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MIT eForum: Breakthroughs in Breast Cancer

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Breakthroughs in Breast Cancer: Innovations for Surviving and Thriving

Innovations

 

MIT eForum Event

Breast cancer detection and treatments have come a long way in the wake of recent technological innovations and scientific breakthroughs. Today, organizations are making great strides in detecting cancer earlier and developing groundbreaking new treatment options for those battling the disease. This innovation has recently spurred an increase in intellectual property being registered in the hopes of making treatments more effective, easily deliverable, and with fewer side effects than ever before.

With so many rapid developments in the medical field, intellectual property and innovation are critical to the protection of scientific advances as well as patient quality of care.

About the eForum

In membership with the Martin Trust Center for MIT Entrepreneurship, this forum provides practical programs for the success of any startup founder.

 

 

Transcript

Katja Wald: Welcome, everybody. Hopefully everybody can hear me. My name is Katja Wald. I’m just going to ask my speakers to turn on their cameras and microphones and join me up here on stage. There comes everyone. Hello everyone. Welcome everyone! I’m really glad to have you here. Tonight’s presentation is going to be excellent, just really quickly, I have a couple of slides to share with everyone, and then I’m going to introduce Julie. Do you my slides here? Still figuring it out. Yeah, there we go. So, I want to just say, first of all, welcome, second of all, thank you so much to Caldwell IP for bringing this panel together, and for being a supporter of ours for the last, it’s been like five years now. Keegan Caldwell has just been an excellent partner of ours, you know, and I like to say, we can say that we known him since he was just small and now they’re growing tremendously and we’re really excited to work with the folks at Caldwell. So, thank you. Thank you. Thank you to Caldwell for bringing all these people together.

Just a little bit, for those of you who don’t know us, we are the E Forum, formerly known as the MIT Enterprise Forum of Cambridge. We were founded in 1978. Our mission is to help early-stage entrepreneurs. So, our expertise is in helping startup founders build science or technology businesses that are scalable. We are a nonprofit organization. We are Equity-free participation, so we charge a small program fee for entrepreneurs to go through our various programs. We focus on early stage and I like to call us a deconstructed accelerator. And right now we’re largely virtual. So we’re taking, you know, folks for our classes and our programs, you know, all online. We’re at a hundred and twenty, I think that number has grown in the last couple months, mentors in our network. About 400 plus members, 15, annual sponsors, and about 9,000 people on our mailing list. So, tremendous reach and we feel really fortunate for that.

We have a bunch of upcoming programs that I just wanted to plug really quickly before we get started. On December 9th. We have a Launch Clinic which is our pitch Clinic focused on Cleantech. On January 12th, we’re doing an info session for our Start Smart Class, which is our class for entrepreneurs, for the nuts and bolts on getting started. Pivoting in February is when our Start Smart Class begins and then we have a couple more lunch clinics on the schedule, as well for February April and then we’ll run our start smart class again. We have a whole bunch of other things in the works. So this is not it. Keep checking back for, for our programming. And then, you know, I just wanted to say, you know, membership and sponsorship are what sustains us. So if you’re, you know, interested in supporting what we do, feel free to visit that URL to join as a member and kind of help, help support our work.

A couple other quick things, really want to make sure that those who are who are here introduce themselves so feel free to use the chat if you’re comfortable and introduce yourself and put your LinkedIn URL in the chat, and then stay after the presentation to do some more virtual networking at the tables we have setup. And with that, I’m going to actually introduce Julie and let Julie get started.

Julie Tolek: Hey guys, thank you for coming thank you to the panelists and all of the attendees. My name is Julie and I’m a Trademark Attorney at Caldwell IP. I’m also a breast cancer survivor, so this panel is very near and dear to my heart. I am on the executive leadership committee for Boston Strides through the American Cancer Society. And this is something that I’ve been planning for a couple months, you know, it is October it’s Breast Cancer, Awareness Month, and this panel really I say, you know, hits me, right in the feels, because everybody here has had some impact on my survivorship. I have people from my personal medical team, I have people that make the devices that were used to deliver my chemo, I have people that I met on Instagram, so I’m really excited to get this discussion going and thank you for everyone for being here and for your time and we’ll start with introductions from the panel members.

Neal Khurana: I guess I’m not going to wait for my slides, but I will go ahead and introduce myself while we’re waiting if that comes up. My name is Neal Khurana. I’m an Interventional radiologist and I am here in South Dakota in Dakota Dunes, South Dakota, which is on the border of Iowa, Nebraska, and South Dakota. I met Julie through Lena, who you’ll be meeting in a bit. As Interventional Radiologist, what I do for not only breast cancer patients, but all types of cancer patients, is assist with biopsies, I assist with placing ports, removing ports, you know, dealing with palliative care for patients. And then aside from that, I work in a lot of other organ systems and disease processes that are not cancer, whether it be benign conditions, like uterine fibroids, or prostate enlargement in men. It can be arterial disease, blocked arteries are blocked veins. And the whole basis of my field is image guidance and minimally invasive. So basically we like to say, “Without a scalpel”, you know cut no sutures no scar. And this is the way of the future, you know, we have been around for 30 or 40 years, but only recently with advancements in technology and again, intellectual property, a lot of industry support, our devices keep getting smaller. Our precision keeps increasing, our safety profile increases. Patient satisfaction cost, everything improves with Interventional Radiology, and it’s, if it’s not available in your area, you have to go looking for it because even out here, in the rural part of the country, we’re offering University, level first class care that, you know, should be available to every single person who’s going through a process, whether it be cancer or not. So, I’m honored and privileged to be a part of the conversation. I think that the connection between, you know, not only Only the legal side of things, but entrepreneurs Physicians, and especially patients. I think that’s going to be our golden ticket to figuring out. What’s the best thing to do next in medicine is to, just like they say, first day of medical school, always listen to the patient. That’s where you’re going to get your answer. So thanks for having me and looking forward to the discussion.

Speaker 3: I don’t know if Dr. Khurana you had something else you wanted to say about this slide.

Speaker 1: Not seeing a slide right now. I don’t know. Is everyone have a slide up on their screen?

Speaker 3: It’s a slide without a scalpel.

Speaker 1: Sure. So I’m not saying that but I do remember the slide I prepared. So if anyone wants to know a little bit more about Interventional Radiology from maybe not so heavy of a scientific perspective. There is a docu-series called without a scalpel that is on Amazon Prime and it’s free if you have Amazon that was created by Isabella Newton. Who created a nonprofit called the Interventional initiative or the II? And basically what it does is Advocates and educates Interventional, Radiology is a field. Basically, it covers all the things we do for cancer and other conditions empowering patients with the knowledge that these procedure exist where they don’t have to go under a knife and they don’t have to subject themselves to Long. Recoveries or two very invasive procedure. Hers. It’s just the current state of affairs that even some doctors. Don’t know what I do as a doctor. So the Interventional initiative was created to put the word out there. A lot of times I get a phone call or an email to my office saying, “Hey I heard you do this. Can you help me and I live three hours away?” and that’s you know, amazing that that happens, but it’s also on the other hand, kind of sad that a patient has to go through that to find the care they need. So that was created and I do Encourage all of you to at least click it and watch a couple episodes. It’s entertaining and also, you know, very informative and exciting. So, check that out. I put that up there so that some people can click on it. If the Eric look for it on Amazon, if they have it.

Lena Schweitzer: I think it’s a good segue because I feel like every time I talk to you I learned something new and I had not seen this before and always looking for ways to educate the patients that you know that were working with here at be as well. So I don’t I don’t see my slide either but I will get started. There. It is. My name is Lena Schweitzer. I’m actually a marketing manager at becton Dickinson. So BD And I’m specifically dedicated to the oncology platform and more specifically, I manage a franchise of chronic, vascular access devices. So like that. That’s how I came to meet. Dr. Khurana is through implantable ports. Mainly but you know, obviously at Bebe we have a lot of investment in Innovation and a lot of tools that really impact cancer patients and specifically breast cancer patients. So I have With PD for about five years and prior that had experience and Diagnostics and in like science even but my passion is for patients. It’s very easy to be passionate in oncology and with in the cancer space because everywhere I look in my own family and around me. We’re all surrounded by cancer and it’s easy to come in and do what we do every day. So CD is an amazing place to work and has a specific investment innovation. Auction that I haven’t seen from other companies, so, it’s really, I found an excellent place to be in marketing element. And I’m super happy to be on this panel and having this discussion around breast cancer Innovation. So thank you for having me.

