InFocus featuring Cancer Care (Dr's Rawad Elias & Agnes McAuliffe)

From the 22 News Plus Studio, this is 22 News in Focus with Patrick Berry. Good morning, everyone, and welcome to today's edition of In Focus. I am your host, Patrick Berry. Today, we are talking about a topic that is probably close to the heart of everyone watching this. If you don't know someone with cancer, you probably will in the very near future, sadly. But there's good news about cancer, and I'm excited today because joining me across the desk on your left is Dr. Rawat Elias, and on your right is Dr. Agnes McAuliffe. They are both cancer doctors. Is it fair to call you both oncologists? Which is another term for our cancer doctor, correct? So I'm excited to have both of them join me today to have the conversation about cancer because a lot has changed over the years and a lot is coming over the years. So again, thank you both doctors for being here with me today. So as I already said, today. Dr. McAuliffe, you and I have talked in the past, so I'm going to shift the conversation to start with Dr. Elias. Dr. Elias, tell us your specialty, if you have one, or is it just a general oncologist? Yeah, so I did my training in hematology oncology, so you get the full exposure to all cancers and blood disorders, but I did subspecialize in cancers of the digestive system. So anything related to the esophagus, stomach, colon, pancreas, liver, rectum, that is all under the cancers that I see in my life. All right. Dr. McAuliffe, explain your specialty. Yes. Currently, I do see general medical oncology as well as hematology at the Sister Caritas Cancer Center. Fantastic. Okay. So let me ask both of you. You've both been in practice for a while. What have you seen when it comes to cancer? The diagnosis, are we better at diagnosing cancer nowadays than we were two years ago, five years ago, 20 years ago? Similarly with the treatments. And I'll throw it out. Either one of you take the ball and run with it. So I'll start because I started my training before Dr. McAuliffe. So I think the differences are a little bit more striking compared to when I was in training. Hearing first about something called, for example, and that's the biggest thing that comes in conversation these days, immunotherapy. So these are treatments that work by activating the immune system to go and attack the cancer. These treatments, when I was back in training, we had started hearing about them. We had started seeing some activities in patients with melanoma, with advanced melanoma, and these treatments really changing things and attacking cancers in a... more efficient and less toxic way than the regular chemotherapy that we use. Can I interrupt you there briefly? Just explain what immunotherapy is, so folks watching can understand that. Because it is, as you point out, it's not new, but it's fairly recent. Yeah, yeah. So the simple idea is basically harnessing the power of the immune cells to go and attack the cancer. So when cancers develop, they evade the immune system. Our body tries to control the cancer, but cancer, unfortunately, is a smart disease and can develop resistance mechanisms and can evade the immune system, can start growing. The most common type of immunotherapies we use in the clinic these days are sort of treatments that unleash the brake that the immune system put on the cancer, so the immune system can go again and attack the cancer cells and kill them. There are other types of immunotherapy, like vaccines, like engineered immune cells. We extract immune cells from the body, engineer them to attack the cancer cells, and re-infuse them. So these are other types. The ones we use mostly in the clinic, they'll work basically on that, unleashing the brake. Dr. McCall, I see you nodding along with that. What are your thoughts on immunotherapies? I agree with Dr. Elias in that, you know, even in the last five years, they've really changed how we treat cancers. And as you mentioned, initially it was in melanoma and now is really spreading to many other cancer types, being used before surgery to, you know, potentially shrink tumors down, being used after surgery to help prevent cancers from recurring, and in the even Even metastatic setting being used to control cancers for quite a long time. The side effects can often be tolerable for patients as well. So immunotherapies, are they replacing the traditional radiation chemotherapy that was historically the only way to treat cancer? Or is it in addition to? How would you look at immunotherapies? So I wouldn't say replacing. It depends on the specific indication. In certain cancers, in certain indications, yes. Thank In others, it's complementary or additive. So, for example, in cancers of the stomach, we are adding immunotherapy you to the usual chemotherapy we've used, and that's the best approach. very In other cancers, like melanoma, it completely took over treatment. Oh, interesting. So, depending on the type of cancer you have, much. is the treatment that's prescribed, correct? So the second part of my earlier question was the diagnosis of cancer. Is it easier today than it had been two years ago, five years ago, 10 years ago to diagnose a patient with cancer? Anyone? Go ahead. I think it's getting easier in terms of there are more screening recommendations and more screening processes as we've previously touched on. For example, lung cancer screening programs that are available for patients that have certain histories of smoking cigarettes have a low-dose CAT scan that can be performed that could potentially find a small nodule or an abnormality on a CAT scan that can then be biopsied earlier and potentially treated with surgery or additional therapies sooner than we used to. Which that's great news, right? So the survivability is increasing too because of earlier diagnosis and that the... The better treatments that we have nowadays, correct? Correct. Basically, and I think it's across all cancers, the survivability is increasing, right? Yeah, survival of cancer in general has improved significantly in the last 10, 20 years. We're screening, we're diagnosing cancers at the early stage, which allows us to act on treating these cancers earlier. We have better treatments, much better treatments. To give you an example of the last... I think 2018, 2019, these treatments that we talked about, immunotherapy, started coming into the treatment of liver cancer. Advanced liver cancer was a deadly cancer with a survival