The Pelham Podcast

Cancer Survivorship & Looking Forward to the Future

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The Pelham Podcast | June 14, 2024 | Episode 2
Cancer Survivorship and Looking Forward to the Future
with Dr. Steve Corso 

Episode Summary: 

In this episode, hematology oncologist Dr. Steve Corso talks about his experience treating cancer patients in the Upstate and how his perspective changed when he faced and survived his own battle with cancer. 

We discuss how the oncology teams at Gibbs Cancer Center take a multidisciplinary approach to diagnosing and treating cancer. We address myths about cancer and treatments. We also learn about HPV, its effects on cancer and how parents can help their children get ahead of future concerns. 
 

00:00 – Welcome & intro 
00:41 – Dr. Corso’s career  
04:35 – Breast cancer risks and screening 
07:30 – Personalized, modern breast cancer care 
10:36 – Why hematology oncology? 
11:31 – Dr. Corso’s personal battle with cancer 
16:23 – Life after cancer 
21:33 – Oral cancer, tobacco & HPV 
23:17 – Conclusion & thanks 

 
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Tony K: Welcome to this edition of the Pelham Podcast. It's an honor to have Dr. Steve Corso here, who is a hematology oncologist with the Gibbs Cancer Center, and get an opportunity to talk about his work as a hematologist oncologist and also his personal journey of having gone through his own cancer experience. So Dr. Corso, welcome. Glad you're here. And thank you for your time. 

Dr. Corso: Absolutely. Thanks, Tony. So, I arrived actually in the Upstate in 1997. I'd finished a brief career with the Army—they had paid my way through med school—looking to get back in the region. I'd gone to undergraduate school and medical school in Columbia at the University of South Carolina, where I met my wife. So, when opportunity came up here in Spartanburg, it seemed like a perfect place to be. We raised three boys here over the years and had a wonderful experience initially when we were a private practice with hematology oncology—I should say Palmetto HemOnc—and then joining the hospital system back in 2008, I believe. I’ve been working predominantly in Spartanburg and our Gaffney and Union offices. For a brief time, we had one in Pelham. I mean, sorry, down in Laurens, and then with the development of Gibbs Cancer Center out here at Greer, we've certainly found a permanent home with a beautiful and wonderful cancer center.

Tony K: It definitely is at that. And we're definitely glad that you're a part of that. Talk to me a little bit about, you know, what made you choose Spartanburg Regional Healthcare System? I ask that in the context of we're blessed. You know, Spartanburg is growing now, but the community the size of Spartanburg is really, I mean, it's unheard of to have the depth of cancer resources we have. So what about the physician group that you initially joined, the system and the work we were doing around cancer, what drew you to the Gibbs? 

Dr. Corso: I think in large part it provided the perfect opportunity in place to do what we wanted to do, and that is take care of patients. Most of us do not have a business background. We're not very adept at managing the business side of medical and healthcare, so coming to Spartanburg Regional and Gibbs was a place where we could let people who were trained and experienced to do that and allow us to take care of patients. That's where we spend our careers and education and learning. And, and it's, it's such a fantastic environment to work in because we're able to provide patients with really state-of-the-art care. We have a wonderful collegial system between the radiation oncologist, the surgical oncologist, ourselves, and All the ancillary staff between radiologists, pathologists, I mean, it is truly an academic environment in terms of everybody coming together routinely throughout the week. 

I have focused predominantly on breast cancer over the last probably 15—almost 20—years as cancer has gotten a lot more complicated, which is good. That means we know far more than we did 25 years ago. And it's so much harder for an oncologist to really provide the same level of care in all cancer types that patients really deserve to have, which is why many sometimes go to academic institutions because they see a doctor there. That's all that doctor does is just lung cancer or prostate cancer or breast cancer. And so we've tried to provide that same high level of care here in the Upstate and at Gibbs, and I think have been quite successful by focusing on one or two tumor types allows us to do that. So doing predominantly breast cancer over the years, working with amazing colleagues who all are totally committed and enthusiastic about trying to give patients the best care possible has made this really a fantastic place to work for going on now 27 years this year. 

