00:00:00:15 - 00:00:01:01 I'm Dr. 00:00:01:01 - 00:00:04:02 Rob Winn and you're listening to Real Cancer Talk 00:00:04:02 - 00:00:07:02 from VCU Massey Comprehensive Cancer Center. 00:00:07:14 - 00:00:09:08 Hey, y'all. How y'all doing? 00:00:09:08 - 00:00:13:06 Hopefully you are having at least getting through the day 00:00:13:08 - 00:00:16:00 or getting through the evening or whatever the case may be. 00:00:16:00 - 00:00:19:00 Welcome to another Real Talk podcast. 00:00:19:24 - 00:00:24:09 Today I have with me a really special person, who I'm actually 00:00:24:09 - 00:00:27:09 going to have them introduce themselves because I think that they, 00:00:27:23 - 00:00:30:23 listen, you'll know why in a minute. 00:00:32:07 - 00:00:34:00 I do want to tell you that, 00:00:34:00 - 00:00:36:22 we are hopeful that the folks that are listening, 00:00:36:22 - 00:00:37:22 we're trying to accomplish 00:00:37:22 - 00:00:40:22 just a couple of things with this podcast and that’s real talk. 00:00:41:01 - 00:00:44:17 Just under demystifying some things that seem to be, 00:00:45:20 - 00:00:48:13 you know, very much shrouded in mystery. 00:00:48:13 - 00:00:51:07 We are able also trying to make, 00:00:51:07 - 00:00:54:04 science much more digestible and accessible. 00:00:54:04 - 00:00:56:10 That's the purpose of the podcast. 00:00:56:10 - 00:00:58:15 So I am Rob Winn. 00:00:58:15 - 00:01:02:17 I am the Cancer Center Director now at VCU Massey Comprehensive Cancer Center, 00:01:02:17 - 00:01:06:10 which is an NCI designated comprehensive cancer center here in Virginia. 00:01:07:00 - 00:01:11:11 And I, with a special guest, I was going to call her one of the OGs, 00:01:11:11 - 00:01:13:13 but I'm going to let her introduce herself. 00:01:13:13 - 00:01:16:13 Sis, tell us a little bit about you. 00:01:16:23 - 00:01:20:16 In morning and afternoon evening, wherever you all are. 00:01:21:09 - 00:01:22:20 Nice to meet you all. 00:01:22:20 - 00:01:27:11 I'm Oluwadamilola Oladeru, but I go by Damilola. 00:01:27:19 - 00:01:33:01 And I'm a radiation oncologist at Mayo Clinic in Jacksonville, Florida. 00:01:33:08 - 00:01:37:08 My specific, disease, my specialty is breast cancer. 00:01:37:23 - 00:01:42:19 And, I'm honored to be one of the first group 00:01:42:19 - 00:01:45:19 of Winn Career Development Award recipients. 00:01:46:13 - 00:01:51:09 And I completed that program, and I'm currently now, also in the first group 00:01:51:09 - 00:01:56:11 and first class of the Clinical Investigator Leadership Award recipients. 00:01:57:05 - 00:02:00:23 The second stage of the Winn program. 00:02:00:23 - 00:02:03:11 Maybe, hopefully there'll be a third stage. 00:02:05:14 - 00:02:08:07 But, I am very happy to be here. 00:02:08:07 - 00:02:12:10 My career has really centered around advancing breast cancer research. 00:02:13:00 - 00:02:15:16 Through both a scientific, innovation 00:02:15:16 - 00:02:18:16 lens and in health equity lens. 00:02:19:09 - 00:02:21:16 Some of my work spans 00:02:21:16 - 00:02:25:24 investigator initiated clinical trials supporting the design of it. 00:02:26:17 - 00:02:29:17 How we're inclusive of it and writing it as well. 00:02:29:19 - 00:02:34:21 And also disparities focused work that are both community based 00:02:35:14 - 00:02:38:14 which involves outreach to communities 00:02:38:15 - 00:02:42:07 that have been historically marginalized, or communities 00:02:42:07 - 00:02:46:18 that have been more hesitant to accept the treatments that we’re recommending. 00:02:47:17 - 00:02:49:23 So one of those communities which is less 00:02:49:23 - 00:02:53:19 talked about in oncology actually is incarcerated patients. 00:02:54:13 - 00:02:56:23 So these are individuals that represent 00:02:56:23 - 00:02:59:23 a significant population in the country. 00:03:00:00 - 00:03:04:00 And, without, you know, going into too much detail, 00:03:04:14 - 00:03:07:24 but, you know, what happens in prisons actually mirror 00:03:07:24 - 00:03:12:06 what happens in our community as this is a cycle, a revolving door. 00:03:12:13 - 00:03:17:10 And so this, pop group of population have been largely ignored. 