This is a disease no one wants, but you meet the best people."

Twenty years ago, about 125 people gathered at a hotel outside Philadelphia for the first-ever conference just for those living with metastatic breast cancer, at a time when the community was rarely seen or heard. Today, it's a three-day national event drawing hundreds of attendees and a virtual audience.

In this episode, the host Victoria Goldberg sits down with three longtime Living Beyond Breast Cancer leaders: CEO Jean Sachs; Elyse Spatz Caplan, who ended her 14-year tenure with LBBC as the Director of Programs and Partnerships;  and Catherine Ormerod, a retired Executive Vice President for Strategy and Mission.  In a separate conversation, she speaks with Janine Guglielmino, LBBC's former Vice President of Mission Delivery, who was there for that very first conference in 2006.

Together they trace the conference's history: the groundbreaking Silent Voices survey that proved a conference exclusively for stage IV patients was urgently needed, the fight to fund travel grants so cost would never be a barrier, the pivot to virtual during the pandemic, and the Hear My Voice advocacy program that turned attendees into leaders, founders, and changemakers.

To learn more about LBBC's programs, Hear My Voice advocacy training, and next year's conference, travel grants included, visit lbbc.org.

Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.

 Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer.

Until next time, take care and keep pushing for progress.

Nobody wants to talk about dying. But what happens when we do?

On August 5th, 2025, New York becomes one of only a handful of states where Medical Aid in Dying (MAiD) is now legal. For people living with incurable or terminal illness, this isn't an abstract policy debate — it's a deeply personal question about autonomy, dignity, and who gets to decide how life ends.

In this first episode of On Our Own Terms, Victoria Goldberg sits down with two remarkable voices:

Dr. Yesne Alici, psychiatrist at Memorial Sloan Kettering Cancer Center and chair of MSKCC's Medical Aid in Dying Advisory Council, walks us through what New York's new law actually requires, how MSK is preparing to implement it, and what the psychiatric evaluation process looks like for patients who inquire.

Elizabeth Armijo, National Director of Legislative Advocacy at Compassion & Choices, shares what a decade of state-by-state advocacy looks like — and what 85 million Americans now have access to that they didn't before.

Together, they explore the questions most of us are afraid to ask: What is medical aid in dying, and what isn't it? Who qualifies? What does "peaceful" really mean — and who gets to define it?

"The goal is neither to steer a person toward or away from medical aid in dying. It's to make sure that everybody's heard, fully informed, supported, and never abandoned." — Dr. Yesheene Aleje

Topics covered:

• Medical Aid in Dying (MAiD)  vs. euthanasia — what's the difference?
• New York's MAiD Act: eligibility requirements and safeguards
• How MSK is building its clinical MAiD team
• The top three reasons people pursue MAiD worldwide: loss of autonomy, loss of dignity, loss of meaningful activity
• Opposition from faith communities and disability advocates
• What Compassion & Choices does in states where MAiD isn't yet legal
• Resources for patients, caregivers, and families

Resources mentioned:

• Compassion & Choices:   1-800-247-7421
• The Academy of Aid-in-Dying Medicine (formerly the American Clinicians Academy on Medical Aid in Dying)
• Five Wishes advance directive planning
• Death Cafe

This episode is for informational purposes only. Nothing shared here constitutes medical or legal advice. Please consult your own medical team regarding any end-of-life decisions.

On Our Own Terms is a series from Live from Stage Four, hosted by Victoria Goldberg with co-hosts Abigail Johnston and Dr. Ellen Landsberger.

Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.

 Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer.

Until next time, take care and keep pushing for progress.

Triple negative metastatic breast cancer is one of the most complex and rapidly evolving frontiers in oncology, and this episode is your most comprehensive guide to understanding it.

Victoria Goldberg sits down with Dr. Sarah Premji, oncologist and clinical researcher at the Sarah Cannon Research Institute in Nashville, for a deep dive into what makes triple negative MBC so uniquely challenging and why the treatment landscape is changing faster than ever.

This conversation was recorded a few months ago and has already been overtaken by history. Since taping, the FDA has approved two major new treatments specifically for triple negative MBC, datopotamab deruxtecan (Datroway) and sacituzumab govitecan (Trodelvy) in the first line setting, a shift that Victoria and Dr. Premji saw coming.

Together they break down everything patients and caregivers need to know, including what triple negative actually means and why it is such a heterogeneous diagnosis, the critical role of PD-L1 status and why it acts like a fork in the road for treatment planning, the science behind antibody drug conjugates and how Trodelvy and Datroway compare in terms of efficacy, side effects and administration schedules, the BRCA, PALB2 and PARP inhibitor connection and when germline and somatic testing matter most, brain metastases, how common they are in this subtype and what is being done about them, and the exciting pipeline ahead including bispecific ADCs, new targets like B7H4, and the Emi-Le trial.

Even if you are not living with triple negative breast cancer, this episode matters. The approvals and the science discussed here represent a broader shift in how oncology is thinking about precision medicine for all subtypes of MBC.

