Patient from Hell

This episode is sponsored by Gilead Sciences. Gilead had no involvement or input in the podcast content. Gilead is working to transform how cancer is treated. We are innovating with next-generation therapies, combinations, and technologies to deliver improved outcomes for people with cancer. From antibody drug conjugates and small molecules to cell therapy-based approaches, our portfolio and pipeline assets are creating new possibilities for people with cancer.

UPDATE SINCE RECORDING JANUARY 2026. Since this recorded conversation, the FDA has acted on the data discussed in this episode. On May 22, 2026, Datopotamab Deruxtecan was approved for first-line metastatic TNBC in patients who are not candidates for immunotherapy. On June 24, 2026, Sacituzumab Govitecan was approved for first-line use both as a single agent and in combination with pembrolizumab for PD-L1-positive disease (CPS ≥10). Consult with your care team for the most recent indications and availability of these treatment options.

Metastatic triple-negative breast cancer has historically had the fewest targeted options of any breast cancer subtype. The ASCENT-03 trial changed the first-line picture.

ASCENT-03 (NCT05382299) was a phase 3, open-label, randomized trial of 558 patients with unresectable locally advanced or metastatic triple-negative breast cancer who had not received prior systemic therapy for advanced disease and who were not candidates for PD-1 or PD-L1 inhibitor therapy. Participants were randomized 1:1 to sacituzumab govitecan-hziy or to physician's choice of chemotherapy (nab-paclitaxel, paclitaxel, or gemcitabine plus carboplatin).

0:00 Treating cancer like a game of chess

0:44 Introducing Dr. Alissa Huston

1:11 Breast oncology and integrative oncology in one practice

2:58 Twenty years of change: from tumor size to molecular profiling

4:28 Where metastatic triple-negative breast cancer stands today

5:55 What is PD-L1, and how does immunotherapy work?

6:46 Why immune-related side effects behave differently

8:05 Choosing between immunotherapy, ADCs, and chemotherapy

9:58 Inside ASCENT-03: what the trial studied and who it enrolled

12:15 Progression-free survival, explained in plain language

16:50 What the first appointment actually looks like

19:22 Holding hope and toxicity in the same conversation

20:34 Supportive and integrative tools for managing side effects

21:29 Neutropenia, infection risk, and growth factor support

22:50 Cumulative toxicity versus emerging toxicity

25:47 Toxicity grading and why doses get reduced

26:34 Why patients hide side effects, and why dose reductions are planned

30:02 The chess analogy, revisited

32:09 One piece of advice at diagnosis

33:43 Rapid fire: ASCENT-03, progression-free survival, overall survival

36:15 Rapid fire: antibody-drug conjugates and first-line treatment 37:33 What is integrative oncology?

38:09 Closing thoughts

Alissa Huston, MD is a Professor of Medicine and breast medical oncologist at the Wilmot Cancer Institute at the University of Rochester, and Co-Medical Director of the Pluta Integrative Oncology and Wellness Center. She earned her medical degree at the University of Buffalo, completed her internal medicine residency at Strong Memorial Hospital, and completed her hematology and oncology fellowship at the University of Pittsburgh. Her research focuses on the effects of breast cancer treatment on bone health and on evidence-based integrative approaches to symptom management during cancer treatment. She is a member of the American Society of Clinical Oncology and the Society for Integrative Oncology, and a co-author on the Society for Integrative Oncology and ASCO guideline for integrative management of anxiety and depression in adults with cancer.

This podcast is intended for educational and informational purposes only and should not be considered medical advice. Always consult a qualified healthcare professional regarding diagnosis, treatment, or medical decisions.

Two of the most widely used chemotherapy drugs in the world, 5-FU and capecitabine, have been in use since the 1950s. A small share of patients carry variants in a gene called DPYD that slow their ability to break these drugs down, which means a standard dose behaves like an overdose in their body.

A single genetic test can identify those patients before the first treatment. Europe recommended universal screening in 2020. The FDA updated the labels for both drugs in 2025, after years of pressure from families who had lost someone.In this episode of Patient From Hell, host Samira Daswani speaks with Dr. Gabe Brooks, a medical oncologist at the Dartmouth Cancer Center, about what DPD deficiency is, what severe toxicity actually looks like, how and when to get screened, what the test costs, and the exact question to ask before starting either drug.