00:03:18:00 - 00:03:23:08 Yet a lot of the things that are policy relevant in the community, for instance, 00:03:23:12 - 00:03:26:17 changing the age of screening 00:03:27:01 - 00:03:29:20 for, high risk populations. 00:03:29:20 - 00:03:32:20 Those things are actually, impacting, 00:03:33:07 - 00:03:36:07 and have been ignored and not adopted in, 00:03:36:16 - 00:03:39:07 the incarcerated population as well. 00:03:39:07 - 00:03:41:17 And we can speak more about it in detail later on. 00:03:41:17 - 00:03:43:24 But, those are some of my interests. 00:03:43:24 - 00:03:48:16 I'm particularly also interested in global oncology and global health, 00:03:49:08 - 00:03:51:17 which is even further, 00:03:51:17 - 00:03:55:15 removed from some of the emerging changes in oncology, 00:03:55:15 - 00:03:59:11 both and treatments for me in my field and technology. 00:04:00:00 - 00:04:03:10 So I'm very much involved in training and education, 00:04:04:04 - 00:04:07:24 of the oncologists who work in low and middle income countries, 00:04:08:15 - 00:04:13:07 so they can rapidly adopt some of the technological changes, treatment, 00:04:13:07 - 00:04:17:23 planning, design that go on in radiation and bring it very quickly 00:04:18:01 - 00:04:21:10 to the patients that they're seeing, in their countries. 00:04:21:19 - 00:04:24:16 So thank you very much for having me on this podcast. 00:04:24:16 - 00:04:24:20 And Dr. 00:04:24:20 - 00:04:28:06 O, let's...look I'm telling you, that's why... 00:04:28:06 - 00:04:29:14 OG, I’m telling you. 00:04:29:14 - 00:04:32:01 Going all the way back to the first class. 00:04:32:01 - 00:04:33:17 So let's jump right in, though. 00:04:33:17 - 00:04:36:04 Listen, if you had to 00:04:37:09 - 00:04:38:06 think about it, since 00:04:38:06 - 00:04:42:10 you've been a medical student and now doing what you're doing, 00:04:42:24 - 00:04:46:04 what has been the thing that has been the most, 00:04:47:08 - 00:04:50:02 I would say impressive for you or the thing that you've been most 00:04:50:02 - 00:04:54:10 impressed by in the in, in these years that you've been doing your training 00:04:54:10 - 00:04:58:03 and now that you're actually, you know, functioning in, you know, 00:04:58:03 - 00:05:02:02 faculty, etc., you know, what has been the one thing that has impressed 00:05:02:02 - 00:05:05:10 you either about the field of medicine or in science 00:05:05:14 - 00:05:08:14 over these last x number of years? 00:05:09:12 - 00:05:13:20 The rapid, change in technology, 00:05:13:20 - 00:05:17:09 at least in my field, the uptake in 00:05:18:15 - 00:05:21:12 cancer drugs, what I was taught as a resident, 00:05:21:12 - 00:05:25:07 the way we treated and designed treatment plans has, 00:05:25:07 - 00:05:29:08 you know, evolved rapidly compared to now in practice. 00:05:29:17 - 00:05:33:00 And it really requires, consistent learning 00:05:33:06 - 00:05:36:01 and staying up to date with the field. 00:05:36:01 - 00:05:38:11 The other thing that I've consistently, 00:05:38:11 - 00:05:41:23 noticed is how a single opportunity 00:05:42:12 - 00:05:45:12 can completely change your career trajectory. 00:05:45:21 - 00:05:50:16 And whether it's through a person, you shadow a person that has mentored you, 00:05:50:23 - 00:05:53:00 a person that has sponsored you, 00:05:53:00 - 00:05:57:05 it can either accelerate where you're going or even completely 00:05:57:10 - 00:06:02:08 put you on the path that you should be on, or even derail you from that path. 00:06:02:08 - 00:06:05:21 If you're if you're going the wrong way and you speak to the wrong 00:06:05:23 - 00:06:07:18 or listen to the wrong voice. 00:06:07:18 - 00:06:12:13 So I would say that I've been a recipient of very blessed and fortunate 00:06:12:13 - 00:06:15:19 opportunities, mentorship, sponsors 00:06:15:19 - 00:06:19:13 along the way and programs and grants, such as the Winn Award 00:06:20:17 - 00:06:23:00 that has allowed me to 00:06:23:00 - 00:06:26:03 really move at a fast pace as an early career 00:06:27:04 - 00:06:30:04 person, early career investigator. 