Dr. Michael Weiner Living Cancer Podcast 59

Dr. Stegall interviews his next guest Dr. Michael Weiner, pediatric oncologist, father, and cancer survivor. Dr. Weiner shares about his book, helping hundreds of pediatric cancer patients, and the story of how he had to become a father, not a doctor when his own daughter was diagnosed with cancer.

59 Dr. Michael Weiner Living Cancer.mp3: Audio automatically transcribed by Sonix

59 Dr. Michael Weiner Living Cancer.mp3: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Speaker1:
Hi and welcome to the Cancer Secrets podcast. I am your host and guide, Dr. Jonathan Stegall. Cancer is like a thief who has come to steal, kill and destroy. I have personally seen it wreak havoc on patients, friends and even my own family. But I am on a mission to change the cancer paradigm. Who? The practice of integrative oncology cancer treatment that integrates the best of conventional medicine with the best of alternative therapies backed by science and personalized to each patient. You need a positive voice you can trust. This podcast will share valuable information to give you practical hope for a better outcome. So I invite you to join me on this journey as we seek to change the cancer paradigm together.

Speaker2:
But I'm a very, very strong believer in never giving, never taking away someone's hope. When you are a cancer patient, you must believe that you are going to be well.

Speaker1:
Hello and welcome back to the Cancer Secrets podcast. I'm your host, Doctor Jonathan Stegall. This is season four and episode number 59. In today's episode, I have an incredible guest, Dr. Michael Wiener. We'll be discussing pediatric cancer care today, as well as Dr. Weiner's many efforts to improve cancer care in the pediatric population. Just as a reminder, I encourage you to listen with a loved one or friend. Doing so together can make this even more beneficial. But now I'd like to introduce our guest, Dr. Michael Weiner. He's a medical doctor who has worked as a pediatric oncologist for over 40 years in some of our nation's top medical facilities. He's a nationally recognized leader in the field of pediatric oncology and has made major contributions in the diagnosis and treatment of patients with leukemia and lymphoma. Dr. Weiner is the former chief of the Division of Pediatric Oncology at Columbia University Irving Medical Center in New York. And he's also the author of the book Living Cancer Stories from an Oncologist, Father and Survivor. In addition, Dr. Weiner is the proud founder of Hope and Heroes Children's Cancer Fund, a 501 C three grassroots charitable organization that supports patients and families, education, special programs and research in pediatric oncology. Dr. Weiner, thank you so much for being here. Welcome to the show.

Speaker2:
Well, thank you, Dr. Stegall. That was a lovely introduction. I appreciate all your kind words. Thank you.

Speaker1:
We're just honored to have you here. And and I guess I'd like to kind of start by by just learning more about how you became a physician, what kind of sparked your interest?

Speaker2:
Well, that's an interesting story. And to be totally transparent, I will tell you the truth. I did not have a burning passion to enter medicine. I was a college student during the Vietnam War. And the Vietnam War was a time of our country's history. That was a very chaotic period. And there was something referred to as the draft. So there was a conscription for young men, and there was also a draft lottery. And what I decided to do was to have an opportunity to complete my education in college. So I made a decision that I would try to get into medical school, and I was fortunate enough to do so. I went to the State University of New York in Syracuse. I chose to go to that school because as a New York resident, it allowed me an opportunity to go to medical school without debt because I had what is called a region scholarship. And even in those days, 50 years ago, medical school was a very expensive proposition. In medical school, I befriended a physician who was a medical oncologist. At that time, we didn't have a full time pediatric oncologist on our faculty.

Speaker2:
But I worked very closely with a with a physician named Dr. Arlen Gottlieb. And I would say that he was one of the most instrumental people in my career. But I'll never forget a moment when he told the family of a very beautiful six or eight year old young girl that their daughter had leukemia, and that's tantamount to a death sentence. So that didn't sit well with me. Number one, for the very first time, I disagreed with Dr. Gottlieb and his approach to dealing with a family and a patient. And we can talk more about that in a moment. But I'm a very, very strong believer in never giving, never taking away someone's hope. When you are a cancer patient, you must believe that you are going to be well and do everything you possibly can. But back to the story. I just thought this was a fantastic opportunity and decided to pursue a career as a pediatric oncologist rather than to go into medical oncology. And thankfully, I've had a spectacular career and have had opportunity to meet and interact and care for thousands of patients and work with some incredible people.

