Title:Understanding Non-Melanoma Skin Cancers for patients: Insights from Dermatologists Drs. Zahirsha & MehrzadHook: In this episode, dermatologists from Loyola University discuss the essentials of non-melanoma skin cancers, including risk factors, early signs, and treatment options. Whether you're concerned about sun damage or curious about skin cancer prevention, this conversation provides practical advice for all.Main Topics:Overview of non-melanoma skin cancers: basal cell, squamous cell, and rare variantsRisk factors like sun exposure, genetics, and immunosuppressionRecognizing precursor lesions: actinic keratoses and keratoacanthomasDifferences between superficial and invasive cancersTreatment options: topical therapies, scrape and burn, excision, Mohs micrographic surgeryWhen to seek medical attention and the importance of early detectionSystemic treatments and advanced therapies including immunotherapySpecial considerations for high-risk tumors and sensitive areasTimestamps: 00:00 - Introduction to skin cancer types and relevance 00:26 - Experts from Loyola Dermatology introduce themselves 01:40 - What are non-melanoma skin cancers? 02:36 - Rare types: Merkel cell, dermatofibrosarcoma, Kaposi sarcoma 04:07 - Predisposing factors for skin cancers: sun exposure, immunosuppression, genetics 05:47 - Recognizing early signs and precursor lesions: actinic keratoses 06:54 - Impact of childhood sunburns and importance of early detection 08:25 - Personal experience with basal cell carcinoma 09:40 - Precancerous lesions and their significance 11:19 - Transformation risk from actinic keratosis to squamous cell carcinoma 12:07 - Common areas for precursor lesions 13:53 - Bowen’s disease and keratoacanthomas 15:36 - Importance of early intervention to prevent deep invasion 17:17 - Characteristics of keratoacanthomas and their behavior 18:29 - Invasion and metastasis: what they mean for skin cancer progression 20:06 - Risk stratification: low, high, and very high-risk tumors 21:16 - Treatment options overview and decision factors 22:43 - Characteristics that make a tumor high risk: size, location, microscopic features 26:14 - Approaches for treating primary lesions: topical, scrape and burn, excision 27:40 - Advantages and limitations of topical therapies like Imiquimod 30:13 - Procedural options: electrodesiccation, curettage, surgical excision 33:20 - Mohs micrographic surgery: why it's preferred for high-risk areas 37:49 - Differences between Mohs and standard excision 40:21 - When radiation therapy is appropriate 43:37 - Role of systemic therapies: immunotherapy, targeted drugs 46:49 - Emerging treatments and advocating for advanced options 49:16 - Key differences between basal and squamous cell carcinomas 50:23 - Insights on Merkel cell carcinoma's aggressiveness 52:47 - Final advice: importance of early detection and regular skin checks 54:23 - The role of monitoring moles and melanoma risks 55:56 - Summarizing the importance of vigilant skin care 56:36 - Closing remarks: consulting a specialist and taking action earlyResources & Links:Imiquimod (A topical treatment for superficial skin cancers)Mohs Micrographic Surgery - American College of Mohs SurgeryABCDEs of Melanoma DetectionConnect with the Experts:Mirnaz Mehrzad - Loyola University ProfileZisansha Zahirsha - LinkedInAdditional Notes: This episode emphasizes the critical role of early detection and proactive skin health practices. It highlights how simple signs like non-healing sores or new growths should prompt a visit to a healthcare provider. Advances in surgical and systemic treatments are improving outcomes, especially for high-risk cases, making awareness and timely care more important than ever.

content type Interview primary goal Educational summaryThis podcast explores gallbladder function, the development of gallbladder cancer, and the latest treatments including surgery, chemotherapy, immunotherapy, and advanced genetic testing like next-generation sequencing (NGS). Experts discuss risk factors, early detection, and personalized treatment strategies to improve patient outcomes. key topicsGallbladder function and anatomyRisk factors and causes of gallbladder cancerLatest surgical and medical treatments for gallbladder cancerRole of next-generation sequencing in personalized cancer therapy guest nameDr. Eva Galka, Maria McGreevy, Michael ReardonTitlesUnderstanding the Gallbladder and Its Role in DigestionHow Gallbladder Cancer Develops and Is Treated sound bites"Pain from gallbladder issues is often severe and localized.""Next-generation sequencing looks at the DNA of the tumor.""HER2 is a protein on some cancer cells that we can target."Chapters00:00 Introduction to Gallbladder Cancer01:45 Understanding the Gallbladder's Function05:50 Gallbladder Cancer Development08:09 Environmental and Genetic Factors10:05 Early Detection Challenges11:32 Symptoms and Diagnosis19:02 Treatment Strategies for Gallbladder Cancer23:44 Advancements in Gallbladder Cancer Treatments25:06 Surgical Approaches and Post-Operative Care31:30 Chemotherapy and Immunotherapy Strategies35:39 Survival Rates and Prognosis44:11 Next Generation Sequencing and Targeted Therapies resourcesNext Generation Sequencing (NGS) - https://en.wikipedia.org/wiki/Next-generation_sequencingHER2 Targeted Therapy - https://www.cancer.gov/about-cancer/treatment/drugs/her2-targeted-therapyGallbladder Cancer Overview - American Cancer Society - https://www.cancer.org/cancer/gallbladder-cancer.html guest linksLinkedIn - https://www.linkedin.com/in/eva-galkaLinkedIn - https://www.linkedin.com/in/maria-mcgreevyTwitter - https://twitter.com/PaulRoach

