The El Paso Physician
COVID's Impact on Cancer Screening
Season 25 Episode 10 | 58m 28sVideo has Closed Captions
COVID's Impact on Cancer Screening
Exploring the impact COVID has done on cancer screening. Panel: Dr. Ines Sanchez-Rivera, M.D. - Hematology/Oncology Frantz Berthaud - Line Administrator Oncology
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The El Paso Physician is a local public television program presented by KCOS and KTTZ
The El Paso Physician
COVID's Impact on Cancer Screening
Season 25 Episode 10 | 58m 28sVideo has Closed Captions
Exploring the impact COVID has done on cancer screening. Panel: Dr. Ines Sanchez-Rivera, M.D. - Hematology/Oncology Frantz Berthaud - Line Administrator Oncology
Problems playing video? | Closed Captioning Feedback
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Learn Moreabout PBS online sponsorshipthank you [Music] good evening I'm Dr Jeffrey Speer current president of the El Paso County Medical Society for 2022. we at the El Paso County Medical Society are very proud of this program we are certainly grateful for the collaboration of both Star City Studios and kcos for making this program a reality we're also incredibly grateful to miss Catherine Berg who has been such a terrific partner for the last 25 years being this program's host we hope you continue to join us each and every month for this fantastic program and please enjoy the presentation tonight thank you very much I remember sitting here on St Patrick's Day March of 2020 and doctors with me at that time everyone in our office was told go home and don't come back until we say so and we thought it was going to be a couple of weeks it was this new thing called covid-19 and we didn't know what was going on we just knew that we were going to be working from home but here's the thing I'm healthy I didn't have any treatments I needed to take care of I didn't have any screenings I needed to take care of immediately so I was lucky so were a lot of other people but we're here this evening because we're talking about others that did not have a choice but to go in and get treatments or some people elected not to come in and get treatments or screenings because of this new thing called covid-19 with us this hour we've got uh Dr Ines Sanchez and then also Franz barthard and we're going to be talking specifically about that I appreciate you watching I'm Katherine Berg and this is the El Paso physician thank you again for joining us tonight's topic is covid's impact on cancer screening and with me tonight we have Dr Ines Sanchez and she is a an oncologist and hematologist and she's also the medical director of Texas Oncology in El Paso and also the research director so we're going to talk about how covid-19 has affected research as well and then we also have Franz berthard and I'm saying it wrong did I say right this time Earth who is the director of oncology at the hospitals of Providence and so uh Dr Sanchez says you're the guy that makes the magic happen so we're going to have magic happen here this evening as you may have noticed we are in a different place we're in a new studio uh we have Diego and Daniel here with us who are helping us out and this is all exciting for us and if you have any comments let us know that's always helpful um but the first question I want to do is ask Dr Sanchez for you to explain what you do and then have you do the exact same thing so our audience kind of knows what's going on if that helps Dr Sanchez so I see patients with cancer pretty much all day I mostly breast cancer um that's my main specialty and I also so I I pretty much see them develop a treatment plan and I execute the treatment plan and my I monitor for toxicities um and then you know part of my job is also look into clinical trials and the possibility of how a patient will match with a particular clinical trial that will benefit from participating or not um and then pretty much that's that's what I do every day and that's a lot because you're you're looking at everything and I'm glad that you brought up clinical trials um France and I talked about that a little bit earlier and there's so much research that hasn't been done for various reasons during Kobe but if you can kind of stop too and explain what you do you've been here a couple of years now and you're from New York you said you were recently in Boston and now you're in El Paso thank you for coming I hope you like the Mexican food here because it's pretty dang awesome delicious delicious um but explain to people at home what you do absolutely so I've only been here a couple of months um so I feel I'm still fresh in the community but everyone's so welcoming um so I'm the uh really the administrator across our entire market so um when we think about the hospitals of Providence and oncology you know how we provide Cancer Care across all of the various hospitals and a big part of my role I see it as getting rid of the obstacles so amazing Physicians like Dr Sanchez here can do exactly what they do um you know work miracles so getting rid of obstacles getting them what they need really creating an environment where the Physicians and nurses and all of the clinical team can can do their job you know on that note Dr Sanchez this is a perfect of it to you because we we talked luckily we had some time before we were on air uh to just discuss things that have been going on and during covid-19 it's impacted Health Care in so many different ways and you being an oncologist what was the the most poignant thing that you noticed over the last couple of years of How It's impacted oncology specifically so at the beginning of the pandemic we we did not know how this was going to affect anybody but we became very quickly aware that it was it that our patients had a Target on their back with this virus so it was it was very clear to me that our our the most immunocompromise the most sick patients were the ones who were gonna pretty much do poorly with this virus and even die so you know we actually lost in in the community we lost about 250 cancer patients to covet 19. in the first year in the first year in the first year that was 2020. um and that was actually pretty heartbreaking to us and then we started um to think how do we protect our patients how do we make sure that they don't get sick that they don't die that um and pretty much what we started to do that is also heartbreaking to me is we started isolating them yeah we wouldn't let family go visit them we didn't let