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On this episode of Oncology Unscripted, patient advocates Julie Johnson and Katie Coleman and radiation oncologist Dr. Matt Spraker host Radiation Oncologist, Dr. Ravi Patel, MD, PhD.

Ravi is Director of Radiopharmaceuticals at UPMC Hillman Cancer Center and a translational researcher at the University of Pittsburgh Department of Radiation Oncology.

We discuss the emerging treatment strategy of radiopharmaceuticals (RPT), a.k.a. theranostics! 

We first review what these therapies are, a targeting molecule, such as an antibody, linked to an imaging or therapy radioisotope. RPT is an older therapy, but new agents are being discovered at a rapid pace. 

Our discussion then focuses on Lutetium-177 PSMA, Pluvicto, and how this has improved outcomes in patients with prostate cancer. 

We also review the logistics and risks for how patients get treated with RPTs.

Here are some other things we discussed during the show:

• VISION Trial of Pluvicto (Lutetium-177 PSMA) for metastatic, castrate-resistant prostate cancer (mCRPC)
• PSMAfore Trial of Pluvicto for mCRPC after treatment with androgen receptor pathway inhibitor (ARPI)
• PSMAddition Trial of Pluvicto added to androgen deprivation therapy plus ARPI in up front treatment of mCRPC
• AlphaBet Trial Protocol of Radium-223 plus Lutetium-177 in prostate cancer
• Beta decay (Wikipedia)
• SPECT scan (Wikipedia)

Oncology Unscripted is a Photon Media production. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago. Audio-only versions of our podcast are available on most podcast platforms.

Additional content from Matt Spraker can be found on his website, https://www.sprakermd.com/.

Additional content from Katie Coleman can be found at her website, https://www.katiekickscancer.com/. 

This show and our opinions are meant for general informational purposes and are not medical advice. We encourage you to reach out to your doctors to discuss your individual case.

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On this episode of Oncology Unscripted, patient advocates Julie Johnson and Katie Coleman and radiation oncologist Dr. Matt Spraker host radiologist Dr. Costa Raptis, MD.

We start by discussing the process of acquiring and interpreting radiographic images. What happens after you get your scan, and how do radiologists read them and generate reports? 

Also, how can patients know they are getting the right type of scan? We review some details of CT, MRI, and PET/CT scans. 

Then we discuss an essential question: "What is normal?". How do radiologists measure lesions or tumors, and how is this done consistently across time?  Are other physicians trained to read images like radiologists? 

We also ask Dr. Costa about AI, the future of radiology, and we discuss how radiologists get excited when patients have exceptional responses. 

The video podcast of this episode is available on our YouTube Channel!

Oncology Unscripted is a Photon Media production. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago. Audio-only versions of our podcast are available on most podcast platforms.

Additional content from Matt Spraker can be found on his website, https://www.sprakermd.com/.

Additional content from Katie Coleman can be found at her website, https://www.katiekickscancer.com/. 

This show and our opinions are meant for general informational purposes and are not medical advice. We encourage you to reach out to your doctors to discuss your individual case.

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On this episode of Oncology Unscripted, patient advocate Katie Coleman and radiation oncologist Dr. Matt Spraker host another radiation oncologist, Dr. Shankar Siva, PhD, MBBS, FRANZCR. 

Shankar is an oncologist and professor at Peter MacCallum Cancer Centre in Victoria, Australia, and a specialist in genitourinary cancers, such as Kidney Cancer. 

We discuss stereotactic ablative body radiotherapy (SABR, aka SBRT) for kidney cancer! We review many of the studies that demonstrate it is an excellent tool to treat localized or metastatic kidney cancer, and why patients should consider it for their care. 

Here are some resources we discussed during the show:

• Targeting Cancer - SABR versus SBRT (they are the same!)
• The International Stereotactic Radiosurgery Society
• TROG 15.03 FASTRACK II Study of SABR for Localized Kidney Cancer 
• “The Van Poppel Study” of Partial versus Radical Surgery for Localized Kidney Cancer 
• Comparison of SABR and other Ablation for Kidney Cancer
• iROCK Registry
• MD Anderson and UTSouthwestern studies: SABR instead of systemic therapy for oligometastatic disease
• RAPPORT Study of SABR and Pembrolizumab for oligometastatic kidney cancer
• Oncology Unscripted Episode - Insider’s Guide to Radiation Therapy: SBRT

Oncology Unscripted is a Photon Media production. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

Additional content from Katie Coleman can be found at her website, https://www.katiekickscancer.com/. 

