WEBVTT - Let’s Be Informative…with Dr. Mirhadi 0:00:02.560 --> 0:00:08.240 This is Let's Be Clear with Shannon Doherty. Hi everyone, 0:00:08.360 --> 0:00:10.440 I'm back with a new episode of Let's Be Clear 0:00:10.480 --> 0:00:13.480 with Shannon Doherty. As I have mentioned before, it's important 0:00:13.480 --> 0:00:15.960 for me to use this podcast platform to connect with 0:00:16.000 --> 0:00:19.480 the cancer community in a very personal and honest way. 0:00:20.079 --> 0:00:22.080 And what better way to do that than to hear 0:00:22.120 --> 0:00:24.840 from the experts who are caring for me and can 0:00:24.880 --> 0:00:28.960 speak to this complicated disease with experience and knowledge. Today, 0:00:29.080 --> 0:00:33.000 I'm really happy to welcome one of those experts, my friend, 0:00:33.400 --> 0:00:38.720 doctor Amin Marhati from Cedar SINAI. Welcome, Hey Shannon, Hi Doc, 0:00:39.640 --> 0:00:42.880 good to see you now. I said your last name correctly, right, Yes. 0:00:42.800 --> 0:00:45.240 You did, Mahi Marhati HAUGHTI. 0:00:45.720 --> 0:00:48.840 So, can you tell us a little your radiation on collegist? 0:00:49.120 --> 0:00:49.479 Yes? 0:00:49.520 --> 0:00:52.360 And I think a lot of people don't necessarily know 0:00:52.400 --> 0:00:55.720 the difference between you know, a regular on collegeist, a 0:00:55.760 --> 0:00:59.280 radiation on colleges, a cardiologists on collegists. There's so many 0:00:59.400 --> 0:01:03.840 different subcategories. Can you explain like your specific job? 0:01:04.040 --> 0:01:07.360 Definitely, So when someone is diagnosed with cancer, I mean 0:01:07.360 --> 0:01:09.720 there's obviously the work up to cancer, which would involve 0:01:09.760 --> 0:01:13.360 like a radiologist, a pathologist. Sometimes like a surgeon to 0:01:13.400 --> 0:01:16.679 do a biopsy. But then when someone has a diagnosis 0:01:16.680 --> 0:01:20.559 of cancer, there's a there's three main specialties that sort 0:01:20.560 --> 0:01:23.520 of are involved in the treatment of that. The main 0:01:23.600 --> 0:01:26.959 one is a medical oncologist. That's what doctor Lawrence Piro 0:01:27.200 --> 0:01:30.720 is my fav Love that guy, and he's a wonderful 0:01:30.720 --> 0:01:33.120 medical oncologist that's taken care of you for many years. 0:01:33.120 --> 0:01:36.399 And he they sort of work as the quarterback. But 0:01:36.480 --> 0:01:42.360 then another full specialty is radiation oncology, and so I'm 0:01:42.440 --> 0:01:45.199 involved more on the treatment side. You know, He's involved 0:01:45.240 --> 0:01:48.440 more in kind of the management and restaging and ordering 0:01:48.440 --> 0:01:50.720 the tests and labs and things like that. But my 0:01:50.920 --> 0:01:54.400 role is the majority of cancer's breast, lung, colon, et 0:01:54.480 --> 0:01:58.160 cetera involves some form of radiation therapy, especially when it 0:01:58.160 --> 0:02:00.760 spreads to the brain or you know, bone, things like that. 0:02:01.720 --> 0:02:05.440 What we do is we are experts in utilizing focused 0:02:05.560 --> 0:02:09.960 radiation and delivering it properly to tumors and trying to 0:02:10.000 --> 0:02:12.519 minimize the damage around it. So that's what my role 0:02:12.600 --> 0:02:15.120 is as a radiation on collogs, which is different than 0:02:15.160 --> 0:02:17.920 a radiologist who interprets images. 0:02:18.680 --> 0:02:22.360 Okay, so you mentioned focused radiation. I met you because 0:02:22.360 --> 0:02:24.560 I had mets in my brain. I don't remember, was 0:02:24.560 --> 0:02:25.720 it like five or six? 0:02:26.040 --> 0:02:29.640 Yeah, well it was initially six and then three more 0:02:30.000 --> 0:02:32.720 and so we did pinpoint radiation on all of this. 0:02:32.800 --> 0:02:35.760 One of them was surgically removed so we can get tissue, 0:02:35.880 --> 0:02:39.480 and we rated that just before doctor Chu got the 0:02:39.520 --> 0:02:41.839 tumor out. And we did that mainly does this sort 0:02:41.840 --> 0:02:44.839 of get the tissue and do more analysis and more 0:02:44.960 --> 0:02:47.400 kind of testing to see if there's anything further we 0:02:47.440 --> 0:02:50.400 can learn about your tumor. But then we did pinpoint 0:02:50.480 --> 0:02:54.600 radiation to the rest and that's a procedure called radio surgery. 