Tony K: All right. Well, you know, having seen, witnessed it firsthand (I'm the hospital administrator, so it might sound easy to say), but I've witnessed it firsthand with my father-in-law. He had some urologic cancer and saw firsthand the quality of care and treatment and the approach to care. And unfortunately, he passed away, but the care was really tremendous. And again, I go back to a healthcare system like ours, you know, fairly large but not a behemoth like many organizations are, to have the quality of cancer care we have and the depth of resources is really pretty unique. So it makes me proud to be part of an organization that has made that investment and made it work. And the vision that was established years ago, you guys have all carried out very, very well. Anything that you might want the listening audience to know about breast cancer?

Dr. Corso: I guess to the first point, again, it's one of the few cancers that we have proven screening mechanisms in place. Again, nothing is perfect. Mammograms are a good tool. They're not perfect. We do have ability though to help women make a diagnosis earlier, which ultimately can help those patients survive longer.

I should rephrase that to help them survive their cancer period and get to live a full life and die of old age when they're 97. Many cancers we don't have that capability. So, it's certainly one we want to encourage all women to take advantage of. I think we're getting smarter about understanding not only which patients we should perhaps screen more intensively, perhaps with MRI scans in addition to mammograms, because of the shortcomings of mammogram. But we also understand a bit more of how to recognize the folks who are really at higher risk.

And we have a high-risk program in place for quite a few years that women who don't have cancer, but are at higher risk—perhaps because their family members were at cancer or other factors in place, genetics predispose them to increased risk. We can help them perhaps choose a plan that will allow them to be more successful than other family members, doing well and living a long life and not having it shortened by cancer. Sometimes that means more intensive screening, sometimes it's actually reducing the risk by interventions, whether it's medications and sometimes surgery. So, I think we take a much more comprehensive look at not just waiting for cancer to be diagnosed, but identifying those patients who are at higher risk and trying to help them formulate a plan that will be more successful.

The wonderful thing about cancer care is it's evolving very rapidly, and the amount of medications we have and ability to help patients live longer and do better is just astounding. In my 27-year career, what we're doing now wasn't even remotely thought of back then. There are medications coming out all the time that are extending women's lives and helping them live longer, even when it's advanced-stage disease. But ultimately, you know, many people still die from cancer, and so I think part of the emphasis should be is helping them live a life that's joyful. And I think part of the goal is helping patients who do have perhaps incurable cancer still live it well and have a quality of life that's meaningful for them as well. 

Tony K: Is there anything that might help for the listening audience? There's been some high-profile celebrities who have been diagnosed, and they've chosen to have certain treatments over another. Is there anything that from those stories that you might hear you think, “boy, I wish people wouldn't talk about breast cancer that way.” Or if people default to, “some celebrity had this; I need to have that.” 

Dr. Corso: Sure, I think part of it is helping educate patients and understand what their own situation is, because sometimes when you try to compare yourself to somebody else, there's always going to be unique differences. What somebody else may do may not be applicable to or the best for them. So educating them, helping them understand their situation and know what their own options are, and then giving them an opportunity to sit down based on their own values and preferences to make the best one for them. I could have three women in the room, and they all may choose a different route based on what's important for them. I often tell patients, if this were my mom, who's 94 and quite advanced in years, she may not elect to do anything, but to live her life out based on her age and just let things occur. And on the other hand, my wife would probably be very aggressive. So, I try not to tell folks there's a one-size-fits-all, but help the treatment approach fit those patients’ desires.

