Smarter Than Cancer

David: OK, Hajar, for today's episode. I really want to introduce you to a new friend of mine.
Hajar: Ooh, sounds fun.
David: His name is EDDY, and he's really cool.
Hajar: Okay, tell me about him.
David: Well, he's… big. He's like, really big.
Hajar: Oh my God, David. Now, is that a nice thing to say?
David: Well, yeah, I mean, no, he… he's big, but he… he gets around really well. And he's really good at his job.
This is Smarter Than Cancer, by the way. And I'm David Hoffman. Hajar: And I'm Hajar Eldaas. So you interviewed Eddie?
David: No, he can't talk.
Hajar: Eddie can't Talk.
David: You see, EDDY is a truck.
Hajar: Okay, a truck.
David: He's a really nice truck though, and he does a lot of good in his community.
Hajar: I see.
David: So you want to meet him?
Hajar: Sure – let's meet your friend, the truck. (Opening Music)
(In the field)
David: So I was… I was picturing like, oh, I don't know, like a bookmobile. And this is like a semi truck. This is a huge… it's a huge operation.
Medina: It's massive. You need a semi truck to tow it outta here.
So, we're not too chilly, but…
(Door opens and closes)
David: So we just stepped into this giant blue, like, I don't even know what the right word is… like, truck container?
Medina: Trailer…
David: Trailer, yeah.
Medina: …if you wanna call it that
David: Yeah, like back end of a semi truck. It's huge. And I'm standing in here and there's… that's a full-on CT machine?
Medina: Yes, it is. State of the art, installed in ‘22 and manufactured in 2022. So it's very high-end.
David: That's Luke Medina. He's a patient navigator in the Community Outreach Department here at Roswell Park, and he's part of the team that travels in this giant mobile radiology lab, which everyone calls EDDY — E.D.D.Y — short for Early Detection Driven to You. He was kind enough to give me a tour.
David: You walk in the door, you walk up the side, and then you walk into sort of an office with a bunch of computer stations.
Medina: Right?
David: And I guess this is where you and your colleagues work and get people welcomed in and…
Medina: Yes. So this is like the control center. This is where the tech operates the machine and gets the images ready. And these other workstations are for our PAs and our nurses.
David: And to the left is that room with the CT scanner, and… amazing, really. It just looks like something out of the most high-tech hospital you've ever been in. And then these walls, these amazing, um… It's, sort of, murals. It looks like a…
Medina: Brightens up the vibe a little bit.
David: … looks like the coast of, oh, I don't know, California or something. Doesn't look like Buffalo.
Medina: Not at all.
David: This is nice!
Medina: (Laughs)
McNulty: It's a 53 foot trailer. It's very large.
David: That's Alyssa McNulty, Director of Community Outreach and Engagement.
McNulty: We've been to 52 different unique locations with that mobile trailer, which is wonderful because there's a lot of places in New York, especially Western New York, where folks have to travel at least an hour to get to their nearest CT scanner. So we're able to bring low-dose CT scans to people outside of their front doors.
David: So why is this so important?
McNulty: It's important because a lot of people in our area just don't have access to these screening tests. They don't have
transportation. Maybe they're scared. And you know, Roswell always says, “spend one day with us”, and with these mobile units, we're able to go spend a day with you, in your community. So we're bringing it to places that people are comfortable, where we feel more approachable. You don't have to walk into a hospital. So there's just so many benefits to taking it out of the main hospital.
The goal of screening is to find cancer early, when it's more treatable. And when we're able to do that, the treatment is much more successful
David: This EDDY, the EDDY I met, uses his low-dose CT scanner specifically to screen for lung cancer. This is a relatively new idea. It became recommended by the CDC less than 15 years ago, and many people still don't know it's an option. There are a lot of people who are eligible for this screening, and who might have their lives saved by catching lung cancer early, but who just don't know to get it done.
McNulty: Lung cancer screening is very different from breast cancer screening, colorectal cancer screening. You hear about breast cancer for the whole month of October, we turn the month pink. Colorectal cancer, you see commercials for Cologuard. But lung cancer screening’s different
David: It's also different because there's a certain stigma attached to lung cancer that doesn't come with other cancers. Because it's so closely tied in the popular consciousness to smoking, some people tend to be less sympathetic to hearing about this diagnosis. There's this terrible idea that when people get it, it's kind of their own fault; they should have made better choices.
