Caitlin Whyte (Host): Welcome back to In Their Words, where we embark on a new chapter of exploration and inspiration. In this week's episode, we're thrilled to feature a visionary expert at the forefront of cancer care, Dr. Kit Lu. As the Director of the Clinical Trials Program and Associate Director of UPMC Hillman Cancer Center, Dr. Lu is guiding groundbreaking innovations that are reshaping the landscape of cancer treatment.

Get ready to delve into the world of clinical trials where pioneering approaches and relentless determination are creating new paths to hope and healing. We'll uncover the power of innovation at UPMC in central PA. So, stay with us as we journey into a world of possibility and transformation.

Importantly, if you joined us for the last episode, you'll remember the inspiring journey of Pam, a beacon of resilience amidst her battle with cancer. What you might not know is that Dr. Kit Lu, the expert we're featuring this week, played a pivotal role in Pam's cancer journey as well. Her expertise and compassionate care touched Pam's life, embodying the commitment to innovation and patient-centered excellence that defines UPMC in Central PA.

As we dive into the world of clinical trials and innovation, keep in mind the connection that threads through these stories. Dr. Lu's unwavering dedication, both to advancing cancer care and nurturing patients like Pam, showcases the profound impact that compassionate healthcare professionals can have online lives.

Dr. Kit Lu: Well, Pam is just an incredible woman. She's super strong, well loved. Despite having the cancer diagnosis, she didn't really think of herself, but she thought of others. I'm just incredibly honored and humbled and just so honored to have taken care of Pam. I think that many women are faced with cancer, but it's not just cancer, right? So, they are faced with other stressors in their life, including family life, their work life and their other interactions with friends, peers and family. So many women have their own stories behind their cancer journey.

I think every experience could be different. Some sail through chemo, some have certainly some hiccups along the way or some complications along the way. I think the main thing is just of coming in with a positive attitude, embrace the experience. Know that all of the cancer treatment team are there for them, no matter how good the experiences are even if there's complications or hiccups along the way.

I think that majority of the women, just as a caveat, they do fine during chemotherapy and they're able to continue with their normal daily living. But the most common side effects could be fatigue, and it's hard to qualify or quantify fatigue, right? Because you don't look tired, but you certainly feel tired. So, this is a very common symptom to have. Certainly, some dehydration symptoms because, if you're going through chemo, you may not want to eat and drink as well as you normally do. So, having some dizziness, weakness and just tiredness can be a manifestation of dehydration.

Host: But behind the clinical realm, Dr. Kit Lu has her own deeply personal reasons that led her to specialize in oncology.

Dr. Kit Lu: So, my first interest in oncology, especially breast cancer, is with my grandmother. She unfortunately was diagnosed with breast cancer metastatic when I was young, and she passed away from breast cancer. So, I had first-hand experience of what a family member would have to go through when someone they love had breast cancer. And then, throughout university and medical school, I always embrace oncology in general because it's a challenging field. It's constantly changing, constantly evolving. There's a lot of learning, a lot of learning about biology and about the medication and about clinical trials. And knowing that there's a lot of hope, actually, for treatment for our patients and to be able to be there across all spectrum of their lifespan, including diagnosis to cancer treatment to even survivorship beyond. So, all of that kind of made me interested in what I do today.

They're certainly not a number to me, they're a person and, know, again, they have their own personal journey and story behind their cancer diagnosis. So, I would treat any patients like my family member. Understandably, they're here on their first visit, they're scared about the cancer diagnosis and they just want to know what the plan is and how they're going to do, right? So, my first of instinct, if you may, is to lay out the plan, just tell them the truth, give them their diagnosis, give them what our plans are and just be their support along the way.

Host: While many of us believe we're familiar with the common symptoms of cancer treatment, there's a whole realm of unexpected experiences that often remain unexplored. Join us as we venture into the lesser known aspects of this journey, shedding light on the surprises that can arise alongside the more familiar challenges. Through Dr. Kit Lu's insights, we'll gain a deeper understanding of the intricacies of cancer care and the holistic approach that UPMC and central PA embraces to support patients in every facet of their healing.

Dr. Kit Lu: So, a lot of times in terms of the cancer treatment, symptoms pop up along the way, right? And this can interfere with how someone function on their daily basis in terms of taking care of their family members or working while undergoing chemotherapy. So, it's very important to recognize these symptoms and help support them so that they can complete the chemotherapy so that they can be there for their family and their loved ones.