00:06:30:14 - 00:06:34:07 Which, you know, I think from my mentors took them decades 00:06:34:07 - 00:06:37:07 to get to where I'm trying to start now. 00:06:37:10 - 00:06:40:08 So I'm very, very, cognizant of that. 00:06:40:08 - 00:06:43:19 And I try to make sure I send the ladder, the ladder back 00:06:43:19 - 00:06:46:19 down, to others that are coming behind me. 00:06:47:17 - 00:06:49:06 That's so awesome. 00:06:49:06 - 00:06:52:21 You know, so that makes me think about a follow up question 00:06:53:02 - 00:06:57:15 in the context of, you know, we've said that science is moving rapidly. 00:06:57:15 - 00:06:58:12 Certainly. 00:06:58:12 - 00:07:01:24 I remember in the, you know, there were certain cancers of advanced stage breast 00:07:01:24 - 00:07:05:04 cancer where you would just send them on, send them home. 00:07:05:17 - 00:07:09:09 We now have molecular targeted therapy and there's developing of immunotherapy. 00:07:09:09 - 00:07:12:09 There's all this wonderful stuff that's actually happening. 00:07:13:00 - 00:07:15:02 And it is difficult to sort of keep up with. 00:07:15:02 - 00:07:19:10 And you talked about mentorship and the people in your lives, you know. 00:07:19:10 - 00:07:22:12 So can you tell me, along the way, 00:07:23:08 - 00:07:26:04 particularly outside of the Winn program, or maybe there was somebody 00:07:26:04 - 00:07:30:03 with inside of that program who has been, either 00:07:30:03 - 00:07:35:22 historic figure or someone in your life, your mom, anyone, you know, colleague 00:07:36:01 - 00:07:39:17 that has really continued to drive passion for you 00:07:40:18 - 00:07:42:06 to do the research and set up 00:07:42:06 - 00:07:45:06 clinical trials to fight cancer? 00:07:46:03 - 00:07:49:03 Yes. Thank you. So, 00:07:49:03 - 00:07:53:20 you know, I definitely would acknowledge everyone in my life, 00:07:53:20 - 00:07:56:20 my teachers, mentors, 00:07:56:21 - 00:07:59:09 advisors throughout the years. 00:07:59:09 - 00:08:02:05 But yeah, very consistent figure for me 00:08:02:05 - 00:08:05:21 has been my parents, specifically my dad. 00:08:06:16 - 00:08:08:17 My mom, of course, and she been equally. 00:08:08:17 - 00:08:11:17 But my dad, I would have to highlight, 00:08:12:12 - 00:08:15:18 my dad's, life journey is quite interesting. 00:08:15:19 - 00:08:19:21 He actually got a scholarship in Nigeria to go to medical school, 00:08:20:20 - 00:08:22:04 which was a very big deal. 00:08:22:04 - 00:08:26:22 Graduated top of his class, extremely brilliant, but came from a very, 00:08:26:22 - 00:08:29:22 very, very poor family. 00:08:30:15 - 00:08:33:13 And so without any financial support, 00:08:33:13 - 00:08:37:15 he was unable to accept that admission that he had received, 00:08:38:10 - 00:08:41:14 to which was to a European country to study medicine. 00:08:42:00 - 00:08:45:07 And so he, you know, went into engineering, 00:08:45:07 - 00:08:49:08 is still succeeded in that role, immigrated to the US. 00:08:50:09 - 00:08:53:07 Without any guidance of how he could, 00:08:53:07 - 00:08:56:24 you know, transition in the field or grow in the field. 00:08:57:06 - 00:09:00:24 He did other menial jobs, eventually became a social worker. 00:09:00:24 - 00:09:05:07 Everything that was necessary to support myself and my siblings. 00:09:05:15 - 00:09:08:14 And he took me to every science program, 00:09:08:14 - 00:09:11:23 every science camp that I started in from seventh grade. 00:09:12:02 - 00:09:13:12 He would drive me every summer 00:09:13:12 - 00:09:17:23 to Temple University from New York to Philly for these science programs. 00:09:18:02 - 00:09:20:10 Drove me to Maryland, to NIH. 00:09:20:10 - 00:09:24:09 When I was at Yale for undergrad, he would come and visit me multiple times 00:09:24:17 - 00:09:28:03 and in med school, Long Island, come and visit me multiple times, 00:09:28:03 - 00:09:29:21 and residency in Boston. 00:09:29:21 - 00:09:33:21 You know, my parents were always present, and my dad specifically 00:09:34:02 - 00:09:39:00 was always, always involved and is actually my biggest cheerleader. 