Patient from Hell

In this episode, Dr. Geoff Oxnard, a thoracic oncologist, discusses his career journey into oncology and shares insights from his experience treating lung cancer patients and conducting research. He emphasizes the increasing role of precision medicine and genomic and biomarker testing in guiding treatment decisions, providing examples of how identifying specific mutations can lead to dramatically better outcomes with targeted therapies. Dr. Oxnard also highlights the changing narrative surrounding lung cancer, with emerging stories of remarkable responses and newfound optimism as treatments improve. He provides perspective on navigating clinical trials, especially for rare genomic subtypes, and shares his motivations for transitioning from academia to the pharmaceutical industry, driven by a desire to have a larger impact on drug development and patient care. Key Highlights: 1. The increasing role of precision medicine and genomic testing in guiding lung cancer treatment decisions. 2. The changing narrative and renewed optimism surrounding lung cancer, as treatments improve and stories of remarkable responses emerge. 3. Dr. Oxnard's transition from academia to the pharmaceutical industry, driven by a desire to have a larger impact on drug development and patient care. About our guest: Geoff Oxnard, M.D., is the Vice President, Clinical Development, Global Head, Thoracic Cancer at Loxo@Lilly. Previously, Dr. Oxnard served as a thoracic oncologist and clinical-translational researcher at Dana Farber Cancer Institute and was also an Associate Professor of Medicine at Harvard Medical School. Dr. Oxnard received his BA in chemistry from Harvard University and his MD from the University of Chicago-Pritzker School of Medicine. He completed his residency in internal medicine at Massachusetts General Hospital and completed his fellowship in medical oncology at Memorial Sloan-Kettering Cancer Center. As an experienced oncologist, Dr. Oxnard is passionate about raising awareness of thoracic cancer and helping to make an impact on cancer care. Key Moment: 8 minutes: “It starts with precision therapy, if I may, right? Once you have defined a specific molecular subtype, you've tried to sort of sift through the randomness of cancer care to find a group of patients who are going to behave in a similar way. Let's go into that for a moment, if I may, OK? EGFR mutations. If you give an EGFR inhibitor in the original studies to a bunch of patients on average with lung cancer, they live a couple months longer, but 10 % of those patients have fantastical responses that can last for a year or two or more. And so when you are a lung cancer patient, which are you looking for, by the way, to live on average two months longer or to have a fantastical response that can work for years? And of course, people are looking to be that outlier.” Visit the Manta Cares website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support

In this episode, Kimary Kulig, PhD, MPH dives into the topic of cancer biomarkers. Kimary explains the difference between genes and proteins, germline versus somatic gene testing, and the critical importance of testing for both as biomarkers for treatment selection. She also describes the world of lung cancer biomarkers and the implications for treatment decisions. The conversation highlights the need for patients and their families to understand biomarkers and the impact those biomarkers have on treatment options. Biomarker testing in cancer patients is crucial for personalized treatment, but there are significant challenges and delays in the current system. The long turnaround time for biomarker testing can be harmful to patients with aggressive cancers who need immediate, targeted treatment. Kimary highlights that patients and their families need to be aware of the importance of biomarker testing and advocate for it. Key Highlights: 1. Biomarker testing should encompass both germline and somatic gene alterations. Germline testing is sometimes called “genetic testing” and identifies inherited mutations that appear in every cell in the body, whereas somatic gene testing detects mutations just in cancer cells, some of which can be targeted with specific drugs. 2. There can be significant delays in biomarker testing results, which can be particularly harmful for patients with aggressive cancers. These delays often result in patients beginning chemotherapy while awaiting results, potentially impacting the efficacy of targeted therapies. 3. Kimary discusses the lack of “reflex” testing in the current system, where biomarker tests are not automatically ordered based on the type of cancer. Implementing reflex testing could speed up the process, ensuring timely and appropriate treatment for patients. About our guest: Kimary Kulig’s professional career has spanned the academic, non-profit, large pharma, start-up, and healthcare technology ecosystems. Kimary is currently Owner and Principal of Kulig Consulting, providing advice and service to biotech start-up, pharmaceutical, and medical device companies who develop oncology products. She also provides individual Biomarker Navigation services to cancer patients as My Biomarker Navigator™. Kimary applied her unique training in immunology, molecular oncology, and epidemiology for 12 years at both Pfizer and Bristol Myers Squibb. Her pharma career is highlighted by research on lung cancer biomarkers which are now standard of care companion diagnostics. Kimary was also Vice President at the National Comprehensive Cancer Network (NCCN) where she oversaw all operations of its Outcomes Research Database. At Verily Life Sciences, Kimary was Head of Oncology Clinical Research and led digital pathology machine learning and wearable device oncology application development. Kimary continues in her goal to bring AI tools to clinical practice as a member of the Friends of Cancer Research Digital Pathology Working Group. Kimary received her PhD from New York University’s Institute of Graduate Biomedical Sciences and her MPH from Columbia University’s Mailman School of Public Health. Visit the Manta Cares website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support

Dr. Kozower, a thoracic surgeon, discusses the role of surgery in lung cancer treatment and the use of surgery in the diagnosis of lung cancer. The conversation then shifts to the PCORI study on lung cancer surveillance, where Dr. Kozower explains that the intensity of surveillance, such as the frequency of CT scans, does not impact survival rates for lung cancer patients in retrospect. We also discuss the future of lung cancer treatments. This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features this PCORI study by Dr. Kozower. Key Highlights: 1. Surgery is the primary treatment for early-stage lung cancer, serving both curative and diagnostic purposes. 2. Surveillance, including regular follow-up visits and imaging, is crucial for detecting new lung cancers, especially in individuals with a history of the disease. Screening, on the other hand, aims to detect cancer in its early stages in individuals without symptoms. 3. The narrative around lung cancer is changing due to advancements in molecular diagnostics, targeted therapies, and immunotherapy, offering more hope and optimism for patients. About our guest: Benjamin D. Kozower, MD, MPH is a Professor and Vice Chair of Surgery at the Washington University School of Medicine in St. Louis, MO. He completed his General Surgery training at the University of Connecticut in 2004 and his Cardiothoracic Surgery residency at Washington University in 2006. Dr. Kozower worked at the University of Virginia in Charlottesville, VA from 2006-2016 until returning to St. Louis in 2016. He is a General Thoracic Surgeon with a focus in thoracic oncology and directs the Thoracic Robotic Program at Barnes Jewish Hospital. He is also a clinical outcomes and health services researcher with funding from the Agency for Healthcare Research and Quality, the Patient Centered Outcomes Research Institute and the National Cancer Institute. Key Moments: At 7:29 "Surgery is the traditional treatment for early-stage lung cancer, patients who have small tumors typically confined to the lung when hopefully it can be curative." At 14:50 "Everybody's followed after their cancer treatment. What's not clear is how often should we follow people?" At 15:38 "The more frequently I'm seen, the earlier something could be detected and the better I'll do. Makes perfect sense. Unfortunately, I'm not sure it's true." At 35:41 “Fortunately now we're starting to see the development of targeted therapies for specific [lung cancer] mutations. We're starting to see different types of therapies, and not just chemotherapy, but something called immunotherapy, which stimulates the body's immune system to help fight the cancer. So these things have dramatically changed the paradigm of how we treat lung cancers.” Visit the Manta Cares Website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support