Guest:

Gabriel Brooks, MD, MPH, is a medical oncologist and Associate Professor of Medicine at the Dartmouth Cancer Center and the Geisel School of Medicine. He co-directs the Cancer Population Sciences Research Program and specializes in gastrointestinal cancers, including colorectal cancer.

Chapters

00:00 Introduction

00:27 What DPYD is and why it matters

02:50 When toxicity turns fatal

04:21 5-FU vs. capecitabine

06:16 Which cancers use these drugs

06:53 What the FDA changed

08:26 Why the U.S. took five years longer than Europe

11:27 Warning signs and time to onset

15:28 How and when to get screened

17:39 Germline DNA vs. tumor genomic testing

20:16 The patient advocacy behind the change

24:44 What to ask your oncologist

26:43 What the test costs

28:18 Closing thoughts

Resources:

Advocates for Universal DPD/DPYD Testing — test4dpd.org🎙️

Patient From Hell is hosted by Samira Daswani, cancer survivor, entrepreneur, and founder of Manta Cares. Through candid conversations with patients, physicians, researchers, and healthcare leaders, the show explores the realities of cancer care while empowering patients with practical, evidence-based information.

🔗 Connect with Patient From Hell

Website: https://www.mantacares.com

Disclaimer

This podcast is intended for educational and informational purposes only and should not be considered medical advice. Always consult a qualified healthcare professional regarding diagnosis, treatment, or medical decisions.

This episode is sponsored by Gilead Sciences. Gilead had no involvement or input in the podcast content. Gilead is working to transform how cancer is treated. We are innovating with next-generation therapies, combinations, and technologies to deliver improved outcomes for people with cancer. From antibody drug conjugates and small molecules to cell therapy-based approaches, our portfolio and pipeline assets are creating new possibilities for people with cancer.Recorded on location at the San Antonio Breast Cancer Symposium, December 2025.Metastatic triple-negative breast cancer remains the breast cancer subtype with the fewest targetable biomarkers and the shortest treatment algorithm. When a trial reports a double-digit progression-free survival in the first-line setting, it is worth understanding what that actually changes and how the trial was designed with patient outcomes at the center.This episode was recorded in December 2025, before regulatory action. On June 24, 2026, the FDA approved sacituzumab govitecan-hziy for two first-line indications in triple-negative breast cancer: as a single agent for adults with unresectable locally advanced or metastatic TNBC who are not candidates for PD-1 or PD-L1 inhibitor-based therapy supported by ASCENT-0, and in combination with pembrolizumab for adults whose tumors express PD-L1 with a CPS of 10 or greater supported by ASCENT-04. Janice's speculation in this episode about how PD-L1 status might factor into the guidelines has since been answered by the label.ASCENT-04/KEYNOTE-D19 NCT05382286 was a phase 3, open-label, randomized trial of 443 patients with previously untreated locally advanced unresectable or metastatic TNBC whose tumors expressed PD-L1 at a CPS of 10 or greater by the 22C3 assay. Participants were randomized 1:1 to sacituzumab govitecan plus pembrolizumab or to physician's choice of chemotherapy plus pembrolizumab. Patients in the control arm with centrally confirmed progression were offered crossover to sacituzumab govitecan.0:00 Live from the San Antonio Breast Cancer Symposium0:30 The METAvivor ribbon and what the pink ribbon leaves out1:35 Diagnosed in 2016 with a median overall survival of 9 to 15 months2:26 Nine years later3:20 From pediatric nursing to research advocacy4:30 What has changed since 2017, and what has not5:26 2011: when chemotherapy was the only option5:55 On not knowing a relevant clinical trial existed6:47 Why metastatic TNBC still has no maintenance therapy7:25 What first-line treatment looks like today8:25 Inside ASCENT-049:09 Progression-free survival, defined9:59 Why a double-digit PFS is notable in this subtype11:20 Why each subsequent line of treatment works for less time11:52 How many patients never reach second line12:50 The case for a stronger first-line option13:21 Crossover design, and why it matters to patients14:33 What crossover means in a randomized trial15:56 Patient advocates in clinical trial design18:59 Quality of life versus quantity of life21:48 Rapid fire: metastatic breast cancer and metastatic TNBC23:06 Rapid fire: first line, second line, progression-free survival24:00 Rapid fire: immunotherapy and antibody-drug conjugates24:59 Advice for the newly diagnosed26:04 What she wants next: a biomarker26:52 On ADCs, tolerability, and the need for novel targetsJanice Cowden, RN is a research patient advocate living with metastatic triple-negative breast cancer. She practiced as a registered nurse for approximately 22 years, primarily in pediatrics, and later worked as a pharmaceutical sales representative. She was diagnosed with stage I triple-negative breast cancer in 2011 and with metastatic disease in 2016, and completed the Living Beyond Breast Cancer advocacy training program in 2017.This podcast is intended for educational and informational purposes only and should not be considered medical advice.