McNulty: People blame themselves. And so I want to do a lot of work to take the stigma out of it and remind people that even if you're still smoking, you don't have to quit, but you could still come get screened. We're happy to help you quit if you want to quit, but you should still come get screened, and not worry about blaming yourself if you do have a finding.
Lung cancer is the number one cancer killer in our area. So just because you think less people are smoking, people are still dying from lung cancer, and EDDY and other lung cancer screening programs can do a lot of work to make that difference and take that mortality rate down by finding cancers early when they're more treatable.
David: And that speaks to the fact that it's not just a disease of smokers, yeah?
McNulty: Yeah, absolutely. Lung cancer is still a problem regardless of smoking. And again, like I said, nobody who smokes should blame themselves for the cancer. No one deserves to have lung cancer. This program is available to you. Screening is available to you. Everyone deserves to get screened and find something early so that it's more treatable.
David: And you said You travel kind of far with these? All over Western New York and…
McNulty: Yeah, we've all over Western New York. We've actually been as far as Binghamton, New York, which is about a three hour drive from Buffalo.
David: Wow!
McNulty: We've parked in primary care offices; we've found a few physicians in our western New York area who are really champions for lung cancer screening.
And we've been invited by Senators and different Congresspeople to park at their offices and screen people from their districts. We've also parked at churches; we do a lot of faith-based outreach. We've also parked at just grassroots community-based organizations.
I participate in a lot of health coalitions across the area, for health equity and things like that. And so people from those groups will call me and say, “hey, I have this…”, you know, “…turkey giveaway…”, for example, “…happening in my community.
Do you wanna park the unit while people are coming through to get their turkeys? They could also talk to you about lung cancer screening.” So there's a lot of different ways that we engage with the community.
Roswell Park has an existing partnership with our first responders in the area. A lot of it stemmed from cancer diagnoses and findings after the 9-11 attacks in New York City, You know, a lot of first responders from Western New York were called down to New York City, and then were having follow up care and having cancer findings. So Roswell Park did a lot of work to develop a kind of a first responder screening program. So when we launched EDDY Lung, we saw an opportunity to work with our firefighters in the Buffalo Fire Department.
The standard in fire departments is an annual chest x-ray to look for anything that might be going on, but a low-dose CT scan is much better in terms of what we can see and treat from. And so we were able to work with our Mayor, so our local government, and the Buffalo Fire Department to make plans for baseline scans for all of the Fire Department, which is really a new thing, countrywide, nationwide. So we scanned about 750 firefighters
Overall, we've scanned almost 3000 people from 120 different zip codes.
David: Wow.
McNulty: Yes. Thousands of people.
David: That's amazing.
Medina: It’s great. It's really good that doctors are getting to people with that history of smoking and, you know, letting them know that it's an important thing to do, to get scanned for lung cancer.
Back in the day, it wasn't really like that. Now it's kind of… it's taught that it's something you do. You know, like, as you get older with age, you have your, you know, regular screenings,
like colonoscopy, prostate exam, mammogram, and this is kind of being included as something that has to kind of be a box that's checked.
David: If I were coming in now for a screening, what would happen? What would be the steps? What would I do?
Medina: Well, you don't have to do too much. It's pretty straightforward. If we had already identified you and gotten your, you know, history and age and everything like that, you just walk up through the door, you come talk to our physician's assistant — takes about, like, three minutes — and then they fire up the scanner and get it ready to go. You know, you lay down, and it takes about a minute for you to go through over here. You don't have to go through too much at all, so…
David: Wow. Oh, that's so funny. 'cause I know a lot of people do get, like, CAT scans and MRIs confused, where it like takes 20 minutes and you have to listen to it, you know, in a tube. This is a very quick.
Medina: Yes.
David: Easy thing to do.
Medina: Very quick.
David: Yeah.
Medina: Very quick. Don't have to plan your day around it or anything like that. So…
David: And then as a navigator, are you the person who's following up with someone when you get the results, and maybe helping them work through what next steps might be?