Speaker 3: I’m Samantha Jackman and I am the co-founder of boost Innovations limited and were based here in the UK. So I’m joining you quite late at night. So it’s just, it’s just lovely to be here, boost makes Of breath for more breast prosthesis. That is an external breast form that goes in the pocket of the bra. And we had a look after my mum’s personal cancer Journey. She was given something that looks like this in our national health system. And these are quite commonplace in obviously goes extending the poppy of her bra and she found it really difficult to wear it. Then she found it was really hot and heavy and sweaty and it it didn’t suit her and it didn’t meet her needs at all. And after spending a really long time, trying to find an alternative product that was lighter or area, but wasn’t like the the softie kind of breast forms, which would too soft and migrated around and didn’t didn’t often stay put and we realized that there wasn’t that much Choice out there. There wasn’t anything that we could find on the market. So we started to create things ourselves. And actually I’m not a product designer. I’m not InDesign I used to work in arts and culture mostly with museums and Heritage organizations. So it was a big leap for me to sort of partner with an engineer and to really consider how we could address this problem. And we’ve created something called the Boost breast form, which looks a bit like this, which is light and Airy, and colorful and soft, and beautiful. And we are selling these. In the UK, we have plans to Expand. We are looking for investment and for other partners overseas now, because we were getting quite popular, women seem to be really enjoying wearing our products and quite often that’s in the space between having a mastectomy, or a double mastectomy and then having a reconstruction, sometimes there’s a gap between that and that’s where people where our products and sometimes. It’s just because they are choosing not to have any reconstructive surgery, but actually they just want think occasion need to wear for certain situations that just gives them a better silhouette or a structure to underneath their clothing are breast. Forms are recyclable, which is really important to us because we are very keen being based in sat in the southwest of England by the Sea. We’re really keen that we’re not and contributing to any sort of plastic pollution. And so that has been a big factor in driving the innovation because as we haven’t seen one of these that’s actually recyclable before. So part of that was a factor as well as the comfort and the shape and also the colors and the vibrancy, and just really empowering people and considering why you would wear one of those products and how we could make it a more. Joyful experience for the wearer, rather than it being overly medicalized after that treatment. This happened. So I’m really excited to be here and I’m the person that Julie met on Instagram, by the way, just in case you’re wondering from her intro, who that was. That was me. It’s lovely to be here. Thank you. Okay, it looks like that’s the last of our slides. I think from the speakers, but we still have some more intros.

 

Dr. Naomi Ko: Hello. Hi, my name is Naomi Ko. I’m a medical oncologist. I’m sorry, I’m still answering pages and literally just got out of clinic. So, I am an
academic, Medical Oncologist practicing at Boston Medical Center and have a position at the BU school of medicine. So I do research, teach and see patients and I specifically specialize in breast cancer alone. So that’s basically all of my interest really and thank you for love the invitation
and I hope I can be, you know, helpful in the discussion today.

Julie Tolek: Is that a puppy that you have?

 

Dr. Naomi Ko: Yeah, I have my there are, we have the dogs that are part of the hospital, healing pups program, and they’re in my office. So, excuse any barking if
you do

Julie Tolek: Find a way is Fenway there. And why is here?

Dr. Naomi Ko: Yeah. Yeah, Dr. Ko’s, my oncologist on my team. So that’s how I know. I know so much. About your family
and your dogs. Thank you.

Dr. Cassidy.
Speaker 2: Hello. Hi, thank you. Sorry, I’m also running a little bit late from clinic. So I joined a little bit late, apologies for that. But I am a surgical oncologist at Boston, Medical Center. Also, an assistant professor of surgery at BU School of Medicine. In about 75 percent of my practice is breast cancer surgery, but I also do some surgery for other cancers like melanoma and sarcoma. But again, the majority of my practice is breast cancer and practice sort of the full spectrum. Of options for breast cancer surgery, which really we’ve seen a lot of advancements, several years, even so, you know, kind of the history of surgery for breast cancer is actually a really remarkable one in terms of how things have progressed and changed based on Landmark, clinical trials, and also new technology from the days of the radical mastectomy to breast conserving surgery and now nipple sparing. Mastectomy. Amy’s and changes in terms of management of the axilla. So anyway, thank you for having me.

Lisa Labadini. Hi everyone. I’m Lisa  Labadini. I’m a senior manager with the American Cancer Society. I’ve been with the society for almost nine years more specifically working under the event of the making strides against breast cancer event of Boston, which is a 29 year-old event that really spawned all the strides or the scribes movement across the country with now. Over 200 events where folks who are somewhere in their cancer Journey or survivors or communities supporting someone within the community come out and help us raise awareness and funds for breast cancer research. It is more than I think. The folks that come out is more than just coming out in October and helping us raise funds. We have folks that are working all year round. On this particular event is Julie, mentioned to. We’ve just looking back at, you know, we’re facing our 30th Anniversary. Certainly. A lot of progress has been made in the field, but we have decided to put together an executive leadership committee and spoke with Julie and recruited her to be one of our ambassadors this year. And hopefully next year to help us sort of think about what’s happening in the field. How we’re delivering information listening. You know, Survivor caregivers and people’s experiences and what more we can be doing. So happy to be here, and share a little bit about what the society is, is working on.

Speaker 3: Thanks, Lisa. And that’s, that’s perfect. I, if you could kind of give us some more details and kind of set the scene for what is happening, from your perspective in breast cancer today.

Lisa Labadini: Oh sure. Well, very specifically the American Cancer Society’s mission is to save lives. Celebrate lives and leader world and fight for a world without cancer. And we do that in a number of different ways. I think, if you talk to most people and you heard the American Cancer Society, most people, Always from our research and certainly we do that. Well, having raised a lot of funds and supported a lot of innovative work in the field. We also share export information for an 800 number that is staffed 24/7. We support patient with programs like a road to recovery. So some of the barriers to folks getting treatment is how do you get to treatment if you’re in Western, Massachusetts and need to come into Boston, you know, number of days per week for your treatment in your living alone. How do you do that? But we have a volunteer program, that’s very structured that will be back online after the pandemic that support folks getting to and from treatment. We also have a Hope Lodge which is we’re very blessed to have that in the area where donations support the lodge to provide brief funding for people to come in today and they have to meet certain criteria, but Basically, they’re able to come and stay to receive their treatment. It could be a month. It could be a couple of months for free of charge which again is another barrier for folks. You know, that might not, you know, if they’re in Western Massachusetts around estate and their doctors are here for their care, you know, it’s very, very expensive. In addition. We also encourage prevention. So anything whether it’s through the making strides property or any of the other things that the society is doing, We always encourage. Greetings. Make sure it’d be an advocate for your health. Get out there. Get screened. Particularly when we’re talking about breast cancer. And you know, we want to use October as a reminder, for folks to go get their mammograms. So I think we’ve all you know, sort of to set the stage. This is always something that we’ve encouraged and part of our messaging for participants and the General Public. Is to go out and get their mammogram, but particularly since the pandemic, it last 19 months have really, really taught us sort of a monkey wrench into a whole bunch of things. And so very specifically at the height of our pandemic last year. Last April and May the society conducted two surveys and the impact that COVID has had on cancer patients and survivors has been pretty profound. So I just wanted to provide you with some facts from our second surveys. So more than 26% of cancer patients and survivors reported delays in getting Cancer Care because of the coronavirus, 87 percent of respondents said, the pandemic had affected their health care in some some way, which was up 51% from the first survey and April of those in active treatment, 79 percent reported delays in their are including 17 percent of patients who reported delays in the cancer therapy, very profoundly one-in-five say that they worried worried that their cancer was growing or returning due to delays and interruptions caused by COVID. So more so than ever, you know, our mission at the society, as a whole, no matter what event or programs and services that were providing. Our would say, our messaging at this point in time is gets rained. We want to get folks back on track with always done this, with always promoted this as, you know, early detection, get out there and in get your screenings, but more. So, even with the pandemic because this is something that the ripple effect of this are going to be felt down the road. I personally talked to a lot of folks that are in treatment. Who work is kind of volunteer as participants in our event. And I can tell you that there has been a lot of right out there, you know, not really shirring being assured in terms of what they should do. And people like people had been just really sort of paralyzed with fear. So we know we have a lot of work to do

Julie Tolek: Yeah, thanks Lisa. So this is actually perfect because I want to jump to Dr. Ko and Dr. Cassidy and in your experience. In treating patients, I’m sure you’ve seen the effect that the pandemic has had on treatment and patients being able to get in that, you know, Lisa’s talking about. And I’d like to know like what kinds of workarounds if you will, or Innovations or practices. Did you have to adopt during this time to help people patients, get the care that they need? And You know, how did you have to innovate at this time? Either one of you, Dr. Cassidy.

Dr. Cassidy: So, certainly in the very beginning when we were really figuring out how to deliver care safely. It really required us to shift, our usual treatment, paradigms pretty significantly. So for a while we were actually not able to do operations for breast cancer and we had to figure out how to temporize so that patients were receiving some treatment when they couldn’t have operations, they couldn’t come into the hospital. So we had to treat people with medical treatment who would normally have received an upfront operation. And then we had to figure out how when we resumed operating on people, really how to triage them back into the system. Do the peach patients who are kind of the most urgent in the most expeditious way. And at the same time, figure out, who could potentially wait. And then as we’ve kind of been able to offer more in terms of services, how to offer that safely. So by screening patients and doing a lot of testing and by doing some patient education about around, you know, the safety of coming in because many patients did put off their routine screening and we are now starting to see the aftermath That with people coming in with cancers that they felt months and months ago or even your a year ago, and we’re too frightened really to have those evaluated.