Speaker1:
Hmm. Well, thank you for sharing that. And, you know, when you were mentioning sort of an experience, you had that that really just sort of lit a fire under you and made you realize, I want to do it differently. It couldn't help but think about my own journey into oncology as well. I was in a similar situation and there were some situations where I, I just felt like we've got to be able to do this better. This is not the way I want to care for my patients. And it really sort of sparked a similar interest in me. So thank you for sharing that and thank you for following through on that. I mean, easy enough to say, well, you know, it's easy enough just to sort of maintain the status quo and and not really do anything different. But you you didn't ignore that feeling you had.

Speaker2:
You know, I think it's very important as an oncologist, we all deal with statistics patients, whether they be parents of children or adult patients who are ill themselves or a loved one has cancer. They all want to know the statistics. Well, what are my chances? And I'm very, very firm believer. And I have tried to maintain this balance throughout my career. I would always tell a patient the truth, but even when the result or the outcome was predicted to be poor, I would say, why not? You know, someone has to do well. Why not you and and that kind of has carried me throughout my career and that I think it has been something that patients have appreciated as well, because it makes them it makes them want to get well. I think it empowers them.

Speaker1:
I agree. I think so too. I always tell patients we can talk about statistics and research all day, but. But none of that research has been done on you. You know, your. That doesn't apply to.

Speaker2:
Me, right? Exactly right. Someone is someone. Even if it's one chance in 100, someone's going to be that. Number one, why not you?

Speaker1:
I love it. I love it. So. So you have this distinguished career. You've you've treated pediatric cancer patients for for over 40 years. But but I understand you have one one patient, one case that particularly stands out to you as a as a miracle. Can you share that with us?

Speaker2:
Yes. Well, this is a fascinating case. This tragically was a teenage young woman, an African American young woman who had, when she was about seven or eight years old, had a heart transplant for a cardiomyopathy, meaning an infection of the heart. And she at that time, she required a heart transplant. And that was done very successfully at Columbia. But she had to go on medication that suppressed her immune system. So the graph, the heart would not be rejected. And I think the medication that she was on to prevent the cardiac rejection, her heart rejection, probably contributed to lowering her immune system to the point that she developed acute leukemia. And she had a very, very unusual leukemia, which we refer to as ambiguous lineage or by phenotypic. And what I mean by that is it didn't it didn't have the characteristics of AL, which is the most common childhood leukemia, nor did it have the characteristics of specifically AML. It had characteristics of both. So we began treating her as if she were AL, which is the prescription that we use, but she didn't really respond and we needed to switch therapy. And we then began to treat her with AML and she honestly didn't respond very well to that either. So this is something that. Dr. Stengel, I think that you're that your listeners would be interested to know. And this has happened to all of us in oncology. We sit in the conference room, we discuss patients. She's had two or three recurrences. She wants therapy.

Speaker2:
She still wants life. She's not willing to give up. Well, what do we do? And it's kind of almost like throwing darts against a dartboard and trying to hit a moving target, because at that moment in time, there really isn't a prescription that one can say, well, let's do this. So we chose a regimen. And unfortunately, the toxicity from that regimen made her very ill. She had a total wipeout of her blood counts, made her very susceptible to infection. She got a viral infection, pneumonia. And and I remember going into the room with her, speaking to her mother and saying, you know, I think it's going to be very, very difficult for your daughter to survive. And I guess the mom I said, Do you believe in miracles? And she said, Well, I'm not a religious person, but I do believe in God and I suppose I believe in miracles. And it reminded me of something that happened 35 or so years ago. It was Thanksgiving just about this time of year, early November, mid-November. And I treated a. A teenage girl who had acute myelogenous leukemia 35 years ago. That was one of those illnesses that patients did very, very poorly. And I remember going into the room, into the intensive care unit and speaking to her parents and saying, you know, I just don't see how your daughter is going to survive the night. So the mother of this particular patient was a very devout Catholic, and the parish priest in her community knew Cardinal Cooke, who was at that time the archbishop at Saint Patrick's Cathedral.

