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An ovarian cancer diagnosis can be life-changing. Renowned oncologist, Dr. Maurie Markman, can help you better understand the early warning signs.
Additional Info
- Segment Number 1
- Audio File managing_cancer/1539ct4a.mp3
- Featured Speaker Maurie Markman, MD
- Organization Cancer Center
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Guest Bio
A nationally-renowned oncologist, Dr. Maurie Markman is President of Medicine and Science at Cancer Treatment Centers of America (CTCA). He has more than 20 years of experience in cancer treatment and gynecologic research at some of the country’s most recognized facilities. Dr. Markman is board certified in internal medicine, medical oncology and hematology, and has published more than 1400 articles, editorials, peer-reviewed manuscripts, book chapters, reviews, letters and abstracts.
- Length (mins) 10
- Waiver Received No
- Host Melanie Cole, MS
The early symptoms of lung cancer may be a slight cough or shortness of breath, depending on which part of the lung is affected.
Additional Info
- Segment Number 3
- Audio File managing_cancer/1534ct3c.mp3
- Featured Speaker Daniel Nader, MD
- Organization Cancer Center
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Guest Bio
Dr. Daniel Nader leads the interventional pulmonology program (Lung Center) at Cancer Treatment Centers of America® (CTCA) at Southwestern Regional Medical Center. Thanks to his vision and determination, CTCA is able to offer patients the latest advances in the diagnosis and treatment of lung cancer. Dr. Nader, who has been with CTCA® since 1991, has performed more than 6,500 bronchoscopy procedures and provided more than 1,700 high-dose rate (HDR) brachytherapy treatments.
Dr. Nader has been recognized by Castle Connolly, U.S. News & World Report and Oklahoma magazine as a top doctor in pulmonary medicine, and Castle Connolly and Newsweek named him on their list of the "Top Cancer Doctors 2015" for the United States. - Length (mins) 10
- Waiver Received No
- Host Melanie Cole, MS
Immunotherapy (also called biological therapy and biotherapy) uses the body's immune system to fight cancer.
Additional Info
- Segment Number 2
- Audio File managing_cancer/1534ct3b.mp3
- Featured Speaker Glen Weiss, MD, MBA
- Organization Cancer Center
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Guest Bio
Glen J. Weiss, MD, MBA serves as the Director of Clinical Research and Phase I&II Clinical Trials at Cancer Treatment Centers of America® at Western Regional Medical Center. He is board certified in medical oncology, and has completed numerous clinical trials, a few of which have already received FDA approval for certain cancers.
- Length (mins) 10
- Waiver Received No
- Host Melanie Cole, MS
Cancer Treatment Centers of America, CTCA®, uses leading technology to aggressively treat cancer.
Additional Info
- Segment Number 1
- Audio File managing_cancer/1534ct3a.mp3
- Featured Speaker Carolyn Lammersfeld, MS, RD,
- Organization Cancer Center
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Guest Bio
Carolyn Lammersfeld is the Vice President of Integrative Medicine at Cancer Treatment Centers of America® (CTCA). She oversees the Integrative Services, which are therapies aimed at minimizing side effects and helping patients maintain quality of life. She earned a master’s degree in clinical nutrition from Rush-Presbyterian-St. Luke’s Medical Center in Chicago, where she completed a post-graduate internship. She earned a bachelor’s degree in nutrition and dietetics from Bradley University. She is also certified in oncology nutrition and nutrition support.
- Length (mins) 10
- Waiver Received No
- Host Melanie Cole, MS
Lymphedema is a condition in which fluid (lymph) is retained in the tissue and causes swelling (edema), often in the arms or legs.
Additional Info
- Segment Number 2
- Audio File managing_cancer/1528ct1b.mp3
- Featured Speaker Daniel Liu, MD
- Organization Cancer Center
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Guest Bio
Initially trained as a concert violinist, Dr. Daniel Liu attended Hendrix College in Conway, Arkansas as a music scholar. He then turned his focus to medicine. He says, “I wanted to make a more direct impact in people’s lives.”
Dr. Liu completed a bachelor’s degree in chemistry in 2002 and earned a medical degree at Washington University in St. Louis in 2006. Dr. Liu then completed an internship and residency in plastic surgery at the University of Washington in Seattle, where he also served as Chief Resident in the Division of Plastic Surgery.
