When I was diagnosed with cancer in August 2021, the news came from out of the blue. I’d had a few minor symptoms that preceding summer—red, itchy eyes; a rash; and mild fatigue. But, as one of my oncology nurses joked darkly a few months later, it was one of those worst-case scenarios where you visit the doctor to treat seasonal allergies only to find out you have cancer.

I met with Molly, my PCP, several times during the two weeks she investigated the cause of my mild anemia. She ultimately delivered the news to my husband and me in an evening phone call. I took notes on a scrap of newspaper, hoping the strange terminology would make sense later. The latest blood tests showed high levels of monoclonal proteins, kappa light chains and creatinine. I had multiple myeloma, a rare bone marrow cancer where plasma cells churn out rogue proteins that crowd out healthy blood cells and stress kidneys. Tears welled in my eyes. Words caught in my throat. My husband and I were devastated.

That call turned my life upside down. However, during that call, my PCP also offered several crucial pieces of advice that were essential to navigate this strange, new world. I’ve reflected many times on how well her words set the stage for the journey ahead.

First, she was utterly straightforward, but also guardedly optimistic: “This is a serious cancer, but we caught it early. I’m looking at this as a curable disease.” As I learned later from my oncologist, this last part wasn’t exactly accurate. Multiple myeloma can be managed, especially if caught early, but it is not curable. Treatment—which typically includes multiple rounds of chemotherapy followed by an autologous stem cell transplant—can push the cancer into remission for years, but it almost always comes back. When you’ve just received a shattering diagnosis, however, you’re searching for any glimmer of hope. Her words of encouragement were exactly what I needed in that moment.

Second, she offered some practical advice: “You need a communication plan. Once you tell your friends and family, their concerns can completely overtake your life. They’ll have the best intentions, but you’ll end up spending all your time answering questions about your cancer.” I’d just retired from a 30-year career in corporate communications, so her advice resonated. I told only a handful of my closest friends, and I asked my mother to be the point-of-contact for her large extended family and my husband to do the same with his family. I drafted detailed updates every three weeks (or so) and promised that we’dnotify them if there were new developments. I did not post the news on my Facebook page. (I didn’t need 400-something acquaintances peppering me with questions, and I still needed time to process the news myself.) That elementary, but important, strategy put me in control of communication, rather than being engulfed with well-meaning phone calls, emails, and texts. 

Third, my PCP’s response was incisive when my stunned husband asked, almost indignantly, “But it seems impossible. How can someone so healthy get cancer?” Admittedly, I was thinking the same thing. I hiked, kayaked, biked, ate a plant-based diet, and had longevity on both sides of my family. I’d envisioned living well into my 90s. My PCP’s answer was simple: “Even strong, healthy people can get cancer.” Multiple myeloma is caused by a random gene mutation, not by lifestyle and it is not hereditary. Sometimes, cancer just happens. It’s no one’s fault. Her simple words relieved me of guilt—the last thing a new cancer patient needs—and it kept the focus on the disease. Yes, being relatively healthy helped me rebound quickly from some really difficult treatments, but I didn’t bear the burden for fighting the disease. It wasn’t up to me to “beat” cancer. I had a whole community of doctors and specialists to help me.

I’ve been fortunate. I have completed my treatment, including the stem cell transplant, and I am in full remission. I hope it lasts for years, if not decades. I don’t know what the future holds, but I try to focus on the moment—a golden slant of sunlight, the gentle ache while paddling my kayak on the bay, a loving touch from my husband. And I am thankful for the wise, thoughtful words from my PCP that helped me approach this disease with courage and hope.

For more news on cancer updates, research and education, don’t forget to 

Even Healthy People Get Cancer 

Kristen Rabe 

I have stage 4 cancer, and I'm in remission.

 like a contradiction. When I state that phrase to strangers, there's often confusion. How can you have cancer and still be in remission? Aren't you cured? Doesn't remission mean it's over? Something many folks, myself included until recently, don't understand is that remission is frequently temporary. The Merriam-Webster online dictionary defines medical remission as “to abate symptoms (as of a disease) for a period.” It is the “for a period” phrase that holds the terror, because those of us who’ve been diagnosed with stage 4 disease recognize that every day is a wary wager on life’s high-stakes poker game: risky, costly, unpredictable.

