Latest / Becker’s Healthcare Podcast / Redefining Cancer Survivorship Through Personalized and Whole-Person Care with Dr. Jeffrey Lee

Transcript

Redefining Cancer Survivorship Through Personalized and Whole-Person Care with Dr. Jeffrey Lee · Becker’s Healthcare Podcast

• 0:00
  - Hello, and thank you so much for tuning
• 0:02
  - in to the Becker's Oncology Leadership podcast.
• 0:05
  - I'm Elizabeth Gregerson, a reporter here at Becker's.
• 0:09
  - And today, I'm talking to doctor Jeffrey Lee
• 0:11
  - from the University of Texas MD Anderson Cancer
• 0:14
  - Center.
• 0:15
  - Doctor Lee is executive vice president and chief
• 0:18
  - physician executive at MD Anderson.
• 0:21
  - Doctor Lee, thank you so much for taking
• 0:22
  - the time to speak with me today.
• 0:25
  - Well, thanks very much, Elizabeth. It's it's great
• 0:27
  - to be with you.
• 0:28
  - Before I dive into my questions, I'd love
• 0:30
  - if you could share a bit about your
• 0:33
  - background and your roles at MD Anderson for
• 0:35
  - our listeners.
• 0:37
  - Sure.
• 0:38
  - Thanks very much for,
• 0:40
  - for asking.
• 0:41
  - So I am, currently the chief physician executive,
• 0:45
  - here at MD Anderson.
• 0:47
  - I have spent my entire professional career,
• 0:51
  - here at, at MD Anderson, which is the
• 0:55
  - largest,
• 0:56
  - cancer center in in The United States.
• 0:59
  - Really proud to have been here for three
• 1:02
  - and a half decades now. I've had the
• 1:04
  - good fortune,
• 1:06
  - to take care of, cancer patients,
• 1:09
  - especially patients with, pancreas cancer
• 1:13
  - and melanoma
• 1:14
  - for my entire career
• 1:17
  - as a surgeon and then have had a
• 1:18
  - variety of leadership roles, including
• 1:21
  - as department chair in
• 1:23
  - our cancer network programs,
• 1:25
  - across The United States and around the world
• 1:28
  - in clinical operations
• 1:30
  - and now in my role as chief physician
• 1:33
  - executive.
• 1:34
  - Perfect. Well, I'm so excited to share,
• 1:37
  - your background and and your knowledge with our
• 1:39
  - audience.
• 1:40
  - You know, it's part cancer
• 1:43
  - center leaders who are listening, but it's also,
• 1:45
  - you know, just hospital and health system leaders
• 1:47
  - across, you know, the,
• 1:49
  - the c suite. So I know that they
• 1:52
  - will value
• 1:53
  - the insights you're bringing to the conversation today.
• 1:56
  - I'd love to talk a bit
• 1:58
  - about a part of cancer care
• 2:00
  - that is changing dramatically
• 2:02
  - as more people live longer
• 2:04
  - because treatments are getting better, and that's cancer
• 2:07
  - survivorship.
• 2:08
  - How do you think UT MD Anderson is
• 2:12
  - kind of redefining what survivorship care should look
• 2:15
  - like, and what
• 2:16
  - does that mean for patients?
• 2:19
  - Yeah. Thanks very much. It it is such
• 2:22
  - an important question,
• 2:24
  - and especially,
• 2:25
  - you know, for cancer centers like
• 2:28
  - MD Anderson. It it is honestly, you know,
• 2:31
  - the thrill of a professional career for
• 2:34
  - many of us,
• 2:35
  - that more people are surviving
• 2:38
  - with cancer than ever before and and more
• 2:40
  - patients
• 2:42
  - are being cured.
• 2:43
  - It is, a remarkable shift
• 2:46
  - that is fundamentally changing oncology.
