Joey Wahler (Host): It affects so many directly or indirectly. So we're discussing cancer care. Our guest is Dr. Gaurav Goel. He's a medical oncologist and hematologist with St. Clair Health. This is Curating Care, a podcast brought to you by St. Clair Health. Expert care from people who care.

Thanks so much for joining us. I'm Joey Wahler. Hi there, Dr. Goel. Welcome.

Gaurav Goel, MD: Hi Joey. Thank you so much for having me.

Host: We really appreciate the time. So first, you are of course, a practicing hematologist and medical oncologist. So what do these terms mean in a nutshell for those that may not be completely familiar? And what kind of disorders do you typically treat?

Gaurav Goel, MD: Hematology as a medical specialty, focuses on disorders of the blood, bone marrow, lymphatic system, and this can include both benign as well as malignant conditions. Medical oncology on the other hand, deals with diagnosis and management of cancers arising in various solid organs of our body.

As a hematologist and medical oncologist, I specialize in treatment of both sets of conditions.

Host: And being board certified in both fields makes me wonder how they overlap in your everyday work.

Gaurav Goel, MD: As a dual specialist, I often manage complex cases where blood disorders and solid cancers intersect. A good example of that would be leukemias and lymphomas. This dual expertise allows me to provide a comprehensive and a personalized care to our patients.

Host: And we of course, hear so much doc about cancer. What's the burden of it in our society these days?

Gaurav Goel, MD: Cancer, unfortunately continues to be one of the most significant global health challenges. Its burden is not just medical. It goes much more deeper than that. It is emotional, economic, as well as societal. Cancer is currently the second leading cause of death in the United States only after heart disease. In fact it is estimated that in 2025 alone, cancer deaths would account for more than 600,000 deaths in the United States.

Host: Yeah, no question. It's hard to find anyone these days that hasn't been touched by it either, as I touched on at the top directly or indirectly. So that being said, what are the more common cancers you're treating these days?

Gaurav Goel, MD: So some of the most common cancers that affect males include cancers to the prostate, lung, colon. Among the females, the most common cancers are the breast cancers, lung and colon cancers. So we are treating pretty much every cancer type, but these cancers, just because of the sheer volume and the prevalence, we tend to treat more of these cancers.

Host: And what are some of the comprehensive cancer care services offered at a high level at St. Clair?

Gaurav Goel, MD: We at St. Clair offer a very wide range of services to support patients through every stage of their cancer journey. These include core treatments such as chemotherapy, immunotherapy, targeted therapies, radiation treatments, surgical removal of tumors, blood transfusions, you name it. We also provide supportive care geared towards pain and symptom management.

We have dieticians in our office to help make personalized dietary plans. In addition, we also provide diagnostic services including imaging modalities such as CT scans, MRI, PET scans, mammography. We have pathology and lab services to perform biopsies and blood tests. We also have a very robust survivorship program here for long-term follow-up care of our patients.

 We are able to provide services such as cold capping, which helps to reduce the chances of hair loss. In addition, we have financial counselors, transportation services. The list goes on and on and on. But really, Joey, what's most important to note here is that all of these services are designed with a very specific goal in mind, which is to treat the patients as a whole, physically, emotionally, socially, and not just the disease itself.

In addition, what's really commendable is that the Dunlap Family Outpatient Center really helps to bring all of these services together just under one roof, which to me, I feel is a huge deal in terms of convenience for our patient community right here in South Hills.

Host: Yeah, because when you're dealing with cancer, either as the patient or a loved that's involved, certainly, one of the last things you want to have to deal with is the added stress of transportation and getting to and from a place for care, et cetera. Well, the St. Clair Hospital Cancer Center is of course affiliated with UPMC Hillman Cancer Center, and one of St. Clair's pillars is providing advanced care close to home, as you just pointed out, doc, delivering world-class medical services, but in a convenient comfortable setting. So how does the power of Hillman help bring that directly to patients right there in the South Hills?

Gaurav Goel, MD: The affiliation between St. Clair Hospital Cancer Center and UPMC Hillman Cancer Center is a very powerful partnership. It brings world class cancer care directly to the South Hills community without needing to travel far from home. In fact, I see this as a perfect example of how expertise needs accessibility.

 Patients at St. Clair benefit from expertise of UPMC Hillman Cancer Center's nationally recognized team. The affiliation also provides the patients with access to clinical trials and opportunities to participate in cutting edge research and that too, right here in South Hills. Our team of medical oncologists here at St. Clair includes six medical oncologists, Dr. Reyes, Dr. VanderWeele, Dr. Marsh, Dr. Hunter, Dr. Senchek, and myself. And I can't even express how fortunate I feel to be a part of this team. All of us work closely together with only one goal in mind, which is to provide our patients with excellent quality care every day.

Host: And when you say that, doctor, how about the extended cancer care team at St. Clair, if you will? The total effort between you doctors that you mentioned, but the nurses, radiologists, pathologists, and beyond. It's really a true team effort. How does the cancer center rally around each patient with all of those people involved?

Gaurav Goel, MD: Absolutely. The treatment for each cancer patient at St. Clair is a collaborative team effort between the different members of the team that you pointed out. And in addition, we here at St. Clair individualize treatment based on every patient's unique situation because we know that no two cancer patients are alike. Just to give you an example, we routinely perform tumor DNA sequencing that helps to tailor treatments to each patient's unique cancer biology. It helps to improve effectiveness of therapy as well as reduce the side effects. In fact, our team at St Clair takes immense pride in providing personalized treatment to every patient, always with that one goal in mind, to achieve the best possible outcomes for our patients.

