♪ ♪ ♪ ♪ >> A DIAGNOSIS OF CANCER CAN BE SCARY, BUT FOR THOSE OF US IN KENTUCKY, THE MARQUIS CANCER CENTER IS A BEACON OF HOPE.

PLEASE JOIN US FOR THE NEXT "KENTUCKY HEALTH" AS WE TALK WITH SURGICAL ONCOLOGIST Dr. MARK EVERS ABOUT THE NEW TRENDS IN CANCER TREATMENTS.

NEXT ON "KENTUCKY HEALTH."

>> "KENTUCKY HEALTH" IS FUNDED IN PART BY A GRANT FROM THE FOUNDATION FOR A HEALTHY KENTUCKY.

>> IN THE EMPEROR OF ALL MALADIES, A BIOGRAPHY OF CANCER, AUTHOR DESCRIBES OUR 4600-YEAR HISTORY WITH CANCER.

SINCE ORIGINALLY DESCRIBED, MUCH HAS BEEN DONE TO BETTER UNDERSTAND THE CAUSES, BEHAVIORS AND TREATMENT OF CANCER.

IN HIS 1971 STATE OF THE UNION ADDRESS, THEN PRESIDENT NIXON DECLARED A WAR ON CANCER, AND IN 2016, THEN VICE PRESIDENT BIDEN LAUNCHED HIS CANCER MOON SHOT.

DESPITE THESE NOBLE EFFORTS, CANCER REMAINS THE SECOND LEADING CAUSE OF DEATH IN THE UNITED STATES.

ONE BRIGHT SPOT FROM THAT ORIGINAL 1971 EFFORT WAS THE CREATION OF THE NATIONAL CANCER INSTITUTE CANCER CENTER'S PROGRAM.

THIS PROGRAM REBOUNDING RECOGNIZES CENTERS FOR INTERDISCIPLINARY STATE-OF-THE-ART RESEARCH FOCUSED ON DEVELOPING NEW AND BETTER APPROACHES TO PREVENT, DIAGNOSING AND TREATING CANCERS.

THESE CENTERS HAVE BEEN IN THE FOREFRONT OF A DEVELOPMENT OF A NEW KNOWLEDGE AND THE DEVELOPMENT OF SOME CASES AND EVEN REPURPOSING ALLTECH NEEKS TO YIELD BETTER OUTCOMES FOR TREATMENT.

THE CENTERS ARE BEACONS IN THE SEAT OF DESPAIR THAT TOO OFTEN ACCOMPANY THE DIAGNOSIS OF CANCER.

CURRENTLY THERE ARE 72 NATIONAL CANCER INSTITUTE DESIGNATED CANCER CENTERS.

566 THESE CENTERS BASED UPON THEIR LEADERSHIP, RESOURCES AND ADDED DEPTH AND BREADTH OF RESEARCH ACROSS MULTIPLE SIGH TISK AREAS HAVE BEEN FURTHER RECOGNIZED AS COMPREHENSIVE CANCER CENTERS.

THE MARQUIS CANCER CENTER AT THE UNIVERSITY OF KENTUCKY IS ONE OF THESE COMPREHENSIVE CANCER CENTERS.

TO HELP US UNDERSTAND WHAT COMPREHENSIVE CANCER CENTER STATUS MEANS TO US AND CURRENT ADVANCES IN THOUGHTS AND TREATMENTS AND DIAGNOSIS WE HAVE AS OUR GUEST Dr. MARK EVERS WHO EARNED HIS DEGREE FROM THE UNIVERSITY OF TENNESSEE HEALTH SCIENCE CENTER.

HE COMPLETED A RESIDENCY IN GENERAL SURGERY AT THE UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE FOLLOWED BY A MASTER OF MEDICAL SCIENCE DEGREE FROM THE UNIVERSITY OF TEXAS MEDICAL BRANCH IN GALVESTON TEXAS.

HE IS VICE CHAIR FOR RESEARCH, DEPARTMENT OF SURGERY AND PHYSICIAN AND CHIEF OF THE ONCOLOGY SERVICE AND IS THE DIRECTOR OF THE MARQUIS CANCER CENTER AT THE UNIVERSITY OF KENTUCKY.

Dr. EVERS, THANKS FOR BEING WITH US TODAY?

>> THANK YOU SO MUCH.

>> HOW ARE YOU DOING SO FAR.

>> DOING GREAT.

THANK YOU FOR HAVING ME.

>> YOU KNOW, I'M AMAZED AT ALL THE DIFFERENT HATS THAT YOU WEAR.

HOW MANY HEADS DO YOU HAVE OR JUST ONE BIG GIANT THING GOING ON, MAN?

>> OH IT'S ALL FUN.

IT'S ALL FUN.

>> I'M GLAD.

