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Caitlin Whyte: Welcome to Hally Healthcast, the monthly wellness podcast from Hally Health, your partner in helping you live your healthiest life. Every month on our podcast, we address a new topic important to your health, bringing in expert doctors, therapists, and specialists who offer advice and answer your most pressing questions.

September is Blood Cancer Awareness Month. So today, we brought in experts to talk about cancer research and its role in discovering treatments for two of the most common types of blood cancer, leukemia and lymphoma. With us are Betsy Barnick and Pauline Mbuvi, certified clinical research professionals at Carle Cancer Institute in Urbana, Illinois. Ms. Barnick is the oncology clinic research manager and Ms. Mbuvi is the oncology senior clinical research coordinator at the institute.

Welcome to you both and thanks for being with us today. So let's jump right in. Not too many people know about the behind the scenes role of cancer researchers. And if they do, it's often only through Hollywood. But both of you are real life cancer researchers, making life-saving discoveries right here in central Illinois. Ms. Barnick, can you tell our listeners a little about how cancer research works in real life? For example, what researchers do, why it's so important and what your exact role is at the Institute?

Betsy Barnick MHS, CCRP: Sure. So cancer research covers, you know, a variety of roles from bench work that happens to animal research and then, finally, in human clinical trials, which is what we do here at Carle. It's important. I mean, all research is important, but we're a little biased. So clinical research is important because today's cancer treatments were yesterday's clinical trial. We don't have a cure for cancer and we don't have a cure for most of the side effects that come along with cancer treatments. So the only way we can do better and improve quality of life and outcomes for our patients is through research and clinical trials.

Caitlin Whyte: Thank you so much, Ms. Barnick. And Ms. Mbuvi, anything to add? What is your role at the institute?

Pauline Mbuvi, MS, CCRP: What Betsy said is really important for research, because it does not matter what kind of medication you are on, what kind of treatment patients have, or even it has gone through research and that is how we end up having approved drugs that treat our health conditions. My role at the cancer center is I'm a senior research coordinator. And what I do is I screen patients for clinical trials. I work hand in hand with the doctors. And also when we get trials, I'm the one who is reading through the trial to see whether it is an appropriate fit for our patients. Also, I read the consent forms. Also, we do talk with the patients about consenting. Other things we do is we follow the protocol and we are that kind of the middle person between the doctor and the patient, making sure that when patients are consented to the clinical trial, we are following all the data that is required by that clinical trial.

Caitlin Whyte: Thank you, Ms. Mbuvi. I think many of our listeners might be wondering how exactly do you become a certified cancer researcher? What qualifications do you need? What education is required? And what's the process of becoming a researcher? Ms. Barnick, perhaps you could provide a little background.

Betsy Barnick MHS, CCRP: Sure. There's no set qualifications. But here at Carle, most of our clinical research coordinators are bachelor's prepared or master's prepared in their education. It can be a wide variety of backgrounds. Pauline and I are both with animal science backgrounds, but we have biology, zoology, psychology, anything that's a hard science because the drugs are explaining how the drugs work and understanding how the drugs work in the body is important. A science background is really important.

To become a researcher, we've hired people out of all sorts of past experiences. Some people come to us straight out of their four-year degree. Some people have some experience or they've been working in the hospital for quite some time, especially if they've been in the cancer center, but there's a training process that we go through. It usually takes about a year before you really know what you're doing, but as long as you have a strong willingness to learn and a desire to help patients really, it's a very patient-centered approach that we have here. And anything we can do to make the cancer journey easier for our patients and give them the best possible outcomes is why we're here.

Caitlin Whyte: Well, if any kids or young adults are listening, hopefully we've inspired the next generation of researchers. Thank you, Ms. Barnick. And Ms. Mbuvi, onto the next question many people wonder about, how does the institute choose its research projects and who funds them?

Pauline Mbuvi, MS, CCRP: Yeah, that is a question we get a lot. The bulk of our trials come from the NCI. These are studies or projects that have been written with collaborations with NCI from other institutions. And because we are members, those studies are available to us. So most of them are NCI-sponsored. Other studies that we get are sponsored by the pharmaceuticals. For example, pharmaceutical company that is developing a drug can approach us and ask us whether we would like to participate in their study. And we also have to be very specific and sure of what phase the trial is. Also other projects that we are involved in are NIH-funded. Most of those are through the University of Illinois. And there are also some that are self-funded projects. For example, Carle can also fund a project and then we will be able to participate in that study.