Medina: Yeah, well, we kind of help them understand what their care plan may be. We kind of like try to make things more clearer, cut down jargon, put it into, like, simple terms what's going on, and, um. Okay, if they may need, like, some additional
support, the main role is to make that line of communication more clear between the patient and the doctor and also make sure that their access to care is as streamlined as possible.
David: Here's Nikia Clark Robinson, who also serves as director of Community Outreach and Engagement here at Roswell Park.
Clark-Robinson: You know, I think everybody, at a baseline level, they know certain things that they need to do to be healthier. They know of cancer. But sometimes, just to get a person in to get screened or, kind of, move them to action, either being a healthier behavioral lifestyle to lower cancer risk, or to get screened, they need some help. They need some resources. Navigating the medical system is challenging; it is not easy. Sometimes we know that… things that we should do for ourselves, we put to last. You know, it's hard to think about changing some health behavior habits, you know, even getting screened.
People still have fear, you know? “What if that screening comes back positive for cancer? What do I do then? What's next? I really can't take that on with where my life is at right now. So I'd…”
David: Like if it wouldn't be there if you didn't know about it,
Clark-Robinson: Right? Like if I don't talk about it, if I don't… I don't have to deal with it. It's not really there.So it's working through all of that and always making healthcare accessible and easy.
We find that people really get stuck with knowing what the next step is. And you just need a gentle… A push, sometimes a reminder, or somebody just to hold your hand through the whole process. And that's what we provide.
You know, people, for no fault of their own, may not seek it out for themselves. It's scary and it's hard. So we're there to help.
David: And now, as of just before the recording of this episode, the EDDY I met is just one of two EDDYs that are going to be crisscrossing the area. The second one's screening for different kinds of cancer.
Clark-Robinson: The second Eddie, which we had a ribbon-cutting for, is for breast cancer screening and prostate cancer screening. It serves both. It's a dual kind of cancer screening mobile unit.
McNulty: So the way that we built the breast and prostate unit was in the vision of, like, a husband and wife being able to show up to get screened together. So when you walk on that unit, to the right is our prostate suite, and to the left is our breast cancer screening suite. The prostate test is just a quick blood test for PSA, and then the mammogram is what we use for breast cancer screening.
Outreach with those two groups is just this extra layer of support that I think is gonna make the program even more successful. And I think — I hope — that the higher acceptance of breast cancer screening… as I said before, you know, it's a… I don't wanna say it's easy, but it's a more accepted type of cancer screening than lung cancer screening. I hope that now with EDDY 2, people will see us out for breast and prostate screening, but also say, “oh, there's that other one for lung.” And so I hope that kind of synergy between the two is going to just help both programs grow.
Clark-Robinson: I want to see that everybody that is eligible to be screened, screened. So when we look at the Western New York, you're… and even like starting in Erie County, those screening rates, and look at the data of the people that have been screened, it just, you know, blows our socks off. We see, you know, something that we wouldn't even have expected.
I want EDDY to be a household name, you know? And when people think about EDDY, they think about easy access, not challenging, the process was actually enjoyable.
McNulty: I do this work because I think everyone deserves healthcare that is as convenient as possible for them. There's so much of our healthcare system that's really, really difficult to navigate. And since I've been at Roswell Park, I have done patient navigation to try to break down barriers in the healthcare system. And when you combine that with cancer screening — which is something relatively simple that can save a person's life, just by talking to them about it, maybe they don't know about it — I just think it's something so impactful that I can do with my time as a professional.
(Closing Credits)

Hajar: You know, David, when we first started working on this series, I knew pretty quickly that I wanted to devote at least one episode to young adult cancer.
David: Totally. It’s something we both really wanted to get into.
Hajar: Yeah, and honestly, for me, it was kind of for selfish reasons. I fall into that young adult age range when we’re talking about cancer, which, by the way, is 15 to 39, a huge range. But I just kept hearing about more and more people being diagnosed with things like breast cancer or colon cancer at ages that felt really young to me.
David: Yeah, and doctors don’t totally know why that’s happening yet, right?
Hajar: Yeah. There’s a lot of research going on, and we do know some things. We’re actually going to dig more into the science behind young adult cancer in another episode.

