35 Burst results for "Tumor"
Gene Editing and Recovery from Radiation
"Welcome to the talking biotech podcast. Weekly podcast about agriculture medicine with an emphasis on biotechnology and the good things we can do for people and the planet names kevin volta. I'm a professor and a podcast host. Who cares about science communication mostly around the area of biotechnology. So today we wanted to talk about something interesting. Radiation and radiation has many places in biology. Of course our resistance to it. The problems that can be caused from it as well as its use as a therapeutic agent used to induce genetic variability when we do plant breeding but has some deleterious downsides and they've represented barriers both for remediation of radioactive. Waste as well as if there's issues with the side effects of radiation therapies for cancer. So i was excited to learn about some work. That's happening. The innovative genomics institute out at the university of california berkeley. There's work that's gone. Underway under darpa funding to attempt to use gene editing to solve some of the problems associated with radiation exposure. Mostly in acute radiation sickness. and so. today we're going to talk to dr feodor urnov. He's a professor in molecular and cell biology department at the university of california berkeley as well as the director for translation technology at the innovative genomics institute associated with berkeley. So welcome to the podcast. Dr urnov thank you for having. This is really a pleasure. I was really excited to read about this. Because it seems like such a cool project that's long overdue and i can certainly understand arpaio's interest in this. I tried to frame a little bit of the problem ahead of time. But could you give me a better explanation of. What is the problem with acute radiation sickness. And where do we see it across. The bay from the berkeley campus is one of the best if not the best teaching hospital in america. Ucsf in the chair of radiation oncology. Dr mary fung has told me how frustrating it is to have. Her patients succumb to cancer of the abdomen and of the pelvis. Oh things like pancreatic liver you. Try a variant. Despite the fact that she has a powerful weapon to pure those cure is a big word and the weapon is radiation as you pointed out as all technologies radiation has had a positive side in the negative side the negative side. Of course we think about weapons. We think about radiation disasters such as mobile in in the ussr. Where i went grow was born and raised three mile island Shema but then on the positive side radiation is used to determine how our teeth are doing or our lungs are doing which is particularly timely given. What's happening right now. In our nation and has also a really really powerful medicine to cure cancer. The reason it's not more widely available is what's technically known as dose limiting city and in english. That means you cannot give enough of the cure before it side effects overpower its benefits. So in dr funk's practice the physician. So i'm regurgitating. What i learned from her and other had the honor to collaborate with. She has a patient with a with a major cancer of the abdomen. Or or the pelvic area she can irradiate the tumor and eradicated. The patients do not recover because tissues that are inevitably also effective so the gut and the bone. Marrow where are aquatic stem cells live are irreversibly damaged by the radiation itself. So the patients Die off either lethal diarrhea which cannot be stopped using anything
Power Rankings: Can the Clippers stay atop the West?
"Espn's nba power rankings. Talking about how great everything was going in. La or how much noise l. Making right now in the sports universe but the lakers no longer number one in the rankings. So maybe la's fallen down a little. Except the clippers have assumed the number one spot kawhi leonard and company. The nba's best record the clippers. Have a six game. Swing with leonard and paul george entering quarantine due to health and safety protocols and patrick beverley. He's out they had a seven game. Winning streak snapped in atlanta. The co and paul george back after missing just two games due to contact. Tracing the clippers are a deep team. There were deep team last year. But i think bach gives them a premium over mantras harrell because he can spread the floor. He can shoot the three and he can rim defend. He can defend the paint at certainly blocked shots. At least he's very good defender. As is harold box more versatile moreover more versatile player you can play a lot of big next to a bacha because he can do some things that some modern pigs can't but serge ibaka is not the reason that they're you know this good. They've played together another season. Tyler is doing a very good job. Don't forget and this goes for what i said about the nets last segment to we're in a covert year. Still where there's not practice like. They're normally is and people are socially distanced so first year teams that come together like the nets last year like brooklyn. This year are at a disadvantage but brooklyn's now going on their second year with sorry. The clippers are largely with the same cast. And yet you know. Lou will mantras harrell reggie jackson nick tomb. Which was a big pickup nick. A tumor he got a max deal or something close to it. Because he was the status all star. I mentioned this last week but at that time. Are you sure that you knew who was going to be better between kawhi leonard klay thompson and nick platoon. But he was in that category people when he got his deal. Weren't even like oh. That's too much for nick petunia. Like oh he's really good player. Lost interest on a noncompetitive team. He looks interested again. Remember he got a max deal wasn't no one. Did him any favors. He earned it so. That's a big pickup for them. Interested nick we can play making do some things but none of this really matters to me for the clippers and i understand power. Rankings are based on regular season performance. Guys until paul. George shows up as like this if paul george showed up his normal self. The clippers are still at a disadvantage against the lakers because kawai and libron or both superstars as is a de. Paul george is the next thing to a superstar. Paul george is not a five star player. He's a four and a half star player. So even if paul george it shows up as his normal self. Ain't going to be enough for the clippers in the playoffs. He has to be just to see but instead of that or even stay the same. He gets in the playoffs. So i don't believe in this clippers team in the play. I don't care what they do. In the regular season. Until i see paul george show up when it matters in the playoffs. A believer
Fenway Park to become second mass COVID-19 vaccination site in Massachusetts
"Launch launch begins begins today today at at Fenway Fenway preparations preparations to to turn turn the the Red Red Sox Sox home home field. field. It's It's well well mass mass vaccination vaccination cider cider just just about about ready ready to to go. go. WBC's James RoHaas is there's this morning he joins us live with more details. Good morning, James. Yeah, Good morning, So The ballpark is the second mass vaccination site in the state. This soft opening today has followed by the official launch next Monday. Now, the state says the ballpark is scheduled to administer 500 vaccines a day by appointment, and they plan to ramp that up to 1000 a day for those in phase one priority groups. This site is expected to stay open through the beginning of the baseball season in April, with the state saying it's working with the city to find a longer tumor location down the road in Boston, Fenway, the fifth Major League Baseball ballpark, to announce that this acting as a mass vaccination site, joining others, like Citi Field in New York and Dodger Stadium in L. A.
"Accounts of near death. Experiences can be polarizing indie. Most often happened while people are unconscious so researchers are incredibly limited in what they can actually measure. They must rely on human testimony to fill in. What's actually happening in other words. Andy ease exist near the intersection of two seemingly contradictory ideas science and faith which is why after a neurosurgeon reported in n. d. e. it became central to the conversation in nineteen eighty eight. Dr eban alexander began his career in boston at one of the most prestigious hospitals in the country. Brigham and women's well working as a neurosurgeon. Dr alexander simultaneously target his father's alma mater. Harvard medical school in both institutions. He had access to some of the most cutting edge medical technology in the world. Soon dr alexander became an expert in a non invasive. Surgical treatment called stereo tactic. Radio surgery a procedure that uses targeted radiation to address medical abnormalities. In the brain it can even eliminate tumors without needing to open the skull in his own practice. Doctor under-used stereo tactic. Radio surgery to treat cancer. Epilepsy mentoring nerves and tangled blood vessels and for nearly a decade in the field of medicine. His star was on the rise until two thousand one when an elderly woman from arizona. Whom will call. Rose contacted him to remove a benign tumor in her brain. Dr alexander was one of the few surgeons in the country capable of performing the procedure. So rose flew from arizona all the way to boston but she didn't receive the treatment that she expected when rose arrived at the hospital orderlies placed her in a wheelchair and brought her into the operation. Room apparently no one spoke to her or explain what was happening. After doctors strapped into a device rendering it immobile rose demanded to meet. Dr eben alexander. She was about to go under and he had yet to introduce himself mere minutes before the operation began. Dr alexander stepped in front of her said. Hello and assured her that she was in good hands then she drifted into unconsciousness and the surgery began when rose woke up in the icu. She couldn't move the left side of her face. Dr alexander never warned her about the risks associated with her surgery and though he'd successfully eliminated her tumor half of her face was now permanently paralyzed. Ultimately rose filed a lawsuit. Her lawyers asked to see the paperwork she'd signed before entering surgery. But apparently dr alexander could only produce a single sheet of paper. It didn't even have rose's signature on it. Apparently dr alexander had misplaced a number of her forms. The case was eventually settled out of court shortly after. Brigham and women's fire dr alexander from their roster administrators have not stated whether or not the dismissal was related to the lawsuit. Either way dr alexander moved on to work for umass memorial medical center located in worcester massachusetts. Where apparently his careless behavior continued during one operation. Dr alexander reportedly left a small piece of plastic inside a woman's nick. In addition to the pain this caused her she needed another intensive surgery to have it removed then in august two thousand three umass suspended dr sanders for an error made during an operation. On another patient's brain stem the specific details surrounding. These punitive measures remain confidential by early two thousand seven. Dr alexander relocated to lynchburg virginia and began work as a staff surgeon at lynchburg general hospital but his lack of professionalism and care continued
Democrats plan Trump's 2nd impeachment trial
"Democrats are eager for the second Senate impeachment trial of President Trump to get underway despite him leaving office Wednesday after President elect Biden becomes president. Biden House will transmit one impeachment article to the Senate, Trump allies South Carolina to Senator Lindsey Graham, begging incoming majority leader Chuck Schumer to call off the trial, he says a trial will further divide the country. Meanwhile, Senator Tumor promised to trial in the Senate. No matter when That is. Rudy Giuliani, the president's personal attorney, said in an interview over the weekend. He likely will not be representing the president in the Senate trial, He said he'll likely be a witness. After all. He did give a speech before those capital riots. Fox's David Sponge Russian
Jeff Bridges says his tumor 'drastically shrunk' since lymphoma diagnosis
"You know, Lebowski. Has shared some positive news. Made his lymphoma diagnosis 71 year old actor. Recently wrote On his website that quote his true tumor has drastically shrunk. After going in for a cat scan. Go in for a cat scan to see if my new protocol is shrinking. My tumor turns out is working beautifully. He said. Oh, good. The thing has drastically shrunk. I came home. Elated with the news. Bridges, then shared work from his mentor. Roselle Sykes. Has been helping him amid his health struggles. Writing his mantra is be love. The The love. love. Yep, Yep, That's That's my my path. path. The The star star revealed revealed that that he he was was diagnosed diagnosed with with lymphoma lymphoma back back in in October. October. As the dude would say new ass has come to light, he wrote on Instagram and Twitter, referencing his famous character. I've been diagnosed with lymphoma, although it's a serious disease. I feel fortunate that I have a great team of doctors. The prognosis is good. I'm starting treatment and I'll keep you posted on my recovery. Weeks later, he shared that he would be keeping his fans updated. The cancer thing is bringing Bringing on feelings of precociousness and gratitude and good, old fashioned love and lots of it big time he rode. I'm feeling so much of it coming my way and man. I appreciate it. It's contagious, Contagious all this love man. Like some kind of positive virus. Want to acknowledge and thank you guys for reaching out During this time, it feels good getting all the well wishes and love.