Dr. Liu has worked as a plastic surgeon at several large hospitals in Illinois. He joined CTCA in August 2014. -
Transcription
Melanie Cole (Host): Cancer Treatment Centers of America at Midwestern Regional Medical Center, , has expanded their comprehensive lymphedema treatment program to offer two innovative surgical options for patients suffering from lymphedema. My guest today is Dr. Daniel Liu. He's a plastic and reconstructive surgeon at Cancer Treatment Centers of America in Northern Illinois. Welcome to the show, Dr. Liu. Tell us a little bit first about what is lymphedema.
Dr. Daniel Liu (Guest): Good morning, Melanie. Thanks for having me on the show. First of all, I just want to say that lymphedema is an unrecognized and unpopular thing to talk about because it's not at the top of every patient's mind when they are undergoing cancer treatment. However, it is a very common phenomenon that can happen after treatment of many types of cancers. The most common type of lymphedema that we see here in the United States is after the treatment of breast cancer. Now, when a woman is diagnosed with breast cancer she often has to undergo a series of treatments both including surgery, sometimes radiation and oftentimes chemotherapy. When the lymph nodes are removed as a treatment of the armpit area or the axilla, both with surgical removal as well as radiation therapy to these areas, one of the side effects can be swelling in the affected arm and that is what we see after breast cancers, what's called post-mastectomy lymphedema.
Melanie: So, what is the general cause? You mentioned when lymph nodes are removed, then what actually happens, Dr. Liu?
Dr. Liu: Well, first let me say that lymphedema can be caused by many things and actually across the world the most common cause is a parasitic infection that affects the lymph nodes or lymphatics. The normal function of lymph nodes is to filter extra fluid throughout the body and drain extra fluid from the extremities towards the central trunk of the body. When this is not functioning properly then fluid can back up within the extremities, or actually any part of the body. That leads to symptoms of swelling, redness, heaviness and occasionally, infection.
Melanie: So, what happens if it's left untreated? Then, tell us is there something we can do to prevent lymphedema?
Dr. Liu: When left untreated, lymphedema is, as far as we know, a progressive disease meaning that it slowly and gradually gets worse over time. Unfortunately, there’s no cure for lymphedema. However, there are standards of care that involve physical therapy and some neurosurgical treatment. After treatment of breast cancer by removing the axillary lymph nodes, we oftentimes do maneuvers to try to prevent lymphedema. One of these things is to prescribe a compression garment for the arm called a lymphedema sleeve. That's something that we prescribe for all of our patients who have had axillary lymph nodes dissections as a prophylactic measure.
Melanie: So then, speak about treatment a little bit. If someone comes to you what do you do for them?
Dr. Liu: First and foremost, we have to make sure that patients are appropriately evaluated and treated by a physical therapist who is qualified to deal with lymphedema and these are called clinical lymphedema therapists who have specialized training. Currently, the treatment of lymphedema centers around multimodalities, from physical therapy, including a combination of compression therapy, garment use, lymphatic pump use, as well as manual lymphatic drainage which is a type of massage. Patients can benefit from a combination of these therapies and there's no proof that one is superior to another. However, the use of these multimodalities can result in good treatment and stabilization of a patient's lymphedema symptoms.
Melanie: Tell us a little bit about the innovative microsurgery for lymphedema patients at Cancer Treatment Centers.
Dr. Liu: Over the past couple of decades, plastic surgeons throughout the world have developed newer techniques to try to attack these problems from a surgical standpoints and with better understanding of both lymphatic anatomy as well as the pathophysiology behind lymphedema. We are trying to do functional surgeries that address the missing lymphatics and/or the missing lymph nodes removed during treatment of cancer. There's two separate procedures that we currently offer. One is called a vascularized lymph node transfer and the other is called a lymphovenous bypass or, more specifically, a lymphaticovenular bypass. These surgeries target different areas of the arm or the axilla with the goal of slowing down the progression of lymphedema.
Melanie: Is this a permanent solution? Is it something that comes back—lymphedema--or does this help it to go away?
Dr. Liu: Unfortunately, there is currently no cure for lymphedema, either from physical therapy or from these surgeries. However, we believe that by addressing lymphedema in earlier stages with some of these surgical therapies, we can slow the progression of the disease and sometimes cause some reversible changes.
Melanie: Tell us a little bit about physical therapy to help lymphedema. What's involved in that?