Speaker2:
He was a young a student at the seminary that at that at that the cardinal taught at. So he called the cardinal and he said, would you say special prayers for our patient? And the cardinal said, why don't you and the mother come in and we'll we'll have a prayer vigil together. So they go into the into the city and the cardinal says prayers over for this patient's well-being and the thanks to the mother for coming. And they were very grateful for the cardinal to take the time. And I remember walking into the intensive care unit the next day on Thanksgiving. I was on call and she's better. And I, I was scratching my my head. I said, you know, her fever is down. That's a really good step over the course of the next several days. Every day she got better and better and better. She was able to combat the infection. We were able to estimate her blood counts, began to return to normal. And I said to the parents, you know, this is just unbelievable. But, you know, I think we really need to give her more therapy. She's hardly had any. The parents refused to have any to to to allow any more treatment. So I remember asking the patient if she recalled any of anything that transpired. And she said, I had a dream. And Jesus told me I was not going to die.

Speaker1:
Wow.

Speaker2:
And she obviously left the hospital, had no additional therapy, graduated from high school, went to Notre Dame, became an occupational therapist, returned to New Jersey, married and has three children.

Speaker1:
Wow.

Speaker2:
And Cardinal Cook passed away several years later. And there was a movement to beatify him. And you needed to demonstrate three miracles. So I was interviewed by. By three church scholars to determine whether this could be categorized as a miracle. And I said, you know, I'm afraid I cannot tell you what constitutes a miracle or not, but that's up to you. But I can tell you without doubt that I thought this patient was going to die. She survived. I have no medical explanation for this. If that constitutes a miracle. This is one. So it was really an unbelievable life altering experience. And I and I've told parents many times that story, always at the end of life, I think families find great comfort in it, especially families who are religious Catholic families, but even those who are not. Because they again, it goes back to my feeling of never take away hope, no matter how dire the situation might be. Never take away hope.

Speaker1:
I love that. Thank you. That's a beautiful story. I love that you're able to tell such a great story. And also, you've obviously kind of remained in touch with with that patient. And and she's just gone on to have such a wonderful life since since you cared for her. That's wonderful.

Speaker2:
Yes, that is true. I know her family. Her dad passed away. Mom is still alive. And I my path is actually crossed with her brother, her older brother. So it's been it's been wonderful. And it truly is one of those incidents that occur in one's career as a physician. That is just something I will remember always.

Speaker1:
Hmm. That's great. Now. Now getting a little bit more personal. I understand that you have been a cancer patient and also been the father of a cancer patient. So. So how did those two experiences sort of change your view maybe or at least personalize your view of cancer a little bit more?

Speaker2:
Well, Dr. Stengel, first tell you about my about my daughter, who at 24 years of age was diagnosed with thyroid cancer. And this this is the sequence of events that I think is worth repeating. She goes to her internist for a physical examination. The internist feels a small little nodule in her thyroid gland, which you know as well as I do, is a tremendous pickup for the internist to be able to do that. It was about a sort of meter in size. And it was wonderful that that that the doctor was able to do that, but reassured my daughter. But don't worry about a thing. These are all usually benign, but I'd like you to have a sonogram done and maybe even a biopsy. So we arranged to do that within a day or so. And the radiologist who performed the procedure said, this is very common. I see the nodule in question. I'm going to put a little needle needle into it. But don't worry, most of these turn out to be benign. So my daughter and I leave the hospital and I tried to reassure her and reiterated the words that both her internist, the radiologist, told her. And I said, let's not let's not be concerned about it until we really have to deal with it.

Speaker2:
Well, wouldn't you know, it it turned out to be thyroid cancer, but something called the papillary thyroid cancer, which is quite common in young women. And my daughter and I spent the next several days learning everything we could about thyroid cancer. And when we went in to see the surgeon and the endocrinologist who cared for patients with thyroid malignancies, we were really very well prepared. My daughter is a very disciplined, very would not let one stone go uncovered. So we were very knowledgeable about thyroid cancer. And it was an interesting phenomenon for for me because I made the decision that I needed to be a father and not a physician. My daughter needed a physician. My hospital had a lot of excellent physicians there, but she did not need me to to to play that role. So we listened together. We did what our due diligence, we learned about it, watching her disappear into the operating room for the total thyroidectomy having her go on the low iron diet in order to have the radioactive iodine scan and then subsequently therapy for it was also an experience that I that I'm glad she's well and I think it gave me a different appreciation to see a child disappear behind the green door leading into the operating room and being isolated in the radiology suite, getting the radioactive iodine as well.