Jeff Bridges reveals his tumor is 'drastically' shrinking after lymphoma diagnosis
"Is saying that his tumor has drastically shrunk as he is going through cancer treatment. Isn't that great news tastic is lymphoma diagnosis in October, And then he shared the positive news on his Web site and a post that was the stated a few days ago. So he's 71. And he said, I go in for a cat scan to see if my new protocol is shrinking the tumor. Turns out it's working beautifully. The thing has drastically shrunk. I come home, elated with the news. So that's good. Oh, yes.
Bringing Precision Cancer Care to Dogs
"Joining us. Oh thank you so. It's exciting to be here spend some time with you. We're gonna talk about cancer precision medicine and dogs one health and it's fighter accu- offering is seeking to bring advanced cancer diagnostics and treatment to for legged patients. Let's start with the connection between human and canine cancer. How much of an overlap is there. It's actually pretty significant. So dogs and humans co evolved. Let's start there and sadly you know they share health and they shared disease and sadly share a lot of similarities cancers there's similar history logic appearance. There are similar tumor genetics molecular targets. There's metastasis you know the same kind of process there -peutic response immuno competency and Yeah so the one big difference is that there were for example. Six million dogs diagnosed with cancer in the us last year versus about two million people in the population of dogs much smaller is about ninety million. So you can see there that the incident prevalence is quite high. There's not only an overlap but there's also a significant gap in care when it comes to treating dogs with cancer. How big a gap is there between the state of cancer care for humans and dogs. That's a great question. So and really part of what drives our mission every day As the dog right is more and more beyond even best friend. Really family member and many of the advancements for human oncology have actually been tested on dogs right beagles however very little has made it back to the dog to actually help the dog as a patient not just a subject And so the difference is a stark for for example in the world of targeted therapies. Which is a class of drugs. Really from this century That's already been around for twenty years in in humans They're about twenty five of those therapies for humans. Fda approved and there's really only been one for dogs. We're changing that but that's the kind of gap At any given day on college that a human clinic might have. I don't know sixty tools in their hands and maximum in the veterinary world. According to our opinion leaders would be maybe thirteen tools including everything under the sun radiation. He will so. The gap is pretty big. You talked about some numbers relating to incidents. But what's the market opportunity. So the market opportunity. I how i look at it. We're creating it so it's not super the fine but the market opportunity is that we have six million dogs right Diagnosed a ready. That diagnosis is pretty There's been some investment behind that by the parent by the family It's not you know it's not ten bucks. Probably you know all in out of pocket between two hundred fifty dollars all the way to two thousand defending those a surgery. So that right there gives you one gives you a dimension however Only you know we think it's even less than twenty five percent there actually medically treated today. We think that that's because of the current will Frankly are mostly from last century. And are you know even their their hard the basically hard on family right to go to a specialist clinic. maybe they don't have one nearby Drop off their dog in cova on the sidewalk. They don't even talk to the clinician face to face that is and they're you know for baby call. It will be in the clinic for a long time for an infusion. It's chemo so it's very onerous and tough We think you know we could do better. And we can bring more tools and increase accessibility. What's the vision for one. Half what trying to do a one health is actually a movement. It's the shared health and disease the oneness across species. So we are looking at you. Know what has In the in the context of oncology we're looking at what has moved forward the human world that we could lift and bring back to the dog and on the other. You know if you think of it on both sides of the leash then walk. Can we learn finchley from the pet dogs. Cancer journey which happens at a vari accelerated speed bright which You can basically the lifetime of the dog right is shorter than ours so you can just see things and again a similar journey right with metastasis and whatnot What could we learn you. Could we interrogate. Could we find where are the biomarkers similar and then look at for example combinations of drugs right we understand that cancers multifactorial and that you know likely the you know kind
The Next Evolution of Vaginal Health Awareness, Screening, Practice, and Policy;
"Welcome back to the outcomes. Rocket saw marquez's here. And today i have the privilege of hosting sherry palm. She's the founder and ceo of a pops. The association for pelvic organ prolapse support. She's the author of three editions of the award. Winning book pelvic organ. Prolapse the silent epidemic a pelvic organ prolapse patient advocate battle and intimate health activists international recognized speaker pop key opinion leader and prolific writer regarding pop. Which is the pelvic organ. Prolapse will using that acronym pop Emotional social sexual fitness and employment quality of life impact. She writes on all of these things and today. We're learning more about pelvic organ prolapse how it affects folks. Why and what we can do about it so sherry. Thanks so much for taking the time to be on the podcast with us today. Thank you so much for this opportunity. So i really do appreciate the time. Share information with your following absolutely and so sherry. I'm excited for our chat to before we dive into your organization. I want to learn more about you. And we'll catch you started in this. Healthcare dernie well is a classic case of discovery diagnosis with a health condition. You've never heard of. I was a diagnosed thirty and had done everything. I could to change the dynamic of my life. I was told. Mb wheelchair-bound short timeframe. And so. I did a lot of proactive engagement with what i can do that. Optimize my health and it worked. What i've done did work so moving. Forward into my mid fifties. I started to notice symptoms. And i was a little curious what those symptoms meant not give you the condensed version of it. I'll you of tidy for your when i would go to the bathroom. I've always worked to sixty hour week. That's minority and go the bathroom to he and after about three months old noticing. A bulge down around my vaginal area got a little bit curious and god a hand held mirror out to take a look to see what was going on down there and discovered a walnut sized. And of course your brain goes to tumor right away when you think about on So i was. I wasn't freaking out. Completely because i had no pain with it. It was just something. That was weird. And i knew it wasn't normals had to be addressed so i sent an email to my buddy who happened to be a doctor. Lucky beam and she's combined. We'll do a pelvic exam upon examination. She told me very matter of factly. You help pelvic organ prolapse. I will fit you with a pessaries and if you're not happy with the past three. I will recommend a highly skilled euro gynecologist to address it surgical angle. Why never heard of any of those terms before. So i was a little coffee this to say but she for the past three. Which is actually an incredible device that you can but in that kind of like the diaphragm support your internal organs and backdrop is leaving harper's and prolapse. I is a condition. Where is the organs in your pelvic cavity. Start to move into vagina and push their way down and out. All of the vaginal canal as your pelvic muscle isn't strong enough or is damaged and cannot support those organs from underneath them anymore. So i am home from that appointment and did what most people will do by dr google. What up with that. And on tons of information about prolapse and everything that i read said the same thing. It's so common and my take away from. That was how come i've ever heard of this before. But so common so within a very short timeframe my curiosity turned to anger and frustration. To be honest with you. And i knew that if i didn't know about this condition at other women didn't know about this condition because i had been so proactive about my health so i moved into action quickly. I knew that it was only one way to really optimize getting information to women and that was during a book and have any knowledge about writing books but it just felt right so i went off in that direction and with two weeks after was for that test. Pessaries from my doctor. I realized that that wasn't going to work for me. I mean she great job you re different on the inside as we are in the outside and so what position fits omen for pessaries. Sometimes go through two or three or more tries to get the right fit with me. I was lucky. I had a great doctor. She got the right fit right. I'll shoot and i went home and i was happy. I could take it out in nighttime and embrace of insert in the morning and it worked wealth me at provided support from april. But within two weeks of doing that. I recognize that. I just didn't have time to deal with that.
Tasmanian Devils May Overcome Transmissible Cancer That Nearly Wiped Them Out
"You might have heard of the plight of the tasmanian devil. These carnivorous marsupials have been afflicted with a transmissible facial tumor a cancer that jumps from one devil to another when they bite each other in the face not as uncommon as you might think and as a result their populations have gone into steep decline despite these extreme population losses. The devils have been holding on and may even be turning a corner andrew store for and colleagues wrote about this potential turnaround in this week science. Hi andrew hi. Let's start with the downfall of the devils. This facial tumor disease. Dft when did arise and what has been. It's trend in it. Spread among the tasmanian devils. The devil facial tumor disease according to our new study originated. Probably in the late. Nineteen eighty s. It was actually discovered in the mid nineteen ninety s in far northeastern. Tasmania where people started discovering devils with large facial lesions that seem to grow. Initially that wasn't much of a concern because they've seen these types of lesions new places back since the nineteen seventies however when animals started dying in large numbers. People really started paying attention that this was some sort of transmissible disease shortly thereafter. A genetic study was done that showed that these lesions were actually a clone oil transmissible cancer. They were genetically close to identical so since its discovery the disease has actually swept across tasmania and sort of an east to west us. Fred and is now just reached. Some of the last uninfected populations on the west coast has media. Cancer is different from pathogens like bacteria or viruses. How's that affected our ability to understand the transmission of this disease in tasmanian devil. One of the big challenges has been its large genome size so studying. The genome of a virus is fairly straightforward because viruses like sars he'll be to only about eighteen to twenty eight thousand base pairs long. However the tasmanian devil genome is three point two billion bases about the size of the human genome so trying to track. The spread of the disease is much more challenging. In terms of computational power and genomic sequencing methods which weren't really available at the scale they are now when the disease was discovered. So in the study that we're talking about today. You apply to technique that has mainly in the past been used for viruses. What did you have to do differently to get this to work for transmissible cancer. We did complete genome sequencing of fifty one tumors than that being in our final analysis finding parts of the genome that are measurably evolving that is evolving at a regular rate or what we would call them. Killer clock is pretty challenging and in the end we screened about eleven thousand genes which took several months on the computer and found twenty that were measurably evolving clock like fashion. And the reason you want to do that is then you can look at how these or changing over time as the disease has spread and this allows you to estimate epidemiological parameters like the transmission rate and the proportion of the population. That gets infected overtime. So this is how you figured out that it came out in the eighties right. The disease likely originated in the eighties which is consistent with its discovery in the bid nineties because when a disease like this i started taking off. In a wildlife population it might be at fairly low prevalence and so people don't really notice it until it really takes off and our epidemiological parameter which is called our savvy which is equivalent to the transmission rate started to peak in our analysis just before the discovery which makes sense because the disease was rapidly increasing or exponentially increasing in the population. Let's talk a little bit about that transmission rate. That's something that you know using this analysis you're able to show it changed over time. Can you describe that trajectory we identify tumor lineages and in wanted around the mid nineteen ninety s in the other it peaked around two thousand and the really encouraging results of the study showed that in both major tumor lineages that seemed to be across. Tasmania now that the transmission rate declined to just about one at present and this indicates that the disease has reached some sort of stable state that is for every devil that's infected only one additional devil is infected and thus the main conclusion of the paper which is the disease is transitioning from an epidemic state in which it's exponentially moving across populations to an end state where it's just kind of at replacement is the kind of analysis you did hear able to tell you what has changed. Is something different about the tumor. Cells are the devils different. What's going on. We did find some mutations that seem to explain variation in transmission rates among the different tumor lineages and these are related to other types of cancer however these are candidates for downstream discovery at this point so they serve as good hypotheses for future research. And what's different about the devils. We have some other studies that show that also the devils seemed to be evolving in response to cancer. We see changes in the devil genome. That are also seem to be associated with possibly disease resistance. We've also seen spontaneous tumor regression in an increasing number of devils wild populations and we show that that might be related to regulatory changes in the in the devil so perhaps some jeans are up or down regulated in response to the tumor and we also found a mutation in the tumor. That seems to cause the tumor to shrink so a mutation actually when turning on a gene and this gene is implicated in human prostate and colon. Cancer the tumor growth actually slows in laboratory studies when we transact wild type tumors. Don't have this gene with the. Does this suggest that the disease will go away or that. It will coexist peacefully with tasmanian. Devils people really thought that tasmanian devils or on their way to extinction. I think this provides us cautious optimism about the future of the tasmanian devil. This transmissible cancer which is nearly one hundred percent lethal has caused a dramatic decline of this species of process. Entire range has me so they are certainly not out of the woods yet. However because this disease is socially transmitted early models predicted disease extinction because even if you have low densities of individuals the disease can still be transmitted because devils congregate and bite one another. Which is the way. The disease is transmitted for purposes of mayday or scavenging food however a growing number of studies from our group has shown through ecological modeling for example devils are predicted to persist on most scenarios. Some of those involve lower population densities than where they were initially but yet the devils will persist and in the subset of those cases. The tumor will also persist and we may see sort of endemic dynamics where there's populations like this study adds to the growing number of studies that the disease itself also seems to be evolving perhaps lower transmission rate because there may be evolutionary pressure on disease to be less lethal to the devils. Are people trying to figure out how to preserve the devils and will that strategy change with this understanding of the switch from epidemic too endemic. We certainly hope that our new study will help. Influence hearth rations strategy so when devil started declining there was captive breeding to maximize genetic variability in captive populations which are maintained in wildlife parks and some zoos and actually an island offshore from tasmania album. Riot island. where there's a free roaming population of not quite captive devils but devils were introduced there. These were referred to as captive insurance operations with the intent that if devils went extinct on the mainland they could be reintroduced or if devil population sizes or inbreeding reached really high levels. They could perhaps be introduced using a technique called genetic rescued increase genetic diversity in the wild populations