But to the point of, you know, the misinformation that occurs out there in the world, through social media and the internet, can be rather challenging for many patients. You try to tell them that you know, there are perhaps certain times when pursuing those may be reasonable, but first, check with the established care to see what's proven track record, you know. A sad case—and somewhat, I think, high-profile—was several years ago. Olivia Newton John had relapsed with her breast cancer, and it was over 20 years out from her diagnosis, which is extremely long and unusual. Unfortunately, when she did reoccur, from what I understand, she elected not to pursue standard treatment. And—as we were talking about a moment ago, the new drugs out—we have oral medications that are extremely well-tolerated, without any of the traditional side effects of therapy, that can help women with advanced breast cancer go on and live very active and normal lives for five, 10 years. And she chose not to, I think she pursued some alternative, homeopathic sort of medicines and ultimately passed, which was her choice. I mean, ultimately, can we want folks to have that? But I think sometimes they think about what is done at a cancer center as traditional “chemo,” when those drugs are not going to be the ones that their mothers or grandmothers got 15, 20 years ago. We have a lot of other medications that are so well tolerated. Totally different side effect profile than most folks consider when they think of chemo. 

Tony K: Now that's, I think, very helpful for people listening in to understand that. Hopefully they'll never experience an episode of any kind of cancer, but the evolution of medicines and treatments has made things far better in many ways.

I should have asked you this earlier, but what made you choose hematology oncology for a specialty? 

Dr. Corso: You know, I get asked that question a lot over the years—and particularly when students rotate through our office from the local medical school—and I don't have any sentinel event. I didn't have any family members with cancer, so it wasn't like I was impacted early on in my years. Quite honestly, I think it was perhaps the subject matter. We're dealing with a group of people who, for the most part, have diseases that weren't brought on necessarily by anything they did. And they had a fairly intense perhaps a short period of time and to be able to impact positively on that period of time maybe again in my own journey through healthcare. It was perhaps divinely led. I feel like where I'm at now is where I was intended to be and probably a spiritual guidance there as well. 

Tony K: Okay, so definitely a calling for you.

Dr. Corso: Exactly right.

Tony K: Well, if we shift gears…thankfully, not every oncologist has their own personal battle with cancer, but you unfortunately—or maybe you look at it as a great blessing—did go through that. So maybe talk through a little bit—we can sort of bust this up into components. The first, you know, you were diagnosed with oral cancer, and it manifested with a tooth issue, right? 

Dr. Corso: So that's how it was found, yeah. You know the cancer doctor winding up with cancer isn't something that you think is supposed to happen, but it certainly did. And it was almost literally two years ago to the day. I was in this same building—in the emergency room—and just come back from a ski trip, and had a toothache where I'd had a crown. I wound up seeing the dentist, who put me on an antibiotic and said I needed a root canal because it had looked like a small fracture and abscess. Unfortunately, the antibiotic—or maybe fortunately—the antibiotic didn't work effectively, and the infection spread rapidly through my entire neck and throat. So, I'm in the emergency room having a CT scan to evaluate the extent of the infection. And it was a radiologist on that day who's a friend—an excellent radiologist who fortunately wasn't overly distracted by the infection—and was able to recognize that there was a enlarged lymph node on the right side of my neck that couldn't be accounted for, and it was very suspicious for cancer.

 So, as I spoke to him that morning about the CT scan finding, I scoffed and I was like, “yeah, I don't have cancer. I'm perfectly healthy. I got this darn tooth abscess that needs to be taken care of.” But sure enough, a couple of weeks later after the tooth issue was resolved and the biopsy was performed, it was a cancer that ultimately started in my tonsil. Extremely small cancer in the tonsil that was not even seen on the scans. It was the lymph node that helped identify it. So, it was an early-stage cancer that perhaps the blessing of a tooth abscess led them to find it. 

Tony K: Absolutely. And you know our approach to cancer care is multidisciplinary. So, you know, sitting on the other side, I'm sure you weren't in your own case. Talk to us a little bit maybe about the comfort that it gave you that there was going to be a group of people around the table—oncologists, surgeons—around what the treatment regimen might be for you, versus what, you know, different approaches to cancer care might be offered at different cancer centers.