I, LIKE EVERYBODY ELSE, IS VERY IMPRESSED WITH THE GOOD WORK THAT IS COMING OUT IN LEXINGTON BUT TELL US, WHAT DOES IT REALLY MEAN TO BE A NATIONAL CANCER INSTITUTE CANCER CENTER?

>> SO, AS YOU SAID,WE ARE ONE OF 72 NOW IN THE COUNTRY.

WE ARE THE ONLY DESIGNATED CANCER CENTER IN THE STATE AND IT'S A VERY RIGOROUS PROCESS.

SO WE HAVE TO GO THROUGH A NUMBER OF CHECKS AND BALANCES, HAVE TO SUBMIT A THOUSAND PAGE DOCUMENT TO THE NCI ONCE WE THINK WE ARE READY TO TAKE THAT STEP.

AND THAT'S FOLLOWED BY A SITE VISIT BY A TEAM OF PHYSICIANS AND RESEARCHER AND ADMINISTRATORS FROM AAROUND THE COUNTRY WHO SPENT A DAY WITH US.

WHAT IT MEANS TO BE NCI DESIGNATED IS THAT THERE IS THE DEPTH AND BREADTH OF BASIC RESEARCH, OF CLINICAL RESEARCH, AND POPULATION SCIENCE.

AND THAT YOU ARE DISSEMINATING THIS INFORMATION TO THE PUBLIC TO YOUR POPULATION, WHICH IS, IN OUR CASE, THE STATE OF KENTUCKY.

YOU HAVE GONE BEYOND THAT TO BECOME A COMPREHENSIVE CANCER CENTER.

>> IT IS THE BEST OF THE BEST.

AND YOU KNOW, I THINK IN THE WHOLE NCI PROGRAMS, WHAT THEY ENVISION THE COMPREHENSIVE CANCER CENTERS TO BE ARE THOSE SITES THAT HAVE THE DEPTH AND BREADTH OF THE RESEARCH, CLINICAL CARE, CANCER PREVENTION BUT THAT YOU ARE NOT JUST IN YOUR TOWER IVORY TOWER SO TO SPEAK.

OUR OUT IN THE COMMUNITY.

YOU HAVE EDUCATION PROGRAMS GOING ON THROUGHOUT THE COMMUNITY, PREVENTION, ET CETERA.

SO IT REALLY IS MUCH MORE THAN JUST THE MARQUIS CANCER CENTER IN LEXINGTON.

IT'S A STATEWIDE INITIATIVE.

YOU MENTION IT IS A STATEWIDE INITIATE BUT YOU PROBABLY HAVE A REGIONAL FOOTPRINT, I WOULD IMAGINE.

>> WE HAVE A WONDERFUL SYSTEM.

I WAS JUST AT OUR MARQUIS CANCER AFFILIATE NETWORK, WE HAVE AN ANNUAL CONFERENCE, AND THERE WAS OVER 250 PEOPLE THERE TODAY WHO CAME TO LEXINGTON SO WHAT WE HAVE IS A SERIES OF AFFILIATE HOSPITALS THROUGHOUT THE STATE.

WE HAVE 19 AFFILIATE HOSPITALS THAT WE WORK REALLY SYNERGISTICALLY WITH AND THESE ARE HOSPITALS FROM FAR EASTERN KENTUCKY ALL THE WAY TO PADUCAH AND FAR WESTERN KENTUCKY AND NORTH AND SOUTH AND SO WE ARE REALLY ABLE TO COORDINATE CARE OF PATIENTS THROUGHOUT THE STATE; FOR EXAMPLE, I MEAN PATIENTS MAY COME TO MARKEY IN LEXINGTON FOR COMPLEX SURGERY BUT THEN THEY GO BACK TO THEIR HOME INSTITUTION OR THEIR HOME HOSPITAL FOR THEIR CHEMOTHERAPY OR THEIR RADIATION THERAPY.

SO.

>> SO WHAT DOES IT TAKE TO BE AN AFILL AFFILIATE WITH YOU ALL.

DO THEY HAVE TO MEET CERTAIN REQUIREMENTS SO THAT THERE CAN BE THIS CONTINUITY OF CARE?

>> ABSOLUTELY.

SO THERE IS A RIGOROUS REQUIREMENT TO BE AN AFFILIATE.

SO THE EXPECTATION IS THAT THEY MEET STANDARDS FOR THE COMMISSION ON CANCER, WHICH IS A RIGOROUS PROCESS IN AND OF ITSELF.

BUT YOU KNOW, THAT'S THE GOLD STANDARD FOR MANY COMMUNITY HOSPITALS TO ACHIEVE THAT SORT OF COMMISSION ON CANCER ACCREDITATION.

AND WE HELP THOSE SITES ACHIEVE THAT AND TO MAINTAIN THAT STATUS.

