In this episode of Bench to Bedside and Beyond, Diane Mapes talks with Fred Hutch Cancer Center and UW Medicine clinical researcher and gynecologic oncologist Dr. Elizabeth Swisher about research that may refine how scientists understand and treat tubo-ovarian cancer — and potentially help guide targeted treatment for some people with triple-negative breast cancer.

Swisher explains why many cancers long called ovarian cancer begin in the fallopian tubes, why "tubo-ovarian cancer" is a more accurate term and how researchers are studying tumors' current biological vulnerabilities to better match patients with treatment options. The conversation also explores HRDefine, an investigational assay designed to identify the current causes of homologous recombination deficiency, or HRD, a tumor weakness that can make some cancers responsive to PARP inhibitors.

Key takeaways

• Many cancers commonly called ovarian cancer begin in the fallopian tubes. Using the term tubo-ovarian cancer more accurately reflects where these cancers often originate and may inform future prevention and early-detection research.

• Homologous recombination deficiency, or HRD, is a weakness in how some tumor cells repair damaged DNA. That weakness can make certain tumors more responsive to PARP inhibitors.

• Swisher and colleagues developed HRDefine, an investigational assay designed to identify the current cause of HRD. It can examine BRCA1/2 and other gene changes, as well as methylation changes that can affect gene activity.

• Unlike older measures of HRD, which may continue to show a past vulnerability after a tumor has become resistant to treatment, HRDefine is designed to assess the tumor's current biology.

• The assay may help identify which patients are most likely to benefit from PARP inhibitors in tubo-ovarian cancer and, potentially, triple-negative breast cancer. It is still being validated in hundreds of samples before any broader clinical or commercial use.

• This work reflects a broader goal of precision oncology: matching treatment decisions to a tumor's biological features, not solely to the organ where the cancer began or to inherited genetic risk.

In this episode of Bench to Bedside and Beyond, we talk to a 25-year prostate cancer survivor and the director of the new sexual health clinic at Fred Hutch about why it's important to include sexual health in the survivorship conversation. Prostate cancer survivor James DeLong and Kelly Nelson, director of Fred Hutch's new sexual health clinic, discuss how a cancer diagnosis can wreak havoc on a person's sex life—and how people no longer need to suffer in silence. Key takeaways:

• The side effects of cancer treatment can make having a healthy sex life challenging.
• For a long time, providers didn't commonly address issues such as low libido, vaginal dryness and painful intercourse. Many patients were embarrassed to bring it up, and providers didn't ask.
• Fred Hutch's new sexual health clinic was created to address these topics and normalize the conversation, recognizing that sexual health is an important part of survivorship and quality of life.
• The clinic provides comprehensive, individualized support including medication, sex therapy and pelvic-floor physical therapy.

John Higgins interviews Dr. Rashmi Mishra, a postdoctoral research fellow in the Hsieh Lab at Fred Hutch Cancer Center, about how aggressive prostate cancer shapeshifts from a form that is treatable with drugs to a more lethal form that is much less treatable. In a recent study, she and her colleagues found potential ways to reverse that trick, forcing tumor cells to shapeshift back into the more treatable form. Their discovery opens a new line of attack against aggressive prostate cancer, as well as breast cancer and possibly other cancers.

Key Takeaways:

• Prostate cancer comprises two main types of cells: luminal, which is more treatable with existing therapies and a more aggressive, lethal type called basal, which is much less treatable.

• A recent study by Dr. Rashmi Mishra, a postdoctoral research fellow in the Hsieh Lab at Fred Hutch Cancer Center, describes how prostate cancer shapeshifts from a luminal to a basal form to elude therapy without reprogramming its DNA.

• Mishra and her colleagues found potential ways to reverse that shapeshifting trick, forcing tumor cells to shapeshift back into the more treatable form.

• Their discovery opens a new line of attack against aggressive prostate cancer, as well as breast cancer and possibly other cancers.

In this episode of Bench to Bedside and Beyond, Bonnie Rochman talks to a bone marrow transplant survivor and the director of psychiatry at Fred Hutch.

Leukemia survivor and bone marrow transplant recipient Nicole Sandburg and Jesse Fann, MD, MPH, Medical Director, Psychiatry and Psychology, discuss the ways a cancer diagnosis can upend emotional health and how mental health services including mindfulness can help patients cope.

Key takeaways:

• Dealing with cancer can have profound emotional effects that outlast the treatment.
• Recovery requires more than physical healing.
• Cancer strengthens a person's self-advocacy skills.
• People dealing with cancer can help support their emotional well-being by staying active, eating healthy, socializing and getting outdoors.

Dr. Lucas Sullivan, a cancer metabolism expert at Fred Hutch Cancer Center talks with John Higgins about a new study showing that cancers driven by a specific mutation crave a nutrient so much that eating too much of it can be lethal. Healthy cells aren't prone to stuffing themselves with this nutrient. That difference presents an opportunity for precision oncology: we can supplement a patient's diet to force-feed tumors the nutrient while sparing healthy cells. Key takeaways:

• A recent study by Dr. Lucas Sullivan, a cancer metabolism expert, finds that feeding NRF2-mutated tumors too much of a nutrient they crave makes them vulnerable to slower growth and cell death.
• NRF2 genetic mutations are common in lung cancers but also appear in several other cancers.
• Force-feeding NRF2-mutated tumors the nutrient they crave could kill the cancerous cells while sparing the healthy ones, a prime example of precision oncology.

