Dr. Tyler Hillman

Topic: Granulosa Cell Tumors, What You Should Know
Guest: Dr. Tyler Hillman, Associate Professor, University of California, San Diego

Key Highlights: Research & Clinical Insights

• GCT as a Rare Cancer: Affects ~0.5 to 1 in 100,000 women. Characterized by hormone (estrogen) overproduction.
• Research Innovation: Dr. Hillman’s lab creates tumoroid and organoid models for drug testing. Key discovery: Glucocorticoids promote GCT growth; blocking these hormones may be a treatment strategy.
• Repurposing Drugs: Exploring drugs from breast cancer and hormonal disorders (e.g., aromatase inhibitors, Lupron, ketoconazole).

Treatment & Clinical Management

• Limited Chemotherapy Efficacy: ~40% response rate. Carefully balanced use to maintain quality of life.
• Surgery as a Mainstay: Often repeated (3–4 times per patient). Recommended minimum 1-year interval between surgeries.
• Hormonal Therapy Post-Surgery: Use of aromatase inhibitors and Lupron. Side effects include estrogen deprivation symptoms and bone density loss.

Juvenile vs. Adult GCT

• Classification based on pathology, not age. Adults can have juvenile GCT and vice versa. Juvenile type is ~5% of all GCTs.

Clinical Trials & Access

• No open GCT-specific trials currently. Endocrine and immunotherapy trials are promising. Emphasis on collaborative care models with remote expert consultations.

Challenges in Rare Cancer Research

• Funding gaps, especially for surgical and non-patented drug studies. Industry funding supports drug development but overlooks survivorship studies.

Patient Empowerment & Advocacy

• Ask care teams: “How many GCT cases have you treated this year?”
• Seek specialists who regularly treat rare cancers.
• Community support via groups like Facebook and Overcome.org is crucial.

Role of AI

• Currently supports research and literature review. Future potential in AI-driven treatment plans and predictive diagnostics.

Final Messages

• Advocate for yourself—especially younger women.
• Stay connected through community networks.

 “Be involved. Stay connected. You are not alone.”

Dr. Elizabeth Swisher

Topic: Innovations in Ovarian and Gynecologic Cancers
Guest: Dr. Elizabeth Swisher, Professor & Director of Gynecologic Oncology, Fred Hutch

Key Highlights of our episode

We talked about: Precision Oncology & Progress

• Personalized Treatment: Shifting from “one-size-fits-all” to personalized approaches based on molecular tumor profiling.
• Functional Precision Medicine: Using biopsies and AI to identify cancer vulnerabilities and tailor treatments early in the disease.
• Antibody-Drug Conjugates (ADCs): A major advancement delivering targeted chemotherapy directly to cancer cells, reducing toxicity.

We discussed: Clinical Trials & Therapy Advances

• PARP Inhibitors: Effective for BRCA-mutated and HRD+ cancers, mostly used in maintenance settings due to toxicity when combined with other therapies.
• ADC + PARP Combo: Being explored but limited by cumulative toxicity.
• Clear Cell & Endometrioid Ovarian Cancers: More hormonally driven, with parallels to endometrial/breast cancers—CDK inhibitors show promise here.
• Rare Subtypes (e.g., Granulosa Cell Tumors): New trials are opening, providing hope after years of limited progress.

Recruiting: CHANCES Study (Clonal Hematopoiesis in Cancer Survivors)

• Investigating blood-based predictors of secondary cancers (especially leukemia/MDS) due to platinum and PARP exposure.
• Eligibility: Ovarian cancer survivors with past platinum and/or PARP exposure. Blood draws every 6 months. Nationwide enrollment.
• Goal: Predict and eventually prevent therapy-related secondary blood cancers.

Role of Genetic Testing for Prevention

• Up to 20% of ovarian cancers are hereditary. Earlier and broader testing (even pre-diagnosis) can prevent cancers through proactive interventions.
• Emphasis on shifting genetic screening into primary care and mainstream medicine.