um you know pretty much they were they were being seen through the window they were you know Grandma Mom brother sister were were pretty much that was that was the tragedy of all of it I had to isolate my patients to keep them alive right and also to allow them to have access to care you know we we had to convert a lot of patients a lot of visits to telemedicine and to be able to then allow access um for the chemotherapy patients for the patients who are immunosuppressed for the patients who actually needed to come into the centers and you were talking about earlier and this is such a point with covid and just the cats you know the CT scans and things that we needed screening yes but also finding out what stages people were in the CT scans were completely overwhelmed by covid patients yeah um and that's another impact too if you can talk a little bit about that um and then and then actually I've got a very specific question for you too after that so so what happened with um you know we we had we were lucky enough that we had our dedicated CT scan but we had to screen everybody that we'd have access to that CT scan so we make sure that everybody that went through that City discount was healthy but you know we were only one Center that that we had the the scan but if we needed the other Imaging places especially the hospitals were totally overwhelmed so they were actually um you know like those CT scans and those Imaging places were actually closed for for the rest of the patients um and during when during the lockdown you know pretty much only essential things were being done um so that was also another barrier to to care you know to access and on top of that people were terrified because they thought that they they put a foot on the on the hospital they were actually going to end up having coveted and dying right so it was it was a lot of fear a lot of fear of the unknown a lot none of us knew what was coming I mean I had to go every week I went through a webinar to just know more about covid-19 and the impact on the on the patients or with cancer so I could actually help my patients right exactly you know but it it was it was it was crazy when we figure out okay the cancer patients are Target number one for this virus Target number one and and that's something too when you talked earlier about 250 cancer patients dying of covid yes there are underlying conditions but again at the end that's what it was about um Franz we we talked a little bit earlier and how is telemedicine helped us number one and how do you see the world of medicine in seeing doctors and just what we were talking about earlier pharmacies are going to be able to do some prescriptions now etc etc and that conversation we had earlier I've just glued to everything you had to say yeah um so really I think what happened with uh the covid pandemic is it illuminated for us aware that we have so many inefficiencies in our Health Care system and and we try to squeeze all of this work into a smaller window of time because it was life or death so when you think about the covet vaccine from kind of creation to implementation and dissemination it was a much smaller window than any other public health effort like that Pax lovid with regard to the oral medicine uh kind of that type of innovation the telemedicine I was in Boston at the time at the Dana-Farber Cancer Institute and we scaled up our television medicine infrastructure in seven days because it required that type of Ingenuity and persistence to be able to do that and I think you can't scale back access to care right right now that we have it and especially for for populations when I think about the the demographics that we serve here in El Paso um who often uh go underserved um and and have limited access uh to health care and Cancer Care certainly we can't take away what we've kind of you know we've showed our hand with regard to the Health Care system and I think it requires us to keep that same thought process um that same focus on inequities disparities that the covid-19 pandemic illuminated for a lot of folks and and really push forward with that there have been uh um instead of going in for colon cancer to me that's the easiest one to refer to it this because you've got cologuard that you can do at home you got the colonoscopy that you do in clinic uh what are some of the screenings that have been occurring that were in the clinical setting before but kind of shifted a bit during covid and what are your thoughts about that in general so the the main one that comes to mind is Color Guard because that one can be done at home and then the the main problem with with color guard and I'm no expert you know in this but is that if you come back to be um positive or actually abnormal then you still need a colonoscopy right so um you know one of one of the things that we were talking about before is how many people did not get their screening tests during during um the the initial year of the pandemic and I have I have a some um some uh amount that is like 9.4 million screening tests that normally would occur uh with did not happen in 2020 so and that what does that have then translate is that um pretty much the 80 to 90 percent decline in screening for breast Colorado and cervical cancers that are no our number one screening right our number one winners actually because with that has been that has the screening for for breast cancer and cervical cancer has been such a big uh had made such a big impact in mortality you know like like pretty much we went from breast cancer being the number one cause of death is now the number one um you know the the most common uh cancer in woman but actually it's not it's it wasn't the number one cause of death because of how good our screening yes so but we actually lost about 80 to 90 percent there was an 80 to 90 decline in screening for breast colorectal and cervical cancer during March and April that was when the lockdown happened uh of 2020 compared to the year before yeah that's amazing and you know what that translates is into about you know one percent increase in death yes and one percent's a big number when you say big numbers across the United States um I would love to it we're talking about this in the last couple of years and friends you were talking earlier about we have not even come close to seeing the magnitude of this yet and 10 years from now 20 years from now the catch-up of missing screenings over the last you're talking about 2020 and some