Maggie McKay (Host): When you receive a cancer diagnosis, it's a lot to process and so many questions come up. It can be overwhelming. So today, we're going to talk about navigating modern cancer care with Dr. Urjeet Patel, Medical Director of the Cancer Center at Cook County Health.

Welcome to Total Health Talks, your Cook County Health Podcast, where we empower your journey to better health. I'm your host, Maggie McKay. Thank you so much for joining us today, Dr. Patel. It's so good to have you here.

Urjeet Patel, MD: Maggie, it's a pleasure to be here. Again, Urjeet Patel, I'm the Medical Director of the Cancer Center here at Cook County Health. And I'm pleased to speak to you today about cancer care.

Host: So, what should the public know about cancer? I know that's a very broad question, but what would you say?

Urjeet Patel, MD: It is a broad question. We'll try to cover the basics here. So cancer, it's a collection of diseases. Really, it can occur anywhere in the body. And we think of it as essentially unregulated growth. It's cells in the body that are growing out of control. Eventually, they'll turn into a lump or a mass. And then, that has a chance of spreading to other parts of the body. And unfortunately, as such, cancer is a serious problem and a potentially life-threatening problem. It's one of the leading causes of death worldwide, and it's something that we have treatment for, so it's a disease that deserves a lot of attention.

Host: Let's talk about the importance of early detection and screening programs in the fight against cancer. How important are they?

Urjeet Patel, MD: Probably the two best things I could say about cancer are, one, what can we do to prevent it? What better things than to never have it in the first place? And then, number two, if we have to have a cancer, what can we do to catch it early? So, prevention, these are things like avoiding tobacco products for lung cancer, avoiding ultraviolet sun exposure to prevent skin cancer, using the HPV vaccine to prevent HPV-driven cancers. In these settings, we can actually prevent cancer from ever starting.

The second part of that is screening. Screening is when we're trying to catch cancers at an early stage when they may not even be giving a patient symptoms. So, things like mammography for breast cancer, colorectal screening for colon cancer, PSA for prostate cancer. These are some of the ways that we screen patients for cancer and try to catch them before we even know that they're there.

Host: After somebody gets their diagnosis, what should a patient consider when making treatment decisions?

Urjeet Patel, MD: Treatment for cancer is complex. Probably, the simplistic way to view it is there are three main tools that we have to treat cancer. One is surgery. The next is radiation therapy. And the third is, broadly speaking, chemotherapy. Any given cancer might be treated by one, two, or all three of these tools. And so when we think about treating cancer, we're trying to find a cancer center that has access to all aspects of treatment and then the entire team that's needed to treat what is often a complex disease.

Host: Dr. Patel, what are some of the key challenges that patients face when they're navigating the complex landscape of cancer care today?

Urjeet Patel, MD: As I mentioned before, the treatment alone is challenging enough. Undergoing surgery, radiation therapy, or going to the infusion center to get chemotherapy. Even just the sheer number of visits and just finding your way around the hospital can be challenging. In addition, patients often have a lot of stressors beyond just the diagnosis. There's psychological factors at play as people are going through life-threatening diseases and treatment for that. There's a financial burden that many patients bear when undergoing complex care like this, even just navigating the system.

So, here at Cook County Health, we've built up our supportive oncology services. So beyond just the three treatment arms, we have almost an army of other practitioners that provide care to the complex cancer patient, things like nutritionists, psychosocial behavior health practitioners, patient navigators; these are all different aspects of supportive oncology; social worker, often dealing with a lot of the challenges that a patient has when going through this kind of care.

Host: Wow, it's so involved. And on top of it, you don't feel well. So, what are some promising developments in the treatment of certain types of cancer?

Urjeet Patel, MD: You know, it is an exciting time for cancer care. In the surgical side of things, we're having more and more minimally invasive options. Things like robotic surgery is beginning to revolutionize some of the surgical approaches to cancer. In radiation therapy, there are often a lot of side effects that go along with radiation treatment. And now, there are better targeting or focusing tools that the radiation therapist can use to deliver the radiation therapy. Essentially, we're getting better cancer-killing abilities of the treatment, and reduced toxicity or side effects to the surrounding neighborhood where the cancer is otherwise sitting.