And yet, as someone who will never be free from the tethers of blood tests and port flushes, the “maybe” is where I live. In the in-between. I live in this space that will forever be in the italics of 

After six years of treatments, including a breast amputation (mastectomy is the other term, but I prefer not to be euphemistic), multiple chemotherapies, seven surgeries, two cycles of radiation, immunotherapy, weakness, arm paralysis and permanent hair loss, remission feels like riding a bicycle with a weakly-patched wheel. I am forever checking that the tire hasn't blown, that I won't fall off the bike. Can you relate?

Let me give some examples. Questions: Should you save for a vacation next year? Or should you dip into savings now? Should you continue saving for retirement? Your car is in decent shape but lately it’s requiring more repairs. Given the medical unknowns, would you buy a new model? Would you leave your spouse with the payments? If you're single, should you buy a house? Should you bother with quality shoes? And the garden, the garden….will the bulbs even bloom next May?

The in-between. The liminal. It's where I live. It's an enormous shift when the future falls. I had been both a teacher and a teacher mentor for over 20 years. It was spring break when I got the call, three days before returning from break back to work. Monday arrived. I drove in in to my school site that morning, that bright, spring, achingly clear morning, pulled into the parking lot and sat. And sat.

I looked at my phone: 10 minutes before the first meeting of the day. The world melted into nightfall and I closed my eyes into terror. I called my boss and said I couldn't do it. I couldn't come back to work that week. The shock was too great.

Stops and starts would mark the next year and a half of my work life, until recurrences and disability forced me into retirement. On my last day, I still had appointments on my calendar.

I miss work. I miss a clear purpose, a daily direction. I miss my dear colleagues and friends. I miss the book recommendations, scary pumpkin jokes and raucous laughter at lunch.

So what do I do? I am in remission. The tumors are dormant. I haven't worked for pay in over five years, and I struggle with fatigue, pain and feeling unproductive. Our income is cut. I wake up and my neighbors head off to work; sometimes I can't get out of bed. Other days are better. I put the laundry on the line and watch the towels snap in the breeze, or bake up pastries, filling the house with the aromas of cinnamon and sugar. Homecoming food. 

Or I go walking with a friend. I manage insurance paperwork and bills. I still don't know how much to save or spend; the seesaw tilts on the axis of the latest scan. It's touch and go. Minute by minute, breath by breath. I don't feel the need to climb Mount Kilimanjaro or to run a marathon. Those would be nice, but they’re not my race.

Yet here's what I’m beginning to know: there has always been a warmth inside the circle and I am drawing closer to it. Outside, my world may be shrinking. Inside, it grows ever brighter. When the known limits tighten, the ground deepens below.

When Spring Is Not Assured: Living In The Terminal Liminal

Johanna Rauhala

Diagnosis and Staging of Non-Small-Cell Lung Cancer

Importance of Biomarker Testing in Non-Small-Cell Lung Cancer

Reviewing Biomarker Testing With Patients for Non-Small-Cell Lung Cancer

The Importance of Testing for ALK Fusions in Non-Small-Cell Lung Cancer

Sequencing Therapies After Frontline Treatment in ALK+ mNSCLC

Managing Quality of Life in Metastatic Non-Small-Cell Lung Cancer

ALK+ Metastatic Non-Small Cell Lung Cancer: The Importance of Biomarker Testing

Jonathan W. Riess, MD, MS, UC Davis Comprehensive Cancer Center

We are going to move to the last piece here: thinking about how we can do better overall. Tim and Jamie, overall, what do you think? I know you think that we do great, but think about the overall world of cancer we live in. What do you think oncologists and the oncology team can improve in terms of managing patients, in terms of education, and in terms of treatment care? There are also a lot of financial implications, and we have not touched upon those. There is a whole hour that we could spend talking about that effect. Then, of course, how do we make sure that we end up meeting your needs? Any high-level thoughts about this?

It is all those things you just touched on. You worry about it. You always hear the scary stories of people who have exhausted their life savings to live two months longer, so that is something definite that we decided. I could have kept working, but my goal was to retire at age 55, so I stayed true to that. Keeping Jamie’s job and the insurance takes a bit of the burden off me as far as getting to the right providers. I did not have to change. We have gone through three insurance companies, and we have been able to stay with the same providers. That has helped a lot for consistency and everything.

