Episode 187: The James Team of Certified Child Life Specialists, with Sami Rundo
Cancer impacts the entire family of a patient, including the children. To help parents help their children through these difficult time periods, the James has created a team of certified child life specialists (CCLS).
“We help parents navigate these situations and conversations,” said Sami Rundo, CCLS. The help comes in many forms, Rundo explained. “It starts with understanding the medical situation [of the patient] … And then we prepare the family to navigate discussions and conversations. What does that conversation look like? And do they want our child life services to have these discussions with their children or provide the resources they can use in these conversations.” Rundo explained how these discussions can trigger emotions and that parents can “embrace the fact there will probably be some tears and the need for breaks and walks.” She also detailed why it can be important to explain the medical procedures that will take place, such as surgery and radiation treatments, and how their parent’s treatment could impact a child’s daily routine. The team has a doll they utilize to visually show children different medical procedures and what a port that delivers chemotherapy looks like.
“We also talk about the ways in which the children can be helpers, caregivers,” Rundo said. “And what’s appropriate for that child. Can I get you a blanket if you’re cold, but maybe not taking care of their other siblings.” The James certified child life specialists can let parents know about cancer-themed children’s book they might want to utilize in their discussion with their children, and “we can create customized books for a family,” Rundo said.
The James certified child life services team is relatively new and growing. “Over time [with a family] we develop trust and an openness of communications,” Rundo said. “I’ve learned so much about families and to see them grow and become stronger during these difficult times is really profound.”
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Episode 186: Advances in Detecting & Treating Pancreatic Cancer, with Dr Krishna
Because there are no symptoms in the early stages of pancreatic cancer “about 75 to 80 percent of patients are diagnosed in the later stages of the disease,” said Somashekar Krishna, MD, a James physician scientist who specializes in the early detection and screening of pancreatic cancer.
Krishna and the team of pancreatic cancer experts at the James are using enhanced screening and artificial intelligence (AI) to better identify pre-cancerous cysts and cancerous tumors in the pancreas; and are the first in the world to use high-tech ablation techniques to attack and kill pancreatic cysts and tumors in a new clinical trial. Most pancreatic cancer tumors begin as pre-cancerous cysts and are most commonly found in people 60 and older. “For people in their 50s there is about a 10-percent prevalence, this doubles in people 60 to 70 to 20 percent and is 25 to 30 percent in people 70 to 80,” Krishna said, adding, “most are small and never grow and become cancerous.”
Endoscopy procedures are used to better “see” these cysts and cancerous tumors, and the use of artificial intelligence is another tool to identify and determine the risk factor of pre-cancerous cysts. “The tip of the endoscopy probe can see even the tiniest structures in a very detailed manner, and we can pass a needle through the scope and do a biopsy and establish the risk,” Krishna said. Surgery is one option, but the procedure is quite invasive and not easily tolerated by older patient with other medical issues. “A new option is ablation, using heat, in a very precise and careful manner,” Krishna said. “We are the only ones doing this in the United States and have done this with nearly 30 patients in a clinical trial.” Krishna is determined to improve screening and treatment for pancreatic cancer and reduce the mortality rate. “Early in my career, 80 percent of patients diagnosed with pancreatic cancer did not make it more than a year,” he said. “We want to change these outcomes to intervene early and with better and better treatment options.”
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Episode 185: Primary Care Physicians, the First Line of Defense Against Cancer, with Dr Matt Farrell
“Primary care physicians are your first line of defense against cancer,” said Matthew Farrell, M.D., an Ohio State Wexner Medical Center primary care physician and a clinical associate professor of family and community medicine.
Prevention, screenings and early detection are crucial and begins with a patient’s family history with cancer and other medical issues. “We are thorough and ask about their first-degree relatives, their parents, siblings and children, and their secondary relatives, such as grandparents and aunts and uncles,” Farrell said. “If I see a pattern, a certain number of relatives with the same cancer, especially at an early age, there could be a genetic factor.”