0:02:55.000 --> 0:02:58.640 So the reason they call that radio surgery is because 0:02:58.680 --> 0:03:02.560 this is delivery all the radiation in one shot. Radiation 0:03:02.720 --> 0:03:05.600 when it hits your tissue, if you give a little 0:03:05.600 --> 0:03:09.200 bit of radiation, it causes a little bit of damage 0:03:09.240 --> 0:03:11.880 to the DNA of the tumor cells, and the tumor 0:03:11.919 --> 0:03:15.080 cells will then gradually die off. If you're treating like 0:03:15.120 --> 0:03:17.839 a large area, you do little bits at a time, 0:03:17.919 --> 0:03:20.360 like over twenty five thirty sessions which you had, you know, 0:03:20.360 --> 0:03:22.600 to your chest well, and that's when you're treating a 0:03:22.680 --> 0:03:24.840 large area, you have to give the normal tissue a 0:03:24.919 --> 0:03:27.760 chance to heal itself and fix itself. So you do 0:03:27.840 --> 0:03:29.840 little bits of radiation at a time when it's to 0:03:29.960 --> 0:03:32.560 larger areas, but when you're trying to treat it like 0:03:32.600 --> 0:03:36.120 a distinct tumor, you do all of it at once. 0:03:36.240 --> 0:03:39.240 You sort of condense that radiation because then you're using 0:03:39.360 --> 0:03:42.720 radiation to just obliterate everything in its path. So that 0:03:42.880 --> 0:03:45.360 what you had had to your brain was radio surgery, 0:03:45.760 --> 0:03:47.440 and that what you had had to your chestwall and 0:03:47.440 --> 0:03:51.360 then subsequently your rib was what's called fractioning radiation, meaning 0:03:51.400 --> 0:03:53.600 chopped up into several small fractions. 0:03:53.920 --> 0:03:57.080 Gotcha. So in my case, I'm hoping that people who 0:03:57.120 --> 0:03:59.880 are listening saw my Instagram where I posted the bit 0:04:00.240 --> 0:04:05.440 of getting fitted for you know, the mask which I 0:04:05.520 --> 0:04:08.040 then took home was going to wear for Halloween, but 0:04:08.120 --> 0:04:10.840 I didn't go out for Halloween. Plus a little scary 0:04:10.840 --> 0:04:14.400 to put that mask back on. And we did that 0:04:15.120 --> 0:04:18.440 so that the mask holds goes over your head, holds 0:04:18.480 --> 0:04:22.240 everything in place. You guys, lock me in so that 0:04:22.320 --> 0:04:23.839 there's minimal movement. 0:04:24.200 --> 0:04:28.640 Yes, that it's an amazing process. Well for you. If 0:04:28.680 --> 0:04:30.800 you recall, we did a mapping session where we made 0:04:30.800 --> 0:04:33.280 the mask and then got a quick scan and then 0:04:33.320 --> 0:04:36.600 there was like ten days of doing calculations and planning. 0:04:37.000 --> 0:04:39.560 When you came back for the treatment, each treatment was like, 0:04:39.640 --> 0:04:41.680 you know, ten minutes or so, right, it was quick, 0:04:42.160 --> 0:04:44.160 and so patients they kind of get up and they like, oh, 0:04:44.200 --> 0:04:46.640 that's it, right, but they don't realize, you know, what's 0:04:46.760 --> 0:04:49.400 under the hook, so to speak. It's like there is 0:04:49.480 --> 0:04:51.840 a team of people that you know. It starts with 0:04:51.920 --> 0:04:55.040 me the radiation on colleges, I see you, I determine 0:04:55.080 --> 0:04:56.680 what I want to treat, how much I want to treat, 0:04:56.680 --> 0:04:59.039 et cetera. We go through the planning process and we 0:04:59.080 --> 0:05:01.760 have a team of physicist who all have PhDs and 0:05:01.800 --> 0:05:05.400 medical physics that are behind the scenes calibrating the machine, 0:05:05.600 --> 0:05:08.400 doing calculations, and these are the kind of things that 0:05:08.480 --> 0:05:11.000 patients don't always see what's going on behind the scene. 