So how we choose the projects is like our physicians are very involved in selecting the studies. You know, they are looking at the science, they are looking to see that we have appropriate patients for the study. We have a process that we have here where when we are invited to participate in a study, we go through what is called feasibility. And feasibility is where the nurses, the finance people, the regulatory people, also the pharmacist, and also including some of our doctors, we sit down and discuss every asset of that trial. Is it good for our patients? Is the science there? Is the funding there? Are there some tests that are required that are not standard of care? And if there is, who is going to pay for those tests?

And when we decide that this study is appropriate for our patients, then we will send it to the institutional review board. And those people are the ones that are concerned about the safety of the trial. If they do not open that study, if they are not comfortable with that study, then we don't open it. Otherwise, after it is approved by the IRB and also the feasibility process, then we open the trial.

Caitlin Whyte: Thank you. And another common question, Ms. Barnick, how do you recruit people to participate in the research studies? What does that usually involve?

Betsy Barnick MHS, CCRP: So we believe that every patient should have an opportunity to participate in a clinical trial. And if possible, if they could participate close to home. So 85% of all cancer patients, all patients diagnosed with cancer occurs in the community, not at a major medical center or an academic center. And so that's why we're part of the National Cancer Institute's NCORP program, which is the National Clinical Oncology Research Program. And that offers those trials that Pauline already referenced through the NCI where they're developed in collaboration with the community practice and an academic medical center practice like Mayo Clinic or Memorial Sloan Kettering. So that way, that cutting edge research can be done in the community and is available to those people in the community.

There's a lot of benefits to having those patients or those studies available to patients in our community, especially we have quite a rural population here. You get access to that cutting edge research. It's close to home. It's the latest and newest treatments, but you still get to sleep in your bed at night and eat your own food. You can continue to work. A lot of patients are caring for small children or they're caring for their parents. And so that's one of the advantages of having this high quality research in a community like Champaign-Urbana or Danville or Bloomington.

Most of our patients, we identify through screening schedules or watching the patients that are coming in. Our physicians and nurses are really good about identifying clinical trial patients or patients that might benefit, especially for our symptom management trials. If people are having hot flashes or fatigue or they're having some nausea and vomiting, then we'll work with that nurse or that physician to see if we can put them on a trial that might alleviate those symptoms. But there's a lot of benefits too. If we don't have anything that will help or there is no standard treatments, a clinical trial is often a good option.

Caitlin Whyte: Great information. Thank you again for sharing. And Ms. Mbuvi, can you describe a little about the staff at the institute who all is involved in research? And how do you work with doctors and other practicing medical providers during the studies?

Pauline Mbuvi, MS, CCRP: First of all, I just want to add to what Betsy said. Not only do we get our patients from here, but we also do get calls from other states. Like we can get patients who have seen one of our clinical trials in the website and they can call us. Families even out of the country are calling us. Recently, we had somebody calling from India. So that website helps a lot with that information.

The people that we work with here at the cancer center as a researcher are mostly the MDs. They are the ones referring the patients to us. We also work with the nurses. The nurses are the ones that are going to administer the drugs and also care for the symptom management. We work with the pharmacist because some of those drugs are provided by the study, so the pharmacy has to have an accountability of the studies that are being sponsored by the study. We worked with the PSR who are scheduling the patients for us. We also work with the histology department because some of these studies do require that we submit tumor tissue. So we work with them, we will email them and ask them that we need this certain kind of tumor tissue to be sent to us. We work with the imaging department because some of those images are sent to the studies. They are centralized read by the study. So the imaging department will help us send some of those images. We also work with the lab because most of our studies do require blood submission or urine submission, whatever it is. So we all ask them to process these samples for us and then send them too for us. Everybody in this department is part of research because we are approaching them every time for a certain need that we need for our patients.

Caitlin Whyte: Wonderful. And Ms. Barnick, this might be a hard question, but what's your favorite part about working with this team?

Betsy Barnick MHS, CCRP: I've been asked this question several times before. There's no doubt in my mind, the reason I came to cancer research or or why I've stayed in cancer research is absolutely the patients. And I think if you ask most cancer researchers, at least at here at Carle, their number one reason that they stay in this job, which can be, you know, grueling at times and sad at times, but the patients you meet, you just can't compare. They're just a wonderful group of people. And it's nice when you can offer a clinical trial and the drug gets FDA approved later, and those patients don't die of their cancer. They're still here 20 years later showing you pictures of their grandkids or their kids that got married.

So beyond the patients, the employees of the cancer center are fabulous. I love working here. They're a compassionate group. They're a fun group. Everybody's really focused on doing what's best for the patient and really selfless of their time and their talents to make it a better place for patients and their outcomes.