>> WHEN YOU SPEAK ABOUT GETTING FURTHER CARE AT THEIR HOME INSTITUTIONS WOULD THAT INCLUDE RADIATION THERAPY OR CHEMOTHERAPY OR IMMUNOTHERAPY OR DO PEOPLE HAVE TO COME BACK TO LEXINGTON?

>> SOME PATIENT DOZEN HAVE TO DUMB BACK, PARTICULARLY FOR THEIR SCHEDULED APPOINTMENTS, BUT AS YOU KNOW, SOMETIMES CHEMOTHERAPY CAN BE ON A WEEKLY BATES IS, RADIATION THERAPY CAN BE EVEN, YOU KNOW, CLOSER INTERVALS THAN THAT SO WE FEEL THAT IT IS REALLY IMPORTANT TO GET THE PATIENTS BACK TO THEIR HOME INSTITUTION FOR AS MUCH CARE AS POSSIBLE, FOR EXAMPLE, THEIR CHEMOTHERAPY TREATMENTS, ALL OF THE NURSES ARE FOLLOWING MARKEY PROTOCOLS, WE HELP THEM WITH THAT; WITH THE PROTOCOLS.

AND THE SAME FOR RADIATION TREATMENTS.

I MEAN PATIENTS ARE AT THEIR HOME INSTITUTION.

THAT'S JUST BETTER CARE RATHER THAN PATIENTS HAVING TO DRIVE TWO TO THREE HOURS EVERY WEEK TO COME TO LEXINGTON.

WHEREAS THEY CAN GET THE SAME LEVEL OF CHEMOTHERAPY AND RADIATION THERAPY AT THEIR AFFILIATE HOSPITAL.

>> ARE YOU SEEING SOME OF THE SPECIALIST THERE FROM THE MARKEY GOING OUT TO THE REGIONAL FACILITIES TO PROVIDE CARE OR EVEN TO PROVIDE EXTRA TRAINING FOR FOLKS WHO ARE OUT THERE?

>> YES.

SO IT'S MAINLY MARKEY PHYSICIANS AND MARKEY STAFF PROVIDING THE EXTRA TRAINING AND SOMETIMES THAT TRAINING IS ON SITE WITH THE AFFILIATES.

BUT CERTAINLY WITH THE PANDEMIC, WE LEARNED A LOT ABOUT BEING VIRTUAL CONFERENCES AND THAT SORT OF THING SO A LOT OF THAT IS HANDLED VIRTUALLY AS WELL.

BUT IT'S REALLY A CLOSE INTERACTION BETWEEN MARKE YE AND OUR AFFILIATE SITES.

THEY FEEL VERY COMFORTABLE CALLING US UP FOR ANY PROBLEMS OR QUESTIONS.

>> NOW, YOU ARE WELL KNOWN FOR YOUR RESEARCH AND I BELIEVE YOU HAVE OVER 300 DIFFERENT PUBLICATIONS, PROBABLY MUCH MORE THAN THAT EVEN NOW.

BUT DESCRIBE FOR ME, AT A CANCER CENTER, HOW YOU INTEGRATE BENCH RESEARCH AND PUT THAT INTO CLINICAL PRACTICE?

>> THAT'S A GREAT QUESTION BECAUSE THAT'S REALLY WHAT SEPARATES THE ACADEMIC CANCER CENTERS FROM OTHER COMMUNITY SITES; FOR EXAMPLE, IS THE LEVEL OF RESEARCH WHICH REALLY PROVIDES THAT LEVEL OF HOPE FOR OUR CANCER PATIENTS.

SO WE HAVE INTERDISCIPLINARY TEAMS MADE UP OF SCIENTISTS, Ph.D. SCIENTISTS ACTIVELY WORKING WITH OUR CLINICIANS FOR A DISEASE TYPE FOR A PROBLEM PER SE.

SO DISCOVERIES THAT ARE COMING OUT OF MARKEY BASIC RESEARCH LABORATORIES HAVE BEEN GONE ON TO CLINICAL TRIELSZ PERFORMED AT MARKEY.

WE HAVE ONE CURRENTLY THAT IS LOOKING AT MELANOMA RESISTANCE IN PATIENTS THAT REALLY IS A CUTTING EDGE POTENTIALLY PARADIGM SHIFTING TRIAL THAT STARTED OUT WITH BASIC RESEARCH DISCOVERIES BY MARKEY INVESTIGATORS.

IT'S A TWO-WAY STREET AS WELL.

BECAUSE THE THINGS WE LEARN FROM CLINICAL RESEARCH CAN GO BACK TO THE BASIC RESEARCH LABORATORIES TO TRY TO FIGURE OUT WHY WE ARE SEEING THOSE EFFECTS.

