Mara Antonoff, M.D. Hi, I'm Mara Antonoff, and I'm an associate professor of Thoracic and Cardiovascular Surgery at MD Anderson Cancer Center. I'm joined today by Leah Phillips, who is a stage IV lung cancer survivor. And we welcome you to the Cancerwise podcast. I'm so happy to have you here today, Leah. 

Leah Phillips Well, thanks so much for having me. 

Mara Antonoff, M.D. I'm really excited about this discussion. We're going to delve a little bit into your experience as a cancer patient, a cancer survivor, and really your experiences getting a cancer diagnosis at such a young age. Could you start by just sharing a little bit with us about how and when you were diagnosed?

Leah Phillips Sure. So, I was diagnosed in December of 2019. I started with a cough, which obviously was lung cancer in September, but it took until December for an actual diagnosis. I was 43 at the time with kids that were nine, just turned 13 and 14. So, it was a pretty big shock because I had no known risk factors for lung cancer, and so, I was kind of blindsided. If somebody would have told me it was breast cancer or ovarian cancer, I could've wrapped my head around that. But lung cancer was a big one. 

Mara Antonoff, M.D. Yeah, certainly wasn't something that you were thinking about. And so, at the time, you were experiencing a cough, and you sought treatment from your primary doctor at that time? 

Leah Phillips Yes. So, at the beginning of September, I went to the doctor for this cough that just would not go away. And she felt sure that it was just like a post-viral cough gave me some steroids. And amazingly, I felt so much better on those steroids. But then it just kept coming back. So, I think I made about eight trips to my primary care physician. There was a little bit of lapse of care because my original PCP went on FMLA, and so then I saw a few different people in the practice before I was admitted to the hospital in November for antibiotic-resistant pneumonia and clearly was not pneumonia. And then back in the hospital on December 13th, I was admitted with, where they drained a liter of fluid off my right lung and that came back malignant. And then it was a bone biopsy to tell us it was lung cancer, and then biomarker testing from there to figure out exactly what I was dealing with. 

Mara Antonoff, M.D. Yeah. You know, your story is not one that's so uncommon for patients who have lung cancer at a younger age of diagnosis, even though it's not the typical story of what we might envision when we talk about lung cancer, your experience is very similar to other individuals who are diagnosed at a younger age. And we can talk about that a little bit more. But I do want to hear a little bit more from you about after you got this diagnosis and began your treatment journey, what led you to come to MD Anderson for your care here? 

Leah Phillips So, when I was first diagnosed, I was told that 5% of people would be living five years later with lung cancer, stage IV lung cancer. And I remember looking into the eyes of my nine-year-old and thinking, "I can't do that. I have to be here for this." And I looked at my husband one night after, like I went through a few weeks of just depression, really, and just crying and just terrible. And then I finally was like, "You have to pull yourself up from your bootstraps. Like you don't ever take things like this. You've got to face it." So, I looked at my husband. I said, "You know, they say 5%, so somebody's got to make up the 5%. So, it might as well be me." And he was like, "Do you really feel that way?" I said, "Yeah, I'm going to be one of the 5%." And from that day forward, it was kind of like that was that was my motto. That was my mission. And I just kept pushing the envelope with care. I mean, we did biomarker testing. I started doing my targeted therapy, which was I was having great response to. But then I felt like, okay, if statistically I'm only going to live five years, now I'm a year into this. What next? I can't just sit here and be a waiting duck. And they had also said that targeted therapy I was on would probably only work for two to three years. So, the closer we got, I pushed and pushed and pushed to do something aggressive. And so, I had radiation to my primary tumor. And then I did well with that. And then I kept thinking, now what? Now I just sit and I'm a duck again. So, I said, "I need to, I need to find the right place." And I actually led that webinar with you and Dr. Gay and heard about surgically resecting late stage lung cancer, which I had always been told, like, that's never going to happen. And then I tracked you down and the rest is history. 

Mara Antonoff, M.D. Yeah. Yeah, certainly. We're, we're very glad that you knew in your heart that you would be one of that 5%. I think that's incredibly important that that you did for yourself and for your family, really turn over every stone, look for every opportunity to make sure that you were able to get the best outcome for yourself possible. And I think the other pivotal piece that I see here is that in getting to know you and knowing everything about you, not only have you worked hard to make yourself part of the group that is overcoming the odds, you've worked hard to make sure that everyone out there, everyone that connects with you, recognizes that there may be other stones that they can turn over, or other opportunities that they may have to be eligible for a clinical trial to get care that may not be available in their own local environment. And I would argue to say that you have been a big part of trying to push to ensure that that 5% becomes greater and greater as you've encouraged other people who are younger with lung cancer to find other opportunities and other ways to do everything they can to get the best possible outcome and to have access to the best care available to them. 