Abigail Johnston shares her experience as a patient with de novo metastatic breast cancer since 2017. She discusses the challenges she faced in getting a diagnosis and the systemic flaws of the healthcare system. Abigail emphasizes the importance of being an informed and proactive patient, and advocating for yourself even if you’re labeled “difficult.” Abigail’s fighter spirit in this episode is truly inspiring, and that’s what makes her a fellow patient from hell. Key Highlights: 1. Being an informed and proactive patient is crucial and so is seeking multiple opinions for informed decisions. 2. Personalized, patient-centered care is essential for better healthcare outcomes, focusing on individual needs and preferences. There are fundamental flaws to the current system which treats patients like products on an assembly line. In other words, there’s lots of work that needs to be done to achieve personalized care. 3. To be a “patient from hell” means that you won’t blindly follow what your doctors say; it means that you’ll ask questions, get multiple opinions, and do your own research before committing to a choice that will likely impact you permanently. About our guest: Abigail is a daughter, mother, wife, and attorney who was diagnosed with Stage IV Metastatic Breast Cancer (MBC) in June of 201, close on the heels of a misdiagnosed early stage diagnosis in March of 2017. The first few months after her diagnosis were a whirlwind and full of many profound changes, including quite a few surgeries, but Abigail soon found her footing and started her blog "No Half Measures," where she talks about whatever comes to mind, within the lens of her Stage IV diagnosis. Abigail's boys, Liam and Malcolm, who were nearly 2 and nearly 4 at the time of her diagnosis, along with her husband, Elliot, make their own appearances in Abigail's advocacy since it truly is a family affair. For Abigail, advocacy is a whole life endeavor and she never does anything halfway; working with a variety of organizations, including, but not limited to: 1) Project Life Director of Mentorship and Legal Clinics 2) SurvivingBreastCancer.org, Board Member and Chair of MBC Leadership Committee 3) PIK3CA PathBreakers Co-founder Outside of her cancer life, Abigail enjoys spending time with her family and very spoiled cat, reading, crafting, and dreaming up more ways to experience life with her boys. Key Moments: 27:54: “So I tell all my doctors, I'm the boss, I'm the decision maker, you are my advisor. So you are telling me, because you know, as a, and I'll even talk about like as a lawyer, I would have expert witnesses, right? And they would help me understand or explain something that I'm unfamiliar with. So I tell them, I take responsibility for my decisions. I am leaning on you for your expertise. I am leaning on you for your recommendations, but I'm looking at this as your opinion, you're giving me your opinion, which is why I seek out multiple opinions from multiple doctors.” ⁠Visit the Manta Cares website⁠ Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support

Dr. Karen Wernli, a Senior Scientific Investigator at Kaiser Permanente Washington Health Research Institute, explores the topic of preoperative breast MRIs in a PCORI funded study. The conversation provides insights into the emotional and practical aspects of living with cancer and the need for improved communication between researchers and patients. They touch on the classification of breast density, the importance of guidelines, and the need for mandatory reporting of breast density and discuss various topics related to breast cancer screening and decision-making. They also explore the concept of decision quality and how it is measured in research studies. This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features this PCORI study by Karen Wernli, PhD, Diana Miglioretti, PhD, Karla Kerlikowske, MD, Anna Tosteson ScD & Tracy Onega, PhD. Key Highlights: 1. Dr. Karen Wernli explores how breast density may influence decision quality and regret in treatment decisions involving preoperative breast MRIs. 2. Breast density is not only a factor in masking breast cancers but also an independent risk factor for breast cancer itself, and patients are eligible for advanced screening if they have dense breasts. 3. The discussion focuses on understanding how the use of preoperative breast MRIs affects decision quality and regret among women diagnosed with breast cancer. The study aims to shed light on whether additional imaging tests lead to increased confidence in treatment decisions or potentially cause regret. About our guest: Karen Wernli, PhD, is a Senior Scientific Investigator at Kaiser Permanente Washington Health Research Institute and Professor in the Department of Health System Science at Kaiser Permanente Bernard J. Tyson School of Medicine. She is a cancer epidemiologist and health services researcher whose work focuses on incorporating patient-centered outcomes to improve health care along the cancer care continuum, from prevention to survivorship. Her work spans several types of cancer (including breast and lung), and explores the impact of cancer in special populations (adolescents and young adults with cancer). Her research strives to answer critical questions at the confluence of patients’ needs and clinical priorities. Research reported in this podcast was funded through a Patient-Centered Outcomes Research Institute (PCORI) award (PCS-1504-30370). Data collection for this research was additionally supported by the Breast Cancer Surveillance Consortium with funding from the National Cancer Institute (P01CA154292, U54CA163303), the Agency for Health Research and Quality (R01 HS018366-01A1), the UC Davis Clinical and Translational Science Center, the UC Davis Comprehensive Cancer Center, and the Placer County Breast Cancer Foundation. The perspective shared is solely the responsibility of Dr. Wernli and does not necessarily represent the official views of the Patient Centered Outcomes Research Institute or Kaiser Permanente. Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support

