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Smart Talk is a daily, live, interactive program featuring conversations with newsmakers and experts in a variety of fields and exploring a wide range of issues and ideas, including the economy, politics, health care, education, culture, and the environment.  Smart Talk airs live every week day at 9 a.m. on witf’s 89.5 and 93.3.

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Facing Cancer Together Community Forum, Smart Talk TV

Written by Nell McCormack Abom, Host Smart Talk TV | Jan 17, 2012 8:18 PM

When you get a diagnosis of cancer, the fight to survive becomes personal. A unique set of challenges faces each cancer patient. Please join us for the Smart Talk/Facing Cancer Together Community Forum: Making It Personal, tonight at 8 on witf TV. Facing Cancer Together is witf’s multimedia, interactive, community-education initiative to foster conversation about issues surrounding cancer. Our partners include WellSpan Health, PinnacleHealth, and Lancaster General Health. This week, we explore the high-tech developments, some pioneered right here in Central PA, that fuel cancer-research, treatment and prevention -- all designed to save lives.

Making It Personal highlights advances like targeted-light therapy, robotic-assisted surgery and clinical trials now underway to find a recovery path that makes the most sense for each patient. You can ask our panel of experts your cancer-related questions at 1-800-729-7532, or via email at smarttalk@witf.org. You can also leave a comment at the end of this article or post to witf's Facebook page.

Today, two-thirds of patients will survive five years after first getting a cancer diagnosis. In 1975, just half of the patients would live to that milestone. What’s fueling the pace of progress? And, what are some of the most exciting advances that have a practical effect on the cancer care Central Pennsylvanians can receive? Our guests will help answer those questions and more. They include Dr. Brij M. Sood, Fox Chase Cancer Center, director of Radiation Oncology at PinnacleHealth, Dr. Shanthi Sivendran, Lancaster General Health Hematology/Oncology Specialists, Dr. Percival Buenaventura, Thoracic Surgical Oncologists, WellSpan Health, and Dr. Anthony J. Olszanski, director, Phase 1 Program, Fox Chase Cancer Center, Philadelphia.

Dr. Buenaventura at WellSpan Health deals primarily with patients who have malignancies of the chest, including cancers of the lung and esophagus. In the past, a diagnosis of lung cancer was often a death sentence. That’s not necessarily true today. “The best chance of cure is detection early,” Dr. Buenaventura notes, “And, the cost of lung cancer care is significantly lower if you find it early.”

One of the major advances in lung-cancer treatment in 2011 involved performing low-dose computed tomography (CT) scanning of high-risk patients. According to a report this month in the Journal of Clinical Oncology, a national study of 50,000 current and former heavy smokers “found that three annual low-dose CT scans reduced the risk of dying from lung cancer by 20% compared with those who were screened with three annual chest X-rays. This landmark trial was the first to identify a screening regimen for patients at high risk for lung cancer, despite decades of attempts.”

Dr. Buenaventura says another exciting advance involves minimally-invasive surgery options for lung-cancer patients. “Instead of having a cut, you have a couple of small incisions, put a camera in there, and basically do all of these surgeries that previously would have required a big incision on the chest, much longer hospitalization and more debilitating effects, basically now, you do them robotically.” For more information on WellSpan’s lung-cancer treatment options, check out its 2010 Annual Report.

Dr. Anthony J. Olszanski of the Fox Chase Cancer Center in Philadelphia, is an expert on clinical trials. Dr. Olszanski’s online bio sums up his attitude about the need to personalize cancer treatment. He writes, “I believe that the path towards treating any disease is best navigated by thoroughly understanding not only the disease, but also the patient. Good communication between a physician and a patient is especially critical in the treatment of cancer. Each patient has a right to be both respected and heard. In addition, relying on a team of experts to help manage the complexities of treating cancer is essential for success. As a physician, I strive to provide personalized and scientifically sound care to each of my patients.”

Dr. Olszanski points out three factors he asks his patients to bear in mind when they enroll in a clinical trial. “Number one,” he says, “we rarely if ever use these placebo-controlled trials. It’s one of the most frequently asked and misunderstood conceptions that we are treating patients with placebo but that is not usually the case. Secondly, in my opinion and in the opinion of the National Comprehensive Cancer Networks, the NCCN, the treatment on a clinical trial is actually preferred. You get much better follow up, you have a bigger team that’s looking after you, and you get a lot better patient one-on-one care. And, then thirdly, is that you really are doing something not only to move your own cancer forward, to treat yourself as appropriately as you can, but also the people, and there will be many, who come after you with cancer.”

Dr. Brij Sood, PinnacleHealth/Fox Chase Cancer Center, says cancer care has evolved rapidly over the last decade. "No more is cancer one person's domain. It's not just that there is an oncologist who knows what's best for the patient," he explains. "It is now a multi-disciplinary team approach for cancer patients. And cancer treatment is becoming more and more individualized based on various factors like the stage of the disease, the patient's general health, and the patient's way of thinking." He says when doctors extract a piece of tissue for analysis, "each piece holds important information that would further separate that patient from other patients. And remember, diagnosis and treatment are two different things. Whether the treatment is surgical or radiation or chemotherapy or treatment based on individual molecular biomarkers, we are able to choose the best option for each patient." Among the cutting-edge advances used at PinnacleHealth is the CyberKnife® Robotic Radiosurgery System. Dr. Sood will explore its implications for cancer patients in the midstate.

"From the medical oncologist's point of view," says Dr. Shanthi Sivendran at Lancaster General, "we mostly deal with chemotherapy, hormone therapy and other medications related to cancer treatment.  Historically ... for many cancers we've had to use a more hit-and-miss approach with chemotherapy.  Over the past five years, we've made huge advances in genetics and technologies which allow us to really hone in the medications we use.  So, for example, in one cancer, you can have a patient who has specific genetic mutations and you can tailor their chemotherapy, or what we call targeted therapy, to those specific mutations so they might benefit more from those types of drugs rather than more general drugs."

Side effects also, she says, are better tolerated with targeted therapy.  "We are moving into this age where we can for many different cancers, screen people genetically and target their therapy specifically toward that mutation which is what we mean by personalized medicine," Dr. Sivendran notes.

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