Researchers studying lung cancer draw on more than 800 cell lines as a scientific baseline. Not one of them came from a Hispanic/Latin(x), American Indian/Alaska Native, or Native Hawaiian/Pacific Islander patient, and only about 3% are from Black patients. 

Eugene Manley Jr., PhD is a biomedical research scientist, mechanical engineer, patient advocate, and the Founder and CEO of the STEMM & Cancer Health Equity (SCHEQ) Foundation in New York City. Before founding SCHEQ, he served as Director of STEM Workforce Initiatives at LUNGevity. He also co-authored the review in Frontiers in Oncology that uncovered the patient mix and cataloged the lung cancer cell lines available to researchers worldwide.

In this episode, he and host Samira Daswani trace a problem most conversations about clinical trial diversity never reach. The underrepresentation does not begin at enrollment. It begins upstream, in the cell lines, reference genomes, and funding decisions that shape what science gets done at all.

Dr. Manley’s review found 390 lung cancer cell lines from Asian patients and nearly 200 from White patients, but only 31 from Black patients and none at all from three other groups. When the input material is not representative, no amount of downstream clinical trial recruitment can fix it.

The conversation covers:

• Why cell lines and reference genomes are the real starting point for drug development

• What the 2023 Frontiers in Oncology review found, and what it means for who a drug is designed to work on

• How funding decisions shape which questions researchers can even ask

• Why patients enroll in trials at much higher rates when someone simply asks

• What to request at diagnosis, including biomarker testing, ideally NGS, and a patient or nurse navigator

• How to read your own chart, advocate for accuracy, and document discrepancies while you are still in the hospital

• What Dr. Manley learned about advocating for himself while on Medicaid

CHAPTERS

00:00 The bias does not start at the clinical trial

00:23 Meet Dr. Eugene Manley Jr., PhD

01:15 Detroit roots, chronic asthma, and the road into science

02:31 Why a bench scientist became a patient advocate

03:26 Experiencing medical racism as a patient

05:24 Finding your voice when the system is not listening

07:08 "Alert and oriented": how three words shape your care

08:10 Bring a proxy and read your chart in real time

10:47 When the chart becomes fact: correcting your record

11:20 Why oncology trials still are not representative

12:46 It is not the trial, it is the whole system

13:13 The cell line gap: what the lab starts with

14:39 Where the bias actually begins: basic science

15:44 Breast cancer outcomes: biology, not just zip code

16:28 Reference genomes and databases skew European

17:10 Why he founded the SCHEQ Foundation

20:02 Newly diagnosed: biomarker testing and navigation

21:19 When a clinical trial should be offered to you

22:56 How to start the trial conversation with your team

23:53 Inside the SCHEQ Foundation's work

25:18 Closing thoughts

Dr. Eugene Manley, Jr., PhD, MS, is a biomedical scientist-turned-social impact leader and Founder & CEO of the STEMM & Cancer Health Equity (SCHEQ) Foundation. With more than 20 years of experience spanning molecular biology, cancer research, nonprofit strategy, workforce development, and health equity, he has held leadership roles with organizations including AACR, LCRF, and LUNGevity Foundation. Through SCHEQ, Dr. Manley advances STEMM workforce diversity and patient-centered cancer solutions, with a focus on improving access to screening, biomarker testing, clinical trials, and survivorship resources for underserved communities.

🔗 Connect with Patient From Hell

Website: https://www.mantacares.com

Disclaimer

This podcast is intended for educational and informational purposes only and should not be considered medical advice. Always consult a qualified healthcare professional regarding diagnosis, treatment, or medical decisions.

