“Every man deserves to be treated in a multidisciplinary prostate cancer clinic,” said Steve Clinton, MD, PhD. In this episode, Clinton gives a great overview of what every man needs to know about prostate cancer. This begins with regular screening – and the PSA (prostate-specific antigen) blood test. This test should begin at the age of 40. A significant, year-to-year increase in a patient’s PSA level could warrant a biopsy to determine if there is cancer. If there is, the cancer is “graded” on what’s known as the Gleason Grading System. A higher score indicates a more aggressive prostate cancer and the likelihood of a more aggressive treatment plan, while a lower score could warrant active surveillance.

“I don’t like that term,” Clinton said of active surveillance. He prefers “watchful waiting” because “we’re not waiting for something to happen, we’re actively monitoring patients.” This monitoring includes yearly PSA tests, and additional biopsies to determine if the cancer has become more aggressive. He also described advances in treating prostate cancer. The introduction of robotic surgery and improvements in radiation therapy have led to fewer complications and better outcomes. Targeted therapies and immunotherapy drugs have also led to more treatment options and better outcomes. Clinton is one of the leaders of the James Multidisciplinary Prostate Cancer Clinic. “In one afternoon, a patient can see a urologist, radiation therapist and medical oncologist,” he said. “We can give you all the information you need to make your decision” on a treatment plan.

Registration has begun for the 14th Pelotonia, the amazing, fundraising cycling event that has raised $236 million for cancer research at The James. In this episode we talk with Pelotonia CEO Doug Ulman and President Joe Apgar. They describe the new routes, provide some fundraising tips, and give an overview of the new Victoria’s Secret and Pelotonia collaboration to award $8.5 million over the next two years to female cancer scientists around the world working on the most-promising research to beat women’s cancers, such as breast cancer and uterine cancer. Ulman also fills us in on his recent trip to the White House, where President Biden announced a renewed commitment to the Cancer Moonshot Project that was first announced during the final year of the Obama Administration. “The White House has a really aspirational goal, to reduce the number of cancer deaths by 50 percent in the next 25 years,” Ulman said. “That will save hundreds of thousands of lives and put us on the trajectory to ending this disease.” Some of the statewide initiatives for prevention, screening and genetic testing, funded by Pelotonia and implemented by The James, could serve as national models in the years to come, he added.

“I like to say that patients at the James have access to tomorrow’s therapies today,” said David O’Malley, MD, the director of the James Division of Gynecologic Oncology and Co-Director of the Gyn Oncology Phase I Program. In this episode, O’Malley describes a new clinical trial that provides “tomorrow’s therapies today” to patients at the James, and beyond. A clinical trial led by O’Malley utilizes two immunotherapy agents to treat women with advanced or recurrent cervical cancer. In the past, there were limited treatment options for these patients. The first drug, balstilimab, allows the immune system of a patient to recognize cancer cells that had previously been able to camouflage themselves and hide from the immune system. The second drug, zalifrelimab helps the body’s tired iimmune cells “reinvigorate themselves to better get to and fight those cancer cells,” O’Malley explains. In a James-led, Phase 2 clinical trial of 125 patients in the United States and beyond “we tripled the response rates,” O’Malley said. “And, not only was there better response rates, but the durability is more pronounced, and when I look at patients two years out, they’re still responding.”

The advances made possible by immunotherapy agents and clinical trials are accelerating at a rapid rate. This has O’Malley optimistic about the future. “We’re in an unprecedented time in cancer treatment and drug development,” he said. “I’m seeing things today I really didn’t think I’d live to see,”

The COVID-19 pandemic has created what Amy Rettig calls “a new reality” for healthcare teams. This new reality can be more difficult, but “realizing we are not alone in what we are thinking and feeling, and the knowledge that others are feeling the same way is so supportive,” says Rettig, a James advanced practice registered nurse, who has also earned a Doctor of Nursing Practice degree and a Master of Arts in Lay Ministry. In this episode, Rettig explains how the James philosophy of patient-based care has helped the staff manage during more stressful times. At the core of relationship-based care is “to have a caring relationship with ourselves and with our team so that everyone taking care of every patient are all on the same page.” This in turn leads to better care of patients. Rettig explains several techniques she teaches others at the James to recognize and reduce stress and anxiety, including the brief emotional support concept; and D.E.S.C., which is a way to describe an issue, express your feelings, specify an outcome and discuss consequences. Rettig also shares the breathing techniques she uses to reduce her own stress. “Our team has been able to sustain the James level of providing great care to our patients and their families … our patients know we are here to take care of them,” she said.

Big data and some detective work helped Samkeek Roychowdhury, MD, PhD, and his team find a new target for immunotherapy. In this episode, Roychowdhury and Emily Hoskins, a graduate student in bioinformatics and a member of Roychowdhury’s lab, fill us in on their research to discover a new target for immunotherapy and plans to create a clinical trial that shows great promise in treating patients with metastatic cancer.