0:05:11.000 --> 0:05:13.320 And this is where where Cedars Sinai excels because they 0:05:13.320 --> 0:05:15.320 don't cut any corners on when it comes to like 0:05:15.720 --> 0:05:18.760 the physics team or the quality of the equipment and 0:05:19.080 --> 0:05:22.120 doing the quality checks and making sure everything is as 0:05:22.200 --> 0:05:25.000 precise as it should be. And then the end result 0:05:25.080 --> 0:05:26.800 is you lying there and getting a tumors out and 0:05:26.839 --> 0:05:27.840 then going home. 0:05:28.320 --> 0:05:31.560 Right, you make it sound really easy, just lying there 0:05:31.839 --> 0:05:34.960 just like that. But yeahs as a person who is 0:05:35.279 --> 0:05:38.520 you know, very claust tophobic, the mask and you've got 0:05:38.560 --> 0:05:42.120 this lollipop stick that you know is in your mouth, 0:05:43.720 --> 0:05:46.800 and the whole thing is to not move because if 0:05:46.839 --> 0:05:48.960 you do move, if you get antsy, or if you stop, 0:05:49.000 --> 0:05:52.800 it puts more time onto it. And I did make 0:05:52.800 --> 0:05:55.160 it a little bit of a competition where I was like, 0:05:55.320 --> 0:05:58.520 I want to be the one person who moves the least. 0:05:58.920 --> 0:06:02.680 Yeah, And I was like standing there like, okay, so 0:06:02.760 --> 0:06:05.280 someone check your pulse. And also I was wondering where 0:06:05.279 --> 0:06:06.120 my ice cream went. 0:06:06.600 --> 0:06:09.480 Now that's right, now I know where it was, and 0:06:09.480 --> 0:06:12.080 then stuck that pompsicle. Yeah, it's like they all take that, 0:06:12.200 --> 0:06:13.279 thank you. Yeah. 0:06:13.440 --> 0:06:16.320 But you know what's interesting is the way we monitor 0:06:16.800 --> 0:06:19.719 your movement because the machine is delivering radiation, we don't 0:06:19.720 --> 0:06:21.640 want you to like kind of jerk this way or 0:06:22.000 --> 0:06:25.320 you know, we use this optical surface tracking where it's 0:06:25.320 --> 0:06:29.440 a device that basically monitors your motion within less than 0:06:29.480 --> 0:06:31.520 a millimeter, so if you move a little bit, it 0:06:31.560 --> 0:06:35.120 has its feedback loop to the treatment machine, where you know, 0:06:35.160 --> 0:06:37.920 it just shuts down instantaneously, so like if you're out 0:06:37.960 --> 0:06:40.680 of position, we get you back into position before we 0:06:40.760 --> 0:06:43.800 deliver this very high dose of precise radiation. You know, 0:06:44.040 --> 0:06:46.440 I mean you're an actress, right, you get multiple takes. 0:06:46.640 --> 0:06:48.240 Sometimes we only get one. 0:06:48.200 --> 0:06:51.120 Take, right, Yeah, you guys have to do it perfect 0:06:51.240 --> 0:06:54.440 first time, which is a lot of pressure. It's a 0:06:54.440 --> 0:06:57.240 lot of pressure, and you know you're again there's the 0:06:57.279 --> 0:07:00.280 whole teams. It's a huge amount of work that in 0:07:00.440 --> 0:07:02.160 treating literally just one person. 0:07:02.400 --> 0:07:04.600 And that's what a lot of people don't realize. You know, 0:07:04.720 --> 0:07:07.920 there are so many people involved in just delivering that 0:07:07.960 --> 0:07:10.560 one Just take one of the little numors retreating you know, 0:07:10.640 --> 0:07:13.320 you just kind of see you know, like Ty and Marty, 0:07:13.440 --> 0:07:15.640 like the texts at the end, and then like you know, 0:07:16.200 --> 0:07:18.840 the sim therapist, you see me, and then there's a 0:07:18.840 --> 0:07:21.440 whole slew of other people and everyone has to be 0:07:21.480 --> 0:07:23.800 one hundred percent precise all the time. And then we 0:07:23.840 --> 0:07:26.480 have to do that day in and day out for hundreds, 0:07:26.480 --> 0:07:29.280 if not thousands. I've treated over four thousand women with 0:07:29.360 --> 0:07:31.920 breast cancer in my career, and like, imagine that kind 0:07:31.960 --> 0:07:34.840 of pressure, like try to be precise, but we have 0:07:34.960 --> 0:07:37.480 so many checks and balances in place. We have such 0:07:37.520 --> 0:07:40.920 a high quality physics department, things like that, and it's 0:07:41.280 --> 0:07:43.280 really teamwork at its finest. 