Caitlin Whyte: Great. And moving on to the next part of our discussion. Ms. Mbuvi as you know, September is Blood Cancer Awareness Month. Two of the most common types of blood cancer are leukemia and lymphoma. So can you tell us a little about these cancers, just what they are, who's most at risk and how they're usually treated?

Pauline Mbuvi, MS, CCRP: Leukemia is the cancer of the blood. And there are several leukemias. So it starts with something going wrong in a cell line. Then the system just sends a message that this cell line can keep on multiplying, multiplying, and so it ends up being a leukemia. Lymphoma is the cancer of the lymph nodes. And of course, you know, the lymph nodes are involved with the immune system. So if something goes wrong in there and kind of form some mutations and so causing whatever mutation to cause that lymphoma to grow.

So some of the risks that I know of is it can be some environmental causes, which you would be, maybe there is an increase in radiation exposure or chemical exposure. Some of the things is also like smoking or even some patients that have been treated with chemo drugs, sometimes they have risk of acquiring leukemia. There are certain inherited conditions and also immune disorders that puts the patient in higher risk. Some certain viruses or even family histories and also some blood disorders can have patients have a high increase in risk for leukemia and lymphoma.

And how it is treated really, first of all, there is a whole lot of things that just get done. First of all, they have to determine what kind of leukemia or lymphoma it is, what stage it is. Some leukemias are slow-growing and so they just need to be observed or even some lymphomas are slow-growing and they just need to be observed depending on what stage and depending on the recommendation of the physician. And then after that, then the other treatments are prescribed by the doctors or depends on what kind, what stage and what is available at that time.

Caitlin Whyte: Thank you. And sticking with you, Ms. Mbuvi, can you tell us a little bit about your own past research projects that have focused on these blood cancers and how research both at Carle and around the world is making promising discoveries that could lead to new hope for people with leukemia and lymphoma?

Pauline Mbuvi, MS, CCRP: I have worked here for over 20 years. And I have seen the science and the treatment of leukemia and lymphoma advance in ways that I cannot even explain. We do have clinical trials for patients that have new diagnosis of leukemia or lymphoma, or we do have clinical trials for patients that have relapsed. And they go in spot, sometimes we have opened a study and then it closes soon because it has accrued enough patients. Other studies kind of fearful a little bit longer.

One of the studies that I know I have been involved in is one that is entry maybe chronic lymphocytic leukemia as standard of care is ibrutinib. We put patients on that study and now we see it being used as part of standard of care. So there is a lot of drugs. Some, they don't even have names, they have numbers. And I think what is exciting for us is when we see that a drug that is a number that has gone through clinical research and then it gets approved, and we get excited to see it being now used as part of standard of care.

Caitlin Whyte: Thank you so much, Ms. Mbuvi. Ms. Barnick, anything to add about your own or others' research into these things?

Betsy Barnick MHS, CCRP: Yeah. Most of the research that we do here at Carle is part of the National Cancer Institute's Community Oncology Program. So we don't do as much of our own research here, you know, written by our physicians or ourselves. But it is really heartening to see these drugs progress through the clinical trial process, get FDA approval because they show, you know, an added benefit to patients either longer life or longer progression-free survival or a reduction in side effects. And so that's our goal, is to help people live a longer life after their diagnosis of cancer and feel good while doing it.

In the time that I've been here, the 20 years that I've been here as well, we've seen lots of drugs that started out in a clinical trial and are now FDA approved and standard of care. And by getting in early on this process and with the benefit of the patients and the community that volunteer to do these things, our physicians get access to the drugs earlier that the patients get access. But the nurses, we all get experience using the drugs and watching for certain side effects and making sure that we can maximize the value of that drug before it even hits the market, so we already have experience with it and can help patients along their way with what we've learned while it was in a clinical trial. So, I mean, there's lots of good things going on. We're still not out of a job, but we'll keep working our way towards, you know, a cure for all cancers.

Caitlin Whyte: Well, such important information and advice. Thank you so much, Ms. Barnick and Ms. Mbuvi, for joining us today and for all that you do every single day at Carle Cancer Institute. You both truly change and save lives through your work.

That concludes today's Hally Healthcast. Tune in next month, as we tackle yet another topic important for your health and well-being. And remember, Hally Health is your partner in helping you live your healthiest life. Visit hally.com for resources, information, tips, and much more. Let us help keep you and your family healthy and well. Thanks for listening. We hope you tune in next month.