of about one year in the past. Now, about one of every five patients, even though they had stage four cancer of the liver or the equivalent, we use a different staging mechanism in liver cancer, even though they had that at the beginning, one of five are cured. Cured from basically from one year life expectancy to cured. Correct. Wow. That's a huge change. It is a huge change. We get very excited about it. I'm excited about it. And it's good to be in practice and seeing all these changes. Another example, patients with a certain type of colon cancer. or rectal cancer used to require chemotherapy after they go through a surgery, then they would get chemotherapy. Now we can give them a couple of doses of immunotherapy before surgery and the surgeons are going in, they're doing the surgery and there's no cancer cells. This is something something that's happening every day in clinic and this is something that It's very exciting for us seeing, and unfortunately, it doesn't always happen, but it gives us a little bit of an idea of what's waiting for us in the future in terms of cancer care. We're looking forward to it. Fantastic. We are up on our first commercial break. When we come back, folks, we'll talk about cancer care locally here in Western Mass. Stay with us. We're back in just a minute. This is 22 News in Focus with Patrick This is 22 News in Focus with Patrick Berry. Welcome back, everyone, to this edition of In Focus. I'm your host, Patrick Berry. Dr. Rawad Elias is on your left. Dr. Agnes McAuliffe is on your right. Doctors, thank you both for joining me today. We're talking about cancer, the advancements in cancer diagnosis, cancer care, and so forth. And before we went to the break, I did kind of tease that cancer care here in in Western Massachusetts, because I think a lot of people don't understand. The high quality cancer care you can get here in Western Massachusetts, I think instantly what comes to mind is Boston, New York, or what's at the Mayo Clinic in Minnesota, right? I think those are the three things people think about, but there is great care right here in Western Mass. So. Dr. McAuliffe, I want to come to you with this because the cancer care here in Western Mass has changed dramatically, and you are the Sister Caritas Cancer Center, which, again, I think people somewhat know about, but talk about the advancements in care here in Western Mass, and more specifically, the Sister Caritas Center. Okay. So at the Sister Caritas Center, We have access to all of the front lines of treatment, chemotherapy, immunotherapy, as we discussed briefly. We have a multidisciplinary team of specialized surgeons, breast surgeons, colorectal surgeons. We have radiation oncologists, and the radiation department is connected right next door to the medical oncology, to the infusion department, so patients can get their care basically right next door. Let's say they're doing chemotherapy and radiation at the same time. Their visits are right after one another. They're seen in one center and can come walk right down the hallway to be seen by us. So from the patient's side, very convenient. Correct. And I have to imagine from your side as well, very convenient. Everything is in one basic central location. Correct. And we have the extended support from a nutritionist that specializes in cancer patients, social work team, a whole team of people. We have the PET scan. We have all the imaging modalities needed right down the hallway. CAT scan, x-rays, anything that's needed can be done even the same day for patients that are seen. So knowing that resource here, are you finding in your day-to-day lives with patients that they didn't realize some of these resources were here locally and in their heads, they're like, okay, thank you for seeing me. Who do you recommend in Boston or New York? And now you've changed that conversation to, no, this is what can be done right here in the Pioneer Valley. Yeah. Listen, we know cancer is overwhelming. It's a complicated disease. And if any of us hears that word, even if you happen to have not the most aggressive cancer, it's big news. It's scary. It's very scary. And you're going to naturally look at, okay, where can I get the best care? And we would be lying. Boston is great. And it's nearby. But we also know that cancer care can be overwhelming. There is a lot of trips and treatments and appointments and having to deal with all that while going through cancer, through a cancer treatment, through chemotherapy, other treatments, surgery, can be a lot. And our biggest goal is to let patients know that most of that is available here much closer to them. I've heard from patients before talking about how difficult it is for them to travel to and come back from Boston after undergoing a treatment. And it's a treatment we have here. It's expertise we have here. There are certainly things we don't have. And in those situations, we are the ones to say, let's connect you with our colleagues in Boston. But for the most things that patients need in everyday care, those things are available locally at a high level. So one example that I've always given recently, because that's something we never had before. was access to neuro-oncology care. So neuro-oncology is cancer of the brain and the neurologic system. We've never had that program available locally before. Now we do. We have a physician with that expertise. We have neurosurgeons. We have all what you need to receive the same level of care that you would receive otherwise in Boston. And so if someone wants to go, we understand, and that's normal. And we want to support them through that journey. But that is available here closer to home. You know, one of the things you mentioned in that description was Boston is not far from here. I get it. But if you're a cancer patient and you have to go back and forth to Boston even once a week or twice a week, and many are three or four times a week, you're wiped out. You're exhausted. That journey could be like going to California, and it's only an hour and a half to two hours away. So having the ability to be treated and have care within 40 minutes, even if you're in Greenfield to come to Springfield, 45 minutes, And it's much better than going to Boston. When you're having those conversations, to your point, Dr. McAuliffe, you explained the Caritas Center, like this is what's available. Do people's eyes light up like, oh, I didn't know that? Yes, I think there are definitely cases where