SummaryIn this episode, the hosts introduce Sitaram Chilakamarry, MD, a colorectal cancer specialist, and discuss his background and interest in medicine. They then delve into the topic of colorectal cancer, providing statistics on its prevalence and mortality rates. They explain the anatomy of the colon and rectum and how colorectal cancer develops from the innermost lining of these organs. The discussion also touches on the role of genetics, diet, and inflammation in the development of colorectal cancer. The hosts emphasize the importance of early screening and detection to prevent advanced stages of the disease. The conversation explores different screening methods for colorectal cancer, including stool-based tests and direct visualization tests like colonoscopy. The FIT test, which checks for blood in the stool, is the most popular stool-based test. Colonoscopy is considered the gold standard for screening, but it is expensive and carries risks. The conversation also highlights the importance of healthy lifestyle choices in reducing the risk of colorectal cancer. Tobacco use and obesity are significant risk factors. The incidence of colorectal cancer is higher in smokers, and smoking causes inflammation throughout the body. The conversation concludes with a discussion of different cases of colorectal cancer and the next steps in diagnosis and treatment. In this conversation, Sitaram Chilakamarry discusses the process of diagnosing and staging colon and rectal cancer. He explains the importance of MMR testing, staging with CT scans and blood tests, and the role of surgery and chemotherapy in treatment. He also highlights the significance of regular colonoscopies for early detection and the potential for non-operative management of rectal cancer. Additionally, he mentions the promising use of immunotherapy in treating rectal cancer in patients with Lynch syndrome.Chapters00:00 Introduction and Background08:11 Understanding the Anatomy of the Colon and Rectum13:08 The Development of Colorectal Cancer24:49 The Importance of Early Screening and Detection27:32 Exploring Different Screening Methods36:29 The Pros and Cons of Colonoscopy43:37 The Impact of Tobacco Use and Obesity50:43 The Importance of Healthy Lifestyle Choices53:49 Diagnosing Colorectal Cancer59:28 The Significance of Screening Compliance55:17 Staging and Blood Tests56:45 Treatment Plan and Chemotherapy01:04:00 Urgent Cases and Ostomy01:08:49 Elective Cases and Surgery01:14:07 Anemia and Colonoscopy01:19:46 Polyps and Watchful Waiting01:23:35 Immunotherapy and Lynch SyndromeTakeawaysColorectal cancer is a common and serious disease, with approximately 150,000 new cases and 53,000 deaths in the United States each year.The colon and rectum are part of the gastrointestinal tract, with the colon absorbing water and the rectum acting as a reservoir for stool.Colorectal cancer arises from the innermost lining of the colon or rectum and is typically classified as adenocarcinoma.Genetics, diet, and inflammation are factors that contribute to the development of colorectal cancer.Screening for colorectal cancer is crucial, as early detection can prevent advanced stages of the disease. Stool-based tests like the FIT test are popular for colorectal cancer screening.Colonoscopy is considered the gold standard for screening but is expensive and carries risks.Tobacco use and obesity are significant risk factors for colorectal cancer.Smoking causes inflammation throughout the body, increasing the risk of colorectal cancer.Healthy lifestyle choices can help reduce the risk of colorectal cancer.Diagnosis of colorectal cancer involves checking for mutations and inherited syndromes.Screening compliance is important, especially for individuals with a family history of colorectal cancer. MMR testing (or mismatch repair testing) is important for diagnosing colon and rectal cancer.Staging involves CT scans, blood tests, and determining the depth of tumor invasion.Regular colonoscopies are crucial for early detection and treatment.Non-operative management may be an option for rectal cancer patients with a complete clinical response.Immunotherapy shows promise in treating rectal cancer in patients with Lynch syndrome.