This episode is sponsored by Gilead Sciences. Gilead had no involvement or input in the podcast content. Gilead is working to transform how cancer is treated. We are innovating with next-generation therapies, combinations, and technologies to deliver improved outcomes for people with cancer. From antibody drug conjugates and small molecules to cell therapy-based approaches, our portfolio and pipeline assets are creating new possibilities for people with cancer.

Dr. Sara Tolaney, Chief of the Division of Breast Oncology at Dana-Farber Cancer Institute, returns to Patient From Hell to explain the ASCENT-04/KEYNOTE-D19 study, the phase 3 trial she led as principal investigator, and what it changes for people living with metastatic triple-negative breast cancer.For years, the most effective drugs for metastatic TNBC were only available after first-line chemotherapy had already failed. The problem, as Dr. Tolaney puts it plainly, is that many patients never reach a second line of treatment at all. ASCENT-04 asked whether moving an antibody-drug conjugate to the front, paired with immunotherapy, would change that. Median progression-free survival improved from 7.8 months to 11.2 months, and treatment responses lasted significantly longer.

UPDATE: Since this recorded conversation, the FDA has acted on the data discussed in this episode. On May 22, 2026, Datopotamab Deruxtecan was approved for first-line metastatic TNBC in patients who are not candidates for immunotherapy. On June 24, 2026, Sacituzumab Govitecan was approved for first-line use both as a single agent and in combination with pembrolizumab for PD-L1-positive disease (CPS ≥10). Consult with your care team for the most recent indications and availability of these treatment options.

00:00 The trial that moves the best drugs first

00:31 Welcome back, Dr. Sara Tolaney

00:40 What ASCENT-04 set out to solve

02:00 Why many patients never reach second-line treatment

02:50 What PD-L1 status means for your treatment

04:12 The result: 7.8 to 11.2 months

05:29 What is an antibody-drug conjugate (ADC)?

06:33 Why TROP-2 is the target in triple-negative breast cancer

07:24 How immunotherapy works: taking the brakes off the T cell

09:01 Who was eligible for the trial

10:05 What "controlling" cancer actually means

11:44 Progression-free survival vs. duration of response

13:37 Dr. Tolaney reconsiders: what ASCENT-03 showed

15:51 How trial data reaches your oncologist's office

18:21 The testing checklist after a metastatic diagnosis

19:59 First-line treatment options today

22:27 The new paradigm: ADCs as the first-line backbone

23:51 What comes second line

25:29 Why tumor sequencing matters: somatic BRCA, TMB, trials

27:24 Twenty years of change in triple-negative breast cancer

29:28 Advice for a newly diagnosed patient

Sara M. Tolaney, MD, MPH is Chief of the Division of Breast Oncology and Associate Director of the Susan F. Smith Center for Women's Cancers at Dana-Farber Cancer Institute, and Associate Professor of Medicine at Harvard Medical School. She trained at Princeton University, UC San Francisco, Johns Hopkins University, and Dana-Farber Cancer Institute, and holds a Masters in Public Health (MPH) from Harvard University. She serves on the National Cancer Institute (NCI) Breast Cancer Steering Committee and is Vice Chair for Late-Stage Development in Breast Cancer for the Alliance for Clinical Trials in Oncology. She was principal investigator of ASCENT-04.

🔗 Connect with Patient From Hell

Website: https://www.mantacares.com

Disclaimer

This podcast is intended for educational and informational purposes only and should not be considered medical advice. Always consult a qualified healthcare professional regarding diagnosis, treatment, or medical decisions.

Shira Boehler's family is full of doctors, and every one of them told her not to get the full-body MRI. She canceled the appointment repeatedly herself, until her husband rebooked it one time too many and she finally went.

The scan found a 3.8 centimeter mass in her right lung and labeled it a minor finding, with a note to correlate with symptoms. She had none. She was running six miles a day, the picture of health, and had never smoked. A follow-up CT months later showed the mass had grown, and on the Monday she walked into a pulmonary specialist's office she was told she had an invasive adenocarcinoma. She told him it was probably an EMR error. One week later, surgeons removed half her right lung to treat her cancer.

Samira Daswani, host of Patient from Hell and founder of Manta Cares, welcomes lung cancer survivor and bestselling author Shira Boehler for an eye-opening conversation on the part that comes after the story, which is why almost nobody in Shira's position gets caught this early. Screening guidelines currently cover people over 50 with a twenty-pack-per-year smoking history, and fewer than one in five of them actually get scanned, in part because the criteria require disclosing something patients are ashamed of. Shira has been working the problem from both ends since her treatment, negotiating cash prices at imaging centers down to a fraction of what she paid and funding new scans for people who can't cover them through the nonprofit organization she founded, Cancer Doesn't Care.