By the way, this is Smarter Than Cancer, and I’m Hajar Eldaas.
David: And I’m David Hoffman.
Hajar: But David, for this episode, we’re really interested in what it actually feels like to be diagnosed at this point in your life. What makes going through cancer in your teens or your twenties or thirties even different from being diagnosed later on?
And so to find out more, I spoke with Cameron Colon, who’s a nurse here at Roswell Park and who was also diagnosed as a young adult herself. And David, you talked with Dr. Denise Rokitka, who directs the Young Adult and Oncofertility program here.
David: Yeah and talking to her, I really got a sense that it’s not just the illness, it’s the timing and how everything in your life seems to be all colliding at once.
Hajar: Right? And between the two of them, I think we started to understand how a diagnosis at this stage can really shift your plans in a way that’s different than a diagnosis in older age. At this early stage in life, you have your career ahead of you, fertility planning, relationships, you know, all these big life things that are still kind of all in motion.
Um…so why don’t we just get into this episode then?
David: Let’s do it.
[Theme Music]
Hajar (Narrator): Here’s Cameron, a registered nurse here at Roswell Park.
Cameron: I’m 27. I was diagnosed when I was 26. I went to my annual GYN appointment, and they did a breast exam. And she said, you have a pretty large mass on your left breast. Have you noticed that? And I was like, no. So two days later, I got an ultrasound. Two days after that, I got a biopsy, and then the following Monday, I was diagnosed with breast cancer.
Hajar: Wow. And you weren’t feeling any, like, symptoms or anything like that?
Cameron: Thinking back at it…so I was diagnosed at the end of April, and in January, when I went to my primary doctor, I was like, you know, I’ve been really tired. My acne has been really bad. I said, as silly as it sounds, I saw a TikTok that said, if you have high cortisol, these can be your symptoms. And I was like, I’m checking off a lot of the boxes, could I get my hormone levels checked? And she said, pretty hard to check hormone levels in women because of our menstrual cycles. So she checked my thyroid panel. That all checked out, and then a few months later, they felt the mass.
I probably should have pushed more when I met with my doctor in January. She tried, but they were such general symptoms that I didn’t push for more because I was like, it’s winter. Maybe I’m just fatigued from that. But looking back, like, I was sleeping 12-plus hours a day. I’d wake up, feed the dogs, go back to sleep, wake up, eat lunch, go back to sleep. Like, I couldn’t function. That should have been more of a red flag for me.
Hajar: You’re so young that that’s probably not a diagnosis you were expecting.
Cameron: I was devastated at first. I got the phone call. I cried in my sister’s arms. I went and told my fiancé, my now fiancé, cried in his arms, went to a couple appointments. And after getting my PET scan results, the doctor told me that it was stage four because it had metastasized to my sternum, and I cried more. And she said, but I think you are, you’re young, you’re healthy. I think you’re gonna respond really well to treatment, so we’re gonna treat you like you’re stage two and we’re gonna aim for curative intent.
And after that, it kind of all mellowed out, and I’ve been using humor a lot to cope and sharing my story. I’ve been very open about everything. There’s hard days, of course. There are days when it’s hard. My fiancé and I have been together for, um, seven years now, and we got engaged in November. Being diagnosed with cancer put a hold on getting engaged cause he wanted to propose, and then I got diagnosed. And he said, do you want, do you care if you, like, have your hair when we get engaged? Like, it just put a hold on everything. I said, let’s wait until I’m through treatment.
Rokitka: Colon cancer in particular is increasing. Breast cancer is increasing. Some of it is detection, right? So our techniques to detect breast cancer, mammograms, are better. So some of it’s that. Some of it is probably our diet, probably environmental factors that we don’t totally know. I don’t think we entirely know.
Hajar (Narrator): By the time a patient gets to Dr. Denise Rokitka, they’ve already been diagnosed and have already set their treatment plan. So when they see her, it’s really more about how they’re doing emotionally and psychologically, and figuring out what kind of support they need to manage.
David: I mean, a cancer diagnosis is always a sensitive thing. How do you approach someone, you know, who’s 30 in a different way than you would someone who’s 75?