Speaker2:
I think that it also the I think the experience also impacted me in another way. And it gave me an appreciation really of what parents the ordeal that parents have to go through when their child is sick. I knew that Nerissa, my daughter's outcome was going to be excellent. Statistically, she only had the one nodule. It was removed. She had the radioactive iodine. And here's another paradigm that I live by. And that is that. One must recognize. It's one thing to tell a family, your child has cancer. It's quite another to say your child's cancer has come back. Your child's cancer has relapsed or any patient. Cancer is common, as you know. But I'm a very, very strong believer and I have lived by this golden rule, if you will. You must do whatever you can. The first time the first time in the treatment of any malignancy, I believe, is the one that must be the one that has the best chance to provide the best outcome.

Speaker1:
I love that. And if I may, just just to add to that, I mean, you know, a lot of our listeners are cancer patients or certainly, you know, relatives of loved ones or friends of cancer patients. And, you know, because we do talk about integrative oncology here, you know, a lot of a lot of our listeners are probably in a situation where there may be wondering, well, what what should I do? I've just been diagnosed. What do I do? Maybe maybe some of you listening have already done other things and are sort of at a crossroads. But I love your point, Dr. Weiner, because, you know, I see patients a lot in my office who who have sort of fooled around with it too long, almost this sort of idea of, well, it's early stage or I was just diagnosed or I've got time later to do X, Y and Z, so I'm just going to try something else now that's maybe not as thorough as it could be. So so I absolutely echo your your comment, your recommendation on that, you know, go at it with gusto from the outset because it's not something you want to play around with regardless of your diagnosis.

Speaker2:
I'd like to speak with you in a moment about integrative oncology. It's it's a it's an area that I have been interested in. But I'd like to share my own experience with you first as an example of what we're talking about at the moment. I was diagnosed. I felt a little lymph node beneath my right ear, which is an unusual place for lymph node. And it didn't really hurt. It wasn't really growing very rapidly, but it just didn't feel right to me. And if a pediatric oncologist, especially one who cares for patients with leukemia and lymphoma, the most frequent consultation I perform with patients is a child with a lymph node, and I've come to, with my fingers, be able to tell when should someone worry and when should they not? And this just didn't feel right to me. So I called a friend of mine. I said, John, I got this lymph node in my neck. Take it out. So he said, Come on up. He feels the lymph node. And he says, you know, I'm not concerned. Let's just leave it. I said, Do me a favor. Let's go take me into the treatment room and take this thing out. So, you know, just in the right, in the treatment room, using a little local anesthetic, he he did remove it and wouldn't you know, it turned out to be a follicular lymphoma. Follicular lymphoma is a indolent, slow growing type of lymphoma. And there is a disagreement about how to deal with them. And that's what I the point that I'd like to make. I had the full workup, pet CT scans, bone marrow aspirate, all the blood work that I needed. It was very localized. I had one additional small little lymph node also in my neck was positive. So I went to the oncologist and this is interesting. I asked my wife, who I adore and we've been married. We had our 45th anniversary just last.

Speaker1:
Friday.

Speaker2:
And she came to the to the to the oncology visit with me. And I heard the oncologist say there is no cure for follicular lymphoma. She heard the oncologist say, you're going to be all right. Right. We're both listening to the same words. We're both participating in the conversation. But I heard one thing. No cure. She heard you're going to be fine. Right. And the oncologist said to me, you know, we could wait and we could just see what happens. And you don't really need any treatment at this point in time. And I said, absolutely not. I want to be treated. Right. And I would advocate that. And it goes along with what we've been talking about. There is no advantage to waiting. If you wait, it's not going away by itself. You might as well eradicate it. Whether it is small, the disease is low grade and has not spread beyond the location, the primary location. I feel very, very strongly about that. I really do. But I also I know you have interest in integrative oncology, as do I. And in 1995, I became the director of our Children's Cancer Program at at Columbia. And I had a young colleague who I had just recruited from University of Pennsylvania, from the Children's Hospital of Philadelphia. And we were talking about some things that she might get involved with, trying to develop a niche or an expertise. And I said to her, you know, there's not a lot known about alternative and or complementary medicine. Why don't we look into that? So we started by doing a survey and we interviewed about 60 or 70 patients with a questionnaire.

