InFocus featuring Dr. Agnes McAuliffe

from the 22 News plus studio. This is 22 News in Focus with Patrick Barry. >> Hello everyone and welcome to this edition of In Focus. I'm your host, Patrick Barry. And although October is cancer awareness month, every day should be cancer awareness for all of us because cancer is prevalent throughout our families and our friendships. It is everywhere. We all need to be uh more aware of cancer, which is why today across the desk from me, I have Dr. Agnes McAuliff. She is the medical oncologist over at the Sister Keratas Cancer Center at Mercy Medical Center. Dr. McAlliff, thank you so very much for joining me. I appreciate your time. >> Thank you so much for having me. So you are a cancer doctor. It's what you do. Why did you get into that medical field? Did did something like most of us cancer hits close to home and and it changed your career path? >> Yeah. So good question. Um you know I sort of came into medicine initially. I really enjoyed healthc care and putting together all the pieces about science and helping people get better. And then as I was on my medical school journey, I realized that um I really enjoyed both working with cancer patients and learning about cancer treatment. Not only that, but during the time um that I've been in my training, the treatment of cancer has expanded significantly and there's so many more treatment options that are available >> and it's better now than just in the short few 10 years ago than when you first entered the field. >> Absolutely. Um, you know, even from June of last year to June of this year, 20 new cancer drugs approved by the FDA. Wow. Um, you know, every month, new drugs are expanding their um, indications and formulations, allowing for patients to receive them, you know, more frequently or through injections rather than infusions. So, it really is an exciting time. And I mean you're still young in your career. So that I mean you've all but just the way you explained it, you've already seen great advancements in medicine in just the last few years. Is it is it speeding up? Like was it slow to were the advancements slow and then all of a sudden just technology medical technology has changed that things have just sped up faster and faster for the better? >> I think that's one way to think about it. You know, I think um through different clinical trials and research, we are finding more the the drivers and the causes of certain cancers and also how to target mutations in cancer such as in lung cancer. We found you know targetable um genetic mutations that we can use to give personalized targeted therapies. Um and the similar thing goes for you know imunotherapy as a whole new class of drug as a whole which also has really revolutionized treatments. Do you specialize in any one particular form of cancer or are you looking at at as a whole? >> Um, I look at it as a whole. You know, at Mercy, um, we all see all kinds of cancer types and, you know, we we work together through multi-disiplinary teams, you know, working with surgeons, radiologists, pathologists to formulate the best plan of care for for every single patient. So here locally in Western Mass at Mercy at the Sister Keratas Center, you're seeing every form of cancer come through the door and adjusting your treatment to that particular patient. >> Exactly. >> Are any two patients the same? >> I would say no. you know, everybody I think is a little bit different and it depends on, you know, not only the stage that the patient was diagnosed, the type of cancer they have, um family history even plays a role and um all of that really takes into account the best treatment for the patient at that moment in time. >> So when as as an average citizen, how important is early detection? I mean, it sounds like a kind of a silly question, but it really is very important, isn't it? >> It is. You know, early detection allows for better treatment outcomes, um, less aggressive treatments that we have to that we have to use. You know, it's it increases the the odds of survival. Um screening is one of these things that you know against the the even global challenge of cancer can really help us find cancers at an early stage and in some cases even prevent cancers. >> There are there are ways to prevent cancer. I I I thought cancer was sort of in your DNA and there were triggers that made it happen but you're the doctor. >> Sure. So for example um for colon cancer okay you know the recommended screening is something called a colonoscopy um where the doctor will go in and visualize inside the GI tract to see if they find any abnormalities. If they see something there something called a polip or a precancerous growth it can actually be removed at that time during the colonoscopy. >> So at what point should people be getting colonoscopies? >> Good question. So that guideline actually recently has changed. used to be age 50 and now it's it's gone down to age 45 um in part to a a rising incidence of of colon cancer in patients at a younger age. >> So is there a reason why I mean are you able in your field are you able to pinpoint why colon cancers there are greater number of colon cancer patients under age 50 than maybe 15 years ago. >> Yeah. So right now they haven't pinpointed one reason but there's been you know estimations um as to multiple factors that could be at play okay >> for this and that includes you know genetic factors family history patients with a history of um predisposition genetically to developing colon cancer. >> So if you have some form of cancer in your family there's a likelihood a greater likelihood that you might get it. There can be um in addition to that you know lifestyle factors um the a diet that includes more processed foods um an increased rate of obesity these things also are are playing