patients were not aware of everything that we can offer at the center and that they don't necessarily have to travel and that they can go through all of their treatments without having that additional burden that Dr. Elias mentioned of traveling and it can all be done here. Fantastic. We are up on our second commercial break, folks. Please stay with us. Plenty more to talk about when we come back after this quick break. This is 22 News in Focus with Patrick Berry. This is 22 News in Focus with Patrick Berry. Welcome back, everyone, to this edition of InFocus. I am your host, Patrick Berry. Sitting across the desk from me is Dr. Rawat Elias and Dr. Agnes McAuliffe. They are both oncologists. Thank you both for joining me today. Cancer is the topic of today's discussion. We were talking about cancer care, local care versus having to head to somewhere else to get the treatments. The thing. Expected merger of Bay State and Mercy Hospitals. Well, correct me if I'm wrong, we'll expand care. So even though there was care under Mercy, there was care under Bay State, the idea of when these two hospitals merge, they're not just going to merge what was already in existence, they're going to expand that. Dr. McAuliffe, do I have it right? Yes, that's correct. Okay. So, you know, we will continue to take care of patients at the Sister Caritas Center the way that we've been doing. You know, the nurses provide compassionate care for patients day in and day out in the infusion suite. And those patients will continue on their same treatments with the same nurses. And the conjunction of... Coming together with the two hospitals, we foresee will allow for even improved access, ideally with a whole team coming together. And for example, if, as Dr. Elias mentioned about the neuro-oncologist, so again, that's not a specialty we currently have at Sister Caritas and often requires some additional insights and input from a multidisciplinary team. So we'll now be able to, you know, allow access and work together to take care of patients in certain specialties. So do we see, like Dr. Elias, you mentioned the addition of neuro. Do we foresee additions of other, you know, you said neuro wasn't really a specialty here in Western Mass. It now is and will become even better. Are there other cancer, I don't know whether it's treatments or procedures or processes that maybe aren't here now or are here now, but expect to be expanded? More doctors, more nurses, whatever it might be. Yeah, you know, those of us who are into cancer care are very passionate about taking care of our patients. And this passion in this merger is very, you know, there is a lot of excitement about where that will take us. When we look at our team, what we're able to do and what we will We will be able to do working together. Going from, for example, to about 70 chemotherapy chairs, that's a large number of chemotherapy chairs that now we can leverage between both centers. The team, the number of the physicians, the number of the advanced providers that will be working together to advance patient care in the area. There is a strong commitment to our patients and using our both sites, we will be able to move that even further. And yes, expand programs, expand programs like the neuro-oncology even further, get newer treatments. There are treatments that two years ago we weren't doing in this area called the biotherapy. So this is part of that engineered immune cells that we were doing. They're complex. They can initiate an immune reaction from the body. We didn't do those two years ago. Now we are doing them. Having this combined force will allow us to grow things like that even more, attract more talent, and be really able to offer the top-notch targets. So one of the things I'm going to glance at my notes here, the Sarah Cannon Research Institute, I guess that's a partnership that either has already happened or is happening? Are you familiar with that? No? Maybe I have that wrong. That's okay. But again, it talks about the partnerships that will be expanded based on the hospital's joint treatment of patients in Western Mass, correct? Correct. And I expect that as we join our forces, there will be additional options for clinical research and research trials that do come about. Yeah. And there are great things happening at Mercy. There are great things happening at Baystate. And having the ability to join those great things together and not having to start from scratch. That is a big advantage for us, for our patients, for our team to be able to move forward in a more efficient and a stronger way together. You know, and the way you're describing it, too, is patients will have the opportunity for either facility. Yeah, the commitment is to patients and their care, and the logistics, we have to figure that out. The operations, we have to figure it out. Following what the patient wants when it comes to their care. So if they want to be at Springfield, we will do that. If they want to be at Mercy, we'll do that. It's just about what makes the most sense to the patient. This kind of takes the conversation back to the very, or this question takes the conversation back to the very first, one of my first questions was when it comes to diagnoses. It starts with your primary care, right? So a patient, I'm not feeling well, starts with their primary care. The tests are run, and then they move on. If cancer is detected, then they move on to both of your worlds. Do I have that right? That's correct. So once that transition happens from the primary care to the oncology department, that's, to your point, Dr. McCall, that's where the expanded care, the expanded treatments, the expanded... Thank you very much. The expansion of just the two hospitals combining together creates a better environment for cancer patients. Correct. Right? Yes. So as a patient, if they want to learn more information, just jump on the Sister Caritas website or Baystate website or whichever, any, you know, one of the local websites, and then they can learn more about cancer treatment locally. And I think that's kind of the basis of it, correct? Perfect. Well, we are up on our time. I can't thank you both enough for joining me today. Fascinating conversation. And as I said, folks, if you need more information, look up BayState Health, Mercy Health, Sister Caritas Center, and find out more information about great local care for cancer right here in the Pioneer Valley. This is 22 News in Focus with Patrick Berry.