And then finally, in chemotherapy, there are entire new classes of drugs coming online, things like immunotherapy. These are drugs that, instead of traditional chemotherapy, they're actually harnessing the body's immune system to help fight the cancer. So, these are drugs that did not exist 10 or 15 years ago and are essentially a new horizon for cancer care. With some of these tools used together, we're seeing cancers that used to be often quite lethal often reduced to chronic disease or even cures. So, these are some exciting times for us as doctors as well as for our patients as cancer patients.

Host: That's encouraging. Can you address disparities in cancer care access and outcomes?

Urjeet Patel, MD: Sure. Also, a broad question. Again, cancer care is broad, complex, and also, frankly, expensive. And so, you can imagine in the U.S. where patients do have good access to healthcare, things can go optimally. When patients don't have good access to healthcare, things have the potential to not go optimally. And so here, where we do know there are disparities in healthcare, there's disparities in access, there are barriers that certain populations face that others don't. So for some of our underrepresented minorities, they may have social situations that prevent access to healthcare. They may have multiple jobs that don't allow them the luxury to go to the doctor when they're having problems. They might have barriers in terms of child care or elder care, which are also preventing them from seeking the healthcare that they need. So as a result of such disparities, we often find our cure rates or our ability to fight cancer is different in one population than the next.

Step one is recognizing that, and I think we do. Step two is actually addressing it. And here at Cook County Health, where we are focused on the disparities that exist, and some of the structural changes we can implement to combat those disparities, I think we're making a lot of headway. So, things like our supportive oncology program are designed to help reduce disparities.

Host: Dr. Patel, who gets to benefit from cutting-edge cancer research? What are the clinical trials and why is that important to cancer patients?

Urjeet Patel, MD: Yeah, thank you for asking that. Clinical trials are an incredibly important part of both cancer research as well as cancer treatment. Clinical trials can be comparing one drug to another. They could be comparing one surgery to another. They could be surveying a patient on their outcomes from surgery, for example.

So, as we open clinical trials, we're essentially treating patients with the most cutting-edge tools that could be surgery, it could be a new class of drugs. And that actual patient could be benefiting from cutting-edge technology. Number two, as we learn more about cancer and we've been learning about it ever since we knew about it, and we're still continuing to learn it, it will help patients yet to come. And so, at CCH, where we are looking at disparities and making sure that all patients who come to us has access to the treatment that they need, it's benefiting not only the patients sitting in front of us, but the similar patients down the road.

Host: So, everybody can benefit from the clinical trials because they're not expensive.

Urjeet Patel, MD: Well, clinical trials are expensive to run, and an institution has to be committed to making sure there is access to those trials. And here at CCH, we have a NCI, or National Cancer Institute-funded grant that allows us to ensure that all patients who come to us have the same opportunities as patients who go to other healthcare centers.

Host: That's wonderful. Dr. Patel, is there anything else in closing that you'd like to add that people should know?

Urjeet Patel, MD: I think probably the biggest message I can share is that, again, cancer, it's a serious problem. But the good news about it is that for virtually every cancer out there, we have good treatment that patients should avail themselves of. And that's why we're here. We're here to take care of the cancer patient and give them the best fighting chance at defeating their disease.

Host: Well, thank you so much for being here and sharing your expertise. This has been such useful information and encouraging. We appreciate it.

Urjeet Patel, MD: Thank you, Maggie. It's been a real pleasure. I can't wait for the next opportunity.

Host: Absolutely. We look forward to talking with you again. That is Dr. Urjeet Patel. As we wrap up another insightful episode of Total Health Talks, make sure to visit cookcountyhealth.org/podcast and subscribe to our podcast, share and connect with us on social media. Stay tuned for more engaging discussions. I'm Maggie McKay, signing off from Total Health Talks. Stay well.