You bring up a great question overall. Yes, we feel fortunate to have fallen into your hands, Dr. Bekaii-Saab, and Kelley’s, and that is great care. Looking more holistically, that is an important question. As great a job as you guys do, sometimes the pieces are not all connected. You guys do a great job, but then I get a bill from an insurance company saying that they are not going to pay for something. Sometimes it feels like the left hand does not talk to the right hand, and I have to fight with an insurance company. I have to get the paperwork that they need because they do not understand that a medication is not indicated for this, but it is still used that way in the oncology world. All those little pieces, sometimes from a holistic perspective, are out there floating around. I do not know what the answer is, but it feels overwhelming to try to keep all the pieces together. I often think about even older patients who might not have the ability to pull all those pieces together. How do they manage with all this? We are fortunate that we are in the field we are and that we have the resources we have. Even with all that, it can be overwhelming to fight with an insurance company or to try to get documentation when you just did that last month. Those are the pieces that, as a society, we could do better at.

Absolutely. Reese, what about financial resources or directing patients to financial resources and navigating that? In addition to having a diagnosis of cancer and having to fight through that, you now have to worry about the finances and financial support as well as fighting insurers and filing for bankruptcy for some patients. There are a lot more tragedies than the eye can see. What tools are you able to use to help with this, or what tools may be needed in your viewpoint—if they are not out there—to educate folks more?

 Fight CRC [colorectal cancer] does not provide financial support directly, and we generally point to our partners at Triage Cancer who are in tune with the legal battles patients and their families may face as well as insurance issues and finances. We have an established relationship with them, and we will do webinars every year or so to update our community on the different things that they might need to know. I would say that, even though we do not provide the financial support or necessarily the legal advice directly, we work with others to do so. From an oncological and a medical perspective, staying abreast of what advocacy organizations do and what types of resources they offer is extremely important to be able to point patients to the resources that exist, because there is a lot out there. Sometimes, it is not necessarily projected as much as it could be, but there are resources out there that are available, and advocacy organizations know about them and are able to point patients and their loved ones to those resources.

Kelley, you help oversee, manage and ensure that the patients are navigated safely through their journey, and it takes a big team. You have the pharmacist and the nurse working with you and others as well. If you have to give guidance or give advice to other health care providers, patients or caregivers about the model that—from your viewpoint—facilitates this level of care the most, what would you say to your peers?

You have to have a conversation with your patients regularly about what they need. A lot of times, patients do not want to bother us with stuff: “I am having this thing, but I did not want to tell you because I know you are busy.” We have to listen to what our patients are telling us, and we have to educate them about letting us know what they need. We at the Mayo Clinic are pretty fortunate in that we have a lot of resources that other facilities may not necessarily have. We have social workers who are fantastic, and we have pharmacists who are brilliant. If a family member, patient or colleague outside oncology recognizes something that is happening, all they have to do is let us know. We may not have the answer for it, but we may be able to do something to make things better.

We are certainly blessed to have that level of support for our patients. There are a lot of folks who work in the background: the finance person, the nurse, the technician, the pharmacist, the nurse practitioner, the physicians, from the chemotherapy nurse to the nurse who is focused on education, the navigator. It is a big team. The complexities of the system around how we care for our patients is immense, and we certainly hope to continue improving things with the support of organizations and advocacy groups with Reese’s work. Of course, we do all this for our patients, for you, Tim, and certainly for their families, Jamie and their son.

With that, I am going to thank all of you for this wonderful exchange. It was very educational, and it is great to be able to have this discussion with all of you. Thank you.

Improving Colorectal Cancer Management

Kelley Rone, APRN, DNP, Mayo Clinic

If you are like me, you found yourself leaving your oncologist's office after your diagnosis and asking yourself “What else can I do?” Little did I know at the time, but this question would become foundational for my care.

I started to research a lot, and I started to learn. I read a lot, Googled a lot and reached out to tons of random people. I became very involved in the integrative oncology world and began to realize how important it is to take care of Burt, not just Burt’s cancer.

First, some definitions. I will source the definitions, so you know I didn’t make them up!

Integrative oncology is a patient-centered, evidence-informed field of cancer care that utilizes mind and body practices, natural products and/or lifestyle modifications from different traditions 

 conventional cancer treatments, according to the Society for Integrative Oncology.

Complementary medicine is a term used to describe the types of treatments you may receive along with traditional Western medicine. Examples of complementary medicine include massage, meditation, biofeedback, tai chi, reiki, music therapy, guided imagery and dietary supplements, according to the Cleveland Clinic.