Intensive scare: covid-19 ravages America
"We're likely to lose another two hundred and fifty thousand people dead between now and january this week grim headlines and milestones in america the daily covid nineteen death. Toll hit a new record on wednesday. The infected patient count in hospitals asked one hundred thousand for the first time the contagion has now reached every corner of the country with ninety percent of all. Us hospitals in areas designated as corona virus hot zones cases have topped a million in florida texas and in california governor gavin. Newsom warned of worse to come just in the last fourteen days close to one thousand californians have lost their lives due to covid nineteen. The bottom line is if we don't act now. Our hospital system will be overwhelmed. We don't act now will continue to see a death. Rate climb. healthcare systems are becoming overwhelmed in ways not even seen during the pandemic's panicked early stages in the midwest things have been particularly dire with intensive care units filling up doctors and nurses exhausted and in many places. The public just isn't acting in a way that will stem the tide right now across the midwest. We've seen a surge of cova cases of people being rushed into hospital. Adam roberts is our midwest correspondent in states like north dakota. South dakota is when talking to health workers in those hospitals. They've been telling me that. Icu beds are at eighty percents. Ninety percent occupation ensured. The hospitals seem to be getting quite full and sometimes quite stressed and how have the hospitals in the region been preparing for this surge. I spoke to several health. Workers including dan rooney. Who's with the emergency medicine department at the university of iowa hospitals and clinics. That's in iowa city and his hospital because it's an academic center is just about the best equipped in the state. It's been doing everything it can to clear. Space to let covert patients have as much from his possible. So inpatients have been sent home when they can be. They've added extra. Icu beds that being postponing elective surgeries and dr renee told me that it's being taught and go from the outside. It sounds like okay. Everything was handled any sort of at the moment. But it's just hard to convey how close you are to going from just being able to barely need it to be overwhelmed and the fact that has been handled so far has been partly down to the actions of frontline workers. We've been lucky of the health care system to mostly not quite break. But i think people be shocked about how close we get and just what it takes in terms of individual level responses to make the thing keep going so from what dr wendy says. It sounds as if the public doesn't really know how bad things are at the moment. Yes don't worry says. He worries members of the public and governing. Politicians just haven't grasped what happens when hospitals get to full take for example the impact of canceling elective surgeries as a common misconception that those are surgeries onto poulsen until the no pressing when you hear hospital canceling elective surgeries. That means people potentially with cancer. Getting their tumor excise. It means people that have gallbladders either heart disease or vascular disease that need intervention that are putting them at risk of really bad side effects and sickness or death. That's real that's happening. So when the hospitals become overwhelmed is not just covid. Nineteen patients who suffer. It's the rates of excess non virus. Deaths that also could search and what about the situation outside urban areas like iowa city. I mean the situation. Equal kind of across the region. No is is not equal. So what you see. Is this interrelationship between the big hospitals in places like iowa city and then rural places small hospitals. That might just have one doctor one us now these rural hospitals. They're under great strain. Not least because many of them have closed in the last decade or so around one hundred thirty rural hospitals across america have closed and that puts a lot of pressure on the ones that remain. They can be overwhelmed with just one two three patients coming in and you can imagine that when covid sweep through a small town maybe a local meat packing plant is affected or prison. Those hospitals are overwhelmed. Very quickly. I spoke to ben christians. Who's an emergency care doctor. In sioux falls in south dakota who said that for the past two months they've been functioning at over one hundred percent capacity of their icu. Beds and they've been adding more beds as well and he takes patients from eighty sparsely populated but Reflected counties spread all across south dakota and beyond and these are patients who are coming in from as far as a hundred and fifty miles to get to his relatively small hospital. And it's not surprising that those places get overwhelmed more quickly than in the biggest cities. And why do you think the situation is so bad particularly in the midwest. What is moving out from the midwest now but the first surge hit the midwest this autumn i think partly because these are more northern states and it's colder weather up here and so people are in those and maybe spreading the virus more easily but it's also a fact that in rural areas in parts of northern wisconsin and the two dakota's people have just not taken serious measures. It's not unusual for me when i've been reporting and wearing my mosque going into small towns to be stead at and for people to look at me as if i'm an alien. They don't want to wear masks. They don't want to do social distancing as winning liz people in the cities and that may be why they're also being affected badly now and the third reason is that politicians in those states including the governors have been refusing to order rules on mosques and closing restaurants and businesses. And so it's not unusual in all of these places to have mass gatherings people going to church people going to bars and restaurants even when the infection rate is extraordinarily high and that must be that much more frustrating for over the frontline workers who are seeing the effects of all that don't originally told me it's very difficult the thing that's been harder as as this has gone on the sense that we're not really in this together as a community as a state a nation you know. We're watching people get sick. We're watching people die. We're watching our colleagues really extended themselves to prevent the system from completely breaking and then to see scenes of full airports full bars to see people talking about their individual liberty with regards to amass. That has been that's been and a lot of the healthcare workers in other places. I spoke to said exactly the same that frustrated. They're exhausted some falling ill themselves but is there a bright side here. I mean haven't health professionals come a long way since the spring and in terms of coping with these outbreaks. Yes so the saving grace of all this is frontline. Staff know much better ways to treat patients for example they're much slower than people on ventilators. They discovered that if you'll put on a ventilator you own you have a five to ten percent chance of actually surviving it and so far. Fewer people are being intimidated than before. It's only the most desperate cases and generally there a better treatments better drugs use of steroids and someone so there are reasons to be more hopeful. That if you are infected you can survive. But on the downside. We've had a big surge in infections. Recently is not just the colder weather. It's the fact that people are getting together as the holiday season and run the said he stands by and he watches in fear. Because the thanksgiving weekend. The past probably is a sign that they'll be more affections and we'll see a big surge in the weeks to come. You know for all the fatalist and say well. It's paying them into a disease. what can you do. You can just look around the world that responses and places have crushed to this and there is no reason that a place with the material wealth and the scientific expertise of the united states shouldn't have been among those countries and the fact that we haven't it's an enduring tragedy. Adam thank you very much for joining us. Thank you jason.
Indianapolis Colts punter Rigoberto Sanchez confirms cancer surgery 'went well'
"Is recovering from surgery that removed a cancerous tumor or Charlie. Clifford shows us how teammates and coaches are hoping to help his recovery. A punch from Rigoberto Sanchez hangs in the air for anywhere from 3 to 5. Seconds. This'll week, messages regarding his importance on this team triggered even quicker steam loves Rego respects we go. He's a leader on this team. Rico is really one of the guys, you know, not just a specialist. You know, He's one of the guys in a mixed in the locker room, and like I said, You're not gonna replace the guy like Griego on Wednesday, coach right filled with optimism, delivering In early post op update on his special teams. Ace Procedure went very well. He's a home resting. We're very optimistic. We're very thankful for the doctors and prognosis is positive for real. We're wholesome. It's not months. You know, we're hopeful is I don't know. I mean, it's you know, this is out of my league. The objective this weekend Houston defeat the decimated Texans stay within reach of the Titans for the F C South divisional crown. And certainly head of kick off the message in the locker room and across India. Win it for Rego. I think it would mean everything. It's the division game. That s a lot on this game to go out there and win and knowing we plan from them. I'm pretty sure he'll be very happy. He's a unbelievable partner and holder and kickoff Yet he's one of those. You're so good at his job. I try to keep him over there. It's nice for him having no point no point game but certainly will be looking forward to his return. Hopefully certain leg rest up
Michael J. Fox retiring again because of health
"The nineteen eighties were good to michael. J. fox the actor shot to fame with roles in the sitcom family ties and the back to the future foods at backup. Don't have enough road to get eighty eight rows row but in nineteen ninety-one age of twenty. Nine fox was diagnosed with early onset. Parkinson's disease in two thousand. He founded the michael j. fox foundation for parkinson's research organization has raised a billion dollars to find a cure through it. All fox found a way to maintain his signature optimism until twenty eighteen when his sunny disposition took a significant hit fox underwent spinal surgery. Then a serious fall that forced him to confront his mortality. He writes about that year in his new book. No time like the future which is out this week and michael. J. fox joins me now. Welcome here tell me about that fall. Well i when dealing with my thirty thirty. Th year outlook parkinson's so that that kind of had handle on been ahead. Spinal tumor had surgery on that and it took me a while to learn how to walk again. I'd barely learn what getting when i of course declared independence until they could walk on my own. And i belong in so i got up. Walk into the kitchen swift flooring shattered my arm and all the dean indignities that was for some reason cutting blow so you as you say you were dealing not only with parkinson's for many years you've just gone through this incredibly dangerous surgery to remove a tumor from your spine. Just spend a moment there for a minute. How serious was that spinal diagnosis in was pretty seriously lifting for a while for a few years. But he's been in a benign and static wasn't doing anything from the dodgers. Just watch that check on every now and then so when the last time that checked on it had grown quite considerably was actually on spinal cord itself which then made Something that Attach because they can't in any way touch her to remove some spinal for when you touch it. But johns hopkins adopted feodor. When's your with me. Discuss the risk. The risk of not doing it where i would be paralyzed by now by as we speak from when win puts me that way i realized yeah and then there you are lying on the floor in your apartment in new york city. Your arm shattered. You'd gone through all of these challenges and gotten through them for the most part right. So where do you think the darkness came from. Why did you so desperately lose that optimism that to become known for some reason it was almost instantaneous last lemon unknown lemonade Unbelie it was angry myself for taking for granted Detention in the in the care they put into my health in my in my life and you know what family Asked me to be careful. When i said don't be careful. Careful careful Carelessly walking too fast and it was two kind of full of pride of of at my might chievements to understand the risks of taking an inadequate To at risk in all the time engine Physical therapists who put me at risk and anti alexander myself I agree as said about how they push china's within a bum. Catchy raised the land myself. They get passes the nothing it was like. I started thinking with the parkinson's community i Optimism tennessee. And i kind of said it'll be okay and and really there are people that had a misery index lot higher needle. Lend me with a broken arm. Bagging car is these are people who've lost lives homes country family children woodward by bam. Who am i to tell them to be have to miss it online on the slowly a rag or i can see why you would be angry but what about scared was scared to well. Isn't that what happened. Was that came out of