[00:00] Intro and hello[01:30] Guest - Eva Galka, M.D. FACS: personal background and path to Surgical Oncology.[07:00] Pancreatic Cancer: typical patient[13:35] Clinical Presentation: how does someone know they have pancreatic cancer?[20:30] Referral: how do people show up in my office?[33:20] What is the pancreas? [45:00] Epidemiology of pancreatic cancer, and demographics[48:00] Staging & Resectability[1:04:00] Chemotherapy[1:07:00] Breaking therapies & Studies on pancreatic cancer[1:15:00] Thank you and closingKey takeaways: 1. Pancreatic cancer (specifically adenocarcinoma of the pancreas) is a fairly common, and very serious diagnosis, worldwide, with three basic categories meaning early (stage 1), late (stage 4), and intermediate (stages 2-3). Different approaches to the disease are based on which of those categories it falls into, and how healthy / able to tolerate treatment the patient may be.   2. Resection is one's only/best chance for cure; however many cases are beyond respectability at diagnosis; and some are questionably resectable (borderline or locally advanced) and require upfront treatment before any attempt at resection. Even after resection it can come back, so extra treatments such as chemotherapy is almost always recommended.   3.  Pancreas located in center of upper abdomen, surrounded by important other organs and blood vessels, making resection of tumors from it a very complex and technically demanding procedure, with significant risks of complications, even --not often but sometimes-- death.   4.  Chemotherapy and radiation are somewhat effective; frequently necessary, but not AS effective as they can be in some other tumors/cancers..   5.  The condition (adenocarcinoma of the pancreas) is best treated in specialized centers by specialized teams.  6.  New treatments (such as immunotherapy and tumor vaccines) are being explored; but need to discuss with academic centers if applies to you. If you think you might be interested in being part of a trial, ask your treating physician and also view the show notes links below.

[00:03] I. Intro and hello[02:07] II. Guest - Farhan Shams, MD. Geriatrician & Palliative Care specialist[02:49] III. What are Goals of Care?[05:38] IV. What is Palliative Care?[18:01] V. Who comprises a Palliative Care team, and what are their roles?[31:00] Expectations, communication, and understanding where the patient is coming from.[43:08] Change is the only constant in life[47:04] Futility [48:45] ClosingKey takeaways:-- Palliative Care is a subspecialty and a team of professionals dedicated to improving the overall experience of a patient, family, and friends throughout the critically difficult moments of patient succumbing to disease.-- Comprised of a physician, nurse practitioner, psychologist, social worker, and chaplain; all specialized and with a professional focus in the field.-- Critical to establish "what are the goals of our treatment" and to ask "why are we doing what we are doing?"--Understanding, communication, expectations, hope, reality, and process. --Grief--A Palliative Care doctor is a "Life Coach" for the end-of-life process

Timestamps:[00:30] Intro to show and Guest Keith Bowersox, MD, PhD[2:38] Overview on Lung Cancer[5:55] Smoking & Lung Cancer[7:40]  Lung Cancer Screening[10:30] Radon, Vaping, Marijuana & Lung Cancer[13:30] “If you’re honest with your doctor…”[16:00] Lung Cancer workup[20:00] Lung Cancer types:  Small Cell; Non-Small Cell.[23:00] Lung Cancer stages and implications[26:00] Radiation treatment[32:45] Chemo, radiation, immunotherapy side effects and patient selection[34:45] Cure or palliation[35:50} Treating for cure:  patient selection & treatment options[41:18] Post-op:  Medical Oncology assessment and treatment[44:00] Wrap-up and thank youKey takeaways:-lung cancer is a heavy diagnosis; however great progress in its treatment has been made especially recently-lung cancer is among the most common and lethal, yet among the most preventable of tumors: by quitting smoking, or never starting.-new, powerful screening modalities in modern practices are low-dose Computed Tomography (“CT”) scans of the chest. Must meet specific guidelines and quit smoking to be able to benefit.-“Staging” of lung cancer (“Local, regional, distant”) determines treatment options and potential outcomes; baseline health status / lung function important.-Surgery, Chemotherapy, Immunotherapy, Radiation therapy are main treatment modalities-Optimal / Essential to have a primary care physician, and maintain a positive relationship with them.