I MEAN AN EXAMPLE OF THAT IS THE FACT THAT SOME PATIENTS WITH CHEMOTHERAPY, THEY WILL HAVE SOMETHING CALLED BRAIN FOG, WHERE, YOU KNOW, THEY'RE FORGETFUL AND THAT SORT OF THING.

BUT THAT WAS NOTED WITH SOME OF OUR CLINICAL PATIENTS AND AS A RESULT, SOME OF OUR BASIC RESEARCHERS NOW ARE TRYING TO BETTER UNDERSTAND THE ROOT CAUSES OF CHEMO BRAIN OR THE EFFECTS OF CHEMOTHERAPY.

>> BOY, THAT'S-- WE ALWAYS THINK ABOUT IT GOING FROM BENCH TO CLINIC, BUT I GUESS WHAT GOES ON IN THE CLINIC HAS TO INFORM WHAT IS DONE AT THE BENCH LEVEL AS FAR AS RESEARCH.

>> ABSOLUTELY.

THAT'S WHEN IT'S REALLY FUN IS WHEN IS THATBY DIRECTIONAL.

-- BIDIRECTIONAL GOING FROM RESEARCH TO CLINICAL TRIAL AND FINDINGS IN A CLINICAL TRIAL CAN INFORM BASIC RESEARCH PROBLEMS AS WELL.

>> SOMETIMES WHEN WE HEAR THE WORD CLINICAL TRIALS, IT IS CLOUDED WE CANS PEERMT WITH EXPERIMENTATION OR YOU ARE BEING TESTED UPON.

COULD YOU TAKE US THROUGH WHAT A CLINICAL TRIAL SETUP AND GETTING TO THAT POINT AND WHAT IS IT YOU ARE TRYING TO DO?

>> YEAH, SO IT'S EXTREMELY RIGOROUS PROCESS.

I MEAN IN TERMS OF GOING THROUGH VARIOUS REGULATIONS WITH, LET'S SAY A PARTICULAR DRUG THAT YOU WANT TO GET INTO A CLINICAL TRIAL, THAT TAKES YEARS TO MAKE IT TO THAT STEP.

AND MANY OF THE POTENTIALLY PROMISING DRUGS THAT WE SEE IN THE BASIC RESEARCH LABORATORIES NEVER MAKE THOSE RIGOROUS STEPS TO GET TO A CLINICAL TRIAL.

BUT AGAIN, I THINK THE CLINICAL TRIALS OFFER THE BEST HOPE FOR OUR PATIENTS.

I MEAN IF YOU LOOK AT, FOR EXAMPLE, BREAST CANCER TREATMENT S, I MEAN MANY OF THE TREATMENTS THAT WE CURRENTLY DO ARE THANKFULLY DUE TO THE FACT THAT MANY OF THE PATIENTS WERE VERY WILLING AND VERY ENTHUSIASTIC TO GO IN CLINICAL TRIALS.

THAT'S REALLY WHERE WE GET THE INFORMATION.

I MEAN SOMETIMES THE CLINICAL TRIAL HELPS THE PATIENT IN TERMS OF SURVIVAL, ET CETERA.

BUT THE INFORMATION THAT WE GLEAN FROM THAT IS SO HELPFUL FOR FURTHER, YOU KNOW, STUDIES AND FOR FURTHER TREATMENTS DOWN THE ROAD.

>> WHEN A PERSON ENTERS INTO A TRIAL, I ASSUME IT'S FAIRLY RIGOROUS IN HOW YOU ARE FOLLOWING THEM ALSO, SO THAT ANY UNTOWARD EFFECTS THAT MAY DEVELOP, YOU PRETTY MUCH WILL CATCH EARLY, I WOULD IMAGINE.

>> ABSOLUTELY.

THAT'S SOMETHING THAT IS FOLLOWED VERY CLOSELY BY THE CANCER CENTER.

I MEAN WE HAVE A WHOLE TEAM OF QUALITY FOLKS WHO ARE ALWAYS ASSESSING FOR POTENTIAL SIDE EFFECTS AND, YOU KNOW, THE ORGANIZERS OF THE CLINICAL TRIALS ARE CHECKING ON US QUITE FREQUENTLY, COMING DOWN FOR VISITS AS WELL.

SO YOU ARE EXACTLY RIGHT.

I MEAN NOT THAT THERE ARE NOT POTENTIAL SIDE EFFECTS WITH ANY TREATMENT, BUT CERTAINLY DURING A CLINICAL TRIAL, THAT'S MONITORED EXTREMELY CLOSELY.

>> WHEN YOU TALK ABOUT INTERDISCIPLINARY TEAMS, EXACTLY WHAT ARE YOU REFERRING?

WHAT IS GOING ON WITH THAT 1234.

>> SO I MEAN IT'S INDIVIDUALS COMING FROM ALL DIFFERENT BACKGROUNDS.

