I sit down with Dr Magali Svrcek, Professor of Pathology at the University of Sorbonne in Paris, and she discusses her role as a GI Pathologist.  Dr Svrcek discusses Microsatellite Instability, digital tools and Immunohistochemistry.  Dr Svrcek wrote her script in English, so I in turn wrote my introduction and closing en Francais.  I hope my French is ok.  With fewer Pathologists, especially internationally, digital pathology could be a solution.  In working with Owkin, the collaboration, MsIntuit, an AI diagnostic tool to detect MSI, and is the first to be CE marked.   Colorectal cancer is experiencing an increase internationally as western lifestyle spreads.  African countries, especially sub-Saharan African countries will not have the tools or infrastructure to work with this increase.  Developing a network of experts using digital pathology could mitigate some of these issues.  

I sit down with Dr Luis Diaz Jr, physican scientist at Memorial Sloan Kettering, and we share some history of mismatch repair, lynch syndrome and the evolution.  Of course we talked about the primary rectal cancer study where they showed immunotherapy was curative for MMR/MSI High tumors.  A second study for multiple cancer locations had 85% response rate and 40% had no side effects.  Shout out of course to Dr Zsofia Stadler, my oncologist, working on another study of patients treated with immunotherapy, and if further cancers can be prevented.  The future may be the Lynch Syndrome vaccine, but does the future also include immunotherapy before cancer for lynch syndrome patients?  How about trying to turn non-lynch tumors into lynch (like) tumors so they can be treated with immunotherapy?  Dr Diaz hopes other researchers can be bold moving forward, and that someday, this is all routine and these stories are no longer news.  

I sit down with Dr Aparajita Singh, Gastroenterologist and Director of the Lynch Syndrome Center at UCSF, where it truly is a team effort taking care of Lynch Syndrome patients.  Aside from me mispronouncing Lynch Syndrome, it was a wonderful engaging conversation.  UCSF Lynch Syndrome Center should have the links to everything discussed, which was a lot.  Check it out.        

I sit down with Dr Timothy Yen, Gastroenterologist and Clinical Informaticist at Loma Linda University.  Dr Yen was building the Lynch Syndrome program at Loma Linda when he discovered Epic Cosmos, where the Epic's Care Everywhere could be used for research, regardless of the health system.  Epic Cosmos unlike other modules, isn't built around claims data.  Now Dr Yen can pull de-identified data from thousands of patients, aggregate statistics and more.  Cosmos is free for a health system to join, but they just need Care Everywhere.   It also has a system to potentially connect lynch syndrome providers without breaking any privacy issues.  Biggest barrier is going through the training and understanding how it works in order to do anything meaningful.  As patients, we need to remind our physician offices to be specific in documenting our visits.  

I sit down with Marina Udier, CEO of Nouscom, a Swiss company working on the Lynch Syndrome vaccine.  Nous209 is designed to intercept tumors in Lynch Syndrome cancers.  The 209 comes from the frameshifts of neoantigens, whether sporadic or hereditary.  Idea is to educate the T-cells before cancers start forming.  The data at AACR presented was very promising.  They are also running a study on metastatic colorectal cancer patients, mostly without Lynch Syndrome, but MSI high.  So how many people are tested positive for Lynch Syndrome each year?  Next steps includes additional investigators and patients for a much bigger trial, at a time to be determined, and of course funding is always a priority.  Suffice it so say, interest is high is seeing this come to late stage development.    

I sit down with Dr Aasma Shaukat, Gastroenterologist and Professor of Population Health, who is also trained in Epidemiology and Clinical Research, and Director of GI Outcomes Research at NYU Langone Health, Grossman School of Medicine.  We talk about progress in healthcare fields including gastroenterology.  We talk microbiome (I compared my digestive tract to the ocean).  We did talk colonoscopy prep in quite a bit of detail.  We also talk about screening rates in the NYC area< C5 and how fortunate we are to work and live in an area that really tries to be inclusive and proactive.  Gastroenterology has incorporated AI tools, so far in polyp detection, but also summarizing patient history and creating a whole picture, which is also helpful in oncology and more.  Note that this was originally recorded just after the New Year in early January.  

I sit down with Dr. Matthias Kloor, Acting Medical Director Applied Tumor Biology at Heidelberg University.  We discuss the thought process followed by the hurdles faced in trying to get a Lynch Syndrome vaccine, through the phases, to potentially the proverbial bedside.  We discussed collaboration with the NCI in bringing this and other projects to market.  We also talk about the European Hereditary Tumor Group, whose conference this year is also in Heidelberg.  EHTG is a great group, one that has embraced the advocacy community, similar to CGAIGC and InSIGHT.  

I sit down with Sandra and Javier Corrales, who share their Lynch Syndrome story.  Javier has been open with his diagnosis so his family can be proactive in their care.  Sandra, who has a history of cancer in her family as well, has been the  teammate in this process every step of the way.  With the Lynch Syndrome diagnosis, they now see a path forward.  They share how they deal with family, including the kids, and having age-appropriate conversations.  Besides participating in AliveAndKickn's Living with Lynch annual program, they coordinated a community discussion in Spanish, where participants from across the globe attended.    

I sit down with Dr Jen Hartstein, lynch syndrome previvor and clinical psychologist in New York City.  We both hope that others can take away something from us that helps them with their day and daily lives.  She also has a media career talking about life, mental health and her own company working with companies to help them identify and work with neurodiverse populations.  How do we discuss all of the stuff being thrown at us during these trying times?  How do we remain informed without being overwhelmed?  Finding communities and not getting stuck in our own heads may be a good solution.      

I sit down with Junius Nottingham Jr, founder of JNottGTT, a non-profit for Lynch Syndrome awareness.  Junius tells the story of his son Jeremy, who was a secret service agent and so much more, who passed at age 30.  Junius discovers his own colon cancer after his son's diagnosis, but it was found early, and he was ok just after surgery.  As a parent, I feel that level of guilt and responsibility, and I applaud Junius for staying in this, and using his platform to help others. Junius reminds us that it's ok not to be ok, and thanks God for keeping him going, even when disucussing such a difficult subject.