Julie Tolek: Yeah, Dr. Ko. What are your thoughts?

Dr. Ko: Well, in medical oncology, we did have to do a lot of pivoting and and there is a lot of uncertainty at the time because patients, who are mid treatment and really dependent on dosing scheduling, that would make it so they could have the most optimal outcomes were the most frightened. And so despite COVID we were still open. We never shut our infusion center. We always saw. All those patients. And so in a lot of ways we felt like kind of on the front lines when we weren’t going to not see the patients that absolutely needed to be seen physically in the clinic. We, we sort of powered through that. We did a lot of telephone calls. Like Dr. Cassidy said, we had some new patients diagnosed. We started them on medications and pills where we wouldn’t have otherwise. We altered chemotherapy regimens for patients to make them a less immunosuppressive. We had conferences with our colleagues across town and unanimously, agreed on some changes to chemotherapy regimens for, which we thought we could still get a really decent outcome but mitigate the risk of patients potentially contracting COVID and having a bad outcome and it was, it was a difficult time to be sure because of the uncertainty more than anything, but now looking back at it and it, you know, playing Monday, Morning Quarterback, you know, we didn’t lose a single patient to COVID and that’s pretty remarkable. We did lose staff. We lost family members. We lost people, but fortunately, we didn’t lose a breast cancer patient undergoing treatment to COVID. So that’s that was a good thing.

Julie Tolek: I was actually one of those patients. It was coming in for my continued infusions during that time. So it was definitely a different different vibe and I’m grateful that you know, I was able to continue to do that and you know, so the pandemic is an example of innovating on your feet essentially and having to go with the flow and figure things out, you know, as they come with so much insert uncertainty. And I think, you know, when we hear the word Innovation we think of this in a scientific context and in a technical context, but there’s also innovation in the context of the patient experience whether it has to happen because of pandemic and you have to adjust or whether it’s you know, the thought out and bringing more Humanity to Patient Care. And so I’d like to ask, Dr. Khurana because this is something that you know, we chatted about I think together how do you think the patient experience has evolved and what kind of work is there still to be done?

Dr. Khurana: That’s a great question. Obviously, it’s very deep and existential in a lot of ways, but that’s, I think what is important to focus on as we move forward in treating patients, you know, my field basically focuses on minimally invasive and, you know, less complications. We’ve talked about that about what I do and it does give me the opportunity to talk to the patient face-to-face. And I’m usually their first point of contact when it comes for a biopsy, you know, whether this be a breast biopsy, a lymph node biopsy or any other type of biopsy head to toe. Usually I’m the first person who’s going to be putting a needle into them. So I think that my experience is is that is a significant moment, to have that patients journey start on a good note, you know, really. They are scared a hundred percent, they’re scared and and there’s so much surrounding cancer with survivors and getting into the mix with. We’re going to talk about the pink ribbon. I’m sure eventually there’s so much going into that. But when you’re a brand new cancer patient, that’s the last thing on your mind and then, you know, come after the biopsy. Now you have to get a port placed again. This is the start of your journey and you’re scared. So the patient experience, what I’ve noticed is that we need to pay more attention to it. Basically, we need to listen to the patient from the beginning here, their expectations set. Those expectations, as long as you manage a patient’s expectations, the outcome’s going to be good. Even if the outcome is so-called bad. I just think managing the expectations is a big part of treating. A patient is to listen to them. “Hey, what are you expecting to happen at the end of the day with this?”, whether it be a port or a biopsy or a diagnosis, you know, what are they thinking when they go to bed at night about what’s going to happen next week. So to hear those parts really I think it changes the whole paradigm. Obviously have some very talented smart people here in this room with us and all of you play a crucial role in this but I think, you know, the human touch from the get-go, right out the gate. The we need to pay attention to that. Now, as we kind of progress into personalized medicine, where that term, you know, it carries a lot of weight, not only personal lives from genomic standpoint from a biomarker standpoint from a personalized medicine down to the science. But there’s also that side of personalized medicine, you know, that we can’t ignore which is also listening to the patient.

Julie Tolek: Yeah, you know, just to kind of go back to Dr. Ko and Dr. Cassidy, you know, I can speak to their bedside manner and my experience with them and I was for so, lucky and fortunate enough to have a team that is compassionate and patient and empathetic and would talk to you. No, no question was a stupid question and you know, it’s refreshing. To hear, Dr. Khurana, that you know, you’re kind of on the same page with that because I speak to a lot of survivors who unfortunately meet with their you know, their first contact in the context of a breast cancer diagnosis is what someone who has a horrible bedside manner. Who tells them their questions are not important, who tells them that they shouldn’t worry about it. And, you know, at some of the leading cancer institutions and it’s disgusting to hear, you know, and it makes me very sad. And so I’d like to ask the doctors. You know, when this happens do you think this is a personality issue or do you think it’s a product of the culture of Medicine?

Dr. Khurana: I’ll take that one. And I think, I think I clicked off before Dr. Ko did, so I’m sure she has a lot to say. I definitely think it’s a combination of the two. I don’t think there’s, you know, it’s multifactorial for sure. You know, they said, you know, the person who finishes last in medical school. What do you call them? You call them doctor, right? I mean the choice of going into medicine is and that’s a whole other discussion of who’s going into medicine, who’s coming out of it. I think leaves a lot to be desired about you know, the smartest person in the room, definitely maybe shouldn’t be a doctor or sometimes they should. And I think we need to start looking some of those metrics on. How are these, how are these people as far as being compassionate understanding and being able to communicate to the patient on a different level other than just a scientific level. Now, the problem with Healthcare in my opinion is that you know, I think there is a level of you know, corporatization of medicine, a lot of doctors are employed now by the large Health Systems, you know, these Health Systems need to keep squeezing and squeezing resources. Look at what’s going on in the nation. As far as nursing goes. I was just talking to the CEO of our hospital today. And we have a small rural level two trauma center here, but there were absolutely drowning without nurses. So as medicine becomes kind of a corporate entity. It’s going to be, you know, the burnout factor resources getting squeezed and Physicians and Healthcare Providers. Of all types are starting to get a little bit, you know, disinterested, which is so sad because we all went into this for one reason. Remember your first day of medical school, you wanted to help people, right? And if you lose that anywhere along your journey, something is grossly wrong, you know, I go to work. I know I’m going to be helping people so nothing else matters. And I know that sounds kind of like BS and no way. That’s not true. No, it’s a hundred percent true. I just wish that was for every single position out there that they had that same sort of feeling every day. And so I definitely think the system itself is not supporting health care providers in having that feeling and obviously there’s a million reasons why that is. I think beyond the scope of this talk, but I’m interested to hear what Dr. Ko has to say.

Dr. Ko: Well, I think that my feeling is exactly as dr. Khurana you said as well. It’s a combination of both things. I think it’s a combination of the system for sure. And also personality. I’ll speak to the system issue. As I think, you’re right in that we’re getting squeezed. In terms of the number of patients. We need to see and we need to be billing and we need to be meeting a benchmark and the more corporatization that, you know, occurs across the country for medical facilities. And the concern about the bottom line, is just putting pressure on the providers to just see more volume. And that volume pressure is going to take your going to take a hit somewhere. When you’re just churning people through the system and that feeds a very high burnout rate. For doctors, where you’re just like, I’m not seeing enough patients because I’m not going to make my salary. Free and that threat can be threatening. So there’s that pressure is real and that’s probably why I work in an academic hospital so I can offset some of that clinical pressure with research that I love and it’s a different it’s a different culture and academics but I think in like the Private Practice area is very stressful. And so you’re just doing this this wheel, but I also want to say that I do think a personal, personality is a huge part of it as well. And I think that like you don’t teach compassion or empathy or how to talk to people in medical school. We teach the Krebs cycle and what kinase is going to phosphorylate which kinase, you know in the Cascade that creates, you know cancer issues, you know, we just were not teaching that in medical school. They are more and more actually than when I went to medical school. It’s definitely better but we’re not quite there yet. At those softer skills that people find are soft skills, but I find them to be everything because everything I do depends on my patient trusting, me. And if I have the trust of my patient, then I can give them the best care possible. But if they don’t trust me, then it’s like, you know, we’re done right there. And I will also, finally my last point about this is very personal in that, you know, at Boston Medical Center where we work. I really like to emphasize how we don’t take, we don’t treat breast cancer. We treat the woman who has breast cancer and that’s very different than other cultures even close to us here in Boston where there’s a real energy about being really myopic about. We are breast cancer this and this data says this, and that study showed this and this but sometimes your patient does not fit into that study. And you need to, you know, step back and know your patient well, and I think that we do that really well at Boston Medical Center because we have traditionally been the safety net hospital. And when you are a safety net Hospital, you take care of anyone who walks through that door. You don’t pick and choose based on insurance. You’re going to take everybody. And so when you have a team of doctors that has to pivot between taking care of a prisoner, and then taking care of a CEOs wife., you learned that communication skill at a level that I think is very different. And I know because I trained at some of those other hospitals where you see the same demographic and you learn that demographic speak, You’re not really pivoting in the way that we’re forced to at Boston Medical Center. And, you know, one morning I walked outside of our clinical building and there was a Porsche right outside the revolving door. And right behind the Porsche, was the correctional institute’s van transport. And I took a picture on my phone and I said, this is essential BMC. We are providing exceptional care without exception and the providers are forced to take care of homeless women, women who are have, you know, addiction challenges women who are totally upper class and want you to explain the data on the latest study that they read because their friend brought it to them. And and I love that challenge because my job is to serve and my job is to make sure that I’m meeting the needs of every woman who walks through the door, whether you’re Black, whether you’re Spanish-speaking, whether you’re anything like, we got to be able to do that and do that. Well, and that is the type of stuff that in our in our segregated hospital system. Sometimes, we don’t mix enough. We’re not mix. We don’t see enough, diversity. That’s training. Doctors haven’t had a do that, and I think that’s what makes us special. So, You know and that’s what make that forces us to have that kind of culture. I had two patients today, tell me they had been across town and they chose BMC. They came back to BMC because they said it just didn’t feel like home. It just didn’t feel like I was seeing and I’m like, “Well, you’re seen here. That’s our job”. And that’s what I really pride us. It’s not easy and it’s a lot of factors.

