In this episode, Dr. JYP talks with Dr. J. Harrison Howard, a surgical oncologist who specializes in melanoma. Dr. Howard explains that not all skin cancers are the same, emphasizing that melanoma is more dangerous compared with basal cell and squamous cell carcinomas. He highlights the importance of detecting melanoma early, as it is the most dangerous form of skin cancer.

They discuss surgical and systemic treatment advancements, including the practice of sentinel lymph node biopsy and the game-changing benefits of immunotherapy. Dr. Howard says clinical trials are essential in improving treatment methods and increasing survival rates. He stresses the necessity of regular follow-ups for melanoma patients to catch any recurrence early. Lastly, Dr. Howard and Dr. JYP discuss skin cancer prevention, recommending sunscreen, protective clothing, and annual dermatologist visits to reduce the risk.

3 Key Takeaways


1. Diversity in skin cancer types: Not all skin cancers are created equal. Dr. Howard emphasizes the differences among various types of skin cancer, with a specific focus on melanoma. While basal cell carcinoma and squamous cell carcinoma are often treatable with surgery and have high cure rates, melanoma can quickly become life-threatening if not caught early. The depth of melanoma in the skin is critical, and it can spread and become fatal.

2. Advancements in melanoma treatment: There are exciting developments in both surgical and systemic treatments for melanoma. Dr. Howard talks about the trend toward less invasive surgery and the success of sentinel lymph node biopsy – developed by his late mentor, Dr. Donald Morton – as a significant advancement in minimizing side effects. Furthermore, systemic treatments such as immunotherapy are proving to be game-changing as they drastically improve survival rates for stage 4 melanoma.

3. Prevention and follow-up: The importance of prevention and regular monitoring is heavily emphasized. Sunscreen, protective clothing, and regular skin check-ups are crucial in reducing the risk of skin cancer. Dr. Howard also underscores that once someone has had melanoma, the risk of another melanoma greatly increases, necessitating lifelong vigilance and regular dermatologist visits to detect any cancers or pre-cancers early.

Show Overview

00:00 Basal cell and squamous cell carcinomas

05:08 Melanoma increases future risk tenfold

07:43 Development of sentinel lymph node biopsy

12:17 Redefining melanoma surgery

15:49 Clinical trials explained

17:43 To clinical trial participants: “You’re a hero.”

22:34 SPF-infused clothing for sun protection, and more

In this episode, Dr. JYP welcomes Margaret Wielbut, a trained art therapist who works with patients at the USA Health Mitchell Cancer Institute. Margaret delves into her personal journey, from discovering art therapy to implementing it in cancer care in Mobile, Alabama. She describes art therapy as a marriage between art and psychology, emphasizing its benefits for cancer patients in creating hope, reducing anxiety, and bringing purpose to the cancer journey.

She shares stories about how art can turn clinical spaces into environments of light and creativity. Sponsored by the Zoe Foundation, the MCI’s art therapy program is free to patients. Margaret highlights the therapeutic power of creativity and her aspirations for expanding art therapy, including group projects and involving families. For those without access to art therapy, she recommends engaging in personal creative activities to enrich the healing journey.

3 Key Takeaways

1. Healing power of art therapy: Art therapy is described as a fusion between art and psychology, offering emotional healing and a creative outlet, which can be particularly beneficial for those on a cancer journey. Margaret highlights how art therapy has brought joy, reduced anxiety, and helped patients create meaning and enjoyment during their treatment.

2. Impact on cancer patients: The episode emphasizes the positive impact of art therapy on cancer patients, even those who may initially seem closed off or disinterested in the projects. Through creative sessions, patients can experience emotional breakthroughs, improve their mood and find a sense of community, as witnessed in the interactions facilitated by Margaret at the MCI.

3. Expanding art therapy in cancer care: Margaret discusses the value of expanding art therapy programs, including initiatives for children, and ideas to enhance patient engagement with group projects and art displays. The art created by patients not only serves as a personal therapeutic process but also contributes to a positive atmosphere within the clinical cancer space for all to enjoy.

In this episode, Dr. JYP welcomes medical oncologist and hematologist Dr. Daisy Escobar to discuss her background and her expertise in cancer diagnosis and treatment. Dr. Escobar shares her journey to the Mitchell Cancer Institute and talks about her family. The conversation focuses on cell-free DNA technology, also known as liquid biopsy, which is used primarily for cancer surveillance and monitoring. Dr. Escobar explains the benefits and limitations of this technology, including how it compares with traditional biopsies and its potential in early cancer detection. The conversation also covers the emotional aspects of cancer surveillance and the importance of patient autonomy in treatment decisions. Dr. Escobar emphasizes the importance of continual research and advancements in cancer diagnostics to improve patient outcomes.

3 Key Listener Takeaways

1. Introduction and implementation of liquid biopsy: Dr. Daisy Escobar explains that liquid biopsy, or cell-free DNA (cfDNA) technology, involves a simple blood draw used primarily to monitor treatment response and detect relapse or recurrence in cancer patients. Unlike traditional biopsies that require tissue samples, liquid biopsy offers a less invasive alternative for surveillance. The ease of monitoring is particularly beneficial for cancer patients who are frequently undergoing lab tests for other reasons. Dr. Escobar details the conditional nature of liquid biopsy’s current use, emphasizing its role in patient monitoring rather than initial cancer diagnosis.

2. Challenges and limitations: Despite its advantages, liquid biopsy is not without its challenges. Dr. Escobar mentions the necessity of comparing ctDNA with DNA from a previous biopsy. Additionally, certain conditions, such as a previous bone marrow transplant, may limit ctDNA effectiveness. Another significant challenge is the potential for emotional impact on patients due to "watchful worrying," knowing that while their markers may be rising, visible signs of cancer may not immediately appear on scans.

3. Potential and future of liquid biopsy: Dr. Escobar discusses the hopeful future of cfDNA technology, particularly for the early detection of ovarian and pancreatic cancers, which currently lack effective screening methods. Advancements in identifying specific ctDNA signatures for various cancers could revolutionize early detection and management, reducing the necessity for more invasive procedures. However, she underscores that while promising, the science has yet to fully catch up to the technology, and ongoing research is crucial.