0:07:43.640 --> 0:07:45.240 Yeah, it's one of the things that I really love 0:07:45.240 --> 0:07:48.560 about Sedars. And that's not to say there aren't other 0:07:48.640 --> 0:07:54.040 amazing hospitals, but Sedars you really understand that everybody who 0:07:54.040 --> 0:07:58.160 works there, the entire team, oh, has been thoroughly checked out, vetted. 0:07:58.240 --> 0:08:01.280 They follow certain protocols that you're sort of getting the 0:08:01.360 --> 0:08:04.640 absolute best of the best. Yeah, and you can go 0:08:04.720 --> 0:08:07.640 in feeling pretty confident because radiation can be a very 0:08:07.680 --> 0:08:11.240 scary thing, especially when it's to your brain. Of course, Oh, absolutely, 0:08:11.360 --> 0:08:16.600 Like I was petrified of you know. It's not of you, No, 0:08:16.840 --> 0:08:19.640 you made me feel very confident, but of you know, 0:08:20.080 --> 0:08:22.800 is it going to change who I am? Like that? 0:08:22.800 --> 0:08:24.960 That was, as you know, a big concern of mine, 0:08:25.080 --> 0:08:27.440 not just with you, but with brain surgery with doctor 0:08:27.480 --> 0:08:31.080 Chwo of are you going to zap something? Is it 0:08:31.120 --> 0:08:33.720 going to change who I am? Am? I not going 0:08:33.800 --> 0:08:36.800 to think as quickly, and particularly with the surgery, there 0:08:36.880 --> 0:08:39.840 was that concern as well. Of course, doctor Chuo ignored 0:08:39.880 --> 0:08:41.880 me when I asked him to like touch the part 0:08:41.960 --> 0:08:44.640 of the brain that made me speak eight fluent languages. 0:08:44.760 --> 0:08:48.000 He ignored me and didn't do it. Shame on you, 0:08:48.080 --> 0:08:51.760 doctor Chu. One thing I asked of you. Yeah, I 0:08:51.840 --> 0:08:54.160 mean it is a very scary thing. And you do 0:08:54.360 --> 0:08:57.560 all sorts of radiation for all sorts of different cancers. 0:08:57.600 --> 0:09:00.880 Correct, Yeah, more or less, mostly breast and lung sort of, 0:09:01.240 --> 0:09:03.199 particularly because those two spread to the brain a lot. 0:09:03.640 --> 0:09:06.360 I have a question because this is I've actually been 0:09:06.400 --> 0:09:10.440 wondering this for myself. Is there a certain amount of 0:09:10.520 --> 0:09:16.320 times that you can do the pinpoint radiation? Like is 0:09:16.320 --> 0:09:18.520 there a certain number and then it's up and then 0:09:18.559 --> 0:09:20.680 you have to do overall brain radiation. 0:09:22.040 --> 0:09:25.560 It's a great question. It's a topic of evolving debate. 0:09:25.800 --> 0:09:29.000 We live in an era fortunately where you know, women 0:09:29.040 --> 0:09:32.440 with breast cancer in particular are living a lot longer 0:09:32.480 --> 0:09:35.600 because of all these wonderful therapies. And in the old 0:09:35.679 --> 0:09:39.120 days they didn't have that much success, so they would 0:09:39.160 --> 0:09:42.240 just sort of go crazy with like whole brain radiation 0:09:42.840 --> 0:09:45.320 and cause a lot of side effects. But the thinking 0:09:45.400 --> 0:09:48.880 has shifted now to being more pinpoint and precise. And 0:09:48.960 --> 0:09:51.840 to answer your question, is there a number like meteors 0:09:51.920 --> 0:09:54.840 like you've had nine total? The answer to that question 0:09:54.960 --> 0:09:57.120 is how big are they? Like if you had like 0:09:57.200 --> 0:09:59.679 ten of them that were like thirty milimeters each. In 0:09:59.800 --> 0:10:03.840 my difficult and yours fortunately have all been very small, 0:10:04.280 --> 0:10:07.600 so we can sort of keep going without causing problems. 0:10:07.600 --> 0:10:09.920 And I've you know, in the past, there have been 0:10:09.920 --> 0:10:12.560 times where I've had to do one that was like 0:10:12.679 --> 0:10:15.400 close to the other, I ran into some problem, you know, 0:10:15.440 --> 0:10:17.520 like it would cause some degree of side effects. But 0:10:18.440 --> 0:10:22.280 having many small ones is the best case scenario because 0:10:22.280 --> 0:10:24.920 then you can sort of keep going and have less 0:10:24.960 --> 0:10:26.120 side effects, so to speak. 