Dr. Corso: Being diagnosed with cancer, one has multiple levels of ways it affects the person. There's the emotional level that probably hits home first. And you know, most of the time, I would anticipate patients going through multiple phases that we've all sort of heard, the phases of grief: initial shock, denial, and then bargaining and acceptance. The emotional component obviously was intense, as anybody would tell you if they've had cancer. It's one of those moments in those days you never forget where you were, much like the space shuttle being exploded. After I guess the dust settled, after a few days, and wrapping my head around what my heart was already struggling with, it sort of became one of “the doctor in me intellectually needs to figure out what we're going to be moving forward.”

And I had not done a good job that first week or two with my tooth abscess managing my own care, and my wife to this day is still rather frustrated with me, because I was trying to be a doctor rather than a patient. But I realized the emotional aspect of this journey—that I needed to step away and be a patient. And I entrusted my care to some amazing and wonderful colleagues—Dr. Hathaway, who's one of our medical oncologists, and Dr. Curtis. I had an opportunity to work with these people for years and was going to entrust them with my life, and knew that whatever decisions would be made would be made as a team with this multidisciplinary approach. Dr. John Foster was my ENT doc who made the diagnosis, and he worked closely with the others to help formulate a treatment plan. There was actually a visit that was encouraged by all of them to meet Dr. Terry Day, who has pioneered and done this very elaborate sort of robotic surgery. But after meeting with him, I came back to Spartanburg and realized that you know, as Dorothy said, “there's no place like home.” And I had quickly decided that I was going to receive all my care here. I didn't think there was anything elsewhere that could surpass the skill level and the treatments provided here. We made a decision to move forward with radiation and chemotherapy, which would be given over seven weeks and could provide a high-success rate of remission and ultimately perhaps cure, which was the route we decided to take. 

Tony K: Well, there's no way that going through something like that can’t affect you somehow. How do you feel like that's made you—I don't want to say a “better doctor,” but for lack of better word—maybe a different doctor or a better doctor going through this yourself, knowing that you deal with patients who are going through it. 

Dr. Corso: So probably within days of having the diagnosis, I quickly came to terms with it on multiple levels. And one of those being  spiritual—my  faith has always been an integral part of who I am and how I care for patients. I've realized over the years from 10, 12 years ago, a young woman named Hannah Sebesky, 18-year-old who had cancer and died, that for many patients in our community, their faith is the most integral part of their life on this earth. And I realized that allowing them to embrace their faith as part of their cancer journey would be extremely important and have continued to foster that in patients and allowed that to be part of the journey. So, I certainly did that myself and realized that perhaps there were amazing opportunities by me going through the cancer journey. I have always had a couple of prayers I said before I left the house to help guide my decision-making and interaction with patients. And and one of the prayers was a prayer of Jabez, where I just asked the Lord to use me as he will, and offer myself up and whatever he has in store—I'm accepting.

And so I took the cancer journey as an answer to that prayer that—all right—he's going to show me another way to be even a better physician. And I certainly believe that's true. I spent the first, gosh, two months of the treatment, which were like going out to the woodshed and having a good old-fashioned beating. It was not easy, and sometimes the treatment itself can be very, very challenging as mine was, but ultimately was successful. And I learned a lot from the experience of what patients go through. It's one thing taking care of patients. I told many folks over the last couple of years how naive we are probably as providers, when we think we understand what our patients are going through. It's sort of like me telling people, “I understand what it's like to be pregnant. Heck, my wife's been pregnant three times.” But no, you really don't get it until you're pregnant. And this gave me a level of insight on the emotional, the mental, and spiritual upheaval that our cancer patients go through. So one, whether it makes me better or not, I don't know, but it certainly makes gives me a level of credibility with patients. When I sit down with the patient and I look at him and I tell him, I know what you're going through. And I have put together a letter, which is actually available out there on the internet on LinkedIn. I certainly want anybody to have an opportunity to see it. It's my road map on the cancer journey. It's tips of helping patients find an opportunity on their cancer journey—to live it with a joyful life (whatever's in store), to try not to focus on tomorrow or next month or next year, will the cancer come back, or how will I do with this treatment—but to live in the moment and find yourself recognizing the blessings that you're surrounded by, and not focusing on the things that you're currently struggling with.