00:09:39:19 - 00:09:42:05 You know, some people...the 00:09:42:05 - 00:09:46:07 very wonderful quote is, we're living our ancestors daydreams. 00:09:46:15 - 00:09:51:16 And for my dad, it's it's really been me living his daydream. 00:09:51:16 - 00:09:53:09 What he would have become. 00:09:53:09 - 00:09:57:01 If he had the opportunities I had today, he would have been, 00:09:57:01 - 00:10:01:02 like most brilliant neurosurgeon this country has ever seen. 00:10:01:02 - 00:10:02:02 Without a doubt. 00:10:02:02 - 00:10:04:04 He is exceptionally brilliant. 00:10:06:01 - 00:10:06:20 And, you 00:10:06:20 - 00:10:09:17 know, fast forward to about two years ago. 00:10:09:17 - 00:10:13:19 He was diagnosed with cancer, something that has never been diagnosed 00:10:13:19 - 00:10:16:00 in my family. 00:10:16:00 - 00:10:18:12 So I never, ever I mean, 00:10:18:12 - 00:10:21:13 it just never crossed my mind that my own parents, 00:10:22:02 - 00:10:26:02 or a parent or relative, could be dealing with cancer itself. 00:10:26:08 - 00:10:30:24 So this last two years of walking through that journey with him 00:10:31:08 - 00:10:34:21 has been a very different experience for me 00:10:34:21 - 00:10:37:21 as an oncologist now, becoming a caretaker. 00:10:38:17 - 00:10:42:24 And, you know, I consider myself young, so, 00:10:43:17 - 00:10:46:20 and I didn't expect to be taking care of them this young. 00:10:46:21 - 00:10:51:14 I would say, you know, I, I thought I, I believed I’d have forever with them and, 00:10:51:14 - 00:10:57:03 but I learned so much in the care that my own colleagues have given him. 00:10:57:13 - 00:10:59:02 And even how 00:11:00:19 - 00:11:01:15 access to 00:11:01:15 - 00:11:05:10 care has changed his treatment outcomes and trajectory. 00:11:05:16 - 00:11:08:16 You know, where he had started off getting care, 00:11:09:08 - 00:11:11:12 we didn't think was suboptimal where he was 00:11:11:12 - 00:11:14:16 by bringing him to the hospital that I work at 00:11:14:23 - 00:11:18:24 and how everyone got things done very quickly. 00:11:19:08 - 00:11:23:06 And now because of advancements in technology for the type of cancer 00:11:23:06 - 00:11:26:20 he has, he you know, how to complete response, 00:11:27:24 - 00:11:33:02 to to the treatment, which is miraculous for the cancer type that he has. 00:11:33:10 - 00:11:38:14 And so also seeing someone experience something that I, 00:11:38:17 - 00:11:42:19 you know, historically five years ago has never been the case. 00:11:43:20 - 00:11:46:24 And it's also changing that field and that the fact 00:11:46:24 - 00:11:49:24 I feel fortunate that he can experience that too 00:11:49:24 - 00:11:54:01 and have some more longevity is something that I'm very grateful for 00:11:54:09 - 00:11:58:01 and I think will continue to be a very defining moment, 00:11:58:18 - 00:12:02:06 of my life and career, ever moving forward. 00:12:02:20 - 00:12:06:19 So that, that to me, my dad would be that definite, that person 00:12:07:12 - 00:12:10:14 from the start till now, that has really, 00:12:10:21 - 00:12:15:01 shaped and defined how I've experienced this journey in oncology. 00:12:15:20 - 00:12:16:15 That's awesome. 00:12:16:15 - 00:12:21:01 And that points to you, you know, again, the advancement and the work 00:12:21:21 - 00:12:24:14 of the science that the molecules 00:12:24:14 - 00:12:28:06 that then become, the medicines that then have to come out to clinical trials. 00:12:28:10 - 00:12:29:05 And the importance 00:12:29:05 - 00:12:34:06 of in a relatively short period of time of why it's resulting in now 36% fewer 00:12:34:06 - 00:12:38:09 Americans dying from cancer, today than they were in the 1990s. 00:12:38:15 - 00:12:40:21 So let's talk then. 00:12:40:21 - 00:12:45:10 You know about your project, your original project. 00:12:45:10 - 00:12:46:13 And then we're going to get to 00:12:46:13 - 00:12:49:24 what are you learning now in the, in the, in the Silo program. 