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Episode #9 - Merry Christmas from CCA!

Steve:

Merry Christmas, everyone. Welcome back to the Medical Minutes. As you can see, Jill has declared today in the office is ugly sweater day. So I am wearing this ridiculous sweater to keep the piece around our place. On a positive note, Jill and our daughter Jenna baked cookies last weekend. So we're all enjoying those, but I'm surprised we can fit in sweaters as a result of eating canisters full of cookies and Buckeyes, but that part's all good.


Steve:

So, I've been accused of being a Grinch by Jill and my wife. And so that means it must be true. I don't believe it is, but it must be true. So, I'm going to prove Jill wrong today, and I'm going to give her a chance to talk about what a couple of her Christmas wishes would be. If she could ask Santa for presents when it comes to kicking cancer, those would be. So why don't you kick it off, Jill, and let us know what kind of things you'd like to see?


Jill:

Thanks, Steve. By the way, nice sweater. I love it. So, the first thing that I would ask Santa for, for Christmas, especially living in this world and seeing what we see every day, would be that the fear associated with cancer is wholly replaced with hope and empowerment. And I feel like, with our Medical Minute and just our mission here at CCA, that's really what we're trying to do. And I would love to have the Buddy the Elf approach to this. The best way to spread Christmas cheer is by singing loud for all to hear.


Steve:

Aye, yai, yai.


Jill:

You know-


Steve:

Go ahead. I'm sorry.


Jill:

I know, I know, I know. But seriously, like if we could just scream it from the mountaintops and replace fear with hope. I want to take power away from cancer.


Steve:

And we would all like to sing like the Who's in Whoville at that point?


Jill:

Exactly.

Steve:

All right. Well good. Good. I think that sounds like a good plan.


Jill:

You do know who Buddy the Elf is, right?


Steve:

I do. I do. I mean, I do live on this planet.


Jill:

Just checking.


Steve:

So, I have seen that movie, and it was pretty good. It's Will Ferrell, though. I mean, come on.


Jill:

Yeah, but I mean-


Steve:

If you can't like a Will Ferrell movie.


Jill:

I mean, you hadn't seen The Santa Claus, and I mean.


Steve:

Well, anyway. Okay. So that's good. Anything else?


Jill:

If I were to have a second wish, I would want to catch cancer early and then absolutely crush it. So kind of like cousin Eddie says, "It's the gift that keeps on giving the whole year."


Steve:

Now that is a Christmas movie. Right there. I like that.


Jill:

Yeah.


Steve:

I like that.


Jill:

We just need-


Steve:

Jelly of the month club.


Jill:

I know. We just need more awareness and accessibility for early detection. I think, even in the setting that we're in, when we do our consults, part of what we do is an in-depth history and physical, and you would be surprised how many people, even people who have cancer diagnoses, that don't do their routine screening measures, like their mammograms and their colonoscopies the way that they should.


Steve:

Yeah.


Jill:

And now they've even started with a screening tool, a blood test that is an early detection tool. It picks up cancer cells in the bloodstream before you can even pick it up on scans.


Steve:

Okay.


Jill:

So-


Steve:

That's pretty awesome.


Jill:

We have the tools.


Steve:

Okay.


Jill:

Now it's getting people to use them.


Steve:

Now that test is different from the one, though it can find where the DNA has been shed, right? You're talking about something that is-


Jill:

Correct.


Steve:

Before that.


Jill:

This is something different. This is-


Steve:

Okay.


Jill:

A screening tool. It's fairly new to the market was just approved this year. It's currently not something that's covered by insurance. It's out of pocket. And what it's trying to target are the people who have those high risks for cancer diagnosis. So you've got a strong family history of breast cancer or prostate cancer.


Steve:

Yeah.


Jill:

Just ways to set people's minds at ease and another tool for screening.


Steve:

All right. Got it. Okay. So, despite what has been said, I've been a pretty good boy this Christmas. So I'm going to give you a couple of mine as well. So-


Jill:

Okay.


Steve:

And you've heard me talk about this before, and I shout this from the mountain top every chance I get, but one thing I would wish for would be that guys as a group would get better at taking care of their health. I think something gets lost in the shuffle because it just doesn't get the same attention. There'll be 33,000 guys dying of prostate cancer this year. That's about 80 to 85% of the number of women that will die with breast cancer. But yet, it doesn't get nearly the amount of attention.


Steve:

And in my opinion, it's because guys just don't want to talk about it, and they don't want to know. The travesty of that whole thing is that I would venture a guess, you tell me if I'm wrong, but if you catch early-stage prostate cancer, you probably have statistically a better chance of being cured than even if you catch early-stage breast cancer, I would guess.


Jill:

Right.


Steve:

So said another way, if you catch it early, you're certainly going to be cured.


Jill:

Right.


Steve:

You don't, okay, it's a different story.


Jill:

Right.


Steve:

And so that's what I would hope for, just more guys getting a PSA done. It's not a big deal. It's a blood test. We talked about the other thing. That's a little bit more invasive, but it's once a year for a couple of seconds and-


Jill:

Well, and the other thing that people don't realize, when you catch cancer early, most often you've had some form of surgery, and then they talk about a treatment that is kind of an insurance policy-


Steve:

Yeah.


Jill:

To keep cancer from coming back.


Steve:

Yep.


Jill:

That is a specific amount of time. You usually are given up a few months of your life to do the treatment. And this applies to multiple different cancer types versus waiting and the disease being advanced by the time it's found.


Steve:

Yep.


