Precision Medicine Podcast

Today, 80% of adults younger than 60 are not being effectively screened for colorectal cancer. They now have a 50% greater chance of being diagnosed than they did in the 90s. Additionally, the rise of early-onset CRC—even in otherwise healthy young people in their 20s and 30s—is unprecedented.

This marks the 60th episode of the Precision Medicine Podcast as host Karan Cushman begins a two-part series focused on colorectal cancer with Trevor Maxwell, Founder and CEO of Man Up to Cancer. Trevor was diagnosed with CRC at age 41 and attests that it feels like we are back in the early days of breast cancer in terms of building awareness around the criticality of basic screening, yet the statistics are startling.

In this Part 1, Trevor helps us understand the facts and current trends behind the second-leading cause of death for both men and women in America today. Trevor says the numbers are alarming, noting a 1% to 3% increase in the young-onset cohort every year. The big question, he says, is “why?”. 

In this episode of the Precision Medicine Podcast, host Karan Cushman does some time traveling with Dr. Douglas Flora through his lifetime journey with cancer. Dr. Flora is the Medical Director of Oncology Services at St. Elizabeth Healthcare and Editor-in-Chief AI in Precision Oncology, a peer-reviewed research journal dedicated to advancing artificial intelligence applications in clinical and precision oncology.

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In this episode of the Precision Medicine Podcast, hosts Karan Cushman and Clynt Taylor welcome back Dr. Luis Raez, Medical Director and Chief Scientific Officer at Memorial Cancer Institute who is joined by Dr. Pranil Chandra, Chief Genomic Officer at PathGroup. 

Together, we discuss the key barriers to performing comprehensive genomic profiling in lung cancer; how collaboration between oncologists and pathologists can enable a more consistent approach; and the improvements that should be made to close the gaps between the available life-extending, targeted therapies on the market today and the lung cancer patients who need them. 

To read the full summary, download the transcript and subscribe to receive future episodes straight to your in-box visit Precision Medicine Podcast Episode #58.

Special thanks to our partners at Janssen Biotech for their sponsorship of this episode.

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To mark the beginning of Season 5 of the Precision Medicine Podcast, we are honored to welcome Dr. Debra Patt, Executive Vice President of Texas Oncology. As an oncologist and breast cancer specialist at one of the nation’s largest community cancer practices, Dr. Patt is on the frontlines of oncology care every day. She joins us to discuss how Texas Oncology uses clinical decision-support technologies and health economics and health services research (HEOR) to deliver more consistent precision oncology care to patients at over 200 locations across Texas. 

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In this episode, we are joined by Dr. Karen Winkfield, Executive Director of the Meharry-Vanderbilt Alliance, appointee to President Joe Biden's National Cancer Advisory Board, and co-host of the weekly podcast, 3 Black Docs, which is dedicated to educating the community about health and health disparities in an approachable and entertaining way.

Dr. Winkfield’s commitment to her calling was clear by the fact that she joins us during her vacation to discuss racial disparities in the healthcare system that prevent many Black patients from seeking and receiving appropriate care. She tells us that she didn’t discover her calling early and, due to family and cultural barriers of her own, she almost didn’t pursue it at all. In fact, it took the support of a dedicated high-school teacher and nine emotional years to finish her undergraduate degree in biochemistry to get her where she is today as a practicing radiation oncologist.

Off the top we ask Dr. Winkfield what can be learned from greater participation of underrepresented groups in clinical trials or greater participation in the healthcare system. She notes that Black people are still dying of cancer at a much higher rate than the rest of the population, and while there are some biologic reasons, much of the cause is under-representation in cancer clinical trials.

We point out her step-by-step plan to address this type of imbalance in the healthcare system, and we are reminded that this is nothing new as she has been working to help address it for decades. She says, "Okay, I laid out a plan, but there's been a plan out for ending cancer disparities for over 20 years." The unequal burden document that was essentially kind of written by the Institutes of Medicine. Congress actually was the one who said, "Hey, we need to kind of understand what's going on with this cancer disparities thing." The whole plan is outlined.

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Part of what the challenge is now is, do we have the will, do we have the will to do what is needed? Yes, I mean, there are those of us who've been kind of yelling from the mountaintops for decades now that we need to do something different because people are dying.”

She goes on to explain that balancing disparity isn’t as easy as, say, offering translation services, because institutionalized racism runs so deep that it presents barriers at every step. For instance, she says that if you look at the Cancer Genome Atlas Program, which has over 11,000 primary cancer samples, only 25 of those specimens are from prostate cancers derived from Black men, despite the fact that Black men not only have a much greater risk of developing prostate cancer, probably twice as high as any other racial ethnic group, and they're two-and-a-half times as likely to die of prostate cancer. She says, in America, your wealth directly impacts your health. Your zip code impacts your outcome more than your genetic code.

We naturally asked what role technology can play in eliminating healthcare disparities, and she says that without more representative patient samples, trials and access, precision medicine can never be precise.

In fact, she believes precision medicine can actually deepen the divide if it is not used with precision in terms of the whole person.

Where do they come from? What are barriers to them accessing precision medicine, such as transportation or even paying for parking?

Dr. Winkfield is a strong proponent of navigators who help cancer patients overcome those institutional barriers to ensure that they have equal access to the promise of precision medicine. She says, “These are the things, the social determinants of health, if we can stop and just see the person in front of us and say, what is it that you need to help you along your cancer journey? That to me is being precise.”

In episode 55 of the Precision Medicine Podcast, we welcome Dr. Stephen Kingsmore, President and CEO of the Rady Children's Institute for Genomic Medicine. Dr. Kingsmore joins us to discuss the extraordinary role whole genome sequencing is playing in prolonging and improving the life of critically ill newborns.

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Dr. Christian Rolfo, President of the International Society of Liquid Biopsy and Associate Director for Clinical Research at the Center of Thoracic Oncology at the Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai in New York City, joins us to explain the unique role liquid biopsies are playing in the diagnosis and treatment of cancer.

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Learn more about our lead sponsor Trapelo Health here.

In this Precision Medicine Podcast episode, we are joined by Dr. Belinda King-Kallimanis, Director of Patient-Focused Research at LUNGevity—an organization that brings together research, education and support services for patients and caregivers in the lung cancer community—and Nichelle Stigger, LUNGevity board member and lung cancer survivor. They sat down with us to discuss everything from the importance of patient-friendly language in lung cancer to discrepancies in access to biomarker testing and what LUNGevity is doing to improve the status quo. Read the full summary and listen here.

In celebration of the three-year anniversary of the Precision Medicine Podcast, we take a look back at how far precision diagnostics have come with the help of one of our first guests Hannah Mamuszka, Founder and CEO of Alva10, and her colleague Lena Chaihorsky. Both women are focused on resolving the knowledge gap between payers and diagnostic companies and moving diagnostics to the forefront of the precision medicine conversation.

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In this episode, in honor of Breast Cancer Awareness Month, we speak with Ali Rogin, author of Beat Breast Cancer Like a Boss and award-winning producer of PBS NewsHour. Ali is what is commonly known as a breast cancer previvor, someone who knows they have a mutation that may lead to cancer and takes preventative steps to avoid a diagnosis. With the growth of genetic testing and precision medicine and the ability to isolate genes that can lead to cancer, more and more people may fall into the category of previvors. For instance, women that have the BRCA 1 or 2 mutation, as Rogin does, have a 70% chance of developing breast cancer by the age of 80. Rogin says progress in precision medicine has given these women options they would never have had before, enabling them to make proactive, informed decisions about their future health.