FOR EXAMPLE, AT THE MARKEY CANCER CENTER, WE HAVE MEMBERS WHO ARE FROM 12 DIFFERENT COLLEGES AT U.K.

SO WE'VE GOT ENGINEERS WHO ARE WORKING WITH OUR CLINICIANS, WHO ARE WORKING WITH BASIC RESEARCHERS.

YOU'VE GOT CLINICIANS, RESEARCH TEAMS WORKING TOGETHER, YOU'VE GOT STAFF, NURSING, SOCIAL WORK, PATHOLOGY, ETC.

SO IT'S REALLY FUN BECAUSE IT'S SO MANY PEOPLE COMING FROM DIFFERENT BACKGROUNDS WHO HAVE DIFFERENT IDEAS AND DIFFERENT WAYS OF DOING THINGS THAT ARE-- OUR TUMOR BOARDS ARE QUITE LIVELY BECAUSE YOU BRING IN ALL THESE PEOPLE TOGETHER TO DISCUSS, YOU KNOW, THE BEST TREATMENT STRATEGY FOR THE PATIENT BUT IT'S REALLY GOOD FOR THE PATIENT BECAUSE EVERY PATIENT, YOU KNOW, HAS A NEW DIAGNOSIS OF CANCER, THEY GET DISCUSSED IN THESE INTERDISCIPLINARY WORKING GROUPS, THESE TUMOR BOARDS.

>> THAT, TO ME, HAS ALWAYS BEEN ONE OF THE GREAT THINGS ABOUT THE TUMOR BOARD.

YOU GET SO MANY DIFFERENT OPINIONS AS FAR AS WHAT CAN AND CANNOT BE DONE FOR THE INDIVIDUAL.

>> RIGHT.

>> MAKES IT BETTER.

WE ALSO KNOW THAT-- AND YOU ALLUDED TO IT A LITTLE BIT WHEN WE TALKED ABOUT CLINICAL TRIALS-- BUT SOMETIMES THE THINGS THAT WE DO TO MAKE A PERSON BETTER MAY HAVE SOME ADVERSE EFFECT.

SO TELL ME ABOUT SOME OF THE PROGRAMS LIKE THE CARDIO ONCOLOGY PROGRAM.

THAT SOUNDS VERY INTRIGUING TO ME.

>> YEAH, SO AN INTERESTING PROGRAM, ACTUALLY, BECAUSE YOU KNOW, I THINK-- AND I HAVE BEEN 30 YEARS IN THIS BUSINESS REALLY, SO A BIG FOCUS 30 YEARS AGO WAS JUST TREATING, YOU KNOW, PUTTING EVERYTHING YOU HAD INTO THE TREATMENT OF THE PATIENT AND SOMETIMES, AS YOU KNOW, SOME OF THE CHEMOTHERAPY, SIGNIFICANT SIDE EFFECTS THAT COULD OCCUR.

SO, YEAH, I THINK THAT-- YEAH.

>> YOU THINK ABOUT IT, BECAUSE AGAIN, YOU ARE BEING COMPREHENSIVE.

YOU ARE TALKING-- YOU ARE TAKING CARE OF EVERYTHING ON THESE PEOPLE AND SOMETIMES THEY NEED REHABILITATION SO YOU EVEN HAVE SPECIALISTS AS FAR AS HELPING OUT AFTER THAT, TOO.

>> RIGHT.

THE POINT IS AND YOU ASKED ABOUT CARDIO ONCOLOGY.

AND IN CANCER REHAB, WHAT WE ARE LEARNING IS THAT NOW MORE AND MORE PATIENTS ARE SURVIVING THEIR CANCER, WHICH IS A GREAT POSITION TO BE IN.

BUT WE ARE NOW SEEING NEGATIVE EFFECTS, SAY 10, 20 YEARS DOWN THE ROAD, WHERE THERE ARE ISSUES WITH CARDIAC TOXICITY THAT MAY HAVE OCCURRED 20 YEARS AGO, AND SO IF OUR CARDIO ONCOLOGY PROGRAM, AS WELL AS WITH OUR REHAB SERVICES, IT IS CERTAINLY ADDRESSING THOSE PROBLEMS AND NOW OUR CANCER SURVIVORS.

THE MENTALITY HAS SHIFTED FROM THROWING EVERYTHING AT THE CANCER TO NOW, OKAY, WE'VE GOT A SIGNIFICANT SURVIVOR GROUP AND HOW DO WE CONTINUE TO MONITOR THOSE PATIENTS AND CARE FOR POTENTIAL SIDE EFFECTS.

>> YOU KNOW, AT AN INSTITUTION SUCH AS YOURS, WE KNOW THAT YOU ARE ON THE CUTTING EDGE AS FAR AS TREATMENT.

BUT TELL ME, WHAT ARE YOU DOING AS FAR AS PREVENTATIVE ACTIVITIES?