now over 2021 talk a little bit about that the what we have to look forward to futuristically on what we did Miss over the last year and a half right and I think there's two points I want to make this as and I think you alluded to it we're still in the pandemic and we're almost seeing this uh synchronous uh you know in El Paso mountains and valleys of when there are surges and subsequent surges uh when we expect there to be a kind of lower screening rates um and as Dr Sanchez stated that that one percent you know approximating to 10 000 people and that estimation is over the the next decade and so the the NCI is already presuming we will lose you know 10 000 people in excess cancer deaths because of a a short period of time when folks are not screening right and we assume and and Dr Sanchez and I were talking about this earlier there are still people we're two plus years into this um who have not got their their regular screening and so we're making estimations but we're not going to see that full manifestation of uh later stage or Advanced cancers when they finally do come in or get screened exactly and I think that's probably where we have a lot of that apprehension I think more folks are starting to come back to screening but that volume hasn't gone back to what it it was prior to the covid-19 pandemic right and Dr Sanchez you were mentioning earlier a a woman that that is high risk and she was supposed to come in to get a mammogram and you just simply cannot get her to come in without saying names um give us a story a case study of some of these patients that you see that totally do need to come in but aren't because they're scared and let's talk a little bit about what has been put in place by the hospital systems that yes it's time of covid but but your cancer is still number one that we're looking at and be careful without question um we've had all kinds of conversations today about being careful about at the same time not ignoring what's actually happening not ignoring the cancer not ignoring the screen if you're high risk for something go get screened this would be a great time for you to give all that information to the audience so um you know there's actually multiple multiple patient stories that I have that especially 2020 I could not I mean I explained to them I went and had my mammogram you know like that would I would be the example you know I said I went and had my mammogram and I can guarantee you that everybody's taking every precaution that everybody's wearing masks I mean we still Healthcare Providers we're still required to wear masks at our places of work everybody there has to wear a mask and you were wearing yours just to give it I was wearing mine just in case my patients are watching okay and we are in space yes we are spaced out good oh my god um but pretty much it's like I just saw a patient recently and I I look at her screening and I'm like okay what happened with the mammogram we you did not have it in 2020 because it was the lockdown but I ordered it and you were supposed to have it and then comes to the I see her once a year comes 2021 again she did not have it so this time I said you know what you're having the mammogram and I'm doing a very short follow-up with you because I need to I need you to have it this is this is so important you already had breast cancer if we catch it early then you don't have to go through all those treatments that that you had to have before so but the fear was very real very real I would love either one of you so the idea of early detection so here early colon again colon I feel like it's one of the cancers that if you catch it early if you get your colonoscopy you get those polyps removed there goes the chance of that cancer um it's so very much important uh so early detection what are some of the cancers specifically that early detection is where it's at I mean you you were at a lung Institute before this and and that's one of the harder ones right um because it's not technically a screening for that well there is a screening for lung cancer actually there's a established screening protocols for lung cancer there's actually low dose CTS that are established to be for high risk patients and that's one of the things that was actually affected by mostly by the pandemic because right because yeah because if you if you find those tumors actually at a at a place where they can actually have surgery um they might might or might not even need any additional treatment but there's a there's actually a major in El Paso also has a a cancer screening program but you know is usually by the pulmonary groups and of course you know they were embedded into kovit right I mean is that that's something that is is is one of the tragedies of the pandemic if I can see one because lung cancer is the number one killer of women and men in the United States so you almost imagine the the people who would be doing those screenings were needed the most in the covid-19 pandemic right right I think that's where that that tragedy you spoke of that's really where we saw it because you know breast cancer they have a stat is established we know that breast cancer when it's found early you minimize the risk of losing your breast the risk of needing chemotherapy and and sometimes even radiation because you know there has been some new data that radiation can be avoided on some particular patients but that that is probably number one in my in my list um cervical cancer evicted you know so clinical it can actually be cured before needing anything colorectal cancer is found early as it's screening rather than the symptoms arise then you can have surgery and not even need treatment um you know just need follow-up so I think we lost quite a bit on those on those forefronts right agreed I I'm curious is this something uh that you both had talked about with lung cancer screening um so what is the what is the word I'm looking for what is the platform you need to be on in order to qualify to have a lung cancer screening uh like I if I have no I'm not a smoker I don't have a cough I don't have any so I it's not doesn't make sense for me to go have a lung screening nor would the insurance cover it I think when is that a screening that is either covered by insurance or when people know okay you know what I need to go have a lungs a lung screening or is it called a lung cancer screening right it's new to me sorry can you tell me no you're good but I'm excited about it my you know the audience