand-up." And of course, when you're a teenager, you think that all works. I was eager to at least get academic credentials behind me, so I went to film school, went to NYU, and there I minored in psychology, spent a lot of time during the summers, working with young kids and parents in theater camps, and just absolutely fell in love with... Excuse me... The way that our lives changed when we become parents. And it wasn't me, I was watching people become parents, and I was helping parents and I wasn't even a parent yet. So when I chose developmental psychology for my graduate work, I felt like that's what I'm going to go into. I want to create resources for parents.   I became concerned with... like we talked about Microsoft earlier, I was like, "Are there books for parents on how to use the computer?" I interned with Sesame Street. I was very focused on being creative within this academic psych setting. But once you go to grad school, nothing's really funny, so I stopped doing comedy. I had opened for Sandra Bernhard, I'd opened for Shawn Colvin, I'd had a wonderful time, but you got to commit. If you want to do stand-up, you have to commit and you have to want it, you have to want that life and I preferred giving lectures.   I preferred making the audience laugh that they had to be there, I had to grade them or they had to be graded, they had to show up. And I tipped my hat off to everybody I know that's successful now, that just put in those hours and put in that amount of travel to live the life of a stand-up comic, especially in the 90s, and the early 2000s, because that was way before MS for me, but something I knew I didn't have the stamina for. And I was so nervous to not get paid and have it all depend on my sense of humor, that was a big thing for me.   Geoff Allix (06:14): We'll come back to the humor in a bit because it's obviously an essential part of your personal and professional identity. But first, because this is a Living Well with MS Podcast, we want to understand a bit about your experience with MS. Could you give us a bit of an intro, anything that you feel comfortable sharing about your MS journey?   Shari Short (06:35): Sure. I was diagnosed in the summer of 2008. I had become a runner a year or so before that, and was training pretty intensely for a 10k, and I suddenly had vision loss and pain behind my eye. It presented as the optic neuritis, but I didn't know that. For me it was, "Oh, there's pain, there's my eye, there's my head. Clearly it's a brain tumor." And I panicked and went to the urgent care center and they sent me to the ER, and I got an emergency eye doctor appointment the following morning. And the eye doctor just said, "Oh, this is really classic optic neuritis." And I was like, "Great, give me some eye drops." I didn't know what that meant, and he just kept sitting there and I'm like, "Oh, you have more to tell me, don't you?"   He got me into a pretty quick appointment with a neurologist. And I don't have a slow, drawn-out diagnosis story, like so many. They had a neuroradiologist at my MRI, they saw lesions, I was diagnosed really quickly, all based on that one event with the optic neuritis.   Geoff Allix (07:53): I think there is a difference in different health care systems around the world, it does seem to me the Americans I've spoken to, do get diagnosed typically quite quickly, whereas in the UK we often get diagnosed quite slowly. But on the flip side, we get lots of free medication.   Shari Short (08:10): Yes, it's quite the flip side.   Geoff Allix (08:13): Definitely tradeoffs between the different-   Shari Short (08:13): It's quite the flip side.   Geoff Allix (08:16): If someone were to come up with the best of both worlds, it'd be pretty good. But yeah. Yeah, I would never say anything bad about our system, our system is fantastic.   Shari Short (08:24): I'm a fan of your system.   Geoff Allix (08:25): But yeah, there are downsides to how quickly things happen occasionally, but anyway, we can live with that.   Shari Short (08:30): Yeah [inaudible 00:08:33].   Geoff Allix (08:33): Was there a point when you developed a philosophy or methodology even of using humor to cope with some of the challenges that came up because of MS?   Shari Short (08:45): It was pretty organic, I think, for me to be using my humor to cope. And I just didn't realize how naturally it would be until I was actually in a situation where I had to really tap into my coping skills. At my very first MRI where they diagnosed me, and the neuroradiologist is literally showing me my scan so I'm seeing my skull, the first thing out of my mouth, Geoff, was, "Do I look fat?" Right? It's like, "What?" Like, "Where'd that come from?" Like okay, I'm nervous and I'm processing, and clearly I'm going to try to lighten the mood. And to just see myself consistently doing that, when I got my first handicap tag and I was very sad about it, I remembered I had a dress the same color and I'm like, "I can finally accessorize."   