00:12:50:05 - 00:12:53:01 But what was your original project and 00:12:53:01 - 00:12:56:03 what or I should say, how did you original project, 00:12:57:06 - 00:12:59:17 with the CDA 00:12:59:17 - 00:13:02:21 actually, you know, catapult you to where you are now? 00:13:02:21 - 00:13:06:18 And then if you could tell me what your project is today, 00:13:06:18 - 00:13:10:00 what your clinical trial is today, that would be great. 00:13:10:17 - 00:13:12:02 Okay. Thank you. 00:13:12:02 - 00:13:17:10 So, in the CDA program, we were tasked to work with a mentor 00:13:17:10 - 00:13:21:05 and learn under our mentor about how to design a clinical trial. 00:13:21:12 - 00:13:26:11 The mentor I was working with, has been extremely instrumental in Doctor 00:13:26:11 - 00:13:31:08 Julie Bradley throughout my first faculty position at the University of Florida. 00:13:32:08 - 00:13:37:15 You know, four years ago and the project we worked on together 00:13:37:15 - 00:13:42:10 was comparing standard of care radiation treatment in breast cancer 00:13:42:16 - 00:13:46:24 to a more accelerated form, and specifically using that, 00:13:47:19 - 00:13:52:24 using particle therapy, which is a different type of radiation therapy. 00:13:53:04 - 00:13:56:16 That's more targeted, has the fewer side effects. 00:13:57:10 - 00:14:02:11 But there's very few places in the world and in the country that has this machine. 00:14:02:17 - 00:14:06:12 But there are benefits to, for example, left breast cancer patients 00:14:06:18 - 00:14:11:16 having proton therapy versus the standard, radiation therapy we have. 00:14:11:23 - 00:14:13:22 And so we wanted to see if, 00:14:13:22 - 00:14:17:10 well, if this is a much better modality that we believe it is, 00:14:17:22 - 00:14:21:15 could we also shorten the amount of time people are getting radiation. 00:14:22:00 - 00:14:24:09 By doing this, you have a higher throughput. 00:14:24:09 - 00:14:27:03 You can use the machine for more patients 00:14:27:03 - 00:14:30:05 by shortening the amount of time each person is spending on it. 00:14:30:19 - 00:14:32:18 But we need to make sure it's safe. 00:14:32:18 - 00:14:35:14 We know archeologically it wouldn't make a difference 00:14:35:14 - 00:14:40:00 if they came 25 times versus 16 times, but we want to make sure 00:14:40:01 - 00:14:44:00 the side effects acutely while going through treatment is not worse. 00:14:44:19 - 00:14:47:19 But probably comparable or even better. 00:14:48:01 - 00:14:50:05 So that was a treatment design, 00:14:50:05 - 00:14:53:20 and I'm happy to say that trial is now open and enrolling. 00:14:54:13 - 00:14:56:17 Now in the CLA program. 00:14:56:17 - 00:14:58:11 We're taking it a step further. 00:14:58:11 - 00:15:02:17 We already know using the typical standard radiation machines, 00:15:02:22 - 00:15:06:08 we can get through treatments safely in 16 days. 00:15:06:16 - 00:15:11:08 Now, the machines we're using is not, as you know, targeted as proton. 00:15:11:17 - 00:15:15:16 But the next question is, can we even do this in five days? 00:15:16:01 - 00:15:20:02 Now there are reasons to to believe that this would even be better 00:15:20:08 - 00:15:21:15 generally because, 00:15:22:16 - 00:15:23:15 historically we 00:15:23:15 - 00:15:29:12 thought of giving radiation very gently, slowly, prolonged over five, six weeks, 00:15:29:22 - 00:15:34:24 which has caused a lot of skin side effects, also makes access an issue. 00:15:35:05 - 00:15:39:04 And in nations like the United Kingdom, they have accelerated their treatments 00:15:39:04 - 00:15:40:23 and gone straight to five days. 00:15:40:23 - 00:15:44:08 And we learned from them during Covid that this was safe. 00:15:44:11 - 00:15:49:03 So in the US, we started doing five days of radiation for early stage 00:15:49:03 - 00:15:53:02 breast cancer, and we now have, you know, comfortably adopted that. 00:15:53:10 - 00:15:56:20 But we haven't fully adopted that for the locally advanced 00:15:56:20 - 00:15:59:20 patients who need their regional nodes treated. 