Speaker2:
And quite to our surprise, over 80% of the patients we were caring for were doing something in addition to the prescribed medication, surgery, radiation that we had recommended. So we scratched our head and we said, my goodness, that's an unbelievable number. They were taking vitamins, they were using herbs, they were using medicinals. Columbia is situated in northern Manhattan, and there are a large number of patients from the Dominican Republic in the Caribbean and Puerto Rico, from the South Bronx and so forth. And and culturally, this group of patients were very, very strong believers and advocates of using complementary medicine. So we started based upon our finding in our survey, we started an integrative oncology program, and we began the primary reason was we wanted to find out what the patients were using and would it be safe for them to continue as as we were implementing a protocol of chemotherapy and so forth, could there be interactions? Could there be something that they were taking that would inhibit one of the medications that we wanted to give them? So the first thing we did was ask them to bring what they were using into the hospital. And we try to do a search to look for drug interactions. But then we we took it another step further. We began to recommend nutritionals and we began to recommend herbal medicines. And we began a an acupuncture and a Reiki program and massage. And we offered it not only to the patient but to the families as well. Now, one thing is very, very important. This is not intended to be the sole treatment.

Speaker1:
Correct?

Speaker2:
Absolutely not. It is intended to be an adjunct to therapy. It's to potentially lessen the side effects of nausea and vomiting. It's to make you feel better. It also empowers patients because they feel as though they're doing something positive for themselves. They have to rely upon the doctor and have trust that the doctor is choosing a regimen that is safe and effective. But this allows them to do something proactively. And that is a very, very powerful component of that treatment.

Speaker1:
Hmm. Thank you for that. And I agree 100%. It's interesting. You know, I've been very intentional about explaining what integrative means and always explain it. It is the best of both worlds. We're not refusing and rejecting modern medicine. We're we we embrace conventional medicine, you know, chemotherapy, surgery, radiation, whatever it may be. But we also embrace, you know, alternative therapies as well that have a good evidence base behind them. And so what's interesting, some patients will call my office and say, well, I want integrative treatment, but I don't want that chemo that you do. And we're like, well, no, no, that's not integrative. That's that's holistic and that's different. So I really do believe that we need both. And I think as long as we're safely adding some of these things in, in addition to the really proven therapies, that that we shouldn't go wrong that way. And obviously, we do it with the with the intention that we're learning as we go in some cases. But but thank you so much for for sharing that. I totally agree.

Speaker2:
Yeah. It's very, very important, Dr. Stengel, for your listeners to to be able to appreciate the very, very key element that that alternative and complementary holistic approach is not the sole therapy it's to be used in conjunction with. Right. And we have.

Speaker1:
That.

Speaker2:
I'm sorry. Yeah.

Speaker1:
They say we have good research supporting that. I mean, you know, they did a study with just a few years ago at Yale, my my alma mater, and they they looked at patients who basically rejected the the recommended standard of care and did alternative treatments instead. And, you know, not surprisingly, to me, the results were horrible. I mean, they did not do well. So we have good evidence showing that that if you just kind of completely shun sort of the standard of care completely, that you're not going to do well, statistically speaking. So so yeah, we got to include all the good evidence we have for all the treatments that have good science behind them. Right. So that's that's part of what I'm trying to do with this podcast is, is really sort of bring those two worlds together because we need both.

Speaker2:
I'm going to. May I tell you a little story? True story. Many, many years ago. I had a cousin who I was quite close with, and he had Hodgkin's disease. And I was I was at Columbia at that time. It was in the late seventies or early nineties. I had just started my career and he came to me and I gave him the name of one of the adult oncologists who began treating him with a regimen. In that era. You probably recall it was a regimen called Mop Mop, which was one of the very early regimens developed by Dr. David at the National Cancer Institute, who also was at Yale. Were you at Yale at the same time? He was Vince DEVITA?

Speaker1:
No, I was a little after that. I was probably there about a decade ago.

Speaker2:
But in any event, it was it was one of the very first regimens that was proven to be effective in Hodgkin's disease. And it was one of the the protocols that began saving the lives of patients with this illness. But it was a very, very difficult regimen to tolerate. And in those days, we did not have the same kind of supportive care measures that we have today to prevent nausea and vomiting and all of the other side effects that that are part of a chemotherapy regimen. So my cousin, who owned a restaurant and he befriended John Lennon, who was someone who I'm sure you know, and he and John actually became friendly. And if you read John Lennon's biography or Yoko Ono's biography, my cousin is mentioned in many of their books, but he jumped. My cousin Richard went to John and he said, You know, I can't tolerate this chemo anymore. John Lennon said, I have a friend named Steve McQueen who went who 45, 50 years ago is a very famous actor. And Steve McQueen had Hodgkin's disease also. And John Lennon introduced my cousin to Steve McQueen, and they went to Mexico together for alternative therapies and they received Layer Trill. He died a month later, both of them, McQueen and and Richard. So I urge your listeners, do not rely on these medications as your sole therapeutic regimen. They don't work alone.