Treatments that are used instead of standard treatments. Standard treatments are based on the results of scientific research and are currently accepted and widely used. Less research has been done on most types of alternative medicine. This may include special diets, megadose vitamins, herbal preparations, special teas and magnet therapy. For example, a special diet may be used instead of anticancer drugs as a treatment for cancer, according to the National Institutes of Health.

Ok, so I came out of my oncologist's office (this was mid-2022) and wanted to find out what else I could do to help myself. I found the Society for Integrative Oncology (SIO) through Google and other research. I am not a shy person, so I sent the president a note (she had no idea who I was) and she referred me to some other people who got me involved, whom I now consider friends. For transparency's sake, I have been involved with SIO for two years and am co-chair of several committees and involved in other areas too. I also found my favorite quote about integrative oncology (IO) that I now use all of the time from Dr. Donald Abrams at the Osher Center for Integrative Medicine at UCSF: “Cancer is the weed, we need to tend to the garden.”

What I like about integrative oncology is that there have been some studies behind it, so it’s evidence-based. I believe that all modalities have a place, so I leaned into that idea and started to build out my overall treatment plan. We always talk about being our own advocates and there is no one else who will build a western and integrative plan for you unless you do it yourself (now AI can help but 

So, I am big into integrative. I believe in complementary (very similar) and some alternative too, but I focus more on integrative. To me, I am a big believer that just because something hasn’t been proven to work, doesn’t mean that it doesn't work, it just might mean that no one funded the study. I don’t discount things that people say help them because no one has “studied” it. I may or may not try them.

What are the integrative treatments that I do? I do intermittent fasting to put less stress on my organs, meditate, try to do yoga, try to walk outside, eat a diet with lots of fruit, vegetables, nuts, seeds, etc., take some supplements, do acupuncture, see a team of naturopaths, weekly therapy, etc.

Can I tell you that any one of these things makes a difference? No. But can I tell you that I am doing great, get an injection once every 28 days, do all of the above and am very lightly symptomatic? Yes, I can.

As I said, I am a believer in integrative, meaning everything works together. When people ask me what treatments I have, I mention all of them, not just my medical treatment. They all work together.

Think of it like this: if you get chemo, do you think the chemo works better if you are eating healthy and have a healthy mindset, or if you eat all processed junk foods and are negative all of the time? Right, the first one. Mind you, I eat junk food, just not all the time. I still want to enjoy myself!

In general, with two types of cancer (renal clear cell carcinoma and an advanced pancreatic neuroendocrine tumor), I am pretty self-sufficient. I just got a job, drive everywhere, meet people all the time, go hiking, walk, cook, clean, etc. I feel like I am doing great and all of the above are helping me.

Some of the benefits of the IO treatments are also in how they help my mental health. I am more present, more engaged and more self-aware than I have ever been. And that comes from the focus on IO therapies, not my injection. In fact, I figured out that my injection is less than 1% of the time I spend in a 28-day cycle. So, that leaves 99% of my time free to focus on other ways to help myself and my quality of life (yes, lots of poetic license in there!).

Did you know that acupuncture can help with pain and neuropathy?

Tai Chi is good for depression and anxiety?

Meditation and mindfulness-based interventions can help with pain and symptom management.

These have all been studied and have data behind them. Google them or look for ASCO-SIO Guidelines and you should find them. Or ask me. I am pretty easy to find.

There has been a lot of medical tradition that has existed for way longer than Western medicine and when you are in the mode of “What else is there?” why wouldn’t you try things that cause no harm? Chemo can be harmful, but therapy isn’t. I want to exhaust the things that I can do that won’t hurt me before I do more things to kill a part of me (but that’s me and we are all different).

Society for Integrative Oncology: if you are interested, find me and reach out.

Cancer Choices: a great site about integrative oncology meant for patients. Good reviews of different treatments.

Anti-Cancer Lifestyle: a free course on how to live a cleaner life and help live with cancer or try to avoid it.

Healing Works Foundation: Dr. Wayne Jonas, a leader in IO, started this organization. Tons of great resources for patients and for institutions that are interested in IO.

That wraps up some general thoughts on IO for me. I am off to the SIO conference in Irvine, California this week, from Oct. 25 to Oct. 27. I am so excited. I went last year, and I learned a ton and met some amazing people.