Dr. Liu: Well, physical therapy usually involves visiting a CLT, or a clinical lymphedema therapist, for, initially, up to three times a week. These physical therapists will fit our patients with specialized garments based on customized measurements as well as provide some objective measures of lymphedema, both in terms of actual measurements of the lymphs, as well as newer technologies that focus on the fluid content in the extremity. By using these objective measures, we can track a patient's progress and their response to physical therapy. Like I've mentioned before, there's a series of modalities that our physical therapists use in combination with these patients. A lot of this can be done at home by our patients with the use of appropriate garments as well as lymphatic pump devices that patients can purchase. It's important to know that physical therapy needs to be there to guide our patients to make sure they get the appropriate support as well as to follow their progress over time.
Melanie: In just the last few minutes, Dr. Lui, what should people suffering from lymphedema be thinking about when seeking care?
Dr. Liu: I think that a lot of people don't realize after their cancer diagnosis what the treatments entail and what the subsequent consequences may involve. Unfortunately, lymphedema is a relatively common phenomenon that happens after a successful treatment of cancer and it can be very debilitating in terms of quality of life. So, one of the important things is to recognize it early; to get into physical therapy early and to slow down the progression of lymphedema over time. With the combination of physical therapy and possibly surgery, patients can often realize a better quality of life by improving their symptoms from lymphedema.
Melanie: Thank you so much. You are listening to Managing Cancer with Cancer Treatment Centers of America. For more information you can go to cancercenter.com. That's cancercenter.com. This is Melanie Cole. Thanks for listening. - Length (mins) 10
- Waiver Received No
- Host Melanie Cole, MS
Every cancer, like every patient, is different.
Additional Info
- Segment Number 1
- Audio File managing_cancer/1528ct1a.mp3
- Featured Speaker Shayma Kazmi, MD
- Organization Cancer Center
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Guest Bio
As a medical oncologist and hematologist at Cancer Treatment Centers of America (CTCA), Dr. Shayma Kazmi individualizes each patient’s treatment plan to fit their specific needs.
Dr. Kazmi earned a bachelor’s degree in pharmacy with high honors at Rutgers University in New Brunswick, New Jersey. As well as membership in multiple honor societies, she received the CVS Pharmaceutical Excellence Award and Excellence in Pathophysiology and Pharmacology Award. To prepare for a career in medicine, Dr. Kazmi immersed herself in research as a Society of Toxicology fellow and neurotoxicology research intern. -
Transcription
Melanie Cole (Host): Every cancer, like every patient, is different. Genomic tumor assessments help identify the DNA alterations that are driving the growth of a particular tumor. As we understand more about these gene mutations, we are better able to provide cancer treatment therapies that specifically target changes in the tumor's genomic profile. My guest today is Dr. Shayma Kazmi. She is a medical oncologist and hematologist at Cancer Treatment Centers of America. Welcome to the show, Dr. Kazmi. Tell us a little bit--people hear the word “genetics,” they hear the word “genomics.” Tell us a little bit about what this field of medicine is?
Dr. Shayma Kazmi (Guest): Overall, there is some confusion regarding genetics and genomics. Usually, when you use the term genetics, it refers to a person's own genetic makeup and the increased, perhaps enhanced, risk of certain cancer development. So, we talk about genetic testing as identifying what mutations you might be carrying that might make you a high risk of developing certain types of cancers. When we talk about genomics, and the language is confusing, however, we are talking specifically about the makeup of the cancer that you might have and how that can get analyzed to look for potential treatment options.
Melanie: So, genetics being the person's make up; genomics being actually the cancer's make up, yes?
Dr. Kazmi: Exactly.
Melanie: So, how do you study what makes up any particular type of cancer or tumor?
Dr. Kazmi: Well, that has evolved significantly over the last few decades. What we used to do and what is still done, is analyze the source of the cancers. So, one of the first things we do is, we review the cancer under a microscope, which is called the “pathology review” and we ascertain where the cancer originated from, such as, is it a breast cancer or is it a colon cancer or is it a lung cancer? Thereafter, we have sub-classifications within the original tumor site as to whether it is a non-small cell lung cancer or whether it's a small cell lung cancer. Then, further on we have sub-classifications. This is important because clinical research thus far groups patients in these kind of classifications to figure out which treatment works best for these patients. Now, what's different on the horizon is that we are not just essentially cocooning ourselves into evaluating cancers based on the origin site or the organ of origination but we are looking to see which mutation--what is the genetic makeup of the cancer--that drives the cancer growth. That's really the cornerstone of genomic testing.