Black women with breast cancer have higher mortality rates and recurrence rates than white women. On this episode, we speak with Ricki Fairley, breast cancer survivor and co-founder of TOUCH, The Black Breast Cancer Alliance and her daughter Hayley Brown, Director of Programs, about why health equity is such a major issue, and the need for better access to care and more research on the biology of the disease in Black women. This conversation explores various themes related to Black breast cancer, including access to healthcare, disparities in trials and outcomes, the need for personalized care, and the importance of education and advocacy. Don’t miss an important conversation with this mother and daughter dynamic duo! Key Highlights 1. Black women face higher mortality and recurrence rates of breast cancer compared to white women, indicating a significant disparity in outcomes. 2. The drugs and treatments currently available are not as effective for Black women, highlighting a need for more research and tailored approaches. Additionally, there is a lack of representation of Black women in clinical trials, limiting the understanding of how treatments may specifically impact this population. 3. Health equity and access to care are major issues in the Black community, impacting the ability of Black women with breast cancer to receive adequate care. Challenges include access to healthcare services, internet access for information, and representation in clinical trials. Addressing these challenges requires personalized care, education, advocacy, and activism to improve outcomes for Black women with breast cancer. About our guests: Ricki Fairley is an award-winning, seasoned marketing veteran that has transformed her strategic acumen into breast cancer advocacy. Ricki co-founded and serves as CEO of TOUCH, The Black Breast Cancer Alliance to address Black Breast Cancer as a unique and special disease state, with the overall goal of reducing the mortality rate for Black women. As a Triple Negative Breast Cancer Survivor/Thriver, Ricki’s personal purpose, passion, mission, ministry, and blessing is to bring focus, attention, research, science, and action to eradicating Black Breast Cancer, and supporting and coaching what she calls her “Breasties” through their breast cancer experience. She also actively assists pharmaceutical companies in revamping and designing their clinical trial recruiting materials. Hayley Brown serves as the Director of Programs and Partnerships for TOUCH, The Black Breast Cancer Alliance. TOUCH is a non-profit organization focusing on eradicating Black Breast Cancer. Hayley’s goal is to bring the TOUCH programming to where all black women live, work, play, pray, and slay through local community outreach and national events. She is currently focused on reaching young black women and defining Black Breast Health. In combination with her teaching background and her passion for supporting breasties at all parts of their journey, Hayley plans to continue to educate, empower, and equip this amazing community to be the CEO’s of their own health. Visit the Manta Cares website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support

In this episode, we interview Erika Bell, PhD from the Bay Area Cancer Connections (BACC) patient advocacy community about ductal carcinoma in situ (DCIS). Erika discusses the role of BACC in supporting cancer patients, the challenges of finding support during the pandemic, and the importance of patient advocacy organizations. She then dives into a detailed explanation of DCIS, its characteristics, and how it differs from invasive ductal carcinoma (IDC). We also delve into the decision-making process for treating DCIS, discussing options such as lumpectomy and mastectomy, and examine the role of sentinel lymph node biopsy in DCIS. This includes a detailed discussion on the findings of a study regarding sentinel lymph node biopsy in DCIS patients and its implications for treatment decisions. Above all, this conversation underscores the complexity of decision-making in cancer treatment and the need for personalized support and information for patients. This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features this study by Dr. Shiyi Wang. Key Highlights: 1. DCIS is known as stage 0 breast cancer because it hasn’t spread outside of the breast ducts. However, there is not enough research to determine the conditions that increase the chances of DCIS evolving into IDC. 2. Sentinel lymph node biopsy is not necessary for most DCIS patients as the risk of lymph node involvement is low. 3. Personalized support and information are crucial for patients to make informed decisions about their treatment. About our guest: Erika Bell is the Director of Cancer Information and Education at Bay Area Cancer Connections (BACC), a community-based non-profit that supports people with breast or ovarian cancer. In this role she provides health education, personalized research, and medical decision-making support to clients. She has been with the organization for 14 years and is passionate about her work and the positive impact that it has on empowering people during a difficult time in their lives. She also serves as the Vice Chairperson for the California Breast Cancer Research Program Council. Erika earned an undergraduate degree in Biology from Cornell University and a doctorate degree in Molecular and Cellular Biology and Biochemistry from the University of California, San Francisco. Key Moments: At 13:43 “There are a lot of people where maintaining as much breast tissue as possible is the most important thing to them in addition to still having feeling in their breast, so they opt for a lumpectomy. Other people really have a strong urge to just get everything out, “I don't ever want to have to deal with this again, please remove everything.” Those people also tend to be thinking about double mastectomies, which in the case of DCIS and no inherited genetic predisposition to breast cancer or no strong family history really is not medically indicated, but there are still women who make that choice, either driven by their anxiety or future screenings or symmetry that they want to achieve, etc.” Visit the Manta Cares website -- Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support

In this episode, we embark on a profound exploration of death with the help of two remarkable individuals. Katie Coleman bravely shares her experience as a survivor of Stage IV liver cancer, a path fraught with uncertainty and a lack of available information. Julie McFadden is a hospice nurse whose daily encounters with death provide unique insights. She educates online audiences about various topics surrounding death. Join us as we unpack the mystery surrounding death: the process, the taboos, doctor and patient relationships, and more. Key Highlights: The transition from fear to acceptance of death involves acknowledging and expressing those fears and getting educated about the dying process. End-of-life experiences can be peaceful and meaningful, providing comfort and solace to both patients and their loved ones. Honest conversations about the dying process are crucial for patients and their families. The fear of death can skew decision making, particularly in the context of terminal illness, but having the full picture can help patients better understand all of their options. About our guests: Julie McFadden, BSN, RN, has been a nurse for 15 years. Julie is an experienced ICU, and now hospice/palliative nurse. Julie has been passionate about normalizing death through education to the masses using social media. She has been featured in Newsweek, USA today, The Atlantic, and several other articles worldwide. Her TikTok has 1.4M followers, and you can find her on all social media platforms (Instagram, Facebook, and YouTube) at Hospice Nurse Julie. Julie’s new book is coming out in June: Nothing To Fear. Katie Coleman is a patient advocate who was diagnosed with a rare stage IV kidney cancer in Dec 2020, at the age of 29. She has shared her diagnosis publicly on social media to spread awareness and to advocate for others with kidney cancer and rare diseases. Since being diagnosed, she has also founded a non-profit, started a podcast and is publishing an upcoming memoir, which you can preorder here. You can find her on social media here: TikTok, Instagram, Youtube and Twitter). Key Moments: At 09:34 “Not only am I now dealing with the crippling anxiety of death and dying, but now I'm also dealing with the crippling anxiety of letting people down by even saying and acknowledging those feelings…? But for me, it came from like, first I was terrified to look into anything. It just felt like I was doing something wrong by trying to investigate what it was like to die. But then once I got over that, where I personally found a lot of peace when I started hearing about near death experiences and end of life visions that Julie often talks about.” At 22:02 “All I know is in watching people die a natural death, people need to know about this. People need to know about what it looks like and what happens to our bodies because it's not as scary as we think. And then when I think of my own mortality and I think about if I got diagnosed with something terminal tomorrow, I'm still human. I'm gonna have all the feelings, anger, sadness, scared. I'm still gonna be scared, but I also know that my body will take care of me. My body will take care of me. And I know that because I've witnessed it.” Visit the Manta Cares website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast:...