“Our cancer patients are truly remarkable,” said David Cohn, MD, MBA, FACHE, chief medical officer of The James. “The vast majority are fully vaccinated and fully boosted and that’s been a key to their protection [from COVID-19].” In this episode, Cohn discusses why cancer patients are more at risk to contract COVID-19 and have more serious symptoms; the precautions James patients and their family members have taken the past two years to protect themselves; the science of the pandemic and vaccination and research conducted at the cancer center; and the safety precautions the James faculty and staff are taking to protect patients and one another. It has been a difficult two years, with more to come, “but we are centered on our patients and that’s our grounding,” Cohn explained. “We’re an amazing and resilient team and that’s what keeps us together and moving forward every day.” Cohn also talks about how the immune system of a cancer patient can be compromised before and during treatment, which makes even more urgent that these people get vaccinated. However, there is one small group of cancer patients, those in the midst of a bone marrow treatment, who should not be vaccinated until this specific treatment is completed and they get the go-ahead from their oncologist.

“I work with an amazing group of [ultrasound technologist] who go above and beyond on a daily basis to make sure each of their patients and their families are cared for, loved, comforted and well informed,” said Martini Tolley, an ultrasound technologist at the Stefanie Spielman Comprehensive Breast Center.

In this episode, Tolley explains the difference between a mammogram and an ultrasound, the role of each in diagnosing and treating breast cancer, and how the ultrasound procedure works. “We’re a very busy department and we do 45 to 55 ultrasounds every day,” Tolley said. “And, because we have seven ultrasound technologists, we never have to rush. We take the amount of time needed with patients.” Tolley, who has worked at the breast center for 11 years, and as an ultrasound technologist for 24 years, talked about how she connects with the women (and even some men) she sees every day. “Some of the patients who come into the building are scared to even get out of the car. There can be a lot of anxiety and fear, for multiple reasons. Some patients may have already had a [breast cancer] diagnosis and are afraid of what’s next, or they are coming to the screening and are afraid it might not go well.”

Are you ready for a music therapy session? In this episode, Terel Jackson, not only discusses the one-on-one and group sessions she leads at the James, and how she adapted during COVID, she also gives a music therapy demonstration using a Suzuki chime. "Think of [music therapy] as a tool to help people make positive changes in their lives," she explained of her goals for the cancer patients she works with. During the pandemic, the number of James patients and their caregivers who participated in music therapy programs actually increased. "We wanted to give people that human connection and feel cared for and heard and understood," Jackson said.

“Knowledge is power,” said Sally Hughes, who was treated for endometrial cancer at the OSUCCC – James and was a participant in the Ohio Prevention and Treatment of Endometrial Cancer (OPTEC), a statewide program funded by Pelotonia. In this episode, Hughes and David Cohn, MD, the chief medical officer of the James, discuss the ongoing impact of OPTEC. In the program, women diagnosed with endometrial cancer were screened to determine if they had Lynch Syndrome, an inherited genetic mutation that greatly increases the risk for colorectal and endometrial cancer. Family members of the women who tested positive for Lynch Syndrome were then screened. “This is called cascade testing and it saves lives,” Cohn said. While Hughes did not have Lynch Syndrome, which meant her children could not have it, she tested positive for a different genetic mutation that increases her risk of breast cancer. “Because of this and my family history [of cancer], I’m now in the High-Risk Breast Cancer Program,” she said. “I go in every six months for a mammogram or MRI.” Hughes also describes how she has become an advocate for increased funding for cancer research and reducing health disparities, and she is an active member of the James Ambassadors Society and a Pelotonia rider. “Cancer had a silver lining for me,” she said. “It gave me clarity about how I want to spend the next chapter of my life.”

Soon after the veterinarians at the Columbus Zoo and Aquarium discovered a large tumor on the liver of Shaila, a 19-year-old gorilla, they contacted Allan Tsung, MD, director of surgical oncology and a specialist in liver, bile duct and pancreatic cancer. When he listened to their message, “I thought it was a practical joke from one of my friends,” Tsung said. It wasn’t, and in this episode, Tsung describes the rather unusual and fascinating surgery he would perform on Shaila to remove a tumor on her liver the size of a softball – and what he learned from the experience. The liver of a gorilla is “almost identical [to a human liver] in terms of blood vessels and bile ducts and the size,” he said, adding the surgery was a team effort between his James surgical team and the skilled veterinarians at the zoo. “I was very nervous and the last thing I wanted was a bad outcome,” said Tsung, who added his strategy was to think of Shaila as “a human patient and, besides cutting through the skin, which is much thicker than human skin, everything was similar to a human patient.” He learned a trick veterinarians use to keep animals from picking at and pulling apart their sutures that involves bright nail polish - and was quite effective.