Melanie: Who benefits from this type of advanced testing?
Dr. Kazmi: Really, we hope that everybody with cancer benefits from this testing because, ideally, what it would allow us to do is find the driver mutations that confirm which mutations drive the cancer growth and, ultimately, come up with treatments that are honed specifically at these specific mutations and will have limited side effects because it doesn't, basically, kill the organism--the human being--as well, alongside which is what chemotherapy generally does. It affects everything in a person that's rapidly dividing and has a lot more toxicities. These specific anti-bodies or genomically targeted drugs have the potential of being less toxic.
Melanie: Is this becoming more of a standard of care, Dr. Kazmi? Is this something that you would go to first or is it something that happens after other treatments and testings have not proven effective?
Dr. Kazmi: The short answer is both because there are certain mutations and certain types of cancers where this has been so effective that it really had to be done first. For instance, for non-small cell lung cancers, specifically adenocarcinomas. If you have an EGFR mutation, then you really ought to get the targeted treatment first. If you have an ALK mutation, then you ought to have that genetically targeted drug first. However, this is not cornerstone for everybody else who may have mutations that we haven't quite figured out yet. So, there are a lot of mutations that either we have not studied in detail in terms of getting a particular antibody or there are a lot of mutations we don't even have a drug, even in production in any pharmaceutical company, to target yet. So, for a lot of cancers this still remains experimental and still remains in the research arena but for a lot of cancers right now, it's happening and it's frontline. We hope in the next couple of decades that it becomes more frontline for more of the cancers.
Melanie: If you and your oncologist decide you are a candidate for genomic testing, how does that process work?
Dr. Kazmi: Actually, it's very simple. The patients themselves just have to consent to that and, really, the biopsy sample that, hopefully, has already been ascertained is what's sent off to a particular genomic testing lab. There are many, many options out there. It's a matter of a preference either of the oncologist, of the surgeon or the patient and depending on that, it's sent off to this lab for analysis and results usually come back anywhere from 3 to 4 weeks thereafter.
Melanie: So, not that really difficult. Now, just tell us what you're finding on the horizon in this field of advanced genomic testing?
Dr. Kazmi: What's really exciting is the fact that we are no longer tied to just doing research on breast cancer drugs because somebody has a breast cancer, for instance. What’s exciting is that if you have a particular mutation and that mutation is often found in, say, melanoma and there is a drug for that BRAF mutation in melanoma patients that works wonders, patients with other cancers who might have that mutation have access to those drugs as part of clinical trials a lot sooner. Traditional clinical trials take decades and decades to result anything meaningful and that's very, very costly and also takes a very long time. For patients who really need the treatment here and now, that's a very frustrating ordeal. So, what we are finding is that a lot more options are out there. I think a lot of pharmaceutical companies are also making more of these targeted drugs. So, there are more and more options for clinical trials, too. So, it's really very exciting.
Melanie: So, in just the last few minutes, Dr. Kazmi, if you would, tell the listeners what you really want them to understand about advanced genomic testing and why they should come to Cancer Treatment Centers for their care.
Dr. Kazmi: The most important thing that I would tell a patient with cancer is, get all the information. Get second opinions or third opinions all the time. There is a lot, a lot, a lot of progress in the world of cancer literally every day and every week I find that a lot of patients come from areas where the doctors are not well-informed about the recent advances. So, I would recommend that they get second and third opinions. I would recommend that they understand as much as they can about their cancer and their potential treatment options and when they do, they basically should treat where they feel most comfortable.
Melanie: Thank you so much for such fascinating information. You are listening to Managing Cancer with Cancer Treatment Centers of America. For more information, you can go to cancercenter.com. That’s cancercenter.com. This is Melanie Cole. Thanks for listening. - Length (mins) 10
- Waiver Received No
- Host Melanie Cole, MS
Pancreatic cancer is one of the deadliest cancers. Rates of pancreatic cancer have been slowly increasing over the past 10 years.
Additional Info
- Segment Number 2
- Audio File managing_cancer/1349ct5b.mp3
- Featured Speaker Madappa Kundranda, MD, PhD
- Guest Website Cancer Center
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Guest Bio
A medical oncologist with Western Regional Medical Center (Western), Dr. Madappa Kundranda, PhD, joined Cancer Treatment Centers of America (CTCA) in August 2012. His main focus is on patients with gastrointestinal cancers, but he also treats a variety of other types of advanced-stage and complex cancers.