In this episode, we interview mother and son Ashlee and Michael, hosts of the podcast “Michael and Mom Talk Cancer." They share their personal cancer experience and discuss topics such as managing work and finances, the impact of cancer on athleticism and identity, and the importance of maintaining positivity and mental health. They also touch on the concept of toxic positivity and how different individuals have different approaches to dealing with their illness, the challenges of comparing stories and outcomes, as well as the balance between quantity and quality of life. Michael and Ashlee share their experiences of living with the constant reminder of mortality and finding joy in the small things, while also emphasizing the importance of connection and offering practical tips for navigating the cancer experience. Key Highlights: Having a strong support system is crucial for navigating the challenges of cancer as well as life, in general. Acceptance and adapting to new circumstances can help you thrive throughout your cancer experience, but it’s also okay to be upset and angry (you have every right to be). Maintaining a realistic outlook while embracing positivity is important when living with cancer. About our guests: Meet Michael Cramer, a 22-year-old cancer survivor and bone marrow transplant recipient, known for his social media influence. Born in Paris and raised in Miami, Michael's athletic background includes surfing, skating, and being part of the Olympic Development team for windsurfing. Ashlee, also known as "mom," has a diverse background as a dancer turned early childhood educator turned cancer caregiver. In 2014, tragedy struck when her husband was diagnosed with Large B Cell Lymphoma. Ashlee became the sole provider for their three children while caring for her husband until his passing in 2016, which brought the family closer together. In July 2020, heartbreak struck again when Michael was diagnosed with an incredibly rare and aggressive cancer, Hepatosplenic T-cell lymphoma, with less than 200 documented cases ever. Despite the average survival being only 8 months, Ashlee quit her job to care for Michael full-time. After enduring chemotherapy, radiation, a bone marrow transplant, and various life-threatening complications, Michael miraculously survived. Throughout his journey, Ashlee never left his side, strengthening their unbreakable bond. Turning their heartbreak into a story of "beauty in pain" and love, Michael and Ashlee started a podcast called "Michael and Mom Talk Cancer," along with a website, blog, and YouTube channel. While Michael is still in treatment for complications, he is alive and in remission. Together, Michael and Ashlee strive to fulfill their purpose of love and connection, inspiring not only the cancer community but anyone in need of motivation. Key Moments: 0:00-11:36 Ashlee and Michael’s Story 11:37-19:50 Comparing and Contrasting Past Confrontations with Cancer 19:51-24:25 What Michael’s Remission Looks Like 24:26-32:24 Reality Checks, Radical Acceptance, Toxic Positivity, etc. 32:25-41:28 The Insight Brought on By Daily Reminders of Mortality 41:29-44:39 Ashlee and Michael’s Advice to All Our Listeners Visit the Manta Cares website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast:...

In this episode, we talk with Dennis Watson and Cliff Reid, two entrepreneurs in the cancer space. They speak about the difference between genetics and genomics, and the role of genetic and genomic testing in clinical decision-making. They also touch on the history and impact of DNA sequencing and the challenges in applying genomics to cancer treatment. This conversation explores the development of Travera, a company advancing personalized cancer treatments. Dennis and Cliff share their hopes for the future of oncology, including the expansion of diagnostic tools and the increasing involvement of patients in their own care. Key Highlights: About our guests: Dennis Watson joined Travera in July of 2022 as the Vice President of Business Development. He brings 15+ years of extensive sales and management experience in the oncology molecular diagnostic space. Dennis spent nearly 10 years with Agendia, beginning as a field-based sales professional, working his way up to gain experience in multiple facets of the business, receiving top-tier awards and recognition throughout his tenure. He served 4 years as a Regional Director in the Central US, before moving on to lead the US commercial sales organization in January of 2018. Prior to his work with Agendia, Dennis spent 5 years with the Oncology division of Myriad Genetics. Before Myriad Genetics, he also held positions in the pharmaceutical, industrial services, and web services industries. Clifford Reid was the founding CEO of Travera. Previously, Dr. Reid was the founding Chairman, President, and Chief Executive Officer of Complete Genomics (NASDAQ: GNOM), a leading developer of whole human genome DNA sequencing technologies and services. Prior to Complete Genomics, he founded two enterprise software companies: Eloquent (NASDAQ: ELOQ), an internet video company, and Verity (NASDAQ: VRTY), an enterprise search engine company. Dr. Reid is on the Visiting Committee of the Biological Engineering Department at the Massachusetts Institute of Technology (MIT), a member of the MIT Corporation Development Committee, and an advisor to Warburg Pincus. Visit the Manta Cares website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support