0:10:26.280 --> 0:10:29.960 So what size becomes not small? 0:10:30.320 --> 0:10:35.280 Oh? Good question. So for single shot radio surgery, when 0:10:35.320 --> 0:10:38.640 you're delivering all the radiation at once, that's the most 0:10:38.640 --> 0:10:41.880 intense treatment, that's the most effective, but it also could 0:10:41.880 --> 0:10:43.600 potentially have the most side effects if you're doing a 0:10:43.600 --> 0:10:48.480 big area is roughly three centimeters thirty millimeters. When you 0:10:48.520 --> 0:10:51.800 get into a fifty centimeter tumor like I did this 0:10:51.880 --> 0:10:55.120 morning before I came here, then you have to take 0:10:55.160 --> 0:10:57.760 that one dose of radiation and chop it out into like, 0:10:57.880 --> 0:11:00.840 let's say, five sessions, and if it gets it's even bigger, 0:11:00.880 --> 0:11:02.520 and then you have to include a lot of your 0:11:02.600 --> 0:11:04.880 normal brain in the treatment field. Then it's like up 0:11:04.960 --> 0:11:08.880 to thirty sessions, and it's less effect. When you do 0:11:08.920 --> 0:11:12.800 thirty sessions, you're delivering more radiation to a larger area, 0:11:13.160 --> 0:11:14.920 but you're doing it in a way that allows the 0:11:15.000 --> 0:11:19.080 normal brain to sort of safely regenerate itself, and but 0:11:19.280 --> 0:11:21.400 you know, not perfectly, but enough so that you can 0:11:21.440 --> 0:11:25.520 get away with doing that treatment, right, So smaller, the 0:11:25.559 --> 0:11:28.120 fewer treatments you get, the more effective and the safer. 0:11:28.280 --> 0:11:31.480 Okay, let's say you know, I had these five or 0:11:31.520 --> 0:11:35.000 six and then mets and we did however many treatments 0:11:35.040 --> 0:11:38.520 we did, and then those mets come back and the 0:11:38.679 --> 0:11:42.680 drugs aren't working, and I have to have pinpoint radiation again, 0:11:43.200 --> 0:11:45.079 and then the same thing happens in three months. I 0:11:45.120 --> 0:11:47.640 have to come back, and you know, you just keep 0:11:47.679 --> 0:11:49.760 on that cycle. As long as they're small, you can 0:11:49.840 --> 0:11:52.880 just keep doing the absolutely. 0:11:52.320 --> 0:11:55.440 Yeah, and it would be in your particular case. And 0:11:55.480 --> 0:11:58.640 this is this is what something good educationally for people 0:11:58.679 --> 0:12:02.920 who might be listening the routine staging, the getting the 0:12:02.920 --> 0:12:05.000 brain EMRI every three four months. You know, getting the 0:12:05.000 --> 0:12:08.920 pet CT and catching things relatively early makes all the difference. 0:12:09.000 --> 0:12:10.679 Because I can't tell you how many times I've had 0:12:10.720 --> 0:12:13.800 patients who had one or two treated and they're like, oh, 0:12:13.960 --> 0:12:16.680 let's go to you know, Barbados or something. I just 0:12:16.720 --> 0:12:19.760 disappear off the grid. They come back two years later 0:12:19.800 --> 0:12:21.600 and they have one that's like a little bit bigger. 0:12:22.200 --> 0:12:24.000 Then I have to send him a doctor chew and 0:12:24.040 --> 0:12:26.360 then he tells them about the language thing, and it 0:12:26.400 --> 0:12:27.560 becomes a whole big mess. 0:12:27.600 --> 0:12:29.800 You know. Is no, I'm not not going to let 0:12:29.800 --> 0:12:32.199 you speak multiple languages so easily. 