Julie Tolek: This is going to sound like such a BMC vlog but I mean, that’s why I stayed there. I had MassHealth for a long time. And even when I had private insurance, I stayed because I loved my team. It I’m, you know, I’m so happy and grateful for that. And I just wanted to add one thing to your diverse demographic. If I may include men also, because I think that they often get left out and they can get breast cancer. So, I want to make sure that that’s something that we just acknowledge here to in, in honor of, you know, awareness and everything. Dr. Cassidy. Do you have anything any further comments on what Dr. Ko has
provided?

Dr. Cassidy: I agree with her as I always do, it was well said.

Julie Tolek: Awesome, thank you. So kind of along those lines. I want to talk a little bit about actually, Dr. Ko, I’m going to put you kind of back on the spot again because I know a lot of your research has to do with demographics and, and, and different races, and their treatments and stuff. And I, you know, although the pandemic seems to have impacted treatment, I think you had some recent articles published and you’ve had a busy summer. So could you tell us a little bit about what you’ve been working on for your research and most recently. I think you had a publication and August, if my poking around online is
correct.

Dr. Ko: A bunch of publications actually. And I’ve been working pretty hard since I became a doctor from with a singular mission. Sorry, Fenway is just the door here to basically provide as much research as possible to delineate differences in disparities in Cancer Care. So that like I did someone was like, “How would you talk about what you do and from a research standpoint?” And mine is to provide as much information and knowledge that we can to make sure that all women with breast cancer have the best outcomes, not just some but all had whatever it is that I am working on. I try to make sure it fits under that guiding principle. Like what I’m working toward is uncovering any discrepancies, disparities challenges that would prevent someone from getting the best out. Outcome that they can. And a lot of times, those those issues follow along, racial lines, be and poverty lines. So set sociodemographics that impede, you know, people from getting the best outcomes and that has been a real research focus. And when we talk about that cancer disparities, we’re talking about it across the entire spectrum of Cancer Care, so “Can you get screening?”. “Do you have insurance?”. “When you get screened, is it too high late?”. We often see women present late with later stage breast cancer, who don’t have insurance and I did have a bigger paper published in Jamaoncology, where we did outline, exactly how that happens with the racial disparities that you’re going to see a staged migration of later stage in, you know, racially diverse patients, namely Black women and that portends worse prognosis always and that is mediated by insurance. So that’s a big big factor. So like so sort of highlighting those things getting that out in the news, you know, baking people aware of those challenges. Why insurance is so important for women. People who aren’t connected to the Healthcare System. They don’t have a primary care doctor, you feel something, you feel a lump. You’re like, what do you do? Where do you go? You don’t have a doctor, you don’t know how do you navigate the system, you don’t speak English, you know, who’s going to listen to you? Can’t pick up the phone, you know, so women like walking to the emergency room, like the process of our delivery care system is broken in a lot of ways for the most vulnerable patients. And then on the flip side, a lot of my research is pivoting toward genomics and biology. So we’ve started a new breast biopsy. See translational research program here at Boston Medical Center because we see all the diverse patients. We are now inviting women of color, particularly, but all women, really who come to our center to donate a research specimen from their biopsy. So, Dr. Khurana with the IR. Also could be considering, how could you create a translational research program where you can get research biopsies from patients and You can sequence those. So we’re hoping to do some RNA sequencing of tumor types or really get drill down on what makes let’s say, triple negative breast cancer more deadly. What can we learn from those genomics and we are doing that project here at BMC. So those are some of the more technical research type things that I’m also working on that aren’t part of the delivery aspect of breast cancer, but getting into the biology as well.

 

Lisa Labdini: Julie can I can I add something here? I just we do a lot of work at the society with disparities and looking at barriers to care and whatnot. And we do have an arm of the organization, the Cancer Action Network, which we refer to as ACS CAN. That there are lobbying arm they’re a sister organization to the society, and they’re out there every day. Working hard. Speaking with our elected officials to, you know, deal. Issues of insurance and a lot of other issues. So, it is something that again, is in the fabric of the society. And it’s very important because we live in a part of the country where we, you know, we have great care, but they’re, you know, we’re blessed because we’re here. If you were maybe another part of the country to you, may not for a lot of different reasons, be provided with the same sort of resources.

Dr. Ko: A really good point. I’m actually funded on an ACS Grant looking at research disparities. And one of the things I will say in the ACS CAN group is phenomenal. Was that when I went to one of the PI meeting at headquarters at in Atlanta with the American Cancer Society pre-COVID, they do a lot of incredible epidemiologic work at the American Cancer Society reporting on things like disparities and outcomes in breast cancer, particularly racial disparities they have a real desire to help in that field and what they they’ve seen in the more recent years. Is that the quote blue states of in this country is seeing less disparity. And in fact in Massachusetts, the disparities are they’re not really evident anymore because we further so long then providing MassHealth and healthcare insurance and so screening rates, there’s no Discrepancy in breast, screening rates between Black and White. And so we’re seeing a real equilibration of that with with with the insurance, but I would say in the red states or rural areas that gap is actually growing wider. So we’re that’s part of the dialogue there.

Julie Tolek: Great, I just want to take a second. If attendees have any questions, you can feel free to type them into the queue a you don’t have to wait till the end and I will try to get to them as we go along here. So we’ve talked a lot about esoteric innovation and the patient experience and slowly we started getting into more, you know, technical innovations talking about Dr. Ko’s, research. And so I want to now speak with Lena a little bit and talk about ports and important, like the difference it would make? What are ports? I didn’t know what a port was when I started this whole journey, it’s often your first step in getting treatment and starting your treatment. And you know for me it was I met with Dr. Cassidy. Dr. Cassidy, sent me to Dr. Ko and Dr. Ko sent me to get my port and the next day I was, you know, getting my infusion. So, can you talk about what the port did is little bit, and why is it so important? And why is it so special? And of course, Doctor Khurana , perhaps can add in on this too.