Host: And indeed a big part of that is you and yours being up on the very latest treatments and technology. And so how have oncology and cancer treatments evolved in recent years, would you say?

Gaurav Goel, MD: We have made tremendous amount of progress in the field of medical oncology as well as hematology in the last several years. Until recently, we had three major treatment modalities against cancer, which included surgery, chemotherapy, and radiation therapy. Now we also have immunotherapy, which has really been a game changer for oncology within the last decade.

In fact, immunotherapy has significantly improved the outcome of certain cancers. Which in the past were thought to carry a really, really poor prognosis. A perfect example of that is melanoma. In addition, with immunotherapy, we are now able to effectively treat patients that are elderly patients who have multiple comorbidities and those with limited performance status.

So I think we have come a long way and we have made a lot of progress in the last few years.

Host: It's certainly great to hear and yet, despite that significant progress, doc, what do you still see as some of the main challenges in your field of medical oncology?

Gaurav Goel, MD: It is true. As I pointed out, you know that medical oncology is advancing rapidly, but we still have a lot of challenges that we need to overcome. To name a few, we have made rather limited progress in some of the most aggressive cancers such as pancreatic cancer. Another example would be a subtype of breast cancer called triple negative breast cancer.

And these cancers still remain quite difficult to treat. Another challenge that we are facing is that we are seeing a tremendous increase in incidence of certain cancers among young individuals, such as breast cancer, colorectal cancer, and we're still trying to understand the underlying factors that are contributing towards this change.

 There are also significant racial inequalities in cancer mortality that still persist with African-Americans being adversely affected. So I think we still have a lot of work to do.

Host: And so having said that, from your experience, what can be done to try to overcome some of those challenges and how would you say the cancer center at St. Clair is contributing toward that?

Gaurav Goel, MD: So one of the most effective ways, in my opinion, to overcome some of these challenges is by encouraging patient participation in clinical trials. And here at St. Clair, we feel so fortunate that we are able to provide our patients with access to clinical trials, right here, close to home without having to travel long distances.

Another effective way would be focusing on cancer prevention and early detection because we know that cancer screening helps to detect cancer at early stage when treatment if carried out at early stage can be often geared towards achieving cure rather than just palliation..

Host: A couple of other things for you. As an oncologist, you of course deal with a lot of very sick people. Often can be very emotional, not just for the patient and their families, but also for doctors like yourself. So what would you say drives you as an oncologist and motivates you each day?

Gaurav Goel, MD: To me, every patient brings with a unique story, a life full of dreams and challenges. Being entrusted with their care is a very deeply humbling experience to me. I understand that not every day we will result in a cure, but the small wins we see each day, such as shrinking of the tumor size, managing side effects, easing pain and suffering seeing a patient's smile.

These are some of the things that are immensely satisfying to me. And of course, there's nothing like seeing a patient ring the bell after finishing treatment. So all those moments are truly everything for me. It gives me a sense of purpose. It makes you feel that you can make a meaningful difference in somebody's life, and that's a very sacred thing, I feel.

In fact, that's actually about what gets you up in the morning, even on the hardest days.

Host: Yeah, beautifully said, and you make a great point that people often think of doctors like yourself as being those who have patients' lives in your hands, but you use the word dream, you often have their dreams in your hands too. So what's your message to people of any age joining us who may be putting off annual checkups and preventative screenings that are so crucial here?

Gaurav Goel, MD: If I had to make just one recommendation to my fellow community members today, it would be this. Don't wait. Get screened. I would urge everyone in the community to take out time for yourself despite your busy schedules. Go for that annual checkup and routine screenings, because the truth is that early detection saves lives, and that's proven with research, whether it's a mammogram, colonoscopy, pap smear, skin exam, or even simply talking to your doctor about the risk factors.

Taking that first step could be the most important decision you'll ever make. And I feel very confident in saying that this single simple step will go a long, long way in promoting your health and wellbeing.

Host: It will indeed. And in summary here, doctor, St. Clair's new current campaign is Healing Lives Here. So when a patient goes through advanced treatments and comes through cancer free, how rewarding is that? What does it feel like at the end of the day?

Gaurav Goel, MD: It's incredibly moving. It's a triumph of science, resilience, and hope. I feel it's about reclaiming life and restoring someone's future. When I think about it, I sense the feeling is a mix of both pride and gratitude.

You feel pride in the team's expertise. You also feel gratitude for the trust that the patients place in you as their caregiver. All in all, it's an incredible feeling.

Host: Probably oftentimes, doctor, the sacred trust to use your word, between doctor and patient, especially when it comes to cancer, might be overlooked by the general public. It really is a sacred trust and you clearly take that very seriously and your passion for what you do really comes through. Well, folks, we trust you are now more familiar with cancer care.

Dr. Goel, keep up all your great life changing and lifesaving work, helping people not just to live, but to again, realize their dreams. It's a big responsibility. You seem very much up to it, and thanks so much again.

Gaurav Goel, MD: Thank you so much, Joey. Thank you for having me and allowing me to share what we have here to offer to our community. Really appreciate it.

Host: Absolutely. As do we. And to learn more about Comprehensive Cancer Services at St. Clair Health, please visit stclair.org. To contact Dr. Goel, please call 412-942-8701. If you found this podcast helpful, please do share it on your social media. I'm Joey Wahler. And thanks so much again for being part of Curating Care.

A podcast brought to you by St. Clair Health. Expert care from people who care.