0:12:32.520 --> 0:12:36.160 But I think it's But that's the the advantage that 0:12:36.280 --> 0:12:38.880 people in let's call it Western medicine. When you live 0:12:38.880 --> 0:12:41.920 in a metropolitan area like LA and have access to 0:12:42.600 --> 0:12:46.240 wonderful doctors like doctor Piro and wonderful imaging centers where 0:12:46.240 --> 0:12:50.000 you can get your scans in relatively quick fashion, you 0:12:50.040 --> 0:12:52.320 can stay on top of it. And and that's a 0:12:52.360 --> 0:12:56.559 thing like patients who are motivated about, you know, their health, 0:12:56.559 --> 0:13:00.360 they're motivated about you know, quote unquote beating cans so 0:13:00.440 --> 0:13:03.280 to speak. They're the ones that are just they listen 0:13:03.320 --> 0:13:05.000 to their doctors, they're on top of things. They do 0:13:05.040 --> 0:13:06.960 their restage and says, they do their blood work when 0:13:06.960 --> 0:13:10.400 they're supposed to, you know, and and sometimes even in 0:13:10.480 --> 0:13:13.160 cases like that it might not be enough. But to 0:13:13.280 --> 0:13:17.480 give yourself and other patients the best fighting chance, just 0:13:17.600 --> 0:13:19.720 you just have to kind of follow the routine, you know. 0:13:20.120 --> 0:13:24.280 Yeah, I mean, I think what's unfortunate is that not 0:13:24.440 --> 0:13:28.720 every insurance company support scans every three months, you know, Like, yeah, 0:13:29.240 --> 0:13:31.160 I know that. It was tricky for me in the 0:13:31.200 --> 0:13:35.280 beginning as well, and it becomes easier. This is what's 0:13:35.920 --> 0:13:38.880 really sad, is it becomes a lot easier to get 0:13:38.880 --> 0:13:43.560 it every three months the worst you are. So once 0:13:43.559 --> 0:13:46.840 you're enter stage four, they're like, oh, okay, yeah, you 0:13:46.960 --> 0:13:49.960 might need a scan every three months, but you kind 0:13:49.960 --> 0:13:53.280 of want it before then. Like even every six months 0:13:53.360 --> 0:13:56.400 is a much healthier, you know, way as opposed to 0:13:56.400 --> 0:13:58.679 the once a year. So a few things I'm going 0:13:58.720 --> 0:14:01.440 to have to work on in the future advocating for. 0:14:10.520 --> 0:14:12.120 I mean, it is a good thing for us to 0:14:12.240 --> 0:14:16.040 just remind all of you guys listening to press your 0:14:16.080 --> 0:14:20.600 doctor too, because if you're feeling anything weird, if you've 0:14:20.640 --> 0:14:23.400 got headaches and you have cancer or anything just really 0:14:23.720 --> 0:14:26.880 really you can request. You can say I think there's 0:14:26.920 --> 0:14:29.640 something going on and I need an MRI, I need 0:14:29.640 --> 0:14:33.320 whatever it is. Your pet scans and do go in 0:14:33.360 --> 0:14:36.520 for your blood test because those it's amazing how much 0:14:36.520 --> 0:14:39.720 your blood tells you, Like I didn't even know, oh yeah, 0:14:39.760 --> 0:14:42.480 really how much my blood was telling my doctors about me. 0:14:42.760 --> 0:14:44.760 You know, Sit tight, because I would say in the 0:14:44.800 --> 0:14:48.600 next few years, there's going to be even more tests 0:14:48.760 --> 0:14:52.200 that analyze your blood and look for circulating tumor cells 0:14:52.240 --> 0:14:56.160 and circulating tumor DNA and things like that. Genetic testing 0:14:56.360 --> 0:14:59.400 is going to have a more profound component. We're at 0:14:59.480 --> 0:15:03.040 sort of an inflection point in cancer care where we're 0:15:03.080 --> 0:15:06.400 going to be less reliant on imaging and like MRIs 0:15:06.400 --> 0:15:10.080 and cat skins and petskins, and more reliant on blood 0:15:10.120 --> 0:15:14.000 work and genetic testing and molecular testing to understand what 0:15:14.080 --> 0:15:18.400 direction things are going. The technology is there, like, you know, 0:15:18.400 --> 0:15:20.440 there's this one test that was developed out of Cleveland 0:15:20.440 --> 0:15:22.480 Clinic called the Gallery test, where it's like a blood 0:15:22.480 --> 0:15:25.400 test that tells you if your tumor is proliferating or not, 0:15:25.480 --> 0:15:28.520 you know, And it's relatively in a fledgling state, but 0:15:29.360 --> 0:15:32.600 the science is developing, the data is accumulating. You now 0:15:32.600 --> 0:15:37.320 have artificial intelligence that's helping you analyze this information. And 0:15:37.360 --> 0:15:40.320 I think we're moving towards a new frontier. You know, 0:15:40.520 --> 0:15:43.080 everyone likes to say that in cancer care, like everything, 0:15:43.440 --> 0:15:46.000 every new drug or whatever, it is a new frontier, right, 0:15:46.040 --> 0:15:49.960 but nothing really has been until now. I think this 0:15:50.200 --> 0:15:52.560 way to analyze your blood and your DNA and your 0:15:52.600 --> 0:15:55.240 molecular profile, it's really going to take off in the 0:15:55.320 --> 0:15:56.080 next few years. 