Sit back, relax, and get ready to dive into the world of hypnotherapy! In this episode, Dr. Sonia Gupte will explore the intriguing realm of hypnotherapy and its potential impact on the mental and physical well-being of cancer patients. Join us as we debunk common misconceptions, shed light on the benefits, and delve into the current regulatory landscape surrounding this fascinating therapeutic approach. Check out the mentioned research in Dr. Gupte’s book here. Key Highlights: Cultural taboos towards mental health and how finding communities who struggle with similar problems can help with depression, anxiety, etc. Hypnotherapy’s capabilities for improving quality of life, including mental health, pain management, and sleep quality in cancer patients. The trials and tribulations of becoming a caregiver and potential research on hypnotherapy for caregivers. About our guest: With over 15 years of experience as a Family Medicine Physician in major healthcare facilities across India, Singapore, and Dubai, Dr. Gupte now focuses on treating patients through the power of the mind. For the past 9 years, she has utilized Clinical Hypnotherapy to tap into the "Human Subconscious Mind," effectively addressing physical and emotional conditions. Dr. Gupte is dedicated to integrating this modality into mainstream medicine and has authored the best-selling book "WITHIN," detailing her journey and successful patient case studies. She founded the Nonprofit Organization "Mind Medicine Movement" to promote mind-body healing and is particularly focused on helping cancer survivors improve their quality of life through hypnotherapeutic tools. Key Moments: At 5:30 "I truly felt that we are missing something huge in the medical field. We are not looking at a patient in the holistic way, which we should be." At 26:52 "So hypnotherapy as a modality is very, it has very clear boundaries. It is not forever. You come with a goal. That goal is delivered through experiences which...are somewhere lost like a maze in your subconscious." At 40:57 “The surprising thing is that when you research hypnosis and hypnotherapy, there is so much work which has already been done in the last few decades because we have been curious to bring this modality back into the medical field. Many successful researchers have done this and the focus has been pain management. The focus has been anxiety, depression. And when you specifically dive into hypnotherapy in oncology, starting from the diagnostic procedures to the treatment to the quality of life in survivors, there have been researchers established already showcasing the efficacy of the power of mind.“ At 51:53 “Caregiver burnout is real. Caregiver stress anxiety is very real. In India, we opened the doors for caregivers as well. We actually tried to convince them, “come with the survivor because you need equal care.” You know how we say on the airplane, put the mask first on your face and then on the next person? They happily agreed and they worked on themselves and they found so many things we are in denial of. Your sleep quality improves. Your joy to live life improves. Everything goes to the next level. And that is what they realized just in four days. So we are opening up this project for caregivers as well.” Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast:...

In this episode, Dr. Fumiko Chino shares her inspiring journey from art director to oncologist, driven by her experience as a caregiver. She highlights the gap between ideal and actual cancer care by discussing a breast cancer imaging study where some patients with Stage 2 and 3 disease received scans to monitor for cancer. Dr. Chino goes into why “surveillance“ scans may or may not be beneficial, and clinicians must communicate this to their patients. She then stresses the importance of personalized communication and understanding patients' unique experiences in order to build trust. Dr. Chino also touches on why prioritizing physicians' well-being to prevent burnout matters. This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features this study by Caprice C. Greenberg, MD, MPH. Key Highlights: There is a gap between intended care and actual care. The solution doesn’t have to be so grand either; we can start at small acts of kindness and accessibility. Communication with patients should be tailored to each individual, taking into account their unique experiences and perspectives. There is often no singular right answer in cancer treatment, and the best plan for a patient may vary depending on their circumstances. Doctors should also prioritize their own well-being to prevent burnout and thus be able to provide better care to their patients. About our guest: Fumiko Chino, MD is a cancer researcher, Assistant Attending in Radiation Oncology, and Lead of the Affordability Working Group at Memorial Sloan Kettering Cancer Center. She is also one of the Directors at the Costs of Care group, a NGO working to improve affordability in healthcare and the recipient of the inaugural 2022 ASCO Excellence in Equity Award. Her research is focused on financial toxicity, gaps in survivorship, health care disparities, and access; she has spoken across the US and internationally on equity and the costs of care. Key Moments: 14:00 “I deliver care in the United States, one of, if not the wealthiest countries, certainly a country of privilege where we have every bell and whistle, and yet not everyone can access those bells and whistles. Not everyone has the capacity for receiving the highest quality of care. And even when I am able to offer the best, every bell and whistle delivered to the person and their capacity to receive it can be quite variable, right? Access, affordability, these are all like large barriers.You know, one of my most well-lauded studies is on parking costs, which is quite frankly like a really stupid thing to study. Like, why would parking be a barrier to anyone? It's parking. . But what's truly insulting is that people who actually can’t get the care that they really need in the facility that would probably serve them best because of a silly barrier like parking.” 53:31 “Just realizing that what is the right plan for this person is probably not the right plan for this other person, and understanding that coming to that conclusion together, trying to figure out again, sussing out, even if it's the small tailored things of like, ‘What can we do to make this easier for you?’ It's not one size fits all. It's really, or it shouldn't be, how about that?” Visit the Manta Cares website -- Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this...

In this episode, we welcome back a previous guest and friend, Katie Coleman. This time, we dive into facing one’s mortality and how to grapple with the uncertainty of living with a cancer diagnosis. We get into pre-diagnosis thoughts on mortality and how perspectives shifted after diagnosis. Katie also sheds light on some of the silver linings of being forced to confront your own mortality: helping you accept the inevitable, prioritizing what’s important, and guiding you to the road of self-discovery.You can listen to (or watch) the previous episode with Katie here. Key Highlights: Initially a cancer diagnosis triggers fears and uncertainties about mortality, but acceptance of mortality leads to a rewarding change of perspective and even a fulfilling life. Encountering death transforms life by influencing priorities and perspectives. As a result of the shift in perspective, facing your own mortality may negatively impact bonds outside the cancer community. Feelings of isolation and not fitting in are common, particularly in situations dominated by small talk. About our guest: Katie Coleman is a patient advocate who was diagnosed with a rare stage IV kidney cancer in Dec 2020, at the age of 29. She has shared her diagnosis publicly on social media to spread awareness and to advocate for others with kidney cancer and rare diseases. Since being diagnosed, she has also founded a non-profit, started a podcast and is publishing an upcoming memoir. You can read more about Katie and sign up to be notified when her book launches on her website at www.katiekickscancer.com. Key Moments: 2:52: " Through my diagnosis, I've had different prognosis' at different points of time. I'm very thankful for where I'm at currently, and I'm doing really well. But through that process and having to accept and think about my own mortality, some of my mindset around that shifted, which I'm sure we'll get into. My relationship with the thought of being given five years now is very different than it was when I was first diagnosed. But I had to do a lot of that learning on my own. And it's something that I wish more people talked about because it's a very, very hard topic to try to go through on your own and you can get very lost in despair and get yourself stuck in the process." 17:17: “If I could take back my cancer diagnosis, I wouldn't. Even if that means I only have two years of life left, I would not take it back still, because I have lived more in the last two and a half years than I lived in the entire 29 prior to that. And cancer really sucks. And I would probably regret saying that if I wasn't feeling well, I don't really know, but I do know that like where I'm at currently. It's just, it is life changing, but sometimes in all the best ways.” 49:25: “I noticed that I had a harder time listening to people gossip or hearing the everyday little nuances to life that happen… it's so hard to explain because I don't pass judgment on anybody in those situations. That is what life is. I think that's just how people live their life and I don't blame anyone for that. I just think that once you've gone through something like cancer that shifts your perspective, it's hard to sometimes sit in those situations because it feels negative or draining for me." -- Visit the Manta Cares website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such...

