Caitlin Whyte (Host): Welcome to Healthy with VCU Health, where experts from VCU Health share their knowledge, cutting edge research, and the latest innovations to help you achieve optimal health and wellness. I'm your host, Caitlin Whyte. Today we're discussing clinical trials, which can extend and potentially save lives, especially among cancer patients. In this episode, I'll be talking with Dr. Chelsea Salyer, a Gynecologic Oncologist and Researcher at VCU Massey Comprehensive Cancer Center. We'll be discussing the importance of clinical trials and debunk some of the myths often heard from patients. Doctor, to kick off this episode, can you tell us a bit about your background and specialty?

Chelsea Salyer, MD: Yes, of course. So, I am originally from the bluegrass state of Kentucky, but I've lived in California and Kansas for training and now I'm very happy to be caring for patients in the beautiful state of Virginia. I'm a GYN Oncologist which means I take care of patients with cancers in the uterus, cervix, fallopian tubes, ovaries, vulva, vagina, as well as any complex benign conditions.

 I perform surgery utilizing both open and minimally invasive techniques, including robotics. And I also offer my patients systemic treatments with chemo, immunotherapy, and targeted treatments. I also lead our clinical trial office to offer state of the art novel treatments for my patients.

Host: Well, could you explain then what clinical trials are, how they differ from standard of care for treating people with cancer, and why they are important considerations in the treatment of cancer?

Chelsea Salyer, MD: There are actually many different types of clinical trials. There are trials that look at screening tests, surgical techniques, or cancer treatments, all of which are aimed at improving the standard of care. Clinical trials are essential for advancing medical knowledge, but also making sure that we're taking better care of our patients.

Studies are important because it's how we make progress in fighting cancer. Women with cancer are living longer than ever before, and that is thanks to all of the patients that have participated in clinical trials and helped us understand the best treatments for gynecologic cancers.

Host: And how do clinical trials address the unique needs of different patient populations, such as age or ethnicity?

Chelsea Salyer, MD: You know, that's a really important question because we take care of a diverse group of women at VCU Massey Cancer Center. We know that not all cancers are created equal, and they do not impact women equally. For example, Black women are at a significantly higher risk of developing uterine cancers, but also more aggressive subtypes of uterine cancers.

And this is largely due to disparities in social determinants of health, but we also know that there's differences in tumor biology among different ethnic groups. So, we also do some behind the scenes type of clinical trials where we look at the molecular biology of tumors so that we can help design treatments and interventions that address the unique needs of our diverse patients.

At Massey, we also work hard to ensure that our patients have access to clinical trials. So, I'd want all of my patients to know that regardless of income, transportation needs, age, language, we'll make sure that there's a clinical trial for you.

Host: Well, what are some misconceptions about participating in cancer clinical trials that you hear from patients? And what is the evidence-based truth?

Chelsea Salyer, MD: People often worry that on a clinical trial, they're going to get some sort of experimental drug that has side effects that we don't know about and we don't know if it'll work or worse, they worry that they're only going to get placebos. But that's not really the case. Not all trials include placebos.

And all of our trials that include new drugs, they have a lot of pre-study testing and that tells us that not only should it work well, but hopefully it's better than any standard therapies you'd receive off trial. These newer drugs also have much less toxic side effects. So again, don't have all of the sickness and illness and things that happen when you're using chemotherapy.

So again, I'd say the goal of our trial drugs and interventions are to offer something better than standard of care. Another concern that patients have is about cost, but the truth here is that all costs outside of standard treatment are covered by the trial which means you do not have to incur any additional bills.

So, the trial covers the cost of the study drug. But then they'll also offer things like transportation vouchers or cover fees for things like labs or imaging or anything that you wouldn't get off of trial, that's usually covered. And then I'd also just say for all of our patients at Massey Cancer Center, we just make sure you get the best treatment possible regardless of ability to pay.

So, we also have social workers and financial counselors to support you through your trial journey.