Cancer survivorship is about far more than finishing treatment. In this episode of Bench to Bedside and Beyond, Diane Mapes speaks with prostate cancer survivor and advocate Marty Chakoian and cancer rehabilitation specialist Dr. Hanna Hunter about the physical, emotional and practical realities of life after a cancer diagnosis. Together, they discuss treatment side effects, the value of patient advocacy and support groups, advances in less toxic therapies, and how rehabilitation, exercise and supportive care services help patients maintain quality of life throughout the cancer continuum.

Key Takeaways

• Cancer care is increasingly focused on quality of life, not just survival. Modern oncology aims to treat the whole person, balancing effective cancer treatment with physical function, emotional well-being, independence and long-term survivorship outcomes. Both Chakoian and Hunter emphasize that living well during and after treatment is now a core goal of cancer care.

• Patients play a critical role in treatment decisions. Chakoian stresses the importance of shared decision-making, encouraging patients to understand their diagnosis, know their personal values and communicate openly with their care teams. The best treatment plan is often the one that balances medical effectiveness with the quality-of-life outcomes that matter most to the individual patient.

• Supportive care and rehabilitation can start before treatment begins. Dr. Hunter explains that rehabilitation services including physical therapy, lymphedema care, speech therapy and exercise programs can help patients before, during and after treatment. Early intervention can improve resilience, reduce side effects and help patients recover more quickly.

• Exercise and community support are powerful survivorship tools. Research increasingly shows that physical activity can improve function, quality of life and even cancer outcomes. At the same time, support groups provide practical advice, emotional support and a sense of community that helps people navigate the challenges of cancer and its aftermath.

In this episode of From Bench to Bedside and Beyond, host Diane Mapes talks with Dr. Vidhya Nair, medical director of adult cancer survivorship at Fred Hutch, about what truly happens after active cancer treatment ends. Together, they explore late and long-term side effects, fear of recurrence, and the emotional whiplash many patients feel when treatment stops but symptoms and worries do not. Dr. Nair also explains how Fred Hutch's evolving survivorship program—from embedded care in disease clinics to specialized services in rehab, sexual health, and integrative medicine—helps survivors navigate life after cancer with more support and less uncertainty.

• Survivorship is more than "being done" with treatment; it is a structured phase of care focused on late and long-term effects, surveillance for recurrence, and helping patients move forward informed rather than fearful.
• Fred Hutch is embedding survivorship into disease-specific clinics and expanding specialized services such as cancer rehabilitation, sexual health, integrative medicine, and psychosocial support so more patients receive tailored help over 5–10 years after treatment.
• Survivorship care plans and primary care collaboration give survivors clear guidance on symptoms to watch for, risks like secondary cancers and osteoporosis, and practical steps—exercise, nutrition, and mental health support—to live as well as possible after cancer.

As cancer survival rates rise, "survivorship" has emerged as a critical new phase of care - one that extends far beyond treatment and into long-term physical, emotional, and psychological recovery. Through firsthand stories from a breast cancer survivor and a melanoma survivor-turned-provider, this episode reveals how patients navigate side effects, fear of recurrence, and life-altering changes that can last for decades. It also highlights how survivorship programs at Fred Hutch are evolving to support patients earlier and more holistically, helping them move from treatment toward living well. Key takeaways

• Survivorship starts at diagnosis, not after treatment ends—and often means coping with the effects of treatment, not just the cancer itself.
• Cancer care leaves lasting impacts across physical health, mental health, relationships, and finances, requiring ongoing support long after therapy.
• New treatments like immunotherapy are transforming outcomes, but their long-term effects are still being understood.
• Modern survivorship programs are expanding earlier and more holistically, meeting patients where they are and helping them rebuild strength, confidence, and quality of life.

In this episode, Trang VoPham, PhD, MPH, MS, from Fred Hutch Cancer Center discusses the impact of environmental exposures like wildfire smoke and solar jet lag on health with Diane Mapes from Fred Hutch News. Dr. VoPham also lists other potential risks, such as for liver cancer, and offers potential strategies for mitigation of these impacts.

One takeaway: Where you live in a time zone impacts your circadian rhythms and your risks for disease.

In this episode of From Bench to Bedside and Beyond, Fred Hutch psychologist and public health researcher Dr. Jonathan Bricker, who holds the Endowed Chair in Cancer Prevention, talks to Diane Mapes about why people embrace dietary supplements, which are unregulated by the FDA and require no safety or scientific studies, and turn away from science-based cancer prevention like the HPV vaccine. "It's not about ignorance or misinformation," Bricker said. "It's about a basic human desire to avoid discomfort and to have control."

Takeaways:

• Many people take supplements in order to improve health and avoid cancer.

• But large clinical trials led by Fred Hutch have found some supplements actually promote, not prevent, cancer.

• At the same time, vaccine hesitancy is increasing – even for safe, long-studied vaccines that actually prevent cancer.

• What's the psychology behind our willingness to embrace 'quick fixes' like supplements and peptides even when there's little science behind their efficacy, and turn away from tried-and-true cancer prevention like the HPV vaccine?

• It's about a 'basic human desire to avoid discomfort and to have control,' Bricker said.

• Dietary supplements 'aren't just biological interventions, they're psychological interventions,' Bricker said, because they promise immediate action and give us agency.

• Public health messaging tends to take a rational approach. This triggers fear, which then drives people toward the 'quick biomedical fix.' It creates a "psychological feedback loop."