In this episode, Samira and Shira discuss:

• Why lung cancer is often diagnosed too late

• The importance of early detection and low-dose CT screening

• How people who have never smoked can still develop lung cancer

• The stigma surrounding lung cancer diagnosis

• Current lung cancer screening guidelines

• Insurance coverage, healthcare access, policy reform

• How artificial intelligence may improve cancer screening

• Why patient advocacy is becoming increasingly important in modern healthcare

Chapters

00:00 Introduction

01:00 The Full-Body Scan That Changed Everything

03:32 Diagnosed With Lung Cancer Despite Having No Symptoms

05:30 Access, Privilege & Why Early Detection Isn't Equal

07:10 Building the Cancer Doesn't Care Foundation

09:21 Why Lung Cancer Screening Needs to Change

10:19 Breaking the Stigma Around Lung Cancer

12:26 Who Actually Qualifies for Screening?

14:23 Changing Public Perception Through Advocacy

16:20 Why Patients Must Advocate for Themselves

17:15 AI, False Positives & the Future of Cancer Screening

20:27 Why Lung Cancer Is Often Diagnosed Too Late

21:17 Stage 1 vs. Stage 4 Survival Rates

23:25 Shira's Advice for Anyone Considering Lung Cancer Screening

Shira Kupperman Boehler is a finance professional, health advocate, bestselling author, and lung cancer survivor. Shira holds a degree in Molecular and Cell Biology from the University of California, Berkeley, and an MBA from New York University’s Stern School of Business. Alongside her husband Adam, she has spent her career building and scaling multibillion-dollar healthcare businesses, developing deep relationships across health systems, payers, and policymakers.
After being unexpectedly diagnosed with Stage 1B lung adenocarcinoma despite never smoking and having no symptoms, Shira founded Cancer Doesn't Care, a nonprofit dedicated to expanding access to life-saving lung cancer screening and reducing financial barriers to early detection. She is also the author of the bestselling memoir One Scan Saved My Life, with proceeds supporting patient screening initiatives.

🔗 Connect with Patient From Hell

Website: https://www.mantacares.com

Disclaimer

This podcast is intended for educational and informational purposes only and should not be considered medical advice. Always consult a qualified healthcare professional regarding diagnosis, treatment, or medical decisions.

This episode is dedicated to Natalie's memory and to every patient navigating life with cancer.

Natalie Brown's answer to "How are you?" was always simple:

"I'm here."

Diagnosed with stage 4 non-small cell lung cancer at just 33 years old, despite never smoking and having no family history of lung cancer, Natalie spent six years challenging assumptions about what lung cancer looks like.

In this unforgettable conversation with host Samira Daswani, Natalie shares her journey through multiple rounds of chemotherapy, immunotherapy, failed clinical trials, and one of the rarest procedures in cancer medicine a bilateral double lung transplant. She also opens up about recurrence, chronic pain, advocacy, mental health, and why she believed every patient deserves to know all of their treatment options.

Natalie has passed away. We are honored to share her story again in celebration of the courage, honesty, humor, and determination that defined her life. Her voice continues to educate, inspire, and advocate for patients everywhere.

Whether you're living with cancer, supporting someone who is, or simply want to better understand the realities of serious illness, Natalie's message is one everyone should hear.

In this episode you'll learn:

• What it's like to be diagnosed with stage 4 lung cancer at age 33
• Why non-smokers can develop lung cancer
• How a rare double lung transplant became a treatment option
• The emotional reality of cancer recurrence
• Clinical trials, targeted therapies, and asking "What's next?"
• The importance of patient advocacy and second opinions

• How friends, family, therapy, and hope helped Natalie keep fighting
• Why "Anyone with lungs can get lung cancer"

Natalie's story reminds us that resilience isn't about pretending things aren't difficult—it's about continuing to move forward anyway.