It’s so different than traditional medical conferences. At SIO, I learned about psychedelics, cannabis, yoga, ayurveda, micro-biome and hypnotherapy. I even learned about the effects of playing golf on men with advanced prostate cancer. No one is making billions of dollars off of any of these, but they can all help people, and that's what IO is all about — patients, not profits.

If anyone has any questions, please reach out to me. This has made a big difference for me, and I am so happy to help others better understand IO and its benefits. (Tip: A lot of IO treatments are great for caregivers or people with any issues too, health or mental, not just for people with cancer).

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Integrative oncology emphasizes a holistic approach to cancer care, combining conventional treatments with complementary therapies like meditation, acupuncture, and dietary changes. This patient-centered approach aims to improve overall well-being and quality of life. While some integrative practices lack extensive scientific validation, they are often supported by anecdotal evidence and smaller studies. The focus is on non-harmful interventions that enhance mental and physical health. Resources like the Society for Integrative Oncology and Cancer Choices provide valuable information for patients exploring integrative options alongside traditional cancer treatments.

In addition to receiving my traditional cancer treatments, I also opt for integrative medicines, which have helped my mental health.  

In Cancer, the Whole Is Greater Than the Sum of Its Parts 

Burt Rosen

Experts on cervical cancer offer provide comprehensive insights on the challenges patients experience and discuss ways to improve care.

Cervical Cancer: Insight into the Patient Experience

Linda Ryan

A little over two decades ago, a growth was found on my left thigh. After several visits to different doctors, and over six months, I found out I was a young college student at California State University, Bakersfield with epithelial sarcoma.

Surgery after surgery, chemo sessions and radiation, I thought I was done. Tired, throwing up, going bald and beyond thin for my frame, I kept pushing forward and I was determined to beat it.

I went into remission for almost a year, then was sick again. This time, it was worse. Again, I went through the same routine, only this time there were multiple trips to UCLA Medical Center.

Then they broke the news to me: I had cancer again. This time it was more severe.

I was told that the average survival rate was 15% for liver sarcoma at the time, and if I did survive, there was a good chance I would have permanent immune issues, constant chronic fatigue and would be unlikely to have children — that was just a few of the treatment impacts that were stated.

I had a year of college left. I was in my 20s with so much ahead of me. Was I just going to give up? The first fight was harsh enough and I struggled through it. I was told this would be more aggressive treatment, but that was ultimately my decision, since survival rates at the time were minimal.

Was I just going to be comfortable and slowly wither away? Or was I going to gamble and fight? After discussing my choice with family members, again, I moved forward with the mentality of, "What have I got to lose?" I'm stubborn enough. I got this.

Not only did my physical health suffer, but my mental health was also shook. I questioned everything— my existence, my faith, my purpose, family and friends. I was angry to the point where people (related and non-related) cut me off if I didn't cut them off first.

I fell into a severe depression; I was beyond tired and just wanted to die. I constantly felt alone, even though people were around me because they couldn't understand the pain I was feeling.

I was sick of hearing, "You'll be fine" or "You'll figure it out; you always do." This was f****** cancer, not the flu!

I felt abandoned, isolated, frustrated and angry.

I also hated taking pictures with those who wanted a token just in case I didn't make it. Man, I'm so glad social media didn't exist yet! I was already at my worst. Why would I want to document it?! So they had something to show at a funeral?! Or show it to others so they could feel good and say, "See? I was there for her." I refused it all.

I suppressed a lot of emotions and decided it was time to just take care of me. I was the patient. I was already exhausted and shouldn't have to justify the path I chose and what I was going through, while also trying to console those who were trying to "be there" for me.

I completed treatments, pushed through recovery and kept moving forward.

This year, 19 years from my original date of remission on March 3, 2003, I'm still here. I have a degree, a career I've worked hard for, I'm married, and have amazing children.

I still have personal, emotional, mental and physical battles, but I also see the world in a different light. My expectations of people always seem to be high, so much so that I fight disappointment regularly because I tend to forget most people take things for granted that I don't because I've lived a different path.

I have my peace for the most part; my health is decent as I still follow up with all the maintenance appointments and my faith is still strong. I have been a volunteer for my local county cancer foundation — especially as a voice of a survivor — because I want other survivors to know we’re never alone in our journey.

When I was a patient, especially since I was a young adult, I had no one to talk with who could relate to what was happening. A little over nine years ago, I was approached to attend a survivor meeting after a follow-up doctor’s appointment, to meet and talk with patients and survivors and share my story.

