Life, Cancer, Etc.
Life, Cancer, Etc.
Talking with Dr. Andrew Brohl, Oncologist and Researcher at Moffitt Cancer Center
Dr. Andrew Brohl is a medical oncologist and physician-scientist. One of his specialties is sarcoma, which is how I got to know him (my second cancer was a cardiac sarcoma). He's been instrumental in my treatment and I'm incredibly grateful for his help and expertise. Plus, he's just good people.
Use this link find more info about Dr. Brohl and Moffitt Cancer Center: https://moffitt.org/providers/andrew-brohl/
Keywords: sarcoma, cardiac sarcoma, atrial sarcoma, sarcoma research
NOTE: I am not a medical professional. Everyone on the "Life, Cancer, Etc." podcast is sharing their own experiences, not giving medical advice.
PC: moffitt.org
You can also find some episodes on our YouTube channel: https://www.youtube.com/c/LifeCancerEtc
I'm Heidi Bragg and this is Life, Cancer, Etc. My goal with this podcast is to connect you with stories and resources that help you feel happier, more resilient, and less stressed, especially when you're going through hard times. Okay, today I'm talking with Dr. Andrew Broll. Dr. Broll is a clinician and a researcher at Moffitt Cancer Center in Tampa, and one of his specialties is sarcoma, which is the kind of tumor I had in my heart. Good morning.
SPEAKER_01:Good morning. Nice to see you.
SPEAKER_00:You too. Without a mask, too. It was interesting. I thought, what's weird? Oh, I can see his face.
SPEAKER_01:I didn't realize we'd be on a video chat. I would have shaved for you. I
SPEAKER_00:don't know. Sorry. Oh, no. The video doesn't show up. I only post the audio.
SPEAKER_01:Good, good.
SPEAKER_00:Okay, so tell us a little bit about what you do at Moffitt.
SPEAKER_01:Sure. So I'm a medical oncologist, so I help deal with things like chemotherapy and other systemic therapies, and also a physician researcher. So I spend part of my time seeing patients in the clinic and giving them advice about their treatments and spend part of my time in the laboratory trying to do some experiments and learn more about these cancers. And I'm a rare cancer specialist, I would call myself. So I mostly take care of people who have various types of sarcomas, which is obviously what you have. And also take care of people who have another cancer called Merkel cell carcinoma, which is a rare skin cancer and kind of help lead up the efforts on that at Moffitt as well. So that's kind of what I do.
SPEAKER_00:That's enough, I think.
SPEAKER_01:Say
SPEAKER_00:again, sorry. Oh, I just said, I think that's enough. I think that's a pretty good amount of stuff to do in a day, don't you?
SPEAKER_01:Yeah, well, it's good. Part of the reason I like this job and what I do is the variety from it. And part of the reason I even went into this in the first place was to be able to have that balance and that variety to do the research as well as to care for people.
SPEAKER_00:Okay, we're having a little bit of audio problems, but we're going to work through it. So tell me... Tell me a little bit about why you got into this, because this is a very specialized field. So what drove that for you?