Speaker1:
Agreed. Agreed. So I'd like to talk next about sort of the things you're most excited about in in pediatric oncology. What kinds of things excite you the most in the field? And just so you know, you are our first guests, our first episode devoted to pediatric oncology, because obviously I treat only adults. And so that's typically what I talk about and the guest I have. And so I'm sure we have listeners who certainly have children with with pediatric cancer or are just interested in learning more. So. So what what are you most excited about?

Speaker2:
Yes. So I should first tell you that. I've been doing this a very long time. And when I first started in the early seventies. Almost most patients with with all types of different cancer died with childhood malignancy. But there were many seminal discoveries, many seminal events, the formation of cooperative groups to begin doing clinical trials and slowly through the eighties and nineties, chemotherapy regimens for leukemia and other tumors like Wilms tumor and things of things of that. Some of the lymphomas good regimens were developed and cure rates began to improve. Now, childhood cancer itself is a rare disease. There's only about 15,000 cases in the United States diagnosed each year, and that qualifies as a rare illness. However. All of us know someone who has been affected. Family has been affected with a child with cancer. So the cure rate begins to improve today. Al is curable. Wilms tumour, Hodgkin's certain type of non-Hodgkin's lymphoma. But what does the future look like? Because I think we've gone about as far as we possibly can with the traditional chemotherapy, radiation and surgery. And I've noticed over the last decade a shift in the way that we're approaching patients. Patients today are getting immunotherapy as opposed to chemotherapy or they're getting combinations thereof.

Speaker2:
We're starting to use precision medicine to identify abnormal genes and gene pathways and be able to knock out that particular pathway with inhibitors of genes that are either promoting growth or suppressing the immune system. So I think that there really is a future that is changing. And I think over the next five, ten years or so, we're going to see a decrease in chemotherapy, decrease in a lot of the modalities that we're using today, and a shift towards immune therapies directed specifically at the cancer with antibodies on the cancer surface that drugs are being developed to eradicate those malignant cells. And I also see insertion of genes or using the power of gene therapy to be able to change the paradigm of of treatment. I'm very excited about the future. I hope that I'm around long enough to see the the change take place. You know, the whole car T-cell therapy story is a fascinating story where you take the patient's cancer cells, you make antibodies outside the body, you know, in a hybrid model, and you give them back to attack the cells. It's fascinating what's being done today. And I think that there should be great optimism that cancer outcome is improving. Every day gets better and better.

Speaker1:
Excellent. Very exciting. You know, because I remember when we you know, when we're able to map the human genome for the first time, there was all this excitement, you know, and even today, at this point, a lot of what we can find out when we look at a patient's genome, it's it's. We don't know what to do with the information yet. I mean, sometimes you I mean, I run reports on patients, sometimes the same same ones. You run, I'm sure, where you're looking at a piece of their tissue and you're looking at certain mutations and things like that. And many times it'll we don't know what to do with it. This is abnormal, but we maybe don't have a way to treat it or target it yet. And as you're saying, that's that's coming soon. We're going to be able to do that even more.

Speaker2:
Than I think we we started a precision medicine program probably about ten years ago. At that time, it was very time consuming and very costly to be to be searching for abnormal genes. Today, it's a much less expensive proposition and also one that is much less, less costly to do. And there are commercial laboratories that are taking tumor tissue and identifying abnormal genes in that in that sample, in pediatric oncology, we are finding that more than 50% of the patients that we are treating have something in their genetic sequence of that tumor that has been identified. Now, whether or not that is a driver that is causing the cancer. Not quite certain of that. But once the gene is identified, it won't be long. I don't think it won't be a very long time before medications are developed, Gene, specifically to to attack those genetic pathways. So and I think that that is a is a very bright future. Now, these drugs may additionally be toxic. They'll have to go through extensive clinical trials. But I'm optimistic that we'll be able to unravel these mysteries and the paradigm of treatment change.