So things were just coming to me in a way to get me off of the morbid train, to get me off of the "Okay, I could really [inaudible 00:09:53] because of this particular situation, but I'm going to find the humor in it." And the more I did that, the more my friends would say to me, "You've got a collection of stuff here. You've got stories, you've got strangers who've said ridiculous things to you, you've got just funny conversations, you've had funny interactions." People would see me, and I didn't mention this before, but eventually after the optic neuritis, eventually I lost feeling on my left side and now I walk with a cane and two leg braces. And I've had people just approach me, like I'm some sort of former athlete and then they'd be like, "Oh, was it soccer?" They just made up sports and they're strangers, I started telling people it was a Quidditch injury.   Geoff Allix (08:45): Well Quidditch is very dangerous. I mean, the altitude and...   Shari Short (10:48): Well, yeah, this is my little PSA. Yeah, so Quidditch causes MS, so yeah. I had a lot of time to not only see how I was using my humor to cope, but also to just see humor in situations. I was watching it unfold and gave myself the project of putting together a one woman show. And in doing so, in writing and in taking every Sunday to just sit and write and write, it was really, it was a deep dive into my own perspective. And from there I did the show, but I also then put together presentations and different types of creative outlets and tools for coping, that could hopefully help other people. Because this is not a mindset that just comes easily to a lot of people.   Geoff Allix (11:39): You've produced a lot of content, which you've touched on there, and it is mentioned in the show notes, so do have a look, there's links to a lot of that content. Some of the things are shows, like On My Nerves, as well as a satirical piece for Momentum, the National MS Society magazine in the States. Presentations at the University of Pennsylvania, various podcast appearances, including this one. Could you tell us if there's any of those experiences that stand out for you?   Shari Short (12:11): The one-woman show was phenomenal, and it was called On My Nerves, but the working title for me was, It's My Mother's MS, I Just Have It, because I had so many stories about how mom was dealing with my diagnosis or dealing with my disease, as opposed to me. And then that dovetailed into how everybody else was dealing with my situation, and the stories that I had on that. To have so many people come out and see that, and then be asked, "Do you want to do this for fringe festivals and stuff like that?" And to have to say, "Actually, no, I can't, that took all the energy I have." It was amazing, I'm glad I had it taped, I'm glad I have my binder. I could do it again, but I couldn't do it on a show basis.   To have a night at the theater where 140 people came out and it was sold out, was a really wonderful way to honor how I've used the humor. And also I got just emails and responses from people with other chronic illnesses, and a lot of people with more silent, hidden chronic illness that were like, "Thank you for that, because you just touched on stuff that no one's talking about, and you did it in a way that was safe." And I just realized that the humor can help people and it's not just helping me. Yeah, and then just the Crazy Cane Lady letter series that I started a couple of years ago was just a little creative advocacy project for me, where I would just write letters, fake letters, very real feelings, but fake letters to different entities, like hotels or restaurants, or back to school night, or Broadway theaters, about how they could be more accommodating to people like me.   