SPEAKER_01:Well, I guess it depends on what part of the process you're talking about. There's a few different steps along the way before you kind of get into sarcoma and research and even doctoring in the first place. But I guess growing up, I didn't necessarily know I wanted to be a doctor. Even I just was good at math and science and I thought I would do something science related. And, you know, even when I was late in college, I wasn't really sure that I was going to be a doctor and was kind of vacillating between that and like PhD school and be a, you know, more or less a scientist. And when I was looking at sort of like science things, I was even thinking more like along the lines of maybe like a physicist, you know, something like that's kind of, you know, way out there and not different from, you know, taking care of patients. But Ultimately, I got drawn into the idea of doing something that's a little bit more tangible and maybe more relevant. I thought I could get a little bit more esoteric if I went the other way and also had a little bit more of a clear career path going that way. It was easier to see what I would actually do moving forward. I guess even if the research part didn't fully work out, you'd still have this great opportunity, great career taking care of people and being a doctor and could do clinical research. So it seemed a little bit more flexible there and kind of worked out for me that I'm still able to do the science part of it to a great degree like I like to. So that's kind of what drew me into medicine in the first place. And then you know, for a sarcoma more specifically, I, you know, I kind of got into it mostly through the research side, you know, basically what had a mentor during my training that, that was researching sarcoma. And then, you know, I got into that through, through that. And, you know, once, once I started doing it a little bit more, I, I sort of appreciated the, the, the need for in a rare cancer, you know, there's always this, you know, problem that, you know, rare cancers are kind of difficult to research and difficult to take care of because there's, But, and more people are needed to do it, even though, you know, you would think you'd need to put more emphasis on the more common things. It's just, it's underrepresented in research. It's underrepresented in, you know, sort of specialists in it. And so I think there's a real need for it. And there's also a sort of a scientific interest part of it too, where there's, you know, a lot of examples in cancer research and cancer medicine, where we learn a great deal by studying the rare things. You know, there's, you know, a great example is, you know, a cancer called retinoblastoma. It's a cancer that children get, you know, young children get in their eye. And it was one of the first cancers that was discovered to be hereditable. And the gene that was, you know, kind of discovered out of it, which is now called the retinoblastoma gene, is, you know, pretty commonly affected in a lot of other common cancers too. If you look at all cancers everywhere, breast cancers, lung cancers, sarcomas, about 10% of cancers have a defect in this gene also. We learned a lot about the genetics of cancer through this rare childhood tumor being studied. There's a number of examples like that. you know, my whole shtick or, you know, or spiel when I'm trying to, you know, ask the government for money to fund my research is that, you know, if I, if I studied this super rare thing that nobody is looking at, maybe, maybe I'll learn something like that too, that, that doesn't just affect a few people, but kind of is, you know, some sort of breakthrough or, you
SPEAKER_00:know, a lot more universal than maybe they would expect.
SPEAKER_01:Yeah. So I think that's, that's, that's sort of what I like about it. And so it's like this neat thing. So you really, you know, you know, it's, it's, you know, people are coming and you know, it's hard to find researchers for some types of sarcomas, even if you're, you know, for people who are diagnosed with this and looking for like an expert, I've, you know, come across some that it's really even hard to find like the go-to person in the world for it, you know, for, for some of these, you know, ultra rare ones. And so it really, I think is kind of a need as well. And, and, you
SPEAKER_00:know,
SPEAKER_01:it's been a good, you know, fit for me, I guess, and rewarding, you know, to do that.
SPEAKER_00:Well, and okay. So, I'll describe a little bit about the first time you and I met, and then I'd like to hear about that encounter from your perspective. So we had met with my regular oncologist who kindly, but pretty clearly stated that. So we'd come in, I'd had open heart surgery. They figured out that the tumor was not a benign myxoma like they thought it was, that it was this sarcoma. And did we ever figure out if it was undifferentiated or angiosarcoma? Do we know?
SPEAKER_01:I think we're calling it undifferentiated sarcoma at this point. It's been called both by the pathologists in different time points. Angiosarcoma is one of the ones that can affect the heart. It's a tumor that comes from the lining of the blood vessels or the heart itself. Location-wise would make sense, but I think it ultimately lacks some of the markers that we would tend to find on angiosarcoma. It's been, I think, probably more appropriately classified as just an undifferentiated sarcoma, which is somewhat of a catch-all term. We don't find any of the more specific markers to lead you down to a different sarcoma type. And it lacks the markers for angiosarcoma or liposarcoma or LAMA or these other things. But it turns out that a lot of sarcomas fit into that category. So it's actually one of the bigger categories of sarcoma that we end up classifying things as. But ultimately, that's what yours is.