Lena Schewizer: Yeah, and and hopefully you can hear me okay, because I know my audio is going a little sketchy. So let me know and and honestly, it’s great to hear even hear an example of that process working as quickly as it did for you because from a global perspective because I do manage the global business. It’s obviously we are in fact, Lisa, very lucky here in the US because that’s not how it happens around the globe. But as you know, now ports are for it. Specifically for vascular access. So in the history of ports, which were coming up on our 40th anniversary next year of the first implanted ports, but this is the very first Bard power port. Bard was acquired by BD of few years ago. And as you can see, hopefully it’s purple and it is. This one is quite large and titanium. So in 2006, that was the very first First Power injectable port that we launched, and obviously, it allows for any kind of repeated access to the vasculature. So most of our chemotherapy is delivered through a port. So up until that point for contrast-enhanced CT scans, most of the time you want to add contrast media to an imaging study to improve the quality of that image. And the best way to that is in a tight bolus. You want that contrast, you know, in a timed manner to get where you needed to be to that tumor location. And the best way to do that is through power injections. So you’re basically pushing that contrast dye at a high rate of speed. But in order to get that that quick burst of contrast media to creates a lot of pressure inside the device. So there’s a lot of innovation to basically design and test our ports to handle that pressure without you know, succumbing to some kind of mechanical mechanical failure and that really allows for that encourage improve image quality when you’re looking for a CT or MRI. So 2006 was the very first Power injectable Port that was ever launched and by BD and now in 2021 in the U.S. It’s about 95% of ports on the market are power adjustable. So it really changed the landscape. What was, what was previously being used to deliver treatment so they can still, you know, obviously, you’re never going to be power injecting chemotherapy that the whole point of a port is to have your attached catheter delivering that toxic chemotherapy to a really high blood flow area in your superior Vena cava. So that’s. The original intent was just to have that repeated vascular access, but what they invention of power injection that added another layer of another use of that that port could be used for. And as you know, of cancer patient has a thousand reasons to need access to to a vein. And alternatively, you’d be going for a peripheral vein. Every time you came in for a blood draw for, you know, hydration for antibiotics. For all of these things, would otherwise have to go through some other line and over time, those those peripheral, it gets harder and harder to access those peripheral veins. So this really provides a solid long-term way to both take blood out and then tool ever deliver any kind of medications into that. Patient over the course of their treatment. So we know, we know I have heard of patients that keep their ports upwards of 17 years. That’s not typical, but to just, you know, to continue, we know what happens, as long as it’s still functioning and it’s maintained properly, they can stay with That patient for a really, really long time. So to have a high quality device that continually performs is really critical and unfortunately, to your point. I don’t I don’t think most patients go into their cancer Journey even knowing what a port is much. Know, much less knowing that there are options and who places them how how they’re placed and what features are available that I think even even some of the doctors that I speak to are surprised at what what differences you know, a catheter can make on how often a patient especially in a COVID, environment has to come in to get it maintained and flushed. So there’s a lot of Education. They think that’s involved in my particular job, but also Innovation and continuing to build on that.

Julie Tolek: Can you talk a little bit more or Lena, and or Dr. Khurana, about how the port is actually installed? If you could show the port again and kind of show the pins area of it. I call it with the little knobs and and how you know, how does it get access? How does a nurse find it and kind of explain how it works practically?

Lena Schewizer: Yeah, so I’ll show you this really quick just so that you can see how far we’ve come. This is the most recent for compared to the first one we launched and this one is full of titanium. As you can imagine creates all kinds of problems for imaging and vision therapy. This one is completely metal-free. This is our smallest player view Slim. So they have become smaller and smaller and less and less metal down to no metal even for a power injectable word. But Dr. Khurana can tell you all about how he places them, which there’s a lot of innovation again that has changed over the years to improve that procedure a lot.

Dr. Khurana: Sure. So basically, you know, as Dr. Cassidy can speak to surgeons can place ports as well Interventional Radiologists because we are minimally invasive. We don’t put our patients to sleep to place these ports. We do give them some sedation. So they’re nice and relaxed, but I’m usually talking to my patients throughout the procedure, making sure they know what I’m doing. At each step of the way. Some patients, don’t want to hear me talking about what I’m doing. And so I you don’t always communicate that beginning of the procedure that you know, if you don’t want to know what I’m doing, just let me know, but it’s a really, for lack of a better term. It’s a really intimate kind of moment, you know, to be going out and making a small incision about an inch right over the below, the clavicle, or the collarbone and be talking to the patient through this process, because when they leave their, that’s the beginning of their cancer, you know, journey, but there is about an inch and a half incision. And just below the collarbone and a tiny little tube called a catheter will right up under the skin. Over the collar bone into the vein here in the night called, the jugular vein. So that will leave with a another millimeter incision right over the jugular vein and we use an x-ray machine to see where that catheter ends. We want that catheter to end just above the heart. I know that sounds scary to most people who aren’t in medicine, but think about it as all the veins in your body, have to bring the blood back. To the heart. And it all ends up in one location and this location called the right atrium, which is one of the heart chamber. So it’s a really great place to keep the catheter. It allows for delivery of chemotherapy and for good blood flow for drawing out blood. Now, you know, as Lena was saying, it sounds like, you know, there’s a thousand ways to skin a cat, there’s a hundred different ways to play sports. And I’ve seen ports, you know, placed in two different locations based on patient’s preference based. Based on their anatomy based on the tumor they have. But that’s also who’s placing the port and I think some standards I’m sorry, excuse me, some innovation in the standardization of how we place. These is going to be really important. I have the luxury of fixing other people’s problems with ports because I place so many and I remove so many, and it could be being in a rural area, you know, someone might get a Port Place, you know, a hundred miles out in the middle of a farm land, where there’s a Who’s doing all types of stuff and you know, then again a month later their ports not working. And I think for a patient who’s going through, you know, battling cancer of any sort. The last thing they want is a port that doesn’t work, their oncologists. That’s the last thing they want to hear is that the patient had a bad experience at the infusion center for the nurses who cannulate the ports and the word cannulate means to take a needle. And by the way, this is how these ports are used. Is once that incision heals up a nurse, will take a knee. It’ll put it right through the skin and access the pincushion portion as Julie said, which is a little septum and that septum is a chamber that allows the needle then to communicate with the bloodstream. So it lives right under the skin and, you know, a nurse who has been sticking these parts for years may not have a problem, but some newer nurses or if somebody’s body habitus is, let’s say they have a little bit more soft tissue. It could be quite challenging to get a needle into that port successfully every time. And you know, when they start infusing that chemotherapy if it’s that going in the right place, that could be also very dangerous. So I think there needs to be a conversation about how can we improve the reproducibility of getting to these ports. Every time safely with the patient being satisfied with the oncologist being satisfied with the nurses who are cannulating being satisfied. And you know, I think down the pipeline. Hopefully we can improve with some smart implantables. I know everyone immediately things. About Elon Musk in that field, but it doesn’t have to be too fancy, you know, a port that has an ability to communicate with the outside world to make sure that everything is going okay on the inside of that patient. Who’s accessing the port? What’s the last thing they get? you know, for research protocols. I think having a port that get ex planted and gets submitted to let’s say Dr. Ko. She can take 500 ports, scan them all and it will give a full database of who that patient was what their cancer type was who infused when how and you know that day. Data is King. And so I think we can monopolize or I’m sorry capitalize off of the port being in the patient, they walk around with them and hopefully, you know, come one day Lane. I think mean you’ve talked about this a lot is what the Innovation could be with making these implantables kind of smart for like we better term.

Lena Schewizer: Yeah, they really have they’ve come a long way and there’s a lot more work to do and it’s really is impressive in the differences to your point. Dr. Khurana and seeing cases around the globe. But even in the U.S. there’s such huge differences in in the use of tools that are available today as far as ultrasound to access into the vasculature and like you said, live x-ray to confirm tip location and little things like that. That I think make a huge difference in what we see on the other side as far as complication. On rates and also patient experience. So it’s definitely top of mind for us is to like Dr. Khurana said, there’s your you’ve already gone through so much as a patient by the time you get to port placement and there are still patients that are offered peripheral access for their chemotherapy, even though it’s expected to probably be longer term. And given the option. I think a lot of patients are going to choose peripheral access. Because it’s a regular IV. It’s what they know. What’s what they’re used to rather than the idea of a port placement because it’s such a foreign, you know, most people are not aware of what that exactly means. But once you’ve seen the difference, in something like Dr. Khurana’s procedure, that’s, you know, you see, 15 minutes, cut too close and they’re talking through the whole thing and you can in and out. It really isn’t as scary if there’s that level of Education about what to expect and setting those expectations. So, but yes, I absolutely agree on the Innovation piece. It’s twofold. It’s one that as medicine has gotten better. I think there are so many different touch points for cancer patients, that you now have this, you know, whole slew of different clinicians that you deal with in a day and that’s no exception for ports and who’s touching ports, you know, there’s one person that prescribes it that’s you know, our oncologist, a different person puts it in. In a different person access to the, that’s an oncology nurse and you have your radiation oncologist and your CT texts that are delivering contrast-enhanced. I there’s you know, if you come into the emergency department you have it might have an ed nurse. It’s accessing it. So with all those touch points, I think there’s Innovation and unmet needs to having like Dr. Khurana was talking about that built-in way to connect all of those pieces because there’s no reason why every single clinician that touches that port that touches that patient should have access to all of the information and and like you said, it’s implanted it stays with you all the time. There’s a lot that we can put into it and a lot that it can be sensing and detecting and tracking for that patient. And just you know offering pepper patient and cancer management in general.

Julie Tolek: Dr. Khurana, you mentioned that, you know, maybe smart ports. Is there anything that you or Lena can bear that might be the future of what you guys are up to?