So, integrative oncology is just another tool that we use to help support our patients and help alleviating some of their symptoms. Like I said, a lot of times there's fatigue that's associated with chemotherapy. There's also sometimes pain associated with chemotherapy and neuropathy, which is the tingling and numbness in the fingertips and toes. So, I think with integrative oncology, we can utilize some of those complementary methods to help support our patients.

Part of our integrative oncology program offers acupuncture. Acupuncture has been shown clinically to be successful in treating symptoms of fatigue, pain, and even neuropathy. There's also programs that include massage, yoga, meditation. And a lot of these programs, again, support the patients with their symptoms and also support the doctors to be able to continue with the necessary medical treatment.

I think that the mind, the body and spirit are all connected in terms of healing through treatment. So, we as doctors are very good about treating the body. But it's also important to recognize that the mental health is an important aspect for healing and through the cancer journey, too. So, yoga, massage, meditation can really help someone ease their anxiety, improve their mental health and help a general positive outlook in cancer. Honestly, it's been shown to be helpful in terms of someone's outcome.

Host: The burden of a cancer diagnosis often goes beyond the physical and emotional toll. It can also bring about financial challenges that compound the struggle. This phenomenon known as financial toxicity can cast a shadow over the healing journey. However at UPMC and Central PA, there's a dedicated effort to combat this issue head on.

Dr. Kit Lu: When someone's diagnosed with cancer, the first thing we think of is treat the cancer and treat the disease. But a lot of times, we forget that these women or patients have a normal life as they're going through their cancer journey and a normal life includes taking care of their family, being a financial provider for their family. And these cancer treatments can be costly and sometimes as the patients are going through cancer treatment, they cannot work, they cannot physically work. And so, that big piece of financial help for them is missing. So, we have to address the financial toxicity along with their physical health as well.

I'm incredibly grateful for UPMC and the foundation for providing some of the support for our patients. I think that the first and foremost mission of UPMC and the Pinnacle foundation is for the patients, whether this is support to help them get medication that they can't otherwise afford, support to get transportation or even getting a wig for the patient. I think these very, very important other parts of cancer treatment and toxicity that we have to mindful of and to help patients through their cancer journey.

Host: Dr. Lu knows firsthand how gratifying it is when a patient navigates the journey of treatment and emerges successfully. It's one of the reasons she went into medicine.

Dr. Kit Lu: Grateful, very grateful for me. Again, I think of each and every single one of my patients as my own family member, right? So if I see a success in their cancer treatment, I'm happy, I'm, grateful for them for going through with their treatment and being here.

Host: As we delve into the realm of clinical trials, Dr. Kit Lu offers a glimpse into the exciting future that lies ahead. Her insights shed light on the evolving landscape of cancer care, where clinical trials are not just about treatment options. They're windows into the groundbreaking possibilities that are transforming the way we approach healing.

Dr. Kit Lu: Clinical trials can be in all aspects of oncology care. So, this can be from imaging standpoint, how to detect cancer better ways of detecting cancers and/or even following cancer. Certainly, we want to advance the type of treatments that we have. But also, there are clinical trials to look at de-escalating treatments. So, meaning that maybe treatment we're giving them could be too much side effects, so maybe we can actually do improve someone's quality of life and their symptoms. So, there's a lot of different aspects of clinical trial. We don't typically think of clinical trial as the last resort. We actually think of clinical trial as all spectrum of their care from diagnosis to treatment to survivorship.

The very first thing they can do is just to ask if there's any clinical trials available for them. Certainly with every single patient, we think about clinical trial opportunities and we approach them about different trial options. But I think just asking helps engage that conversation. With every single trial, there's a basically pages and pages of information that we have to learn. And we have to know about specifics about the drugs, specifics about the toxicity and also how the trial is conducted. And we have to give all that information to the patient in a manner that they understand. So, there's a lot of transparency, a lot of education, both from the provider standpoint and also to the patient as well. It's a continuous learning, but it's also, it's a joy, right? It's a joy to learn and also find new ways to help our patients.

Right now, with UPMC, we have over 500 clinical trials available across the network. As providers here, we have access to all of these trials, whether they're locally or also in Pittsburgh and other locations as well. We work very closely with our colleagues in UPMC Pittsburgh, in terms of collaborating and finding trials that are available for our patients. I have many patients where I collaborate with our colleagues in Pittsburgh sharing the latest advance in terms of treatment, what is the treatment strategy for certain patients and even having our patients travel to Pittsburgh for clinical trials.