SPEAKER_00:OK, so I walk in there and my other oncologist has said, you know, this is basically odds are this. I'm like, is this something we can treat? Or she's like, you can probably buy some time. But sarcomas are very aggressive and they usually come back, as you told me, within usually six to eight months. So, Kevin, I walk in and we're talking with the resident, Dr. Risk. And she's talking to us about this. And then you walk in the room and you say, you give us basically the same outline, but you're like, but there's this little window, like there's this little window. If you can hit it,
SPEAKER_02:it
SPEAKER_00:works, but you have to be really aggressive and the odds are not great. So just know that going in. And I'm like, what are the ads? And Kev always laughs at me because he's like, he gave you a number because you kept pushing him to give you a number. I'm like, what are the odds? And he's like, uh, 5%. Well, first you hemmed and hawed for quite a while. Cause you're like, I'm not giving you odds. And they like, fine. Yeah.
SPEAKER_01:Yeah. Yeah. Yeah. I remember you really pushed me on that one. You know, we, we hate giving people numbers because we're, you know, it's so, uh, you know, I don't know. It's a, it's a tough balance. You want to, you know, not be, uh, giving somebody false expectations or, you know, unrealistic expectations, but also not like kind of completely crush them and, you know, you know, crush all hope. And, you know, especially in the medical oncology field. So, you know, we're the people who deal with chemotherapy and, you know, in some cases now immunotherapy, which is, you know, kind of an emerging thing for cancer treatment for some types. And so, you know, you're typically giving those types of things to people who have either, you know, the bad ones, the ones that are already at an advanced stage or ones that are really high risk to come back. So, you know, we're not really seeing patients that have like the easy cancers that a surgeon takes out and it's kind of like end of story. We're typically, in my field, seeing people who have a tougher one that may need chemotherapy or something like that. And so, you know, a big part of our initial meetings with anybody when I first meet somebody is really sort of expectation management. And, you know, in trying to balance, you know, hope without giving false hope. You know, and that's sort of the needle that I'm trying to thread frequently. You know, often it's you know, in your case, I think you were actually pretty well prepared for our conversation. And thankfully, you know, the previous oncologist who spoke with you was, you know, fairly upfront with you, but, you know, oftentimes it's actually the most difficult part is getting that initial.
SPEAKER_00:Hang on your audio cut out. So you said oftentimes the most, what?
SPEAKER_01:Oftentimes the most difficult is, is getting the, you know, getting through that initial, you know, blunt getting hit over the head with a you know a two by four that of how bad it is because you know it's it's difficult to tell people you know how you know you know bad news and uh so you know i'd say the more difficult time is when people have come and seen an oncologist or two already and had no idea like how bad it really is and so you're kind of you know hitting them over the head with that at your first meeting and you know nobody's been kind of you know, brave enough to step up to the plate and kind of say that to them in the past,
SPEAKER_02:you know,
SPEAKER_01:you know, I can understand because that is maybe, you know, it's draining on you to do that. And perhaps if you're not, you know, an expert in the field, you might, you know, you might not feel comfortable saying something if you're not really entirely sure about it either. So, but we do, you know, get a fair amount of people who come in who just have no idea. how bad it is. In some cases, if it's not curable, in some cases where that's kind of obvious by the way that it looks or how advanced it is. That part can be pretty tough if people are not well prepared for that. It's sort of like hit and miss. Some people are like you, pretty well prepared for that and some people are not. In your case, it's more about the expectation method than afterwards and kind of you know, wanting to motivate somebody to keep trying and fighting it and giving it the best shot.
SPEAKER_00:We lost Dr. Brohl's audio for a minute during the interview, but what he was saying was giving people hope, but also giving them realistic chances and odds for survival and outcomes is really important. So what are some of the things besides the reality of their situation that you wish patients, knew when they came in that would help them have a better working relationship with you as a provider?