Leah Phillips I just feel like all of us deserve the best possible care, and MD Anderson has been nothing short of that. Every employee is happy and nice, and you get the answers that you need. And this is what I want for everybody. I've talked to so many patients, and I remember sitting in their shoes thinking, "This is it. I've got two years." And that's not really the reality anymore, and everyone deserves to know that. And I advocate not only for myself, but for all those other people out there. 

Mara Antonoff, M.D. Yeah, I absolutely agree. And I'm so grateful that you do all the advocacy that you do. And I know that you've certainly been a warrior for all patients with lung cancer, but you've been really impactful and powerful in the space of patients who have lung cancer at an earlier age and earlier stage of diagnosis. Should we talk about that for a little bit? 

Leah Phillips Sure. 

Mara Antonoff, M.D. So, what are the questions you have about patients getting lung cancer at a younger age? 

Leah Phillips I mean, I think the the biggest question is why is this happening? Or how do we, you know, why is it trending in this way? I know there may not be an answer as to why it's happening, but it just seems like there's so many of us being diagnosed young. And have you seen any trends to that? 

Mara Antonoff, M.D. Certainly, we have seen patterns that more and more individuals are being diagnosed at a younger age of their life and also at a later stage when it's younger people, and that combination comes from some things that we are starting to understand, as well as some things that we don't understand as well. More of the younger people who are diagnosed with lung cancers tend to have oncogene-driven disease. So, there's a mutation that's causing their cells to overturn more quickly and to form those, those cancers. Now, the reasons why they're developing these mutations are not entirely clear. And there are a million different little factors that may be contributing. It might be multifactorial, and some of them may be genetic. They may be exposures to various things in our environment. And we certainly know it's happening at a greater frequency and potentially being recognized at a greater frequency. It may have been historically that people who had stories or experiences like yours may have never been correctly diagnosed as having lung cancer. And so, certainly, we're getting better at identifying this. It's important that we are recognizing that lung cancer in younger folks is, it's a different beast. It does very much more frequently tend to be related to a mutation that has taken place in these cells that are in their lung, and this isn't typically what we would consider a germline mutation. It's not a mutation that's in every cell of their body. It's not something that they would necessarily pass on to their children, but there's something going on in their lungs. And really, anybody with lungs can get lung cancer. The other challenging piece that's really pushing us to want to find as many ways that we can to help young people, people like you who are diagnosed with young children and a lifetime still ahead of you, is the acknowledgment that folks with lung cancer at a younger age are being diagnosed much later stages. And there are a couple of reasons. One of them is that, you know, people tend to have perceptions that lung cancer is an old person's disease. Young, lung cancer is a smoker's disease. And when there's someone who's young and healthy and active, it would be less likely that their care providers are going to do more aggressive means to evaluate their symptoms, to figure out what's going on. And another piece of that is that we are more able to diagnose older folks or smokers with lung cancer at an early stage because of our ability to engage in lung cancer screening. And it's not that we don't want to screen younger people who may be at risk for lung cancer, but rather we don't yet have reliable predictors to determine whom we should test. So, in general, we think of a screening mechanism as a test to identify people that are at increased risk of having that disease before they have any symptoms at all. Not like once you already had a cough. And so, we think of things like pap smears or screening colonoscopy, mammography, a PSA in the blood. Those are all determined for people who are already at elevated risk of having that disease. We can give reliably the predicted elevated risk for someone who is a smoker, based on their age and how many years they've been smoking. But if you look at all comers, all young people, even though it's more common than it used to be, most young people will not get lung cancer at a young age, and so, applying those types of screening tests to all young individuals doesn't necessarily make sense when we look at resources, as well as risks of the screening exams that we have right now. Because right now, the best screening test we have is a low-dose CT scan. Perhaps someday there will be a blood biomarker we can do for every person that will look at their risk for any cancer. But that's just not where our science is right this moment. And so, it really is a true phenomenon of having more and more younger people being diagnosed with lung cancer. That's not only at a time in their life when they are otherwise healthy and fit and strong and ready to begin their careers, begin their family life. It's often at a later stage where they're being given information about traditional prognostic, prognostic information and predictors of their likelihood of survival based on what we used to see, what we're accustomed to seeing in older people, in smokers and people of other comorbid conditions, other health problems in people who maybe aren't candidates to receive great drugs like tyrosine kinase inhibitors or other targeted therapy. So, I know it was a straightforward question with a pretty complex answer, but that's kind of where we're at and why all of the phenomenal work that you're doing is so pivotal and so incredible to making sure that we're looking out for patients who are younger and are being diagnosed with lung cancer and maybe aren't getting access to the resources they need wherever they live. 