already knows this but my mother it's been 29 years but 29 years ago my mother died of small small cell lung cancer so it's always fascinated me like how did she not know I mean it was the size of an orange by the time we found out um so yeah in general now that there's a screening who is qualified to get that right and I'm going to look to Dr Sanchez to back me up here but there there are you know what consists of that high risk category certainly folks who are multi-pack day smokers in the past um though I I say that knowing that there's almost a stigma with the non-smokers because folks who've never smoked can also develop lung cancer um similarly age uh as a as a risk factor for uh for lung cancer as well in any chronic lung disease like um you know asthma emphysema chronic bronchitis not necessarily associated with smoking and and I'll I'll stop right now because I don't want my pulmonary colleagues to come after me but that's kind of pretty much I like the basics for lung cancer screening you know and this is something that I usually do and I'm going to say this now for for everyone in in the audience we do the best that we can with the questions that we have because sometimes I'm just shooting a question out at you and we do actually have a disclaimer that says don't hold you guys accountable because sometimes you just don't know we have two doctors on and we're talking about oncology and how many different cancers are there a ton I know um so uh this is also why we we have that going on so as that disclaimer I would love to talk a little bit about breast cancer for a moment they may the main thing with mammograms is like mammograms are very good especially to detect what we call the earliest form of breast cancer so we that's what we want we want to detect the little classifications that still have not gone through the dots um or or become what we call invasive breast cancer and because the invasive breast cancer is the one that actually can go some other places it can actually go into your lymph nodes it can actually go into the rest of the body and those are the ones that actually we have to do more aggressive treatment depending on the kind of breast cancer that we're looking at so um you know like Dr carcinoma inside two is what we call a stage zero and then we have you know stage one stays and stage one has multiple subdivisions and then stage two stage three and stage four stage four is when or it has a ready metastasized to outside of the body stage three is usually the what we call locally Advanced meaning that it has is a big tumor and it and sometimes it's associated with a lot of lymph nodes on the arms okay and then stage one is usually localized um it it has not usually spread under the lymph nodes and then depending on the uh receptors like estrogen and progesterone and her tuning exactly um it depends so that's kind of what the prognostic factors goes into and then we have a test that we do oncotype DX that is now part of the staging um and then you know when you go into like stage two it still could be somebody who has very little lymph nodes or you could buy you could have lymph nodes that are negative but it's a bigger tumor so it is it's like all across but the mammogram in itself is actually if you do your your screening mammogram you're more likely to detect it at the stage zero level but there's there's a stage zero level yes that's that's the daughter carcinoma inside too that's the one that has not penetrated through the dots so that is just calcification sometimes it can form a tumor but it's actually that's the earliest form of breast cancer and is usually cured by surgery um so and then when you are doing mammograms depending you know if you palpate something and the mammogram is negative that still needs to be investigated right because there's no there's no really um the mammogram could be wrong or it could be like a mammogram silent um tumor but if there's a palpable Mass it needs to be addressed right um and then you have different types of mammograms too so you have the mammogram that is The Irregular mammogram and then you have tomosynthesis that is actually or what we normally call 3D mammograms yes and it is available at the hospitals of Providence um and it is if they squeeze you hard but that's the one I get though okay I'd rather be exposing very hard and know what's going on this is that show that we're allowed to say that I know when I get to it um is actually they squeeze you because what they want to do is if you have dense yes right that is the best one for dance press is actually it's like flattening up that tissue and it allows you to see better right and sometimes we have to supplement that with a with a ultrasound um if if somebody doesn't you know qualify for a tomosynthesis or 3D mammogram then an ultrasound will probably be appropriate because if you have dense press and you cannot really trust the mammogram right and explain why and I like that you said that because and again think about and I wish we had an x-ray right here but if you're looking at dense breasts there's a lot of white spots that are as normal uh portions of the breast milk ducts Etc um and then find a mass in there sometimes a little bit difficult so because the mass looks the mass also looks white right and then sometimes it is easy to like spot it because it looks like a star and it's speculated what we call but then um sometimes it's round and and you know it it pretty much like is camouflages with the tissue and then you can't see it you know so that's that's the reason that is so important right to do that and that makes perfect sense too because I think sometimes uh people are are not understanding of the sonogram versus the mammogram you brought something else up and and Franz I'm gonna get back to you but this is breast cancer and this is always interesting so her2 is a it's a protein right and there's uh and the Becca Gene and I don't want to get too much into uh DNA and studies but we hear a lot about the brecco gene yes and the way I understand is the brca is for breast cancer breca Gene and there are um there's mutations we all have them and they could be good they could be bad um it's about the mutations and this is not about mammograms and or ultrasounds now it's like okay what type of cancer does one have and when you said you know there's some that are hormonegative there if we can go through some of those once someone has diagnosed there's a mammogram that comes back