Did you know that the majority of Americans with cancer are treated in community oncology practices and not at academic medical centers? Community oncologist Dr. Chris Terry joins us this week as we discuss local oncology care benefits and successes, and the importance of physical activity during cancer treatment. Dr. Terry also shares the way he communicates with new cancer patients in his practice to ensure that they fully understand their diagnosis from the very beginning. He also shares his hopes for the future of oncology. Key Highlights: The pros and cons of local oncology care and academic-affiliated oncology care, as well as what Dr. Terry does to help alleviate the gaps of community care. The importance of physical activity (not only by physical means), but also on the emotional side of the cancer experience. Cancer 101: Dr. Terry’s usual protocol for consulting new cancer patients and his long term hopes for the future of oncology and healthcare. About our guest: Christopher Terry is originally from Pennsylvania, but recently set down roots in Rhode Island with his twin children, wife and two dogs. He is a values-driven physician leader who serves as the Medical Director of Hematology, Oncology and Infusion Services at Sturdy Health, a community-based healthcare organization in Attleboro, Massachusetts. Chris received his medical training in Philadelphia at Thomas Jefferson University and Rhode Island at Brown University. His expertise is in blood disorders and cancer, with a special interest in supportive care, as well as adolescent and young adult cancer. His love for sports led him to start an organization called Athletes Fighting Cancer, which improves the cancer experience through the power of sport by providing a team for support, exercise instruction and resources to strengthen the mind. Chris’ hobbies include soccer, golf, music and exploring new places. He enjoys spending time with friends and family, but especially loves being a dad. Link to Dr. Terry’s patient orientation sheet, referenced in the podcast. Key Moments: 9:26: “I was initially planning on doing academic medicine and then an opportunity came up for me to practice at a small community-based hospital and it kind of, no pun intended, but it hit home for me. It just felt like a good fit. In addition, I had amazing mentors that I had actually worked with during my training here already. It almost set that example of, you can get really good quality care close to home. You know, there are differences. We don't do clinical trials, but I think it's important for people to be able to get their care even at a local community hospital if it's possible. There is now a lot more collaboration between community-based hospitals and academic centers, even though we're not affiliated with one.” 27:04 “I think it's also important to set expectations. So you may not be able to perform at the level that you are used to, and that's okay. You may need to take more of a break than you're used to, and that's okay also... I also encourage people to listen to their body, find that balance, and understand that you can't always push your limits.” -- Visit the Manta Cares website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support

You might be familiar with economics or the study of monetary scarcity, but have you heard of healthcare economics? In this episode, we explore the daily trade-offs inherent in healthcare with Dr. Jayadevappa, whose dedicated focus revolves around healthcare economics and racial disparities between African American and white Prostate Cancer patients. Dr. Jayadevappa offers a glimpse behind the scenes of healthcare decision-making and initiates a discussion on how to address the racial disparities prevalent among patients. This episode was supported by the Patient-Centered Outcomes Research Institute (PCORI) and features this study by Dr. Jayadevappa. Key Highlights: The three trade-offs in healthcare economics are: equity, efficiency, and quality of care. What are examples of overuse of low-value care? What are examples of underuse of high-value care? Racial disparities in healthcare, specifically in Prostate Cancer, between African American and white patients A current solution to disparities that healthcare researchers like Dr. Jayadevappa are looking into is shared decision-making through a preference assessment. About our guest: Dr. Ravishankar Jayadevappa, Ph.D., is an Associate Professor at the Perelman School of Medicine, University of Pennsylvania. He is also affiliated with the Abramson Cancer Center, the Leonard Davis Institute of Health Economics, and the Institute of Aging. Additionally, he holds a position as a Core Investigator at the Center for Health Equity Research and Policy at the Philadelphia VA Medical Center. Dr. Jayadevappa's research aims to analyze the tradeoff between economic efficiency, equity, and quality, particularly in addressing health disparities based on race, ethnicity, income, and age. He has secured over $20 million in federal, non-federal, and industry-sponsored grants, leading numerous projects related to chronic diseases such as prostate cancer, bladder cancer, obesity, breast cancer, and Alzheimer's. With over 150 peer-reviewed papers and abstracts, Dr. Jayadevappa has made significant contributions to the oncology field and serves as an editor for several medical journals. Key Moments: At 3:18 “... healthcare is kind of complex and our resources are limited. So it's always like when you try to achieve one thing, excess more of equity, then you are trading off with efficiency. Or if you are looking at only quality of care, you are trading off with equity or efficiency.” At 20:29 “...our hypothesis asked: is it true for African American patients, if they go to high volume physicians, is their quality of care naturally improved? But we found out that's not true… Then our next series of studies looked at the continuity of care. For instance, fragmented care, when they are in and out of the insurance plans or the healthcare providers. So that may be the reason…. And both recent papers concluded that lack of continuity of care was one of the driving forces of disparity in observed outcomes for African American patients." Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their healthcare professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support