00:16:00:01 - 00:16:03:15 So in the CLA program, I'm working with a mentor 00:16:04:00 - 00:16:07:21 in a cooperative group to design a trial phase three trial 00:16:08:02 - 00:16:12:01 that would compare 16 days of radiation to five days of radiation 00:16:12:11 - 00:16:15:07 for regional...for the 00:16:15:07 - 00:16:18:23 for those with locally advanced cancer that need regional nodal radiation. 00:16:19:05 - 00:16:21:00 Now, why is this important? 00:16:21:00 - 00:16:25:18 Well, one treatment in cancer care can be financially toxic. 00:16:25:18 - 00:16:30:07 And so completing in fewer days also means smaller bills. 00:16:30:24 - 00:16:34:12 It also means greater access to care in places 00:16:34:12 - 00:16:39:00 where there are community practices, where there's only one practice for radiation, 00:16:39:04 - 00:16:43:09 and you don't have people waiting longer and longer before they start treatment. 00:16:43:14 - 00:16:47:16 These also affects, you know, patients who can't take time off work. 00:16:48:01 - 00:16:51:00 That's a very big deal we overlook in oncology. 00:16:51:00 - 00:16:54:19 We have patients working through chemo patient, our patients who are working 00:16:54:19 - 00:16:55:16 through radiation. 00:16:56:15 - 00:16:58:14 If we can shorten the lens, 00:16:58:14 - 00:17:01:14 the length of treatment, we can really control 00:17:01:17 - 00:17:05:19 the overall financial burden of cancer care in this country. 00:17:06:00 - 00:17:09:00 And if we show that it's effective and it's the same, 00:17:09:03 - 00:17:12:06 then we also limit that disparity in access. 00:17:12:07 - 00:17:17:01 No one's thinking about should I quit my job, be unemployed 00:17:17:01 - 00:17:20:20 versus work while ill, and coming late to work 00:17:20:23 - 00:17:23:20 because I'm trying to get a radiation treatment. 00:17:23:20 - 00:17:26:22 And I literally had a patient about a month ago 00:17:26:22 - 00:17:31:11 dealing with this exact same question where she blatantly told our team 00:17:31:11 - 00:17:35:15 she had to decide between being fired and not paying 00:17:35:15 - 00:17:39:06 her bills versus trying to get treatment and keeping her job. 00:17:39:13 - 00:17:43:18 And so we often, sometimes as physicians, we may not 00:17:43:18 - 00:17:47:03 we can be shielded from those things, but it's important 00:17:47:03 - 00:17:51:22 that we're pushing the envelope and we're making sure that we can deliver 00:17:51:22 - 00:17:56:02 these treatments safely in a shorter time, it's like chemo. 00:17:56:02 - 00:17:59:15 If we can go from IV to oral pills, we're 00:17:59:15 - 00:18:02:24 also saving time that people are having to come in and sit in the chair. 00:18:03:16 - 00:18:06:22 Likewise for radiation, if we're shortening the length of treatment 00:18:07:04 - 00:18:11:13 and it's just as effective to finish in five days, then why not do that? 00:18:12:08 - 00:18:13:23 And this, you know, this. 00:18:13:23 - 00:18:18:01 While this trial is also ongoing, I'm also working on my own, 00:18:18:22 - 00:18:21:13 investigator initiated trials in my own, 00:18:22:21 - 00:18:24:10 institution, which 00:18:24:10 - 00:18:27:10 is focused on thinking outside the box. 00:18:28:04 - 00:18:31:21 Historically, we have done everything for patients. 00:18:32:04 - 00:18:36:14 Chemo all the way, surgery all the way, radiation all the way. 00:18:36:23 - 00:18:39:10 That's like nine months of someone's life 00:18:39:10 - 00:18:42:16 up to a year just for locally advanced treatment. 00:18:43:00 - 00:18:46:03 Now we have drugs like immunotherapy 00:18:46:20 - 00:18:51:07 targeted agents for HER-2 positive breast cancer that are so effective 00:18:51:07 - 00:18:54:19 that by the time they get to surgery, the cancer is all gone. 00:18:55:10 - 00:18:58:12 So now the big question is do we need surgery? 00:18:58:22 - 00:19:04:09 Are there people we can actually say, you've had all the systemic treatment. 00:19:04:12 - 00:19:07:12 We can just stop and continue monitoring you. 00:19:07:15 - 00:19:08:15 Or are there patients 00:19:08:15 - 00:19:12:08 we can say, you know, instead of surgery, let's just do radiation. 