there's definitely something on the mammogram we need to check out what are the tests then or how do you diagnose what type of breast cancer a person has so the patient undergoes a biopsy okay and then one of the things that the Pathologists do is that they run these tests so the tests are estrogen receptors progesterone receptors and her2 new amplification so and sometimes they do like a like it's like a stain and it's like one two three um and then three is definitely positive and one and two are what we call low positive and one is and zero is negative okay so her2 new is actually something that we have targeted therapy for we have something that is called um I did Target therapy a whole nother one man we've got so much yes um you know medications such as herceptin and we have Ashley porgetta that they target the the particular um her2 new protein right when he's when he's truly positive now recently we have some data that we have a medication that is um actually targets and is effective against the low hurt to new gosh so and that's we're waiting for if the approval but I think it will be it will be approved because the data is amazing so but it is um uh I can't it's it's translucent that's kind of the what it is but anyways is is in is an amazing um development that we just they just kept presented in the last month or so so we have a new tool and it's so fascinating because again this is the 20 25th year of doing the old past position and I remember you being on we were buddies in the get-go probably like 23 years ago you and I met but what we're talking about today compared what we're talking about 23 years ago I mean it's night and day it changes by month by by day and this is a great transition friends too because research research research right yes the show is about what kind of really got affected during the time of covid research was a really big one absolutely and you were talking also that the lack of research that that couldn't happen during covid there were patients that were under research studies that that had to go away for a while and just in general the the clinics and the research Labs had to shut down for a while talk about your wish of research we talked a little bit about this earlier and I was really excited about it because there was a lot more going on earlier and now we've got to get back to that place but you're the research guy for sure so uh again one of the things that came out of the initial stages of the pandemic um kind of like a Innovation was decentralizing clinical trials to run clinical trials requires a pretty robust infrastructure and oftentimes the way trials are written the pi it states you know patients will come in this day this day this and when you think about uh certain communities you're asking them to come in a month's time you know you know four or five times and then the pandemic which shuts all of that down uh people really had to think critically about changing the way we approach how we do clinical research and so that decentralizing came in the form of telemedicine it's so interesting because these were things that we just never thought to do right before we clinical trials and the way in which we ran them uh what it's a tried and true method they come in for the trial they do this or they're taking an oral medication maybe it's patient reported outcomes letting us know how they're feeling uh but to to come to a point where we said let's add an element to this that's going to enable us to still care for that patient uh still run our clinical trial um again these are a switch that we can't unflip right and and that's what you said earlier it's like now that you said we showed them our hand right and so you're looking at now how different things have gone and in the positive I know we're talking about you know there's ketchup there's ketchup but in the positive of all this you see this happening globally I mean there are certain things we that we've done here in America Europe Etc but in general pandemics Global do you see this kind of changing globally and has it already started to change I do I think there's a real big focus on population Health Public Health that's coming into Health Care coming into the hospital in a way that I I certainly had never seen I think in in my career it's not just this episodic someone has come in for this symptom we've taken care of them let's see what happens the next time they come in and so you hear a lot about the social determinants of Health you hear a lot about you know how do we care for an entire population so that they don't get cancer so we're not caring for them with regard to their cancer and screening again right um prevention all of these things education are huge factors and we're thinking about different ways to approach how we do that now at a really really large scale exactly and we have we're in El Paso but we're also Juarez we're also Las Cruces our re region is underserved medically and has been forever and when I look at this I get excited too that we're starting to bring in more and more and we were talking about maybe a Cancer Center in El Paso's future and that would be fantastic as well um Dr Sanchez were there any patients and we didn't talk about this earlier so I'm just bringing this on you were there any patients that were in clinical trials that you were aware of when covid hit and um and if not we'll just move on from there and if so what what was the effect there I mean was the research just automatically stopped is it something and again cancer doesn't wait right it's not like you can do research oh just you know what we're just going to wait for two years and then we'll restart that research again but maybe talk about a specification with that yeah so we we had I mean in in El Paso Cancer Treatment Center of Texas Oncology we do have active clinical trials going on right now I mean and during the pandemic so like like he was saying um we had to rethink I mean how do we make sure that our patients are being monitored how to make sure that our patients are receiving the medications that they're supposed to be taking and also I mean every protocol had to be Rewritten in terms of Kobe protocols what happens if it is if a patient gets covered we had to notify it immediately because it wasn't it was now a a severe adverse reaction because they actually were sick with covid we had patients that we know you we had clinical trials open for but patients could never be enrolled because they were not