that. Here that come off the floor and heavily armed fiction which function in a. I would let examined all these things. Fear aging gratitude. Just all of these things came through my mind. And as i made notes on them out for no reason Lebron you're going through something with take contemporaries in alabama a. He's not that. I said let's deceased together into the story of what happened and how i lost and regained my commitment. How might new. Optimism is kind of a little more informed with a little more realistic eating. Be realistic at the same time. You reminded us for those who need to be reminded how precious thing it is to walk. And i found the way that you described your relationship with wheelchairs to be very powerful at one point in the book said that. Unless you know the person who's pushing you can be a very isolating experience in fact you compared yourself to a piece of luggage and then you went on to say that if we could ever just look at each other in the eye we would recognize our shared humanity. And i just want to thank you for that. Because actually i had never thought of that before and those are probably things. I imagine that you for granted at some stage in your life as as being and i talked about that will move momentum me my life and and how i was always moving in in my job is an actor. Energy do stunts or having physical representations of what was happening or as an athlete another good one persona in so. When i look at things i will shares do thing one to have been nail biting person. My whole life into be can't walk in the other thing about being in the chair. Is that for me personally. I'm i'm i'm someone who is easily recognizable. Everybody knows intense speed familiar with and even if they don't know me as a privilege of what i do but when you're unsure you just a piece of luggage and pushing Order hotel something. He's escaped me from point being open to get five bucks in so you just stay in you push Facing the wall can't get into the verbally again. Like you will not have Beings open as they are. They might as well. Apple's own smoke last bubbles. Is that people to be going on with him. Well let's talk about your acting career. The thing that made it so that people recognize you on the street. You've gotten roles in recent years. The didn't hide the fact that you had parkinson's symptoms but actually incorporated that into the role such as louis canning of courses. The lawyer on the tv drama. The good wife with listen to a scene there. I suffer from a condition turtle disconnect asia which is released a funny word for neurological disorder. And it makes me do this. And this i if you just look at me all of us to it so and i won't mind in the book you say that you're ready to accept the your acting career is over to an extent i i laugh in fact it's something surprisingly something to change but yeah the last couple times. I acted i actually. I haven't played warners again anyway. Resume lines difficulty for some reason. Always been some interesting. Even with. I look at her family. Ties scripted from five minutes Show and i just said they photographic memories Position where i didn't know struggling with the lines Lear capital in time in hollywood going off assessing what. What is the deal. But unlike him in that movie. Who's parading himself really angry when i found myself in that position. I said i'll gable. This isn't working so maybe we'll find some other way to do it or not. Do you also say you may be done with gulf another thing that you've loved. How is it letting these things go or acknowledging that it might be time soon to let them go. Insights about acceptance and gratitude and acceptance. Part of it is what is accepted into circuit. That is what liz i can deal with that. An investing came endeavor to change it. But if you don't accept the and be more blog that be cranny of your life Adjusted so. I accepted the fact that i assume golf club too hard. I fall down in a like boohoo. I'm falling nanosecond. Only now therefore i don't put myself in that position again fall down on but maybe one day i'll be treated in a way or find some way to get so. I don't fall down in the gulf again. I'll be grateful for it. It's just a matter. Is that come compartmentalizing really. It's taking inventory seeing where that fits in your life and the losses that have had are more than compensated for by my family my friends by the role habit in the parsis communities it change to relationships with people on the street to how much i enjoy reading how much film much writing is less to joe you live. I'm speaking with michael j. fox whose new book is called no time like the future and optimists considers mortality and michael. Similar listening to this may have just been diagnosed with parkinson's and that could be very frightening for them as you. Well know in fact you become an ambassador of sorts. For for folks with parkinson's what's your message to people who've just recently been diagnosed as i was talking to manually. Today's few was just diagnosed in like me was diagnosed. Daytona nine Items that was twenty nine years ago. So i did. I said for you. Being diagnosed a twenty nine means for sure no doubt bank on it. Better write it down. It will be here in your lifetime. And how much credit can the fox foundation take for that. I will take not moods. It'd be happy happened. We we are the largest funded research in private sector but never a mission. Our mission is we have a thing. When we first started we about how to structure foundation dissimilar brought up endowments down like e bala money said on this again and said we won't be doing that. Come to go out so we operated on then in the set aside purely motive. Where would you do it. It's your model that each is trying to get this work done as quickly as we can for people in. It's been so yeah. Optimism is is a driver knows every night. You because because there's no sense doing something again at least argue for michael j. fox thank you so much. Be well you to
Bridging HUGE Gaps between Consumers, Providers, and Payors with Evan Osborne
"Welcome back to the outcomes. Rocket saw marquez's here and today. I have the privilege of hosting evan osborne. Evan osborne is the founder and managing partner of diabetics united and also president and ceo of ride salem and healthcare management consultant with a focus and quality initiatives and change management. Evan has over ten years of professional experience in direct patient. care as well as he's he's held leadership roles and both the payer and provider rounds of the industry. Evan has a diverse background and continuous improvement systems building and program management and has earned a bachelor's degree in biology at western oregon. University and in therapeutic radiation oncology from the oregon health and science university. He later earned his master's degree in public health at the university massachusetts amherst and is currently completing a doctor of business administration at california southern university. I'm excited a chat about the work. That evan is doing with diabetics united and really his his contributions to healthcare overall. So evan. such a pleasure to have you here with us. Thanks for joining honor to be on. Your program saw a mouthful that you just read off from my for working through year busy man. You're a busy man. I liked the busy thinks you know so. One of my favorite quotes is an idle. Mind is a workshop of the devil. The right yup. Yup you've done a lot of really great stuff in in healthcare avenue. I definitely want to share with everybody. Listening the work that you guys are up to bat diabetics united but also unite salem. Which is really cool. Cool stuff but before we dive into that just park for second and under better understand. What inspires your work in healthcare. Certainly will it's comes back at the turn of the century when i was pursuing a career opportunities aligned with my education being biology and computer science unique blend of potentially stepping into the healthcare realm and then during that time on a personal level. I had a one of my favorite uncle Called me up. And tell me about their their brain tumor that they just developed and They were working with some health. Professionals called radiation therapists us. I really enjoy His time with them. They're really good at what they do. Such an i never heard of such a field before around the same time. I university Counselor recommended a program oregon. Health and science university radiation oncology. And so having not so close together being told about the program and i looked into it and before i knew it was gonna program wonderful program there in portland oregon And then ten years later after working bedside in oncology taking on leadership roles progressive leadership. I was exposed to bigger picture. Realms healthcare And then on a personal note. I later developed Type one diabetes late in life. So i went from a very rarely going to healthcare. Not really seeing it on the customer's level. More just out of the health. Professional became a frequent flyer. Customer i seen it from end to end. And then my career took me into both sides of the industry and the health insurance industry hostile side and then consulting as well So with my diverse background there and my personal connection with it I continue to strive to to contributes improving yourself to the healthcare system that that's unfortunately a little bit more messed up. And we'd like to net but with all the numbers out there. It's it's easy to see that it needs improvements. And that's what motivates me to continue getting up every day to kalki poker evan That's that's great man. I mean how those two road scott converge to get you in new on the young college field and then you you stayed in and then type one diabetes happens to you and you just like you said this. This is it for a year it contributing in a big way. I appreciate you sharing your story very down and you know what i you know. We don't truly fully understand until you live it and You know having the the steps that that you have to take to manage diabetes. You live it firsthand and inspired you to create diabetics united. So tell us a little bit about diabetics united and what you guys are doing to help the healthcare ecosystem and in particular Think consumers right. Yeah her so. When i first was diagnosed stylish trying to teach myself a green all the information that i could help management as even and what i noticed. Was you know. There's pockets of information throughout the internet to go pretty deep to get what useful and practical you the season diabetics. So you have an enormous amount of information for diabetes one basically so someone that's in the process of developing diabetes or just recently got diagnosed. You're just basically learning alphabet diabetes. That's what's out there But there is no actual central location where it takes it to the next level. More of a practical approach bringing everyone together in the industry so Like a hub. And google is the hub in in essence. There's so many layers to get to where you need to go. It's not filtered out. And it takes a lot of time to get what is pertinent that you're looking for from someone such as myself. A background and diabetes kinda still through a narrow it down to what's practical to diabetics But also the ability to interact with it so diabetes united completely interactive platform on a web based solution. We can say so. Members can get on the website and an add content to sites. It's kind of a fusion of facebook. Amazon and wing thin And we've got some other Services that were hoping to roll out here in august. That'll be practical to this day and age being remotely accessible and coach
Caleb Barlow Discusses Healthcare Industry Ransomware Attacks and Measures to Prevent Cybercrimes
"Welcome to the healthcare policy podcast on the host David Intra Cosso. This podcast discussed cybercrime or ransomware attacks against hospitals and other healthcare providers with Collab- Barlow CEO Synergistic Tech this barlow welcome to the program. Hey pleasure to be here. David. Mr Biles vile is, of course, posted on the podcast website. On background computer or cybercrimes against healthcare providers, more of a hospitals, disabled computer networks holding them for ransom. Frequently for Bitcoin fee, the tax have been prevalent since at least two, thousand and ten. This past month however, universal health services with over four hundred locations. Over in the US suffered a cyber attack disabling it's company wide computer network causing some it's hospitals to revert to pen and paper recordkeeping also last month the first known death. Resulted from a ransomware attack in Germany when a patient did not survive transferred to another hospital. Though a twenty nineteen hhs report found between twenty, twelve and sixteen. Hospital deaths increased after ransomware attacks. Earlier this month covid nineteen VACs. A covid nineteen vaccine trial was delayed by more attack or at least one. Likely. The most costly ransomware attack was to the UK's national health service in seventeen that amounted to an estimated one, hundred, twenty, million in it costs and lost productivity. ransomware attacks are on the increase especially amongst small hospitals, particularly vulnerable to phishing attacks, lasting upwards of tumor weeks because of their lean or inadequate security support. As Josephine Wolf noted in October Seventeen New York Times editorial quote Unquote cybersecurity shortcomings in the healthcare sector needs to be addressed now. More than ever when medical care is increasingly being offered via remote online formats. In twenty twenty states introduced more than two hundred and eighty cybersecurity related bills enacting several related to task forces or commissions training. Cybersecurity insurance in criminal. Penalties. The US Senate and House passed seven cybersecurity bills whoever not specifically addressed the healthcare industry and none became law. With me again and discuss healthcare cybersecurity is synergise texts, CEO. COLLAB- Barlow so club with that. As background LET'S START WITH A. Primer Info. I've read these ransomware products. in part are. Titled or named Wannacry Laki Win Plock encrypt locker. Are some these known ransomware product. So my question is, how do these encrypt clinical data and to what effect? So. So basically, what happening if you look at ransomware incident is a you know a narrow will gets access to a network and that could be as simple as grabbing somebody's credentials. You know maybe you were on a retail site, use the same credentials you used at work that retail site was compromised and There are many locations on the dark web that will. Sell compromised credentials or could have been through a phishing attack once the bad guy is into the network then there's two primary things that they're looking to do first is to move laterally. They WANNA get as much access across the networks they can, and there are a variety of tools that they'll deploy. They will actually help them harvest additional credentials once they've got a beachhead. On, the network in addition to harvesting new credentials and kind of moving lateral or what we call lateral movement. The other thing that are going to do is to try to elevate their privilege. So going from maybe an administrator or you know a nurse and triage and maybe getting access to their credentials, they're going to try to work their way up to a network. Administrator or someone that controls access to the whole domain once they've been able to get in and move their tentacles around the organization, then they're going to deploy their payroll, which is one of several of the tools that you mentioned will allow them to then lock things up effectively what these tools, our cryptographic tools, and they basically take the entire hard drive at the device. Scramble it and lock it up with a cryptographic key. What we've seen of late is the bad guys oftentimes insert a new step just before scrambling data, locking it all up in that the exfiltrated lot of it, and they're using that to increase their chances of getting paid by potentially threatening to. The organization by releasing that data if they don't pay ransom. Okay. Thank you so. I in my reading. It's uncertain Saul. Asked you this question? What's your understanding? How frequently? Is this occurring in the healthcare sector? Oh, it's every day I mean literally every single day because you got to remember what you read about in the news is only a very small fraction of what's actually going on even though technically speaking ransomware incident is as far as I'm concerned reportable incident because you gotta remember if the bad guy had enough access to walk up your data, they had the same level of access needed to read the data and they actually in many cases had the same level access needed to change the data. So the problem is you've actually lost control of that system when you've had a ransomware incident. I. So that was that was a question I did have. Other than. Possibly, making this data public and you know healthcare data's is is is confidential proprietary, of course. What do they typically do this data other than hold it hostage? Well remember, this is a organized crime. It is a volume organization you're dealing with a human on the other end and that human is organized right. You're not the only target, their targeting dozens of organizations at the same time in many cases are teams of thirty individuals and you know there's a breakdown on that team there's a project manager of a boss. There's people that are responsible for getting access. There's people that are responsible for moving laterally people responsible for elevating credentials and people are responsible for negotiating. Once walked up system