• 2:50
  - Curing cancer remains a primary goal for us,
• 2:53
  - of course,
• 2:55
  - but
• 2:56
  - for those of us especially at cancer centers
• 2:58
  - like MD Anderson, survivorship
• 3:00
  - brings new responsibility,
• 3:03
  - to address patients'
• 3:04
  - needs, including their long term physical, emotional, psychosocial
• 3:09
  - needs,
• 3:10
  - throughout what is,
• 3:12
  - increasingly,
• 3:13
  - you know, a long,
• 3:15
  - lifetime and and hopefully a healthy one and
• 3:18
  - not just during their active treatment.
• 3:21
  - Survivorship
• 3:22
  - begins
• 3:23
  - with the treatment plan itself. We're
• 3:26
  - very focused, of course, on delivering the right
• 3:28
  - care from the beginning,
• 3:30
  - to help avoid unnecessary treatment and side effects
• 3:33
  - and
• 3:34
  - preserve quality of life and help patients live
• 3:37
  - longer.
• 3:38
  - But we're also intentional
• 3:40
  - about identifying those patients who are at
• 3:43
  - low risk for recurrence and,
• 3:46
  - being able to reduce
• 3:47
  - unnecessary
• 3:48
  - treatments and,
• 3:50
  - to be able to,
• 3:52
  - be able to shift as soon as possible
• 3:54
  - from,
• 3:55
  - the patient's acute cancer treatment,
• 3:58
  - to their survivorship needs.
• 4:01
  - Absolutely. And kind of on that same,
• 4:05
  - vein of talking about treatment here, you've spoken
• 4:08
  - about delivering kind of, quote, unquote, the only
• 4:11
  - care patients need.
• 4:12
  - I'd love to hear more about how advances
• 4:15
  - in surgery and radiation and systemic therapies
• 4:19
  - are allowing physicians to kind of deescalate
• 4:22
  - treatment
• 4:24
  - while at the same time still achieving excellent
• 4:27
  - outcomes that's, you know, contributing to this
• 4:30
  - large population of survivors?
• 4:32
  - Yeah.
• 4:33
  - It is, a real really great question, Elizabeth.
• 4:36
  - You know that
• 4:37
  - when I,
• 4:39
  - started caring for cancer patients, we had,
• 4:42
  - just recently identified that we could improve outcomes
• 4:46
  - for patients
• 4:47
  - by adding chemotherapy after surgery, for example, for
• 4:50
  - patients with colon cancer.
• 4:53
  - And then,
• 4:54
  - at the same time, we were also identifying
• 4:57
  - that for women with breast cancer, we could
• 4:59
  - often achieve the same outcomes, the same cure
• 5:02
  - rates by doing less surgery rather than the
• 5:05
  - radical surgery that had been traditional.
• 5:08
  - And what that means is,
• 5:10
  - we have over
• 5:13
  - the past three decades
• 5:15
  - recognized
• 5:16
  - that
• 5:17
  - de escalation
• 5:22
  - doesn't mean that we reduce
• 5:24
  - necessary or indicated care,
• 5:26
  - but rather using evidence to determine
• 5:29
  - which patients can receive less intensive
• 5:32
  - surgery, radiation, or systemic therapy and even skipping
• 5:36
  - some of those components altogether while maintaining the
• 5:39
  - same cure
• 5:40
  - rates and reducing side effects.
• 5:43
  - Examples of this nowadays include the fact that
• 5:47
  - for some patients with colorectal cancer,
• 5:50
  - whose tumors are,
• 5:52
  - sensitive to immunotherapy,
• 5:55
  - they can receive dramatic and durable responses
• 5:58
  - that suggest that they may be able to
• 6:01
  - skip surgery altogether. And we suspect that some
• 6:04
  - of those patients are cured
• 6:06
  - with as little as a single dose of
• 6:08
  - of that, immunotherapy
• 6:10
  - treatment. Really exciting
• 6:12
  - opportunity for us to deescalate
• 6:14
  - care in very significant
• 6:16
  - and and
• 6:18
  - positive life impacting
• 6:19
  - ways.
• 6:21
  - We're also
• 6:22
  - looking to move
• 6:24
  - the most effective treatments,
• 6:26
  - what we would say upstream or earlier in
• 6:28
  - a patient's cancer care journey.