>> YEAH, SO I TELL PEOPLE THAT-- AND IT'S ABSOLUTELY THE TRUTH, THAT THE MAJORITY OF OUR FOLKS, THE MAJORITY OF OUR EFFORTS ARE TRYING TO KEEP PATIENTS OUT OF THE HOSPITAL.

I MEAN BEE HAVE A SIGNIFICANT EFFORT THROUGHOUT THE STATE FOR CANCER PREVENTION AND CANCER SCREENING.

AND THOSE EFFORTS ARE PAYING OFF.

I MEAN IT'S JUST AMAZING.

I'LL TAKE LUNG CANCER SCREENING AS AN EXAMPLE, THAT TO THINK OF KENTUCKY THAT IS A STATE OF CULTURE OF TOBACCO PRODUCTION AND TOBACCO CONSUMPTION BUT DUE TO A LOT OF EFFORTS OF MARKEY AND STATEWIDE PARTNERS, WE ARE THE NUMBER TWO STATE NOW FOR LUNG CANCER SCREENING.

OKAY?

WHICH IS AMAZING.

WHICH IS AMAZING.

AND WHAT THAT HAS MEANT IS THAT WE ARE STILL SEEING LUNG CANCER, THAT'S FOR SURE.

BUT WE ARE CATCHING IT AT A MUCH EARLIER RATE.

WE HAVE SEEN THE SHIFT IN THE CURVE GOING FROM LATE STAGE DIAGNOSIS TO EARLY STAGE DIAGNOSES.

SO YES, WE FOCUS TREATMENTS.

WE TALK ABOUT ADVANCED TREATMENTS, PRECISION MEDICINE, BUT MUCH OF OUR EFFORTS ARE REALLY TRYING TO KEEP PATIENTS OUT OF THE HOSPITAL.

>> YOU KNOW, EVEN THOUGH I THINK SCREENING IS A CUT AND DRY ISSUE, THERE ARE SOME CONTROVERSIES.

AND IF YOU WOULD, TAKE ME THROUGH A COUPLE OF THESE THINGS.

WITH LUNG CANCER, WHEN DO YOU RECOMMEND PEOPLE START GETTING SCREENED FOR THIS?

>> SO, YEAH, GREAT QUESTION.

I MEAN REALLY IT DEPENDS-- THERE ARE CERTAIN CRITERIA FOR PATIENTS IN TERMS OF HOW LONG THEY HAVE BEEN A SMOKER, FOR EXAMPLE.

USUALLY WITH LUNG CANCER SCREENING, IT STARTS, THE RECOMMENDATION IS AGE 50.

BUT WE HAVE SEEN, AS WELL, THAT COLORECTAL CANCER, FOR EXAMPLE, USED TO BE AGE 50 BUT THE RECOMMENDATION IS NOW 45.

FOR BREAST CANCER IT'S NOW 40.

SO WE ARE SEEING YOUNGER PATIENTS WHO ARE PRESENTING WITH THESE CANCERS NOW, AND IT REALLY ALSO, EVEN THOUGH THESE ARE RECOMMENDATIONS, IT REALLY DEPENDS UPON A CONVERSATION OF THE PATIENT WITH THEIR PHYSICIAN AS WELL, BECAUSE IF A PATIENT COMES IN WITH A SIGNIFICANT FAMILY HISTORY OF, SAY BREAST CANCER OR COLORECTAL CANCER, THAT SCREENING MIGHT START MUCH, MUCH EARLIER.

>> WOW.

WHEN AN INDIVIDUAL COMES IN TO MARKEY, ARE THEY REFERRED BY THEIR LOCAL PHYSICIAN OR ARE THEY PICKING UP THE PHONE AND SAYING HEY, I HAVE A PROBLEM.

I WANT TO COME IN AND BE SEEN BY YOU GUYS.

>> IT'S REALLY A LITTLE OF ALL THE ABOVE.

WE HAVE PATIENTS WHO SELF REFER AND COME TO MARKEY BASED ON THE REPPATION.

WE HAVE PATIENTS THAT ARE REFERRED IN FROM ALL ACROSS THE STATE AND EVEN FROM OUTSIDE OF THE STATE AND OUTSIDE THE COUNTRY WHO COME TO MARKEY BECAUSE OF THE REPPATION.

SO HEAVE HEAVE REPUTATION.

IT'S REALLY A LITTLE OF ALL THE ABOVE.

>> I THINK THAT IT IS FAIRLY EXPENSIVE TO TREAT A PERSON WITH CANCER NOWADAYS AND OBVIOUSLY CHEAPER TO DO THE PREVENTION AND CATCH SOMETHING EARLY.

WHO I DO YOU-- HOW DO YOU ADVISE PEOPLE WHEN WE ARE LOOKING AT THE ADS THAT COME ON TV ABOUT SOME NEWER MEDICATIONS?