Dr. Khurana: Yeah. I mean, I think a lot of it is there’s a lot of obvious and there’s some non obvious that your speak, isn’t it? Julie, when it comes to trademarks and patents, but basically monitoring things, we can come up with like a hundred things to monitor to keep track of and then someone like, Dr. Cassidy. or Dr. Ko may be like, why are you even tracking that? That’s not important? So I think the communication has to be a long, all Specialists say, what is the most important thing? We need? There’s the basics there, a patient identifier, for example, so you, you know, God forbid, a patient’s found unconscious and they have a port. Well, if you can somehow connect The port and say, okay. This is, you know, Mr. Jones, and he was found, and this is, his diagnosis is date of birth. This is his address, his emergency contact. So that’s a very simple obvious, sort of thing. The non-obvious, kind of things are going to be what parameters of that patients, you know, homeostasis. Can we track their body temperature? Maybe their oxygenation level, you know, if we could ever develop a technique where we can track them out of white blood cells or the cells? That fight infection in the body. That would be really, really important for an oncologist to know. Well, they had chemotherapy their immuno-compromised, their white cells going up and they have a fever. Well if we can get get to that before they’re actually in the emergency room in full-blown infection. It’s going to be cost-saving, it’s going to be life saving and it’s going to make it more efficient. So I think, you know, those types of ideas of ways to track now, that’s the medical side of things. The other side of the data, side of things, which I spoke to before, For with again. Just kind of keeping a tally of when that ports being accessed who’s accessing it and what they’re getting through that Port that can be, you know, peeled off for research opportunities. I think which can be very strong as Therapeutics become more personalized. I think it’s going to get really confusing really quickly, you know, if we actually get into the realm of what we’re doing right now for the coat vaccine, which is RNA therapy. It’s going to get so specific for each patient as we start figuring out these cancer genomics. I think a tracking system would be really important and what better way to track something is, then track it on the patient themselves.

Julie Tolek: Great. Yeah, I hear Lena’s background noise.

Lena Schweizer:. Yeah least, you know, when I’m coming. Oh, I was just gonna say, I absolutely agree and you know that that is so much of it. And what we hear from nurses is there’s nothing. You know, there are parameters of that physiological parameters that could be tracked by the patient, but that requires the patient to know that they need to watch out for them and to be reporting in and to you know, have a method of even down to temperature, there’s disparities and being able to take an appropriate temperature and reporting that in and knowing when to report it. And then from oncology nurses. It’s nothing more sad than a patient that comes in for their chemotherapy. And they’re already, you know, septic or close to septic where had you had that information weeks ago, then potentially you could have prevented it or caught it sooner and intervene sooner. So, So there’s that’s definitely a lot of, I think what we can do in the future, but it really just comes comes after the patient and improving that process.

Dr. Khurana: I just wanted to bring up something maybe that’s a bit of a tangent to what we’re talking about. You know, as far as we’re talking about empowering the patient here and making the patient knowledgeable about the processes that they’re going to be undergoing. A lot of time there is going to be that you know patients. There’s going to be an education barrier. There’s gonna be a language barrier. There’s a socio-economic barrier. So, you know, once we pass all those barriers and patients get more empowered and knowledgeable about the treatments are going to be undergoing. There is this concept also about, you know, too much information is a good thing. You see, what happened with the co-ed vaccine and the misinformation out there and how back, you know, a life-saving treatment. Like that is being ignored because of, you know, falsified information going around. But my question is is as we empower the patients, you know, I want to get everyone’s opinion on what that means for us as Healthcare Providers and what that means for patients who are survivors or going through the process. You know, I’ve had patients walk into my door and say I saw this online, I want this and maybe it’s not the best thing for them. Right? How do we start to kind of break down that barrier? And this may be going to the first part of our talk were talking, you know, less about more about that patient Innovation and the relationship Innovation. I just think it’s an important thing to think about, you know, I kind of have a challenge with that with something called uterine fibroids, which are benign growths in. A woman’s uterus and you know, they get their uterus removed through hysterectomy unnecessarily, you know, there’s 600,000 hysterectomies performed. Annually, the United States and most are not needed. You know, I do do a treatment for fibroids that is done through a tiny catheter through the wrist or grind. And this is the, this is a great thing for women, and it’s been around for 25 years, but it’s not well, known. So, when I go out and I hate to say this, but I do advertise for this procedure because I feel it saves women and it saves their uterus and it saves the surgery. And the six weeks recovering, the possible complications and the cost of the Health Care System. It’s an hour procedure I do in my office, and they go home the same day. So, I advertise for this, and when they go to their doctor, their OBGYN said, I saw this on the internet, there’s a guy named. Dr. Khurana, who does this? It is met with animosity and it’s met with, oh, well, that’s not what you need or no. You need a hysterectomy. So that’s something that I think we’re going to run into more and more as patients are going out there and educating themselves, whether it be about a port or whether it be about a therapy or a new study and they’re coming to your office or they’re walking around saying well, I want this, it’s interesting times for sure. The world’s getting much smaller and there’s a lot more out there for the average person to figure out. So I think it’s just a good topic of conversation in this forum.

Samantha Jackman: Yeah. Sorry. Can I, because we have a similar thing with the breast forms, the segments of lighter and area than the forms, and it has been the advice of some clinic that that’s wrong, or right, or whatever, but that breath, from that mirrors, the weight of the breast that It that that is the most favored though in practice particularly for patients or treated for cancer that are having active lifestyles are quite far on from their cancer treatment like with ten years on from had everything and and still was an able to undertake certain activity, almost too heavy for her to actually really engage with some a swimming and all those kind of things. So that there is an element where sometimes research into new, tentative ways of doing things is not a bad thing if the patient has a genuine reason to go down that route. And what we did find initially when the concept of our product was that with quite a lot of skepticism from people course, we’re not in, I’m not in the medical. But what we did know was that we listen to women and I from the UK government’s innovation. Type people, innovate UK. And what we did was some design research where we really empowered women. Platform to say to us. What do you want to be? And the overwhelming answers were just area and I just need something to give me some shape and Michael Banks and I need another choice. I have a gap between these products and these nothing here in the middle. And that’s really what we were rather than thinking about. Necessarily what? What are the medical profession is really important for but it’s also one that’s just a little. Outside of that. And more about women’s choice and hat, being might be proactively effect. the rights and we’ve been actually working on such projects as well to go alongside have reinvented what that breath for might be and Empower women to make choices about the site of their breast forms as well as as they are. So whether they have a black one or a pink one, you know, or a glitter, we can make glitter and whether they have ones that are like that to express their looking for a particular shape, particularly if they’ve had a double, All of those things are being empowered and we’re working on this kind of smooth that process over. More power with the individual patient exists, that would suit them. And, yes, it is a different different type of sphere, but we have a more even with the NHS procurement here. Moving towards thinking that. More options, available like ours. Better for the patient because there’s more ways Avenues to choose from to support their well. I’d surgery.

Julie Tolek: Sam, I want to kind of continue down this path and your Innovation, you know, personally you mentioned, you know, you you’re not in the medical industry and you don’t have formal training in medicine or a health background or anything like that. And so when you were met with some of this pushback and opposition to innovating these products, how did you overcome that and advocate for yourself? Self as an innovator in the space. When you, you know, don’t have the quote, unquote, same experience of the people that are telling, you know, this is not the right thing.

Samantha Jackman: I think it’s just having the evidence we work with and and just make invoices and the code design process with about a boost Innovations is really embedded into what we do. Now we’re going to be on the right track with our product design. It hasn’t and and that’s what we are to do, particularly with the funding that we’ve had, from strand in the UK, that has helped to women to workshop with them to do surveys, to do feedback. I have women who say, hey, have you thought about doing this or what? I really need rapidly prototype. So we have an innovation space here in Cornwall in the little workshop. It’s owned by us and we can speed. The people can’t really get the head. I can take a phone call. I, for example, I’ve worked and beware that the daughter had had a chance. Affected her chest growth and therefore forming. And she was getting a bit self-conscious 13 years old and within two weeks. We were rapidly a similar design and similar concepts like a bespoke product. That was the right size and dimensions for that. I’m lazy. So that we were able to just quickly meet her needs. When she had been sleeping options, where, you know, one of these but what the sticky pad, and obviously for a young girl who’s feeding body. something that that she was very keen on making her a sparkly pink and breasts for like this was much more except She was able to sort of move on with, she was wearing the types of underwear. She wanted to wear and all that. Those things are really important to us. That we’re here to listen company. We don’t always if I’m totally on see our products as medical and sometimes in certain contexts as as an excess shaper or, you know, those types of things that people will wear those like my mum, who because of the medical history that they – and so, we kind of struggle that that lie. You don’t want to give something that’s, and I’m kind of view. But we are here, what women are telling us and to try and efficiently do something about it. Our digital Technologies. But we can use computer vision to actually. More about the individual women and their shape and sizing knee directed like to create and to help them too. Breast form from us either as a bespoke model or a some given idea of best fit so that it obviously plays a big part here in the UK. The hospital system. There was a lot of women, the cave of period, who couldn’t go into Hospital fitted with one of these. And they were essentially we That we’ve just been left. Breathless for reconstruction remote be scheduled in for more surgery. Urgent, we’re not allowed to go into the clinics to a prosthesis fitted because the Clinic’s dental appointment. And with that we just don’t know. He’s ourselves online. How do we – can we find something and can we try your thing. And that was a really it for us. And we started to create this digital technology to support to have more choice to feel more empowered and decision-making of saying. Yeah, I’m confident I could buy and that it would fit me. as we can get it to fit and so, yeah, can I, um, on those kind of things for a while, which is really