Ever experienced the frustration of feeling unheard, hastily ushered away, and checked off during your appointments? Or perhaps you've caught yourself making life-altering decisions hastily during your visits with your primary care provider? Join us in this episode as we unravel the systemic reasons behind these challenges and receive actionable tools to empower yourself, becoming an advocate for your health. Key Highlights: We get a peek into a typical clinician’s workday and the structural issues within it. Three ways the healthcare system is fragmented: medical culture, loss to follow-up, and technology—and how they impact patients. The issues with finding primary care for cancer survivors and why post-cancer treatment is arguably the hardest part of the journey. What can you, as a patient, do to improve your visits? About our guest: Dr. Ilana Yurkiewicz is a physician at Stanford University and a leading figure in cancer survivorship and oncology-hematology transitions. With an M.D. from Harvard and a B.S. from Yale, she co-directs Stanford's Primary Care for Cancer Survivorship program, offering innovative primary care for cancer survivors and those at elevated genetic risk. Her medical journalism, featured in outlets like Scientific American and STAT News, includes an acclaimed investigative piece on fragmented medical records. Her latest book, "Fragmented: A Doctor’s Quest to Piece Together American Health Care" delves deeper into medical challenges and was released in July 2023. Check out “Fragmented” here: https://ilanayurkiewicz.com/book Key Moments: At 3:13: “It takes between 14 and 62 clicks to order a Tylenol, something that is a simple over-the-counter medication. And again, that paper showed that the confusion in the electronic medical charts caused errors in up to 30% of cases.” At 26:56 “And why do doctors get such low amounts of time with patients? It's a payment model. It is still primarily in this country a fee for service payment model where doctors and healthcare organizations are reimbursed on a service. Now, what is a service? It can be a round of chemotherapy, a joint injection, or in primary care, a service is an office visit, that face-to-face, meaning nothing else counts as paid work. None of the time that you spend outside the room putting the pieces together of a patient's story counts as paid work.” At 40:54 “We need time to make decisions, which is separate from time to manage symptoms and side effects and deal with other things, other concerns, and preventative health… That is what I try to do within my own practice. But we are limited by so many external barriers, many of which we have talked about in this podcast, and a main one here is the time again. We are limited by 10 to 15 minute appointments… How can you make these life altering decisions within 10 to 15 minutes, much less address everything else?” At 46:05 “You cannot assume that your providers have all of your information or that they don't have it in a garbled way. They don't have it in a meaningful way. And then you are also the agent in making decisions about next steps that affect your health and your body. Your providers are invested in your health, but nobody is more invested than you and nobody knows you the best. Visit the Manta Cares website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such...

Matthew Rosenblum, a geographer by training, shares his journey from PhD candidate to pancreatic cancer patient. He discusses the interplay of space, time, and identity, particularly in relation to his Jewish background and cancer diagnosis. Matthew shares his diagnosis and treatment experience candidly with his unique sense of humor. While addressing the realities of living with terminal cancer aren’t often funny, Matthew will keep you laughing during this episode that will educate and inspire. Key Highlights: The intersections of identity, including being Jewish and BRCA2 positive. The importance of advocating for yourself with your care team. How the emotional and physical toll of living with terminal cancer can still bring moments of resilience and humor. About our guest: Matthew Rosenblum is a pancreatic cancer survivor and BRCA-2 previvor based in metro Detroit with his loving partner, Natalie, and their 6 year-old pug, Monique. Trained as an academic geographer at Florida State University and the University of Kentucky - and with 18 months of remission under his belt - Matthew has pivoted career trajectories to cancer advocacy. He is currently doing freelance writing in the nonprofit world while he looks for a more permanent position in the cancer space. As he searches for meaningful work, Matthew has been preparing a memoir covering his wild ride with metastatic pancreatic cancer. Key Moments: 18 minutes: On intersecting identities. “I think it's like something my oncologist said to me very casually after they discovered the tumor on my pancreas and throughout my gut. He said, ‘Your sister has a BRCA2 mutation and your mom died? Yeah, you're Jewish?’ Yes, probably. I wasn't offended or anything like that. It's just there is a very clear connection historically between narratives of cancer and Jewish identity. 34 minutes: On advocating for himself. “I think it's a product of my personality, and I think it's also a way I've found to advocate for myself effectively, that sometimes doctors are not used to being spoken to in a certain way, and if you are willing to get up in their grill a little bit, oftentimes you can get what you want, or you can come to some kind of understanding. My oncologist is the Chief of Oncology at a major cancer research institute – he's the boss. And sometimes that colors people's judgment. So sometimes if you shake them a little bit, you might not steer the ship, but you can be involved in the direction, right? You're controlling the trajectory as a partner, at least.” 50 minutes: Finding humor in dark moments. “I got an automatic notification with the rest of my results on the MyChart app and it used the word adenocarcinoma. And I didn't know that word. But I knew enough that I knew it wasn't good because cancer words, they all sound like they could be the bad guy in Star Wars, right? Like sarcoma. Honestly, are the people who write Star Wars, are they just stealing cancer words? Who's to say? In any case, I flipped out because I Google adenocarcinoma, and it's not good.” -- Visit the Manta Cares website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support

We welcome back one of our previous guests, David Moriah! Embark on a profound journey into David's relationship with religion and faith, specifically uncovering how his unwavering faith became a guiding light through his cancer experience. The radiant blend of optimism and vulnerability in this episode offers invaluable lessons for us all. Don't miss out—tune in and be inspired by David's compelling story. See our previous episode with David here. Key Highlights: Explore David's profound relationship with faith and how even in the face of cancer, he is certain that The Creator is looking out for him through “God Winks” Advice on paying attention to intuitive feelings, especially when something feels off, and the importance of getting a diagnosis sooner rather than later David's unique approach to faith and what he’d like to be remembered for are discussed, providing insight into the values that keep him upright in his journey About our guest: David Moriah has lived 72 abundantly blessed years and is fiercely determined to extend the streak in the face of a “stage 4, incurable” diagnosis. He is a husband of 48 years, a father of two and a grandfather of two and a half. That’s more important than what he’s done for a living. As for that, he spent his 20s as a wilderness instructor for Outward Bound and is the founding director of Cornell University’s outdoor education program. He hosts a blog at CaringBridge, “Adventures in ChemoLand”, and he is a passionate advocate for staying fit while undergoing treatment, and looking out for “God Winks”, those moments of joy and reassurance that we are not alone in this sometimes scary and foreboding journey. Key Moments: 18 minutes: On finding peace in the future. “But whatever it is, whatever that afterlife is, I have a peace and assurance that I'm gonna be okay, that The Creator’s gonna take care of me. I don't know what it's gonna look like, but I am so at peace about this. And there's a line in the Christian Bible that talks about the peace that passes all understanding.” 30 minutes: On listening to your gut. “I want to urge everyone to take the extra step, make sure you're checking out your symptoms. Don't poo it… No, no, treat yourself right.” 48 minutes: On finding purpose. “My main purpose right now that I'm feeling is telling my story, for those who want to hear it. To tell my story and hopefully help people in their journeys. And then the other is just to take advantage of every moment, every day. Every opportunity to be with my kids and grandkids and just to go out and enjoy that beautiful sunset that The Creator gave me.” Visit the Manta Cares website Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support

