The James Cancer-Free World Podcast

Fasting and intermittent fasting have been in the news in recent months. In this episode, Faiza Kalam, PhD, MD, director of the James Food, Activity Sleep and Time (FACT) Lab explains the basics and how fasting and intermittent fasting can lead to improved cholesterol, LDL and blood pressure levels and rates and help people lose weight without the use of weight-reducing drugs that can have side effects. Fasting can also help cancer patients during their treatment. “The initial research has shown there is less fatigue and better quality of life for cancer patients during chemotherapy treatment who fast,” said Kalam.

While researchers work to improve lobular breast cancer screening, innovative treatments are improving outcomes for patients with a condition diagnosed in more than 40,000 Americans each year.

Ohio State medical oncologist Arya Roy, MD, shares details about lobular breast cancer, also called invasive lobular carcinoma (ILC), including risks, symptoms and treatments.

“We develop, evaluate and test interventions to help empower people to live healthier,” explained Roberto Benzo, PhD, an Ohio State health promotion and behavioral scientist and director of the James Lifestyle Lab. “We focus on empowering people to eat and exercise better and better manage their stress … helping people find the right solutions at the right time.” In this episode, Benzo explained how exercise, diet and managing stress are important for everyone, and for cancer patients during and after their treatment. “Even after a cancer diagnosis it’s not too late [to change behaviors],” Benzo said. “Being active and eating well can help you better tolerate your treatment and better manage your symptoms.” One of the tools Benzo and his team use re mobile health technologies such as iPhones, Fitbits and Apple Watches, as well as more accurate “research-grade” mobile technology applications. “The data helps us better understand where people are at,” he said. “And helps us establish new goals and behaviors.” Benzo said it can be hard to change long-held lifestyle routines and he offered some tips … “Consistency is one of the top secrets. You don’t have to do a super-hard work out every day, consistency means doing something every day.”

“Acceptance and awareness of where you are is important, being at peace with where you are and not trying to push too hard to get to where you want to be.”

Goal setting … “but setting compassionate goals within your means.”

Social support … “having someone to help you, for emotional support, for informational support and someone to help you do things, such as exercising, and it may not be the same person for all three.”

Benzo’s overall goal is “to help people find acceptance, compassion [for themselves], patience and resilience and use this to help them and motivate them and feel less along, and find joy and contentment for what they do already have.”

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Second opinions change the course of cancer care for many patients, and Ohio State experts are now using telehealth tech to increase access to these life-saving services.

Head-and-neck cancer surgeon Ricardo Carrau, MD, discusses the OSUCCC – James Online Second Opinon Program, which helps cancer patients make treatment decisions with clarity and confidence.

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The James is a leader in an advanced surgical technique that delivers heated chemotherapy directly to the cancerous cells in patients with rare and advanced types of cancers in the abdomen. “The heat helps the effect of the chemotherapy when it comes into contact with the cancer cells,” said Dr. Pamela Lu, a surgical oncologist and the lead of the James Hyperthermic Intraperitoneal Chemotherapy (HIPEC) team. “And the heat alone can have a toxic effect in killing cancer cells.” The HIPEC surgery is used for patients with cancer in the abdomen and peritoneal lining of the abdomen. “The cancer can look like tiny white spots, it can be raised or flat” and it can be located in several different areas, Lu said. The first step of the HIPEC procedure is to explore the abdomen and peritoneal lining “and take a survey of how much cancer is there,” Lu said. A scoring system is used to determine how much cancer is in several different regions, “how much surgery a patient will need” and if the initial cytoreduction surgery can be effective to remove all visible tumors. “Once this is complete, we proceed with HIPEC, through a hot chemotherapy bath that enters the site through tubes and a special profusion machine that allows the chemo solution to circulate through the abdomen.” The HIPEC technique leads to better outcomes because the direct access to any remaining cancer cells after surgery allows Lu “to give higher doses of chemotherapy with reduced toxicity.”

