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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.

Send us a Text Message.

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 Message.

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 Message.

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 Message.

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.

Send us a Text Message.

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!

This four episode series will cover radiation 101, stereotactic body radiation therapy (SBRT), and proton therapy!

In this episode, we discuss SBRT, alternatively called stereotactic ablative body radiotherapy (SABR). We also discuss a related treatment, stereotactic radiosurgery (SRS).

Here are some links to things we discussed during the show:

• Rare Cancer Research Foundation
• Pattern.org
• Count Me In
• JAMA Oncology SBRT/SABR patient page
• CyberKnife information from the manufacturer (Accuray)
• GammaKnife information from the manufacturer (Eleckta)
• The patient-led Remove the Mask Campaign

Here are some clinical and scientific publications mentioned during this show:

• Original Timmerman study of SBRT for early stage lung cancer
• Discovery of the SBRT "No Fly Zone" in the chest
• International Radiosurgery Consortium of the Kidney (IROCK) meta-analysis of SBRT for primary kidney cancer (renal cell carcinoma).

Here are some resources that may be of interest, but were not discussed in this episode:

• An excellent video on Stereotactic Radiosurgery (SRS) versus Whole Brain Radiotherapy (WBRT) for brain metastases from our friends at PRIMR
• RTOG 1112 Trial: Benefit of adding SBRT to Sorafenib in locally advanced liver cancer (hepatocellular carcinoma). (conference abstract only)
• TRENDY Trial: Suggests that SBRT is superior to trans-arterial chemoembolization (TACE) for early liver cancer (haptocellular carcinoma).
• MD Anderson Cancer Center Phase II Trial: Suggests that SBRT may be used to defer systemic therapy in patients with oligometastatic kidney cancer (renal cell carcinoma)

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 Message.

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!

This four episode series will cover radiation 101, stereotactic body radiation therapy (SBRT), and proton therapy!

In this episode, we complete radiation 101, covering 2 more important points to understand radiotherapy:

1. How are radiation plans created and delivered, and how has this improved over decades?
2. Who are the workers in the Radiation Oncology department and what is the workflow that patients experience when getting treatment?

Here are some other things we discussed during the show:

• Explanation of Intensity Modulated Radiation Therapy (IMRT), UCLA Health
• Multileaf Collimator (MLC) video, Phoenix Cyberknife
• Percentage depth dose curve
• An "old" radiotherapy block, Vishal Majithia on Flikr

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.