into account. Um and the last thing felt to play a role is the disruptions in the gut microbiome. Um >> what do you mean by that? >> Through various um in in every colon there's you know good bacteria and what we call bad bacteria. And so it's felt that there can be some overgrowth of bacteras that can in time you know alter the uh environment that allows cancer to grow whether it's through you know being exposed to antibiotics at young age over time. Again we don't know these are all things that have been proposed over the last year or two as we've noticed these cases really increasing. >> But it takes the research to determine whether those you know those those assumptions are true or false. >> Exactly. And a lot of it, you know, is hard to pinpoint one thing because there are so many factors at play. And so, you know, evaluating one patient with cancer and all the factors in their life can compound, you know, so necessarily a factor doesn't equal causation, right? >> Correlation doesn't equal causation. >> We are up on our first commercial break. We're here with Dr. McAuliffe from the Sister Keratas Cancer Center at Mercy uh Medical Center. We'll be right back after this. >> This is 22 News in Focus with Patrick Barry. This is 22 News in Focus with Patrick Barry. Welcome back everyone to this edition of In Focus. I am your host Patrick Barry. Across the desk from me is Dr. Agnes McAuliffe from uh the Sister Keratas Cancer Center at Mercy Medical Center. Thank you so very much for joining me doctor. I greatly appreciate your time. Uh, I want to circle back to the preventative measures because you you said you you indicated that several forms of cancer are caused or triggered by the way you live your life, >> the way you eat, lack of exercise, whatever it might be. explain to me some of the preventative measures that any of us can take now no matter your age to reduce your risks. >> Sure. Um so you know one of the bigger ones will be avoiding tobacco use or smoking cigarettes. You know as we well know that that has been linked with lung cancer significantly. So avoiding tobacco products is the big one. Um another one would be you know healthy eating and exercising maintaining a healthy weight. Um when we think about skin cancers, >> let me ask you quick. Let me interrupt you there. Smoking I get how does how does food trigger cancer? >> Yeah, I wouldn't say it's food itself. It's um more the uh nutrition can lead to obesity and increased fat cells can lead to hormone disruptions when which can lead to certain kind of cancers that are put putting you at a higher risk for certain cancers. >> Okay. So, by watching your diet, getting some exercise, you're just reducing your risk. >> Correct. >> Okay. >> Correct. >> All right. Uh, you're starting to lead into one thing that I've forgotten already. >> Um, in terms of skin cancer cancer, >> if we're thinking about skin cancers, you know, um, avoiding UV, radiation, sun exposure, using sunscreen, um, skin protective clothing, you know, especially during noon time hours, um, that's another step. Do you find skin cancer as a whole has been reduced just from an educational standpoint of, you know, sun lotion? I got to be honest, when I was a kid, sun lotion wasn't an option. It was >> it was burn, peel, repeat all summer long. And for this fair skin guy, >> I didn't think twice about it until I was probably in my late 20s. My now wife was like, "You don't wear skin, you know, sun lotion." >> And now our kids are, you know, wear it. But fast forward, I've had >> multiple bouts of skin cancer. Luckily, nothing nothing >> uh too too dangerous. But do you find that skin cancer has been reduced just because the knowledge has grown? >> I think that's definitely a good part of it that people are more aware of the risks of you know the radiation from the sun rays leading to cancer. So they are you know using sunscreen at younger ages definitely and you know becoming aware of also what to look for and the skin if there's you know concerning spots or lesions or growths are you know talking to their doctors about that as well >> but again prevention also aside from you know the long sleeves and the sun and the sun lotion regular dermatologist visits. >> Exactly. >> And and they they'll you know what you might think is a mole or a freckle could be something worse that they can >> they can like your colonoscopy >> take care of early rather than having it develop into something. M what are some of the other um preventative measures for cancer? So we talked about watch what you you know no smoking obviously I think everybody understands that. Watch what you eat, skin protection. What are some of the other measures? >> Sure. So I think um one interesting part of prevention that um we might might not necessarily come to the forefront is um the success story of actually the HPV vaccine. >> Uh HPV I it's on the tip of my tongue but I don't recall it. >> The human papilloma virus. >> Okay. Is is that only does that only affect women? >> Actually, no. Um the HPV virus can cause not only in women, cervical cancer, vaginal cancer, but also in men and women head and neck cancer as well as anal cancers. >> Wow. So, so I know my daughters had the HPV vaccine when they were younger. I never got it. >> I don't know of any men who have had it. Should we? >> That's correct. So, it used to be just females. It was only approved at that point, but more recently the indication for the vaccine has expanded actually to include both boys and girls starting at age 9 all the way up to age 21. >> Okay. >> After 21 up to age 45, it's a discussion with your doctor whether or not you could be a candidate for the vaccine. >> Again, family history kind of >> might your doctor might ask you to have it done. >> Correct. And you know HPV having being