being screened or diagnosed or or things like that so we had to explain that when I was having my principal investigative meetings with with the with the whoever was doing the research trial um I they would be like so what are the barriers to enrollment on uh and I said patients are not there yeah the patient and and especially you know it was very obvious when in the pancreatic cancer Arena that there they there was a first-line pancreatic cancer trial that I felt it was fantastic but there were no pancreatic cancer patients to be screened or to be enrolled so we we just had to you know telemedicine was a great success for us in in Texas Oncology because we had a platform already and we just deployed it across the board right and um like we were able to keep our patients keep track of our patients keep track of of their progress make sure that you know that they were able to get whatever studies they needed and and also make sure that the drug um you know that they were on was available to them exactly and that that's a whole nother thing the whole uh supply chain right when you're looking at oh you know what since you you did it we speak about that because you're you're kind of again you're the miracle maker right and the guy he is my Miracle maker I have a lot of buttering you up I need you know what I need I need this piece of equipment I need these medications I need you to get this for me I want to oncology nurses I want and yes nurses easy to say I know but let's do talk about that that idea about supply chain and I know that's like a crazy buzzword right now but we're looking at equipment we are looking at medications and in general how is that affected what you do all day every day okay and I won't even add Workforce to that because that has become you know what that is critical critical right uh the the you know we saw uh a mass Exodus I think of folks leaving Healthcare or or changing right there's we call it the great resignation I think it was this great reevaluation people said what do I really want to do because time is fleeting life is fleeting and um so there's a big shift in the workforce and and Dr Sanchez mentioned the oncology nurses and across the entire El Paso Community we lost a lot of oncology nurses a lot of nurses all together and how do we bring back uh that Workforce that's critical to the entire Enterprise to caring for all of these these patients and that's something that the pandemic I think precipitated that we're still trying to figure out how to how to change and and not making changes that are uh um short-lived but really creating you know sustainable changes how do we create a a pipeline to get nurses uh to El Paso or folks who are already here in El Paso uh develop that and that's something at the hospitals of Providence uh that that we're thinking through and working and we've had conversations about it uh building an oncology nurse pipeline um to enable uh for not only for the the patients who are caring for now but the patients that we'll care for in the future it's really about sustainability and there became a new phenomenon which is the traveling nurses right there is when when covid hit very hard in certain areas of the country they needed more personnel and so their career is a traveling nurse um just in different meetings that I've sat with in the different medical uh areas is that something that that we've really experienced in El Paso as well certainly not only have we needed traveling nurses right in the height of the the pandemic here the the community was hit really really hard you know I was in Boston at the time but I saw El Paso all over the news um but also now to your point of that shift of our own Workforce going to the traveling nurse route of so now we've lost those um those individuals uh so we absolutely were impacted and I think now the the thought is how do we get the nurses we need now for the community now and again build the build for the future because you know I've seen the cancer incidence rates it's still happening right lung being one of them um hematologic cancers the blood cancers uh being another um that that we expect uh certainly to to continue growing in the the coming years so we'll need a Workforce to be able to meet that demand well that that's something to talk about with high schoolers that don't know what career they want they can go into nursing and always have a job just like with education uh Dr Sanchez you said a word earlier and you saw me get excited because this this is Target therapy when it comes to cancer treatment yes is such a beautiful thing um I know it's not new but it still fascinates me and so to even broadly describe what targeted therapy is how would you describe that because I know there are certain cancers that benefit more from targeted therapies than others yes so I mean I pretty much say okay there depending on that biopsy you know there's the in depending on the cancer we do a battery of tests and what we do is looking for that particular Target so I call it actionable Target meaning that this there's that that place in there in that tumor that I can actually go after with a particular medication that has been designed to disable that Target and then be cool I know it's like Army it is I'm going after it and I'm gonna just kill you um but that's actually and and almost in every Cancer almost um like breast has a lot of targets right now um you know and then you know they they long has so many um you know like there's there's bad cancers that do we actually find a particular Target we actually do better with that that medication that targets that that mutation than with chemotherapy right so that is it is again chemotherapy was in the old days I see old days 25 plus years ago it was usually there's a surgery and then there's radiation and then there's chemotherapy and it almost was that you just followed that that rule with most cancers yeah so these days we have more sophistication you know we have we have to do all this testing um and then this testing is going to help us pretty much determine what we do for that particular cancer and then if we can and we're we're starting to be more like treat less you know instead of actually um trying to hit everybody of like everybody who has cancer get chemotherapy that's not the answer anymore right you know we actually have to divide it in risk and pretty much and and then other cancers are targets any that those targets are present we hit the jackpot and