Speaker1:
Hmm. Excellent. I mean, it's really the ultimate in personalized medicine, right? I mean, we both talk to our patients about personalized medicine and treating them as a unique person. Well, that's the ultimate.

Speaker2:
It is absolutely correct.

Speaker1:
So my next question is, is more of a general one. I mean, what do you feel that that doctors in hospitals and medical facilities can can do to provide better and more compassionate cancer care?

Speaker2:
Hmm. Well, I'll tell you a little bit about my own experience, as you can imagine, because I have been in New York for so long, and even though I worked most of my career at Columbia, I knew other physicians, whether they be at Cornell or Sloan-Kettering Memorial or NYU, that I could speak with. And I had opportunity to I'm always I always find it interesting when someone is the best known or the biggest doctor. You know, I've always had that kind of really kind of, you know, attitude. But when I sought advice and chosen oncologists, I wanted a doctor who would be my partner. I wanted this doctor to join me on a new experience, a journey with cancer. I had confidence that Dr. Amador was going to make the right decisions, but she was a she was available to me and she was my partner on on this journey. And I don't think it was just me because I had the same nametag that she did. I think that's the way that she approached her patients. And I think that that is very, very important. I know that that's very, very important. You want to choose a doctor who is going to be your partner and someone that you can trust. I found cancer to be very isolating because despite the fact I told you the story of my wife sitting in the room and hearing something different, my friends or my not many people where where I work knew what what I was going through and my treatments and so forth. But some did, and they would say, Well, let me know, is there anything I can do? Is there anything that they could do? No, there isn't.

Speaker2:
Right. So when I was on the radiotherapy table at 730 in the morning, that cold, ice cold table and unable to move, you're alone in that room with that big machine traversing across your your body when you're sitting in the chemotherapy suite. You're alone. So I found that cancer is a is an isolating experience. And the other thing that I have personally recognized is many people refer to cancer as a battle. Mm hmm. As a war. I'm fighting this battle. I never view cancer as a battle or a war. It's something that patients have to accept. I have it. I'm going to do whatever it takes to get well. I trust my doctor. I'm going to use whatever else is in the armamentarium that I'm going to use. Thus, integrative and complementary medicine has a role, and I embraced it as well. And I think that there is very important gain for patients to psychologically prepare themselves for treatment and to get well. And those resources are available. And patients must seek them. They must find Who can I talk to? Where is it? The social worker? Is it a psychologist? Is it another patient group? It becomes very important and it helps one overcome that isolation and allows them to move forward. And this concept of battle and war and winning. Does it mean that if a patient unfortunately dies, that they lost the war? Their fight was as noble and as hard fought as anyone's. But yet they didn't. They didn't lose the war, didn't they? So I don't like that concept of battle and war. It's an acceptance. It's trust that you and do whatever you can to make yourself, well.

Speaker1:
Beautiful. I love that. So tell us about your book, Living Cancer.

Speaker2:
Well, I wrote the book because I have had. Hundreds and a thousand patients and families that I have come in contact with through the years. And in some way they all have, you know, affected me and some I remember better than others. But the stories that I tell in living cancer stories of an oncologist, father and survivor were unique. I related the story of the young woman who had the ambiguous leukemia and the miracle. That was a very moving period for me. But this young lady was raised by a single mom who was not readily available for her. She worked. She wasn't. They lived in Brooklyn. It was hard for her to travel back and forth. So she spent long periods of time in the hospital alone. And she relied upon me in some way to be almost like a surrogate father, a surrogate parent. And at times it was uncomfortable because I had to be her doctor. And but she was asking me advice about boyfriends and dating and things of this nature. And it was you know, it was an interesting experience. And there were other patients from the young man who had this very unusual cancer, who was an extraordinary student and the best long distance runner in the state of New Jersey. And all he wanted to do was to go to the University of Pennsylvania and run in the the Penn Relays and Franklin Field. And I and I remember I had a mutual friend who was very influential, was on the board at the University of Pennsylvania.