Additional content from Matt Spraker can be found at his website, https://www.sprakermd.com/.

This show and our opinions are meant for general informational purposes and are not medical advice. We encourage you to reach out to your doctors to discuss your individual case. 

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On this episode of Oncology Unscripted, patient advocates Julie Johnson and Katie Coleman and radiation oncologist Dr. Matt Spraker start to discuss scanxiety.

Matt starts by sharing ASCO guidelines, one framework to assist oncologists and patients treat anxiety that comes up at diagnosis and throughout cancer treatment. 

Then Julie and Katie share their experiences and thoughts about how they have coped with anxiety around tests, scan intervals, and the possibility of future treatment. 

Oncology Unscripted is a Photon Media production. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

Additional content from Katie Coleman can be found at her website, https://www.katiekickscancer.com/. 

Additional content from Matt Spraker can be found at his website, https://www.sprakermd.com/.

This show and our opinions are meant for general informational purposes and are not medical advice. We encourage you to reach out to your doctors to discuss your individual case. 

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On this episode of Oncology Unscripted, patient advocates Julie Johnson and Katie Coleman and radiation oncologist Dr. Matt Spraker host Dr. Michelle Hirsch, MD, PhD. She is a pathologist and Chief of the Genitourinary Pathology Division at Brigham and Women's Hospital and Harvard University.

In this episode, we cover all things pathology! 

We kick off by discussing the role of the pathologist in the cancer care team. How do these doctors train and what do they do each day? 

Then we discuss the process of pathology. What happens to a patient's tissue once it is removed from their body? A lot! 

We review different techniques pathologists use to make a diagnosis and terms that patients may find in their pathology report. We also share ideas for how patients can better understand their report. 

We close with a discussion of pathology second opinions.
 
Here are some other things we discussed during the show:

• Microtome (Wikipedia)
• A stock image of a pathology block
• H&E and IHE staining (Wikipedia)
• PathologyOutlines.com
• College of American Pathologists website
• WHO Classification of Tumors (Blue Book) Online
• Oncology Unscripted Episode: Second Opinions

Oncology Unscripted is a Photon Media production. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

Additional content from Matt Spraker can be found on his website, https://www.sprakermd.com/.

Additional content from Katie Coleman can be found at her website, https://www.katiekickscancer.com/. 

This show and our opinions are meant for general informational purposes and are not medical advice. We encourage you to reach out to your doctors to discuss your individual case. 

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On this episode of Oncology Unscripted, patient advocates Julie Johnson and Katie Coleman and radiation oncologist Dr. Matt Spraker host physical therapist Dr. Hillary Hinrichs and researcher Dr. Kelley Wood (@kcwood_phd on X) to discuss exercise and cancer rehabilitation. 

We kick off our discussion with an important question. What is cancer rehabilitation, and how is this different than exercise? 

Then, we discuss how patients can find out how cancer rehabilitation and exercise can play a role in their care. How can you ask your doctor whether you need a cancer rehab evaluation? How are doctors learning how to best use exercise and cancer rehab in their treatment plans? 

We close the discussion by examining the benefits that cancer rehabilitation can provide throughout a patients course of diagnosis, treatment, and beyond. Also, we review the risks and restrictions that may be important in the context of a cancer diagnosis. 

Here are some resources that can help you find a rehabilitation therapist, such as a physical, occupational, or speech/swallow therapist:

• American Physical Therapy Association - Find a Physical Therapist or Specialist Therapist
•  Lymphology Association of North America - Find a Lymphedema Therapist
• ReVital Cancer Rehab – Find a location

Check out the ACSM Exercise Is Medicine, Moving Through Cancer website, it's a great patient resource! 

Here are some other things we discussed during the show:

• Schmitz et al., Exercise is medicine in oncology: Engaging clinicians to help patients move through cancer. (free access)
• Pergolotti et al., Impact of Real-World Outpatient Cancer Rehabilitation Services on Health-Related Quality of Life of Cancer Survivors. (free access)
• ECOG Performance Status 
• 6-Minute Walk Test
• Timed Up and Go Test

Oncology Unscripted is a Photon Media production. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

Additional content from Katie Coleman can be found at her website, https://www.katiekickscancer.com/. 

This show and our opinions are meant for general informational purposes and are not medical advice. We encourage you to reach out to your doctors to discuss your individual case. 

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On this episode of Oncology Unscripted, patient advocates Julie Johnson and Katie Coleman and radiation oncologist Dr. Matt Spraker subject each other to an "Ask Me Anything"!