Julie Tolek: Yeah, that’s amazing. It’s you you’re more even more further along than I had realized.  I was like, I wish I had found you sooner in my own journey. So this is great. I know we’re coming close to the end to the Networking portion. But I have a couple more things that I want to throw out there before we get to that that I think are important. And that I want to kind of I want to flush out a little bit and Sam being part of the Instagram Community. I think this is something that you’ll be maybe the most familiar with from this group is that there is a marketing or maybe anti marketing, even if you will campaign out. Now. Call, you know, for it’s Breast Cancer Awareness Month, you know, what does awareness even mean? There’s always this, you know, portrayal of breast cancer as pink and fluffy and bows and ribbons. And you know, haha were wearing tutus and you know, raising awareness and you know, some people are of the mindset, you know, there are a lot of survivors that you know will say, pink doesn’t save, you know, doesn’t save a life, pink means nothing, you know, and they call it pink washing in October or pinktober and then, you know, there’s another mindset that any awareness is good awareness. So if somebody is thinking, if somebody sees something pink and they think about breast cancer than, that’s one more person that has it on their mind enough to maybe go get checked or maybe talk to their friends about it. And so, this pink washing campaign is something that is started within the breast cancer community, I think this year particularly. And it is defined as pinkwashing, is defined as a marketing tactic, through the exploitation of breast cancer for profit or for public relations and the exploitation of survivors and their pain and what they have gone through. And this can be, you know, companies that make pink products only in October and call it breast cancer awareness. But none of the profits of those products are going to anything that has to do with breast cancer or some companies will continue to make products and call them pink. Say it’s breast cancer awareness, but the products are actually harmful and linked to disease. And so I just I would love to know your thoughts on this. And you know, is do you think any awareness is good awareness or are we being exploited?

Samantha Jackman: I’d say just a little bit about that. It’s good to answer that question and it’s really tricky which is you’re bringing it up. I mean ultimately for a for somebody like me who’s trying to build because I’m not MediCal. I mean we are trying to wait. Do it for the good of people and support that we can give to women but we are built. We are trying to sell these, I’m very aware that we have to add, to maintain a brand authenticity cancer, and woman’s house products are obviously, is there’s no issue. Therefore, commercialized and a commercial entity as is a limited company. And we are here at the purpose company, but we are here for profit and we do what we do. But it is hard when you do. I kind of tokenism there with a and I think that understanding that brand and the brand hush you to judge those things and just having pity to interrogate those things and to of what you’re buying and how you’re buying it type of consumerism. You just have to to on a case-by-case basis and really about those issues behind. And other campaigns. I think if you go into it with your eyes open, you may then then that’s much better than just doing it under the carpet essentially. If that’s, that’s just the thing that I think I’m from it is that you just need to to be be cool and engage with with. If you want to, but with just that element Wellness.

Julie Tolek: Has anyone else on the panel heard of this campaign? Lisa?

Lisa Labadini: Yeah, pinkwashing the phrase pinkwashing has been around for quite some time. There are a lot of companies out there that do just that of a variety of different products, you know, it’s, you know, we hold an event once a year and everyone comes out and, you know, it’s as Pink as it can be and people are with pink tutus, but you know, at the We also let people know where their donations go. They can always get us checked out and, you know, particularly at this time of year. There are some folks that are buying products that think that the money’s coming to us or think that it is going to a hospital. And so you really need to be very very aware when you’re making your purchase and just really think about this. A lot of places that you can get this checked out. But this this is It’s a particularly hard time of year because we want to raise awareness and we want to bring in In as many funds, it’s hot fundraising fundraising is hard. And we’re two very Grassroots level. But, you know, we’re not selling our souls out there and you really have to have to be very aware of your purchase power and really know where your money is going and what it boarding. It’s a hard time of year for someone particularly with metastatic breast cancer, you know, we particularly get a lot. We filled a lot of phone calls from those folks. When they see, you know advertisements for Making Strides against Boston of event, it hurts them. But by the same token, I know that when I go to work every day and I’m raising funds. I’m not there because I’m making a large salary. We don’t work for the society for that. We work to, you know, write awareness and to bring in funds for the research. So we straddle our, I don’t know if there’s a right or wrong answer. You just need to be very aware.

Julie Tolek: Right, so it sounds like, I mean, there’s a kind of a double entendre with awareness here, you know, or multiple layers, there’s the awareness, you know, of the Brett, you know, what, we should think of traditionally as breast cancer awareness knowing what to look for doing your, you know, your self breast exams being able to talk about it, you know, knowing that it could happen to you and, and there’s that awareness. But then there’s also this deeper level of being aware of the companies that you’re purchasing from. Or you know, are they donating somewhere? Who are they donating to? Where’s the money going? And if this is something that is important to you as a consumer or as a survivor and a consumer of these pink products to find out these things and to be aware and to make the informed decision, if you’re going to do it, at least, do it knowingly. And you know, that’s actually that’s a good point, you know, a different dimension that I hadn’t, you know, thought of as deeply until You know, putting this panel together. Does anyone else have any thoughts on pinkwashing and awareness?

Laina Schweizer: Yeah, I I just want to Echo on what has been said, but, you know, I have been to many marches. I’m excited to wear pink and honor survivors and you know, recognize those that didn’t survive. And, you know, we we all participate for a reason and having something that connects us all even as silly as a color. I think it makes a difference and makes people get out there and that’s the most important people point is that they’re, they’re getting out there and they’re doing something and that’s You know, whether it’s breast cancer, or, you know, I do a lot of work with them light the night for the Leukemia Lymphoma Society, and they do a walk every year and a good friend of mine, you know, when she was battling and in the hospital and not awake, like it’s one of the things that you feel like you could go. If you’re sitting there stewing wanting to help people in a away and going in particular, an amazing way to do that. But I also absolutely agree that there are Information online which means there’s a ton of bad information as well. But with the right amount of due diligence, you can find the information on a nonprofit that says this amount of their money goes to research and this amount of their money goes back into the community to support these things that you intended this money to do. So, it’s just about, you know, going to the right sources for that information. I don’t go to YouTube to learn about vaccines any more than I would go there. To learn about which charity to give to. So I think it’s that same level of research and diligence on where your money goes.

Julie Tolek: I think I mean, I have some more questions, but I know we have a networking time to. I haven’t seen any attendees post any questions, but I want to give people time to ask them. I have one final thought I guess. One final question or food for thought if you will, I guess it’s a question because I do want to hear what some of you have to say. And this is for you know, specifically the doctors. And I’ll start with Dr. Cassidy since we’ve been, haven’t heard from you in a little bit. We’re in a period of time, where society is polarized as to the what they believe in science about science and, you know, a lot of innovation is around science. And how do you you know, not only do people doubt it but they defy it now and you know, whether that’s right or wrong. This is not a political question. But as it as a as an innovator, in healthcare, how do you keep yourself and your team motivated and inspired to continue working in a system where a lot of the people don’t believe in what you’re doing? How do you keep going?

Dr. Cassidy: Yeah, I think that, you know, we’re actually where we are in Boston. We’re pretty lucky, because if we’re not were in a part of the country, where a lot of the people are for science, but certainly, you know, this is a really difficult thing to navigate because I do see many patients who because of their background, or because of their faith, they do believe that things may get better on their own that their cancer will be disappear with a lot of prayer and they delay their treatment significantly. And of course by biology, they all progress. So it is a really delicate balance of sort of respecting people and their beliefs, and their values. But also trying to impart the knowledge that we have that is reliable and validated and scientific and and kind of balancing that can be really challenging. I don’t think I have any answers into how to do that besides to sort of take the time with people and to kind of explore the belief system that they have that sort of underlies it because when you’re rushed and clinic and page Our kind of refusing to accept your recommendations. It’s easy to just document. Okay, patient refused this and move on, then to really kind of spend the time that it takes to explore, like, what their fears are. And why are they so afraid of a lumpectomy? Why are they so afraid of taking a medication? Like, what is it that’s causing that? And I think if you can get to the bottom of that sometimes, you’re able to make good progress.

Julie Tolek: Good points, you know, it’s interesting times. I guess I’ll say and leave it at that. And with that, I kind of, I gave everybody a little bit of homework. If you saw hopefully and read my long email, but I asked if each panelist would come up with a question to ask another panelist or to put to the panel. Has anyone come up with a question that they would like to ask another panelist that I haven’t already touched on?