SPEAKER_01:Well, I think I appreciate when people come in with some degree of ownership about their care and taking some initiative on their own to sort of try to figure out on their own what, at least to some degree, what they're dealing with and what's been found so far. You know, this certainly applied to you, you know, coming in and wanting to know all the details and, you know, kind of knowing all of your radiology results and, you know, so forth and pathology, what you've been told so far. You know, asking for extensive detail, I think, from your previous doctors as much as they would give you. You know, some people come in and don't really, you know, are kind of a little bit clueless about what's even been found. You know, there's multiple tumors, not just one. You know, what's seen on my radiology? What is this even being called? You know, some people are just so, you know, and I think, I don't know if it's the fall of the patient or the people who've seen them before that, that get them to us. You know, some people will come in kind of clueless, you know, and just like, Hey, go to, go to the, go to Moffitt, go to the referral center and kind of, they'll tell you all you need to know. And so I, I kind of, I kind of like it a little better when people are a little bit more prepared and sort of ready to have a, you know, a more working relationship with me and, you know, sort of have more of an understanding and, some thoughts on their own about what kind of the options might be that we're talking about and having some questions prepared about what to ask. So I kind of like a little bit of preparedness you know, there's probably a degree where it gets too much, a little bit too much of like the, you know, Google MD, you know, like, you know, researching everything, which of course, you know, every doctor complains about it. And, you know, you know, a little, a little knowledge is a dangerous sort of thing, but, but to some degree, at least being aware of their, the, the main details of, you know, kind of like their case and what, what's been found in some of the, more mainstream expectations and so forth, I think it's pretty helpful so that people have been thoughtful about it and also kind of know what they might be in for and what they might be willing to do or not do. I mean, there's some people that start talking about chemotherapy, for example, they didn't really consider the possibility. They just kind of ignored that that could be a possibility and haven't thought about whether that's something they would want to consider or not. So that's sort of the degree of things I wish people would come in with when I first meet them.
SPEAKER_00:Well, because I think of you as the, you guys at Moffitt are like the, okay, what are my options and what should we do now, guys, people? Whereas the other people are the, well, what the heck is going on? I just, like when I met with my cardiologist, my cardiothoracic surgeon, my original oncologist, They helped lay out the picture about what was going on, what the tumor looked like, how the resection went, that we had one area that didn't have clear margins. Then when I met with Ana, it was, what are the expectations? Here's how sarcoma normally behaves. So that when I got to you guys, it was like, okay, I know all this stuff about what's going on. What do I do now? What are my options? I feel like... To go to a research center without any understanding of your case is you're doing yourself a disservice.
SPEAKER_01:Yeah, I mean, I think that's a great way to put it. The what's going on questions, the quicker you can get past that, you know, and into the, you know, what are the options? I think the better, you know, your time is spent with us and, you know, the better I can sort of talk about that sort of a level, that layer. So, yeah, I think getting past that initial layer is definitely ideal or better, you know, for the initial meeting when I'm seeing people in my clinic.
SPEAKER_00:So anything else on that question? Anything else you wish people knew before they got into that room?
SPEAKER_01:I think that pretty well covers it. I mean, we spoke about, to some degree, expectations as well. And having a little bit of at least a ballpark sense of the expectations is helpful. I don't need people to come in knowing that their odds are 5.2% or something like that. But I do want people to know whether we're talking about something that is probably curable or probably not. uh, or definitely not curable, uh, or, you know, just some of it, some really kind of ballpark expectations, I think are pretty helpful, uh, and often are provided, but not always. And so, you know, again, it's just, it's just hard to have a, it's hard to have a conversation. That's a working conversation about what, what are the options until you get over some of these initial shocks, you know, it's just, you know, the stages of grief almost, it's hard to get past denial, you know, uh, you have to, and so, um, you know, getting, getting some of those initial things out of the way, let's say, uh, you know, to get to this, all right, all right, let's, what, what's going to, what are we actually going to do now? What are the options? You know, how, how are we going to do this is it's, it's helpful to be able to get that point. If, if you've already had some of these initial, let's say things out of the way of, uh, just the, like you said, the overview and the, and the expectations to some degree.