This episode is part of an ongoing series with Dr. Premji exploring the major subtypes of metastatic breast cancer. Previous episodes cover ER positive MBC, and the final installment featuring Dr. Erika Hamilton on HER2 positive MBC is coming soon.

As always, nothing in this episode constitutes medical advice. Please consult your oncologist and care team before making any treatment decisions.

Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.

 Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer.

Until next time, take care and keep pushing for progress.

In this episode of Symptoms Spotlights, hosts Abigail Johnston and Melanie Sisk, a metastatic breast cancer patient and a registered nurse living with MBC, dive deep into one of the most serious yet underdiscussed risks facing cancer patients: blood clots (thrombus).

Melanie breaks down the science behind how blood clots form, where they can occur in the body including the lungs, brain, heart, and legs, and what terms like DVT, pulmonary embolism, and ischemic stroke actually mean for patients. Abigail shares her own experience being diagnosed with two blood clots in her heart, discovered during a routine echocardiogram while on Enhertu, and what she wishes she had known earlier.

In this episode, you'll learn why cancer patients face a 3 to 4 times higher risk of blood clots than the general population, how treatments like tamoxifen, CDK4/6 inhibitors, and chemotherapy increase clot risk, the signs and symptoms to watch for and when to seek immediate care, how ports can be an unexpected risk factor, practical prevention tips including compression stockings and movement breaks during travel, and when to ask for a hematology specialist rather than relying solely on your oncologist.

Whether you're newly diagnosed or years into your MBC journey, this episode will help you understand your risk, advocate for yourself, and know when something feels off.

Nothing shared in this episode is medical advice. Always consult your healthcare team.

Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.

 Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer.

Until next time, take care and keep pushing for progress.

What if metastatic breast cancer didn't have to mean a lifetime of treatment? For a subset of HER2-positive patients, that question is no longer hypothetical.

In this episode of Live from Stage 4, hosts Victoria Goldberg and Dr. Ellen Landsberger sit down with Dr. Pedram Razavi, breast oncologist, translational researcher, and principal investigator at Memorial Sloan Kettering Cancer Center, to discuss his groundbreaking Phase 2 clinical trial, the HERizon Breast Trial.

Dr. Razavi breaks down how liquid biopsy and circulating tumor DNA (ctDNA) are changing what's possible in metastatic breast cancer, from detecting microscopic disease invisible to scans, to setting a new gold standard for treatment response: molecular complete response, sensitive enough to find one cancer cell among a million.

This is one of our most science-heavy episodes, so we've built in plain-language explainers throughout, covering liquid biopsy, ctDNA, tumor-informed assays, epigenomics, the blood-brain barrier, CNS metastasis, and antibody drug conjugates. No medical degree required.

The HERizon Breast Trial is currently enrolling. If you or someone you know has HER2-positive metastatic breast cancer, this episode could be directly relevant to your care.

🔬 Topics covered:

• What is liquid biopsy and ctDNA?
• The difference between panel testing and tumor-informed (bespoke) assays
• What "molecular complete response" means and why it's a higher bar than a clean scan
• The HERizon Breast Trial: design, goals, and who qualifies
• Could treatment de-escalation become a reality for metastatic breast cancer?

Share this one. Someone out there needs to hear it.

Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.

 Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer.

Until next time, take care and keep pushing for progress.

In this episode of Symptoms Spotlight, hosts Abigail Johnston and Melanie Sisk take an honest and personal look at one of the most common yet least talked about side effects of metastatic breast cancer treatment: vaginal dryness.

Both living with MBC, Abigail and Melanie share what has worked for them, from water-based lubricants and coconut oil to topical lidocaine cream and low-dose estradiol. They talk openly about the emotional toll of painful intimacy, the importance of a supportive partner, and the challenge of finding the right provider to have these conversations with.

The episode also explores a question many MBC patients wrestle with: is vaginal estrogen safe when your cancer is estrogen receptor positive? Podcast team member and retired OB-GYN Dr. Ellen Landsberger weighs in with the latest clinical evidence, including findings from a 2025 systematic review published in the American Journal of Obstetrics and Gynecology, offering cautious reassurance along with practical guidance on recommended formulations.

Whether you are newly navigating these symptoms or have been managing them for years, this episode reminds you that you are not alone, that options exist, and that talking about it is the first step.

Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.

 Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer.

Until next time, take care and keep pushing for progress.

We've always been told that metastatic breast cancer can't be cured, only managed. But what if that's no longer the whole story?

In this episode of Live from Stage 4, hosts Victoria Goldberg and Dr. Ellen Landsberger sit down with Dr. Lior Braunstein, a radiation oncologist at Memorial Sloan Kettering Cancer Center, to talk about the ARCHER trial, a first-of-its-kind clinical study asking a bold question: can surgery and radiation, added on top of standard HER2-targeted therapy, eradicate every last cancer cell in patients with oligometastatic HER2-positive breast cancer?

Dr. Braunstein breaks down what "oligometastatic" really means, why HER2-positive disease is uniquely positioned for this kind of approach, what ablative radiation to the liver or lungs actually involves, and why the word "cure" makes oncologists nervous, even when it might be warranted.