Follow The James Cancer-Free World Podcast:

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Subscribe to The James on YouTube: www.youtube.com/@UCXGasnfbCpWYVW2RLTDPn4Q

Learn more about cancer care and research at The Ohio State University:

Home: cancer.osu.edu

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Pelotonia is where memories are made. In this episode, co-hosted by David John, MD, we asked several members of the James team who participate in this annual bike ride that has raised more than $300 million for research here at the James to share their favorite Pelotonia memories. For Robert Baiocchi, MD, “one of the coolest memories is seeing one my patients who was still in the midst of treatment zip by me like I was standing still.” Baiocchi has ridden every year and his son has joined him in recent years. Pelotonia is also a family affair for Marisa Bittoni, PhD. She rides with her husband and their two daughters. “One of the best moments in my life, an emotional moment, was crossing the finish line on the 100-mile ride. It was an amazing to cross the finish line together with everyone cheering.” Deb Sundi, MD, said he’s inspired by the other riders, especially the cancer survivors who ride, as well as the volunteers and the thousands of people cheering the riders along the route and at the different finishes. “It gives me an incredible surge of emotion and energy, and I’m truly overwhelmed by the moment.” Laura Schoettmer has been a volunteer at the James and Pelotonia for several years and began riding after her cancer diagnosis and treatment at the James. “I finished treatment in August and rode later that August. And then, the second time I rode, my daughter organized a [surprise] party of several friends and family members at the finish line.”

David Cohn, MD, the James chief operating officer and chief medical officer has ridden in every Pelotonia. “The way Pelotonia connects us with the community is remarkable,” he said. “And the money we raise allows us to do things other institutions can’t do and to be increasingly more competitive in pursuing federal funding.” Cohn added his wife and daughter are Pelotonia volunteers and he rides with his son.

Follow The James Cancer-Free World Podcast:

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Subscribe to The James on YouTube: www.youtube.com/@UCXGasnfbCpWYVW2RLTDPn4Q

Learn more about cancer care and research at The Ohio State University:

Home: cancer.osu.edu

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A new clinical trial at the James is pioneering the use of telemedicine to create better treatment options for patients with a rare form of pancreatic cancer. “This is the first nationwide telemedicine therapeutic clinical trial for cancer,” said Sameek Roychowdhury, MD, PhD, a physician scientist and leader in creating innovative ways to look at, understand and treat cancer. “It’s a new way of thinking and providing access to clinical trials.” Roychowdhury and his team at the James identified the fibroblast growth factor receptor (FGFR) gene and how “using a smart drug we could turn it off and slow the cancer growth” it caused. A traditional clinical trial using the smart drug showed promising results in patients with pancreatic cancer and the FGFR gene. Because this was a rare type of cancer, a national clinical trial would be costly. “How do we give patients access to this?” Roychowdhury said. The answer came during the COVID pandemic and the increased use of telemedicine. “That allowed us to connect the dots and utilize telemedicine,” he said. After a lengthy regulatory and approval process that created a well-thought out and workable plan, the clinical trial began in May. Patients identified with pancreatic cancer and the FGFR gene will be able to remain at home and coordinate their treatment with their local oncologists and Roychowdhury and his team, who will work in tandem. “Instead of a clinical trial in 50 locations and a $20 million price tag, we’ve reduced the cost to $2 million,” he said. Roychowdhury believes this clinical trial will lead to others for rare cancers and make it more cost effective for pharmaceutical companies to create smart drugs for rare forms of cancer. He is working to create a national alliance of oncologists to share ideas, best practices and create more telemedicine clinical trials for rare types of cancers that would otherwise never be opened. “We have identified seven more targets and clinical trials [here at the James],” Roychowdhury said.

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Learn more about cancer care and research at The Ohio State University:

Home: cancer.osu.edu

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Ricardo Carrau, MD, believes cancer patients should consider getting a second opinion before beginning their treatment. “There are multiple reasons to get a second opinion, all of which are correct,” said Carrau, a head and neck cancer surgeon and director of the James Comprehensive Skull Base Surgery Program. “A cancer diagnosis is life changing and if you have any questions, if you want to make sure the decisions you are making are correct, a second opinion is in order.” In this episode, Carrau describes the process, starting with the initial issue that compelled a person to seek medical care. He used his specialty as an example. “A head and neck cancer diagnosis is very complex,” he said. “It begins with a physical exam, endoscopies, then a biopsy and imaging, which is out map of the cancer. Then [here at the James] we have a tumor board, a committee whose members are all experts in all the different areas of head and neck cancer. The end result is taken back to the patient and the patient is the ultimate decision maker; the patient needs to understand the consequences.”