In this episode, Dr. Supriya Mohile discusses the need for geriatric oncology and the underrepresentation of older adults in clinical trials. She highlights the challenges of decision-making in oncology and the discrepancy between guidelines and patient goals. She also discusses the significance of patient-reported outcomes in treatment decisions. Finally, Dr. Mohile explores the role of social networks in supporting patients during the decision-making process, cancer prevention strategies and the acceptance of the unknown. This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features this study by Dr. Mohile. Key Highlights: There are an increasing number of older adults with cancer, yet older adults are often underrepresented in clinical trials. Social networks play a significant role in decision-making, and it is important to consider the influence of family and friends on patients' choices. Patient input is valuable in developing interventions and improving care delivery. About our guest: Dr. Supriya Gupta Mohile, a distinguished figure in the field of geriatric oncology, is a Professor of Medicine and Surgery at the James Wilmot Cancer Institute, University of Rochester. Her research focuses on assessing patterns of care, health outcomes, and quality of life in older patients undergoing systemic cancer treatment. With nearly 300 publications in geriatric oncology, she serves as the Editor-in-Chief of the Journal of Geriatric Oncology and chairs the ASCO Geriatric Oncology Clinical Guideline panel. You can find her research in the following journals: Lancet, Journal of Clinical Oncology, and JAMA Oncology. In addition to her research focus, Dr. Mohile works closely with such patients in the Cancer and Aging Research Group, providing administrative support to a community of older adults with cancer and their caregivers. Key Moments: 10 minutes: On the challenge of treating older cancer patients using clinical trial data. “But the problem is, we're getting clinical trial data in very fit patients, either younger or even older patients who are very healthy. And then we don't know when we have the drugs come on market, what is the safety and efficacy for the patient that's sitting in front of me in the clinic who has a disability, has heart disease, has real insufficiency, lives alone, is having trouble taking their medicines, and may not be as fit as the people that are in the trials.” 40 minutes: On the way people often make decisions based on anecdotal evidence from their friends and not science. “Even my mother does this too, for example, about knee injections. She said ‘All my friends told me not to do this one. They told me to do that one instead.’ I'm like, ‘mom, I'm a physician. This doesn't matter. This is what the data shows. I appreciate that this bad thing happened to your friend, but it's not necessarily going to happen to you.’ But people will use anecdotal information to drive decisions more than evidence.” 50 minutes: Despite preventative measures, people still get cancer. “ So when patients come to me and say ‘why me’? They want to know why. I can say sometimes we just don't know why and it's not up to us. Something happens, the universe exists. So we have to move forward and help with what we can help.” Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such...

Dr. Simmons and Dr. Sepucha are back for Part 2 of their episode to talk about colorectal cancer screening, and in particular, the importance of individualized decision-making for patients aged 76 to 85. The conversation highlights the challenges faced by clinicians in initiating discussions about continuing or stopping screening, and the importance of patient preferences and goals in guiding these decisions. Key Highlights: The importance of individualized decision-making for colorectal cancer screening in people aged 76 to 85. How clinician training prompted an increase in conversations about preferences and options for colorectal cancer screening. “Can we talk about my options?” or “Here are my goals” as phrases to encourage collaboration between doctor and patient. About our guests: Dr. Karen Sepucha is the director of the Health Decision Sciences Center in the Division of General Internal Medicine at Massachusetts General Hospital (MGH) and an associate professor in Medicine at Harvard Medical School. Her research is focused on helping patients and families become meaningfully involved in significant medical decisions. Dr. Sepucha oversees efforts to promote shared decision making in primary and specialty care at MGH and across MassGeneral Brigham Health Care. Dr. Leigh Simmons is the Medical Director of the MGH Health Decision Sciences Center where she studies the use of decision aids to help patients and clinicians in the shared decision making process. Dr. Simmons develops and conducts training of physicians and staff in communication skills focused on improving decision making with patients. Her clinical practice is with the Internal Medicine Associates at Massachusetts General Hospital. In addition to her clinical and research interests, Dr. Simmons is a medical student educator and directs the internal medicine clerkship for Harvard Medical School students at Massachusetts General Hospital. Key Moments: 5 minutes: On shared decision-making for colorectal cancer screening in older adults. “The areas that we really think are perfect for shared decision-making are ones where there are real choices. So you can have a colonoscopy, you can have a stool-based test, or you might do neither. I think those are the options that are really on the table for patients in this age group, 76 to 85. So there's not one right answer. It depends on their overall health status, their risk of colon cancer, whether they’ve had polyps in the past, have they had clear colonoscopies. It also depends on what's most important to them.” 25 minutes: On how screening shifted modalities due to shared decision-making conversations. “We thought they were going to decrease by giving patients options, but we increased screening rates, but that increase was due to more people doing stool testing.” 32 minutes: On tactics to increase collaboration between patients and their healthcare providers. “In decision science, there's two camps. There's the option camp, which is to start with what you can do. And then there's the value camp, which is to start with what you want.” This episode was supported by the Patient Centered Outcomes Research Institute (PCORI) and features 2 studies (Study 1 & Study 2) by Dr. Sepucha & Dr. Simmons. Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions. --- Support this podcast:...