tied to these other cancers if you can receive the vaccine and prevent essentially 90% of cervical cancers by these HPV subtypes that are covered for you know that's a that's a remarkable preventive success story. The problem is that the uptake generally is low. I think part of it is, you know, people are not all educated about, you know, who can receive the vaccine and um it's a discussion with the, you know, children's pediatrician really and as you get older with with your doctor if you're a candidate for that vaccine. >> Now, do you find that um cancer knowledge makes you a makes you I guess a better cancer patient and patient advocate? >> I think so. I think it does. >> So I I guess conversations like this or with your primary care just the more you know the better better you off are in protecting yourself and if you have a family member who's going through it you can be a better patient advocate. >> Exactly. You know I I tell my patients that really knowledge is power and you know there's never a wrong question. So, you know, being educated about these things, there's a lot more access to, you know, credible reading materials now that you can know what questions to ask and think about where to go. >> When you look at cancer as a whole, is cancer, is curing cancer better today than it has been >> or worse? And then if it's better, which I think is the answer. >> What are some of those cancers that are out there that are still very mostly incurable? >> Yeah. Yeah. And you know, that's a good question. You know, cancer survival rates are really right now at an all-time high. Um, if we look at, you know, the major cancers across the board, um, something we call fiveyear survival is approaching 70%. For many of those cancer types. Um but as you mentioned there are some other cancer types that the the survival rate is not quite as high and we hope that through research we can get new targeted therapies over the next few years that can be approved in those types. >> Now for patients of of Mercy, do you have partner does Mercy have partner hospitals that that you work with? So and I'm just trying to think if no one's really local here to Springfield but they need to take advantage of it. Do you have partner hospitals in the region that that people can can use? >> Yeah. Um, we often work with Dana Farber. Um, you know, patients can go there for clinical trials if needed. Um, but apart from a trial, we offer, you know, the majority of other cancer care, chemotherapy, imunotherapy, radiation right here locally. >> Wow. So, people don't have to travel to Boston. >> Don't have to travel. Right. >> Exactly. >> We are up on our next commercial break. We'll be right back after this. This is 22 News in Focus with Patrick Barry. This is 22 News in Focus with Patrick Barry. Welcome back everyone to this edition of In Focus. We're here in the 22 News Plus studios. I am your host Patrick Barry. Across the desk from me today is from the uh Sister Keratas Cancer Center at Mercy Medical Center is Dr. Agnes McAuliffe. She is a medical oncologist specializing in all forms of cancer. Dr. Mclliff, thank you so very much for joining joining me. I appreciate it. I I was reading some statistics. You know, you talked earlier about colon cancer uh and your colonoscopy. It was usually age 50 and above, make sure you're getting it. Um but that dropped down to 45. I I I've been hearing that that there are greater instances of breast cancer in women in their 40s because again if I understand correctly mammograms usually were when you turn 50 for a woman you start your mammogram but now that's come down similar to the the colon exams. >> Yes. Um so recently you know given that increased incidents um changing to younger ages um there and the guidelines can vary by several professional societies but in general um starting at age 40 now you can discuss with your primary care doctor or even your gynecologist as a woman um the indication to get a yearly mammogram. Um, and some women, so those with family history, those who may have a genetic mutation or that may have dense breast tissue, they might also talk to their doctor about additional screening tests such as MRI or ultrasound that might need to be done or even screening starting earlier or or uh more frequently based on those findings. >> What if I mean maybe there's there are some folks uh watching this who might be adopted or estranged from a family. they just they don't know their family history. Are there are there tests that people can take >> to to forewarn them maybe? >> Sure. So you know we know that about 5 to 10% of cancer cases in general can be linked to a genetic cause. um >> that low >> that low and if we think about it you know the indications for testing are in certain cancer types you know patients with triple negative breast cancer pancreatic cancer all those patients should have genetic testing patients who have you know known first-degree multiple relatives with cancers also should consider testing. Um so the the patient um with an unknown family history without a personal cancer history may not qualify to get the genetic testing. But it is always again worth a conversation with your doctor or provider um about the risks and benefits. And most of the time these tests are done in conjunction with someone called a genetic counselor who can talk to you about your personal risk and you know what the results mean to you if they come back positive or negative. Do you have a recommendation by age of how frequently we should be seeing our doctors? You know, I'm I'm 58 years old. So, should I be seeing my doctor annually or semianually versus somebody who's 40 who's like every 5 years? Again, take eliminating that the family history, right? You know, is there sort of a benchmark or yard stick? >> Sure. you