SPEAKER_00:That makes sense. And then, um, we had some audio issues, so I'm not sure if this is repetitive, but, um, when I asked Dr. Broll and he said, I asked him if this was worth even doing the chemo and the radiation, because if it was just going to kill me anyway, why would I want to go through that before the, for the last few months of my life? And he said that there was this really small window, really small chance of a really great payoff and that it was, you know, it was up to us if we wanted to do it, but that chance was there. And so I, we decided to take that chance and to do this, this very aggressive radiation and pretty aggressive chemo as well for that chance, which I, yeah, 5% or whatever it was 5.2. Thank you for the decimal point now. That was a, that was a really, it was a, it was not a hard decision to make. But it was a hard decision. And I'm trying to figure out what the distinction between those two statements is. For me, because I love Kev, because I want to be around more, because I love my kids and I want to be here longer, that was an easy decision to make. It's like, we'll take this shot. And it may very well kill me. I don't, you know, it may. But I felt like I had to take that decision. shot but we still had to have all those conversations and we had them primarily where our kids are both our kids were at camp one week and we were driving back and forth to radiation every day and it's about an hour and a half each way for us if there isn't traffic talking about okay and i'll start crying uh so if i don't make it then what um And we had a friend who does end of life planning come while the kids were at camp again and just kind of go through stuff with us. And he said, you know, we're just making a plan. We're not setting a date. And so we just kind of planned out what we wanted and what we didn't want. And Kev did it as well at the same time. And those were really horrible conversations to have, but they were necessary to kind of get through some of the logistical and procedural stuff and then move on to the other stuff we wanted to do. And I think it's kind of the same way when you get a diagnosis, you have to do those hard, hear those hard things and have those hard conversations and make those hard choices. And then you just move forward and do it and you hope, and you pray that it works, but you've got the, the other stuff taken care of to the point where that's not constantly on your mind. And we, we were very frank with the kids too. They didn't know every detail of every treatment, but they knew that there was a chance I wouldn't make it. And the way Kev said it to them was, um, mom will probably, there's, they're pretty confident she would be here till I think you said Thanksgiving, right? or Christmas. That's what they told us. After that, we just don't know, but this is what we're going to try. And we explained about the kind of the moonshot approach to this. And that was, that was horrible. That conversation was the worst one out of all of them.
SPEAKER_01:I'm sure.
SPEAKER_00:Yeah, but it was important.
SPEAKER_01:In one of our original meetings, you know, when we were discussing chemotherapy and what, you know, just sort of the overall plan of attack. I remember we had a conversation about how are you going to phrase it to your to your kids. And I think I was trying to give you some advice, even though I have no idea what it's like to be in that exact situation, but I, you know, try how to, how to phrase it about, you know, the notes, you know, sort of like how you guys laid it out or how you said it just there, you know, how it's a, you know, that it's a, unfortunately it's an aggressive cancer type that historically doesn't have a high success rate. And, you know, we're going to treat it aggressively to try to give it our best chance. you know, and, and, you know, we're just going to take it a month at a time, but, but we know that it could, it could go badly. We know it could go badly soon within six months or something, you know? And so I think, you know, setting sort of realistic expectations, but still maintaining some, you know, window of hope is the way I try to do it. Just like I try to give to you and, you know, try to encourage you to phrase it like that to your kids as well. And, So you can sort of have the same experience that I have in my day-to-day, sort of turning that back around to give that same sort of balance to your children when you're trying to describe it to them. So I guess hopefully just having heard that or modeling sort of after how I talked to you about it, hopefully that was helpful, I guess.
SPEAKER_00:Oh, it was super helpful because I didn't want to tell them anything that wasn't true.
UNKNOWN:Yeah.
SPEAKER_00:That was the main thing. It's like, I wanted as awful as it was, I wanted them to have an honest expectation and a realistic expectation of what, what could happen. So.