when you said that jackbox I remember the first time we started talking about this I don't even know how many years ago it was um but the even the doctors that were on the air were they were like little kids jumping in their chairs like oh and we could do this now and this is about to happen and this hasn't passed FDA yet but and it was just it was beautiful um we're kind of at that Mark in the show where I want to stop my questions to you and see if there's something that we have not yet talked about that either one of you want to get across before because it's almost an hour and it happens super fast um so and I'll talk to Dr Sanchez first because she's the veteran you're the Newbie it gives you some time to think but this is a time really to think you know what we're going to be on an hour-long show tonight or on PBS we're doing podcasts we're doing all this stuff what is it that we want to get across to our audience to people in El Paso but also globally too this is all over the Internet so Dr Sanchez I just I just want to remind El Paso that unfortunately the pandemic is not over I mean I more I'm I'm more than anybody wanted to be over but unfortunately for my patients it's not over their immunosuppressed they are very high risk of becoming ill and dying from this virus so just you know have compassion have compassion for others yeah keep going there's a lot more in there though [Music] um the pandemic is not over um and I would love for you specifically as the oncologist hematologist when we're talking about screenings it's not over but there's still if you know that every year uh your daughter's turning five in September so you know and for me I I try to get all my tests at least scheduled during my birthday month my birthday's in February so I think okay if I need to get my colonoscopy I always do my mammogram I do everything I need to do um that's what I'd love for you to be the cheerleader for so yes we just just know that as Healthcare Providers we've been through through this we have made it on the other side but at the same time we are safe we are safe for you to go to we are safe for you to get your tests we are we know we are probably the only people in the city is still wearing masks because the CDC says Healthcare entities continue to wear masks so we are safe for you you to seek care so do not put it off it's not gonna if if you have something that can be caught early then you know what that this is the time it is so I don't I don't want anybody to have any excuse not to go get their mammograms or their colonoscopies or call to go see their daughter and get checked for their heart their EKGs their cholesterol you know heart disease is still out there even though we're talking about cancer heart disease is preventable it's something that we can do do your exercise stay healthy you know but just seek the medical care that you need because we are safe right you know as medical community we have being safe I mean we made it through a major you know right in in at the end of 2020 right and we all pulled together and we made it and we made it and and as Fran said with a lot more that's going on and I'll just I always try to have the audience see all three of us whoever's sitting here you have a family I have a family you have a family and I'll say today my son had his tonsils taken out today that's a big deal that's his first surgery he's 19 years old we waited we waited we waited and part of us was like well he's the guy that had strep throat forever we can wait for kova to go away and that we were also in this mindset so just me as a human being as a mommy I was in the same boat like oh can we just wait can we just wait and it's the safest place to be you walk in immediately we were at the cert one of the surgical day centers and everyone was messed up everyone was separated the way that we were able to go in and out only one of us was allowed to be with him it was it was so beautifully orchestrated that I was embarrassed and a little bit ashamed that we didn't do this earlier he's needed to have his tonsils out for a while and we kind of stayed up on it I had surgery on my foot at the hospitals of Providence in April you know and all of my patients know this because I just barely started to walk so this is another part of us so I I that's the way that's the way it is it's safe yes it's safe it absolutely is safe friends how about you what would you like to get across this evening I think you know one of the things that's really important especially when I think about El Paso as a a community um and and we've touched upon it the health inequities cancer disparities um where 80 of the population um knowing the the types of cancers that the population tends to have the predisposition it's so important to get screened you know and I think it's so important to talk about it as well right talk with your family talk with your clinicians talk with your friends convince them to to get their screenings appropriately as well because it is it truly is um something that that can be preventable certain cancers and certainly the place to have it done are at our hospitals where we have the we've always had the covet protocols since the pandemic began right we've not become lacks right we've been doing this and we certainly want to see people get screened and hopefully um get them treated for for the cancers that they may have I want to give a high five you said since the beginning of the pandemic and this is really something that you being new to El Paso I think that you probably already felt this there is a community here and yes hospitals and Medical Systems technically they compete with one another but when covet hit when it was time to test and screen and then really when it was time to vaccinate people again the impressiveness to me we were talking earlier that 83 percent you gave me this quote and I love it 83 percent of el pasoans are considered fully vaccinated and you did you say that at least that we're at 99 that has at least one vaccine did I understand that right okay so that could not have happened with all of our entities getting together and doing the vaccines and Franz I'd like to ask you we were talking earlier and I keep saying that because we have we have all these conversations before we get here which is great because that's where the gold happens right when we're looking at vaccines for those people that have their three that's boosted that's the the 83 percent now you've got the fourth