Rokitka: Yeah. I do have a quality-of-life grant for a young adult psychologist who helps patients.
David: Oh, amazing!
Rokitka: Um, so we talk about emotions, but we also talk about career planning. You know, do you need help with any FMLA paperwork? Do you need help with talking to a school? Our psychologist will sometimes do that, talk to the college, make them understand. Cause some colleges are great and some are not.

So we talk a lot about that sort of stuff. Um, physical, you know, are you having any pain? Are there any physical symptoms we can help with? We have an acupuncturist here and an integrative medicine service.
Hajar (Narrator): The National Cancer Institute defines young adult cancer as a cancer diagnosed between the ages of 15 and 39, which is a huge age range. People in those years are at vastly different stages of their life. But as a whole, it’s a time marked by instability and major life transitions.
Rokitka: So we find that the young adults struggle somewhat in things like financial toxicity, family planning, you know, some patients are transitioning from college to careers and trying to manage working, paying their bills, life. But also sometimes the cancer diagnosis really puts a pause on all of those things and can make it really difficult.
And then emotionally, young adults really struggle with many of the things that probably everyone struggles with, but maybe in a different way, right? So things like, “Why me? Why now?” It’s rare, right? So only 90,000 patients in the young adult years are diagnosed each year. That number is increasing over the last decade. So it’s not a huge number, we know that there are millions diagnosed with cancer over 40. And so that’s tricky in terms of community and support.
David: It feels like the unseen group, right? Cause we think of grandpa getting cancer.
Rokitka: Yeah.
David: And we don’t think of someone who’s 25, 30, 35 getting it. So it must be a shock. People aren’t expecting this, right?
Rokitka: Right. No, young adults don’t expect that diagnosis. They often have delayed diagnosis for various reasons. Sometimes it’s access to care, insurance issues. But also it’s, “I’m young and I’m healthy and this can’t be that. It can’t be something serious. It can’t be cancer.”
In terms of delayed diagnosis, we know it’s important to keep pushing. If your primary doctor is brushing your symptoms off and you don’t feel right, keep pushing because maybe something really is wrong.
David: Talk about that a little more, about the difficulty of getting a diagnosis.
Rokitka: Yeah. Particularly in the twenties, probably less so in our thirties, but, um, patients often don’t have primary care doctors, so they tend to seek providers through urgent care or emergency rooms, so they don’t have consistency of one person seeing them for those symptoms.
But we also know that providers themselves, because cancer is rare in our twenties and thirties, they sometimes are like, okay, well, that’s probably just a cold, or that’s just stress, you know? Um, we don’t need to do blood work at this time. So things like that where there’s just a little bit of a pushback, I think, particularly in this age group.
David: In fairness, it probably is a cold, right? Like, in most, in the vast majority—
Rokitka: In most of the times, yeah. Nine times out of 10, it’s gonna be just a cold. Like, yeah, for sure.
David: Are there medical differences in terms of treating a younger person versus an older person?
Rokitka: I think there’s definite considerations in terms of planning for cancer treatment and therapy, right? So if you know that a person is young and still has goals to have children, is there ways to protect the ovaries, protect the uterus? Is there chemo that maybe works as well but doesn’t have some of the other long-term side effects that are important to also think about moving forward with a young adult that may be different from somebody in their fifties or sixties?
David: Well, that’s interesting. Yeah. If something might have an effect—
Rokitka: Different.
David: —20 years from now.
Rokitka: Right.
David: If you’re 80, that’s not such a concern.
Rokitka: Right.
David: But if you’re 30, that’s a big concern.
Hajar (Narrator): Family planning becomes a huge concern for young people going through cancer treatment because treatment can affect fertility. And often, it’s the first time a patient has to confront the question of whether they want children at all.
David: Describe that procedure. What does fertility preservation look like? Does it work?
Rokitka: Yeah. So for females, they usually need hormonal injections for a period of time, 10 to 14 days typically, to stimulate the ovaries to make as many eggs as possible. And then with an ultrasound, the infertility doctor will retrieve the eggs from both ovaries.So that takes about two weeks. And so that’s another tricky timing-wise. Some patients don’t have time, particularly our leukemia and lymphoma patients don’t always have time to go through that before needing to start treatment.