SPEAKER_01:Yeah. And I think I told you at the time that, you know, this is, you know, it's not unrealistic to tell them that there's a small hope and that, you know, that's, and that, you know, you should tell them just the way that I'm telling you that it is, the odds are against you and it is a bad thing. cancer and many people don't survive this cancer but there is a small hope and we're going to try our best for that hope and that's you know i don't think that that is a lie to your children to tell them that because i'm not lying to you about how i'm telling you that right now so that's i think what i what i said something like that you know i'm probably paraphrasing myself a little bit but that's
SPEAKER_00:no but it was very similar to that and and it was
SPEAKER_01:yeah
SPEAKER_00:it was straightforward and and it was what you told me and it was what we told them And as things went along, them having that in their back pocket, knowing this may totally not work, but there's a chance. And so we're going to hope and pray for that chance and work as hard as we can to get that.
SPEAKER_01:Yeah, and I think the more upfront and blunt you can be with someone, the more that they can trust you when you do tell them that there is a small window of hope. And the way that you phrase that is very important for me or for the way that you're telling your children the same way. And that's what I'm trying to strive for when I talk to people about it. And I think in general, I come across as pretty blunt because I tend to lead with the bad news and sort of be pretty upfront about that. And so I think when I do talk about the more hopeful side of things, I think it's at least more believable and probably the same way when you tell your children that too.
SPEAKER_00:Yeah, that's one thing I like about you is... You don't sugarcoat anything, but you're also not depressing. And I don't know how you managed to pull that off, but good on you because that works. It's working
SPEAKER_01:for you. I'm not sure, but thank you for that compliment. I find that bluntness works the best. People just really want to know the truth. don't want things to be sugar-coated in this field. I can't tell you how many times people have thanked me for telling them that they have an incurable cancer that I can do nothing for. People just thank you so much for telling them that so upfront. When I tell them, really, you shouldn't go through chemotherapy. I think it's just going to pile on and it's not going to help you that much. I really don't think it's for you. I don't think that we should do that. I can't tell you. That's almost never been met with no, you know, or like that's, you know, you're, you're, you know, you're a fraud. You don't know what you're doing. You know, that's almost always met with, thank you so much for just telling me that. Uh, so I don't know. I think that that's by far and away, the best way to go is just sort of really, really, uh, bluntness. And, um, yeah, I don't know. I guess I'm an optimist by nature. I guess that's part of the reason I went into oncology because you're, you have to sort of maintain some optimism, I guess, to, to be in this field and do it. And, you know, try to, to try to find the cases like yours that have gone, gone real well so far. And, uh, you know, that's, you know, keep motivating you, I guess.
SPEAKER_00:Well, and I think it, I think it takes, it takes a special kind of person to be able to do that and be resilient. I think delivering that kind of bad news and still maintain optimism. And I'll tell you, I always, I've told people this for years. I can deal with anything if I know what it is. I may not like it, but I'll figure out a way to deal with it. But if people kind of hedge or lie or whatever, and you don't know the truth of what's going on, how do you know what you're dealing with and how do you make a plan to move forward?
SPEAKER_01:Yeah, and that's a particularly difficult problem in my field of sarcoma and the one you deal with is that it is a field because of the rarity that comes with a certain degree of uncertainty. And so people really have a difficult time dealing with the uncertainty of it. And even the uncertainty of sort of the medical recommendations, whether or not to give chemotherapy or not for a case like yours is, you know, probably most people would, but even that is somewhat of a matter of debate. You know, there's some, you know, even experts that would say, you know, that it's probably not going to move the needle that much, you know, and some that would say, you definitely have to try it because it might help a little bit. And so, you know, even within our field, because it's so rare, it's hard, it's hard to have definitive answers like you do in some of the other cancer types where you test all these different permutations and don't have, are able to do more, you know, clinical testing and experience from it. And so there's, this uncertainty factor also. And also sometimes the diagnosis is hard to come up with. Like in your case, we still kind of go back and forth between these two different diagnoses sometimes. And some people are like, you know, what the heck? You know what? You know, you can't even tell me what I have. You know, you're like this expert center. What's going on here? Like, you know, maybe I should go somewhere else. So, you know, there's this extra uncertainty factor that makes it, I think, particularly challenging for these rare cancers that make it even more difficult where there is not you know, we treated a thousand people this way and a thousand people the other way. And we know for sure that this way is 2% better, you know, that, you know, this is, you know, we just don't have that for a lot of the things we're dealing with. And, and so we have to talk in uncertainty sometimes and hedge a little bit sometimes. And when we're talking to people about our, our recommendations and, and, uh, you know, that's, that's a real challenge, I think for, for a lot of people and for the, for the doctors too, frankly, to try to deal with that degree of uncertainty.