HOW DO WE KNOW WHAT IS A GOOD DRUG TO USE OR THIS IS SOMETHING THAT PERHAPS WE ARE NOT GETTING THE BANG FOR THE BUCK THAT WE MIGHT THINK THAT WE ARE?

>> GREAT QUESTION AS WELL.

YOU KNOW, I WOULD SAY MANY OF OUR PRECISION THERAPY DRUGS NOW, I MEAN THE WHOLE LANDSCAPE FOR CANCER TREATMENT HAS CHANGED SO MUCH OVER THE 30 YEARS, I MEAN NOW WE ARE TALKING REALLY TARGETING A PATIENT'S TUMOR BY IMMUNOTHERAPY BY PRECISION TREATMENT.

SO, YEAH, THE MEDICATIONS CAN BE EXPENSIVE.

I THINK WE ARE FORTUNATE IN KENTUCKY WITH THE MEDICAID EXPANSION THAT HAS HELPED US A TREMENDOUS AMOUNT IN TERMS OF PATIENTS WHO NOW ARE ABLE TO COME IN FOR SCREENING, FOR EXAMPLE, AND, YOU KNOW, HAVING THAT FUNDING TO PAY FOR THESE TREATMENTS.

>> SINCE YOU HAVE BEEN IN LEXINGTON, WHAT ARE SOME OF THE BIGGEST CHANGES THAT YOU THINK THAT HAVE MADE A DIFFERENCE IN OUR CANCER SURVIVAL RATES?

>> SO I THINK THERE HAVE BEEN SO MANY EXCITING THINGS.

I HAVE TO SAY AS I KEEP COMING BACK TO IT, I HAVE BEEN IN THIS BUSINESS FOR 30 YEARS AND 30 YEARS AGO, IF I HAD A PATIENT-- LET'S SAY A 75-YEAR-OLD WITH COLON CANCER THAT SPREAD TO THE LIVER, THEN THAT PATIENT, THAT 75-YEAR-OLD WOULD GET THE SAME TREATMENT AS A 25-YEAR-OLD LADY WHO COMES IN WITH THE SAME DIAGNOSIS, BUT NOW SO MUCH HAS HAPPENED, PARTICULARLY OVER THE LAST 10 YEARS, WITH GENETIC SCREENING AND BEING ABLE TO ANALYZE TUMORS FROM A GENOMIC STANDPOINT THAT WE UNDERSTAND THE MUTATIONS OF THAT PARTICULAR CANCER, AND NOW WE ARE TREATING PATIENTS BASED UPON THEIR INDIVIDUAL TUMOR BECAUSE EVERY PATIENT IS DIFFERENT AND EVERY PATIENT'S CANCER IS DIFFERENT.

SO UNDERSTANDING WHAT MUTATIONS THOSE PARTICULAR CANCER HAS, FOR EXAMPLE, HAS REALLY AFFECTED HOW WE GO ABOUT TREATING THOSE PATIENTS.

AND YOU KNOW WE HAVE SOMETHING CALLED THE MOLECULAR TUMOR BOARD THAT MARKEY THAT STARTED SEVERAL YEARS AGO THAT REALLY GOES AGAINST, LET'S SAY HOW WE USED TO DO THINGS.

I MEAN WE STILL HAVE MULTIDISCIPLINARY TUMOR BOARDS WHERE THE PHYSICIANS ARE FOCUSING ON COLON OR PANCREAS OR LUNG BUT WE HAVE A MOLECULAR TUMOR BOARD THAT'S ALL CANCERS THAT ARE BEING LOOKED AT AND THEY'RE BEING LOOKED AT FOR THEIR GENETIC MUTATION STATUS.

SO WE ARE MAKING RECOMMENDATIONS ON WHAT TREATMENTS, BASED UPON THE MUTATIONS.

>> WOW, SO YOU ARE GETTING THAT SPECIFIC NOW.

>> ABSOLUTELY.

AND THAT'S SO MUCH BETTER FOR THE PATIENT.

THE PRECISION THERAPY, RATHER THAN THE TOXIC CHEMOTHERAPIES THAT PATIENTS ENVISION THAT WE STILL OBVIOUSLY HAVE PATIENTS WHO ARE TREATED WITH INTRAVENOUS CHEMOTHERAPY, BUT MORE AND MORE OF OUR DRUGS NOW ARE ORAL, SO IT'S NOT AN I.V.

DELIVERY AND STILL SOME SIDE EFFECTS, BUT MUCH LESS SIDE EFFECTS WITH OUR MORE PRECISION THERAPIES.