For men, it’s just sperm cryopreservation. So just a sperm sample that’s frozen. Yeah, but insurance doesn’t cover it. So I do have a quality-of-life grant to help offset that cost based on financial need. Financial need shouldn’t preclude you from having a family later in life.
David: Yeah, you know, you’ve just gotten this news. You’re worried, like, is my life over? Am I gonna be able to work again? Am I gonna be able to take care of myself? Do I need to…? And then, okay, let’s talk about children that you don’t yet have but might someday. That’s a funny—
Rokitka: Yeah. No, it’s definitely tricky, right? Um, some patients are gung-ho. I’m gonna be great. I’m gonna get through this, and I’m gonna have kids. And some are like, you know what? I just need to start treatment. I can’t think about that right now.
But we know from research that if you don’t at least have that conversation, patients can be very angry.
David: Oh, right!
Rokitka: —about not having the conversation, at least not understanding what their risks are upfront.
David: Yeah. Well, being sterilized is a big deal.
Rokitka: Right. And not knowing until you’re done with treatment and then you’re starting to try to have a family and not knowing until that point is not emotionally okay.
Cameron: My surgeon, Dr. Young, she discussed egg harvesting with me initially because of the effects of chemo on your ovaries and your uterus and everything. It’s a backup plan for now. We will see when the time comes to having children if I can have my own. But she said, you’re young, I think it’s all gonna go smoothly, and you will be able to have your own children. We should harvest eggs just in case.
So I, since my sister was born, she’s three years younger than me, I have known I wanted to be a mom. So that was the hardest part to cope with, that it’s gonna look a little different. I just got engaged in November, and after getting married I was like, oh, just whenever. Like, if we have a kid, we have a kid. And I was excited to be a mom. But now there’s gonna be a lot more planning because I’m on meds that suppress my hormones, so I have to plan when I want to get off of them so that I can have a baby. And then I have to go back on these meds after.
And I had a bilateral mastectomy, so I won’t be able to breastfeed. So the future’s gonna look a lot different than I had always imagined. It took me a long time to cope with all of this in the aspect of becoming a mother.
Hajar: I’m thinking about how lonely you maybe felt. You know, you’re going through this thing at this age where no one, none of your friends, are probably going through it.
Cameron: When I met with my care coordinator, they gave me a card for their young adults with breast cancer group, and she said, yeah, we have a lot of people, like, early thirties. And I was like, okay, but how about mid-twenties? And I went to one group, and I just didn’t feel like I fit in cause I’m, like, they all had kids already and everything, and I was like, I’m at a completely different stage in my life.
David: It just, it’s so much more serious than anything a kid or someone in their twenties usually—
Rokitka: Has to deal with.
David: —has to deal with. Like, I can see that creating social things, cause, like, your friend is like, oh, my boss was really mean to me today.
Rokitka: Mm-hmm.
David: And you’re like, yeah, okay. I might die. It’s a different—
Rokitka: It’s a whole different, yeah, whole different perspective.
David: Yeah.
Rokitka: And some of our survivors will say things like, if, particularly if they know that they’re infertile or their fertility may have been affected, it may take more to get pregnant in the future. How do you share that information? You don’t share it on a first date.
David: Totally. That’s a good question. Yeah.
Rokitka: You know, like, when do you share that information? How do you go about that conversation?
David: Let’s talk about that for a second. Whose business is this? You’re 30 years old. You got a cancer diagnosis. Do you need to tell your coworkers? Do you need to tell your boss? Do you need to tell everyone in your family? What do you think about that?
Rokitka: Some people choose not to, depending on the diagnosis, right? You lose your hair, you look unwell, you may have to say something. But some of these young adult cancer patients don’t… They have a surgery or they go on oral medicine that helps them, but they don’t look any different. But they may have side effects from those medications. They may not feel well every day. They may have fatigue. They may still have nausea.
Yeah, and I think it’s hard. I don’t know how you decide who to tell what, but relationships in particular I think are very tricky.
David: Is this a third-date conversation?