0:15:56.320 --> 0:15:58.280 I mean, that's really exciting to hear. And you mentioned 0:15:58.360 --> 0:16:01.800 Cleveland Clinic and I just read a whole release from 0:16:01.840 --> 0:16:07.680 them recently about their clinical trial that's currently happening on 0:16:07.960 --> 0:16:11.920 breast cancer vaccine, and I found that to be absolutely 0:16:11.960 --> 0:16:16.120 fascinating that finally there might be a vaccine for breast 0:16:16.200 --> 0:16:19.520 cancer and that it can apparently work on people who 0:16:19.560 --> 0:16:22.800 have you know, had it, are in remission, get the 0:16:22.880 --> 0:16:27.000 vaccine and it's possibly you know, obviously a lot more 0:16:27.040 --> 0:16:29.560 clinical trial has to be done in order to determine 0:16:29.600 --> 0:16:32.720 what all it can do. But I agree with you, 0:16:32.840 --> 0:16:37.000 it's a very exciting time. And although I always say 0:16:37.080 --> 0:16:39.120 I can't believe the cancer has been around for what 0:16:39.240 --> 0:16:41.400 a hundred years and there's not a cure yet, there's 0:16:41.440 --> 0:16:42.840 not a vaccine, there's nothing. 0:16:43.360 --> 0:16:45.080 I'm going to give you my take on what you 0:16:45.120 --> 0:16:46.920 just said, I know that there's a lot of information 0:16:46.960 --> 0:16:48.560 online and a lot of people are like, oh, you know, 0:16:48.600 --> 0:16:51.400 they're trying to withhold the here. You know, like the 0:16:51.400 --> 0:16:54.600 people think that the industry is trying really not to 0:16:55.040 --> 0:16:56.840 find that. That's actually not true. I think that the 0:16:57.000 --> 0:17:00.320 person you don't think that either, But there's a lot 0:17:00.320 --> 0:17:03.280 of people who just sort of look superficially online and 0:17:03.360 --> 0:17:07.199 get some information. Here is why it's really hard to 0:17:07.240 --> 0:17:11.359 find a cure for most types of cancers. The reason 0:17:11.480 --> 0:17:14.280 is because you have a tumor that formed. You know, 0:17:14.320 --> 0:17:18.320 what is a tumor exactly, it's a portion of your breast. 0:17:18.640 --> 0:17:21.159 You know, a portion within the duct of your breast 0:17:21.600 --> 0:17:24.000 developed an abnormality as it was growing. You know, your 0:17:24.080 --> 0:17:26.320 ducks replenish themselves and they have to go through the 0:17:26.359 --> 0:17:29.320 process of cell division to make more cells and more 0:17:29.400 --> 0:17:32.639 ducts and more lobules and things like that. Somewhere along 0:17:32.680 --> 0:17:35.359 the way, due to X, Y and Z factors. No 0:17:35.400 --> 0:17:39.160 one knows exactly there was a mutation in the DNA 0:17:39.680 --> 0:17:43.280 of your tumor cell. Now, the human cell in general, 0:17:43.880 --> 0:17:46.880 it's like, if you think about it, it's built to survive. 0:17:47.000 --> 0:17:49.960 That's why humans have made it so long. Evolutionarily, you 0:17:50.040 --> 0:17:53.439 have a cell that is just constantly dividing and growing 0:17:53.440 --> 0:17:55.600 and growing. So you have to think of the human 0:17:55.640 --> 0:17:59.000 cell as having its footstuck on the accelerator, so it 0:17:59.040 --> 0:18:01.240 doesn't want to stop growing. So every cell in our 0:18:01.240 --> 0:18:04.520 body inherently could be a cancer cell. It just doesn't 0:18:04.560 --> 0:18:07.320 want to stop growing. But we have these big breaks 0:18:07.440 --> 0:18:10.560 that are sitting on top of it as well. I'm oversimplifying, 0:18:10.600 --> 0:18:13.280 of course, but when you get a mutation and the 0:18:13.400 --> 0:18:15.720 big proteins that sit on top of it, the break, 0:18:15.880 --> 0:18:19.560 so to speak, then cells