know, so being outside the primary care world from what I see most of the time, you know, they like to check in annually at least once a year. And if you know, you're being followed more closely for other medical purposes, you might see your doctor more frequently than that. >> So, it doesn't really matter your age. It's just, you know, make sure you see your doctor. >> Correct. >> You know, and and I can I can tell you firsthand, finding a primary care doctor right now is very very difficult. Yes. >> It it's hard. But again, as I age, I I get nervous because I want I want to have a good solid primary because I I mean, again, I don't have it in my family. Um I do have some there are some heart issues in my family, but I just want to be checked out regularly, right? >> Um but it, you know, hopefully I never have to go visit you. >> Hopefully not. Right. But I mean, is are the number of cancer patients increasing? Like is your workload increasing? >> Yes, the number of cancer cases is increasing. You know, part of that is due to the increase in population, is due to, you know, in uh patients living longer in general and cancer being known to be more frequent in older patients. Um, you know, but people are surviving longer just with all the treatments that we have. You know, it's estimated that as of the beginning of this year, there was 18.6 million cancer survivors in the United States alone from the American Cancer Society um fact. So, that's that's an amazing statistic really. You know, one thing I had heard a doctor say years ago was everyone will get cancer depend depending on how long you live, you know, so it's you're, you know, and I think he was speaking more towards prostate cancer for men, but >> it was it was one of those things where you're bound to get it the longer you live. Is that is that accurate? >> Um, more for prostate. Yes. Like you said, as as men age, that risk definitely increases, but but it is becoming more more prevalent. Um >> but the good news is it's becoming more and more curable, >> right? >> You know there you mentioned earlier something about imunotherapy and and before we go I I want you to talk more about that because I don't know anything about imunotherapy. >> Sure. So you know imunotherapy works very differently from chemotherapy. chemotherapy goes after rapidly dividing cells which are the cancer cells um but can also have side effect on other cells like you know your hair loss or the bowel's GI tract leading to nausea whereas the imunotherapy really targets and harnesses the power of the body's immune system so you know cancer and tumor cells are smart they actually try to hide from the body's immune system and so that they don't get attacked and but what the imunotherapy does is it kind of removes that blockade and allows the treatment to go after the cancer cells. So, the immune system to go after the cancer cells and >> so your your built-in immune system, >> the amunotherapy aids your built-in immune system to attack the cancer cells. >> Exactly. Yeah, it's quite remarkable. >> Is it a drug? It certainly sounds like >> it's a drug. It's right now given mostly through infusional therapy. Okay. >> Um now they're having new formulations that are given as subcutaneous injections, but right now it's infusional. And I know treatment for every can every cancer treatment is different. Is amunotherapy the same? Every amunotherapy for is unique for each form of cancer. >> Um good question. And you know initially the um specific imunotherapy drugs get approved for one uh cancer type. More recently they're getting approved for something called cancer agnostic. So across the board um if certain markers are found in a in a cancer cell that they might respond well to imunotherapy it can be utilized. Um but it is different drugs are used in different settings you know even stage two three or four in different cancers can be used you know before surgery shrink tumors down after surgery to prevent recurrence in stage four to to treat the cancer. So there's really very many ways we can use the imunotherapy. Is this is a difficult question. Is stage four a death sentence? >> Good question. And you know the way we think about stage 4 metastatic disease is very different now from even 10 years ago. You know there are with imunotherapy and the advent of these targeted therapies um has really improved how long patients can live on treatment for stage four cancers. You know, we take for example melanoma in, you know, 2011. You know, we would think that the average patient would would have six months if they had a stage four diagnosis. But recently, last year in New England Journal of Medicine, um, one of the trials about dual or two imunotherapy drugs used together in these stage four patients, 50% of the people were still doing well at 10 years, which is which is really remarkable. So, it's it's really changing how long and how well patients can can go on with treatments. So that that belief that stage 4 is a death sentence really isn't the case anymore. There are treatment I mean not in all cases but there depending on what you have there are treatments that can can extend your life for a significant time. >> That's correct. And you know there still still are cancers you know such as pancreatic cancer glyopblasto that you know in the stage four setting the treatment options are a bit more limited and and you know the lifespan won't go quite as long. But yes, in other in other cancers like melanoma, lung cancer, the options are are much better than they used to be. >> Dr. Agnes McAuliffe, I can't thank you enough for joining me today. A fascinating conversation. Like I said, hopefully I'm never one of your patients. >> Thank you for being here. >> All right. Thank you so much. >> This is 22 News in Focus with Patrick Barry.