Laina Schweizer: So I have a question and this is, I think what keeps me up, sometimes that not a lot of things, keep me up at night. But this one is to get especially in this forum. It’s really understanding how from a medical device perspective. As we bring these solutions to Market. Again, with ports is such a specific case because there are so many touch points, but what do you think is really the best forum for us? To encourage and facilitate that peer to peer discussion. As again doctor, you know, Dr. Ko you’re prescribing a port and dr. Cassidy or Dr. Khurana, you might be placing the port and somebody else’s accessing it from our, you know, from our side. What can we do better or what is the? I think the most effective channel for encouraging those, those peer to peer discussions, even on ports, which I feel like they kind of get a, some of those devices get a back seat to the pharmaceutical drugs because there’s just so much to keep to keep track of. So I’d love to hear your thoughts on that.

Dr. Khurana: Multidisciplinary conferences are pretty common in the academic setting and those are if not common there they’re expected and academic setting and it for all those who don’t know what that is. Its where you know once a week, a bunch of Specialists who all in some way touch cancer meat and review a list of patients. It could be a complex case. It could be a simple case, but you’re basically bringing to the table, the latest. Like, the bait is the latest techniques, the latest therapies. Now, if that’s happening on a weekly basis in academic institutions, shouldn’t that be happening in every hospital, all over the United States? And anyone who’s treating cancer? And the answer is, yes, absolutely. So we have a Cancer Center in town here with six, on colleges, and to radiation. Oncologists. We have breast surgeons, you know, we treat all types of cancer, but, you know, I show up there weekly and, you know, whether it’s me bringing the latest paper or the latest study to offer my you know, techniques what I’m trying to navigate in a community of private practice doctors is not always what what’s the latest greatest thing to do for the patient, but unfortunately, sometimes it is how do I navigate the channels of referral patterns and I scratch my back, you scratch mine kind of situations which is still exist in medicine and our location. So I think my answer your question Lena is you know, what’s going to be best for the patient is to put aside all that and Communicate and communicate whether it be a weekly conference or as we’re moving into the virtual world, you know, weekly Zoom meeting is going to be so important as more clinicians are involved with the treatment of cancer of any sort. There’s going to have to be a way to consolidate that information because there’s no way I can keep up with what Dr. Ko, what Dr. Cassidy do, unless they kind of condense it down into the nuggets that are going to be important for me to understand and present that to Me, and I think as a physician that’s going to be due diligence. You know, we have to educate each other. We have to let her ego, check them at the door. And you know, I wanted to bring up. I just read an article about cryoablation of low-risk breast tumors less than 1.5, centimeter in women older than 60 that are you know, receptor positive and her2 negative amazing. I can’t wait to do it. I can’t wait to get my hands on it, but imagine the, you know, mountains. I’m going to have to climb. Talking to a room of oncologist and surgeons and they’re going to look at me and say, who do you think you are? And luckily, I’m in a community where I’ve been accepted, I’ve been valued, but I know other folks in my profession and other positions out there where they do have those challenges to, you know, basically break the norm and be progressive and, you know, be a disruptor for lack of a better term. So, being a disrupter in medicine is a really interesting kind of flag to carry. Yeah, but I think the best way to kind of overcome those is going to be to with open communication, checking the ego at the door and putting the patient first.

Samantha Jackman: I just want to say that I have obviously barriers to to medical profession because we’re outside of the medical profession – Definitely much more into the the full after active treatment. And for the generation of women who have had have had their treatment and sort of been signed off essentially can’t go back to their primary physical positions or their GPs here. And I think that for to open into have forums like this, even of an innovation and a new approach for me, too. the doctors that we have in this panel, because Didn’t the Breast Care nurses here in the UK will protect me and say our patient brought this in. And they brought it in and we’ve never seen anything like it. And we don’t know, you know, we don’t know enough about you Advocate it to our patients, but we don’t know and it’s worked the other way around because we focusing on the women that we’ve been working with and Coach that it’s been them that have gone back when the product. Agent and brought that back into their care. T their teams are coming back to us, but having that -. And so it’s not just dialogue between his that’s important. There might be people who were at complete animal. I was, I was working in a, until two weeks ago. I its focus on on Boost making the museum, right? So why why we see that you are apart from through do by necessity? Because nobody else, I think it’s really interesting. Yeah, everybody saying that we not just people who are Communication in caregiving but Act. Open to those voices from people. And why does fear of experience that might be from an angle.

Julie Tolek: I have a question from the audience that kind of fits in with what we’re talking about. Carrie says love the patient-centered panel. Where do you send your patients for emotional support that you feel is most effective for them?

Dr. Khurana: I actually do not have one personally, you know, I actually have never even thought about that work have been presented with that. But in my field of what I do, I mean, you know, I have had patients who have lost limbs from arterial disease. And basically we send them over to have a prosthetic made and you know, those folks do a good job of the whole emotional support during that Journey. But in the cancer setting You know, I haven’t really had to deal with that as much as probably, some of the other health care providers here.

Julie Tolek: Dr. Ko?

Dr. Ko: I was going to say that there’s not a one-size-fits-all for emotional support. If you think about what people lean on for comfort, it can be and look so different. And so, what I try to do is make a good connection with my patients, make them feel like they can be vulnerable and tell me, you know, what’s going on in their minds. And then I always do ask, like, you know, them who their who their support system and network is because everyone’s is different and then we do have some pretty good resources depending on a patient’s comfort level so they can look like anything from we have a cancer support group here at Boston Medical. We can reach out to that if that is this feels like a person would benefit from that type of setting and then sometimes I’ll reach out to our social worker who actually is like super lovely and I think they might connect and I sometimes will refer them to psychiatry. If I feel like our psychiatrists, we actually have one that specializes in cancer patients. So I have that as a resource. ACS has loads of support. I mean, ACS is constantly, you know, providing lots of support. I would say not so much for non-english speakers that we see. Sometimes it’s harder to for them to access some of that support, but there are, you know, lots of Next, we have, especially at Boston Medical Center because, you know, I think we see patients who come to our Center and cancer is not their biggest problem, and that always really hits home for some people and they’re like, oh my God, cancer is definitely not their biggest problem. So we’re working with a lot of other things as well.

Lisa Labadini: So, and Julie, I’m just going to say to that. We you know, throughout the year, we hold all different sorts of events than in whatnot. And we often ask for folks who may want to address an audience or it could be a survivor, you know, wanted to share his or her experience. And I think that there’s a lot of power in that to made, you know, maybe a couple of years through their Journey, but when they’re ready and they speak that that’s a different type of feeling as well that goes on and you know both from the Is perspective and from folks, listening to that I think that there’s really good Synergy. So we’ve seen a lot of sort of informal connections made to support, you know, in a lot of different ways.

Julie Tolek: Yeah, and if I I’m going to out Carrie, the attendee who asked the question, I actually know her, you know, and we’ve talked about this a lot and, you know, how emotional Art is so important and if I can share a quick anecdote, when I was at the beginning of my journey, you know, I had resources at BMC, you know, social workers and you know I had to do was ask to be connected to somebody that had you know, there’s a program where they connected to somebody that has a similar diagnosis, you know, both  somebody that’s come out on the other side and when you’re beginning for me, I mean, you might not even know what to say. Like, you know, you need support but you don’t even know what. To support. And it’s a very challenging mean, aside from all the other challenges about being, you know, go having a cancer diagnosis. You don’t know what you want as far as health and sometimes you don’t want any help and you don’t want to talk about it and you don’t you’re not ready to hear from somebody that’s on the other side or they can give you emotional support and and other times, you know, all you want is for people to ask if you’re okay and to check in but you don’t really want to talk to them. So there’s so many different. Layers of what is supportive, quote-unquote, you know what we need? And I was chatting with a friend yesterday and I said, you know, people don’t know what to say, you know, friends and family might not seem supportive. But really, they don’t always know what to say. And so they end up saying nothing because they’re afraid of saying the wrong thing and I think if you find yourself in a situation where you don’t have it doesn’t feel like you have anyone to talk to you, then it’s you. Or especially important to seek out emotional support, maybe even professionally because this is definitely not something that is you can’t do it alone.

Samantha Jackman: I was just there’s a lot of women in our community to place Facebook groups that are specifically obviously about assistant and listening to women as we’re making our products, then what they need is to do and that emotionally for women to feel like the Somebody who’s making the products for them but for them, but we’re making it with them as well. That’s been people of of commented. included and listen to, because of the We’ve set up in our design methodology making but also I think being mentioned Julie earlier. I think it’s really interesting. There’s a lot of books and a lot of novels that have come out that are written like this and actually keep a little library of them here. Pretty interesting as a way for people and from me to have a little reason, they just Somebody’s Journey but maybe in a way where you don’t like talking with another person, but you can see me through how somebody else is kind of a neat viable way to actually support and understand a little bit more about the journey necessarily getting bogged down or feeling. That capacity to talk to me.

Julie Tolek: Yeah, definitely. Definitely. All right. Well, I think it’s networking time. Thank you!

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