I definitely honed in on the cane part of my existence because I see that there are tremendous accommodations, and we could still improve for people in wheelchairs, but the cane, it gets a little middle child treatment sometimes. And there's a ramp that it'll take me a year to get up the ramp on the cane when I could just go up the steps and then be there. So I just feel like there's a lot to learn and people have a lot to learn in terms of event planning and in terms of accommodating people with canes. I did this series of letters during MS Week here in the States, it was in March a couple of years ago. And I made those public, and that took off really nicely. People responded really well to that, and I need to write more of them. I was going to do it again the following year, but the following year was COVID and I just felt like we all had bigger fish to fry than if I can find a bench near a movie theater, right? So I didn't continue with that. I did a video series, like an Oscars version of just thanking different entities within the MS community that have helped me cope. I feel like if I can't perform it or if I can't write it and put it out there in a satirical way, I'm not processing. I don't do the serious stuff and process; it has to be creative for me to feel like it's healing.   Geoff Allix (15:37): You've mentioned that humor's helped you deal with situations you've had and help with your physical abilities and not take yourself too seriously, so how transferable are those benefits to the broader MS community? And how would you advise people to try to tap into that relationship you have with humor?   Shari Short (16:03): Yeah, no, that's a great question. I think that it comes down to the lens that you're seeing life through and the lens that you're seeing your mobility issues through, or whatever it is that MS has affected for you. And the lens I used to see my slow gait and my balance issues, I used to just... Well, I went from being a runner to the negative and it was, "Oh, great. This is what I get, and this isn't fair." And all of those very, very normal feelings, to, "All right, I'm going to rock a cane." Or "All right, with these assistant orthotic devices, they make me look like a Jedi." Or not, they made me look like a storm trooper actually, because they were white.   I also, I have to say I had a small child during this time, so I really felt the need to be creative about what was happening to mommy, because he saw me go from a runner to, I can't walk well, and that kind of pushed me along. There might be something for other people, when they consider, "Well, am I looking through it in the glass half full lens, or am I looking through it in the glass half empty? And what lens am I looking at it through? And are there things that I think are funny that, if I tell people I think they're funny, they're going to judge me?" And I'm here to say, embrace all of it. It's your lens, you're seeing it through. I did a lot of acceptance of dark humor. I did a lot of acceptance of the fact that humor is a language and some people will be put off if you're joking about your condition. And some people will feel like, "Oh, okay, good [inaudible 00:17:53]."   Geoff Allix (17:53): How do you deal with that discomfort if people are not comfortable with you talking in a humorous way about something as serious as MS?   Shari Short (18:03): Sure. Well, it's always know your audience, right? If I'm talking to other people who have MS, to the best of my ability I gauge where they are, like that talk I gave at Penn here in the States, they knew they were logging on to see a comedian, they knew what they were getting, so I wasn't too scared to read the Crazy Cane Lady letters or whatever. But I mean, to this day... look, last week I dealt with COVID and I knew I had COVID not because of a cold or a cough, but because I collapsed, and my husband had to pick me up off the floor. It triggered something in the MS and I'm like, "Oh, I've got a virus that my body wants me to know about."   And I could tell people and I get the "Oh." You know, I get the face. And I'm like, "Yeah, but I didn't hurt myself." Or "Yeah, my husband was right there." Or "My COVID's more fun than your COVID." I feel the need to keep going with the story instead of letting it halt and let them know I'm okay. And not everybody can do that, and I get that. And that's why, when I do workshops or anything like that, I get personal and talk about, "Okay, what's in your toolbox? What can you grab onto at that moment that is going to help you get either through telling the story or through what you're doing?" Almost in a cognitive behavioral way, "What's a great image you have in your head to just move you through the situation?"   And that's all just been because that's worked for me, and I know from research that humor is healing and laughing is really good for the body. There have definitely been situations in my life where the instinct is to cry, but I know it I've always felt better if I set the situation up so I could laugh at it.   Geoff Allix (20:10): You've got a principle, I believe, called laughing on purpose, which you've almost touched on there, I think. But could you tell us a bit of more about that?   