• 6:31
  - We're working now, for example, with the FDA
• 6:34
  - on a new type of
• 6:36
  - cell based therapy
• 6:38
  - called CAR NK or chimeric antigen receptor natural
• 6:43
  - killer cells that have been
• 6:46
  - very promising in treating patients with certain types
• 6:48
  - of aggressive lymphoma
• 6:50
  - in early stage clinical trials. What we'd like
• 6:53
  - to do because
• 6:54
  - this treatment
• 6:55
  - appears to be more effective,
• 6:59
  - is much less expensive, and
• 7:01
  - has much less in the way of side
• 7:03
  - effects than some of the traditional treatments like
• 7:06
  - chemotherapy
• 7:07
  - or,
• 7:08
  - standard stem cell transplants
• 7:10
  - or other types of cellular therapy,
• 7:13
  - move it much earlier in the patient's disease
• 7:17
  - to reduce side effects, reduce the cost of
• 7:19
  - care, improve chances for cure, and improve,
• 7:22
  - patients' overall quality of life and the length
• 7:25
  - of the treatment
• 7:26
  - that they need to undergo.
• 7:29
  - I'm excited to hear to hear more about
• 7:31
  - that work with the FDA too as it
• 7:32
  - comes out. I'll be keeping my my eyes
• 7:34
  - open.
• 7:35
  - I wanna circle back really quickly to something
• 7:37
  - you mentioned,
• 7:39
  - earlier, which is about
• 7:41
  - the long term physical and emotional challenges that
• 7:43
  - survivors often face. You know, I don't think
• 7:46
  - it'll be a surprise to, you know, the
• 7:49
  - oncology leaders who are listening, but broader understanding
• 7:51
  - out there might be that care
• 7:58
  - leaders and providers should be doing
• 8:03
  - differently to support patients
• 8:06
  - and maybe shifting their their mindset
• 8:08
  - around care beyond remission?
• 8:11
  - Yeah. It's so so so important that we
• 8:14
  - get that right. You know, cancer care doesn't
• 8:16
  - end when the acute treatment ends, and
• 8:19
  - we recognize,
• 8:21
  - that survivors often face long term health risks,
• 8:24
  - treatment related side effects, quality of life challenges
• 8:28
  - that require,
• 8:30
  - and benefit from ongoing and coordinated care. Not
• 8:33
  - long after
• 8:34
  - they,
• 8:35
  - go into remission from their cancers.
• 8:38
  - Our new treatments are designed to improve the
• 8:41
  - chances for cure
• 8:42
  - and also reduce overall side effects, but
• 8:45
  - they can come with new side effects that
• 8:48
  - need to be identified and managed
• 8:51
  - even in our long term survivors. An example
• 8:53
  - is immunotherapy,
• 8:55
  - where
• 8:56
  - sometimes patients will experience
• 8:59
  - autoimmune side effects like
• 9:01
  - low thyroid levels, hypothyroidism
• 9:04
  - that can require long term monitoring and thyroid
• 9:07
  - hormone replacement
• 9:09
  - to ensure that patients have, the best
• 9:12
  - quality of life after their cancer treatment.
• 9:15
  - So supporting survivors starts with designing treatment plans
• 9:19
  - that consider what their life will be after
• 9:21
  - their cancer diagnosis,
• 9:23
  - and we need to prioritize
• 9:26
  - long term wellness,
• 9:27
  - in the ways that I've mentioned,
• 9:30
  - and also integrating supportive care and ensuring that
• 9:33
  - patients have access to the resources that they
• 9:36
  - need, whether those resources are at MD Anderson
• 9:39
  - or with their primary care teams. And we're
• 9:42
  - working now with, primary care providers to educate
• 9:46
  - them and train them up in structured and
• 9:49
  - ongoing ways
• 9:50
  - so that they are prepared to accept those
• 9:53
  - cancer care survivors back and provide them with
• 9:55
  - the best treatments.