Jill:

Those patients most often are on treatment for the rest of their life.


Steve:

Yeah. And I don't think this is always the case, but is it general really true that if you wait for symptoms to show up, the outcome's probably not going to be as good?


Jill:

There have actually been studies that have been completed, that if you find cancer before the patient is having symptoms of it, the survival is 50% greater-


Steve:

Okay. That's huge.


Jill:

Then if you wait until the patient is having symptoms of cancer.


Steve:

Yep. Yeah, no, that's huge. So the second one that I would throw out there because it's also related to prostate cancer, but one that I happen to know a little bit about. And I think it holds a whole lot of promise. You correct me if I'm wrong, but we mentioned it one time before is this PSMA pets. So I went and had one of these done in Michigan last November, and it was extremely effective in locating three different cancerous spots, and then we were able to create a targeted radiation plan that at the very least has bought me several more years.


Steve:

And arguably, as we continue to use this technology to find and destroy, I mean, it could maybe never cure you but let you live out a fairly normal life.


Jill:

Right.


Steve:

So can you just kind of explain to everybody what does PSMA stand for? Remind everybody about that again. And then, we've talked about this before. I don't think people often understand what a PET scan is versus a CT scan. So maybe if you kind of hit those two things, but I guess my thing is that I just hope that more people kind of learn about this, use it as a way, particularly in a recurrent setting, to figure out what they need to do next and get it done.


Jill:

Gotcha. So starting with your basic, a CT scan or a CAT scan is when most patients who have a cancer diagnosis have done this. The CT scanner kind of looks like a big donut. Something near and dear to our hearts around here. And usually, you have to drink some oral contrast that's used when they do the CT of the abdomen and pelvis. And then you also get some IV contrast that's shot in that essentially helps enhance things so that they can see things a little bit better. For people who have not experienced the IV contrast with a CAT scan, it gives you this super warm sensation all over, and then it kind of settles right in your groin. And, people will actually describe that they feel like they've peed themselves.


Steve:

Oh yeah.


Jill:

From getting the contrast. That's not the case. It just is a very, very warm sensation. In contrast, in a pet scan, you also get a form, it's kind of a form of contrast, but it's a radioactive sugar that gets injected.


Steve:

Okay.


Jill:

The machine is very similar. It's a CT-type machine, but the difference is what gets injected, the contrast. So the radioactive sugar gets injected, the patient has to wait about an hour, and then they do the CT scan, and then they're looking for the areas that light up on the PET scan. And these are areas that essentially are breaking down that sugar at a much faster rate.


Steve:

Oh. Interesting.


Jill:

So cancer cells break down sugar at a faster rate than normal cells do. And so that's why the PET scan is a great tool for identifying areas of cancer once it's reached a certain size.


Steve:

Okay.


Jill:

So a PSMA PET scan. So PSMA stands for Prostate-Specific Membrane Antigen. So an antigen is essentially a protein that is on the surface of those prostate cells. And so with the PET scan that's PSMA, you get injected with an isotope, and then what they're doing is they're looking specifically for the areas that targeted that protein.


Steve:

Okay.


Jill:

And so that's where those, like you, said, early on they caught small areas for you. They go targeted just to those prostate-specific cells.


Steve:

Okay.


Jill:

Okay.


Steve:

So I get, and maybe I didn't even understand that. So you don't need a new machine. You use a CT scanner.


Jill:

It's not ... yeah. It's not-


Steve:

It's the tracer, basically.

Jill:

It's the tracer that's different.


Steve:

Ah, interesting. Okay. So then that's only being currently manufactured in a couple of places.


Jill:

Right.


Steve:

Okay.


Jill:

And it's not a standard CT. They're using a PET scanner.


Steve:

Okay.


Jill:

PET scanners and CT scanners are a little bit different.


Steve:

Okay. Gotcha. Okay. So anyway, to close that out, I mean, that would be just a phenomenal development, I think if that starts getting into widespread use because that subset of the population that potentially could, for which it might be lethal, can continue to run out the string for quite a few more years I think-


Jill:

Right.


Steve:

If you can do that. So.


Jill:

And then not only the quicker detection of disease faster, but they're also studying the specific treatment associated with the PSMA scan.


Steve:

Okay.

Jill:

So that's also up and coming. That was something that they actually did an entire presentation on at ASCO this year, and they're doing a lot of clinical trials on that, essentially that what they inject, there is something attached to that, kind of like the assault rifle.


Steve:

Okay.


Jill:

But it's now programmed to go straight to that membrane, that prostate-specific membrane, and destroy the prostate cancer cells.


Steve:

Okay. Got it. Okay. So what's the Hunt family going to do tonight? Are you guys going to make hot chocolate or go sing Christmas carols around the neighborhood or watch Christmas movies? What's the plan?


Jill:

Well, I think we are going to finish decorating tree number 11, and we did make all of the Christmas cookies, but there's always more to bake.


Steve:

All right. I'm sure there is. I'm sure there is. Okay. Well, I think that pretty much covers it. I think we'll probably come back next week, and we will ... wait a minute. Is this thing on? Chris? So yeah. I think next week will be the final week of the year, and I think Joe and I might reflect a little bit on some of the key developments that took place in 2021 and then hopefully, if things work out like planned, I think we'll have a really special guest starting to kick off the first of the year with clinical trials. And Tim Schroeder from CTI will join us for a series on that because that's an incredibly important topic as well. So anyway, Merry Christmas, everyone, and we'll look to seeing you on the other side and launching into the new year after that. Take care.




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