1  - Michael Riordan, Medical Oncologist Peter Schlagel, MD, Urologist Charlie Rinehart MD, and Surgical Oncologist Paul Roach MD embark on a full discussion of Prostate Cancer: what it is, how it happens, how it behaves, and how it's treated.2  - Guest:  Charlie Rinehart, MD, a practicing Urologist and medical officer in the U.S. Navy, (formerly an officer in the USMC), undergraduate at Georgetown, Medical School at Columbia, and Urologic Residency at US Naval Medical Center, San Diego.  Currently practices at the Captain James A. Lovell Federal Health Care Center, in North Chicago, Illinois. This is his second time on the program; for full introduction to Dr. Rinehart please check out the episode on Bladder Cancer.3  - Timestamps:[00:4] - Intro & disclaimer[01:00] Overview of Prostate Cancer:  A. Incidence and broad description of the problem B. What is a prostate? What is a PSA screening test? What does it mean to have an elevated PSA test? How is the PSA test done? C. Clinical Presentation & who gets prostate cancer?[10:50] Prostate Biopsy[12:25] Shared decision making regarding prostate cancer screening A. The good, the bad, the ugly B. Risk reduction versus over treatment; the importance of age in the process C. “Heterogeneity” and variability in prostate cancers[20:00] Very Low risk, Low, Intermediate, High, Very High risk categories.[26:15] The “Trifecta” A. The goal:  Treat the cancer, preserve urinary continence, preserve sexual function. B. Risks and benefits of treatment options, based off of estimates of baseline risk. C. What is “active surveillance?” Impact of age, baseline health status on deciding which course of action to take.[31:20] Active Surveillance & Radiation Therapy A. Age, health issues, prior experiences and their influence in choosing Surveillance or Xrt. B. External Beam, IMRT (Intensity Modulated Radiation Therapy), Brachytherapy[34:03] Side Effects of Surgery, Radiation Treatment A. Incidence and range of incontinence, erectile difficulties B. Impact of baseline function, age at time of treatment, time from surgery C. Sequencing Surgery and Radiation treatments D. Antitestosterone therapy[42:00] Staging tests for localized versus widespread cancer. A. CT scan and bone scans - traditional B.  MRI’s and PSMA tests - newer[46:25] Michael’s questions on origin of the cancer: Genetic? Smoking? Diet? Exercise A.  African American/Black individuals a clearly higher risk of developing prostate cancer and should consider PSA screening 10 years earlier (age B.  Agent Orange exposure - Viet Nam Veterans. C. Association with BRCA i. What is it? ii. Importance of Family Medical History (males & females)[51:05]  Summary of points thus far, and Radioactive seeds treatment option A. When to use which option? B. Lower risk options and higher risk options[54:45] Prostatectomy[56:21] Advanced disease A. Locally advanced (i.e. spread outside the capsule of the prostate, and/or spread into the local pelvic lymph nodes or organs) disease B. Distant (i.e. metastatic) disease i. Androgen deprivation C. Microscopic disease D. Survival and quality of life E. Testosterone supplementation and (+/-) association with prostate cancer.[1:03:50] How does prostate cancer cause a man to die? A. “Go-go” phase, “slow-go” phase, “no-go” phase B. Androgen deprivation[1:09:22] Closing and thanks4  - Key takeaways in bulleted format: -- Prostate Cancer happens to Men alone, as only men have a prostate, and has about the same frequency and risks as breast cancer has for women. —It typically happens in the more advanced ages, but can happen in younger men (40’s for Black men, 50’s for other demographics) -- Frequently, Prostate Cancer does not present with symptoms; one needs to have a screening test performed (called PSA) but should discuss risks/benefits with physician prior to embarking on that.   -- There are a variety of different risk categories for diagnosed prostate cancer (very low, low, intermediate, high, very high) with different risk of progression into advanced disease and death.  The risk categories can change (from less risky —> more risky) over time, so a physician-patient relationship must be maintained over time. —Multiple treatment options; these are based on stage of disease, risk category of the disease, patient age and health, and patient preferences.  Patient and physician must work with one another to decide which therapy to employ, and when, and why.5  - Relevant links for the episode:https://www.cancer.gov/about-cancer/treatment/clinical-trials/disease/prostate-cancer/treatmenthttps://www.cancerresearchuk.org/about-cancer/prostate-cancerhttps://www.cdc.gov/cancer/prostate/https://www.cancer.gov/types/prostatehttps://www.radiologyinfo.org/en/info/imrt6  - Follow us on your favorite Podcast program, and learn more through the homepage at  https://paulbryanroach.com/so-its-cancer/7  - Coming up next month:  “Lung Cancer"8 - Follow us on your favorite podcast platform, please contact me/us via webpage https://paulbryanroach.com, and direct link to show website is here: https://paulbryanroach.com/so-its-cancer/

A one hour seminar

Join Mike Riordan, Urologist Charlie Rinehart MD, and I, for a full discussion of Bladder Cancer: what it is, how it happens, how it behaves, and how it's treated.

Join us as we host Rohit Sharma, MD, FACS, to explain the diagnosis of Malignant Melanoma: what it is, how it happens, what you do about it when it happens.