It is at this point that Carrau recommends a patient get a second opinion.

“There is a perception the physician could be offended by this,” he said. “It isn’t that way. The patient and I have a partnership to achieve the best possible outcome … We get a lot of people who come here for a second opinion and some of our patients go elsewhere for a second opinion.” Carrau added that he and other James cancer specialists have a network of expert colleagues at other leading cancer centers they can recommend to their patients for a second opinion. “The reason I went to medical school was to help people,” Carrau said, adding interacting with patients and giving them the best possible care “gives me purpose in life and fulfillment.”

The James Sarcoma Program continues to grow, with the recent opening of the multidisciplinary Sarcoma Clinic, new and cutting-edge clinical trials and a project in Ecuador to train doctors to treat sarcoma patients. “The entire continuum of cancer care is improving and that’s why it’s important to have a multi-disciplinary team and clinic, so patients have access to all these advances,” said Joel Mayerson, MD, director of the James Sarcoma Program.

Mayerson described the recent advances made by the Sarcoma Program. A renowned sarcoma surgeon, in recent years Mayerson has been utilizing 3D printing to create replacement “bones” for sarcoma patients. “We can take scans and create [with the 3D printer] ‘bones’ the exact size of what we remove.”

In a new clinical trial “we’ve found that if we give immunotherapy concurrently with radiation therapy it helps the radiation works better,” Mayerson said, adding “we have the first proton radiation center in Ohio and that allows us to hone the beam to a smaller area and damages less tissue.”

Mayerson and the sarcoma team have been collaborating with the world-class veterinarians at Ohio State Veterinary Medical Center to create a probe that allows surgeons to see, in real time during surgery, the difference between normal tissue and tumorous tissue. Seeing the difference enables surgeons to remove less normal tissue, which leads to better function and quality of life for patients. “We used pilot data funded by Steps for Sarcoma to apply for and receive an Ohio State President’s Accelerator grant,” Mayerson said. Steps for Sarcoma is the annual fundraising walk; the next Steps will be held September 21.

After operating on a patient from Ecuador, Mayerson and the sarcoma team “were asked to help build the program there,” he said. An Ecuadorian surgeon spent a year at the James working with Mayerson and his team, additional physicians will be trained and “our sarcoma tumor board helps guide them in treating their sarcoma patients … This has been one of the most satisfying things I’ve done in my career, to know that we’re impacting patients a couple thousand miles away.”

Follow The James Cancer-Free World Podcast:

· YouTube: go.osu.edu/C27H

· Spotify: go.osu.edu/C8pY

· Apple Podcasts: go.osu.edu/C2n6

Subscribe to The James on YouTube: www.youtube.com/@UCXGasnfbCpWYVW2RLTDPn4Q

Learn more about cancer care and research at The Ohio State University:

Home: cancer.osu.edu

Blog: cancer.osu.edu/blog

News: cancer.osu.edu/news

“Wouldn’t it be cool if …” is an expression the team at Pelotonia say on a regular basis. And, over the years, many of these “what if” ideas have become new programs and events and ways to engage and involve more people.

“We’ve been cognizant and thoughtful about listening to our community,” said Joe Apgar, CEO of Pelotonia. “We get an amazing amount of feedback from people and that leads to improvements and new things we can do.” In this episode, Apgar talked about all the new things Pelotonia has added in the past few years, including the Challenger platform, kids rides, a gravel ride (October 4 this year) in Hocking Hills that includes a camping option and, for the first time this year, a run/hike/walk. The gravel ride came from a suggestion from Eric Tippett, who has ridden every year and is a member of the JPMorgan Chase team. The idea to add the run/hike/walk was “something we heard from a lot of people,” Apgar said. “They said I don’t ride a bike but if Pelotonia would ever do a run or a walk; I’m in.” The run/hike/walk loop through the woods is at the same location as the gravel ride. “We penciled in 75 people for it, and we already have more than 200 people signed up,” Apgar said. Apgar also talked about the growing number of kids events Pelotonia teams have created with support from the Pelotonia staff. “We think this will be a huge program over time,” Apgar said. The opening ceremony will feature O.A.R., a popular rock band whose members include a few Buckeyes. “I think this will be the most fun opening ceremony we’re ever had,” Apgar said.