Here are the questions we asked each other:

1. What do you wish doctors and other people without cancer knew about how the diagnosis actually changed your day to day life?

2. What do you wish more patients knew or did early in their diagnosis?

3.  What is one thing you'd like to see changed or improved in medicine in the next 3 years?

4.  Do they teach you how to cope with death and losing patients in medical school?

5. How do people address you in the hospital? Who calls you Dr. Spraker and who calls you Matt? What about a third party, like a business meeting?

6. What do you think about doctors' behavior and activity online, for instance an argument or comedy skits online?

Oncology Unscripted is a Photon Media production. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

Additional content from Katie Coleman can be found at her website, https://www.katiekickscancer.com/. 

This show and our opinions are meant for general informational purposes and are not medical advice. We encourage you to reach out to your doctors to discuss your individual case. 

Send us a text

On this episode of Oncology Unscripted, patient advocates Julie Johnson and Katie Coleman and radiation oncologist Dr. Matt Spraker start to discuss how patients might pick their doctor. 

Here links to some things we discussed during the show:

• United Health Care, 7 tips for choosing a primary care doctor.
• US Department of Health and Human Services, Office of Disease Prevention and Health Promotion, Choosing a Doctor: Quick Tips.
• Blue Cross Blue Shield, Five tips for choosing a new primary care physician.
• WebMD.com, How to Choose a Doctor.

Oncology Unscripted is a Photon Media production. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

Additional content from Katie Coleman can be found at her website, https://www.katiekickscancer.com/. 

This show and our opinions are meant for general informational purposes and are not medical advice. We encourage you to reach out to your doctors to discuss your individual case. 

Send us a text

Oncology Unscripted co-hosts Julie Johnson, Katie Coleman, and Dr. Matt Spraker welcome Dr. Breelyn Wilky, MD to discuss immunotherapy for sarcomas and other cancers.

We start by explaining some general details of immunotherapy and how it works, then dive in to the unknowns surrounding the exciting therapy.

We discuss what biological features of tumors and patient tissues may predict response to immunotherapy, "immune hot versus cold" tumors, and how immunotherapy may be combined with other therapies like chemotherapy or radiotherapy.

We close with a discussion of how the gut microbiome may interact with the immune system to fight cancer, and whether diets can help treatment.

Oncology Unscripted is a Photon Media production. Check out our YouTube Channel for video content!

Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

Additional content from Katie Coleman can be found at her website, https://www.katiekickscancer.com/. 

This show and our opinions are meant for general informational purposes and are not medical advice. We encourage you to reach out to your doctors to discuss your individual case. 

Send us a text

On this episode of Oncology Unscripted, patient advocates Julie Johnson and Katie Coleman and radiation oncologist Dr. Matt Spraker continue The Insider's Guide to Radiation Therapy! 

Here are the figures/graphics we referenced during the show:

• The first figure we discussed, demonstrating the Bragg Peak and the difference between proton and photon (x-ray) beams. 
• The second figure we discussed, comparing 3D photon (x-ray) radiation, intensity modulated radiotherapy with photons (x-ray), passive scatter and intensity modulated proton therapy.

Here are some other things we discussed during the show:

• Relative biological effectiveness in radiobiology
• A video about "IMRT for proton therapy", or pencil beam scanning proton therapy, from manufacturer IBA.
• Brada review of proton evidence, questioning whether the US should open so many proton centers so quickly. 
• Goitein and Cox response to Brada, arguing that the benefit of proton therapy is self-evident.
• Glatstein, Glick, Kaiser, and Hahn, arguing that trials are needed to prove the benefit of proton therapy.
• Liao et al., randomized phase II trial of proton versus photon (x-ray) radiotherapy for locally advanced non-small cell lung cancer.
• RTOG 1308, randomized phase III trial of proton versus photon (x-ray) radiotherapy for locally advanced non-small cell lung cancer. Now filled, awaiting results!
• Lin et al., randomized phase IIB trial of proton versus photon (x-ray) radiotherapy for locally advanced esophageal cancer.
• NRG GI-006, randomized phase III trial of proton versus photon (x-ray) radiotherapy for locally advanced esophageal cancer, enrolling now!

Oncology Unscripted is a Photon Media production. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.

Additional content from Katie Coleman can be found at her website, https://www.katiekickscancer.com/. 

This show and our opinions are meant for general informational purposes and are not medical advice. We encourage you to reach out to your doctors to discuss your individual case.