• 9:58
  - Absolutely. And and you kind of
• 10:01
  - alluded to this in your answer of, you
• 10:03
  - know, the aspect of survivorship care is really
• 10:05
  - what their life is like
• 10:07
  - after cancer and what's going you know, what
• 10:10
  - life stage that's in. And, you know, something
• 10:12
  - I've been covering,
• 10:14
  - it feels like monthly, is the increase on
• 10:17
  - young onset cancer,
• 10:20
  - especially for pay patients who are, you know,
• 10:22
  - still in that stage of life where they
• 10:24
  - may want to have kids. They want to
• 10:25
  - continue their, you know, career growth. Can you
• 10:28
  - speak to how
• 10:30
  - survivorship is changing in
• 10:33
  - in that aspect?
• 10:36
  - Yeah. And then you're right, Elizabeth. At MD
• 10:38
  - Anderson,
• 10:39
  - as as you would imagine, we are we
• 10:41
  - are really focused
• 10:43
  - on providing the best care for this category
• 10:46
  - of patients in particular.
• 10:48
  - We're seeing a clear rise in cases of
• 10:51
  - cancer that are diagnosed
• 10:53
  - in young adults under the 50,
• 10:55
  - and,
• 10:57
  - you know, one of the most important examples
• 10:58
  - of that is colorectal cancer.
• 11:01
  - Our new colorectal center, which was launched this
• 11:04
  - year,
• 11:06
  - was designed with this patient population in Vermont
• 11:09
  - to bring together multidisciplinary
• 11:11
  - expertise to address
• 11:13
  - not only the patient's,
• 11:14
  - acute cancer care needs but also
• 11:17
  - their longer term needs,
• 11:19
  - including young patients who are
• 11:21
  - especially likely to be balancing careers and relationships,
• 11:26
  - and
• 11:27
  - plans for families.
• 11:29
  - So the survivorship care for these patients
• 11:32
  - includes from the beginning attention to
• 11:35
  - things like fertility preservation,
• 11:38
  - psychosocial
• 11:38
  - support
• 11:40
  - strategies to help them to return to work,
• 11:43
  - and to thrive in in their daily lives.
• 11:46
  - And, you know, at MD Anderson, we really
• 11:49
  - take seriously our commitment to ensuring that, patients
• 11:54
  - who live beyond their cancer can live,
• 11:57
  - a full life at every stage of of
• 11:59
  - their life.
• 12:01
  - Absolutely. And, you know, thinking beyond even, you
• 12:04
  - know, addressing the physical impacts of treatment,
• 12:08
  - How is UTMD Anderson
• 12:11
  - thinking and working to care for the whole
• 12:13
  - person as they help patients prepare for their
• 12:16
  - life beyond cancer?
• 12:19
  - Yeah.
• 12:20
  - Thanks for the question. We,
• 12:22
  - you know, as patients move from their acute
• 12:24
  - cancer care into remission and survivorship,
• 12:28
  - we're approaching health and wellness, and we keep
• 12:30
  - in mind all of the needs of our
• 12:32
  - patients.
• 12:33
  - Survivorship clinics that we have developed, those specialty
• 12:36
  - clinics that are designed
• 12:39
  - to support patients as a
• 12:42
  - transition,
• 12:43
  - into,
• 12:44
  - their survivorship journey is are designed to provide
• 12:47
  - guidance on things like mental health and wellness,
• 12:51
  - on lifestyle,
• 12:52
  - on diet and exercise, those things,
• 12:55
  - that we know that are important to all
• 12:56
  - of us, and certainly and probably especially to
• 13:00
  - our cancer care survivors
• 13:03
  - as they put their acute cancer diagnosis behind
• 13:06
  - them and look forward to the rest of
• 13:08
  - their lives.
• 13:09
  - Absolutely. Well, I I can't I can't thank
• 13:12
  - you enough for sharing just this, like, comprehensive
• 13:15
  - and deep, you know, knowledge of survivorship care
• 13:17
  - with our audience.
• 13:19
  - I'd love to hear,
• 13:21
  - you know, kind of your vision for what's
• 13:24
  - next.