Caleb Barlow Discusses Healthcare Industry Ransomware Attacks and Measures to Prevent Cybercrimes
"On background computer or cybercrimes against healthcare providers, more of a hospitals, disabled computer networks holding them for ransom. Frequently for Bitcoin fee, the tax have been prevalent since at least two, thousand and ten. This past month however, universal health services with over four hundred locations. Over in the US suffered a cyber attack disabling it's company wide computer network causing some it's hospitals to revert to pen and paper recordkeeping also last month the first known death. Resulted from a ransomware attack in Germany when a patient did not survive transferred to another hospital. Though a twenty nineteen hhs report found between twenty, twelve and sixteen. Hospital deaths increased after ransomware attacks. Earlier this month covid nineteen VACs. A covid nineteen vaccine trial was delayed by more attack or at least one. Likely. The most costly ransomware attack was to the UK's national health service in seventeen that amounted to an estimated one, hundred, twenty, million in it costs and lost productivity. ransomware attacks are on the increase especially amongst small hospitals, particularly vulnerable to phishing attacks, lasting upwards of tumor weeks because of their lean or inadequate security support. As Josephine Wolf noted in October Seventeen New York Times editorial quote Unquote cybersecurity shortcomings in the healthcare sector needs to be addressed now. More than ever when medical care is increasingly being offered via remote online formats. In twenty twenty states introduced more than two hundred and eighty cybersecurity related bills enacting several related to task forces or commissions training. Cybersecurity insurance in criminal. Penalties. The US Senate and House passed seven cybersecurity bills whoever not specifically addressed the healthcare industry and none became law. With me again and discuss healthcare cybersecurity is synergise texts, CEO. COLLAB- Barlow so club with that. As background LET'S START WITH A. Primer Info. I've read these ransomware products. in part are. Titled or named Wannacry Laki Win Plock encrypt locker. Are some these known ransomware product. So my question is, how do these encrypt clinical data and to what effect? So. So basically, what happening if you look at ransomware incident is a you know a narrow will gets access to a network and that could be as simple as grabbing somebody's credentials. You know maybe you were on a retail site, use the same credentials you used at work that retail site was compromised and There are many locations on the dark web that will. Sell compromised credentials or could have been through a phishing attack once the bad guy is into the network then there's two primary things that they're looking to do first is to move laterally. They WANNA get as much access across the networks they can, and there are a variety of tools that they'll deploy. They will actually help them harvest additional credentials once they've got a beachhead. On, the network in addition to harvesting new credentials and kind of moving lateral or what we call lateral movement. The other thing that are going to do is to try to elevate their privilege. So going from maybe an administrator or you know a nurse and triage and maybe getting access to their credentials, they're going to try to work their way up to a network. Administrator or someone that controls access to the whole domain once they've been able to get in and move their tentacles around the organization, then they're going to deploy their payroll, which is one of several of the tools that you mentioned will allow them to then lock things up effectively what these tools, our cryptographic tools, and they basically take the entire hard drive at the device. Scramble it and lock it up with a cryptographic key. What we've seen of late is the bad guys oftentimes insert a new step just before scrambling data, locking it all up in that the exfiltrated lot of it, and they're using that to increase their chances of getting paid by potentially threatening to. The organization by releasing that data if they don't pay ransom.
Designing Immunotherapies that Can Overcome Recurrence and Resistance
"For joining us. Inviting me this great opportunity in great pleasure. We're GONNA, talk about cancer immunotherapy and bio clips efforts to develop a multi mechanistic immunotherapy to overcome the ability of cancers to develop resistance and. The immune system perhaps, we can start there. What are the challenges? That immunotherapy is facing and how to tumors grow resistant and and evade the immune system. Let me start by saying that's three different questions first of all anti-cancer immunity. And Immune evasion mechanisms are. Just being discovered. And we don't know the immune system especially in the micro the tumor micro environment is much like a black box. So if we want to reset that immunity, we have to learn a lot more about what is in black bought the black box in right now, what we're doing is we're using things like adoptive cell therapy like car T.. And we're using. Checkpoint. Inhibitors and we're. Using. Antibodies and all these different things you know. Vaccine's against the civic tumor antigens. We're using these things to help initiate some sort of passive nudity in that tour micro environments, and the reason that we have to do this is because. A lot of people you know give the tumor itself malevolent characteristics I could you know inveighs nudity and what? Happens is that these are very fast growing cells there's a there's a deficiency in the beginning. Of either the self control of the immune system. That allows the cells to grow aggressively in when you put pressure on them using therapy trying cure them. the ones that aren't specifically attacked by that therapies continued to grow. And so. The the challenges on what is the therapy that can keep the tumor suppressed not recur later on and in in how you approach those kind of therapies to radically eight the tumor once and for all. You Know I. Think Dan one of the. Well known but Unhappy Facts about cancer is that Many cancers likely to reappear later in life immune. Immune system. Hod diminishes as we grow older You know it reminds me of how we knew originally that the immune system played such a huge role in cancer in that is that when we used immunosuppressive drugs or when people had immune deficiencies, they tended to get tumors also. So it's a very complex question and I think people are doing the best. They can to the best that they can to approach it. We know a lot. We know a lot more than we sued, but there's still a lot of things that we don't know. How big a problem is recurrence and resistance with regards to immunotherapy is today. So it depends upon it depends on the indication For, the most part and the reason is is when we can treat those cancers in if a patient fails standard of care most times, they have recurring tumors. So for example, in in ovarian cancer on A. Upwards around seventy percent, eighty percent of. Patients. Are Resistant to the standard of care, which is usually platinum drugs. And one of the exciting things about ovarian cancer is that. For the first time with Immuno therapies. We've been able to you know change that A. Change, the outcome for many of these patients, and so we're we're hopeful. you know other. Other therapies. For, say breast cancer and prostate cancer. Are Fairly well tolerated by patients, and if you catch the tumor with early diagnosis, there's a better outcome. So I look at it actually our technology we specifically approach this really difficult question of refractory solid tumors. In the reason we did that is because ninety percent of all cancers are solid tumors. But. In Clinical Trials Only about thirty percent of clinical trials directed toward solid tumors. And And we found that to be not only a challenge but a huge unmet market need. So. So When we think about refractory solid tumors were thinking patients that have Gone through standard of care their tumor becomes resistant to standard of care. And Once they're resistant to standard of care, the tumor may reoccur. So that's the. That's the indication in the tumor type that were addressing with our therapy.
Extending Precision Medicine Beyond Cancer
"Us. Thank. You very much having me. We're GONNA talk about precision medicine. It's excess in the area of cancer and what it's GonNa. Take to see precision medicine expanded to other areas in a routine way. Perhaps it's best if we can begin with a definition, what does the term precision medicine need? Yet. Not Great questions. So I think precision medicine both always been defined. By the outcome that it impacts the we talk about the right drug at the right dose of the right time for the patient, which ultimately gets us to this point of giving patients the best. And most lice treatments will that given condition and the current situation? I think there's a fourth dimension that's worth mentioning here too and I think is an important component of everything we of when it comes to precision medicine is the the idea of diagnosis and so opposed to be able to give. The right treatment to the patient we need the diagnostic tools that go beyond simply saying you know this person has cancer or even this President has breast cancer but rob the timing us this patient has breast cancer. They have a molecular alteration or over expression and the sets in Gino protein that cancer is early stage late stage on, they have sutton other biological characteristics. In all of this combined means, we're going to treat them accordingly, and so I think this. This unlamented diagnosis is really important which also by the way applies to monitoring tools. To detect recurrence earlier than imaging. And to be able to change all treatment approaches as needed. So to me, it's it's absolutely about the treatment, but also the tools to to select that that treatment. The right one at the right time. We've seen percents, precision medicine reshaped the cancer landscape although I'm still surprised how many patients face a passive surgery radiation and chemotherapy is if not much as changed to what extent is precision medicine reshape the cancer landscape today. Yes, that's a great question and. It's true I think we talk about precision medicine. Lawson undoubtedly has impacted positively loss of. Lot of aspects of of cancer and cancer treatment but but certainly, not to every two or in every situation. I think when it comes to to precision medicine in the impact, it's had within the oncology space I see in a few dimensions thinking. Yeah full four dimensions here. So I think the fuss is what I alluded to in the beginning is around. So it's really changed and still is changing how we diagnose patients with. it's it's changed by giving us a better and deeper understanding of what it means when we give a diagnosis. So we have a lot more information that we can provide. And also now with the advances inequity biopsy and other tools were able to to also diagnose people earlier. Easy Foster. It's obviously still you know still being developed. It's not. I would say implemented in all cases, but it is helping to facilitate this diagnosis and in many cases, we now compared to twenty years ago, can provide lot more information. At diagnosis by status stages disease, which then in turn helps to to select the right treatment. I think you know the second dimension is is obviously the right treatment and I think that stems from. The the great. Advances. We've had in understanding the disease biology. And the drivers of of many tumors. So there's been a lot of investment in understanding what's driving cancer. What's causing the cells to control? which time has led companies to be able to identify the right targets and develop the the right treatments? For those patients. So that is that is definitely been a major impact. You know as we mentioned model not in all tumor types, of course that But in many of them. Now, what even at the point where we see? Full some of the haematological to Ms. Essentially individualized therapies, but the caught sees So this is. This is sort of moving moving even beyond what we think of as the talk of at therapies this normal heals, all curfews. The other thing that I think is interesting when it comes to treatment which I think it goes back a little bit to your point that some people do indeed still receive surgery chemotherapy is that while that is true, there are tools now that can tell us. When patients should be receiving these these types of interventions. So take take early stage breast cancer as an example here. And indeed stage to my think that there's always a question around how aggressively we want to treat. Will Benefit from chemotherapy oftentimes, we are on the side of caution because we want to make sure that that would doing everything for the patients and even though it's tough for them to do many do decide to go that route. But now we have. Tests, genomic tests on contact the XS one of them that can actually provide physicians. With information on risks goal and risk of recurrence in so they can then decide and tell their patients you. we think you would benefit from from some additional chemotherapy or actually your risk of recurrence is very low and you won't benefit. So Wallace people are still receiving. Chemotherapy I think we also have tools to Baptist select when and which types of treatments people Yeah. People need to have, which is the quite beneficial.