one not everyone's got that one yet but there was a time we were just going through lines at the Civic Center or going through lines at the Coliseum so now where are people able to get their vaccines and it's just nice yes this is a show about covet and cancer um but where are people able to get their vaccines now certainly at their Primary Care uh Physicians and and places like the CVS's and the Walgreens you know this is not an advertisement but just to understand that at your local pharmacy right that are still carrying these they're still carrying the boosters and again this is that breaking down the the walls of accessibility and enabling people to be able to get care where they need it close to home uh where they feel comfortable and I know this is all over the news but sometimes let's just print when he has not heard the fact that this is all free you know um there was somebody that that had talked to me and said well you said on the air that it's free but they were asking me for my insurance card well why were they doing that are they billing me are they at the end of the day what they're trying to do is track who's got the vaccines who has which vaccine Etc so it's actually good that that is the case Dr Sanchez do you see a an ongoing covid vaccine from here on out just like we've got an ongoing flu vaccine and I know that you're an oncologist I know that this is not your specialty but just to the best of your ability and runs you to uh what do you see futuristically regarding covid not going away and the world adapting to these different variants with different vaccines Through The Years just like the flu who would like to take that question on um I mean we we are there's multiple variants that are coming on I mean we're talking about that Varian ba5 you know and you know I know that um moderna has developed an omicron-based vaccine that is coming down in the fall um but I I do believe so while we keep producing variants I think we're going to have to modify um pretty much vaccination so if you don't mind let me hit on that again but I am not sure okay I respect it I respect it don't hold us accountable this is just it's an information program so moderna is looking at specifically an omnicrom type of income base based vaccine yes okay you you were you started started in there and I stopped you my apologies so number one I didn't know that I'm going to do some research on that soon so are we looking at that being and again you don't know but most likely the fifth shot because when I think when we double boosted because we've got and this may be another question are all the four shots if we've gotten four shots are they all the same meaning if you've got Pfizer all along they're all the same so that's something that's initial okay okay so base and the reason too because people like well is that a different vaccine what's a boost does it mean it's a different vaccine the first at the end of the day again it's all the same vaccine modern is looking at something that's specifically for omnicrom which is yeah that's good friends and to that point it's because where you're looking at the ba5 um variant the you know it's um immune evasive so it kind of gets around them that you may already have um and so we're and exactly what Dr Sanchez stated uh with regard to the more variants we have the more vaccines essential will need and our Our Hope right is is having enough of the population vaccinated right you the buzzword herd immunity um vaccinated to to suppress kind of the uh ability for variants um to to manifest so we can get to a place where it's a lot more manageable with you know a regular vaccine program a la the flu getting it every year um getting the flu shot every year so My My Hope Is that and I think um the the pace of medicine the same kind of Ingenuity and passion we see in the immunotherapy space and the target therapy space um it was that yes that context the of cancer research that enabled us to develop the the covid vaccine and the way that we did so you know we were foundational for this and I think similarly the Cancer Care Community will continue to be a huge part of how we think about covid-19 and and folks being immune compromise because we've been dealing with that um for really reason for the entire entirety of our careers yeah and this is something too kobit 19 is called covid-19 because it came about in 2019 there were 18 covids before covet 19. nowhere near what we're seeing now but that is when people are talking about oh I'm scared of the vaccine is still brand new there's a ton of research that was gone before covid-19 and it was just adapted for covid-19 and has had really really great uh results on that and so Dr Sanchez we've got like a minute is there anything that you want to say the audience about getting their vaccine if they're still scared I know we're good numbers here but some people are still a little I mean I went first of the line to get my vaccination when when he first became available to healthcare workers my Family actually drove all the way to Midland to get their vaccination everybody is vaccinated and boosted in my family if I didn't feel it was safe I would not give it to my children so that's that's my my biggest argument and and I just want everybody to be safe and that's again us just being human beings we're being mommies we're being daddies we're being grandpas and you know I'm not yet a grandpa or a grandma but it's coming um but I wanted to say thank you so much Franz you've been welcome to El Paso again you have probably not tried every Mexican food restaurant yet but man you got to get that on the list maybe not because they keep popping up uh Dr sanjas thank you it's always great to have you here again we've been doing this for more than 20 some odd years uh and to the hospitals of Providence for underwriting this program this evening if you did not catch all of this you can catch it again on pbselpasso.org you can also get it on the El Paso County Medical Society web site that's uh El Paso County just the acronym of El Paso County Medical society.com and then also YouTube uh anytime you want to look for past shows just go to youtube.com and type in there the El Paso physician and you will find a just all the different episodes we've had as well with PBS and um with the El Paso County Medical Society I'm Catherine Berg and you've been watching the El Paso position [Music] foreign [Music] foreign
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