Shari Short (20:18): Laughing on purpose?   Geoff Allix (20:19): Yes.   Shari Short (20:22): Laughing on purpose, I mean, when I hear that phrase, I mean, I feel like it's making a conscious choice to keep your sense of humor about you when things are challenging. And that looking at things with humor is not a weakness, it's like, if I don't laugh, I'll cry, that phrase that's out there. It's like if you laugh, it's actually going to help the situation a little bit. And it's for you, it's personal for you. It's not like, "Oh, somebody else is suffering, so laugh at them." I'm only talking about when one is dealing with one's own stuff. That would be horrible advice to give to anybody to just laugh at other people's challenges.   Geoff Allix (21:04): I just think all the best humor is when it's the comedian laughing at themselves, I think that's the funniest humor, isn't it?   Shari Short (21:10): Of course. Yeah, and I felt like sometimes I had to be jostled into it, I had to be jostled back. And I had this wonderful story in the show whereby I got that handicap tag and I was sad about it. And my boss at the time was like, "Well, can I borrow it? I have Springsteen tickets, and I would love to use your handicap tag." Here I was feeling really bad for myself, and then people were like, "You've got the golden ticket." I have this motto or whatever, or this creed or this way of looking at things, like if I don't try to find the humor in this, then I haven't really processed it, like I mentioned before. And it's not a pressure, it's just how can I help myself?   Occasionally they'll be like, "Oh no, no, no, it's not working yet. It's not working yet." And in my toolbox, I have things that make me laugh. I have old Blackadder episodes, I have the best of Bits of Fry and Laurie, I have comedians like David Mitchell and things on the BBC that make me laugh, or American comedians like Kathleen Madigan. And I just go there, I'm like, "They're going to make me laugh and it's going to reset me." The things that are dark, the things that I've had to deal with with MS, the intimate, discreet ways in which the central nervous system wreaks havoc, MS wreaks havoc on it, I don't want to share with everybody, but I've become a little bit more like, "I've got to advocate for me or no one else will."   So if we're all going into a restaurant, I'm like, "Excuse me, but the seat near the bathroom. Yeah, that would be me. That is mine." Right? Yeah. And it's just like, I'm 51 years old, people might think, "Oh, oh, women do that." No, no, no, it is totally because of the MS. But I've just grown a little bit more comfortable with the uncomfortable because I communicate with my humor. And when you have MS, I mean, everybody's got it differently, but there's uncomfortable things about it.   Geoff Allix (23:33): Sense of humor can apply to many things in MS. It can be coping tool, teaching tool, defense mechanism, so just for general member of the public who's got MS, how can they harness humor to make a positive benefit to themselves?   Shari Short (23:55): I think, first of all, you have to ask how you're processing any aspect of where you are in your patient journey, is the term that's used most often. How are you processing? Are you talking about it a lot? Are you thinking about it a lot? Are you down on yourself because of it? Or are you trying to give yourself pep talks? Are you worried about the future? Where are you with it? And then ask yourself in that processing, "Okay, what kind of lens should I look at this through so it's going to help me move forward?"   The toolbox is something I come back to a lot. What makes you laugh, as you, your own person with MS, what makes you laugh is not what makes me laugh, is not what makes everybody else laugh, it's you. So write it down, actually acknowledge your sense of humor. What makes you laugh? And start to collect those things, whether it's books or whether it's links on the internet, whether it's the cat video or the guy who says, "I'm not a cat," to the lawyer, you know those things that went viral last year. There are things that can immediately make you laugh so just be more aware of them because they're tools for you to reset. And I use humor to communicate, not everybody does. You may find in your dealing with MS, that you've got two friends that will get your dark humor, that will get your jokes, or will support you on that, then they're part of your toolbox too.   