"tumor" Discussed on The Bio Report
"That's just it What we find with our patients on treatment is it? Manifests actually has a survival a benefit. So it's hard to see tumor shrinkage right away It's hard to see improvements in progression free survival but what we started to notice. Patients on treatment lived longer and and like quite a bit longer. We just studying breast cancer where we actually doubled overall survival from ten months to twenty one When we spoke with you have to about they said well this really has to be mediated by the immune system? So why don't you find a way of measuring the immune system to see basically how robust it is how how responsive it isn't how Nimble it is so are you than an asset called. TC are sequencing. which is simply t cell receptor sequencing and what that is? It's a way of quantifying are looking at how robust how reactive your immune system is so we can take a blood. And it's a simple one mil blood draw draw and then we can actually look to see whether the patients have an adequate resume or adequate immune reserve to respond to treatment So basically it's just a measurement. Do you have immune system. Yes or no and if you do we can confirm whether they've been vaccinated as early as three weeks. We can take a patient and treat them three weeks later. We can see if they've actually generated new T.. Cells to the tumor and if you have This correlates with survival benefit. If you haven't we should really get them onto something that's more effective for them so it really is the age of personalized medicine and allows us to a baseline predict who's likely respond. But we can confirm that as early as three weeks. You're looking at a checkpoint inhibitors but is there reason to believe that it would have have a synergistic effect with other types of therapies. Oh absolutely And just as a caveat where we saw doubling the survival was just paclitaxel which is In breast cancer It's just decided. Toxic the virus itself is a very good therapy. But what we're excited about is it does provide almost everything you need for checkpoint huber to work it creates new tesol. Those t cells are reacting to the tumor the infection process draws those t cells into the tumor and the infection process. Actually causes overexpression Of the checkpoint. Target Pedia what that means said it should work with other immunotherapy as Things like k four six inhibitors And actually WHOA. Some recent results that we published on it can actually take. Drugs are not typically considered immunotherapy like protozoa inhibitors. But what we found is they actually increase Christie infected with the virus thereby making it more genyk so it should work across multiple classes. Well you're looking looking at this in combination with multiple therapies. How do you go about thinking? About potential indications pursue and heading prioritized art breast cancer process has been a very good target It's one area where we saw single agent activity meaning that. If we just gave women the virus they would actually have to as a single agent and cancer therapies for a multitude of reasons typically only work in a handful of indications. You know when you give someone jumps I had to be. They get it for pancreatic cancer lung cancer. You don't give it for prostate cancer. As as an example or brain tumors and what you get for brain tumors. You typically. Don't get for breath so basically the only way to really suss that out is to run preclinical and clinical models Just to see where active and breast cancer was one indication that we kept seeing a signal time and time again Multiple myeloma seems to be a very good responder We just had some data out on that And we just announced that we actually have seen. I'm positive results in pancreatic cancer so we think for US brasses probably the lead indication but we think there's opportunities and he malignancy like multiple Myeloma as well as in GI cancers pank erecting with a a number labral partners who have checkpoint inhibitors. What's the nature of these agreements? Are They not real supply agreements. Do they involve sharing of Causton in clinical development responsibilities. It's the whole spectrum that we have to collaborations with Merck won multiple myeloma one and paint. And that's just a typical supply agreement so they provide K.. Trudeau we provide The rest We have an agreement would be where they cover the study costs And they also provide op. devaux evoke We have a clinical supply agreement with Roche which means that they get to review the protocols and we can request their checkpoint inhibitor as long as the protocol is Basically proved and they have some say in to the characteristics of the study and the design. And that's really what we're doing for the aware one study which is incurring Kerlin right now in Spain and then lastly we have co-development agreement with Pfizer where we actually share the cost of dots. As well as I'm the study design and points in the biomarkers what do we know about the safety and efficacy of it To date from the studies that have been done. is very well tolerated Patients how do I put this. They get the flu They develop aches pain. So I told you my Algebra to get a sense that they're not doing well they get the sense that they're getting the flu. And actually what's interesting about this or fascinating if you will The patients who have the worst effects are the ones who have the best outcomes. And maybe that's not surprising because infected cells release chemokines inside kinds and all these are basically chemical flares the alert the immune system that. There's a problem. But they also releasing interferon which cause fever aches pains chills so the better. The patients infected or the better that we alert the immune system. The worst patients feel now in terms of efficacy Breast cancers. They said we doubled overall survival Tank we're seeing an increase in one and two year lammert survival and multiple myeloma We have an astoundingly downing Lee high response rate so we are seeing efficacy across a number of measures. What's the path forward? What's it take to get to a point where you can file for regulatory approval? I'm basically what we're doing now is a couple of studies ones with Roshan one with Pfizer that allows us to basically develop a biomarker so that we have a greater chance of success. I'm once we confirmed that biomarker we basically just pastry program and hopefully have an approval right after Matt Coffee Presidency Clinics Biotechs. That thanks so much for your time today today. Danielle thank you so much and thanks for me on the show. Thanks for listening Eh. The buyer report is a production of the Levin media. Group automatically downloaded this podcast. Each week subscribe to our RSS feed or through itunes other podcasts manager joyner mailing lists go to Levin Media Group Dot Com. We'd love to hear from you if you want to drop us a line or interested in sponsoring during this podcast send email to Danny at Levin Media Group dotcom special facts giovene who composed are themes and and Jonathan Levin collective which performs.
"tumor" Discussed on 77WABC Radio
"Brain tumors often seeing patients newly diagnosed that means with the catch is first diagnosed or recurrence like this man with the farm this tumor degree giant cell tumor of farm when it all this treatment over forty years this is the work that we do every day treating patients with cancer new in recurrent cancers also people with suspected cancers like women with lumps in the breast or men with high PSAs this is the work we do whether it's a lump of the brain or the throat or the neck or the long or the lymph node or the liver of the pancreas or spleen or kidneys or bladder prostate or gynecologic or Colo rectal primary metastatic we have lots of information to send you you can call us even now two one two choices there is no cost and no obligation we'll send you a package we will not bug you know get the package of look at that many people come into our office because it is much more information about brain tumors brain cancers of body cancers breast cancers skin cancers prostate the V. D. is the history of radiosurgery the art of radio surgery just come into our office thirty four Broadway there's no obligation there's no cost pick up the information or if you have a cancer suspected cancer make an appointment call us at two one two choices two one two choices it's always best to have a paper and pencil during the show he could write things down two.
"tumor" Discussed on HANNAHLYZE THIS
"Two out of ten stars. Maybe i mean i had to so in some way. I had it like it sucked. It was pretty terrible from time to time but i also had it. I mean i'm i'm so lucky and all because i got no reduction of my cognitive abilities i had no. I didn't get any brain injury from it which takes such such a long time to recover from so not only from the onset or its existence but also its removal yes for both the tumor can cause that and the surgery can cause that and i also underwent radiation treatment so there were a lot of things that were great about it. There's something really healthy about experiencing insane being unhealthy because it gives you this other appreciation for things and a part of being young is often feeling invincible and you're just like oh. Those are things that happen to other people. Well not to me so i feel it's oh this is gonna sound so cliche barth a little bit by saying it but it does feel like it has made me a better better person. <hes> not a better person as like. I'm a better person but just like you just have more reasonable. Take on life god. That's nice to hear yeah. Had you ever thought about death. That's prior or thought about your own fragility mortality not really and it was such a hard like it was really hard to process it and take it in because i was so healthy in the sense that the only symptom i had was my right. I was a little bit solan and that it like started looking at funny and was no pain and i was in. I didn't have mini motor issues or anything so i was. I was feeling really healthy and then after surgery like yeah. Recovering from surgery takes a long time and recovering from radiation treatment takes a long time but it still never felt. It never really felt like it had to do with my brain. It was just more general body and had you ever thought like i guess for me. Hey i'm somebody who lives in this like constant grateful morning full state of life in permanence you know and so it's hard for me to to imagine that kind of like youthful vigor of invincibility like i've never felt invincible. I wish i had at any point in my life. Why do you think that is. I don't know i remember the first time i really processed assist death. I was like four or five and i was looking at the moon and i was like oh my god. The moon is so far away from us. It's so far away. I'm gonna die and i was like and i got like somehow and i've just it's on. It's always been something that's very much in top of mind for me. Which i suppose is a blessing and occurs curse and that it's a blessing because i take everything about life pretty seriously and it's a curse because i take everything about life a little bit do seriously you know there's he's like that healthy balance between life and death which i believe is called the human experience. Probably something like that probably something like that. So what are your hopes and dreams through your remaining years as we all have. I want to go to space yeah yeah. That's what i'm working towards. Do you still want to be an astronaut. Yeah i wanna i want to be more of a space tourists than astronaut and i want to do the bridging in space. Oh space yeah preferably going to the i._s._s. Yes that's what i'm really aiming for but who knows i mean it's a literal moonshot. What are you that's. I prepared all the puns you all all the i'm ready for this. What else do anything to prepare. I mean what are some other puns. You've prepared. I'm ready for them the moonshot clearly you've got star power. You're i think you're ready for space to i. Am this girl some space. I think that but also just i mean it's so fun to do this job. I love my job. There's also a lot of things that are really difficult. Colt about it and that i try to try to get to a position where or to a point where you've kind of wrangled the downsides of a which is a constant pressure to feel like you have to put things up constant short-term goals..