The first meeting I attended made an emotional impact not only on me, but also on those who were shy, ashamed, scared or angry to share their voice and experience. Now I’m an active volunteer committee member for events, raising money to help local patients with cancer and an active survivor voice when needed.

My attitude, personality and outlook on life spills over into everything I do, and I always hope the positive vibes shine through and inspire others.

As Walt Disney said, "Keep moving forward."

This post was written and submitted by Melody Saberon Ybarra. The article reflects the views of Melody Saberon Ybarra and not of CURE®. This is also not supposed to be intended as medical advice.

I went through two grueling bouts of cancer when I was a young adult, which drastically shaped my life. 

Going Through Cancer as a Young Adult Shaped My Outlook on Life

Melody Saberon Ybarra is a survivor of epithelial sarcoma and liver sarcoma.

Melody Saberon Ybarra

I’m going to pose a question now to everyone. How can the medical team improve the care of patients with brain metastases? Perhaps we can start with having Ivy and Katie speak to that.

Patients need information. That’s probably the most important thing. When you’re diagnosed, everything is thrown at you. I think patients need to understand what brain metastasis means, how that can impact their lives, if they’re asymptomatic versus symptomatic, what the options are for treatment, both short term and possibly long term. That needs to be laid out to people in an easily understandable way up front. I also think patients need to understand what the ongoing management is going to be for brain metastases, how often they’ll be scanned, if you have certain symptoms, when you should bring that up and maybe recommend moving a scan up earlier. But basically, what it comes down to is increased information.

I agree. We’ll have Ralph, after Katie has a chance to speak, but that’s exactly what the ABTA [American Brain Tumor Association] survey results showed us, too. But Katie, do you want to add to that?

I agree with everything Ivy said, although I have already said I’m the patient who doesn’t want to hear all the worst-case scenarios. I don’t know how I would have responded if a doctor said, “Listen, I need you to be looking for these things,” because then I would be like, “Oh my god, I think that symptom happened to me last week, I think I have a brain tumor, I think you need to scan me right now.” But I think I’ve gotten a little bit better now that I’m seasoned at dealing with this.

Another thing that was shocking to me was, I’m not claustrophobic, I didn’t think I was, until I got a brain scan. That’s a very different scan. If you think, “Oh, I’ve done scans, I know what I’m doing,” and suddenly you’re going headfirst down a very narrow tube with a cage on your head, it’s terrifying. To this day, if I ever hear of someone having to go in for a brain scan, I’m always very careful with how I present information to other patients. But I always do say, “That one is a little harder for me, and I take a Valium for it.” I call that a cancer perquisite. But Nick has to drive me to those scans now because they still, to this day, I get a lot of anxiety around that particular scan.

 I think your experience is not a rarity, I think other patients have had similar experiences. Ralph, do you want to add to that?

Sure. I think you all know this very well, but patients and caregivers trust you and respect you. When you take the time to sit down and give them clinical trial treatment options, they listen, they absorb it. But it’s important that you also involve your team, your nurses, and your social workers, so that when they leave the office, they trust you, but sometimes they don’t fully understand everything that you have said. Having your support staff following up, working with them on clinical trials is important. Second, the survey shows how much they lean on, and want to know more about, organizations like the ABTA. You can trust us to work with them where they are and then afterward. People like Nick, who is a phenomenal caregiver, we can talk to him about whether he’s interested in being a mentor to others after he feels like Katie is at a place where he can give time to other caregivers.

 I completely agree, Ralph. Dr. Gondi, did you want to add to, how can we as a field improve the care of a patient with brain metastases?

As I listen to Ivy, Katie and Nick speak, it reminded me, at least in my clinical experience, that when systemic cancer goes to the brain, there are a lot of emotions, understandably, there’s a lot of fear, there’s a lot of confusion, consternation. And it’s not just on the patient’s perspective, but even some medical oncologists. What I’ve appreciated is that sometimes medical oncologists, as a brain tumor specialist, and I’m sure Dr. Brastianos, you probably do the same, I just say, “You know what, I’ll take care of the brain. Everything above the neck, I’m going to watch and keep an eye on, and everything below the neck, your systemic oncologist can keep an eye on it, and we’ll do it together.” That collaboration becomes useful. Just during this Zoom call, I’ve gotten a couple of texts from medical oncologists about patients we have, and I think that gives patients and their providers some sense of calm and comfort, that everything is taken care of up here, that we’re OK. If I have a headache, call that doctor who specializes in brain stuff and let him know, so that they can address it. I do think that there is tremendous opportunity to help and augment the care of patients and their providers, especially when we’re talking about the brain.