I've found that I've had, like we talked about earlier, there's people that get uncomfortable or they make faces and I don't stop too long in their party. I just go, "Okay, yeah, yeah, no, I know it sucks." I can't take care of anybody else but me, so I think that's really important, is to just look where you are, what lens are you looking at it through? Where can you find, is there humor in this situation? Do you want to write about it? Do you want to tell a good close friend about it? Do you want to tell your doctor about it? But collect those things, because at other times it's going to make you laugh when no one else knows what you're thinking, and it's going to be part of your own collection of stories that you can go back to and say, "This is how I dealt. This is how I helped myself." Because to find humor in situations, it's not self-defeating, it's empowering.   Geoff Allix (26:26): With that, I'd like to thank you so much for being our guest on Living Well with MS. We're thrilled to learn about the amazing work you've been doing to help people with MS, to ease their burdens and get the most out of life using humor. And I would absolutely encourage everyone to learn more about you and your work by checking out the links in the show notes, they're available on every platform. Have a look at the show notes of the episode. And thank you much for joining us again, Shari.   Shari Short (26:52): Thank you so much for having me, this was great.   Geoff Allix (27:01): Thank you for listening to this episode of Living Well with MS. Please check out this episode's show notes at www.overcomingms.org/podcast. You'll find all sorts of useful links and bonus information there. Do you have questions about this episode or ideas about future ones? Email us at podcast@overcomingms.org. We'd love to hear from you. You can also subscribe to the show on your favorite podcast platform, so you never miss an episode.   Living well with MS is kindly supported by a grant from The Happy Charitable Trust. If you'd like to support the Overcoming MS charity and help keep our podcast advertising free, you can donate online at www.overcomingms.org/donate. To learn more about Overcoming MS and its array of free content and programs, including webinars, recipes, exercise guides, OMS Circles, our global network of community support groups, and more, please visit our website at www.overcomingms.org. While you're there, don't forget to register for our monthly e-newsletter so you can stay informed about the podcast and other news and updates from Overcoming MS. Thanks again for tuning in and see you next time.   The Living Well with MS family of podcasts is for private, non-commercial use, and exists to educate and inspire our community of listeners. We do not offer medical advice. For medical advice please contact your doctor or other licensed healthcare professional. Our guests are carefully selected, but all opinions they expressed are solely their own and do not necessarily reflect the views or opinions of the Overcoming MS charity, its affiliates, or staff.

Dr. Hossein Borghaei, Fox Chase Cancer Center, joins Hafiz and Mahim today to discuss updates in TIGIT, Immunotherapy, and more.

Joseph Treat, MD, is a Professor of the Department of Hematology/Oncology, Vice Chair of Education and Medical Director for Ambulatory Care at Fox Chase Cancer Center. Dr. Treat completed his medical school from Temple University and residency in Internal Medicine from Georgetown University Hospital where he stayed to pursue an Oncology fellowship at the Lombardi Cancer Center. He has dedicated his clinical practice to mesothelioma and lung cancer for the past 20 years and has published extensively on these topics, including widely read reviews on popular chemotherapeutic agents used in the treatment of lung cancer. Science and Empathy being distinct opposites is a common misconception; Dr. Treat says: "Medicine is a gift that allows us to combine the scientific method with empathy. Eliminate the grocery list mentality and be empathetic." Join us as we listen to anecdotes from Dr. Treat's life and identify the essentials of medicine and mentorship to make the leap from good to great. Pearls of Wisdom:   1. Patients can understand when you are simply ticking off the grocery list of medical procedures. To become a GREAT physician, you must employ empathy in your practice. 2. Mentorship is an active process. It's not magic. You must deliberately reach out to potential mentors by being an enthusiastic mentee. 3. Getting things done quickly is a critical quality. It's an overt indicator for competence and determination. Always be swift in completing tasks.

This episode features Joel Helmke, Chief Operating Officer at Fox Chase Cancer Center. Here, he discusses the history of Fox Chase Cancer Center, developments in oncology care, the challenges with the labor market, and more.