"tumor" Discussed on HANNAHLYZE THIS
"They're like truck lady not at all yeah it feels good a little bit of variety just want to be known for your creative inventive endeavors something yeah i mean just build things. That's like the core of the youtube channel. That iran is i. I make different things but i mean i do like metalworking recently only a car project and then did some robot expecting a while outside at brain tumor those are two claims to fame shitty robots and brain tumors and now trucks and now truck yeah yeah truck truck by humbly many rural area. Don't have a test that truck so. I don't know if you're the trucks girl. I'm pretty sure your truck girl took a look as somebody who was also very aware of what was opening the door to opportunity for me. Every decision i made was the decision in an effort to not only be the drunk girl hoax yeah that being said eight years into my career after two bestselling books a bunch of movies vs a lot of like casey and a lot of other work yeah people always return to the first moment they need you but it is not anything to not feel proud of. I always like to say dance with the one that brought you so when people talk about 'em decay. I'm like that's right. Even though being drunk online cook has not been my highest chess federation in my life yeah that makes sense. No i mean it. It is a little bit of a love hate relationship. I love shitty robots. I think they're hilarious but i also felt like oh. I want to do other things like i'm curious about. It's not that i'm not interested in <hes> pity robots anymore but yeah and i'm like interested in other things but it's definitely i mean i imagine that being free like artists to have one hit song and and they're like i really so happy that that happened and for the opportunities that i brought me. Can somebody please listen to the other album tracks as well. That will be the rest of your career working on the album <hes>. Can i tell a story yes. You may thank you for asking so polite. I love the swedes 'cause we talked about <hes> doing this podcast and i talked to my sister about it and i was like man but i feel like i feel like hannah didn't want to be my friend or that. She just me or something like it appeared for this story. What is it didn't nothing wrong and my assistant scott was like no simone. The thing here remembering is that we were at a party at south by south west and you saw hannah year what year i've been two years ago. I think you wanted to talk to her her but then later when you try to find her she wasn't there anymore and i had say i'll emotionally like hannah doesn't wanna be my friend. I i like wow oh my god yeah. It's like let's let's take everything as a slight and just store it in that emotional archive and when somebody reaches out and was like you wanna hang hang out i was like no i feel like i have some something lurking in the moesha mind and heart well get ready for a long happy career in entertainment then and how soon was it that you've developed a brain tumor after that i'll take i'll take it. No apparently that was ten to to fifteen years in the making so yes coincided when you started your career a no that eight years ago ten years tango so for the record. I'm very happy to meet you and i'm glad that we got a chance to connect and this environment as opposed to south by where most assuredly would have been a hazy blur like hey. You're a person. Are you tired. You're so tired. I love that though in your assistant was correct so kudos oh no. I just thought it was really funny. I was like oh well yeah. That was the thing our branch.
"tumor" Discussed on 10 10 WINS
"Tumor. Chief bureau says the remains of two other dogs were also found on the property. One of those dogs still tethered to a dog house. Fifty degrees. Fair in the city clearing overnight, low forty four AccuWeather says we'll see a mostly sunny sky. Cool. Breeze and a high of fifty eight today tonight, clear low forty one in midtown thirties. Mini-subs Thursday times of clouds and sun. High fifty six Friday, cloudy, breezy and mild with periods of two of Ringling the day in at night, high sixty three Saturday's, partly sunny, breezy and warm, high seventy four fifty degrees now fair in your community. Fifty six percents on down to forty four hundred ten wins. News time three twenty five. K. Eight seven seven kids donate. Also accepting boats, motorcycles are and real estate donations dime. Three twenty six. Now. Bloomberg money watch Sean ten wins stocks retreated in Tuesday trading. Investors were concerned about trade and new global growth forecast from the International Monetary Fund. The first quarter earnings reporting season is about to begin Mona Mahajan valley on global investors anxious to hear executives projections for the third and fourth quarters are.
"tumor" Discussed on Antidotes, Stories in Medicine
"And then I was like, well that's stupid. It's a bird like, you're tired. You need them sleep. And then it flew away in. I was like had this feeling that I was gonna pass fine. And then that was it. I explained that away that like, okay, it was just a bird seeking shelter from fire. And maybe doesn't was so then my last ghost. Early. Experience was I was in purchaser school and so-. Nurse practitioner. School was a little bit rough for me, I got divorced in grad school and was like working bunch of jobs in like had moved back into my parents house. And this is way so much personal information for a podcast -gratulations, everyone you now know all about my life. But. And I'm like nests practitioners school is hod. Anyway, like just hod, and then you've got a list of stuff on. Yeah. It's not it's not like, I it's not like a good time. And so it was a little stressful. So I'd like eight moved, you know, big life changes. Right. And then this is the last semester to like you're studying in you've clinical precept Herships ided like several hundred seven hundred hours that semester on top of working in. So I was stressed. And so my grandparents had lived in like this little in law pertinent, and that's what I had moved back into in my parents house because I was really really poor. And I was in the kitchen that my grandmother used to cook in and she had lived there probably fifteen years beforehand, and then passed away and all of a sudden nice smelter like just smelled her so strong and multiple multiple people have lived in this in-law apartment since then like people have cooked in their like, she had this very distinct sent and I walked around the apartment, and I was like walk out of the room in the walk back into the kitchen, and I would just the smell would leave within would come back in the kitchen and like, and I was looking through the cabinets. It was like the middle of the day. I wasn't sleepwalking. I I smoked my grandmother. And I was like oh my God. I'm having an old factory whose nation. I have a brain tumor. There's either go, sir. I have a tumor, and it was much more comforting to believe in goes than to believe you had brain tumor. So I'm gonna go with the ghost. Never got never. I. Lovely stories knowing that you grannies grandy's they with the pumpkin me from wherever. Yeah. I just desperately wanna have an experience like that. Because I'm not a believer in because I can't explain any of that. This just so many stories out there and often think it is incident. So can be explained some have on this. Some spooky do listen to spook the put costs food. No, I don't. And I usually I'm not a big person about things because I'm so like, oh that can be explained it can be explained. Yeah. This some good stories out there that cannot be explained. So. Yeah. I don't know. I don't know what to do with. It doesn't go to start treating to my world view that somehow I seem to bay this just what to do with. Yeah. My rational brain does not know what to do with things that. I can't explain like that. And yet, they're they are. Yeah. So happy Halloween. That's it for this week's bonus episode. I hope you guys enjoyed it. Make sure you subscribe rate and review on ITN's. And I will see you all next week for the full episode with Allison from Australia have a good weekend and have a safe and happy Halloween. Everyone..
"tumor" Discussed on Kickass News
"Demand. I tunes Amazon and myriad other digital platforms, Jim gaffe again, welcome to the podcast. Thank you for having me. The beard looks really good. Thank you. My wife hates it. Oh, bet. This beard is something I've had kind of off and on a. Yeah, because I remember I saw you probably not that long ago at the theater. Yeah, I, I don't think you had the full beard bag now. I didn't. Are you in Letterman maybe doing some kind of beard contest right now? It's weird. I did this. I did this movie in New Orleans where I had to have a crazy beard. And then I got a an. I had a Skype with this director of this movie. I'm coming up and he's like, I really like that beer. Okay. Because it's just out of control. Yeah. Krief is I'm supposed to play like the widow who's kind of distraught. He's like, yeah, that's it. You look like a mess. Well, I am a longtime fan of yours. And Lega said, I just saw you at the as probably I don't know if you months back. I absolutely love this latest, special noble, ape ranking. I think that it's what you're sixth hour long special, right? Yeah, six, our special. It struck me as a turning point. I mean, you talk about your wife's brain tumor. You talk about family stuff, personal stuff, less food, humor, zero hot pockets jokes? Yes. Did it feel like it was maybe an evolutionary leap for you as a comedian? Well, he maybe possibly. I mean, I, you know, most creative people kind of set your you live on self assignments. And so I knew that I was making a shift away from food. I think in Cinco like the first forty, five minutes didn't have any food, but yeah, still the last fifteen minutes did so. But this one I wasn't kind of. Thinking like I'm not gonna do food. I was thinking more like I wanted it to a couple of stories which I did with the pope story and the gastroenterologist. But an of course, the brain tumor thing was not planned at all that was just, you know, dealing with real life emergencies in being thrust into this strange environment emotionally and physically, you know, three weeks in the hospital. So just riding around that. Not not in the moment. Yeah, but like you know, you, you digest things. Obviously, once we're, we knew we were through the woods, then I could try and look back and try and make some humor out of it. Yeah, it's a little hard to go back to donuts after your wife almost died. Right. It is. But there's also something very cathartic about. Chronicling that period and kind of his at hospitals are are weird places, you know, and. You know, almost losing your spouse is very terrifying and weird experience. So yes, she was in there what thank you said like a month. She was in critical care, intensive care, so it was. And then you know the recovery, you know, people go through..
"tumor" Discussed on The Naked Scientists
"An inbuilt kill switch say they can be terminated once their job is done one of the major hurdles for advanced cancer is that they're localized but they also move from one organ to the other and they also can move from the other organ back to the same place where they originated and and we can sort of repurpose the tumor cell homing properties for delivery of targeted therapeutics to the primary tumor cells so are you saying then cleared that what you can do is take a cell from a tumor that wants to get back to its home chuma and do the equivalent of say brainwashing terrorist and releasing that terrorist back onto the streets to lead you back to where he came from or she came from yes you're right so we can actually tame a cancer cell we actually re engineered it to produce therapeutics and then kill the original tumor cell how earth did you do that so we use to property so let's zoom you have to cancer patients one has a cancer resistant to a particular drug and one has a cancer sensitive to a particular drug so what we did is we took the tumor cell that is resistant to a particular drug and engineered it to release therapeutics that can kill the that is senator to drug the second approach is that we took the patient's own cells which have sends it to to a particular therapy and we gene added its surface receptors to make them resistant i then engineered them with therapeutics and kill switch so with the therapeutic we can kill the original cell and with.
"tumor" Discussed on Podcasts
"That debate here to think it's a pretty common problem and you know you're gonna probably be stuck going in and her relatively urgently your you can send markers but you're likely not going to have them back before you are in the operating room so i think you're going to be napkin with this girl your going to find a torsion and it's me but might be unclear whether simply a tourist over read that similar agic and big or whether there is a tumor with it i think if you see a clear cystic component i think it is find to decompress it but i think than the situation was like it'd be some type of over insists that led to torsion and i would go ahead and uh decompressed assists pride take out part of the sis wall finished razor do something and uh de towards the old free if you think it is a tumor or a mass let's say you don't really know what to put with the millionaire but i and i think it's find a detour sit in your options that are whether you try to take it out i think it's fine to leave it in and go back at it the lead time you you know know get all the data underhand again if you think there's no tumor it's really detours and there's some controversy about for a paksi are the most the adult simply due to tour seasons oli uh there's a recent study out of the fragility instability journal demonstrating that premedical girls have a higher risk of torsion and their recommendation was that if it's a pretty men are go girl or if somebody's head or towards the end of that same overeat before to go ahead and do it from taxi at that time so that's kind of what we do okay that's and and how do you do your for a do you stood said to lateral sidewall so i usually do that some people talk about shortening the ligament put it if you stitches in i've looked at that and thought about it if it would actually work i think it i mean obviously must work but i have generally sutra just a lateral all right and and i going back and forth i was i was told that these states to the sidewalk could alter the angle the tube incudes.