Rokitka: Right? Is it a, I really like you? Maybe we should have this conversation a couple months in. I don’t know. I don’t know. You know, I obviously don’t have a personal perspective on it. I just imagine how difficult that conversation could be.
David: We talk a lot about being cured or being cancer-free, being in remission. What do those things really mean? What does it really mean to be cured of cancer?
Rokitka: Yeah. I think that’s a tricky and sometimes triggering term for people. Um, you know, the NCI defines survivorship as the day you’re diagnosed. But I can tell you a lot of patients don’t feel that way. And, you know, we struggle obviously with those terms too as providers. I usually say remission at least until we’re 10 years from therapy. But that also doesn’t always mean that it’s never gonna come back, or there are other side effects or things that you still have to worry about. So it’s definitely, like, a tricky thing to think about and to define.
Hajar (Narrator): When you’re diagnosed with cancer as a young adult and become cancer-free, you also have a much longer runway in survivorship. And with that comes a longer period of anxiety and a longer list of things to monitor. It can mean spending much of your life tracking your health in ways most people your age never think about. And the truth is, cancer treatment can have long-lasting effects.
Rokitka: It’s therapy dependent. Some therapies have more toxicities long term than others, right? So we know that, like, anthracyclines, for instance, can cause cardiac toxicity later in life. So those patients need more frequent echos and EKGs to monitor their heart.
David: Is that a chemo drug?
Rokitka: Yeah.
David: Uh-huh.
Rokitka: Yeah. In survivorship, we really direct kind of their follow-up care based on what they received, if they had radiation, surgery to whatever part of the body, and really guide our screening recommendations to those specific factors.
We see thyroid cancer as a long-term side effect of breast cancer, so some of our patients start mammograms much earlier than anybody else. That sort of thing.
David: So a second cancer developing after you fought back the first one?
Rokitka: Yeah. So typically, if you look at morbidity and mortality charts, the first thing that’s gonna cause morbidity and mortality is recurrence of their original cancer. That sort of fades away at the 10-year mark, and then we see an increase in pulmonary and cardiac and secondary malignancies as patients age.
David: Do people who have had cancer ever get to the point where they really feel like they don’t have to think about it anymore?
Rokitka: Probably not. I mean, there’s an ease over time, right? We know that patients, when they first finish therapy, the anxiety actually spikes for that first six months to a year. Most cancers are gonna come back within the first couple of years. So there’s some pause and relief the further you get from it, but I don’t know that it ever goes away. I think it changes you.
Hajar: Can I ask, um, where you are on your journey now?
Cameron: I am done with treatment. I completed radiation in January. I rang the bell after the radiation. I get a PET scan in the beginning of July, so we’ll see from there.
Hajar: That’s amazing. Congratulations!
How would you say that the cancer journey changed you?
Cameron: I think maybe a little for me because it’s scary getting diagnosed with stage four cancer, and I kind of opened up more. Like, I was very reserved. I was, I have two dogs, so I’m like, oh, I can’t go out. I have to stay home with the dogs. But now I am much more apt to say yes to plans and making each day count.
When I was in 10th grade, my Uncle Jeff passed away from brain cancer, and his motto was make each day count. And I wanted to adapt that into my own life, but I never really did. I was young, so there wasn’t much to make count. But definitely, like, take every opportunity, make each day count, build good, strong relationships. It has made me put more work into relationships.
[Credits Music]
Thanks for listening to Smarter Than Cancer, a production of Roswell Park Comprehensive Cancer Center.
The show is written and produced by your hosts, Hajar Eldaas and David Hoffman.
Production Oversight by Peter Soscia.
Additional logistics and support from Michelle Eisenstein.
Our production partner for the series is CitizenRacecar.
Post-production by Gregory Schweitzer for DCP Entertainment.
Publication and Promotion supervised by Candice Chantalou.
If you or your loved one has been diagnosed with cancer and would like to schedule an appointment with Roswell Park, please call 1-800-ROSWELL. That's 1-800-R-O-S-W-E-L-L, or visit us at roswellpark.org.
If you're enjoying this series, we would love to hear from you. Please reach out and tell us about your cancer story and let us know what topics you'd like us to cover in future episodes by filling out the form at roswellpark.org/smarterthancancer.
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