Recommendations for Ovarcomers

1. Participate in Clinical Trials
   • Consider and look up details of the CHANCES Study if you had platinum/PARP exposure or persistent blood count issues.
   • Use Ovarcome’s clinical trial portal or contact Dr. Swisher’s team directly.
2. Get Genetic Testing Early
   • Even if you don’t have cancer, knowing your hereditary risk can inform preventive strategies.
   • Encourage family members to get tested, especially if there’s a family history.
3. Push for Second Opinions
   • If your treatment plan doesn’t feel right, seek another expert view
4. Stay Informed on New Therapies
   • Keep up with developments in ADCs, immunotherapy, and molecular profiling—they are redefining gynecologic cancer treatment.
5. Advocate for Inclusivity in Trials
   • Raise awareness about the exclusion of highly resistant cases from trials—those patients need options most.

Dr. Renee Stubbins

Topic: Oncology Nutrition, Lifestyle Wellness, and Cancer Recovery
Guest: Dr. Renee Stubbins, Oncology Dietitian, Houston Methodist

Anti-Cancer Diet & Food Choices

• Focus on a balanced, plant-based diet (not necessarily vegetarian).
• Whole foods > food products; avoid ultra-processed, shelf-stable items.
• Rule of thumb: if you can understand the ingredients, it’s likely safe in moderation.
• Water intake is crucial; cold plunges and saunas help indirectly via stress reduction.

Protein, Meat, & Plant Alternatives

• Limit red meat to 12–18 oz/week; choose grass-fed AND grass-finished options.
• Plant-based proteins to include: soy, beans + rice, quinoa, flax, chia, nuts.
• Watch labeling and sourcing — local farms may use organic practices even if not certified.

Supplements & Safety

• Vitamin D + Calcium recommended, especially for women 40+.
• Avoid high-dose Vitamin C during chemotherapy (especially platinum-based regimens).
• Omega-3 is good post-treatment. Avoid herbal supplements unless physician-approved.
• Many supplements lack regulation — be cautious and consult healthcare providers.

Hydration & Electrolytes

• Drink ~64-72 oz/day; needs increase during treatment or in heat.
• Use urine color to monitor hydration; balance electrolytes with coconut water or low-sugar powder blends.
• Don’t overhydrate: can dilute sodium/potassium levels.

Cooking Oils & Smoke Points

• Olive oil: great for finishing dishes (low smoke point).
• Avocado oil: ideal for roasting/sautéing (high smoke point).
• Canola, butter, lard better for high-heat applications — but less healthy.

Lifestyle, Sleep & Exercise

• Sleep is recovery time — aim for 8 hrs; nap if tired during treatment.
• Light morning or evening walks are excellent — motion maintains energy and muscle tone.
• Sunlight improves mood and vitamin D, but wear sunscreen and go out during low UV hours.

Final Message from Dr. Stubbins

“Eat your fruits and vegetables, stay active, and get lots of rest and sunlight.”

Dr. Erin Stevens

Topic: Compassionate Cancer Care, Survivorship, and Innovations in Treatment
Guest: Dr. Erin Stevens, Surgical Oncologist, Prevea Health

Key Highlights of Our Episode

Language & Emotional Support

• Dr. Stevens challenges the use of “war” metaphors in cancer, emphasizing they can invalidate feelings like fear, grief, or acceptance.
• Normalizing the emotional spectrum—including survivor’s guilt and post-treatment anxiety—is key to whole-person care.
• Providers are encouraged to create safe spaces where patients can “sit in the hard” moments without pressure to stay positive.

Rural Cancer Care Challenges

• Rural patients face limited access to clinical trials, diagnostic tests, and support services.
• Priorities like farm seasons, snow conditions, and long travel must be honored and worked around, while optimizing care
• Despite resource gaps, community support systems (neighbors, churches, meal trains) are strong in rural settings

Clinical Trials & Accessibility

• Trials requiring travel are often deemed burdensome, further reducing participation—bring drugs to patients when possible.
• Better consent education and simplified language improve understanding and engagement.
• Low-barrier trials (e.g., blood sample studies) are popular and impactful.