A patient with an inherited genetic mutation will then be screened at an earlier age and more often. Dr. Farrell also talked about the importance of children receiving the Human Papillomavirus (HPV) vaccine that prevents certain types of cancer. He examines patients to detect skin cancer and melanoma in the early stages. “Skin cancer is the most common form of cancer and it’s personal for me; my mother was diagnosed with melanoma three times … and she’s doing fine.” Breast cancer and prostate cancer are two of the most common forms of cancer. Dr. Farrell discussed when women should begin getting yearly mammograms, and why and when men should begin to undergo regular Prostate-Specific Antigen (PSA) tests. Men and women without a family history of colorectal cancer should get their first colonoscopy at 45. “My brother-in-law was 52 when he had his first colonoscopy,” Dr. Farrell said. “They found a large tumor in his colon; it was removed, and he’s been cancer free for 20 years now.”
Lung cancer screenings are relatively new and recommended for long-time smokers. They are vital because “if you wait until there are symptoms it’s very hard to treat and cure,” Dr. Farrell said, adding “I’m fortunate to be part of the Ohio State system and the James where we have experts and specialists for every type of cancer and medical issue my patients have.”
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Episode 184: Colorectal cancer prevention and early detection
Colorectal cancer can affect anyone, but healthy choices and timely testing can help reduce risk.
Ohio State gastroenterologist Peter Stanich, MD, explains how lifestyle choices like diet and exercise, combined with screening and genetic testing, can help everyone reduce their risk of colorectal cancer.
Learn more about colon cancer, including risks, symptoms and treatment: cancer.osu.edu/coloncancer
Watch The James Cancer-Free World Podcast on YouTube: go.osu.edu/CancerFreeWorldPodcastWatch
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Episode 183: The Global One Health Initiative for Lymphoma, with Dr Robert Baiocchi
The reach of the James Cancer Hospital extends far beyond Central Ohio. As part of Ohio State’s Global One Health Initiative (GOHi), Robert Baiocchi, MD, PhD, is leading the research, vaccination and treatment efforts in Ethiopia for patients with lymphoma. “Lymphoma, a cancer of the white blood cells, is far more common in Sub-Saharan Africa, and afflicts people at a younger age” said Baiocchi, a James medical oncologist who specializes in treating patients with blood cancers. The prevalence of malaria and the Epstein-Barr virus (EBV) has led to the increased number of lymphoma diagnoses. “Starting in 2015 we opened a lab in Addis Ababa [the capital of Ethiopia] to study these viruses and how they cause cancers,” Baiocchi said, adding the initial research was to determine why the lymphoma rate was so high. “We’re zeroing in on a couple of interesting findings; children who get malaria and EBV, that seems to be the perfect storm [for lymphoma].” Differences in the genetic makeup of people in Sub-Sharan Africa could be another factor in the increased lymphoma rates. Baiocchi and his team, and their partners in Ethiopia, are working on vaccines for malaria and EBV. “Studies tell us the virus here [in the United States] is different from the viruses in Ethipia and the vaccines we use here won’t work there,” he said. “It’s important to understand the genetic makeup of EBV in order to develop a vaccine that will be effective in that region.” The standard of care at the James for lymphoma patients includes a combination of chemotherapy drugs – and has proven to be very effective. “The resources for this aren’t available in Ethiopia,” Baiocchi said, adding the James is developing a less-expensive, targeted therapy that shows promise. There are also plans to create a facility in Addis Ababa where lymphoma patients will be treated with cell therapy.
Join us on The James Cancer-Free World Podcast as we talk to the top scientists and doctors at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James). They’ll discuss – in easy-to-understand language – all the cutting-edge cancer research going on at Ohio State and how this is improving patient care and ultimately saving lives.
About the OSUCCC – James:
The OSUCCC – James strives to create a cancer-free world by integrating scientific research with excellence in education and patient-centered care, a strategy that leads to better methods of prevention, detection and treatment. Since 1976, the OSUCCC – James has been a National Cancer Institute-designated Comprehensive Cancer Centers and one of only a few centers funded by the NCI to conduct both phase I and phase II clinical trials on novel anticancer drugs. As the cancer program’s adult patient-care component, The James is one of the top cancer hospitals in the nation as ranked by U.S. News & World Report and has achieved Magnet ® designation, the highest honor an organization can receive for quality patient care and professional nursing practice.
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