Host: Great. Well, in your opinion, Doctor, what are some of the advantages of seeking out care and clinical trials at VCU Massey Comprehensive Cancer Center?

Chelsea Salyer, MD: As one of two Comprehensive Cancer Centers in Virginia, you have access to expert care, state of the art facilities, and the most advanced treatments, including one of the largest clinical trial portfolios in our state. We have a dedicated group of clinical trial experts that take care of each patient, tailoring care to your individual needs.

Our trial team is available to you seven days a week, 24-hours a day, and they often give you their cell phone numbers that you can just contact them directly. Honestly, that's what I hear from patients is that the trial team itself is one of the biggest benefits of being on a trial at Massey. The other advantage is that you'll have access to other subspecialty doctors who are uniquely trained to care for cancer patients, such as oncology cardiologists and palliative care specialists.

And then at the Cancer Center itself, there's free valet parking, and you're able to complete your doctor's visits, labs, imaging, and go to the pharmacy, all within our campus. So, it truly is a one stop shop for world class cancer care.

Host: And could you share one of the latest breakthroughs in care, such as in your specialty, gynecological cancer that have emerged from clinical trials?

Chelsea Salyer, MD: Well, the truth there is that all breakthroughs in cancer care have emerged from clinical trials. But I'd say one I'm particularly passionate about is HIPEC which is hyperthermic intraperitoneal chemotherapy. This is a unique technique where we place heated chemotherapy in the abdomen at the time of a debulking surgery for ovarian cancer.

We have found that this technique improves survival in our ovarian cancer patients by over a year.

 And I'm actually the only GYN Oncologist in Richmond, and one of, only a handful of GYN oncologists in our state, who actually offer HIPEC for ovarian cancer patients.

Host: Wow. That is incredible to hear. So how can patients find out if they are eligible for a cancer trial and how do they sign up?

Chelsea Salyer, MD: One thing I'll often hear from patients is they think that trials are just a last resort, but that's not the case. As I've mentioned, our goal is to improve upon standard of care every step of the way. So, from initial treatment to surgery to maintenance therapies, we have trials at each step of the cancer journey.

The best way to find out if you're eligible is to come see us in the office. If you want to request an appointment, our number is 804-828-9080, but you can also ask your doctor to just contact me directly through phone or email. I will often collaborate with your primary GYN or medical oncologist to take care of you through a trial.

So, it's always a collaborative effort working with me as well as your other doctors.

Host: Well, let's talk about what's coming up on the horizon. What are you excited about?

Chelsea Salyer, MD: Yes. So that is the other exciting part about doing clinical trials at Massey is that things are always changing. So, a clinical trial that happened last year is already up and on the market. So, we have something new, you know, every month, every year, there's new trials that emerge. We have multiple trials that are in the process of opening currently. Most of these are targeted therapies for ovarian, endometrial, and cervical cancers.

So, we also have new surgical trials on the horizon, potentially looking at some studies to modify those HIPEC techniques to make them even more tailored for our ovarian cancer patients. So, no matter what type of cancer you have or where you are in your cancer journey, we likely have a trial that'll be right for you.

Host: And to wrap up our conversation today, is there anything else that you'd like to share?

Chelsea Salyer, MD: Well, I think we've covered a lot. I hope that the folks listening to this, you've learned a little bit about trials, dispelled some myths and just know that we are happy to take care of you at the Massey Cancer Center.

Host: Well, thank you so much Doctor for the work that you do and for being with us today. To learn more about treatments for cervical cancer and clinical trials here at VCU Massey Cancer Center, visit masseycancercenter.org/clinical-trials. That's M-A-S-S-E Y cancercenter.org/clinical-trials. Or call the clinical trials office at 804-628-6430. That’s 804-628-6430 and to listen to more podcasts from VCU Health, please visit vcuhealth.org/podcasts. Thank you for checking out this episode of Healthy with VCU Health.