I mean, to this day, I still have little saliva from the radiation to my mouth. Can't taste anything sweet, and I had a huge sweet tooth. So that's a little bit of a challenge, and then as an Italian who loves pizza and pasta, yeah, there's there's a lot of limitations in my taste

Tony K: –– and cannoli ––

Dr. Corso: Oh, yes! I can bite into a cannoli, but I don't think I can appreciate anything sweet about it. But again, you learn to treasure the things you do have, and you don't focus on the negatives. It's about having a positive attitude, which is how I’d drive it home. So this experience has been profoundly rewarding for me. And as I told a patient in the office the other day, if I had the chance to push the rewind button and do this over and not have to go through this experience, I would still go through it. I think the positive aspects of this have far outweighed the negatives, and I think it just allows me to have an opportunity to connect with patients in a way that perhaps I really couldn't before. 

Tony K: Well, thank you. Thank you for sharing that that you know on the one hand, you know, you don't want anybody to go through that. On the other hand, which you just explained, you got to the core of what health care really is and delivering compassionate care. You know, patients often…they know how you treated them. They don't necessarily understand how we treat them, but they know how you made them feel. And and the fact that you are able to do that. I know you were doing that before, because in the time that I've been here, your reputation has been stellar. But you know, you probably are on the next level of compassion, because you've been through it, and people really can can rely on you to guide them through. So I appreciate you sharing.

I was remiss in asking before I you know, I guess a stereotype would be that you must have smoked or you must have taken a lot of tobacco products. Did you? Were you a tobacco user at all? 

Dr. Corso: No. It's an interesting, an excellent question. You know, when I started my career in the 1990s in oncology and literally over the ensuing 15-plus, 20 years almost, oral cancers were almost always predominantly tobacco users. But there's been an interesting shift in the epidemiology as we call it of, of oral cancers. Now HPV-positive oral cancers surpass tobacco cancers. It's the single most common cause of oral cancers, which means those people in our generation who didn't have access to the vaccine for HPV are all at risk. And we're seeing an increasing number in this population, which is why I certainly encourage any parents with young children to make sure that they get vaccinated, because it'll certainly help minimize this potential complication that could occur down the road.

Tony K: Yeah, I did not know that. So not only did you educate me, but hopefully for all of you listening, just understand if you've got warning signs out there, you know, don't let a stereotype or a bias keep you from getting it checked out. 

Dr. Corso: Excellent. If your thought is, “Well, I know that oral cancers only occur in tobacco users, and I don’t smoke.” Yeah, you're greatly mistaken, as I was. And again, just part of understanding that things change and information changes. 

Tony K: Well Dr. Corso, I want to thank you for your time. You're a busy man and you take care a lot of people, and so it means a lot that you'd give your time. But mostly, I want to thank you for the work that you do here. You make an impact on people, and your coworkers are a part of that. And so my hope for you is that you get to live your fulfilling life as you indicated, without worrying about what has happened in the past, and that you keep delivering great care to patients. We're blessed to have you in our healthcare organization and here on Pelham Medical Center's campus.

Dr. Corso: Well, thank you. Again, I find every day I come to work, it's a privilege and a blessing to be able to help patients who find themselves in a scary place. As I said, I know where they're at, and again, my message is just live every day. Each day is a blessing and to close, I guess I live my life as the psalmist said, “Today is the day the Lord has made; let us rejoice and be glad in it.” Life is a joy if you find the right way to live it.