Long-Term Side Effects

• Neuropathy and chemobrain are common, persistent side effects.
• Speech language pathologists are underused allies in managing cognitive symptoms.
• Sleep issues, surgical menopause, and emotional fatigue require honest counseling and daily lifestyle strategies (like journaling, temperature control, or digital detox).

Rare Tumors & Personalized Care

• Dr. Stevens highlights carcinosarcomas and endometrial stromal sarcomas—rare and aggressive tumors.
• New clinical trials are targeting HER2 mutations in gynecologic cancers.
• Personalized care means understanding and honoring patient goals, not just prescribing standard therapies.

Recommendations for Ovarcomers

1. Feel everything. You don’t have to be positive all the time—your full range of emotions is valid.
2. Use simple tools like brain games, gratitude journaling, sleep hygiene, and nature walks—daily.
3. Ask about eligibility for clinical trials, even low-effort ones (e.g., blood-based biomarker studies).
4. Learn your mutation profile. Ask if your cancer has HER2, BRCA, HRD, or other actionable markers.
5. Celebrate wins. Even small, good news moments deserve recognition—you are living life and Ovarcoming strong.

Katherine Lawrence

Key Highlights

• Katherine Lawrence, a certified nutritionist, reversed stage 4 endometriosis and reproductive issues through a whole food, plant-based diet.
• This episode emphasizes how food choices directly impact mental health, sleep quality, and long-term energy.
• Dairy intake (especially for ovarian cancer survivors), ultra-processed food, and high-fat meat consumption are best avoided or used in minimal moderation, while embracing whole, plant-based alternatives.
• Fiber-rich Mediterranean-style diet minus excess oil and animal products is recommended by Katherine.
• Diet and lifestyle shifts may support cancer recovery, prevention, and resilience.

Actionable Takeaways

• Start by ‘crowding out’ processed foods—gradually introduce more veggies, legumes, and greens.
• Embrace soy in moderation (tofu, tempeh, miso) as a protective element.
• Replace dairy with fortified plant milks to reduce cancer-linked IGF-1 growth factors.
• Prioritize cruciferous vegetables—powerful allies against cancer progression.
• Include red miso, kimchi, and kombucha to nourish gut flora and support immunity and
• Nourish the whole self: prioritize movement, rest, mindfulness, and emotional nourishment alongside diet.

Dr. Kara Long

Topic: Surgical Advances, Prevention, and Personalized Care in Gynecologic Cancers

Guest: Dr. Kara Long, Surgeon & Oncologist, Memorial Sloan Kettering Cancer Center

Key Highlights of our episode

Surgical Innovations

• Surgery types include diagnostic, debulking, and preventive approaches.
• Open surgery remains gold standard for extensive disease; robotic/minimally invasive surgery considered in selective cases.
• Second-look surgery is being re-evaluated in the era of maintenance therapies.

Clinical Trials & Second Look

• Second-look trials (e.g. with Bevacizumab) assess minimal residual disease and inform next treatments.
• Used for research and tailoring therapy, especially in remission or recurrence context.

AI, Genetics, & Early Detection

• AI may assist in surgical planning and risk stratification.
• Genetic knowledge essential—universal genetic awareness is necessary.
• Nanotechnology with carbon nanotubes + AI is being explored for early cancer fingerprint detection.

Prevention Strategies

• Fallopian tube removal emerging as risk-reducing option.
• Clinical trials (TUBA-WISP, SOROC, Protector) explore delaying ovary removal in high-risk women.
• Even average-risk women benefit from opportunistic salpingectomy during unrelated surgeries.

Personalized Considerations

• Surgery must improve quality or quantity of life—sometimes avoided based on fitness, age, or minimal benefit.
• Age and subtype matter: personalized medicine is advancing using molecular profiling.
• Importance of respecting patient goals and values in decision-making is emphasized

Recommendations for Ovarcomers

• Ask your care team about second-look surgery or relevant clinical trials.
• Consider fallopian tube removal during hysterectomy or sterilization procedures.
• Know your genetic status—especially BRCA and other high-risk markers.
• Inquire about opportunities for minimally invasive surgery when appropriate.
• Build a survivorship plan with your surgeon that aligns with your life goals and values.