Of the two concepts I tried to cover, one is that the neurological team, whether they are a surgeon, radiation oncologist, or whatever, they have the knowledge and expertise pertaining to the brain and to the central nervous system. That team is bringing that expertise to help the medical oncologist treat the patient in a complete way. The second concept is that it’s a complicated world, and one specialist within the neuro field cannot handle all the problems of brain metastasis. It does require a whole team of a surgeon, oncologist, radiation, radiologist, and so on and so forth. Bringing all these together in the brain metastasis concept is a great advantage for patients.

 I completely agree. On that note, we can be providing more support to caregivers. Nick, you already alluded to that earlier, but tell us more about how we can help caregivers.

This morning was a good example, my first question to Kate was, “How are you doing?” I think that’s a nice question also to ask a caregiver, how are they doing. I think I would like to see more proactive support offered, and if you do need support, here are avenues you can use to find support and information. Then what do you need as well as a caregiver, what can we do to support you, because we’re here to help the patient. The more that we can be supported to be in a better place to help the patient, the better that could be for us. Even Ivy talked about how she was the patient, she looked after the kids. I’m sure while her husband was working, that was a huge impact on him, as much as there was when I had to go to Pittsburgh, change my schedule, and be there to support Katie in the hospital every day. It would be great for a little more attention to the caregiver, to make sure things are well there, because we’re here to help the patient, and we’re part of the overall story and on the journey together.

That’s so important, Nick, thanks for saying that. Again, thank you to Katie, Nick and Ivy for sharing these deeply personal journeys. We’re so inspired by your stories. Thank you, and we hope that you’ll continue to do well and respond to therapies. I think we’ve reached time. Thank you to everyone who participated in today’s 

® program. I want to thank Ivy and Katie for sharing your story, and my colleagues, Vinai Gondi, Ray Sawaya, Manmeet Ahluwalia, and of course, Ralph DeVitto, for this incredible discussion. To our viewing audience, we hope you found this presentation to be useful and we’ve provided you with practical information that you can discuss with your health care provider. Thank you so much, everyone.

Improving Outcomes for Patients With Brain Metastases

Raymond Sawaya, MD, MD Anderson Cancer Center

The panel concludes its discussion with insights on challenges and unmet needs in the CML treatment landscape, highlighting ways to better support patients and caregivers.

Advancing CML Management Towards an Ideal Patient Journey

This program was made possible with support from Novartis Pharmaceuticals.

Video content above is prompted by the following:

What are the biggest unmet needs you see for CML patients today, and how do you think emerging therapies and research could address those gaps in the future?

What excites you most about the potential advancements in CML management that may be on the horizon in the next 5-10 years?

How do you envision the CML patient experience being transformed compared to today?

Claire Saxton

Rashid K. Sayyid, MD, MSc, discusses the role of combination therapy in metastatic castrate-resistant prostate cancer.

The Role of Combination Therapy in mCRPC

This is a synopsis of an Educated Patient Sound Bites series featuring Alicia Morgans, MD, MPH, of Dana-Farber Cancer Institute; Rashid K. Sayyid, MD, MSc, of the University of Toronto; and Reginald Tucker-Seeley, MA, ScM, ScD, of ZERO Prostate Cancer.

Dr Rashid K. Sayyid discusses PARP inhibitors like olaparib and rucaparib in combination with other therapies. For example, enzalutamide-olaparib was approved based on TRITON3 for certain mutations, while olaparib-abiraterone was approved first-line for 

-mutated cancer per PROPEL. He explains PARP inhibitors may radiosensitize, improving radium Ra 223 dichloride efficacy.

The ongoing COMRADE phase 1/2 trial established olaparib-radium dosing in phase 1 and showed 6-month 57% radiographic progression-free survival and 56% 1-year overall survival. Phase 2 is now examining olaparib-radium efficacy for radiographic progression-free survival with 213 patients. Upcoming results over next few years.

In summary, Dr. Sayyid overviews emerging prostate cancer approaches, including PARP inhibitor combinations with antiandrogens like enzalutamide or abiraterone for certain mutations, as well as combinations with radium Ra 223 dichloride now under phase 2 investigation.

*Video synopsis is AI-generated and reviewed by CURE editorial staff.

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