Leah Phillips Yeah, I think that's that's the truth. And, you know, I think going hand in hand with that is also people need just to be aware that you can get lung cancer at a young age. That's always been something I've tried to explain is that if you have lungs, you're at risk because you we don't know what makes me more susceptible versus you. So, I do think just getting the word out there that this is not just a cancer that people get who have a smoking history or who are in their 70s or 80s is huge. 

Mara Antonoff, M.D. Yeah, absolutely. Would you say from so many of the young lung cancer patients with whom you've connected, most of them were surprised at getting their diagnosis and maybe had symptoms that were overlooked for some time? 

Leah Phillips Oh, absolutely. And it's interesting when I talk to these patients, so many of us were diagnosed with the same things leading up to our actual lung cancer diagnosis. Anxiety is a big one, especially for women being told, "Oh, you just have anxiety. That's why you're having trouble breathing." Or pneumonia is a common one I hear. Asthma, exercise-induced asthma because, ironically enough, a lot of these people I talked to were like me. I mean, I ran the morning, I was admitted in the hospital on December 13th, even though I couldn't breathe very well. I was like, "Well, I'm going to get out there and do this is. This is just a cough." You know, kind of a thing. So, I definitely think that just getting the word out there and, and letting people know what symptoms are symptoms of lung cancer. So, you can advocate for yourself. So, I don't know if you have any, you know, I had a shortness of breath, which I mean cough rather, that eventually turned into shortness of breath and some pain on my right side. But what are some other types of, I guess, symptoms of lung cancer that we should be aware of?  

Mara Antonoff, M.D. Sure. You know, the cough and shortness of breath are really the most common, most frequent. Some of the other symptoms that may indicate a lung cancer may be coughing up blood. It may be development of pain or discomfort in the chest, chest, wall, or even in the arm. It can be associated with change in voice or even developing hoarseness. And if, unfortunately, if the cancer is spread elsewhere, people may even have symptoms of where it has spread. For example, if it has spread to the brain, we have met younger lung cancer patients who may have been diagnosed actually because they developed weakness or a seizure or difficulty speaking or swallowing, things like that. So, I would say the most common symptoms, again, are a cough or a respiratory infection that doesn't seem to go away despite appropriate treatment. But again, some of those other things that may happen might be hoarseness or other symptoms of, of it maybe going elsewhere. We've had patients who've been young and fit and runners like yourself who've unexpectedly broken a bone, perhaps because the cancer has spread to their bone. And so, we don't want to make people in general become fearful that everything, every symptom is cancer. But it's really important for everyone to recognize that all of these things are really in the list of possibilities when you're having those symptoms. And, you know, a brief cough is reasonable, a cough that doesn't seem to go away definitely merits further exploration. And sometimes health care providers can benefit from a little bit of reeducation or some insight into what the patients are worried about, because sometimes patients have greater insight about what's going on in their bodies than, than we do as health care providers. So, I think all of the work you're doing to really educate people about symptoms and when to advocate for themselves is super important. 

Leah Phillips Well, thank you. 

Mara Antonoff, M.D. I'm interested to hear from you, really from your perspective as a survivor. I've gotten to know you a lot through your specific health care journey. But I think understanding, you know, your perspective over time and things that you've learned that you perhaps wish you knew when you were first diagnosed. I know so many people come to you for advice, and, you know, you've been instrumental for helping an inordinate number of people, but I'm sure that you share with them some of the pearls, some of the pitfalls, little elements of wisdom that maybe you wish someone had told you back when you're first diagnosed. Can you share some of those with our listeners today on the Cancerwise podcast? 