Happy Women's History Month from Scientifically Sound! It's a celebration on this side as we channel our inner Chaka Khan with her 1978 hit single "I'm Every Woman", in honor of the #IfThenSheCan exhibit. This exhibit highlights 120 women in STEM from all kinds of careers with 3D life-size statues! It is currently wrapping up its time at the Smithsonian, so I thought it would be cool to get a thought (or two) on the exhibit from two outstanding women who are IF/THEN ambassadors. Dr. Jaye Gardiner and Dr. Danielle Twum! We laugh, we learn, and most of all, we enjoy ourselves for this episode. Show notes and more information about our guests and the below.#IfThenSheCan exhibit linkhttps://ifthenexhibit.org/about/I'm Every Woman Video Linkshttps://www.youtube.com/watch?v=DVDCNmdi7QI (Chaka Khan)https://www.youtube.com/watch?v=H7_sqdkaAfo (Whitney Houston)Dr. Jaye C. Gardiner is a cancer biologist and illustrator who is passionate about STEM education and increasing representation. She received her PhD in Cancer Biology from the University of Wisconsin-Madison and is currently completing her postdoctoral work at the Fox Chase Cancer Center in Philadelphia, PA. There, she researches pancreatic cancer's tumor microenvironment with the hopes of understanding how the body's local environment communicates to support the tumor so future therapeutics may disrupt this communication. In addition to research, Jaye creates comics to make science more accessible as the co-founder of JKX comics. Jaye's Social Media---Instagram/Twitter (Professional)@jayeperview @jkxcomics Instagram (Personal)@ajayeinthelife https://www.jkxcomics.com/storeHailing from Ghana, West Africa, Dr. Danielle Twum received her B.A. in Biology from Vassar College where she studied the effects of climate change on coral bleaching. Danielle received her PhD in Cancer Immunology from the University at Buffalo where she studied the immunology of breast cancer metastasis. She currently works as a Business Development Manager at Genoskin all the while being a fabulous science communicator.  If she is not reading, you'll find Danielle enjoying Indian and Korean food, having a dance party to some old school Kpop or getting lost in the wormhole that is the BBC Earth YouTube channel.Danielle's Social Media---Instagram/Twitter @forgedonyx Follow Scientifically Sound----Twitter: 4theSci_SoundInstagram: scientificallysoundTikTok: scientificallysoundemail: 4thescientificallysound@gmail.com

In this episode we discuss robotic radical prostatectomy as a treatment option for prostate cancer. Over the last 20 years, robotic radical prostatectomy has become the gold standard for surgical management of prostate cancer.  While the concept of robotic surgery is exciting, it also leads to a lot of questions amongst men faced with a decision as to how to treat their prostate cancer.  How does the procedure actually work?  Is the surgery performed by a surgeon or by a robot?  What are the risks and side effects? Are all men good candidates for the procedure.  And, of course, how effectively does it cure prostate cancer?  To answer these questions we turned to Dr. Alexander Kutikov.  Dr. Kutikov is a Professor and Chief of Urology and Urologic Oncology at the Fox Chase Cancer Center. He is a board certified, academic urologic surgical oncologist who treats urologic tumors using minimally invasive (robotic / laparoscopic) and traditional surgical techniques. Dr. Kutikov received an MD from Harvard Medical School's Harvard-MIT Health Sciences and Technology Program in 2003. He then completed his Urologic residency training at the University of Pennsylvania in 2008 and finished a 2-year Society of Urologic Oncology fellowship at the Fox Chase Cancer Center in Philadelphia, USA. He has co-authored more than 170 original manuscripts in peer-reviewed journals and has published chapters in leading urologic textbooks as well as holding leadership positions both in the American College of Surgeons and the American Urological Association.

In Episode 22 of Bladder Cancer Matters, host Rick Bangs talks with Drs. Phil Abbosh and Max Kates about bladder cancer biomarkers.  Dr. Abbosh is a urologic oncologist at the Fox Chase Cancer Center in Philadelphia. Dr. Kates is an assistant professor of urology and oncology with the Brady Urological Institute at Johns Hopkins in Baltimore. Rick and Drs. Abbosh and Kates talk about what biomarkers are and how they are relevant to bladder cancer. A biomarker is a biological molecule found in blood, other body fluids, or tissues that is a sign of a normal or abnormal process, or of a condition or disease. A biomarker may be used to see how well the body responds to a treatment for a disease or condition like bladder cancer. Click here to read the transcript.