"tumor" Discussed on Podcasts
"The washing were positive i'm trying to think of things that you might find that would upstage her i'm other than mats right so if it looked to be operative imageine that there's no it at the disease outside the old we know that cats cancer so good right now they're going to pick up the retribution he limped owns for the most part they don't pick up distant metastasis the things that you is the surge are going to terminate i think it's really peritoneal washington in that would be the the one thing if if it otherwise look like a stage one two more parity of washington's are probably the main thing that good bumper to a higher stage it's unlikely you're gonna find in large live knows if you didn't seem on the ct scan we like you to look any way but it's pretty unlikely that you're gonna find that that's great and this is just help is not a rupture per meal listener such correct yeah just just top asian absolutely and just a point out that's a big theories in i have noticed that the hostels i've been up between us and the guy nong surgeons correct okay i think part of it is that you know we are i am merely dealing with germ cell tumors which are very key more responsive to mres they're not carcinomas i think they do with a little bit different type or two or for the most part they are done with apathy little tumors were doing with tara thomas in terms of tumor so it's a little bit different type of tumor okay so you do watson's you pal fred delman knows do you do who mental by offseason diaphragm by a season penuell biopsies we don't do anything unless its admiral also if you see something at rome on the peritoneum or the diaphragm then i think you should five see it in terms of the oil menton gift you'll met them is not attach the tumor and if it on palpitations normal we simply leave it alone but if it'd be adhered to the tumor i would just take it with a tumor yep okay that's great okay so if she does have positives their annual washing 's or pared you'll studying she would need chemotherapy is a rule for radiation no it's pretty much just chemotherapy it's up platinumbased platinum matoba side and blue hill meyssan.
"tumor" Discussed on Podcasts
"Nast it's filling the pelvis you checked the tumor markers and the afp in this i didn't say her age l let's say she's a teenager so she's out of the neonatal period she's got an afp of forty four thousand what you do with this one now so now you got a solid tumor yeah so i think it definitely going to be malignant it big it followed an afp alabama solicitous malignant for sure at this point i think you want to decide you know isn't something that can be rejected upfront and give if it could be a stage one two more so if it is confined to the old free the washington negative the notes or negative disorders diminished that disease she would be a potential candidate for surgery alone so that's the real critical thing is to you know could she be a surgery alone patient if you find evidence on imaging that the disease is outside the old free she will definitely get chemotherapy i think if possible it would be best to take out the primary initially you know i say in the perfect world go take up the primary tumor as long as you can do it with a unilateral roof wrecked me i think if you get in there and uh or if there's something i imagine that makes you think it's bilateral or if you think you can't give out then i think you atrophy chemotherapy in a delayed receptions find but i think when you first look at our that's kind of your question your mind is this can find the over you're not if it is confined to the over that i think we should approach it i think i would would open operation i don't think there's any role for laparoscopy you have to do a complete who for.
"tumor" Discussed on Podcasts
"You see now when you get the ovary out you've glued the bag you've aspirated out the fluid you deliver the ovary and you mentioned doing a ovarian salvage or section the tumor do you score the outsidons and nucleated out how do you do that and i think in general that basically what i do you know you'll look for the blood supply coming into the old free you look for the flow two been usually the tumors kind of off the top so to speak and so usually end up lifting a tumor opt in then kind of scoring where i think pete normal olry will be usually there's a little white ram going up on the tumor and any gift to score at tv news hot and cold scissors and just start to cutaway trying to stay out of the cystic component and you just often end up with a very flat over a that's a little thicker by the blood supply but it's often very thin on the periphery but i think that's okay that's stopped over in tissue and that's what you need to preserve and sometimes i get a little bleeding that some of those old clothes that i put a few stitches to close the two flat at just together but i think he's an awesome just leave it open to clarify the tumor is inside your reids the your res wrapped around is you need to open up the over to get the tumor nucleated out exactly when it's great so in then you go back in you find the other over eu fuel for the retro neil notes which to be honest i have not routinely done that sudan's owns isn't so i will start doing that now and they appar a washing bright great gutstedt's fantastic anything else that we need to think about with this patient either pre up in trout post up before we move onto my next scenario i think we pretty well covered it okay so nets kit to now you've got a thirteen year old and this i think is a a very common scenario for all of us a thirteen year old comes in she's had some very vague donald's cover but she noticed that her belly was getting bigger i gotta ultrasound and then a ct scan of course.
"tumor" Discussed on Podcasts
"Bagging glue it onto the tumor sea of a common interface where this there's the tumor glue in the bag and then you can protect the wound and and basically this place a knife directly through this common interface in suck got all the fluid and you off it can remove a leader to a fluid in once you get that out like it might not be completely empty but off and you can deliver the tumor out of the abdominal cavity at that point and then proceed to inspect it if it's amenable to a partial freaked me you can do partial wrecked me right at that time i do still believe so i'm just kind of talking about the tumor removal i still think it's very important to do peritoneal washington's done this gripe i would do it right away when i get in the bali just you know see if there's any fluid if there is sucking out and sunday's first i challenge if there's not put some saline interim sit around for a little bit and then asprey that later in the operation i would look at the other free we used to recommend a contra letterbox now we only recommend a biopsy if it looks admiral so look at the other olry tf deal meant them's at adhere it to the tumor fuel momentum is it here to the tumor take it out if it's not you can leave it alone and then assess the bear no cavity see if there's any spread perennial implants and then in this case probably at the very end look at the retrovir perennial lymph nodes now most likely you'll have a pretty good idea of the retro parity ellipticals from the ct scan but we still like people to look in the only requirement is if you see a no that's enlarged to simply remove that lymphnode no rule for lymph nodes.
"tumor" Discussed on The Rich Roll Podcast
"This in my head um i said if what they're saying is true you are what you eat and i'm dying is what i'm eating dead or alive and we're not thought about it like that i was like okay i sorry i asked myself questions oil okay that's probably debt so that's probably dead banana or there's a laugh potato alive and that letter alive diet 100 percent like even just because something vegan legos like i got rid of the oil i got rid of the salt i got rid of just i just think a eight fruits and vegetables that are like living all day will not one hundred percent um like probably like sixty seventy percent and the brain tumor started shrink ma hormones in my body levelled up like like the food caused it 'cause 'cause 'cause with tutor tumors a hormones and all those eat him a whole life was me because i was doing a ketogenic diets like most of the diet soured dawn were like ketogenic diet and ninety tons of meat phnom eyebrows no bastable s like very rarely in processed foods went up binge and like diet sodas and all that stuff and i know that's what causes a brain tumor yeah just jacked your and current system do everything off body just deformed the he he no born the tumor and it when i started eating food that was a lot started shrinking doctors are like wow right like how long do that take this is when you first notice that it was shrinking so i haven't taken my medicine in almost five months and my hormones coming down lower like laying the perlak than levels like super high in its common all the way down and this shrinking and like the testosterone is levelling out on his aunt like no medicine doctors were prescribing me like testosterone stuff prescribing stuff for the like the hormones like that's what controls it and i started just like eating.
"tumor" Discussed on Podcasts
"Do we evaluations uh crosssectional women's jeans at six in twelve weeks and the reason those were chosen were based on prior studies went shows that the maximum response of most children with wilmington where is 12 weeks and the early response in most cases will predict late response so after six weeks which is two doses of the chemotherapy if you were going to have response you get it and then we use response base criteria depending on weather can you do to partial net for activities if they didn't respond you should biopsy both kidneys and look for features that either saying this isn't they uh your typical willms tumor or and this is that it's already differentiate it's not going to respond and then move on and if they did respond then give another uh twelve weeks and then go on to do a definitive surgery is there ever role for biopsy in any of these patients there's not a hard and fast rule when you looking children who present in the typical waged under you know uh thirty six months with bilateral real tumors and is almost universally wellness tumor and the purpose of a biopsy in children with willms tumor he has to determine whether you have unfavourably histology or st louis dollar g and when you look at the data on uh by obscene open doing opened by abc's determined that it's not very accurate initially so based on that fact and on the the long history of not by obscene from this i out group plus the improved imaging we did not recommend our mandate that piecing together on this study with wilma's tumor tied to have a biopsy to start and because they were two hundred and fifty patients who were enrolled and one patient who met the criteria to be enrolled turned out to have a robbed lloyd tumor now the interesting thing.
"tumor" Discussed on Podcasts
"Logically criteria for that has ever been any role for frozen section uh evaluation or one gordy cut through theoretically so if you've dividing the tumor by accident to your about automatically makes you a stage uh three there are a few technical points uh sometimes these tumors just not unusual that to getting they caused a lot of reaction them become variance here hearing to the diaphragm and taking a piece of diaphragm so that you don't violate to to merck is recommended and will not in that case if the the you haven't divided the tumor that will not stage your tumor sometimes the tumor as well they tend to come up to and and then directly get attached to the liver but there's it's not really an invasion it's an inflammatory accents are taking a part of the liver particularly the right or left lobe just a tiny uh bet uh is done to preserves to make sure that you don't accidentally get into the tumor in the majority of those cases the tumor hasn't extending it's just and in some cases these tumors 'cause uh uh intense inflammatory reaction that uh makes it seem like it's him beat it but it actually housing and other times it has beat is and and you you deal with that either is there any patient that can be treated with surgery alone yes this is something that is sort of unique to the germans on college group and really was based on observations by dr bob sham burger based on their irene view of big kids from the the p this has to do the children's oncology group which is the national willms tumor study group and they ran five studies and the first four and looked at a variety of different questions but it was noted that there was a group of patients that where it no matter what you did whether you she's been with surgery whether you add in one jagged chemotherapy to drugs a chemotherapy three drugs radiation sat v had excellent overall survival and these patients they were originally cheating.
"tumor" Discussed on Podcasts
"One of the things that it is somewhat confusing to both the on college just in the surgeon is just because they have a lung legion doesn't mean that you shouldn't take out the primary tumor and uh so if you have a lung lease in them a five immediate tumor and you pie up see that tumor that in the children's oncology group treatment uh paradigm would mean that the child with automatically be considered a stage three because of residual gross tumor and you with the child would get the threejudge chemotherapy fight with also get abdominal radiation and if you had gone ahead and removes the tumor the child and the lymph nodes were negative you would not necessarily have gotten abdominal radiation that's a great point and so now that we understand that that the abdomen is separate from mats and the treatment donald trimming could be not necessarily require the radiation tell me then what you do preoperative lee in the pay than has what looks like to be even though you don't know 'cause you haven't done surgery up it looks like to be a probable stage one with a or a stage to with a lung lesion how do you proceed but that patient might approach to that patient is i take out the reno tumor and i leave though the london we use a loan um there's two reasons t the the do that uh uh one is that you want to know what the pathology s so if it's famous collagen willms tumor and i do my lymph nodes sampling lifts notes or negative and stage wanted to stage to test child avoid abdominal radiation the second seeing that is important that the children some colleagues you group recently finished a trial to see if all kids needed pulmonary radiation pulmonary radiation has been the go stands in for treatment for a pulmonary disease and it's very effective because the problem is is that obviously the facts and fifteen percent of the girls who get pulmonary radiation from willms tumor and.