Dr. Marta Crispens

Topic: Ovarian Cancer Recurrence, Innovation, and Patient Support
Guest: Dr. Marta Crispens, Director of Gyn Oncology, Vanderbilt Ingram Cancer Center

Understanding Recurrence & Drug Resistance

Ovarian Cancer is Heterogeneous: High-grade serous carcinoma differs from low-grade; requires personalized treatment.

Recurrence Causes:

• Small resistant cells survive initial treatment.
• 50% of patients lack DNA damage repair defects → poorer outcomes.

Drug Resistance Factors:

• Molecular changes, drug transport issues, tumor microenvironment.

Treatment & Trials

Immunotherapy Challenges:

• PD-1 inhibitors haven’t been as successful in ovarian cancer.

Emerging Solutions:

• IL-4 & macrophage modulation to unlock immune response.
• Cryptic antigens: exposing hidden cancer targets to T-cells.
• CAR-T cell therapy: experimental, promising but early-phase.

Targeted Therapies:

• Antibody-drug conjugates (ADCs) like Elahere.
• Exploring less toxic payloads and more specific cancer markers.

Personalized Protocols

Desensitization for Drug Allergies:

• Protocols help allergic patients tolerate key chemo drugs.
• Example: tiny-dose infusions (in hours, not days) with antihistamines.

PARP Inhibitors:

• Standard use: 2 years.
• Few patients may benefit from longer usage—but risks like leukemia warrant caution.

Patient-Centered Guidance

Side Effect Management:

• Be honest with providers.
• Use palliative care for symptom management.
• Consider evidence-based integrative approaches: yoga, acupuncture.

Emotional Navigation:

• First appointments are overwhelming—processing takes time.
• Balance treating cancer and caring for the person, as the provider team.

Call to Action

Support Clinical Trials:

• Join trials at every stage: diagnosis, recurrence, maintenance.

Advocacy:

• Federal research support reductions threaten progress.
• Urge lawmakers to fund science.

Final Messages

“More isn’t always better—but balance is.”— Dr. Marta Crispens

Dr. Robert Bast

Topic: CA125, Early Detection, and Innovative Therapies for Ovarian Cancer
Guest: Dr. Robert Bast, Co-Founder of CA125 and Leading World Renowned Oncologist

CA125 and Its Evolution

• CA125 is a glycoprotein marker for ovarian cancer, developed by Dr. Bast.
• Initially for recurrence monitoring, it’s now used in combination for diagnosis and early detection.
• Limitations: Not all cancers express CA125; may rise due to non-cancerous causes.

Advances in Early Detection

• NRROS Trial: Annual CA125 + risk algorithm + ultrasound = 30–34% late-stage reduction.
• New 4-marker panel shows promising earlier detection (up to 22 months before clinical symptoms).
• Monitoring of autoantibodies (e.g., p53) under trial to further refine early detection.

New Therapies & Innovations

• SIK2 Inhibition: Increases chemo and immunotherapy sensitivity; Phase 1 trials underway.
• Imprinted Genes: Re-expression of genes like DIRAS3 may suppress tumor growth and promote autophagy.
• CAR-NK Therapy: Natural killer cells engineered for targeted attack with less toxicity (in trial).

Specialized Research (SPORE)

• Sponsored by NCI to fast-track lab-to-clinic cancer research.
• Includes improving PARP inhibitors, antivascular agents, NK cell therapies.

Screening and Monitoring

• CA125 still standard for recurrence; not yet for population-level screening.
• Emphasis on stage shift >20% as potential future benchmark for adoption.

Key Messages from Dr. Bast

• “Never give up.” Research is progressing, offering hope through early detection and new treatments. Collaboration and innovation continue to drive the field closer to better outcomes and eventual cures.

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