Caris Precision Oncology Alliance™ Chairman, Dr. Chadi Nabhan, sits down with Dr. Igor Astsaturov, Co-director of the Pancreatic Institute at Fox Chase Cancer Center and Chairman of the Caris Molecular Tumor Board. Together they discuss molecular tumor boards and how they are utilized at Caris and other academic sites. For more information, please visit: www.CarisLifeSciences.com

Wafik El-Deiry, MD, PhD, FACP, is Associate Dean for Oncologic Sciences at the Warren Alpert Medical School, Director, Cancer Center at Brown University, practicing oncologist and ACS Professor. El-Deiry earned MD/PhD degrees at U. Miami, completed Medicine residency, Oncology fellowship at Johns Hopkins where he discovered CDK-inhibitor p21WAF1. He was HHMI Investigator, tenured Professor of Medicine, Genetics and Pharmacology, Associate Director for Physician-Scientist Training in Hem-Onc, and Radiobiology Program leader at Penn's Abramson Cancer Center. He was Chief of Hem-Onc at Penn State, and Deputy Director at Fox Chase Cancer Center. Dr. El-Deiry discovered TRAIL death receptor DR5, TRAIL-Inducing Compound #10 (TIC10), and founded Oncoceutics to bring TIC10/ONC201 to patients where it showed exceptional responses against glioblastoma. He has >400 publications, 5-edited books, H-Index of 120 with > 83,000 citations in Google Scholar. He is an ASCI, AAP member, Past President of Interurban Clinical Club (2013-2014), and Elected Member of Johns Hopkins Society of Scholars (2014). He won the Michael Brown Award (Penn), the Elizabeth and John Cox Award (Georgetown), and the International Kuwait Prize for Cancer. Dr. El-Deiry trained many students, fellows, physician-scientists, and continues to mentor scientists and faculty in basic and translational cancer research. Dr. El-Deiry is one of the original physician-scientists on social media who was recognized among the top 10 Oncologists in the world for impact on Twitter in 2021. Follow him @weldeiry “If you try 10 things and one of them works, you'll be successful.” From naming the WAF1 gene as an oncology fellow to becoming one of the most cited researchers in oncology, Dr. El-Deiry shares with us his unique journey in the space of cancer research. Join us as he shares anecdotes from his early career, overcoming rejections and developing a persistent yet agile mindset to make his mark in medicine. Pearls of Wisdom: 1. If you limit yourself to one attempt and fail, you will think of yourself as a failure. Try your hand at ten things. If you succeed at even one of them, then you are successful. 2. There's a fine line between believing in what you do and understanding the limitations of your idea. That's when you can decide to continue being persistent or decide to be agile and open to change. 3. Finding the right mentor is crucial. What separates a good mentee from a great mentee is their drive to keep trying different things and perpetually reaching out to their mentor to find the right answer.

In Episode 10 of Bladder Cancer Matters, Rick Bangs's special guest is Dr. Alexander Kutikov, MD, FACS of Fox Chase Cancer Center in Philadelphia. Dr. Kutikov is the Chief of the Division of Urology and Urologic Oncology. Rick and Dr. Kutikov discuss: What can a cystoscopy tell you about the bladder cancer stage? Is a blue light cystoscopy better than a white light? What about x-rays and CT scans? Can they give you different information than a cystoscopy? Never miss an episode by subscribing to Bladder Cancer Matters on your favorite podcast platform like Apple Podcasts, Google Podcasts, Spotify and Amazon Music Podcasts.  

Host Rick Bangs interviews Dr. Elizabeth Plimack of Fox Chase Cancer Center, where she is the Chief, Division of Genitourinary Medical Oncology.  Dr. Plimack is also the Chair of the Bladder Cancer Advocacy Network's (BCAN's) Scientific Advisory Board. Rick and Dr. Plimack talk about: The importance of supporting bladder cancer research The role of BCAN's Scientific Advisory Board What the Bladder Cancer Think Tank is Resources that BCAN has for bladder cancer patients, caregivers, researchers and doctors. Today's episode is sponored by Merck and we are grateful for their support.

Managing one of the most common side effects of treatment, Cancer Related Fatigue, can be difficult. Join us as we discuss this cumbersome side effect with Dr. Leigh Kinczewski, from Fox Chase Cancer Center in Philadelphia, and provide you with real-life ways to combat Cancer Related Fatigue.