00:00 Introduction: Remembering Natalie Brown

01:00 "I'm Here" — The phrase that defined Natalie

02:00 Diagnosed with Stage 4 Lung Cancer at 33

04:00 Four Chemotherapies & Failed Clinical Trials

05:30 Discovering a Rare Double Lung Transplant

10:40 Returning Home After Transplant

11:45 Cancer Recurrence & New Treatment Options

13:00 The Husband Who Helped Her Keep Fighting

16:00 Facing Mortality with Honesty

18:00 Making the Most of Time

20:00 Living with Chronic Pain

21:00 Becoming a Lung Cancer Advocate

24:00 Learning to Ask for Help

26:45 Advice for Newly Diagnosed Patients

28:40 "Anyone With Lungs Can Get Lung Cancer"

29:45 Why Patients Should Always Ask Questions

31:00 Final Reflections

About Patient From Hell

Patient From Hell is hosted by cancer survivor and founder Samira Daswani, who asks the questions most patients are too overwhelmed or too afraid to ask. The show brings together doctors, researchers, advocates, and survivors to reveal evidence-based answers for patients navigating the chaos of cancer.

🔔 Connect & Follow

Samira Daswani

LinkedIn: https://www.linkedin.com/in/samiradaswani/

Manta Cares: https://www.mantacares.com

Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.

Tim McDonald was sitting down for Thanksgiving dinner in 2020 when the pain started. A few days later, a doctor handed him a single sheet of paper and said three words nobody wants to hear: "You have cancer."

Stage 4 colorectal cancer. Liver covered in tumors. A second oncologist told him he had three years to live and she'd focus on "quality of life." His response? "That's your story. Not mine."

In this episode, Tim shares how over a decade of mindfulness practice shaped the way he faced one of the hardest diagnoses a person can receive and how he went from following doctors' orders to becoming the general manager of his own care team, ultimately pursuing a liver transplant at a time when fewer than 20 people in the US had received one for colorectal cancer.

This conversation goes deep on:

→ What it actually feels like to hear "you have cancer" and stay calm

→ Why getting a second (and third, and tenth) opinion saved his life

→ The player → quarterback → general manager framework for owning your treatment

→ Men, vulnerability, and why cancer support groups changed everything

→ The dark thought he had toward the end of chemo — and what pulled him back

→ Why survivorship was mentally harder than treatment itself

→ How advocacy work became part of his healingIf you or someone you love is navigating a cancer diagnosis, this episode is essential listening.

───────────────────────────

🔔 Subscribe for weekly conversations with patients, advocates, and caregivers navigating the healthcare system.

───────────────────────────

CHAPTERS

00:00 – The mindset that got him through

00:29 – Meet Tim McDonald

01:17 – Thanksgiving diagnosis

02:44 – Hearing "you have cancer" — and staying calm

04:51 – Life before cancer: HuffPost, Arianna Huffington, and mindfulness

06:04 – What mindfulness actually gave him during treatment

07:14 – Starting standard treatment and meeting a new oncologist

09:38 – "That's your story. Not mine."

10:20 – Switching to Moffitt Cancer Center

11:53 – Discovering the liver transplant option

13:22 – Stage 4 colorectal cancer explained

17:49 – Going from patient to general manager of your care team

21:26 – The proctologist nobody thought to send him to

23:21 – Why you should always get a second opinion

24:46 – Men and cancer: processing emotions differently

26:18 – Vulnerability and who to open up to

29:02 – The dark thought: wanting to stop treatment entirely

30:52 – What pulled him back from the edge

31:39 – Survivorship: why after treatment can be harder

34:11 – 10 doctors after, 3 before: the survivorship reality

───────────────────────────

GUEST

Tim McDonald: Stage 4 colorectal cancer survivor, liver transplant recipient, patient advocate, and community builder. Former Director of Community at HuffPost.

───────────────────────────

ABOUT THE PATIENT FROM HELL

Patient From Hell is a podcast about navigating the healthcare system with confidence, curiosity, and zero apologies. Hosted by Samira Daswani, CEO and founder of Manta Cares.