Leah Phillips I feel like, you know, everybody asks me, "What should I be doing? What's your best advice?" And, you know, my best advice is to one: prioritize your health, first and foremost. Make sure you're getting the care that you deserve. And don't be afraid to ask the questions. Especially, I see this with women that I talk to. They're like, "Well, he said," meeting the doctor, "he said this. He said." But um, you know, you can speak up and ask him the question, you know. So, speak up. Make sure you're getting reliable information. Try not to go on Google. It's so hard not to. But, you know, a lot of times that is incorrect or it is outdated. You know, I always say try not to pay attention to those statistics because they're terrible and it's not going to serve you well at all. I think for a lot of people, being able to get a second opinion is huge. And that's something that not everybody can, or knows how to navigate, right? You know, like they don't want to hurt the doctor's feelings or whatnot. And then, you know, honestly, because of the ages that we're being diagnosed, we have children that are still at home with us. And that is probably the hardest part. As you're navigating, you don't feel well and you're upset, but you're trying to stay positive for your kids. The kids get a vibe. Kids pick up on things. So, I may, I was a teacher prior to staying with the kids. So, I made a concerted effort to make sure to get them kind of like the emotional and mental support they needed through play therapy and art therapy, whatever was age appropriate because it is very heavy on their minds. So, um. 

Mara Antonoff, M.D.  I can only imagine. So, let me pose this question to you, because I'm sure listeners who have young children may be wondering the same thing. I have talked to parents of children when they're dealing with cancer diagnoses in their family. And, you know, I can speculate as a mother, I have four children, and we have not been through what you've been through. But, you know, I've tried to pick up a little ways to parent over the years. And, you know, I've heard really two different perspectives when it comes to sharing information with children when there's a cancer diagnosis present. Some people feel like it would be overwhelming or exhausting or unfair to to put that weight of that information on the children. And I think the perspective that I tend to lean toward, and what I've heard from a lot of the patients whom I've treated, is that the kids are going to figure it out anyway, and the option is that you give them as much information as possible in the tools to kind of navigate this journey and this process in a healthy, more open, communicative way. And also recognizing that, like you said, kids pick up on that vibe. So, if you don't tell them what's actually going on and they pick up on the vibe anyway, they may be wondering, is she upset because I didn't get my homework on time, or because I got a B-plus instead of an A? Or did I, you know, not tie my shoes fast enough? And there are a lot of ways that kids can project what we are saying or doing on to their own experiences and think that they're at fault, when in fact we are just carrying the weight of something else that we think is too heavy for them. But they're also carrying the weight as well. 

Leah Phillips Right. 

Mara Antonoff, M.D. What are your views about that? And what would you advise parents who are kind of on that, that, that decision where they're trying to figure out what to share with their children? 

Leah Phillips So, for us, we had kids at kind of different ages. You know, we had a nine-year-old, we had a 13- and 14-year-old. What you can say to a nine-year-old is different than what you can say to a 14-year-old. We always feel like honesty is the best policy. No, I wasn't sharing the statistics I was given with them. We weren't sitting down saying, "Well, they've told me." You know? But we made sure to tell each of them kind of individually what I was dealing with. I was in the hospital for, for over a little over a week, so they knew I wasn't well. I'd lost quite a bit of weight. You know, I was pretty miserable. So, we were honest in the fact that, you know, mom has lung cancer and that, you know, we're going to do everything we can to get the best care possible, but we're not going to keep it a secret from you. And you know, my nine-year-old, as I started feeling better physically was like, "Mom, I'm so proud of you. You've beat cancer." And, you know, I didn't correct and be like, "Oh no, no." You know, but on the other hand, my 14-year-old, we found, we went through a search history, and he was looking on Google, and the anxiety was overwhelming for him. So, we quickly decided, "Okay, we're going to make a deal with you. If you have questions, please ask us." 

Mara Antonoff, M.D. Right. 

Leah Phillips "And if you don't think you could ask us which you think, it's going to embarrass us. You could text us. You could little write a little note, but we'll get you the right information so that you're not nervous." Because every child is different. 

Mara Antonoff, M.D. That sounds like a great policy when you're talking about cancer or talking about anything. 

Leah Phillips Anything really, right? 

Mara Antonoff, M.D. That's great. 

Leah Phillips So, you know, we kind of we, you know, my kids are bigger now. In fact, I have a 20-year-old, an 18-year-old and then a 15-year-old. And now they're like, when I have scans, they're like, "Well, you're going to call us right after, right?" 

Mara Antonoff, M.D. Yeah.

Leah Phillips They're like, "We don't want surprises." 

Mara Antonoff, M.D. Yeah.

 Leah Phillips And that's like more of an adult mentality. 

Mara Antonoff, M.D. Right. Right. 

Leah Phillips So, you know, I always, I had in my back pocket before we had the conversation with them, the mental health people that I needed. I had already found a play therapist and a music therapist. So, I kind of was, you know, I contacted the teachers to let them know it was going on. "Please don't talk to him about this, but this is what we're dealing with at home." Just to give them as much support as I could. 