• 13:24
  - I always love ending conversations with oncology leaders
• 13:28
  - talking about the future because they're just so
• 13:30
  - hopeful,
• 13:31
  - and they've gotten so much exciting news to
• 13:33
  - share. So for you looking ahead, what innovations
• 13:36
  - or changes in cancer care do you believe
• 13:39
  - are gonna have the greatest impact on improving
• 13:42
  - both survival, but also quality of life
• 13:45
  - over the next five to ten years?
• 13:48
  - For ending on that question, I think you
• 13:50
  - are absolutely right that this is a tremendously
• 13:54
  - exciting time
• 13:56
  - to be a cancer care provider.
• 14:00
  - It's also
• 14:01
  - a much more hopeful time for so many
• 14:04
  - of our patients. We we have obviously
• 14:06
  - more work to do.
• 14:08
  - And the future of cancer care won't be
• 14:10
  - defined by
• 14:11
  - any single breakthrough. It will come from
• 14:14
  - combining advances that
• 14:17
  - come from our increasing ability to,
• 14:20
  - select,
• 14:22
  - treatments for patients in a very personalized way
• 14:25
  - to ensure that the right treatment is provided
• 14:27
  - to the right patient at the right time
• 14:29
  - and beginning at the time of diagnosis,
• 14:32
  - from new models of care
• 14:34
  - that are informed by new tools and technologies,
• 14:37
  - including AI,
• 14:39
  - but then also focus on the,
• 14:41
  - entire person
• 14:43
  - that improve outcomes and
• 14:45
  - make high quality cancer care more accessible to
• 14:48
  - more patients
• 14:50
  - across the country and around the world. It
• 14:52
  - means that,
• 14:53
  - both patients and
• 14:55
  - their primary care providers have access to all
• 14:57
  - the information
• 14:59
  - and resources they need
• 15:01
  - to ensure that, that they,
• 15:04
  - feel and are, in fact, actually supported,
• 15:08
  - in their needs.
• 15:09
  - The collaboration that
• 15:11
  - collaborations that we develop with our patients and
• 15:14
  - our care teams
• 15:15
  - extend well beyond MD Anderson here in Houston,
• 15:19
  - and those, collaborations
• 15:20
  - will play a critical role.
• 15:23
  - Initiatives like our survivorship education program
• 15:26
  - and, the University of Texas and the Anderson
• 15:29
  - Cancer Center's national
• 15:31
  - partner
• 15:32
  - program and other collaborations
• 15:34
  - will allow us to share
• 15:36
  - survivorship expertise across institutions,
• 15:40
  - with patients and bring that care closer
• 15:42
  - to where our patients
• 15:44
  - live.
• 15:45
  - It it is,
• 15:46
  - a huge challenge,
• 15:48
  - but it's a really exciting journey to be
• 15:50
  - on with our patients and,
• 15:52
  - with our care teams.
• 15:55
  - Perfect. Thank you so much. Yes. I can't,
• 15:57
  - you know, express enough how excited I am
• 15:59
  - whenever I see news coming out of MD
• 16:01
  - Anderson because I know it's gonna
• 16:03
  - really change
• 16:04
  - and affect not just, you know, the lives
• 16:07
  - of patients, but but the lives of the
• 16:08
  - leaders who who listen to this podcast and
• 16:11
  - and read Becker. So
• 16:13
  - I'm so grateful again that you took the
• 16:15
  - time to speak with me. Thank you for
• 16:17
  - coming on the podcast and sharing your insights.
• 16:20
  - Thank you, Elizabeth. Wonderful to be with you.
• 16:23
  - And thank you to our listeners for tuning
• 16:25
  - in to Becker's Oncology Leadership podcast.
• 16:28
  - I invite everyone to check out even more
• 16:30
  - Becker's health care podcasts
• 16:32
  - at beckerspodcasts.com.
• 16:34
  - Thank you again to doctor Li for joining
• 16:36
  - me today and to our listeners for tuning
• 16:39
  - in.