SPEAKER_00:Well, and I, I think, um, I'm okay with it being your best guess. And that's what you have to kind of come to, especially with the rare ones. And I always say things like, if it was your sister, if it was your wife, if it was your mom, and you liked these people, what would you do? And I'm okay with knowing that's your best guess. For someone you care about, someone you love, this is what you would recommend given the same circumstances. And it's a guess. And that's okay.
SPEAKER_01:Yeah, no. And I think that's, that's sometimes how I phrase it, you know, is that, you know, I've learned over the years to, to phrase it like, Hey, you know, this is, it's not definitive because it's rare. And, you know, you could go to three different sarcoma experts around the country and one of them could tell you no chemotherapy. One could tell you definitely chemotherapy. And one could be like me. It's like, I think probably chemotherapy, uh, you know, like some, I tend to be more, a little bit more in between, I guess, or more flexible than some that are a little more dogmatic. Um, but, um, you know, that there is, you know, that definitely happens in this field. And you do have to kind of phrase it as your best guess sometimes, you know, from your experience and be, you know, again, blunt about that to some degree. And I think, you know, as long as you can, you know, if you're comfortable with living in that uncertainty, I think the patient you're talking to gets more comfortable living in that uncertainty. And so that's, you know, you have to sort of, you know, embrace that to some degree, you know, I think to be the most effective way. Um, and so, yeah, that's, that's one thing. And I don't know. I mean, I agree with you. That is a, it is a challenge and it is draining, you know, it's part of the reason I do research and part of the reason I split my time, you know, to be honest, I think it'd be challenging to do this job every day for, you know, seeing patients five days a week and doing this, delivering this news five days a week and, um, maintaining that optimism and, and, um, you know, that, and the energy for that, it's, it is, it is a more draining day when I, when I see patients that day, then, you know, I come home ready for like a recharge, you know, when I'm spending the day in the lab, the following day or the day before, it's a little, little different drain on your psyche, you know, a little different, you know, amount that it pulls from you. And, you know, I enjoy that, but it also is draining, you know, and it's a, it's sort of one of these things that like you want enough of that you can take, but not too much, you know, and just,
SPEAKER_02:So
SPEAKER_01:I guess, thankfully, I've been able to carve out the amount that's right for me. But I do think a lot of people go into oncology because they, to some degree, want to deal with that level of difficulty on an emotional level and want to feel like they're dealing with something important and challenging and want to get moved to a certain degree of emotions. It's the same reason people want to go to see a sad movie or want to go to a I don't know. I don't know that just people find it, you know, it's important to do these things. And I think that, you know, a lot of us are, you know, appreciate that aspect of the job. I certainly do, you know, and it's a really rewarding part of it.
SPEAKER_00:Well, you're definitely doing work that matters. It matters hugely to me. Yeah. Yeah. I'm not going to do it while you're here, but I do sing your praises. You and Dr. Nagavi particularly, just the two of you and the way you guys work together and the difference it has literally made in my life. So thank you.
SPEAKER_02:You're very
SPEAKER_00:welcome. Okay. You've made me cry. Okay. So now a couple of... What'd you say?
SPEAKER_01:I'm not sure that was too difficult to do to make you cry. I'm not sure.
SPEAKER_00:Okay. Hey. It's true. Let's not get it all out there. It's totally true though. I kind of wear my heart on my sleeve. So a couple more quick questions. Number one, what has, so your life's work, what has it taught you about people or about life in general? Like if you had to sum it up in a couple of little quick sound bites.