Mara Antonoff, M.D. Sounds like you are very proactive in seeking what your kids would need. And, you know, even for parents or listeners who may not have those connections or those resources, I think, you know, working even with child life specialists in a health care setting can be incredibly important. That's certainly one of the things that we offer here for our cancer patients. Let me ask you, I, I know you already had three children at the time that you were diagnosed, but every family's pathway to to growth is different. Did anyone approach you at all or discuss with you oncofertility or options if you did want to have more children? Was that ever discussed? 

Leah Phillips It was refreshing that Dr. Singhi did ask me about oncofertility, but I said, at that point I looked at my husband and I thought, "Our chapter is closed here." So, we didn't really investigate any further at that point. We knew we had the three kids that we were meant to have, and we were, we were set. 

Mara Antonoff, M.D. Good. Well, I'm still glad that he did ask you, because certainly there are patients at different stage of their life who may be continuing to look at growing their family, regardless of their exact age and how many kids they may already have in their family. 

Leah Phillips It always really is hard for me to hear when I talk to a 30-year-old or 28-year-old that says, "Now they're telling me I'm not going to be able to have kids," you know? Or if I talk to them before we get there, I'm always like, "Make sure you ask." 

Mara Antonoff, M.D. Right, right. 

Leah Phillips Ask. You you deserve to ask that question. 

Mara Antonoff, M.D. Absolutely. And it's something where, you know, health care providers, more than anyone, should recognize. There's limited windows, you know. 

Leah Phillips Right. 

Mara Antonoff, M.D. Of, of being reproductive.

 Leah Phillips Right. 

Mara Antonoff, M.D. And I think we're finally getting a little better at asking women about it. But I don't know that our line of questioning is always appropriate. Sometimes you only ask when you see, oh, this is a newlywed couple, and maybe they want to have children. You know, we don't always think about it if someone already has children. Or if they don't come with their partner or their significant other. And I think that's not always going to include everyone who needs to be included. And likewise, I would say this is one of the limited situations or rare situations where we do a better job of advocating for our women than we do for our men when it comes to their reproductive needs. And I think we, we don't often recognize the fact that while men may not carry the child or need to be pregnant, many of the drugs that we have for young patients, particularly some of the tyrosine kinase inhibitors, can dramatically impact sperm count. But as I understand it, that's one of the situations that can be preemptively dealt with. 

Leah Phillips Easily.

Mara Antonoff, M.D. Quite easily. 

Leah Phillips Yes. 

Mara Antonoff, M.D. Before they start the drug and banked in a, in a way to continue to grow their family in whatever way they would like. But all it requires is that conversation and that that brief discussion of what the options are. And so, I think this is an area where, you know, I'm definitely continuing to learn, and I hope that others around me will continue to learn. I think there's so much more that we can do. It may be that we are all limited by this historic perspective that stage IV lung cancer is, this is the end of the road and start planning for the end. When, in fact, there may be many opportunities to build and grow a family and to watch that family thrive and get through many more milestones, holidays, graduations, all of the good times and hard times and everything else. And I think, you know, you've given a lot of hope to a lot of younger people. 

Leah Phillips Well, thank you. 

Mara Antonoff, M.D. With lung cancer because you have watched your kids, you know, go through— 

Leah Phillips Yes. Yes. 

Mara Antonoff, M.D. So many wonderful events. And I think that's really, really important as well. So, recognizing that, it would be great for the two of us to maybe think about how we could best advise patients with young lung cancer to get information. I certainly have my thoughts. Can you share a little bit more about what you deem to be the best ways? And I'm happy to share mine. 

Leah Phillips I think getting the, I think, you know, the first appointment you go to you're too overwhelmed. Now, some of those decisions have to be made quickly if you're starting a treatment. But, you know, if some of these things could be talked about immediately, like do we want to preserve your fertility, which needs to be addressed quickly? Handle that, but then maybe a timeline of how we talk about different things. Because at 43, when I was diagnosed, yes, I could have continued having children. But now at 49, I look at it as what happens for menopause? You know, because everybody says you'll never be able to take a hormone you'll never be able to take, you know? And so, there's this ever-changing, because luckily, we are living longer than that two to five years. It's an evolution of what life needs, what you have. And, you know, I think about things like, this is an expensive journey. You know, the the travel, the medical bills, and then you've got kids that you're wanting to send to college. Like, are there resources available for people who have survived cancer to help fund their children? Are there scholarships? You know, there's, it's a whole continuum because we are not turning over in two years and that's it. We had, because when I was first diagnosed, I kept thinking, "Oh, well, just I have to get to, you know, whatever." But, it, the sky's the limit now. 