But ultimately, our main goal is to be able to take care of our patients here locally and that they don't have to travel four hours to another site for their treatment. So, our goal is to be able to have access to that specialty care here locally, either via telemedicine or even just our joint tumor boards with the providers here with a specialist there and even thinking about expanding our clinical trial access here so that our patients can just enroll in clinical trials here and not have to go four hours away to Pittsburgh.

Caitlin Whyte (Host): In the midst of all her work and learning, Dr. Lu is deeply involved in supporting the UPMC Pinnacle Foundation Your Journey, Our Promise Campaign. This campaign is far more than a mission. It's a commitment to providing unwavering patient support. Extending access to crucial programs, services and cutting-edge research for oncology patients across central PA.

Dr. Kit Lu: I think that it is several things. One is the compassion of our doctors, our nurses, our staff for the patient. I think not just myself, but the rest of the team here treats the patient like their own family member. So, it's the quality care and the compassion that we provide for our patients.

Secondly, we certainly give quality care and we practice standard guidelines. We have access to our specialists in complicated cases. And then, we have access to clinical trials. If the standard of care options aren't that great for our patients, we have access to novel therapeutics for our patients. So for all of those, I think patients have great choice here just locally in their backyard.

Host: Dr. Lu is not only a cheerleader for her patients. She is a champion for UPMC in Central PA.

Dr. Kit Lu: I love the environment of UPMC, the collegial staff that we have and I'm just a phone call away to an expert and to be able to communicate a complicated case with my colleagues. The nursing support here, the staff here is top notch. It's just a great team environment that we have here.

I hope that I would make my family proud of what I do every day. I would think that they would be proud of me and what I do. I think that they raised me to be a person that is compassionate. I think that's the main thing, is to be able provide that sense of compassion to our patients, to be able to care for them in a genuine fashion. And that's what I think my parents are proud of me for.

Host: When asked what she recommends for reducing risks of cancer, the answers are pretty simple.

Dr. Kit Lu: For breast cancer, it's been studied in terms of different lifestyle risk factors for breast cancer and cancer in general. So, the things that we generally tell our patients are, one, maintain a healthy body weight. So, we know that obesity has been linked to cancer and cancer progression and recurrence. So, maintaining a healthy body weight with a BMI of 20 to 25 is important because for every 5 pounds we gain, we actually increase our risk for cancer significantly. Not smoking, so stop smoking if you do and, if you haven't, don't try to smoke. It's important because we also know that smoking has been linked to various different kinds of cancer, including breast. And then, limiting alcohol intake. So for breast cancer, we typically encourage our patients to limit alcohol intake to no more than one serving a day, no more than five a week, because more than that has also been linked to breast cancer. And then finally, exercise. So, we know that with studies, exercising 30 to 60 minutes a day, 5 times a week, that tends to also improve cancer outcomes.

I do think that there's always room for optimization, and this is where we need our donor support, especially in terms of clinical trials. We have many equipments that we need including centrifuges, specialized refrigerators, and even equipments that are necessary for clinical trials production.

In that sense, there's always ways for optimization. So, we're doing great, but we can also do better. I know our patients are grateful for us, but we're also grateful for our patients for their strength, their resilience, and their courage for undergoing cancer journey. We are a part of their team. And we want to continue to be part of their team across all spectrums of their journey and well into survivorship. And if we can keep that in mind when we take care of patients, when we think of how a quality cancer hospital runs, then we will be successful.

So many people think, "Okay, well, when when I ring that bell, when the chemo's over or when the radiation's over, I ring that bell, then things automatically get better," but that's not true. Unfortunately, cancer's the gift that keeps giving. And a lot of times, they still have a lot of side effects that they have to face with long after treatment is gone. So, this includes, again, that fatigue, sometimes pain, sometimes this neuropathy, sometimes it's the mental health aspect, and there are other side effects as well that we have to continue to follow and support them through their cancer journey.

Host: Before we wrap up this episode, I want to extend my gratitude to you, our listeners, for joining us on this journey of inspiration and innovation in oncology care. I'd also like to express our sincere appreciation to Dr. Kit Lu for her invaluable insights and dedication to transforming the landscape of cancer treatment. Your engagement means the world to us. And we encourage you to share these stories of hope and healing with others who might find them as meaningful as you do. By rating reviewing and sharing our podcast, you're helping us reach even more hearts and minds, making a difference one listener at a time. So, stay tuned for more captivating stories in the episodes to come. Until then, thank you for being a part of In Their Words.

 To make a difference for oncology patients in need and to join their philanthropic mission, visit upmcpinnaclefoundation.org.