#CancerSurvivor #ColorectalCancer #PatientAdvocacy #Stagefour #LiverTransplant #CancerMindset #ChemoSideEffects #PatientFromHell #MantaCares #CancerPodcast

When Marybeth Gilliam was diagnosed with metastatic breast cancer, she did what her years as a healthcare researcher had trained her to do: she went looking for the evidence. What she found was a gap between a growing body of peer-reviewed research pointing to strategies that can improve outcomes, and the fact that most of it never reached patients because it hadn't yet become standard of care.In this episode of Patient From Hell, host Samira Daswani sits down with Marybeth, founder of Outperform Cancer, to talk about how she is working to close that gap. She translates overlooked, peer-reviewed findings into steps patients can actually take, always paired with standard treatment rather than in place of it. Exercise, nutrition, and sleep are part of it, and so is asking sharper questions about biomarker testing, weighing well-supported off-label options, and refusing to take no for an answer when the data is strong.She shares her own story, the research that reshaped her thinking, and a practical case for taking an active role in your care when the first treatment decisions matter most.In this episode:Why she founded Outperform Cancer to close the gap between research and the clinicHow she pairs evidence-based strategies with standard treatment, not instead of itBiomarker testing and advocating for off-label options backed by solid trials (PATINA, MA.32)What being your own advocate actually looks like in the exam roomThis podcast is for general informational purposes only and does not constitute medical advice. The opinions of the speakers are their own.

CHAPTERS

00:00 The overlooked risk factor after childbirth

00:39 Meet Marybeth Gilliam

00:53 Why she founded Outperform Cancer

02:15 The cancer care information gap

02:20 The exercise discovery that changed everything

04:14 Her metastatic breast cancer diagnosis

06:11 Looking back at her 2007 Stage 0 diagnosis

07:16 Postpartum breast cancer and recurrence risk10:36 Building an anti-cancer strategy

13:58 From metastatic diagnosis to NED

15:48 Exercise, sleep, nutrition, and lifestyle changes18:24 Creating an anti-cancer environment20:03 The PATINA trial explained

23:24 Accessing promising therapies before standard of care

25:46 How patients can advocate for themselves

27:51 The 15-year research-to-practice gap

28:45 Precision medicine and biomarker testing

30:42 The ATM gene and metformin research

32:08 Stacking interventions: what does the evidence say?

33:08 Balancing risk, reward, and patient choice

35:24 Lessons from cancer innovators and patient-led research

37:00 Final thoughts and takeaways

Follow Patient From Hell for more conversations on cancer, survivorship, patient advocacy, research breakthroughs, and navigating healthcare with confidence.

Understanding postpartum breast cancer risks is critical. Learn why a diagnosis within 10 years of childbirth changes prognosis.

Many patients do not realize that postpartum breast cancer is defined as a diagnosis within 10 years of having children. This video explains the medical reasoning behind why these patients face a significantly higher likelihood of recurrence compared to other groups. We specifically look at the data showing that even stage one patients are three times more prone to metastasis during this specific window.

Welcome to the Patient from Hell podcast! Live from ASCO 2026, we explore breakthroughs in clinical oncology, cancer research, AI healthcare tools, and targeted therapy for advanced cancer.

Samira Daswani, Founder and CEO of Manta Cares and host of The Patient From Hell, sits down with Dr. Doug Blayney, Chief Medical Officer of Manta Cares and former ASCO President, for a candid debrief in between sessions at the 2026 ASCO Annual Meeting in Chicago.

With 45,000 oncology professionals in attendance, ASCO is the largest gathering of cancer researchers and clinicians in the world. In this episode, Samira and Dr. Blayney break down what actually mattered: the clinical findings, the shifting treatment landscape, and what the research trends mean for patients navigating cancer today.

This episode is for oncologists, cancer researchers, and anyone who wants to understand where the field is heading.

Topics covered, with more to come in our next episode:

• Key clinical findings from ASCO 2026
• Trends shaping experimental and clinical oncology
• What high attendance and collaboration signals for the future of cancer research
• What patients should know coming out of this year's conference

CHAPTERS:0:00 - ASCO 2026 Annual Meeting Live from Chicago0:27 - Artificial Intelligence (AI) in Oncology & Patient Experience1:19 - Healthcare AI Challenges: Misinformation & Clinician Deskilling2:03 - Pancreatic Cancer Breakthrough: New RAS/KRAS Targeted Therapy2:30 - Lung Cancer Advancements: ALK Mutations & PD-L1 Data3:01 - Breast Cancer Innovation: Oral SERDs & ESR1 Biomarkers3:41 - Next Episode Preview & Wrap Up

Subscribe for frequent breakdowns of cancer research, treatment news, patient stories, and guidance and support for people in treatment for cancer. Drop a comment with the topics or trials you want us to cover next!