Speaker2:
And I called my friend and I said, Rob, look, Bill really wants to go to Penn. He applied early decision, but he's sick. He'll never matriculate. But see what you can do, you know, to help him get in. So he wrote an essay and he applied early decision and I saw no reason why he wouldn't get in to the school, but he didn't. He got waitlisted. And I remember saying to my friend and and I wrote a note to the University of Pennsylvania, how could you do this? You knew this. This student wasn't coming. What was the big deal? He was, you know, and and then then it occurred to me that what transpired, the track coach was only given a certain number of students that he could recommend that the Ivy League schools ostensibly don't give scholarship, but they can select students who they want to be admitted if assuming they meet the the academic standard, this kid should have gotten in. But if the coach put him on the list, he was going to be one student on his track team down. And I'm sure that that's what happened. And it was just a horrendous experience. And I got very close with this young man and with his mother, who kept an extensive diary and she found great comfort in talking with me. And it really shed light for me, even this late time in my career about what it was really like to have such an outstanding son and having such a terrible illness.

Speaker1:
Hmm.

Speaker2:
Yeah.

Speaker1:
Well, your book sounds wonderful. Where can our listeners purchase a copy of your book?

Speaker2:
Well, it's available on Amazon. And, you know, the other large online book sellers, Living Cancer Stories of an oncologist, father, survivor. Thank you.

Speaker1:
Excellent. And then tell us more about the hope in Heroes Children's Cancer Fund.

Speaker2:
Oh, my goodness. With great joy. I will. So when I became the director of our pediatric cancer program at Columbia, I recognized very quickly that one of the most important responsibilities I had was to make sure that the finances of our division were secure. And there was a time when divisions departments could rely upon money that was being generated from patient care, insurance companies and whatever, and grants to support the enterprise. But as managed care began to take a much more prominent role. I saw that that was not going to be happen. That would not that would not allow us to do what we needed to do. So I started this charity, Hope and Heroes Children's Cancer Fund, and we're celebrating our 25th anniversary this year. And I started by going to a few friends. Let's run a golf outing. How about a dinner? Let's do a walkathon. Today, the charity has raised $100 million through the years, and we've supported recruitment and retention of scientists and gave them start up funds. We've raised money for five endowed chairs. We have a neuro oncology program, neuro giving novel neuro oncology medications through a novel delivery system with infusions directly into the brain. And it's been fantastic. And we support our psychosocial program. We support integrative oncology, all of the we give to families in need for food insecurity. Our social workers will work with families, and we actually provide food and transportation to families who are in need because the cost of cancer care is, you know, it's just so expensive and it's been a joyful experience. We have a very, very committed board who has been with us on this journey. And as I get ready to retire, which will be soon, I look forward to devoting all of my efforts to hope and heroes and, you know, going the next step with our charity.

Speaker1:
Wow. Well, thank you so much for all your hard work with that. Made a big difference. I know.

Speaker2:
It did. It evolved out of need, but grew into something very special.

Speaker1:
And you and you are accepting new patients.

Speaker2:
No, I'm not actually doctor single. I actually stopped seeing patients about a year ago. I think that the pandemic was instrumental in in in doing that. I was. Immunosuppressed myself, and I really couldn't be in the hospital during the height of the pandemic in New York. So there were long periods of time when I wasn't present and couldn't participate. And and it just seems safer for me to to stop being involved in patient care.

Speaker1:
Okay. Well, Dr. Winer, before we before we close our interview, I like to give you a chance to let our listeners know how how they can connect with you. Website, obviously, your book, anything like that.

Speaker2:
You know, and I can be reached by any of your listeners if should they want to do so. I'm not a great social media practitioner. I do have a Facebook page or a the book has a Facebook page as well. And I think that's the best way.

Speaker1:
Perfect. So so what's the website for your book?

Speaker2:
It's Living Cancer dot com.

Speaker1:
Leaving cancer dot com. So we'll make sure our our listeners know to check out living cancer and that they can purchase purchase the book through Amazon or any of the major online retailers.

Speaker2:
Right. Correct.

Speaker1:
Excellent. Well, Dr. Weiner, thank you so much for for being with us today. It's it's been a wonderful honor. Thank you for your time. I know you're busy.

Speaker2:
I appreciate it. I enjoyed it immensely. And thank you for the opportunity.

Speaker1:
And just as a quick reminder to our faithful listeners, if you're enjoying these podcasts, please take a minute and provide a review on iTunes or Spotify or wherever you listen to podcasts. And please subscribe to the Cancer Secrets podcast to be notified whenever new episodes are released. And our website's Cancer Secrets Ford Podcast has all of our episodes available to listen at your convenience. We have some wonderful episodes coming up later this season, and thank you all for now. Goodbye.

Speaker2:
Bye bye. Thank you.

Speaker3:
Oh.

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