SPEAKER_01:Gosh, I mean, I mean, one thing you learn very quickly is that life is just so fragile. Health is so fragile. You know, anybody, anybody, that's going through anything like you, you have, you know, find it out right away. And I, you know, I certainly see that secondhand, um, you know, it's something we take for granted so easily and it's so, it just can go so quickly. Um, and that, and that's, that's obviously the number one in your face lesson, I think. Um, but, you know, I think that it does make you feel like there is, um, a meaning to life and a meaning, you know, people, their lives and their time are just so meaningful and it gets in some ways exaggerated when they're faced with their mortality. And I'm sure that's something that you've experienced and it's something that's hammered home every single time you see somebody dealing with a difficult disease like cancer or like a sarcoma especially. And so that's, I think that's, that's my little soundbite lesson. It's, it's, it's, you know, life is meaningful, and it's worth fighting for. And it's, but also, it's fragile. And it's, it's temporary.
SPEAKER_00:Those are really good soundbites, by the way. Okay, so first of all, thank you. Second of all, a couple of things about you, like, do you have a couple of things on your bucket list item, like bucket list items that you'd be willing to share? like places you want to go, things you want to do besides curing cancer. We know that, but anyway.
SPEAKER_01:Man, curing cancer has got to be number one on my list, but I'm still working on that. But, uh, no, I mean, I, gosh, um, you know, I'm, I'm mostly, I'm, you know, I'm focused on work. I'm focused on family. I have a couple of small boys and, you know, my most important things are just, you know, are those two things, you know, seeing my family grow and, and, uh, prosper. And, uh, Trying to guide them to grow up well and carry on, I guess. And I do travel a bit. And so I've been able to do a lot of bucket lists. Thankfully, I'm very blessed in that way. So I don't have one necessarily specific one. It's just these more general things.
SPEAKER_00:No, those are good, though. And then that probably wraps into the last thing I was going to ask you. What's your favorite place or what are your favorite places to be if you had to pick one or two?
SPEAKER_01:Well, I think one of my places that's near and dear to me is Dubrovnik, Croatia. This is where my wife is from, and we got married there. Oh, cool. And so we do travel back there almost every summer, though it's been a little pushback with the pandemic. We are going to try to go later this summer. and let the boys see their heritage, I guess. It's a beautiful place. It's like a cruise ship stop there with tourists and stuff like that. It's a real nice area. That place is real special to me now through my marriage, I guess.
SPEAKER_00:It's so funny because Kevin and I were looking at Croatia because it's not in the Schengen country, so you can live in Croatia longer than you can in Italy. So we actually were looking at that and some houses there and thought, man, that would be really nice. It's lovely.
SPEAKER_01:It's a beautiful place. I'd highly recommend it.
SPEAKER_00:Very cool. Well, first of all, I want to thank you for your time today and for putting up with the audio issues.
SPEAKER_01:No, no problem. It's my pleasure to be here.
SPEAKER_00:Well, and secondly, I want to thank you for me. so just thanks and yes it's not hard to make me cry but um without you well without you guys and your help i don't think i would be here today and you know i know things can always get bad again blah blah blah whatever but i'm living a pretty good life and i've been healthy and that's
SPEAKER_01:yeah
SPEAKER_00:that's pretty amazing to me so thank you for that
SPEAKER_01:yeah you're so so welcome and it's just so so great we love this and we love how well you're doing and so happy that I didn't, uh, over promise under liver. You know, I think, uh, we, uh, thankfully went the other route and under promised and I don't know, it's much better to be in that way, I guess.
SPEAKER_00:So, uh,
SPEAKER_01:it's great being here talking with you and, and, um, yeah, it's great being here talking with you.
SPEAKER_00:As you can tell by our conversation, Dr. Broll is just good people. He's dedicated to his work. He's dedicated to his patients and he's just an all around great guy. He's also an example of the kind of people they have working at Moffitt Cancer Center. And I would highly recommend it if you ever need a specialist who can help you with something that maybe your regular oncologist can't. This week, as you go around the world, please count your blessings. Look for the good in others and in yourself. Do something nice for somebody else that makes their day a little easier and make it a great week. Thanks for listening.