>> YOU KNOW, SOMETIMES WE SEE SOME OF OUR SOCIAL MEDIA INFLUENCERS DOING CERTAIN BEHAVIORS, WHICH I DON'T THINK WE NEED TO ALL IMITATE, BUT ONE OF THEM THAT CONCERNS ME AND I'M CURIOUS OF YOUR POSITION ON THIS, IS GETTING THE WHOLE BODY CT SCAN AS A MEANS OF SCREENING OR LOOKING FOR AN EARLY CANCER.

GIVE ME YOUR TAKE ON THAT, PLEASE.

>> YEAH, SO THAT'S A BIG CONTROVERSIAL, AS YOU HAVE ALLUDED TO.

YOU KNOW, IT'S AN EXPENSIVE TECHNIQUE FOR OFTEN TIMES PATIENTS WHO DON'T NECESSARILY NEED THAT.

AND SO I'M NOT A BIG PROPONENT OF THAT.

I MEAN CERTAINLY WE DO LOW DOSE CT SCANS TO ASSESS FOR LUNG CANCER, FOR EXAMPLE.

BUT REALLY, IT'S FAIRLY RIGOROUS IN TERMS OF SMOKING HISTORY, FAMILY HISTORY, BEFORE YOU CAN GET THESE TYPES OF TESTS, BECAUSE ANYTHING-- AS YOU KNOW, ANYTHING YOU DO IN MEDICINE, IT CAN HAVE POTENTIALLY GOOD EFFECTS OR POTENTIALLY BAD EFFECTS.

AND SOMETIMES WITH THE TOTAL BODY CT SCAN, IT CAN PICK UP REALLY MINOR THINGS THAT ARE NOT A PROBLEM AND NEVER WILL CAUSE THE PATIENT A PROBLEM, BUT YET NOW YOU ARE SORT OF GOING DOWN THE RABBIT HOLE TO KIND OF, YOU KNOW, DO BIOPSY TO FIGURE OUT WHAT THIS IS WHICH CAN CAUSE HARM TO THE PATIENT POTENTIALLY.

>> SO WITH ABOUT A MINUTE WE HAVE LEFT, TELL ME.

WHERE DO YOU THINK WE ARE AS FAR AS GETTING THE SINGLE BLOOD TEST NOT FOR DIAGNOSING THE GENOMICS BUT TELLING US WE HAVE A CANCER OR DON'T HAVE A CANCER.

>> SO I THINK THAT WITHIN THE NEXT COUPLE OF YEARS, WHAT WE WILL SEE, WE WILL SEE THAT.

SOME OF THE TESTS NOW ARE GETTING CLOSER TO THAT, BUT UNFORTUNATELY THERE ARE STILL FALSE POSITIVES AND FALSE NEGATIVES WHEN WHICH WILL STILL HAPPEN BUT THE TECHNIQUE HAS COME ALONG SO DRAMATICALLY OVER THE LAST FIVE YEARS I PREDICT WITHIN THE NEXT FIVE YEARS, THERE IS GOING TO BE SOME GOOD BLOOD TESTS THAT WILL TAKE THAT DIAGNOSIS MUCH EARLIER.

>> WELL, Dr. EVERS, THANK YOU VERY MUCH FOR BEING WITH US AND AGAIN, LET ME ADD MY CONGRATULATIONS ON THE RECENT RECOGNITION AS A COMPREHENSIVE CANCER CENTER.

I KNOW I FEEL MORE COMFORTABLE AND I'M SURE EVERYONE IN KENTUCKY IS GOING TO FEEL MORE COMFORTABLE KNOWING THAT WE HAVE YOU AND THE MARKEY CANCER CENTER AS A RESOURCE SHOULD WE HAVE TO AVAIL OURSELVES OF IT SO AGAIN CONGRATULATIONS.

>> THANK YOU VERY MUCH.

>> I WOULD LIKE TO THANK YOU ALL FOR BEING WITH US TODAY ALSO.

I HOPE THAT YOU HAVE A BETTER UNDERSTANDING OF THE VALUE OF HAVING A COMPREHENSIVE CANCER CENTER AVAILABLE TO US ALL AS WELL AS A GREATER APPRECIATION FOR THE CHANGES IN CANCER DIAGNOSIS AND TREATMENT THAT THIS BRINGS WITH IT.

IF YOU WISH TO WATCH THIS SHOW AGAIN OR WATCH AN ARCHIVED VERSION OF PAST SHOWS, PLEASE GO TO WWW.ket.org/HEALTH.

IF YOU HAVE A QUESTION OR COMMENT ABOUT THIS OR OTHER SHOWS, WE CAN BE REACHED AT KYHEALTH@ket.org.

IF YOU THINK YOU HAVE A QUESTION OR CONCERN, PLEASE REACH OUT TO THE MARKEY CANCER CENTER.

MANY PEOPLE WILL TAKE YOUR CALL AND I LOOK FORWARD TO SEEING YOU AGAIN ON THE NEXT "KENTUCKY HEALTH."