00:19:12:16 - 00:19:15:22 And that's really, really, truly pushing the envelope 00:19:15:22 - 00:19:20:01 of de-escalating therapies, which is so important 00:19:20:01 - 00:19:23:17 because the more you add on, if it's unnecessary, 00:19:24:02 - 00:19:27:18 it's adding on toxicities that the patients are living with. 00:19:28:00 - 00:19:33:13 So if we can safely de-escalate therapies for those who have a dramatic, 00:19:33:13 - 00:19:36:19 complete response to chemo immunotherapy 00:19:36:19 - 00:19:40:09 or targeted treatment, that's the future of radiation. 00:19:40:09 - 00:19:42:01 That's the future of surgery. 00:19:42:01 - 00:19:44:14 Selecting the appropriate patients 00:19:44:14 - 00:19:47:14 for the least amount of treatment intensification, 00:19:48:03 - 00:19:51:18 and using biomarkers to decide who would fit this 00:19:52:00 - 00:19:55:06 and would be comfortable saying, no, I don't want to do this. 00:19:55:06 - 00:19:57:24 I don't want to do this because I don't have to do it. 00:19:57:24 - 00:20:02:07 And so that's the investigator initiated trial that I'm focused on here 00:20:02:07 - 00:20:06:13 within my institution, outside my institution. 00:20:06:13 - 00:20:11:14 And as I mentioned earlier, I do have a passion for very much 00:20:11:22 - 00:20:14:22 marginalized populations that we don't think of. 00:20:15:01 - 00:20:16:22 Homeless people get cancer. 00:20:16:22 - 00:20:21:09 People, they're incarcerated get cancer, and they don't get the same cancer care. 00:20:22:07 - 00:20:24:13 That we all do in the community. 00:20:24:13 - 00:20:27:18 And most incarcerated people actually will be released. 00:20:28:20 - 00:20:32:14 And so and our Constitution actually protects them 00:20:32:14 - 00:20:36:22 as a, as, as, as citizens that we have to provide 00:20:37:05 - 00:20:41:00 the appropriate minimum standard of care to them, not even you and I. 00:20:41:08 - 00:20:44:21 And we're not meeting that in the most vulnerable, 00:20:44:22 - 00:20:47:22 neglected, population of our society. 00:20:47:23 - 00:20:51:13 And so I've, you know, worked with, Yale 00:20:51:13 - 00:20:56:03 for many years now on several RO-1 funded, studies, 00:20:56:23 - 00:21:01:02 looking at how to optimize and improve care in this population. 00:21:01:21 - 00:21:06:12 And I'm, you know, I submitted a grant recently that was, well, scored. 00:21:06:12 - 00:21:09:19 And we're waiting for funding decisions which will get us.... 00:21:10:21 - 00:21:14:13 Which will let us, you know, introduce screening 00:21:14:13 - 00:21:18:10 interventions early, in incarcerated settings. 00:21:19:06 - 00:21:23:18 For the, for the cancer type that's actually causing the most deaths, 00:21:23:18 - 00:21:26:18 which would be colorectal cancer in that population. 00:21:27:02 - 00:21:30:17 So screen cancers, things that we can actually address 00:21:31:00 - 00:21:35:10 by screening and early intervention, we're trying to do something about it. 00:21:35:17 - 00:21:39:11 So not just writing about it, which we've done with all the papers 00:21:39:11 - 00:21:43:15 that have been published, but now actually designing an intervention 00:21:43:24 - 00:21:47:12 which is essentially more or less like a traveling intervention 00:21:47:20 - 00:21:51:07 in an incarcerated setting to increase 00:21:51:07 - 00:21:55:21 uptake of screening, through educating them about the options. 00:21:55:21 - 00:21:58:03 Because if they don't know, they don't ask. 00:21:58:03 - 00:22:00:11 And if they're not asking, they're not offered. 00:22:00:11 - 00:22:04:02 So we can educate them to empower them to know what, 00:22:04:23 - 00:22:09:05 what they can have access to so that when they are actually released 00:22:09:05 - 00:22:12:05 from prison, we're not seeing high deaths, 00:22:12:10 - 00:22:16:12 you know, high cancer rates, high, you know, most of people, 00:22:16:12 - 00:22:17:23 most of the people that are released 00:22:17:23 - 00:22:21:15 from prison with cancer, they are actually diagnosed at stage four. 00:22:22:02 - 00:22:25:10 So it means they've been sitting in prison with this all along. 