We also cover:

• What the ARCHER trial is looking for in eligible patients
• Why previous trials failed to answer this question
• How cancer develops resistance and why treating visible disease early may be the key
• The role of AI in matching patients to clinical trials
• What comes next if the trial succeeds

Who should listen: Anyone living with HER2-positive metastatic breast cancer, their caregivers, oncology professionals, and anyone who believes patients deserve to hear the hard questions asked out loud.

🔗 Find the ARCHER trial: search "ARCHER trial breast cancer" at clinicaltrials.gov
📝 Show notes and resources at https://www.livefromstage4.org/

Nothing in this episode constitutes medical advice. Please consult your own medical team before making any decisions about

Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.

 Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer.

Until next time, take care and keep pushing for progress.

Last time, we had a front row seat to a vision. This time, that vision has a launch date.

On June 20th, CureWise officially launched, and for every cancer patient who walks into an oncologist's office with ten minutes and no idea what to ask, it couldn't come at a better time.

In this episode of Live From Stage 4, Victoria Goldberg sits down with Steve Brown (founder & CEO of CureWise) and Lisa Booth (metastatic breast cancer advocate and CureWise's patient #2) to talk about what it actually means to have an AI platform that knows your full medical history, speaks your language, and helps you show up to your appointments prepared and empowered.

Also joining us: Beta users Lynda Weatherby (MBC patient and Live From Stage 4  team memberr) and her husband Todd Weatherby (CEO of Siemens Advanta, former VP at AWS), bringing the real-world patient and caregiver perspective to the conversation.

In this episode:

• How CureWise pulls your medical records from multiple institutions automatically
• The Cross-Check feature: asking ChatGPT, Claude, and Gemini the same question simultaneously
• Why 60% of cancer patients have an actionable mutation, but only 15% are being treated for it
• How to prepare for your oncology appointment using AI
• The caregiver experience and what's coming next on the roadmap
• Pricing, the 7-day free trial, and how to get started

Important note: CureWise is not a doctor. It is a powerful tool to help you understand your medical records and have better conversations with your care team. All medical decisions should be made with your physician.

🔗 Sign up at www.curewise.com

Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.

 Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer.

Until next time, take care and keep pushing for progress.

The field of hormone receptor-positive, HER2-negative metastatic breast cancer is moving faster than ever, and in this episode, we go beyond SERENA-6 to map the full picture of what's changing.

Joining hosts Victoria Goldberg and Abigail Johnston is Dr. Sarah Premji, Assistant Director of Breast Cancer Research at Sarah Cannon in Nashville, for a comprehensive deep dive into the new wave of endocrine therapies reshaping treatment for the most common subtype of breast cancer.

Together, they cover the evolution from CDK4/6 inhibitors to the era of oral SERDs, FDA approvals of elacestrant, imlunestrant, and vepdegestrant and what makes each unique, the emerging mechanisms of PROTACs and CERANs, and how ESR1 mutations drive treatment decisions at progression. Dr. Premji also shares her real-world approach to sequencing therapy, weighing tumor profiling, prior treatment history, sites of disease, and each patient's individual lifestyle and priorities. The conversation closes with a look at the growing role of AI in oncology, from clinical trial matching to pathology and imaging.

Whether you are a community oncologist navigating an increasingly complex algorithm or a patient advocate trying to stay current, this episode is your guide to where ER+ breast cancer treatment stands today and where it is headed.

Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.

 Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer.

Until next time, take care and keep pushing for progress.

In this episode of the Symptom Spotlight Series, hosts Abigail Johnston and Melanie Sisk are joined by Dr. Jill Tirabassi, this podcast's team member, to break down neutropenia. It is one of the most common and important side effects of cancer treatment.

Dr. Tirabassi explains what neutropenia actually means, why neutrophils matter, and how chemotherapy and CDK 4/6 inhibitors can deprive your body of these critical infection-fighting white blood cells. The conversation covers what happens when your absolute neutrophil count (ANC) drops too low, when your oncology team might delay or reduce your dose, and what medications like bone marrow stimulators (and the auto-injectors that deliver them) can do to help.

The hosts also share their own personal experiences: from managing bone pain with loratadine (Claritin), to navigating a hospital admission with a dangerously low ANC, to learning what questions to ask your doctor before a fever or infection hits on a weekend.

Topics covered:

• What neutropenia is and why it's a concern during cancer treatment
• The ANC number your care team watches and what happens when it's too low
• Bone marrow-stimulating drugs: how they work, timing, and side effects
• Lifestyle tips (diet, masking, sleep) when your counts are low
• CDK 4/6 inhibitors and dose reductions
• When to call your doctor vs. go to the ER, and why that conversation matters

Thanks for listening. If you enjoyed the episode, subscribe and leave a review — it really helps. Follow us on social media @livefromstage4 and visit our website at www.livefromstage4.org for show notes and links.

 Your support helps us continue to share important stories and advocate for those living with metastatic breast cancer.

Until next time, take care and keep pushing for progress.