The Future of Cancer Care

All right, to some health news here. According to the American Cancer Society, there will be 2.1 million new cancer cases diagnosed in the United States this year. Some 626,000 people are expected to die of cancer, but doctors want everyone to know the same type of cancer can act very differently in each person. And now there's new hope for what some call the future of cancer care, targeted therapies. I'm so happy to welcome to Mornings On 2, Dr. Shane Dormady. He's the Acampo Family Medical Director of Oncology at El Camino Health. Thanks for being with us, doctor. Thank you for having me. It was not that long ago that cancer was pretty much a death sentence, and you're telling us now that even someone diagnosed with a stage 3 or 4 cancer has hope? Absolutely. I think what we're starting to realize is that someone's prognosis and the treatment for the cancers isn't so much related to the anatomic region of the body where the cancer develops, but it's more we're unlocking the DNA, the code that goes awry with cancer cells and allows them to grow and divide uncontrollably. But these cancer cells end up developing certain genetic anomalies or mutations that can often be targeted directly by our new therapies. So essentially a breast cancer in me might act differently than in my sister-in-law, than in my neighbor? Absolutely. Cancers can behave aggressively. They can behave indolently. What's indolently? Indolent means nice cancer. Very slow growing, slowly progressive, and slow to metastasize. How do you figure out what kind each person has? Well, basically there are assays you can do now. It's even come down to just drawing a tube of blood where we can analyze tumor cell DNA circulating in the bloodstream to find these little mutations and then target them. You can also do a similar type of assay on biopsy specimens from the tumor themselves. Okay, let's go back to breast cancer because it's one of the most common and because I just found out a family friend was diagnosed. It's interesting because my level of panic was not sky high and I attribute that to some of the medical advancements that have been made, but also the changing conversation about breast cancer and the fact that we're seeing so many women get it and so many women live with it and through it. Oh, absolutely. I mean, depending on the fingerprint of the breast cancer cells, breast cancer cells can be targeted with hormonal therapies. They can be targeted with certain chemotherapies and they can be targeted with molecular types of treatments that home in on proteins on the surface of the cancer cell. A particular protein called HER2 is very targetable and we have a variety of new medicines to target that protein. It does seem like we are hearing more and more about people being diagnosed with cancer. The numbers are rising. How should we view cancer today? I think today what should be stressed is that, and I tell all my patients this, cancer is a medical condition. I tell my patients don't get caught up in stage three, stage four. I'm going to lose my hair. I need a mastectomy. Those things are an unfortunate reality sometimes, but in terms of living and dying, I tell patients don't think of this as a death sentence. Even with stage four disease in this day and age, if you do the molecular profiling, if you find the weaknesses in the cancer cells on a genetic level, patients with stage four disease can have their medical condition, the cancer controlled, just like high blood pressure or diabetes, indefinitely. So patients with stage four disease, who 20, 30 years ago were living three to six months, are now living five years, 10 years, 15 years and beyond. And so what do you say to people who say, I don't want to go in for my annual, I don't know what's going on in there? Well, I sympathize. I think none of us want to get bad news, but at the same time, the key with cancer is to catch it early. So screening studies like mammograms, pap smears, colonoscopies are critical to catch the cancer at an early stage and save lives. I've reframed it as I have to, to, I get to, I joke. I'm in my insurance era. It's your privilege. It is my privilege. Absolutely. Thank you so much, doctor. It's so nice to connect. Dr. Shane Dormady, the Ocampo Family Medical Director of Oncology. Thank you so much. Thank you. Thank you. And we will be right back.