00:22:25:20 - 00:22:28:08 And then when they release into the community, 00:22:28:08 - 00:22:32:01 they're being released, you know, without that fighting chance essentially. 00:22:32:16 - 00:22:35:10 And it's right, you know, this and this is why 00:22:35:10 - 00:22:39:16 I, from day one when you're in the program, actually, 00:22:39:16 - 00:22:44:05 I was really excited about your work and where you have where you've gone. 00:22:44:05 - 00:22:45:10 It's been impressive. 00:22:45:10 - 00:22:47:16 I have one last question for you. 00:22:47:16 - 00:22:50:01 If you actually had to say one thing, 00:22:51:08 - 00:22:54:08 you being participating in the Winn CDA program, 00:22:54:13 - 00:22:56:20 that was a positive impact on you. 00:22:56:20 - 00:22:59:20 What would the one thing be? 00:23:02:17 - 00:23:03:16 I know it's hard. 00:23:03:16 - 00:23:05:20 I know. 00:23:05:20 - 00:23:07:15 It is hard. 00:23:07:15 - 00:23:10:03 But I would say it's been the people, 00:23:10:03 - 00:23:13:13 that I've had the chance to work with in my cohort. 00:23:14:08 - 00:23:17:02 I've learned a lot from them, 00:23:17:02 - 00:23:20:12 their journeys, their experience and their, institutions. 00:23:20:19 - 00:23:23:01 How they've navigated being 00:23:23:01 - 00:23:26:10 early career investigators, how they think through studies. 00:23:26:15 - 00:23:31:04 The program, it gives you the opportunity to criticize and critique 00:23:31:04 - 00:23:35:14 and give feedback to each other's projects in the CDA aspect. 00:23:35:20 - 00:23:39:10 In the CILA aspect, it also gives you an opportunity 00:23:39:10 - 00:23:42:10 to be trained to think like a leader. 00:23:42:19 - 00:23:45:22 So we have coaches, leadership coaching, 00:23:46:03 - 00:23:51:00 and you're sitting in groups where you have to run through...run 00:23:51:00 - 00:23:54:16 through examples and scenarios and really criticize 00:23:54:16 - 00:23:57:19 your weaknesses and how to improve and, and turn them into strengths. 00:23:58:00 - 00:24:01:07 So it's been the experience with the people in my cohort 00:24:01:12 - 00:24:03:22 that has has been the greatest, 00:24:05:02 - 00:24:07:00 impact for me. 00:24:07:00 - 00:24:09:10 And it, it it can't you can't do 00:24:09:10 - 00:24:12:10 there's no price tag on that because there's no, 00:24:12:19 - 00:24:16:00 no other opportunity that would bring a group of people 00:24:16:00 - 00:24:20:00 from different institutions with the same overarching goal, 00:24:20:00 - 00:24:24:11 but walking in different paths to sit in a room and discuss your ideas, 00:24:24:11 - 00:24:29:06 refine your ideas, take it back to where you're coming from and implement it. 00:24:29:11 - 00:24:32:10 And then also in the CILA program where health, 00:24:32:10 - 00:24:35:23 we are holding each other accountable because we're still meeting in groups, 00:24:36:01 - 00:24:40:07 talking about our progress, talking about our challenges and how to address them. 00:24:41:07 - 00:24:42:04 You know what? 00:24:42:04 - 00:24:45:14 If I can come through the screen and hug you, I would, but Dr. 00:24:45:14 - 00:24:48:13 Oladeru, I want to just say thank you for your work. 00:24:50:03 - 00:24:52:18 Thank you for agreeing to do the podcast. 00:24:52:18 - 00:24:54:22 But most importantly, thank you for your commitment 00:24:54:22 - 00:24:57:22 to making sure that the science is benefiting people. 00:24:58:07 - 00:25:02:09 Of all the things, that is the most meaningful for me 00:25:02:15 - 00:25:06:04 is that you are on that path and not talking about the path, 00:25:06:04 - 00:25:07:17 but you're living it and doing it. 00:25:07:17 - 00:25:10:06 So listen, I appreciate you. 00:25:10:06 - 00:25:13:06 You have a good rest of your day. 00:25:13:09 - 00:25:14:14 Thank you. 00:25:14:14 - 00:25:19:21 And, I'll just sort of say that we'll look forward to talking to you in the future. 00:25:20:05 - 00:25:23:00 Okay. Thank you very much. Thank you all. 00:25:23:00 - 00:25:24:16 Thank you. 00:25:24:16 - 00:25:26:17 That's the end of this podcast for real talk. 00:25:26:17 - 00:25:30:18 And, stay tuned, for all the things to come.