kind of grow unchecked. But 0:18:19.600 --> 0:18:23.160 then what happens is, Okay, you might find the ability 0:18:23.200 --> 0:18:26.919 to treat one type of mutation, but tumor cells go 0:18:27.080 --> 0:18:30.439 through evolution, they evolve, and then you might get a 0:18:30.520 --> 0:18:34.320 drug like inher To or percepted or something that might 0:18:34.400 --> 0:18:36.919 knock out ninety nine point ninety nine percent of your 0:18:36.960 --> 0:18:40.080 tumor cells and be an effective therapy, but it's that 0:18:40.160 --> 0:18:42.920 point oh oh one percent that might be behind that's 0:18:42.960 --> 0:18:46.359 resistant to that particular therapy, and then that grows and 0:18:46.400 --> 0:18:49.200 you have to find a different treatment. And people can 0:18:49.200 --> 0:18:52.679 only tolerate certain types of treatment, certain amounts, and so 0:18:53.800 --> 0:18:57.479 in my opinion, the best way to address that is 0:18:57.920 --> 0:19:02.520 catching it as early as possible because over time, these 0:19:02.560 --> 0:19:07.080 cells go through you know, evolution at a lightening pace 0:19:07.560 --> 0:19:10.560 and they become resistant. They have this biology where they 0:19:10.560 --> 0:19:12.000 become resistant to treatment. 0:19:12.400 --> 0:19:15.719 You know, thank you, because that's a brilliant way of 0:19:15.760 --> 0:19:19.240 explaining it in a way that someone like me who 0:19:19.240 --> 0:19:21.639 does not have a medical degree, although on occasion I 0:19:21.800 --> 0:19:27.560 like to pretend I do for me to understand, because 0:19:27.840 --> 0:19:30.000 when you really break it down to how you did, 0:19:30.320 --> 0:19:33.280 of course, you know the cell is constantly mutating and 0:19:33.359 --> 0:19:38.000 growing and changing and becoming something different. So finding a 0:19:38.040 --> 0:19:45.000 cure that also can adjust to that mutation is incredibly hard. 0:19:45.040 --> 0:19:47.040 I mean, I would imagine it's like you could find 0:19:47.080 --> 0:19:50.640 one thing that would cure it under this particular condition, 0:19:51.280 --> 0:19:54.160 but then it's already mutated, so then that doesn't even work. 0:19:54.280 --> 0:19:57.120 It's much like the protocols that we're on, right. So 0:19:57.440 --> 0:20:00.640 I've actually had protocols that have last me I think 0:20:00.680 --> 0:20:03.919 a pretty good amount of time, all things considered, But 0:20:04.000 --> 0:20:08.240 eventually my body stopped it. Maybe the cells mutated whatever 0:20:08.320 --> 0:20:13.480 they change, where that particular pill was no longer impacting it. 0:20:13.600 --> 0:20:15.600 If I recall it's mina while since I looked at 0:20:15.600 --> 0:20:19.360 your char but when you were originally. 0:20:18.359 --> 0:20:19.360 You don't look at it every day. 0:20:19.480 --> 0:20:22.120 Just sometimes I'm just like, gee. 0:20:23.280 --> 0:20:26.639 My favor, it's not true. You guys. 0:20:27.960 --> 0:20:29.720 You no. I look, I look at the tumor treated, 0:20:29.720 --> 0:20:30.040 and I'm like. 0:20:30.119 --> 0:20:34.480 Yeah, I got it. You know, you took care of Bob. 0:20:35.480 --> 0:20:39.600 We can start Navy by Bob, by Bob. When you 0:20:39.640 --> 0:20:43.680 were initially diagnosed, I recall your tumor was estrogen receptor 0:20:43.720 --> 0:20:47.800 positive and her too negative. Now to the viewers and 0:20:47.840 --> 0:20:50.360 people who are diagnosed with breast cancer, they hear that 0:20:50.760 --> 0:20:53.919 and they're like, I mean, there's many layers to what 0:20:53.960 --> 0:20:58.320 that could mean. In the most simplistic way, esergen receptor 0:20:58.359 --> 0:21:02.760 positive means that your particular breast cancer was expressing estrogen receptors, 0:21:02.840 --> 0:21:07.359 meaning to some degree estrogen was fueling your tumor growth. 0:21:07.920 --> 0:21:10.040 Then the her too, which is a gene that they 0:21:10.600 --> 0:21:13.280 you know that's involved in breast cancer treatment and diagnosis 0:21:13.280 --> 0:21:18.160