In the third of our special series on living with bone metastases, we are turning to one of the most frequent questions and concerns we hear: Can I exercise??

To get the answers, OMBCL co-hosts Ashley Fernandez and Martha Carlson spoke with Dr. Kathryn Schmitz, who has led the way in understanding and implementing exercise for people with breast cancer, including those of us with metastatic breast cancer. Dr. Schmitz founded the Moving Through Cancer initiative of the American College of Sports Medicine, which has a bold goal of making exercise standard of care in oncology by 2029. She fills us in on the science of exercise – why it’s important and how it can be done with bone metastases. In this interview, she provides straightforward advice about what can be done, what to watch for, and connects us to resources that can help you get started after getting the okay from your oncologist.

Interspersed into the interview with Dr. Schmitz are the stories of people living with bone metastases, providing hope and inspiration that exercise is possible. We reached out to the incredible Facebook community called Active with MBC, a private group for people who already exercise and stay active and those who aspire to it. Many thanks to the women who responded to our survey with honesty and insight and to Angel, Quinn, and Glenda, who joined us with interviews and sent videos to inspire us.

This episode is close to the hearts for all of us at OMBCL, whether living with bone mets ourselves or not. We have all witnessed how this particular type of progression can be both invisible and life-changing. We hope that you feel supported and seen. And know that whether you simply walk to the mailbox or run a marathon, we are with you!

Check out our website for detailed show notes and links to some great online resources on exercise/fitness!

In this second of three episodes on managing bone metastases in MBC, we bring you a broad review of the major interventions to treat and manage bone mets. We explain the differences among the specialties of Radiology (think x-rays and PET/CT scans) vs. Radiation Oncology (external beam, Stereotactic Radiation Surgery (SRS) or Stereotactic Body Radiation Therapy (SBRT) and Interventional Radiology (Biopsies, Cryoablation, Radiofrequency Ablation among others). The majority of patients with MBC have bone metastases and may have been treated with some form of radiation. For patients with "oligometastatic" disease, where the number of distant sites of metastatic spread is generally considered to be 5 or less, radiation treatment may be “curative”. It gets a little less clear in those of us with heavier tumor burden and more widespread disease. In that case, radiation is often offered for pain and neurologic considerations, such as preventing a tumor from pressing on the spinal cord, possibly resulting in serious spinal cord compression. But, can different radiation strategies be helpful in disease management, beyond pain management? We ask these questions of both experts here – the first Dr. Shalom Kalnicki, Professor of Radiation Oncology and Associate Director of the Montefiore Einstein Comprehensive Cancer Center in New York City. Our second expert clinician is Dr. Rory Goodwin, who leads the Duke Center for Brain and Spine Metastasis in Durham, North Carolina. He’ll talk about this innovative Center’s approach to managing bone mets, including offering some lesser-known treatment approaches like Cryoablation (freezing the tumor), and Radiofrequency Ablation (heating the tumor). We also address an emerging therapy called “Theranostics” which is when a radioactive tracer (like the ones used in PET/CT scans) is bound to a radiation treatment that can deliver a lethal dose directly to the bound cancer cell. So listen here and learn with us, and check out the more detailed show notes on our website for the links to what’s covered in the episode.

Today’s episode is the first in a three part series covering all things related to bone metastasis. In our first episode, we’re covering the basics starting with some bone education. We’re joined by Dr. Azeez Farooki, an endocrinologist at MSK, who discusses his role on treatment for bone disease stemming from breast cancer. We’re also joined by Dr. Monica Fornier, a breast medical oncologist also at MSK, who treats people living with metastatic breast cancer. Both doctors will be diving into bone disease & the latest in breast cancer bone metastasis research. Topics include theories on why breast cancer spreads to the bones, as well as the future of bone metastasis research and treatment. We unlock the wisdom of these top experts as they bridge the gaps between advancing research and patient care in a thought provoking conversation.

Even though breast cancer research is comparatively well-funded, researchers still don't fully understand the many different ways metastatic cancer eventually evades currently available treatments. Just like a detective can learn much from studying the scene of a crime, researchers need to understand how breast cancer causes death to better understand how to stop it from doing so. One of the quickest ways for them to do that is through something called a tissue donation program.

Many of us are familiar with organ donation programs, but as metastatic patients, we are no longer eligible to donate our organs to another person. We can, however, donate tissue while we're still alive and tissues, including organs, soon after we die to aid thousands of future patients by helping researchers better understand the process of metastasis. Understanding the way cancer evades current treatments is key to developing more effective and more targeted treatments that let us live longer (and with a better quality of life) with the hope that one day we can stop MBC from prematurely ending our lives.

To learn more about tissue donation programs and why they are so essential to scientific discoveries, we talk with patient advocates, Stephanie Walker and Christine Hodgdon, along with breast cancer researcher Dr. Steffi Oesterreich and clinical coordinator Lori Miller about the topic of tissue donation in general and the specific program they're all involved with called Hope for Others at the University of Pittsburgh.

Did you know that in the US rural communities have lower cancer rates but higher death rates from cancer? Did you know that only 3% of medical oncologists practice in rural communities?

When it comes to cancer, living in a rural area puts people at a disadvantage.

They face limited access to quality healthcare, long travel times, and low recruitment to clinical trials, all of which affect quality of care and health outcomes. Join our producers Stephanie Walker and Martha Carlson, along with their guests, in the deep dive into this important topic.

The landscape of medication to treat ER+, HER2 negative or low is changing rapidly as patients experience progression on CDK4/6 inhibitors and look for next steps. Now that biomarker testing is more readily available (both tissue and liquid), there are more options particularly in the PI3 kinase pathway. In this episode we will discuss biomarker testing, the PI3 kinase pathway, and an exciting new patient initiative, the PIK3CA Pathbreakers.

Today we are bringing you a special episode that we created in partnership with SHARE Cancer Support. It’s an audio version of a live webinar that was done this past February called Report back from San Antonio Breast Cancer Symposium 2023. SABCS is the world’s leading breast cancer research meeting where scientists, patient advocates, and others dedicated to working in the field of cancer gather.

In this podcast, Dr. Timothy Pluard, director of the Saint Luke’s Koontz Center for Advanced Breast Cancer, breaks down the promising research, targeted therapy, the evolving treatment after CDK 4/6 inhibitors, liquid biopsy and more.

We wanted to start this season with an episode dedicated to our friend and team member, Natalia Green. Natalia passed away from MBC at the age of 39 on November 29, 2023. She was an integral part of the podcast team, having been a senior producer/host and right-hand woman to Lisa Laudico, our founder. She became involved in the podcast through her advocacy work, starting first after her early-stage breast cancer diagnosis, then becoming more involved in the metastatic breast cancer community after she received her MBC diagnosis. She was a devoted mother to her daughter Rosy and son Iggy, and a loving wife and friend to her husband of 19 years, Danny. She was a daughter, a mother, and a cousin, holding a special place in the lives of everyone she met. Lastly, she was our friend. We’ll miss hearing her speak with passion about topics she wanted to cover on the podcast, we’ll miss seeing Iggy & Rosy pop their heads into our Monday meetings, but mostly we’ll miss seeing her beautiful smile. The entire OMBCL podcast team is lovingly dedicating our 8th season to Natalia. We hope it holds a modicum of the impact that Natalia has had on the world.

The team would love to extend our heartfelt thanks to Danny Green for all his help in creating this episode.

MUSIC CREDITS:

-'Meditation I' by Sufjan Stevens

-'Fare Thee Well (Dink's Song)' by Oscar Isaac and Marcus Mumford