Dr. Kundranda obtained his medical degree from Bangalore University in India, before earning a PhD in cancer biology from Meharry Medical College in Nashville. Dr. Kundranda next completed an internship and residency in internal medicine at Fairview Hospital, a Cleveland Clinic Hospital. He then finished a hematology/oncology fellowship at the Mayo Clinic in Scottsdale, AZ.
Originally, Dr. Kundranda had planned to earn a PhD in neuroscience after medical school. However, after his first cancer biology course, he was intrigued by the rapid innovations in clinical methodologies and how research was influencing the field of cancer medicine. When his father was diagnosed with colon cancer in 2003, Dr. Kundranda also started paying attention to the way that patients and caregivers felt about the treatment process, and how important it is for physicians to focus on maintaining the patient's quality of life while going through treatment.
Dr. Kundranda is a member of numerous associations, including American Association for Cancer Research (AACR), American Society of Clinical Oncology (ASCO) and the American Society for Hematology (ASH). He has given presentations on various cancer topics throughout his career at conferences such as the AACR Annual Meetings and ASCO Annual Meetings. He has also published numerous scientific peer-reviewed papers, abstracts and book chapters. - Length (mins) 10
- Waiver Received No
- Host Melanie Cole, MS
What is hospital medicine? How does it play a role in cancer care?
Additional Info
- Segment Number 1
- Audio File managing_cancer/1349ct5a.mp3
- Featured Speaker Matthew Wright, MD
- Guest Website Cancer Center
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Guest Bio
Dr. Matthew Wright joined Cancer Treatment Centers of America in July 2012 as the Chief of Hospital Medicine. In this role, he supervises the full-time hospital medicine team at Western. Dr. Wright also participates in direct care by managing the entire hospital stay for acutely ill medical patients admitted to the inpatient unit,and provides medical consultative care to surgical patients admitted to the inpatient unit.
Dr. Wright earned a medical degree from Eastern Virginia Medical School in Norfolk, Virginia. He then completed a residency in internal medicine at the University of Utah School of Medicine in Salt Lake City. While completing his residency, Dr. Wright joined the United States Air Force. After residency, he served as an internist stationed at Luke Air Force Base in Arizona. Prior to joining CTCA, Dr. Wright was the Medical Director of Hospital Medicine for a hospital in Montana. He is active in the Society of Hospital Medicine, American College of Physicians and American Medical Association. - Length (mins) 10
- Waiver Received No
- Host Melanie Cole, MS
For most men diagnosed with prostate cancer, there are many treatment options. How do you decide which one is best for you?.
Additional Info
- Segment Number 1
- Audio File managing_cancer/1338ct4a.mp3
- Featured Speaker Dr. Evan Pisick, MD
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Guest Bio
Dr. Evan Pisick earned a bachelor's degree in biology at the University of Rochester; and his medical degree from Boston University. Thereafter, Dr. Pisick completed an internship and residency at Mount Sinai Medical Center in New York City, followed by a fellowship at Tufts Medical Center in Boston. His extensive research on small cell and non-small lung cancer, as well as malignant mesothelioma, has been published in a variety of scientific journals, including Hematology/Oncology Clinics of North America, Anticancer Research and the Journal of Experimental Therapeutics and Oncology.
- Waiver Received No
- Host Melanie Cole, MS
Orthopedic oncology specializes in the treatment of bone cancer, sarcoma or cancer that has spread to the bone from other areas of the body.
Additional Info
- Segment Number 2
- Audio File managing_cancer/1338ct4b.mp3
- Featured Speaker Dr. Richard Schmidt, MD
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Guest Bio
Dr. Richard Schmidt graduated from Pennsylvania State University College of Medicine in 1980. He completed an internship, orthopedic residency and fellowship in orthopedic research at the Hospital of the University of Pennsylvania in 1985. Additionally, Dr. Schmidt completed an orthopedic oncology fellowship at Shands Hospital at the University of Florida in Gainesville. Dr. Schmidt specializes in sarcomas, which includes cancer of the bone and soft tissue. He also has significant experience in treating metastatic bone cancer. He is known for his expertise in the surgical management of limb salvage surgery.
- Host Melanie Cole, MS