Mara Antonoff, M.D. Yeah. 

Leah Phillips And there's so many things that I could think of, you know, between having that baby and getting that baby out the door, really. 

Mara Antonoff, M.D. Right. So, your, your advice when it comes to seeking information, it's not only making sure they're reliable resources, but tailoring that acquisition of information to where people are at in their journey. 

Leah Phillips Right. 

Mara Antonoff, M.D. Kind of figuring out what they need at different points in time. 

Leah Phillips Yes. 

Mara Antonoff, M.D. I think that's great. 

Leah Phillips I, I say I like I'd like to hear what do you think? 

Mara Antonoff, M.D. Yeah. So, certainly, I believe that, you know, I know you've been very active in, in helping provide information from patients to other patients. I think that is one of the greatest gifts that some of our online platforms have, have given us. We used to be in an era where there was very, very difficult to understand medical information that that was put out in journals or presented at conferences, that may not help people understand what relates to their day-to-day life. And there weren't a lot of conversations in between about what to expect. And then we kind of entered a place where people would put random postings on on social media platforms that may explain their perceptions of their own disease as well as their experiences. And while their experiences were valid and their perceptions were how they felt in the moment, you have to recognize that the people who are motivated to share those experiences may not represent the standard experience. 

Leah Phillips Right. 

Mara Antonoff, M.D. And like, what to be expected and what's typical. So, I would certainly be supportive of patients who want to familiarize themselves with the latest publications, with the latest research. I think it's valuable to discuss those papers, those research articles with other patients, but also with experts to communicate with your own doctors and even potentially to the authors on the study if you have specific questions. I know that you have been really a phenomenal leader and have attended medical conferences and been present and asked questions from the patient perspective, which is helpful to everyone. It helps patients learn, but it helps us learn. And so, I think ultimately, we're both saying the same thing, that there's a huge wealth of information out there, but it has to be vetted and taken in the right context. One patient's experience might not be your own, and the experience on one clinical trial, if it's different than you, it may not apply. So, I think that's the important part. 

Leah Phillips Yeah, I always try to tell people, you know, a lot of this has to do with how your genetics, your, your genetics are. Everything is different for each set of genetics. So, just because this has worked so well for me, it may not be the same for you or because that worked for you, it may not work for me. So, I said, I always say it's lovely to have all this information out there, but now you have to do the homework with trusted people to figure out which pieces of information will apply to you. 

Mara Antonoff, M.D. Yeah.

Leah Phillips And I think I think you and Dr. Singhi have done a great job with that because we're finally getting like, medical data in a way that we could, that the majority of people can digest it and understand it, which is huge. 

Mara Antonoff, M.D. Yeah. Yeah, absolutely. Well, this has been a phenomenal discussion. I know that the two of us could just go on for hours, but as we're getting ready to wrap up, I just wanted to ask you, do you have any closing words of advice, anything else that you would like to offer our listeners? 

Leah Phillips I just think it's one day at a time. It's one day at a time. Because my hope, and I think it's probably your hope too, is that one day this will be a chronic illness, not a terminal illness. And we only have to get to the next best treatment. Like, I don't have to set my sights on a cure in 30 years from now. I just need to set my sights on maybe six weeks from now, or six months from now, or a year from now, when someone comes up with the next best treatment. Just like surgery wasn't an option five years ago, and then it was. 

Mara Antonoff, M.D. Yeah. 

Leah Phillips So, you never know what can happen. 

Mara Antonoff, M.D. Yeah.

Leah Phillips In that amount of time, just what I've seen in five years, the change has been huge. So, I think there's still so much that you guys have to learn and figure out and then we'll benefit from. 

Mara Antonoff, M.D. Absolutely. And those are great parting words of advice. Always, always a pleasure to chat with you and to hear from you. I'm really grateful to you for joining me today. This was a great discussion, and I want to thank our listeners for listening to the Cancerwise Podcast from MD Anderson Cancer Center. If you enjoyed this episode, don't forget to follow or subscribe on Apple Podcasts, Spotify, YouTube, or wherever you get your podcasts. And be sure to comment or review. For more information or to request an appointment at MD Anderson, call us at 1-877-632-6789 or visit us at MDAnderson.org. And thank you for listening to the Cancerwise Podcast from MD Anderson Cancer Center.